The psychopath inside, p.12
The Psychopath Inside, page 12
These swings in body and mind, in intellectual and emotional expressiveness, seemed exactly opposite to the way the body and mind are supposed to respond to being in and out of shape. This became a running joke among my friends and me (but not so much to Diane, who was constantly on my case about my health), throughout the 1990s and to this day. I have never figured out why these seventy- to one-hundred-pound swings in weight and behavior occurred, but naturally I suspected abnormally large cycles of activity of serotonin, dopamine, and perhaps the endorphins and testosterone in my limbic system, especially in my temporal lobe and associated limbic/emotional brain where these neurotransmitters, modulators, and hormones were having their greatest convergent impacts. One can guess that alterations in my serotonin-regulated daily rhythms, including those for sleep, were fueling these wild fluctuations, but this is only speculation. Usually my weight swings happen into their own, but sometimes I’ll notice that my ass is knocking into the furniture and decide I need to lose some weight, and I do. I’ve got quite a strong will when I put it to use.
I had only started to wonder in 2011 about how my changes in connectedness fit into these months- or years-long swings in behavior and body type, when I learned, or rather realized, that there might be something seriously wrong with my ability to have normal interpersonal relationships.
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Empathy can be thought of in several ways. The first way is to contrast empathy with sympathy. Empathy is usually thought of as being able to put yourself in another’s shoes, that is, to imagine that what he is experiencing emotionally is something you have also experienced. Sympathy, on the other hand, does not require that one feels or has actually experienced what one might imagine another is experiencing. Sympathy is more of a recognition that something is eating away at someone, and a desire to do something to lessen her pain. Empathy usually refers to one’s emotional reactivity to another individual person. An example of sympathy is when someone hears of the plight of earthquake or flood victims and, although not actually having experienced anything like that, still donates time or financial relief to those victims. This is not to say that the compassionate person responding to this need doesn’t also empathize with those victims, only that it is not necessary to do so. Likewise, there are empathetic individuals who sense that they feel the pain of others but do nothing about it to help the other person. The groundbreaking physiological studies of Marco Iacoboni of UCLA offered a mechanism for how brain processes connect people, at least on an intellectual or cognitive-perceptual level.
The mirror neuron system is a hypothesized cortical brain circuit based on Iacoboni’s finding that in primates there are neurons that respond when a person watches the actions of others and when the person performs the actions himself. The superior ability of primates, especially humans, to watch another do something once, and then be able to do the same thing themselves immediately, is thought to be based on the circuit formed between these neurons in the areas of the frontal lobe and parietal cortex.
This system may help to explain why human children can watch their mother do something, let’s say fold a towel, and the child can immediately attempt to fold a towel. The sensory motor system that is used to watch the mother do this is the same group of cells that the brain uses to do the task. More difficult motor tasks may also be mimicked effectively by adults using this mirror neuron system.
The first time I lived in Africa was in 1990 to 1991, when I was in Kenya doing research on growth factors in the primate brain under the auspices of a Senior Research Fulbright Fellowship. My brother Tom, arguably the best athlete among my siblings, journeyed from New York to visit me in Kenya. On one of our safaris, he came with me to visit a village in a remote area near the Ugandan border. The shamba man (gardener) Bernard, who took care of my Nairobi yard and gardens, had his family out there, and I had provided him and another family with modern roofing (sheet tin) materials, as the rest of the people in his village lived in small round mud homes covered with thatch. Tom and I had also planned to play golf en route, so I had my clubs along for the ride. Many of the people in his village had never seen an actual white person, let alone golf clubs. Tom and I noticed that Bernard’s village had a large three-hundred-yard-long field in the back of the homes, so I had Bernard interpret a question to his neighbors: “Would any of you like to learn how to play golf?” Among the hundred or so of his clan amassed there, a few brave souls stepped forward, including the family elder, a gentleman of about eighty years who was dressed in a full suit and a hat with a red Christian cross emblazoned on it.
They first watched as I flubbed a shot about thirty yards, drawing a chuckle from Bernard and a belly laugh from Tom. Then Tom stepped forward and blasted a three wood to the very end of the field, and there were gasps of awe from the gathered clan. Then the elder stepped forward, grabbed one of the clubs (an implement he had never seen, let alone used before), and took a quick and furious swing at the teed-up golf ball. He whiffed it, but no one made a peep. Then within three seconds, as if clearing a field with a scythe, he swung at the ball again, catching it on the sweet spot, and the ball took off about a hundred and fifty yards, with a hint of a slice. Applause erupted from all of us. Then, one by one, every man, woman, and child stepped forward and each one missed with the first swing, and then nailed the ball with the second. Some of the adult men drove the ball more than two hundred yards.
This was an example of the mirror neuron system cranking away with all cylinders firing. The next year when I visited that village, it was like they had created their own two-hole golf association, an effect I never intended to curse them with in the first place.
This mirror neuron system may help explain why humans can quickly pick up a complex task without any practice. Does a similar circuit, one that interacts with the mirror neuron system, process empathy? Although no one knows the details of such a circuit, there are some imaging studies that point to a consistent set of brain areas that are activated in the laboratory setting that illuminates factors thought to be in play in empathy, and the lack of it. Jean Decety of the University of Chicago, Yan Fan at the University of Ottawa, and Knut Schnell at the University of Heidelberg, among others, have all carried out functional brain imaging studies with fMRI to study the elements of empathy. When we see a happy, sad, or angry expression on someone’s face, regions responsible for those emotions light up in our brains, too. Taking the basic mirror neuron system, a cognitive circuit, and adding in areas that are connected to the mirror system but that process emotion, we can envisage a broader circuit underlying empathy. These additional areas include the insula, an area of cortex “insulated” from view by the outer folds of the frontal, temporal, and parietal cortices that all connect to it, plus the emotion-mediating anterior-medial temporal lobe and amygdala, not seen in a surface view of the side of the brain.
Those regions connect with the orbital and inferior frontal cortices. These three areas are represented in figure 7A that follows. These then connect with and control the hedonism, pleasure, stress, and pain areas deep in the brain, which are bathed in serotonin, dopamine, testosterone, corticotropin-releasing hormone (CRH), and endorphin receptors, as well as vasopressin and oxytocin systems.
FIGURE 7A: Mirror neuron system.
These hormone and neurotransmitter systems, as it turns out, play a significant role in empathy. Simon Baron-Cohen of the Universities of Reading and Cambridge, Paul Zak of Claremont Graduate University, and Sarina Rodrigues at the University of California, Berkeley, among others, have demonstrated the importance of the genetic alleles that process these empathy-related neurochemicals, which affect a range of empathy-related sensations, from fear, rejection, pain of separation, envy, jealousy, selfishness, and schadenfreude, to the positive end of this spectrum where we find sympathy, pity, compassion, familial and tribal connectivity, generosity, trust, altruism (if there is such a thing), romantic love, and, perhaps, love of country, humanity, and God.
For a comparison of brain activity in the areas that process emotional empathy, refer to figure 7B below. In these three cross sections of the PET scans through my brain, the region of my insula with an abnormal mix of very low and very high activity is identified by the tips of the white arrows. You can’t tell in this black-and-white reproduction, but that area is shaded to indicate decreased activity. Another area involved in empathy, the anterior cingulate, also has lower activity in my brain. Meanwhile, the areas of cortex on top of the brain are significantly higher in activity in me compared to other people. This may be associated with cold cognition.
FIGURE 7B: My PET scan.
Given the myriad brain areas and genes involved in what we simply call empathy, perhaps it is not too surprising that the term and its meaning have proliferated into so many different descriptors and their related concepts. We usually associate lack of empathy with psychopathy, and rightly so, because although most psychopaths are not violent, they often treat individuals in a callous, almost numb way—they just don’t care. But many express caring for something, and often someone. Even psychopathic murderers will express their love for their parents and siblings, even if those same people were the ones who initially triggered the psychopathic tendencies through abuse and abandonment early on in the psychopath’s life. Think of the Buffalo Bill character from The Silence of the Lambs, who butchered innocent women without a second thought but became noticeably anxious when his poodle was in danger. But those same psychopaths may hate the rest of society and be out to exact revenge, both violently and nonviolently.
A psychopath whose father lost all the family’s money in the stock market or a business deal may exact revenge on the world by directing his antipathy at financial institutions. Terrorists or dictators with psychopathy might seek revenge for perceived slights against their clan, tribe, nation, ethnicity, or religion. But this leaves us with the disquieting notion that the coldest, most violent of our terrorists, lone killers, and dictators have a great sense of “empathy”—an empathy toward their own group, but little toward the life and well-being of others.
Beyond this mix of types of empathy according to individual versus group (in a sense also related to the dichotomy of empathy versus sympathy discussed at the beginning of this chapter) is another important dichotomy, and that is between emotional empathy and cognitive empathy, also known as “theory of mind.” Theory of mind, as I’ve previously discussed, arises early in childhood, developing progressively until adulthood, and is a key developmental accomplishment in which the child learns she possesses mental states like desires and intentions and beliefs, and that others possess similar states, though those may be different from her own. Someone with autism will not show a normal theory of mind. This lack may also be present in people with some personality disorders such as borderline personality disorder, and also some forms of bipolar disorder. In contrast, people with psychopathy, narcissism, and certain affective types of schizophrenia will have cognitive empathy but lack emotional empathy. These two types of loss of empathy may be associated with underfunctioning of different parts of the lower, or ventral, half of the prefrontal cortex.
Rebecca Saxe of the Massachusetts Institute of Technology has recently shown that theory of mind is centered, in part, in the nondominant hemisphere where the temporal lobe abuts the parietal lobe, the so-called temporo-parietal junction, that is, one node in the mirror neuron system. It is a key spot in a circuit that processes how one perceives the intentions, morals, and ethics of others, a partner to the orbital cortex of the frontal lobe that processes one’s own intentions, ethics, and morality. And these two areas of the posterior and anterior cortices connect with each other, perhaps forming the neuroanatomical circuitry for the Golden Rule.
A key question becomes: How does one know if one lacks empathy? If you lack it, there’s a good chance you have no idea you lack it, because you don’t know what “it” is. This isn’t exactly like asking a person blinded since birth what blue looks like, since that person has no reference point at all. But it may be similar to asking a person with color blindness for blue what blue looks like. He can see things that are blue, and blue objects may appear similar to green objects, but blue per se is a mystery. Based on my viewing of interviews with serial killers, it appears that many of them don’t seem aware of lack of connectedness. So minus a professional assessment, how can you become aware of your emotional color blindness?
For the first sixty-plus years of my life, I never thought I lacked empathy at all. I was happily married, had a wonderful nuclear and extended family, and a large circle of friends and friendly acquaintances and colleagues—thousands of them—so why would I ever question my sense of empathy? After all, who would want to closely associate and live with someone lacking emotional connectedness?
Before I discovered my brain scan, and even for a few years after, I didn’t give a second thought to negative comments about my personality. In 1990, a colleague and I were supposed to give a presentation at a professional meeting, but I blew it off and went to a bar because I knew some cute girls would be there. Miffed, my colleague said, “You’re an absolute sociopath to do that.” Another time, in Miami, I skipped a presentation to meet up with some gals I’d met and hear a great Cuban band. “You’re a psychopath,” my collaborator said. “How could you do that?” I told him my car broke down. I knew it wasn’t right, but nobody got hurt so I didn’t see the big deal.
People often refer to others as “crazy” or “a psychopath” without meaning it literally. Looking back, though, I probably should have paused to consider the sources in my case: trained psychiatrists who specialized in mood and brain disorders and would probably not be so quick to abuse a professional term simply because they were mad.
After reflecting on my brain scan for a year or two, I slowly began to reconsider these statements, and for the first time I thought about what central message my friends and family and colleagues were trying to convey to me.
I realized that I often, in fact, do not directly connect emotionally to people, or understand the way my behavior affects them. I see these things in a cold and distant way, and only upon seeing the effect can I then cognitively appreciate what I am doing. I then realized that my playful teasing of people could actually hurt them, and I was not stopping to read the signs on their faces that they were, indeed, hurt. I was also regularly putting people close to me in harm’s way, just for my own edification and for the good times I might experience. It’s not like I know exactly what empathy is, but I can now look at behavior—the way people go out of the way for one another, the amount of crying they do—and I can see that I’m really different from most people.
There have been many incidents that provided harbingers of an adult life characterized by a flattening of emotionality and borderline psychopathy. In 1968, I was a witness in a vehicular murder case in Canada during a midwinter jaunt to Quebec City for its storied Winter Carnival. While I was driving from Burlington during a blizzard, my car was passed by two speeding cars, one of which disappeared down the road into the night, while the other went off the road into a ditch, crashing head-on into a tree at about seventy miles per hour. I jumped out of my car and ran down the hill and was just able to crawl through a smashed window to position myself over the face of the driver, who was an elderly gentleman in the throes of death. His chest was crushed and while he was vomiting and regurgitating blood into my face, I kept him revived by mouth-to-mouth for about twenty minutes, until the police arrived. They pulled me out of the man’s car by my legs, and I was furious, since I was so intent on reviving him. After testifying at the police station, I ended the interview melodramatically by throwing the old man’s bloodied dentures onto the police sergeant’s desk. Within a minute I no longer cared at all about the incident, and went on to party heartily in Quebec City, only casually mentioning to my former classmates what had happened. But something did bother me for a long time about that event. I hadn’t really cared so much about the dead man after the event, but rather enjoyed the thrill of the whole escapade.
On other occasions I noticed that when people were crying over a tragic or sad event, I had dry eyes and a steady heart rate. I remember when JFK was shot because the people around me were upset; I was more interested in how it went down. One day when I was working at the University of Nairobi, I walked into the morgue and a whole family was standing around a little girl laid out on an iron slab in a white dress. I looked at her and said, “What a nice dress.” My attention to the dress rather than the dead girl didn’t strike me as odd at the time, but it does now. Even personal injury doesn’t bother me. In college I put my arm through a plate-glass window and cut it open from wrist to elbow. I calmly looked at the tendons with an anatomist’s eye. These incidents should have told me something wasn’t exactly right about all of my emotional responses, or lack of them. But how could I have known that my brain wasn’t normal?
As I’ve continued to examine my own behavior and personality, I realize that my relative lack of empathy complements my overall competitiveness—since I have little emotional regard for the feelings of others, I have few qualms about doing whatever it takes to win a competition or persuade someone to do what I want. Even when they were young, I never let my children win at anything, and now that they are grown, they have started mercilessly beating me at games, especially Scrabble. As you might surmise, I am a sore loser. Playing Scrabble, I might mislead people and lie about what I’m planning, to set them up. I don’t think I cheat—it’s no fun to cheat. It’s much more fun to manipulate (a prime trait of psychopaths). I’ll win fair and square but still stick it to them. I taught my kids that games are best played in a ruthless way—it’s all about the aesthetics of winning. And I argued that ruthlessness respects your opponent, but that’s bullshit. I also just have to win. It’s narcissism, ego, pure competitiveness. To some degree that competitiveness runs in our family, thanks to the warrior gene(s).
