The Psychopath Whisperer: The Science of Those Without Conscience (32 page)

Prison records indicate Brian’s IQ tested well above average. He completed his high school equivalency degree while in lockup and started taking college courses.

Brian made few friends and many enemies in prison. An investigation by the Federal Bureau of Investigation into prison rape concluded Brian was sexually assaulted by other inmates. Brian testified against the other inmates in return for placement in protective custody, where he was kept isolated from the general population.

Brian’s cooperation with the authorities and good behavior while in protective custody earned him early release from prison. But once on the street, Brian quickly returned to a life of crime. At the age of twenty-five, he was arrested on suspicion of sexual assault of a twenty-two-year-old woman. He posted bond and eventually beat the charge when his brother Steve provided an alibi for him on the night of the crime.

Next, Brian hit the road, with brief stays in Texas, Arkansas, and Arizona. He moved frequently from location to location, from job to job, and from relationship to relationship. After more than a year on the road with no fixed address, Brian returned to Illinois. He was unable to maintain stable employment or romantic relationships.

Within six months of returning to Illinois, Brian was arrested on suspicion of several unsolved burglaries. During questioning, he got in a shoving match with one of the detectives and was charged with assaulting a police officer. The charges were eventually dropped and Brian was released.

Brian became a well-known suspect to the police, who frequently arrested him on suspicion of committing burglaries and other crimes. In one altercation with the police, he received a broken nose and had to stay overnight in the hospital.

Brian’s aberrant sexual behavior continued to escalate. He was arrested several times on suspicion of sexual assault, but the victims were unable to identify Brian in lineups.

He continued to drink heavily, as well as use a wide variety of illegal drugs. He supported himself through pawning proceeds from the burglaries he committed.

Just after his twenty-sixth birthday, Brian sexually assaulted a young woman and was arrested. The police considered him a suspect in other serious crimes. His public defender recommended he accept a plea deal for a ten- to fifteen-year sentence to avoid a trial and, potentially, a much longer prison term.

Brian was looking at spending the majority of his adult life behind bars.

Eric was sentenced to a supermax juvenile facility designed to manage the unmanageable. He was assigned his own cell. He enjoyed being alone. Eric spent just over a year in the facility before being released back into the community on his eighteenth birthday.

Eric relocated to California, where he found a job and enrolled in a local community college. Two years later, he switched to a four-year institution and competed his bachelor’s degree.

By age twenty-five, Eric had been employed for over three years. He had not committed a crime since being released from the juvenile supermax facility.

How was Eric’s turnaround possible when he had exhibited such severe antisocial behavior throughout his youth?

It turned out that Eric was a participant in an experimental treatment program provided by the State of Wisconsin. Eric had received state-of-the-art intensive treatment at the supermax juvenile prison, known as the Mendota Juvenile Treatment Center, designed to stop him from continuing down the path of a lifetime of crime and incarceration.

The program’s success surprised even its creators.

In the early 1990s, there was a national epidemic of juvenile violence in the United States. Rates of juvenile crime nearly doubled between 1980 and 1993, and there appeared to be no hope in sight to slow the flow of new juvenile offenders.
²

Wisconsin, like most other states, was reeling from the massive flood of juvenile offenders. However, unlike other states, Wisconsin decided to conduct an experiment to determine if state-of-the-art treatment might stem the tide of the juvenile crime wave.

In 1995, the Wisconsin legislature established the Mendota Juvenile Treatment Center (MJTC) as part of a juvenile justice reform act. Located on the grounds of the Mendota Mental Health Center, the state’s largest forensic psychiatric mental health hospital, MJTC was to be operated under the administrative code of the Department of Corrections but staffed by employees of the Department of Health Services.

The organizational structure was not created by accident. Because of its location on the grounds of the state psychiatric hospital, MJTC could evolve as a clinical-correctional hybrid in which physical security and mental health principles would operate in concert.

The Wisconsin legislature wanted to see results. Indeed, lawmakers required that a research psychologist be hired to conduct evaluations of MJTC and to follow treated youth upon their release back into the community to determine if the program showed any benefit in terms of reduced recidivism compared to the regular standard of care in the juvenile justice system. Moreover, the research psychologist was to publish the results in the peer-reviewed literature—regardless of whether the program worked.

MJTC started with forty-five beds. The clinical psychology staff included three psychologists and three social workers, for a ratio of two professional staff per fifteen youth. This was a very high ratio of staff to inmates. In one prison where I worked, there was a single psychologist responsible for the mental health care of over 550 men.

The program also employed a full-time child psychiatrist. The day-to-day operation was managed by a psychiatric nurse. The nurse supervised all front-line staff, including those assigned with daily care, such as meals, hygiene, and education. Thus, the unit was administrated and operated by trained mental health professionals who were integrated into the security structure.

Because MJTC was located on the grounds of the psychiatric center, the facility was able to avail itself of services from the hospital, including speech and language therapy, occupational therapy, dieticians, a chaplain, dentistry, and medical programs.

The boys sent to MJTC were special, even by juvenile justice standards. Youth were selected for MJTC if the two other larger state juvenile correctional institutions were unable to manage them.
Nearly all the boys sent to MJTC had been deemed uncontrollable at the other institutions. They were the most severely violent youth in the state of Wisconsin. Indeed, the average youth sent to MJTC had over a dozen formally filed charges. Over 50 percent of the youth sent to MJTC had been convicted of a violent felony offense. The average Youth Psychopathy Checklist score was 28 out of 40, meaning the majority of youth at MJTC were in the severe range on the test. As reviewed in
Chapter 4
, the Youth Psychopathy Checklist scores range from 0 to 40, with the mean incarcerated youth scoring about 20. The Youth Psychopathy Checklist is the gold standard in assessing the callous and unemotional traits and impulsive behaviors that typify the highest-risk youth on a potential trajectory toward developing a full diagnosis of psychopathy as an adult.

In traditional correctional models, the state wields incredible power over the individual. Inmates who misbehave in a correctional environment are typically punished with more and more severe security measures, including isolation from the rest of the inmate population and prison staff up to twenty-four hours a day, seven days a week, three hundred sixty-five days a year.

These punitive measures are often seen by the inmate as something to be defied. The result is an escalating arms race in which the most violent or extreme side wins.

Violence by inmates begets only more violence. And as the famous Stanford Prison Experiment
³
showed, even prison guards are susceptible to adopting violent attitudes and behavior toward inmates that they would never normally resort to in another environment. The Abu Ghraib prison scandal
⁴
in Iraq several years ago was a disturbing example of how guards can be adversely influenced by their environment and end up becoming violent themselves.

The Wisconsin legislature’s decision to create MJTC was thrust upon staff at the Mendota Hospital with relatively little warning. In shaping the program, the founders examined all the peer-reviewed literature on psychopathy, the latest models of cognitive behavioral therapy for severely disruptive youth, and the publications on what had failed in the past to show any benefit to youth and adults in correctional settings.

The architects of MJTC were experts in treating violent psychiatric
patients, patients who were psychotic (as opposed to psychopathic) and highly volatile, and who were further agitated by being locked in prison. The MJTC creators relied heavily upon their experiences working with this complicated population in designing the treatment model for MJTC.

It was a high-risk investment; the State of Wisconsin was betting that the psychologists at their flagship psychiatric hospital were up for the challenge. And a challenge it would be.

The leaders at Mendota responded by developing a radical new model that flipped the typical correctional model upside down. The treatment was designed to intervene in the self-defeating and mutually reinforcing interactions between the prison’s need to control prisoner behavior and the inmate’s desire to resist.

The model was founded on the belief that prison deterrence and prisoners’ defiant responses can become a vicious cycle. As the cycle repeats itself, prisoners give up more and more investment in convention, and their lives become “compressed” as the use of punitive and restrictive sanctions increases. Eventually, individuals are so compressed that the only response left in their behavioral repertoire is violence.

The Decompression Model developed for MJTC was named after an ocean diver’s slow ascent from the pressures of the deep. The program sought to slowly uncompress the oppositional defiant behaviors and attitudes that pervaded the youth’s psyche. The model created treatment aimed at developing basic prosocial bonds with the youth, to gradually “decompress” their behaviors and attitudes, and to reorient their existing social skills toward minimal prosocial bonding.

Punishment was not effective for this segment of the youth prison population. It is sometimes difficult for the general public to understand that some people simply don’t learn or benefit from punishment. Fear of punishment is something most of us take for granted. We learn to avoid punishment, which helps to form how we make moral decisions. However, as with all psychological phenomena, there is a bell-shaped distribution that ranges from those who are highly responsive to punishment to those who are highly resistant to learning from punishment. Most of the population falls somewhere in the middle of these two extremes. Unfortunately,
when individuals with a low punishment temperament are thrust into the wrong circumstances, their resulting behavior can be antisocial and violent. In extreme cases, such youth end up committing acts that result in their being placed in maximum-security juvenile prisons.

I came to appreciate the fact that punishment is not the only path to shaping behavior early in my career. As I noted earlier, in college I volunteered to work on a project recording brain waves from captive killer whales. The trainers did not punish the whales for not doing as they were instructed. Rather, the trainers used positive reinforcement practices, like feeding them salmon, to positively shape their behavior in our experiment. Indeed, it seems silly to think of spanking a killer whale for not performing the way a trainer wishes, just as it is silly to harshly discipline a child who does not respond to punishment. It’s just not an effective means of changing behavior.

The first goal of the Decompression Model is to effectively ameliorate the youth’s violent institutional behavior. As the youth’s outlook improves, the next step is to conduct more psychiatric interventions, educational activities, and eventually offer more recreational activities.

Youth are monitored continuously throughout the day by the MJTC staff. Everyone contributes to monitoring the positive behaviors exhibited by the youth, even if such behaviors are rare. By monitoring frequently, the staff can identify these positive behaviors and reinforce them. The more the positive behaviors are reinforced, the more likely they are to be repeated.

A critical component of the program is that every staff member, from the cooks to the cleaning crew to the director of the program, is trained and invested in the Decompression Model.

Reinforcement of the youth’s prosocial behaviors is immediate and substantial. Using what is termed the “Today/Tomorrow” program, youth learn that if they are good today, they earn positive reinforcement tomorrow. The rewards are graduated, in that if a youth is fantastically good today, the rewards will be fantastically good tomorrow. Rewards include things as small as candy bars to as much as the right to play video games in their cells. Psychologists call this type of positive reward structure
contingency management
.

Interestingly, brain scan studies have shown that both candy bars and video games are intrinsically rewarding—that is, the reward learning centers of the brain are engaged by both food and video games. The scientists at MJTC drew upon all the science available to them to improve their Decompression Model.

There was no way for the youth at MJTC to fail the program. Youth were sent to MJTC because they could not be managed at other facilities. MJTC was their last resort. And the staff at MJTC refused to give up on a single youth in their care.

Youth who responded quickly to the Decompression Model were often transferred back to other juvenile institutions or, at the end of their sentences, released into the community. Youth who were more disruptive were more likely to spend the majority of their sentence at MJTC.

The research psychologist at MJTC was required by the State of Wisconsin to determine if the Decompression Model was doing anything to alleviate the burden of crime in Wisconsin. In a series of studies, the research team followed over three hundred youth who had been admitted to the MJTC program over a five-year period. Next, youth treated at MJTC were compared to similar youth treated in the correctional system at other facilities.