Mad or bad?

A week ago I had a brief contretemps with a van driver, in which I found myself drawing attention to his reckless behaviour. He replied that he was not concerned about other people. I checked my rejoinder that he must be a psychopath because I thought of my friend, Jack. That’s not his name but I am sure you’d like him. He has bags of charm and seems to get on well with everyone. Of course, he has faults: he is a bit of an egocentric, and he is very persuasive. He’s quite determined and, although some call him unscrupulous, he claims that if you want to succeed you’d better go for it without delay. Certainly he’s brave. If he’s set his mind on something he isn’t frightened of the consequences.

You probably know a Jack, too. But he worries you because, behind the charm, he really seems to have no awareness or care about other people’s feelings. And his otherwise admirable determination to achieve seems blind to the damage he does to others on the way. It occurs to you that Jack might be a psychopath. But you dismiss the thought – Hannibal Lecter, yes; Charles Manson, yes. But Jack, a hail-fellow-well-met in a coffee bar in the high street? Never!

Well, hardly ever. Some experts in such matters tell us that there is no such thing as a psychopath. Psychopathy is not a condition of genetic damage which one either has or hasn’t got. Instead, we should think of a range of traits which can be found in any population, but which are sufficiently marked in certain individuals that we can recognise the type. They will not necessarily be violent, nor need they be psychotic. Manson, for instance, was a psychotic rather than a psychopath, claiming at one time to be Christ, and at another time to be the Devil.

One characteristic of psychopathology is a lack of fear. In some contexts – on the battlefield, for instance – that would be a quality. Another is a feckless disregard for consequences, accompanied by difficulties in social relationships. Long-term impulsiveness is likely and negative effects such as anxiety, anger and alienation will be present. The characteristics, of course, exist on a continuum, and everyone will have friends, perhaps relatives, who exhibit some of these to some degree – just like Jack.

One long-held belief is that a psychopath can never be cured. While this is certainly no easy task, more modern methods of therapy, such as cognitive behavioural therapy, show encouraging results as measured by rates of re-offending, but there seems to be little evidence as yet that the traits themselves can be modified. Generally the view of the experts is that these characteristics, like so many others, are a result of the complex interplay between genes and personal experience.

So we should not be surprised if we find some of the symptoms associated with psychopathy in other members of the population. And that indeed was the finding of Board and Fritzon in 2005. They found that the characteristics of “disturbed criminals” were actually commonly present in business leaders. What kept these out of jail was that the anti-social aspects, such as criminality, impulsiveness and physical aggression were at a lower level. Similarly, a study of American presidents showed that fearless dominance (or boldness, to their friends) was present typically in the successful presidents compared with the less successful. No wonder that the dominance of Romney over a tentative Obama in their first television debate was a matter of considerable comment at the time.

Readers of this column will expect to find some evidence of abnormality in the brains of those with psychopathic tendencies. And some relevant evidence has been reported. Apparently some damage to the pre-frontal cortex may be preventing transmission of information to the amygdala. Since the amygdala plays a major part in the emotions, this may well cause the reduction in empathic feeling and a reduction in the capacity for fear, characteristic of psychopathy.

In the prison population in this country, about a third of male criminals suffer from anti-social personality disorders. And the evidence suggests that only a third of these have significant psychopathic tendencies. This is, of course, relevant in deciding the guilt of the psychopath. If you imagine yourself as highly impulsive, free of fear and dead to the feelings of others, how would you react to a marvellous, if illegal, opportunity to benefit yourself, or to deal with someone whom you know wished you harm?

Other work suggests that the psychopathic brain has an oversensitive reward system, suggesting, it is argued, that the psychopath may fixate on reward behaviour, and so be blinded to any other considerations. This would influence impulsiveness, and indifference to consequences.

In this context it may be interesting to see how the law behaves. An American study showed that judges were inclined to give substantially longer prison sentences for aggravated violence to those identified as psychopaths. This was related to their belief that the criminal behaviour was likely to re-occur. But the judges who had received an explanation about psychopathy from a neuroscientist, including the difficulty that sufferers may have in telling right from wrong, reduced this higher sentence by a year on average.

So once again we are forced, as so often in this column, to look at a little grubby corner of human nature where we find our fellows to whom, apparently, loving your neighbour as yourself has no meaning. To accuse my van driver of being a psychopath would have been rash judgment. But I prayed for him, just in case.

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About Quentin

Science Editor, Catholic Herald. Portrait © Jacqueline Alma
This entry was posted in Bio-ethics, Catholic Herald columns, Moral judgment. Bookmark the permalink.

35 Responses to Mad or bad?

  1. Peter D. Wilson says:

    I don’t know about other people, but find it salutary to remember discerning heavily-suppressed traces of it in myself.

  2. Iona says:

    “Ruthless” is a word that springs to mind.

  3. Vincent says:

    This does raise for me the whole problem of guilt. As I read Quentin on related subjects I begin to think that I have no hope of even judging myself let alone judging anyone else. Have I in fact ever made a moral choice from pure motives or am I always likely to be subject to pressures (temptations, personal characteristics etc)?
    On this blog we have some people who tend to express themselves vigorously (both ‘orthodox’ and ‘unorthdox’). Are there motives clear and free, or are they creatures of their genes and upbringing?

  4. St.Joseph says:

    No one in perfect-we all have some quirk or call it what ones like.
    Even Jesus in His humanity lost His temper in the Temple. We don’t know how many more things He did as a human being-obviously His Divinity it would be easier for Him to learn quickly, Even when He gave grief to His Mother and St Joseph in thoughtlessness .
    I think as we get older we become more placid-hopefully.
    Love one another as we love ourselves, is that the same as Do unto others we would like done to us?

  5. Ion Zone says:

    One of the big problems with this kind of thing is that there are many other types of condition that leave people with little or no empathy, they just aren’t famous.

    Autism, for example, can leave a person ‘internally focused’? Should we worry? The truth is that it depends, just as it does with psychopaths. There was a very interesting documentary on this a while ago.

  6. Geordie says:

    We were taught to avoid bad company; thus we have to make judgements. If we know a person is a psychopath, are we supposed to avoid him or her? Or are we meant to show him love and friendship? I have my own opinions on this but I should like to know what others think.

    • Mike Horsnall says:

      I used to frequent a church which was next door to both a prison and a pyschiatric hospital….as you can imagine we had our moments. It depends of course on the case. We have a duty to protect our selves and our family lives but that doesn’t mean we cant be civil, listen and meet a need here and there. The chinese have a saying which broadly speaking means don’t start helping a person unless you can take responsibility for them, a bit harsh but somewhere near the truth I think.

    • tim says:

      I don’t think there’s a general rule. It depends – both on you and me and on them. On them – just how dotty are they? Surely there must be a range, and if they are only slightly affected, then the stronger the case for trying to treat them like everyone else (not ‘discriminating’). It also depends on me. How good am I at relating to others? If I’m socially incompetent and marginally autistic, maybe I am as likely to do harm as good. Do I want to help, or to be seen as helpful? Or am I just too lazy and cowardly to get involved?

  7. Horace says:

    The definition of ‘psychopath’ is very much disputed and when looking at various aspects I found the interesting suggestion that a psychopath was a person without a conscience (interesting in view of last weeks blog post which generated much discussion of the nature of conscience).

    My own suggestion would be that a psychopath does not altogether realise the consequences of behaviour; whereas a psychotic does not properly realise the nature of behaviour.

    Quentin notes that damage to the prefrontal cortex may be implicated. I remember on one ward round that, when we came to the bed of a patient who had recently had an operation to remove a cerebral tumour which had involved some damage to the prefrontal cortex, we were treated to the surprising sight of our neurosurgeon being pursued down the ward by the patient enthusiastically wielding a knife!
    [All was well in the end:- the neurosurgeon escaped through a door at the end of the ward and the nursing staff had no difficulty persuading the patient to return to his bed,]

    One day as a junior doctor with an interest in electronics I was asked to try and repair an ECT (electroconvulsive therapy) apparatus which had been damaged by being plugged into the wrong power socket. While disassembling the apparatus I was frequently interrupted by patients enquiring “How are you getting on? I need to have my treatment this afternoon!”. Then I happened to touch the electrodes of a fully charged 250V 50μF condenser – and the next patient remarked “Oh, have you found the fault? I saw you dancing for joy!” – a superbly schizophrenic assessment.

  8. Mike Horsnall says:

    Three months ago I came off my bicycle on a patch of gravel. I was travelling at about 16 miles an hour at the time.It was the first time I had fallen off in such grand fashion over a 12 year history of cycling……unfortunately it was also the first time I had donned my linen cap and then forgotten to put on my crash helmet….. I woke up an hour later in the trauma unit of my local hospital to be roundly chastened for not wearing a helmet and then sent home after a CT scan failed to find a fracture.

    Two weeks later I was standing in a coffee queue at a Leonard Cohen concert and accidentally bumped into a chap, much bigger than myself he was. What would have normally have been inconsequential and led to a swift apology on my part turned instead to a rising confrontation- to the point at which I was preparing to deposit a cup of hot cofee into both of my opponennts eyes and then swiftly grab him bny the ears in preparation for a full blown assault…some part of me was whispering…”Mike you are a 60 year old man training as a Deacon…” but the rest of me simply wasn’t interested one iota in conciliation, hearkening instead back to to the atavistic aggression of youthful days spent on the football terraces…in other words I was gearing up to do for the blighter!

    Fortunately my best mate – coincidentally employed by the Crown Prosecution service- stepped authoritavely in to the fray and led me firmly away by the arm so in the end no one was hurt or arrested. A couple of weeks later, realising I wasn’t right I googled in “Symptoms following Traumatic Brain Injury”,… all then became clear…after 3 months of being very quiet all is settled now and I have returned to my normal personna of comfortable Mike…but it was a close call.

  9. tim says:

    You either have a broken leg or you don’t. But mental symptoms – I suppose – aren’t like that. I once had to act as ‘prosecuting counsel’ in the case of a colleague who had been thrown out of his professional institute for misconduct. Should he be let back in? His conduct towards people who’d tried to help him had been extremely aggressive – he misinterpreted all such efforts. I said – among other things – that he was ‘paranoid’. His counsel objected to this, as a medical diagnosis which I had no qualification to make – and when the case went to appeal, the judge was inclined to agree (though not to the extent of reversing the decision to exclude him). Surely what we have in most cases is not ‘Yes/No’ but a bell curve of tendencies – maybe you shouldn’t call someone paranoid unless they are at least two standard deviations from the mean. And correspondingly there are degrees of moral responsibility. I am much more likely to sin against charity when tired and hungry. No doubt when I sin under those conditions my responsibility is reduced – but not removed. There is – I suppose – a similar gradation in responsibility according to intensity of mental illness, and in extreme cases there is no blame attached. So we may judge acts as wrong or not, but not the people who commit them – that is for God.

  10. Iona says:

    And what measures would you carry out, to determine how far along the bell curve a person was and whether he was at the extreme 2% end of it and could be called “paranoid”?

    “A lot more likely to sin against charity when tired and hungry” – but once aware of this, you can avoid the occasion of sin (or try to) by avoiding making decisions affecting other people when you’re in that tired-and-hungry state. You can even avoid the occasion of sin by having something to eat and a nap. (I often wonder about the wisdom of fasting, which some saints seem to have taken to extremes; how did they manage to avoid being uncharitable?)

    • tim says:

      I’m sure there’s a standard test to determine how paranoid someone is, but I do admit that administering it (particularly to someone who has already displayed symptoms of paranoia) is likely to present special difficulties. Use your best judgement! It’s nice to measure things where you can (scientists think) but it’s not always possible. For example http://dlvr.it/2Z9wJC (courtesy Tim Harford Tweet).

  11. Geordie says:

    Thanks for your comments on bad company and the urge to help others. I particularly liked Tim’s comment: “How good am I at relating to others?” Never mind how dotty the other person is, how dotty am I? In my younger days I got well out of my depth by trying to help those in need. I hope I’m a bit more circumspect now. Without trying to be too sanctimonious, I think prayer is probably the best starting point.

  12. Vincent says:

    It is really helpful, I find, to read about the experiences of my friends on this Blog. I find it easier to forgive others and easier to forgive myself. Having said that i think there is another element which also requires emphasis.
    I want to distinguish between the man and the deed. If we assume that a particular psychopath, who has wrecked many life through his behaviour, is in this instance entirely free of guilt because of his mental condition, he has nevertheless done evil things. The law of God in man’s heart — in effect the Natural Law — is based on what brings about or reduces flourishing in human society. A wicked act there for has a destructive effects in the short or long term irrespective of the actor’s freedom to choose.

  13. Mike Horsnall says:

    Which is ,I guess the reason for the high proprtion of personality disorders behind bars-Society punishes those who transgress its laws which, it generally believes, are based on some higher principle….even in Communism the understanding of ‘the people’ as the highest authority can have quasi religious status. We once had a chap who had served his sentence for murder coming to our church and a woman who had spent time in prison for violent assault. People found it quite hard overall but we managed to rub along until the woman wanted to start working with the children which caused a mammoth hoo haa and plenty of soul searching all round.

  14. St.Joseph says:

    Women blame a lot on hormone imbalance.How true that is I don’t know but post-natal depression is I believe a fact. It does take self control which will come with maturity .
    I had a row with my husband before we were married -in fact many. I can’t’ remember., but I do remember throwing all the books he lent me out of a top window one day, one after the other I was about 18-also when we were engaged, at some cousins and my brother 21st joint birthday party in an aunties house, all the drank to much in the garden and the ladies had to put them to be and we slept in chairs. In the morning no one spoke to the men,I gave my future husband’s engagement ring back so unforgiven after seeing my father come home drunk many a time.We didn’t drink in those days .
    When I was married to him and my hormones were haywire after a few pregnancies and miscarriages I threw a plate of porridge at him one morning ,meant miss but he ducked and went all over his suit, as he was just going to work.We laughed about it in later years.
    And we ended up in the Licensed trade and he never drank while working or I never saw him leg less-. The lessons we learn in life are worthwhile experience’s-if we need them-some have to cool their passions.I would not call them illnesses. I can understand youth-having been one myself. WE have to stay young at heart or else be miserable in old age-even sometimes in ill health.

    • St.Joseph says:

      Missed out men above ,and be meant to be bed.
      Sorry. But one will have guessed it maybe.

      • Peter D. Wilson says:

        St.Joseph – Don’t worry too much about misprints; they can be very difficult to avoid, and I’ve always been able to make out your intended meaning – I think! We probably all have “finger trouble” on occasion. However, if the thought is at all complex and time permits (it can actually save time in the long run), I find it helpful to draft a comment in a word-processor with full editing facilities, review it carefully, then copy and paste it into the submission panel.

        Keep up the good work!

  15. Geordie says:

    Do we still believe in satanic possession or even satanic oppression? Or is this just a superstition from the past? Satan certainly has a free run in the world when no-one accepts his existence. Can some mental illnesses be put down to the influence of Satan in our lives?

  16. St.Joseph says:

    Peter Wilson.
    Thank you for your comment and kind words.
    My lap top sometimes has a mind of its own, being a bit antique .
    I have written by hand ,not having a Word Processor-it would be useful.
    I don’t mean to write so much but get carried away a bit-I have tried to alter something I wrote then lost it and have to do it again. I have lost Internet Explorer-it won’t send, so I go into Google and that sometimes gets lost somewhere or other. I have been shown a few times how to copy and paste, then when I go to put it into the blog I haven’t got a clue.
    I have only used the computer since coming on the blog and don’t know much else about it, but I am learning slowly. Many years ago my late husband bought me a book ‘Computer for Dummies’
    and I still did not understand, maybe if I look it up the little I have now may help me.
    I have been trying for ages to get Word Press to send me the posts on my e.mail.I think it was you who told me how to do it-but it didn’t.
    Thank you.

  17. Singalong says:

    I don`t think I have ever been directly involved with a psychopath, who will do real harm, but I do know people who can come across as very charming and agreeable, until experience shows that they are really very self centred, and will not put themselves out much for anyone else, which can make

    I have more experience in dealing with a son with Aspergers Syndrome and complications, who still lives with us, though he refuses to admit to the condition, and I often feel quite angry at the lack of support within the Church community for people in his position. He does not intend to cause problems, but he can be very difficult, and can seem to “bite the hand that feeds him” . I suppose this is rather unfair of me, a few individuals have been outstandingly persevering in their efforts to help. i read in one of Paul Vanier`s books, that there are some individuals that even the L`Arche communities are unable to help.

    On the other hand, Our Lord`s teaching is very clear, that we must go the extra mile and turn the other cheek.

  18. John Candido says:

    I believe that we have all met psychopaths in our lives. They can be quite scary. I find myself kowtowing to them in one circumstance or another. Blessed are the peacemakers I suppose. Thankfully, I don’t have to see any of them regularly.

    I am sure that any one of us could be psychopaths, given a suitably horrible upbringing, which is all too common if you were to ask me. Recently in Melbourne, we had two appalling murders allegedly committed by male psychopaths, in separate incidents. Both murders victims were women. How horrible, useless, and gut wrenching these things are.

    Most of the world has heard of the untimely and gruesome end of Melbourne woman Jill Meagher, aged 29, who was raped and murdered in September 2012 in Coburg, which is an inner northern suburb of Melbourne. There was quite an outpouring of emotion and disgust Australia wide, culminating in members of the public placing flowers in two places along Sydney Road, as well as conducting a large public demonstration against violence perpetrated on women, on the same arterial road passing through Brunswick and Coburg. Incidentally, I grew up in Brunswick not far from where this rape and murder was committed.

    As if we didn’t have enough of barbarism; not long after the murder of Jill Meagher, another woman named Sarah Cafferkey was murdered in the Victorian town of Bacchus Marsh, which is 50 km west of Melbourne and halfway between Melbourne and Ballarat. Three men are being questioned in relation to this incident by the police. She was 22 years of age.

    I recently celebrated the birthday of one of my friends at a restaurant, and the issue of these murders became a short and sobering point of discussion. I remember shaking my head and asking both of my friends twice in the same sentence; ‘why do they do it, why do they do it?’ I was really pleading with them to enlighten me because I am at a complete loss. All that we could come up with is that the suspects were either evil, and/or they must have had a very poor childhood, which could have involved child abuse. It is an interesting question. Are we primitives for believing that some people are quite evil, or is there a rational aetiology to most criminal behavior?

    http://www.heraldsun.com.au/news/hearts-break-across-the-globe-for-jill-meagher-the-girl-who-liked-to-sing/story-e6frf7jo-1226484250547

    http://www.abc.net.au/news/2012-11-23/police-release-latest-cafferkey-arrests/4387530/?site=melbourne

    • Don McGovern says:

      It is nan error to assume that psychopaths are the result of poor parenting. I personally know of a young woman who clearly demonstrated psychopathic tendencies even as a small toddler, she is now nearly forty and is still unemployable, unreliable, regularly abuses alcohol and is frequently involved in petty delinquency, while her six siblings have all grown up to be absolutely splendid human beings. There appears to be a fault in the basic “clay” of some people that predisposes them towards this sort of behaviour. nevertheless, I believe that still retain free will and are ultimately responsible for the choices they make.

  19. Geordie says:

    There was a documentary on TV during the last 12 months on psychopaths but I can’t remember its title. The American professor who had done much of the research was absolutely shock to find that he had all the attributes of a psychopath. He hadn’t degenerated into killer or evil-doer, which he put it down the fact that he had a loving family upbringing and he was happily married. But he did think that his lack of emotion in certain circumstances was now explained. He was genuinely taken aback by his condition.

  20. Mike Horsnall says:

    Geordie,
    I have a friend who was diocesan exorcist (Anglican) for many years. He attributed most things to natural psychic causes -but reckoned he had encountered frank evil two or three times in his working life; though a very intelligent,well read and much experienced minister, my friend took, and still takes, the existence of evil very seriously

  21. Geordie says:

    Mike
    A former parish priest was our diocesan exorcist. He told us in no uncertain terms that the devil definitely exists and he knew from personal experience. He didn’t try to frighten anyone with this; he just informed us that it was a fact. He died last year and I was sorry that I was unable to attend his funeral. He was a good man and a caring pastor to his flock.

    • Quentin says:

      The late Fr Anthony Ross OP was something of an expert in this field. He had no doubt about diabolical possession, which he had often experienced in his work. I knew the late Dennis Wheately who wrote well-researched novels such as The Devil Rides Out and Toby Jugg, and others. He also had no doubt about the strong activity of the Devil amongst us.

  22. Geordie says:

    John,
    Your information rings a bell. The professor was an American from California.

  23. St.Joseph says:

    We have our own exorcist’s. in the Catholic Church.
    Before an exorcism is performed it is important to ascertain that one is dealing with the presence of the Evil One and not an illness. 1673 Catechism of the Catholic Church.550 1237 Jesus’ exorcism at Baptism.

    December the 12th the Feast Day of ‘Our Lady of Guadulupe’, if one does not know the Miracle of St Juan Diego -one will find it on the Web.The human sacrifices in the thousands, placing the skulls on the cliff for people to see-.It is considered to be the equivalent to the human sacrifice of the unborn.
    When it was stopped people were Baptised and converted.I believe in the millions in a short time. Our Lady of Guadlupe is patron of the unborn.,and there are still miracles happening with the Tilma St Juan Diego’s Cloak.also the replica’s.
    I always thought about Jesus’s Baptism was His cleansing of the water. not the other way around!.’only my thoughts’- ‘not to be taken seriously’!!
    I believe Satan has more of a difficult job when people are baptised not saying that we are free from guilt when a person is baptised a Christian. But Satan will have to work a bit harder!
    And his work is a lot easier nowadays as people do not see the importance of it.-or know what sin is.Spiritual illness is not diagnosed, maybe because it is not necessary for ‘living ‘in this world.

  24. Iona says:

    There’s a CTS booklet on exorcism, published 2008 so pretty much up-to-date. No doubt in the author’s mind that demonic possession, obsession etc. are realities.

    An abusive childhood doesn’t have to result in psychopathy or other personality disorder. Fr. Michael Seed’s autobiographical account of his childhood, “Nobody’s Child”, details the most appalling treatment, over years, with no respite; yet he not only survived but eventually “played a poor hand well”.

  25. mike Horsnall says:

    “Playing a poor hand well”..now there’s a phrase thats worth mulling over…When I went for my three day psychometric tests and general grilling at the hands of the Diocese selectors and tame psychologists they came to the conclusion that though fit and welcome for overall purpose I had probably been grappling with an attention deficit disorder for most of my life. In this day and age apparently my difficulties would certainly have been flagged up at school. I was mulling this over yesterday as I chauffered my daughter down to Magdelene College Oxford for her interview and how it was that my own interests in the Law,aged 17, were more to do with its avoidance than of hers in applying to study it!
    The other phrase I like is the one used for failing medics found…”doing an inadequate best”

  26. Psychopathy is a continuum. If one wants to know what low-level psychopathy looks like, one need look no further than the House of Commons. Psychopathy, with its willingness to publicly humiliate and destroy one’s rivals, is an essential part of the job description of an MP working in the party system. The expenses scandal and indeed the current drive for gay “marriage” can all be seen in this context. Both require a ruthless disregard for every moral norm that conflicts with one’s own interest, be that interest financial or ideological.

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