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.