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Authors: Dean Haycock

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The association of both OCD and psychopathy with the prefrontal cortex merely illustrates that brain regions implicated in one disorder can be just as involved with, or make contributions to, other disorders. For instance, based on MRI scans, some adults with bipolar disorder appear to have smaller and less metabolically active prefrontal cortices than adults who don’t live with bipolar disorder.
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There may be no single brain region solely devoted to OCD, bipolar disorder, or psychopathy. But they share brain structures that are intricately connected. When the circuits are disturbed or damaged to different degrees and in different ways, differing symptoms result depending on the nature of the interruption or flaw in the connections.

Sorting out the pattern of interconnections or brain circuits that underlie the brain’s higher cognitive functions and—when they are compromised or impaired—dysfunctions or mental disorders has proven to be very difficult. It is, after all, brain science and, as the cliché goes, if it were easy, everyone would be doing it. But it is progressing, although slowly, thanks in part to brain-imaging studies.

An Exception that Proves the Rule?

One indication of the advances being made in the area of neurocriminology is the appearance of studies that are beginning to reveal differences in the brains of subgroups of psychopaths. In 2004, for instance, Raine and his colleagues used structural magnetic resonance imaging (MRI) to scan the brains of sixteen unsuccessful psychopaths who had not been able to avoid the law, thirteen successful psychopaths who had managed to avoid the law, and twenty-three control subjects or non-psychopaths who, of course, also managed to avoid the law.
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They found that psychopaths whose activities landed them in prison had 22 percent less prefrontal gray matter than non-psychopaths. Successful psychopaths, by contrast—those who managed to stay out of prison while still scoring high on the Psychopathy Checklist—did not share this abnormality.

Criminal or unsuccessful psychopaths additionally showed signs of abnormalities in the hippocampus (Figure 11), with the right side being larger than the left.
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The hippocampus is closely associated with the transformation of short-term memory into long-term memory. It also plays an important role in social learning and, particularly relevant in these studies, in learning to fear the consequences of one’s actions. This is a skill that keeps a person from doing something, out of the fear that they might get caught and be punished or suffer otherwise unpleasant consequences. That is exactly what jailed psychopaths are not very good at. The observation that unsuccessful psychopaths have abnormal hippocampi should not be too surprising; psychopaths who avoided prison time did not have abnormal hippocampi in this small study.

Raine’s research raises the possibility that the different career tracks of successful and unsuccessful psychopaths may have their roots in these anatomical differences. It is possible that successful psychopaths have other abnormalities that leave them with no conscience but with intact brain function in other key brain regions. These neurobiological “gifts” or attributes might allow them to behave like psychopaths but not get caught, either because they are more clever than their jailed peers or because they limit their misdeeds to those less likely to land them in prison.

Their unsuccessful cousins, on the other hand, are more seriously handicapped. Their impairments, both in brain structure and function, may predispose them to commit more thoughtless crimes, to impulsively engage in more overt criminal behavior. They may also be less skillful at masking their inability to empathize with others and hide their emotional deficits.

A potential problem with this study is that the unsuccessful psychopaths scored a bit higher on the Hare Psychopathy Checklist than the successful psychopaths. But other researchers have observed differences between successful and unsuccessful psychopaths as well, so that may not weaken the implications of this research.

We know, for example, that psychopaths who land in prison have reduced stress reactions and reduced ability to think like an executive in psychological tests when compared to non-psychopaths. Jim Fallon, perhaps not so coincidentally, reports very little response to pain, anxiety-provoking situations, and violent, horrifying images that other people find disturbing.

A lot of the frontal cortex is devoted to “big issue” questions like: What happens now? Where will this get me? What are we going to do next? And what will happen if I do this?

This part of the brain weighs options, compares potential outcomes, and examines multiple choices whenever a person makes a decision. Similar to a CEO, it functions like an executive. People with injured prefrontal lobes have significant problems acting as an effective CEO. But successful psychopaths, including some real CEOs,
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have increased stress reactions and in some cases possibly better executive function.

If successful psychopaths have fewer abnormalities in the prefrontal cortex and other parts of the brain that evaluate and handle executive decisions than incarcerated psychopaths do, it is easy to imagine how they can avoid getting caught or taking risks likely to lead to capture.

Apparent differences between successful and unsuccessful psychopaths suggest that psychopathy may include two distinct personality disorders with great similarities but significant distinctions. Another possibility is that psychopathy describes a spectrum of behaviors. Psychopathy may not be a single disorder, just as schizophrenia or autism are not single disorders. The standard test used to define psychopathy, Hare’s Psychopathy Checklist, itself includes multiple categories of traits. For example, one measures emotional detachment and another measures antisocial behavior. It would be possible, for instance, for a successful psychopath to have high scores in emotional detachment and low scores in antisocial behavior, while an unsuccessful psychopath could have a different profile. Both could still score high enough to be classed as psychopaths but with emphasis on different psychopathic traits.

This, along with studies on brain-injured people, implies that having an impaired prefrontal cortex is one way to end up an unsuccessful psychopath. Other, more subtle changes could lead to a more “successful” life in those with psychopathic features.

As with most complex medical conditions, and particularly mental and personality disorders, multiple factors appear to contribute to the development of psychopathy. Genetics evidently can predispose some people to psychopathy. And the environment in which the brain develops could play a role. This might be related to inheritance, or it might be related to other
factors affecting the fetus, as is suspected in schizophrenia. Finally, early life experiences may promote the development of psychopathy in some susceptible individuals.

Why Isn’t Dr. Fallon a Practicing Psychopath?

Why doesn’t Jim Fallon charm, threaten, manipulate, exploit, and use people for his own ends and amusement? Why isn’t Jim, with his quiet orbital prefrontal cortex and amygdala, multiple “warrior-like genes,” and low empathy genes, a practicing psychopath, a murderer, or both, like more than half a dozen of his ancestors? He has, as he has said, “the exact brain pattern of a psychopathic killer,” but he is not a psychopath by any testable standards. He has some personality traits in common with psychopaths and his brain scans raise interesting questions about the origins of psychopathy.

A person who was abused as a child and who inherited genes that predisposed him to psychopathy may have a greater chance of becoming a psychopath than someone who did not inherit the same genes but suffered the same abuse; he would also have a greater chance of becoming a psychopath than someone who inherited the same genes but was raised in a loving and supportive home. Fallon says that he was lucky enough to be raised in a loving, supportive home.

“It’s an unlucky day when all of these three things [genes, abnormal brain function, and abuse] come together in a bad way,” Fallon said on NPR, “and I think one has to empathize with what happened to them [psychopaths].”

Often, of course, it would require the compassion of the Dalai Lama to empathize with criminal psychopaths while thinking about their victims. And this is the source of the growing controversy about the liability of psychopaths in light of recent findings indicating that the problem lies, to a significant degree, in their brains which seem to be incapable of processing emotions and relating to others.

Chapter Five

Troubling Developments and Genes

“M
Y MOTHER WAS CANCER,”
murderer Richard “The Ice Man” Kuklinski said in Trenton State Prison. “She slowly destroyed everything around her. She produced two killers—me and my brother Joe.”
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Richard lied routinely to his family and his associates during his forty-year-long criminal career, and he lied to journalists after it ended. But he was deadly accurate when he summarized himself and his twenty-five-year-old brother, Joe, who was indeed a killer too.

Joe lured twelve-year-old Pamela Dial, with her black-and-white mixed breed dog “Lady” in tow, into a building on Central Avenue in Jersey City, New Jersey on September 15, 1970. The weather had been clear and comfortable that day, nearly 74°F. As midnight approached and the three of them ascended the stairs to the roof of the four-story building, the temperature was cooling down to the high 50s. Pamela had found Lady wandering in the neighborhood around 11:30 p.m. and was returning home when she encountered Joe and accompanied him into the building.

When they reached the top of the building and stood on the roof, Joe attacked. He sodomized the girl, strangled her, and threw her body off the roof. Then he threw Lady after her.

Joe had been seen with the girl. The next morning, as the day heated up and the temperature began to climb to 92°F, police found him in the house he shared with his mother at 434 Central Avenue. It was just around the corner from the murder scene, two doors from where Pamela was found after the injured dog crawled to her body and howled to wake the neighborhood.
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At the police station, Joe confessed under interrogation. It led to his rapid conviction, and he was soon sent to Trenton State Prison to serve out a life sentence.
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He finished serving it thirty-three years and one week after raping and murdering the child; he died in prison on September 22, 2003.

Joe’s older brother Richard was thirty-five years old when Joe killed Pamela. Richard managed to stay out of Trenton State Prison for sixteen more years before he joined Joe inside. During those years, he raised his son Dwayne and daughters Chris and Merrick while supporting his wife Barbara, whom he married in 1961. They thought he was a businessman with a terrifying temper. They knew he was an abusive husband. They did not know that he killed people when he went to work.

“He would set up business deals and when the people arrived with their side of the bargain, he would kill them,” New Jersey State Attorney General W. Cary Edwards said when Richard was arrested on December 17, 1986.
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After his conviction, Richard actively sought attention and publicity. He had the time to pursue it since he wouldn’t be eligible for parole until he was 110 years old. He agreed to take part in three HBO documentaries and spent days speaking to two biographers. During one of the interviews, he admitted to killing New York City police detective Peter Calabro. That got thirty more years added to his sentence. He promoted his image as “The Ice Man,” a cold-blooded, emotionless, ruthless, highly efficient killer. The nickname came from his attempt to hide the time of death of at least one of his victims by storing the body in a freezer before disposing of it.
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“I was a person who was able to hurt somebody at any given time with no remorse and who could do it over and over again without it bothering them,” Richard told forensic psychiatrist Park Dietz, M.D., M.P.H., Ph.D., who had been hired by HBO to interview the murderer in 2002. They talked
over a four-day period for a total of thirteen hours. Part of the interview was included in HBO’s documentary “The Iceman and the Psychiatrist.”
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Dietz, a consultant to the FBI and now president of the forensic consulting firm Park Dietz & Associates, asked Richard if he thought of himself as an assassin. The question amused Richard. “Assassin; it sounds so exotic. I was just a murderer.”

He hinted that he had killed at least 200 people during an unlikely career as a contract killer working for organized crime families in New York. He said he committed his first murder when he was 13 or 14 years of age. Solid evidence, however, points to half a dozen or so victims, mostly low-level criminal associates. Two were his accomplices, three were drug or pornography dealers, and one was a police detective. It would surprise no one if he killed more, perhaps many more, but without strong evidence who is going to believe Richard Kuklinski’s unsubstantiated claims? He also claimed he used everything from a crossbow to hand grenades, from garrotes to pistols, from cyanide to strangulation to kill in the triple digits.

It’s hard to tell while watching the documentary when Richard was lying and when he was telling the truth. This is not surprising, since he had, in the professional opinion of Dietz, two personality disorders that accounted for his behavior. Dietz saw evidence of paranoid personality disorder in Richard. The more dominant feature of his personality, however, was antisocial personality disorder, which Dietz later made clear he considered the same as psychopathy. The psychiatrist explained that he was referring to “someone who does not have a conscience, does not have remorse, does not feel a sense of guilt about most of the bad things they do, is impulsive and violent.”
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This diagnosis might also explain Richard’s embrace of the media a few years after he went to prison for the rest of his life. The attention and widespread reputation it earned him is consistent with a trait common in psychopaths: grandiosity. Richard also displayed another trait that is a characteristic feature of psychopathy: fearlessness. Richard said he rarely felt anything that approached nervousness or fear. There was, the psychiatrist explained, a genetic basis for that.

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