When is a psychopath not a psychopath?
Instead of the old ten personality types, DSM-V has simplified the system by cutting them down to just five: Antisocial/Psychopathic, Avoidant, Borderline, Obsessive-Compulsive, and Schizotypal types. Each type comes with a narrative paragraph description.
1. Significant impairments in self-identity or self-direction and interpersonal (empathy or intimacy) functioning.
2. One or more pathological personality trait domains or trait facets.
3. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.
One of the question which has haunted me since I first worked at the Yardville Youth Correction Center in New Jersey and later as a consultant on prison reform for the state of New Jersey has been to what extent, if any, are those we label as antisocial or psychopathic able to learn or develop empathy. Anyone who has worked with one individual or a group of individuals who carry this label knows that they seem as if they are not able to change. Yet, my experience is that they are more complicated than this. As with both fictional and real life mob figures, there seems to be an ability to compartmentalize parts of themselves. Thus, they may with their immediate family and their mob family be kind, empathic, generous and capable of a variety of emotions. Yet, these very same people seem to have no sense of connection with those they decide threaten some aspect of their operation or the “family” structure. Certainly, the creators of the Tony Soprano character fit this profile. Then there are those who seems unable to have an empathetic relationship with any humans. Yet, some of those will have a very empathetic relationship with an animal such as a dog.
Yesterday I listened to two Ted Talks while at the gym. The first was by Daniel Reisel entitled “The neuroscience of restorative justice.”
“Daniel Reisel grew up in Norway but settled in the UK in 1995. He works as a hospital doctor and a research fellow in epigenetics at University College London… Daniel is current training to be become an accredited restorative justice facilitator with the UK Restorative Justice Council.” For those not familiar with the concept of restorative justice it is an approach to justice that personalizes the crime by having the victims and the offenders mediate a restitution agreement to the satisfaction of each, as well as involving the community. This contrasts to more punitive approaches where the main aim is retributive justice or to satisfy legal principles/laws. I have long believed that restorative justice can be for many a much more effective approach for both the victims of crime and the individuals who commit the crimes. Regardless of how people feel about such alternatives the fact is that punishment is a very costly and largely an ineffective means of bringing about change. The question, of course, is whether an adult brain is capable of changing especially for those who appear to be unable to consider the rights or needs of others – who lack the ability to empathize. Daniel Reisel and his colleagues are discovering in their study of inmates who have been convicted of serious crimes the following:
“These individuals were not just the victims of a troubled childhood. There was something else. People like Joe have a deficit in a brain area called the amygdala. The amygdala is an almond-shaped organ deep within each of the hemispheres of the brain. It is thought to be key to the experience of empathy. Normally, the more empathic a person is, the larger and more active their amygdala is. Our population of inmates had a deficient amygdala, which likely led to their lack of empathy and to their immoral behavior.” Furthermore, he reports:
“So can brains change? For over 100 years, neuroanatomists and later neuroscientists held the view that after initial development in childhood, no new brain cells could grow in the adult human brain. The brain could only change within certain set limits. That was the dogma. But then, in the 1990s, studies starting showing, following the lead of Elizabeth Gould at Princeton and others, evidence of neurogenesis, the birth of new brain cells in the adult mammalian brain, first in the olfactory bulb, which is responsible for our sense of smell, then in the hippocampus involving short-term memory, and finally in the amygdala itself.”
Readers may recall that research has been showing that those on the Autism scale lack the development in the part of the brain which allows for empathy. Many are now working very successfully with Autistic children.
Researchers are also discovering that stress will grossly inhibit the growth of new brain cells including in the amygdala. If anyone has worked in or been resident in a prison/jail one knows that the stress level is very high. Treating people as less than in an atmosphere where one is forced to function on the lowest level of the Maslow hierarchy is very stressful. Thus, the possibility of positive changes in the brain while in prison is practically non-existent.
Another Ted Talk to which I listened was by: Franciscus Bernardus Maria "Frans" de Waal, PhD (born 29 October 1948), a Dutch primatologist and ethologist. “He is the Charles Howard Candler professor of Primate Behavior in the Emory University psychology department in Atlanta, Georgia, and director of the Living Links Center at the Yerkes National Primate Research Center[1] and author of numerous books including Chimpanzee Politics and Our Inner Ape.”
His talk is entitled, “Moral behavior in animals.” Dr. de Waal and his colleagues have studied chimpanzees, bonobos and elephants. He summarizes his findings:
“I believe there's an evolved morality. I think morality is much more than what I've been talking about, but it would be impossible without these ingredients that we find in other primates, which are empathy and consolation, pro-social tendencies and reciprocity and a sense of fairness. And so, we work on these particular issues to see if we can create a morality from the bottom up, so to speak, without necessarily god and religion involved, and to see how we can get to an evolved morality.”
One of the observations he and his colleagues make is that the animals they study will work to help others even if they are not hungry and if they do have a fight; they will reconcile after a fight. Chimpanzees may kiss and embrace following a fight. “Bonobos do everything with sex. And so, they also reconcile with sex.” (Some human males may be tempted to use this as “proof” that their desire to engage in sex right after a fight with their partner is logical and, in fact, a ‘natural’ desire, while their female partners may use this as further proof that their male partners have not evolved beyond the primitive state of bonobos. We will save that for another discussion.)
Once again, the research findings for both of these areas of science are strongly suggesting that although punishment may be temporarily satisfying to some victims and to the community as a whole, in the long run it is not likely to lead to positive results. If the goal is to create a safer, more empathic and cooperative society then one would want to do everything possible to develop new brain cells in the amygdala of those convicted of crimes.
Can everyone who is convicted of crimes and who may be labeled as sociopaths or psychopaths develop brains which are guaranteed to be cooperative and empathic? I do not think we are close to being able to set and achieve that goal. On the other hand, we keep amassing evidence that what we are doing is not working, is very expensive and, in fact, counterproductive.
In all areas of medicine, we keep discovering that:
· Our human bodies are capable of much more healing and growth than we previously thought possible.
· Development of our brains and other parts of our human body does not occur at the same pace and the same level for everyone.
· If we, as a species, want to continue on the path of reducing violence of humans toward each other than we need to quit allowing our emotions to dictate our approach to such issues as healing and justice.
Written March 24, 2017
Instead of the old ten personality types, DSM-V has simplified the system by cutting them down to just five: Antisocial/Psychopathic, Avoidant, Borderline, Obsessive-Compulsive, and Schizotypal types. Each type comes with a narrative paragraph description.
1. Significant impairments in self-identity or self-direction and interpersonal (empathy or intimacy) functioning.
2. One or more pathological personality trait domains or trait facets.
3. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.
One of the question which has haunted me since I first worked at the Yardville Youth Correction Center in New Jersey and later as a consultant on prison reform for the state of New Jersey has been to what extent, if any, are those we label as antisocial or psychopathic able to learn or develop empathy. Anyone who has worked with one individual or a group of individuals who carry this label knows that they seem as if they are not able to change. Yet, my experience is that they are more complicated than this. As with both fictional and real life mob figures, there seems to be an ability to compartmentalize parts of themselves. Thus, they may with their immediate family and their mob family be kind, empathic, generous and capable of a variety of emotions. Yet, these very same people seem to have no sense of connection with those they decide threaten some aspect of their operation or the “family” structure. Certainly, the creators of the Tony Soprano character fit this profile. Then there are those who seems unable to have an empathetic relationship with any humans. Yet, some of those will have a very empathetic relationship with an animal such as a dog.
Yesterday I listened to two Ted Talks while at the gym. The first was by Daniel Reisel entitled “The neuroscience of restorative justice.”
“Daniel Reisel grew up in Norway but settled in the UK in 1995. He works as a hospital doctor and a research fellow in epigenetics at University College London… Daniel is current training to be become an accredited restorative justice facilitator with the UK Restorative Justice Council.” For those not familiar with the concept of restorative justice it is an approach to justice that personalizes the crime by having the victims and the offenders mediate a restitution agreement to the satisfaction of each, as well as involving the community. This contrasts to more punitive approaches where the main aim is retributive justice or to satisfy legal principles/laws. I have long believed that restorative justice can be for many a much more effective approach for both the victims of crime and the individuals who commit the crimes. Regardless of how people feel about such alternatives the fact is that punishment is a very costly and largely an ineffective means of bringing about change. The question, of course, is whether an adult brain is capable of changing especially for those who appear to be unable to consider the rights or needs of others – who lack the ability to empathize. Daniel Reisel and his colleagues are discovering in their study of inmates who have been convicted of serious crimes the following:
“These individuals were not just the victims of a troubled childhood. There was something else. People like Joe have a deficit in a brain area called the amygdala. The amygdala is an almond-shaped organ deep within each of the hemispheres of the brain. It is thought to be key to the experience of empathy. Normally, the more empathic a person is, the larger and more active their amygdala is. Our population of inmates had a deficient amygdala, which likely led to their lack of empathy and to their immoral behavior.” Furthermore, he reports:
“So can brains change? For over 100 years, neuroanatomists and later neuroscientists held the view that after initial development in childhood, no new brain cells could grow in the adult human brain. The brain could only change within certain set limits. That was the dogma. But then, in the 1990s, studies starting showing, following the lead of Elizabeth Gould at Princeton and others, evidence of neurogenesis, the birth of new brain cells in the adult mammalian brain, first in the olfactory bulb, which is responsible for our sense of smell, then in the hippocampus involving short-term memory, and finally in the amygdala itself.”
Readers may recall that research has been showing that those on the Autism scale lack the development in the part of the brain which allows for empathy. Many are now working very successfully with Autistic children.
Researchers are also discovering that stress will grossly inhibit the growth of new brain cells including in the amygdala. If anyone has worked in or been resident in a prison/jail one knows that the stress level is very high. Treating people as less than in an atmosphere where one is forced to function on the lowest level of the Maslow hierarchy is very stressful. Thus, the possibility of positive changes in the brain while in prison is practically non-existent.
Another Ted Talk to which I listened was by: Franciscus Bernardus Maria "Frans" de Waal, PhD (born 29 October 1948), a Dutch primatologist and ethologist. “He is the Charles Howard Candler professor of Primate Behavior in the Emory University psychology department in Atlanta, Georgia, and director of the Living Links Center at the Yerkes National Primate Research Center[1] and author of numerous books including Chimpanzee Politics and Our Inner Ape.”
His talk is entitled, “Moral behavior in animals.” Dr. de Waal and his colleagues have studied chimpanzees, bonobos and elephants. He summarizes his findings:
“I believe there's an evolved morality. I think morality is much more than what I've been talking about, but it would be impossible without these ingredients that we find in other primates, which are empathy and consolation, pro-social tendencies and reciprocity and a sense of fairness. And so, we work on these particular issues to see if we can create a morality from the bottom up, so to speak, without necessarily god and religion involved, and to see how we can get to an evolved morality.”
One of the observations he and his colleagues make is that the animals they study will work to help others even if they are not hungry and if they do have a fight; they will reconcile after a fight. Chimpanzees may kiss and embrace following a fight. “Bonobos do everything with sex. And so, they also reconcile with sex.” (Some human males may be tempted to use this as “proof” that their desire to engage in sex right after a fight with their partner is logical and, in fact, a ‘natural’ desire, while their female partners may use this as further proof that their male partners have not evolved beyond the primitive state of bonobos. We will save that for another discussion.)
Once again, the research findings for both of these areas of science are strongly suggesting that although punishment may be temporarily satisfying to some victims and to the community as a whole, in the long run it is not likely to lead to positive results. If the goal is to create a safer, more empathic and cooperative society then one would want to do everything possible to develop new brain cells in the amygdala of those convicted of crimes.
Can everyone who is convicted of crimes and who may be labeled as sociopaths or psychopaths develop brains which are guaranteed to be cooperative and empathic? I do not think we are close to being able to set and achieve that goal. On the other hand, we keep amassing evidence that what we are doing is not working, is very expensive and, in fact, counterproductive.
In all areas of medicine, we keep discovering that:
· Our human bodies are capable of much more healing and growth than we previously thought possible.
· Development of our brains and other parts of our human body does not occur at the same pace and the same level for everyone.
· If we, as a species, want to continue on the path of reducing violence of humans toward each other than we need to quit allowing our emotions to dictate our approach to such issues as healing and justice.
Written March 24, 2017
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