While hooked up to an EEG that tracked brain activity, study participants looked at neutral or emotional words — table, desk, carpet, corpse, maggot, torture — followed by scrambled words. “With emotional words, most people can differentiate between words and scrambles very quickly, with high accuracy,” says Hare. “But psychopaths responded the same way to emotional and neutral words. There was no emotional turbo boost. That was stunning. In 1991, we submitted the paper to Science, and it was turned down at first because the editors thought these can’t possibly be real people.”
Science ultimately published the paper later that year, and it was replicated a few years later in the first-ever brain imaging study of psychopathy, a collaboration between Hare and the Bronx Veterans Affairs Medical Center substance abuse clinic.
As Hare drives us to his home near Horseshoe Bay, commenting occasionally on dangerous drivers exhibiting psychopathic traits, he points out that “scores of researchers doing MRIs have since replicated those early studies.”
Hare’s reputation for cutting-edge scientific research attracted many students to the Hare Lab, including Kent Kiehl, who completed his master’s and doctorate degrees there from the mid-1990s until the lab closed in 2000. “We discovered very striking differences between psychopath and non-psychopath brains,” says Kiehl, who has continued his research at the University of New Mexico since 2007. “But Bob taught me that it’s more important to listen to their stories and life histories. He’s interviewed some of the most notorious psychopaths in Canada. That makes him unique. Eighty percent of the researchers in psychopathy, some of the biggest names, have never actually met a psychopath. They haven’t spent time with the material, if you will.”
The 46-year-old Kiehl is executive science officer at the Mind Research Network forensics lab, which travels to local prisons with a mobile fMRI machine, tracking blood-flow changes while subjects are exposed to neutral and violent words and imagery. So far, Kiehl has assessed more than 5,000 brains and found that psychopaths have functional and structural anomalies that affect emotions, impulse control and cognition, leading him to view psychopathy as a neurodevelopmental disorder — a belief he shares with a number of other researchers and psychologists.
Neuroimaging is now increasingly used in the courtroom, including at a 2009 death penalty trial for Brian Dugan, a Chicago prisoner already serving a multiple murder sentence and who was later convicted of the 1983 rape and murder of a 10-year-old girl. Kiehl was hired by the defense to assess Dugan with the PCL-R and a brain scan, to convince the jury that the convict with an IQ of 140 had a neurological disorder that made him not criminally responsible, as is already the case for people with low IQ (a neurological disorder that qualifies for ineligibility for execution in nine states). Kiehl doesn’t know whether the brain scan and the accompanying PCL-R psychopath label impacted the jury’s ultimate death penalty conviction. (A year later, the death penalty was abolished in Illinois.) But like his mentor, Kiehl believes that brain scans could be just as common in the courtroom as DNA, as long as the information is conveyed by credible experts.
“I think that brain scans will one day be routinely used to categorize psychopaths and become standard fare in court trials. They’ll be just as revolutionary as the use of DNA evidence,” contends Kiehl, citing his recent study on impulsivity — “that brain scans were better than the PCL-R at predicting that psychopath offenders were four times more likely to reoffend.”
Hare is wary about the impact of brain scans in the courtroom. “Neuroscience is sexy right now, and brain scans are attention-grabbers,” he acknowledges as we sit on his balcony drinking cappuccino. “There’s some dramatic new stuff showing there might be anomalies in the cells between the frontal cortex and the limbic system, referred to as ‘potholes’ along the neural tracks. It’s interpreted as evidence of some sort of disconnection between frontal and limbic regions.”
But as Hare points out, “we don’t even know what the variations of a ‘normal’ brain look like. It might turn out that psychopathy is causally associated with functional and structural deficits, but for now the jury is out. We still have a lot to learn.”
Evil, or Evolution?
Even though there’s an abundance of scientific research on psychopathy, perhaps more than with any other personality disorder, specialists still can’t agree on the specific origins. “The majority interprets anomalies in brain structure and function as a cause-effect relationship,” says Hare. But some researchers think nurture trumps nature, and they equate it with early abuse and trauma. “That’s part of the picture,” acknowledges Hare. “It’s just as reasonable, and more so in my mind, to interpret psychopathy as a developmental evolutionary thing,” he says, citing work by psychopathy specialists at Waypoint Centre for Mental Health Care, a clinical and forensic hospital in Penetanguishene, Ontario. “They argue that psychopathy is not a disorder; it’s what they call ‘an adaptive lifestyle strategy,’ ” says Hare. “You can pass on your genes by having one or two children and investing a lot into their well-being. But we know psychopaths’ relationships are impersonal, that they favor the strategy of having a lot of children, and then abandoning them.” This biological adaptation theory qualifies psychopathy as an advantageous, albeit deplorable, method of genetic reproduction, not as a neurological disorder.
“…but maybe we’re also just a bunch of algorithms. It’s a mystery of human nature that makes my head hurt.”
Both etiology theories could have serious real world implications. Could children be vilified as bad seeds or given special resources or medical treatment? Could workers be tested for psychopathic tendencies by employers? Could criminals be imprisoned for life based solely on brain scans?
“These are big issues,” acknowledges Hare, who now fields questions about neurological comparisons between psychopathy and autism at every talk he gives. “I don’t think psychopaths have a more primitive or a more evolved brain. . . . Nature provides for all sorts of diversity — that’s the point, isn’t it? We have some super-empathetic people and if a fly dies, they feel remorse — one extreme. The other extreme may be the psychopath. Most of us are somewhere in-between.
“From an evolutionary psychology perspective, the structure and functions [of psychopaths’ brains] may be a little different, but they’re properly designed for engagement in predatory behaviors. They could be genetically programmed, but what trigger mechanisms might set genes off? We don’t know. But we know that environmental factors are also a determinant,” says Hare.
Whether the debate is settled soon or not, Hare thinks we need therapy programs designed for psychopaths, including ones for children who are too young to bear the psychopath label but have callous-unemotional traits, alongside conduct disorder behaviors like fighting, bullying and stealing. “But you have to be very careful with labels and treatment. Psychopathy might not be so disordered and unnatural; it’s something that we can probably work with, help them take advantage of and shape in a way that’s pro-social and productive, good for the individual and society.
“My view is that psychopaths have the intellectual capacity to know the rules of society and the difference between right and wrong — and they choose which rules to follow or ignore,” says Hare. “They might even consider themselves more rational than other people. A psychopath I met in my research once told me that using his head instead of his heart gave him an advantage. He saw himself as ‘a cat in a world of mice.’ ”
After all these decades, Hare claims he’s often no better than the next person at identifying a psychopath, and that helps explain why he periodically eyeballs the proverbial windows to my soul. I ask Hare about the root Latin definition of psychopathy, which means a sickness of the soul. “People will say the behavior is pure evil, but what does that mean?” wonders Hare.
“I’ve never used these terms. Psychopaths can be dangerous and cause very serious problems in society. But I don’t know what the soul is. I think a better word is conscience, but what is that? Is it the concept of self-awareness? Can a computer think in this kind of abstract sense? I don’t think so, but maybe we’re also just a bunch of algorithms. It’s a mystery of human nature that makes my head hurt.”
Journalists have beagle traits, too, so I return to the question of what attracted him to specialize in such dark matter? Was it like an archaeologist discovering a new world?
“OK, sure, that sounds good,” he allows. “It’s funny to think that on my tombstone, it’ll say I was the developer of the PCL-R. This is my claim to fame? Do you know that Heimlich did a lot of basic science research? No, you just know the Heimlich maneuver.”