@Risk
Thursday, July 27, 2017

Cold Hearts or Broken Brains?

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In one scene played by Sigourney Weaver in the horror classic Aliens, director James Cameron sets up a dialogue between the heroine and a little girl discussing monsters.  The little girl states that her mother had told her long ago that there were no such things as monsters.  “But there are” she continued.  “Why do grown-ups tell kids that?” “Because,” Weaver replied, “most of the time it’s true.”

The names of serial killers are generally familiar to the public and we hear about them through books, movies and other media sources.  Why are we drawn so much to this aspect of our culture? Three reasons.  We have a preconditioned need to face our fears in a safe environment, such as going to a horror film.  The second reason is that movies like The Silence of the Lambs and a Netflix series like Dexter gives people a sense of control, by way of delving into the psyche of serial killers.  A third reason is that many of us just simply have a perverse need to understand and face that freakish side of life –  Guinness Book of Records is a testament to that statement.

My interest in psychopaths goes back to my days of clinical training.  After graduating from the University of Chicago, I was certainly intellectually rich, but financially very poor.  After my first summer back with a degree in biology, I earned a living working for a biotechnology firm in Boston, subsequently once again packing my bags and leaving for California.  It was here, that I met my first psychopath.  I entered graduate school in psychology, found work, and met Scott (name changed) during one of my initial assessments as a trainee.  There is nothing dramatic that I can say about Scott, except for his thirst to live on the edge.  His stories were both impressive and fascinating, revealing bits and pieces of his antisocial personality.  I asked him about the crimes he had committed.  Already incarcerated, he had no motivation for deception and listed the crimes in a detached manner.

I remember the very first feeling I had, was my heart pounding.  I mean really pounding.  The second feeling I had was that my hands were sweating.  And the third feeling was fear, and the kind of reality set in that there was a murderer in front of me.

You know Christmas, that wonderful time of the year where family is getting on your every nerve, lines in department stores are too long to fathom and you feel so bloated from all the food you ate that you vow to never get off the couch?  We can all empathize with that feeling of irritation, frustration and laziness.  But can we also empathize with Herbert Weinstein, a 65-year-old ad executive who was charged with strangling his wife Barbara to death, (after the twelve days of Christmas) and in an effort to make the murder look like a suicide, throwing her body out the window of their 12th-floor apartment on East 72nd Street in Manhattan? Herbert must have been cooped up at home for too long.  Holidays do have that stuffy atmosphere.  Only Herbert did not have any prior history of crime or violence and after a referral to a PET scan, unknown to even Weinstein himself, it was discovered that a subarachnoid cyst was growing in his left frontal lobe.  The cyst displaced brain tissue in both frontal and temporal cortices.  The implications of this finding were considerable.  The defense team went with an insanity defense and eventually, the prosecution and defense agreed to a plea of manslaughter.

There is no simple answer to why people kill.  Why also, are some one time killers and others are serial killers.  The case of Herbert Weinstein highlights the importance of the brain in predisposing someone to violence.  The MRI brain scan of Herbert’s brain showed enormous structural impairment.  But if we were to compare the MRI scan of an antisocial individual and also a murderer, Scott, we would see similar structural abnormalities.  In particular, an eleven percent reduction in the volume of gray matter in the prefrontal cortex.[1] The extent of this finding begs the question.  Why is one murderer off on an insanity plea and the other is in line for a lethal injection?

The case of Phineas Gage is well studied by all students in psychology programs.  He was a well-respected, well-liked, industrious and regarded individual in the community, until September 13, 1848 when he organized the destruction of a boulder lying on the path of a railway track.  Holding a metal rod in one hand, Gage tamped down with the rod right on top of the exposed gunpowder covering the boulder.  The gunpowder ignited, blasting the spear through Phineas’ head.  Gage had lost his left eye, but was out of bed in three weeks.  From the words of his friends and employers, Gage was no longer Gage.  Gage had been transformed from a well-liked and respected railway worker to a psychopath.  He was impulsive, irresponsible and a drunk.  The case was remarkable at the time and pointed to the fact that damage to the prefrontal cortex really can transform an otherwise normal, law-abiding citizen into an antisocial individual.

There is no escaping the fact.  Lawyers routinely order scans of convicted defendants’ brains and argue that a neurological impairment prevented them from controlling themselves.  The evidence is usually admitted.  Indeed, a Florida court has declared that failure to admit neuroscience evidence during capital sentencing is grounds for a reversal.  Neuroscientific evidence has persuaded jurors to sentence defendants to life imprisonment rather than to death.

What do we make of this? Although we often think of psychopaths as antisocial villains with a lot of negative characteristics and cold hearts, they actually just may have broken brains.  Easier said than done.  Decades are rolling by and we are still mulling over psychopathic behavior.  As a researcher and a clinician, I like to organize and classify the behaviors I see.  Sometimes, however, the circumstances do not allow that to be done and I may still find myself judging, sweating and fascinated when faced with a cold-blooded killer.

[1] Raine, A., Lencz, T., Bihrle, S., Lacasse, L & Colletti, P. (2000). Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder. Archives of General Psychiatry 57, 119-27.

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