Friday, March 27, 2015
Are Psychopaths Still Moral Strangers?
In Darwinian Natural Right (first published in 1998), I have a chapter on psychopathy ("The Poverty of Psychopathic Desire"), in which I identify psychopaths as moral strangers. By that I mean that since they do not feel the moral emotions that support the evolved moral sense that most human beings have, we cannot engage in moral persuasion with them. They demonstrate that Immanuel Kant was wrong in claiming that morality arises from a purely rational comprehension of moral principles free from any emotions or desires, because the lack of conscience in psychopaths comes not from any defect of rationality but from their failure to feel the moral emotions that motivate moral conduct. Psychopaths know the difference between right and wrong, but they don't care.
We cannot properly blame psychopaths for lacking the moral sentiments natural to us, but neither must we pardon them when they threaten us. Although they are not bound by our morality, they cannot rightly expect us to refrain from defending ourselves against their predatory behavior. To sustain any social order at all, we must treat psychopaths as defective or dysfunctional deviations from human normalcy. Criminal psychopaths must be either confined or executed to protect their potential victims. When Ted Bundy was asked whether he deserved to die for raping, mutilating, and killing three dozen or more women, he answered: "Good question. I think society deserves to be protected from me and from people like me."
Recently, I have been studying the research on psychopathy that has been conducted over the past twenty years, which I see as largely supporting my account of psychopaths as moral strangers, although it also suggests the possibility that young psychopaths could be rehabilitated by the right kind of therapeutic treatment, which would deny my assumption that there is no cure for psychopathy.
Morris Hoffman has provided a good framework for how our punishment of psychopaths fits into the evolved human nature of law and punishment. Hoffman is a trial judge in Colorado who has sought to explain his experience as a judge through evolutionary neuroscience. "Evolution built us to punish cheaters," he declares. We have evolved instincts to cooperate because of the benefits of living in cooperative social groups. But we also have evolved instincts to cheat, because cheating in the right circumstances can confer short-term survival benefits. This choice between cheating and cooperating is what Hoffman calls The Social Problem. To solve that problem--by promoting cooperation rather than cheating--we have evolved instincts for punishing cheaters.
There are three levels of punishment, Hoffman argues. In first-party punishment, we punish ourselves with conscience and guilt. In second-party punishment, we punish our tormentors with retaliation and revenge. In third-party punishment, we act as a group to punish wrongdoers within our group with retribution. Our brains have evolved propensities for all three kinds of punishment.
The brains of psychopaths differ, however, from normal brains, because psychopaths do not feel conscience or guilt. And so, since they don't punish themselves for cheating, they will become successful cheaters, unless they suffer the second-party punishment from retaliation and revenge or the third-party punishment from retribution.
Such punishment requires that our human brains have mental capacities for both moral reason and moral emotion. We need moral reasoning to detect cheating, and we need moral emotions to motivate our punishment of them. Psychopaths have the rational capacity for understanding the social norms against cheating, but they lack the emotional dispositions that enforce those norms.
The emotional poverty of psychopaths is manifested in a variety of traits that can be used to identify the psychopathic personality. When I wrote my chapter on psychopathy in 1998, I used Robert Hare's Psychopathy Checklist, which was being adopted as the standard profile for the psychiatric assessment of psychopathy. At that time, Hare's checklist had 12 items. Now it has 20 items:
1. Glibness/superficial charm
2. Grandiose sense of self-worth
3. Need for stimulation/proneness to boredom
4. Pathological lying
6. Lack of remorse or guilt
7. Shallow affect
8. Callous/lack of empathy
9. Parasitic lifestyle
10. Poor behavior controls
11. Promiscuous sexual behavior
12. Early behavior problems
13. Lack of realistic, long-term goals
16. Failure to accept responsibility for own actions
17. Many short-term marital relationships
18. Juvenile delinquency
19. Revocation of conditional release
20. Criminal versatility
Those trained in the assessment of psychopathy study the record of a subject's life and conduct interviews so that they can rate how well the subject conforms to each trait. For each trait, there is a score of 0 (the item does not apply to the individual), 1 (the item applies in some respects), or 2 (the item applies in most respects). The highest possible total score is 40. Anyone with a score of 30 or more is identified as a psychopath.
Almost everyone will have some of these traits, and some will have enough of them to be somewhat psychopathic. But only a few people will score 30 or more. It is estimated that as many as 1 out of every 250 people could be a psychopath. Of violent criminals, 15% to 30% are probably psychopathic. But most psychopaths are not violent criminals.
Hare has done most of his research with psychopaths in maximum security prisons in Canada, and his checklist emphasizes criminality (as indicated in the last three items on his list). This has provoked criticism from scientists who argue that Hare has mistakenly made criminality central to his conception of psychopathic personality. The critics argue that criminal behavior should be identified not as part of the psychopathic personality but as a possible consequence of that personality.
Like Hare, Kent Kiehl (one of Hare's most prominent students) has become an expert on psychopathy from studying criminal psychopaths (first in Canada, later in the United States). Kiehl is responsible for the first brain scanning of psychopaths--first with an electroencephalogram (EEG) and then with magnetic resonance imaging (MRI). With structural MRI, Kiehl can map the enduring structural traits of the psychopathic brain. With functional MRI, Kiehl can create images of the psychopathic brain as engaged in specific mental activities.
Kiehl has shown that while the intellectual intelligence of psychopaths can be high, as indicated by high IQ, their emotional intelligence is low; and he can show that this low emotional intelligence is correlated with low activity and low gray matter density in the paralimbic and limbic systems of the brain, which include bilateral parahippocampal, amygdala, and hippocampal regions, bilateral temporal pole, posterior cingulate cortex, and orbitofrontal cortex. Deficits in these parts of the brain are associated with deficits in emotional processing, which could explain why psychopaths lack the moral emotions of guilt, shame, love, and empathy that sustain the moral sense of most people. (Does this cast doubt on the argument of Steven Pinker and Michael Shermer for a "moral Flynn effect"--the idea that increases in IQ can bring moral improvement?)
One example of the testing that Kiehl conducts is the "moral picture task." People in a fMRI machine are asked to rate pictures on the severity of the moral violation in the scene. Some of the pictures have high immoral content (like a man yelling aggressively at a cowering child). Others have low immoral content (like a picture of a surgical procedure). Viewing pictures with high immoral content activates the amygdala in the brains of normal people but not in the brains of psychopaths. Normally, the amygdala amplifies the emotional response to images of immoral activity; but this does not happen in the psychopathic brain. Psychopaths can comprehend moral rules intellectually, but violations of those rules arouse no moral feelings in them.
Exaggerated claims for MRI brain scanning as if it were a way of photographing the mind at work have provoked justified criticisms. MRI creates an image not of the thoughts and feelings of the mind but of the flow of oxygenated blood associated with increased neural firing. We can never be sure what that means. Neural firing can be excitatory or inhibitory. The neural firing in one region of the brain is interconnected with the neural firing in other parts of the brain. A neural correlation is not causation. If there are neural correlates for psychopathic behavior, we can't be sure whether the neural activity caused the behavior, or whether the behavior caused the neural activity. The brain is plastic in changing in response to experience. So it could be that the experience of psychopaths in living a psychopathic life has shaped a psychopathic brain. And if psychopaths could be persuaded to change how they live, this might change their brains to make them less inclined to psychopathic behavior.
Moreover, in all of this, we face the fundamental mystery of consciousness. Each of us has a subjective awareness of our consciousness, but we have no direct access to anyone else's consciousness. We must infer the internal thoughts and feelings of others from external evidence. So we can ask them to look at moral pictures and rate the pictures for moral severity, and we can then study the neural firing in their brains. But we cannot directly observe their conscious activity. We can assume that the activity of consciousness depends on the activity of the brain. But we cannot explain exactly how that brain-mind interaction works.
Part of this mystery of consciousness is the mystery of how our conscious decisions for action move our brains, which then move our bodies into action. Holding people morally and legally responsible for their actions presupposes that their minds can make free choices that are then executed by their brains and bodies. We don't hold children fully responsible for their behavior, because we judge that only adults have developed enough mental capacity to act voluntarily and deliberately. We also judge that some adults who suffer from severe insanity, such as psychotic states that induce delusions and hallucinations, may lack the mental capacity for making rational decisions, and thus they cannot properly be held fully responsible for their behavior. The puzzle of psychopaths is that, unlike psychotic people, they intellectually understand what they are doing when they violate moral and legal rules, and yet their lack of emotional understanding seems to impair their control over their behavior.
All of these problems were raised when Kiehl introduced into a courtroom for the first time MRI scanning images of psychopathic brains. In the summer of 2009, Kiehl was asked by Brian Dugan's defense attorneys to assess his psychopathic personality, scan his brain, and testify in a sentencing trial that would determine whether he would be sentenced to die.
In 1983, Jeanine Nicarico, aged 10, was abducted from her house in Naperville, Illinois, then raped and killed by Dugan. For several months, the police could find no suspect, and they were under great public pressure to solve the case. Finally, they arrested three men; and two of the men were sentenced to death.
Then, Dugan abducted, raped, and killed two more people--Donna Schnorr, aged 27, in 1984, and Melissa Ackerman, aged 7, in 1985. Dugan was arrested and then he confessed to killing Ackerman and Schnorr, for which he was sentenced to two life sentences. He also offered to confess to Nicarico's murder, but prosecutors refused to accept this. Later, it turned out that the prosecutors and police had framed the two men convicted for Nicarico's murder.
In 1995, after 10 years on death row, the two falsely convicted men were released. In 2005, Dugan was indicted for Nicarico's murder. In 2009, he pled guilty. He then had to go to trial for sentencing by a jury. Capital punishment would require a unanimous decision from the jury. The prosecutor would argue that the aggravating factors in the murder justified a death penalty. The defense lawyers would argue that Dugan's psychopathic brain should be considered a mitigating factor justifying a life sentence rather than execution.
After studying the files on Dugan's life of crime and interviewing him, Kiehl concluded that he scored high on the Psychopathy Checklist. When Dugan read the list of traits for psychopath, he said, "I can see that I have almost all of them." Kiehl observes: "This was the first time I'd ever had a psychopath recognize the symptoms in himself without any help." Dugan remarked: "But I still don't feel any different. I mean, I really wish I felt different about what I did, but I just don't." (Last December, in a prison interview with a Chicago Tribune reporter, Dugan declared: "Yes, I am a psychopath.")
One Canadian prisoner objected when he saw Kiehl's Psychopathy Checklist for him. He grabbed the scoresheet. He crossed out the word psychopathy on the top of the page and wrote in big block letters SUPERMAN. He said: "I'm no psychopath. That's the wrong term for me. I'm renaming this the Superman Checklist. And now I'm Superman." If a psychopath is "beyond good and evil," does that make him a Nietzschean Superman?
Kiehl's structural MRI scan of Dugan's brain showed atrophy of gray matter in every region of the paralimbic system. And although the judge in the sentencing trial did not allow Kiehl to show his brain scans to the jury, he did allow Kiehl to show sketches of Dugan's psychopathic brain.
Although some of the jurors were swayed by Kiehl's testimony early in the jury deliberations, eventually the jurors unanimously agreed to a death sentence. Some of the jurors said afterwards that since Dugan was not psychotic, he knew what he was doing and knew that it was wrong, and thus that his psychopathic personality did not diminish his legal responsibility.
In 2011, the Illinois Legislature abolished capital punishment, and Governor Pat Quinn commuted Dugan's death sentence. Dugan continues to serve out his two life sentences.
In Kiehl's testimony at the sentencing trial, he told the prosecutor: "In my ideal world, Brian would have received treatment as a youth and perhaps, just perhaps, we could have prevented his crimes from ever taking place."
In his writing, Kiehl has pointed to the success of an unusual program for treating the most violent teenage boys in Wisconsin at the Mendota Juvenile Treatment Center. Psychopathic people cannot learn from punishment, because they do not feel the emotional weight of punishment the way normal people do. When psychopathic boys are punished, they respond with defiant violence. The treatment program at Mendota turns away from punishment towards rewards for good behavior. There is some evidence that the boys who have gone through the Mendota program are much less likely to return to violent crime than those who have not.
Kiehl has plans for scanning the brains of these boys before and after their treatment to see if the treatment changes their brains, so that they show less psychopathic traits. If he can show this, this might illustrate how the mind can exert mental force to change the brain, which would show how the emergent evolution of the mind in the brain to support our human freedom of choice.
Elsa Ermer, Lora M. Cope, Prashanth K. Nyalakanti, Vince D. Calhoun, and Kent Kiehl, "Aberrant Paralimbic Gray Matter in Criminal Psychopathy," Journal of Abnormal Psychology 121 (2012): 649-658.
Robert D. Hare and Craig S. Neumann, "The Role of Antisociality in the Psychopathy Construct: Comment on Skeem and Cooke (2010)," Psychological Assessment 22 (2010): 446-454.
C. L. Harenski, K. A. Harenski, M. S. Shane, K. A. Kiehl, "Aberrant Neural Processing of Moral Violations in Criminal Psychopaths," Journal of Abnormal Psychology 119 (2010): 863-874.
Morris B. Hoffman, The Punisher's Brain: The Evolution of Judge and Jury (New York: Cambridge University Press, 2014).
Kent A. Kiehl, The Psychopath Whisperer: The Science of Those Without Conscience (New York: Crown Publishers, 2014).
Jennifer L. Skeem and David J. Cooke, "Is Criminal Behavior a Central Component of Psychopathy? Conceptual Directions for Resolving the Debate," Psychological Assessment 22 (2010): 433-445.
Some posts on related topics can be found here, here, here, here., here, here., and here.