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  Spot the Neurological Difference

  One of the major differences between a psychopathic brain and a “normal”-looking one is in the function of the prefrontal cortex; there are also differences in brain structure. Researchers led by Dr. Michael Koenigs at the University of Wisconsin discovered, while examining the brains of male prisoners, that psychopaths have reduced connectivity between their prefrontal cortex and their amygdala.

  This study, “Reduced Prefrontal Connectivity in Psychopathy”—which came out in 2011—was the first time “structural and functional differences in people diagnosed with psychopathy” were identified. Since you’re reading this book, it’s pretty plausible that you may have heard the terms prefrontal cortex and amygdala before. It’s also highly likely that you heard those terms fall from the lips of Dr. Derek Shepherd on Grey’s Anatomy, got distracted by his flowing locks, and aren’t totally certain what they actually mean, but don’t worry, we’ve got you.

  The prefrontal cortex is the brain’s control center and it’s located right at the very front, just behind our eyes. It’s responsible for executive functions like personality expression, decision-making, and moderating social behavior, but its main job is to control our emotional responses to stress. It functions kind of like an emergency brake or, according to neurocriminologist Dr. Adrian Raine, a guardian angel that stops us from making decisions we might regret.

  The amygdala, often referred to as the brain’s emotional center, is probably best known for its starring role in driving the fight-or-flight response, and as such it is associated with our responses to fear, stress, and anxiety. So, when you’re filled with increasing existential dread when facing a looming deadline, a social engagement you don’t want to be at, or another fuckboy appointment, that’s your amygdala working its magic. (So is the sweat imprint of your bum that you leave on the chair after a job interview. Thanks, amygdala.)

  The relationship between your amygdala and your prefrontal cortex is absolutely vital because it is believed to play a critical role in the regulation of emotion. How does it work? Well, the amygdala is there to detect threats in the environment, and when it spots one it sounds the alarm. The prefrontal cortex assesses the threat and then “tells” the amygdala whether the panicky alarm is proportionate. Essentially the amygdala is there to pick up on any biological or emotional stressors that may be dangerous (which is of course absolutely crucial to our survival), but the prefrontal cortex is there to course correct and calm the amygdala down so that we aren’t all freaking out from stress and having meltdowns at the slightest threat.

  When the connection between these two regions is weakened, it results in an individual’s inability to regulate emotion and social behavior in a typical way. This can lead to the callous, unemotional, and unempathetic behavior we would expect from a psychopath.

  What’s also interesting is that while this brain structure seems to be congenital in a psychopath, this lack of communication between the prefrontal cortex and the amygdala can also be induced by a significant brain injury. See our sidebar on head injuries to learn more.

  GAME-CHANGING HEAD INJURIES

  We’ve all heard stories about people having massive accidents and becoming total nightmares to be around—history’s most famous being Phineas P. Gage, who you can read about in consultant neuropsychiatrist Kieran O’Driscoll’s paper “No Longer Gage: An Iron Bar through the Head.” The title of the paper gives the game away—Gage had a 1.1-meter-long tamping iron wedged in his skull in an 1848 accident and he miraculously survived, but his personality didn’t. Before he took an iron bar to the prefrontal cortex, he had been a perfectly nice person. After the accident he was belligerent, irreverent, profane, and didn’t care about anyone but himself.

  As we will see in chapter 2, a lot of prolific serial killers sustained serious head traumas as children. If you have even a cursory interest in the National Football League and the sport that we like to call “American hand-egg” (known to many of you as American football), you may be aware of the devastating effects of the degenerative brain disease chronic traumatic encephalopathy (CTE).

  Only diagnosable after death, CTE is understood to be a result of repeated blows to the head and repeated concussions, such as those sustained in contact sports. In possibly one of the most harrowing cases of this condition, Aaron Hernandez, a former New England Patriots football player, murdered Odin Lloyd in 2013 before hanging himself in prison at the age of 27. When his brain was examined, according to the Washington Post, he was found to have “suffered from the most severe CTE ever found in a person his age.” And while one can’t say definitively that CTE caused him to kill, it certainly would have influenced Hernandez’s ability to manage his impulse control, decision-making, aggression, and rage.

  Testing Psychopaths

  Criminal psychologist Robert Hare is also the main man when it comes to spotting psychopathic personalities. Dr. Hare created the PCL-R, a test that can be used as a tool to determine whether someone is a psychopath, and it is considered to be the gold standard test across various disciplines. However, Hare expressly warns against nonprofessionals diagnosing those around them—so don’t do that. Just observe and feel smug at how clever you are.

  Hare laid out 20 key characteristics in relation to psychopathy. If a characteristic is spotted partially in a person, they get 1 point. If a characteristic applies to the person fully, they get 2 points. If a trait is not present at all, they are given—you’ve got it—no points. If an individual scores more than 30 points, they are, according to Hare, a psychopath. Interestingly, in the UK a score of 25 will get you over the psychopath line. What can we say, we just have lower standards when it comes to personality disorders (and teeth, if you ask Americans).

  So let’s take a look at the 20 characteristics, shall we?

  1 Glibness and superficial charm

  2 Grandiose sense of self-worth

  3 Pathological lying

  4 Conning/manipulative

  5 Lack of remorse or guilt

  6 Emotional shallowness/a shallow affect

  7 Callousness and lack of empathy

  8 Failure to accept responsibility for actions

  9 A tendency toward boredom/a need for stimulation

  10 A parasitic lifestyle

  11 A lack of realistic long-term goals

  12 Impulsivity

  13 Irresponsibility

  14 Poor behavioral control

  15 Behavioral problems in early life

  16 Juvenile delinquency

  17 Criminal versatility

  18 A history of “revocation of conditional release” (i.e., violating parole, skipping bail)

  19 Multiple marriages/many short-term relationships

  20 Promiscuous sexual behavior

  We all know someone who displays some of these traits; maybe we even display a few ourselves. For example, Suruthi impulsively buys skin care products and silk hair turbans, whereas Hannah gets bored at the speed of light, and we’ve both had our fair share of short-term relationships. But each trait exists on a spectrum, and there’s a threshold that needs to be met in terms of how damagingly impulsive you are, or just how lacking in empathy you are. If your behaviors fall within the parameters of what is generally acceptable and they don’t negatively impact your life, they don’t count. This is why assessment needs to be done via a clinician interview. Read our sidebar on Ted Bundy and his PCL-R test score to see why this checklist is still very subjective and open to interpretation.

  TED BUNDY

  Usually, you can’t utter the word psychopath without hearing the name Ted Bundy being whispered on the wind. And this time is no different, but Bundy’s PCL-R score is all over the bloody place. It is reported to be anywhere between the low 20s and a perfect score of 40. Lynne Awe and her paper, “Who Are They? The Psychopath and the Serial Killer Personality—Differences, Detection, and Diagnosis,” peg him at 24. Whereas, in “Psychopathy and Gender of Serial Killers: A Comparison Usin
g the PCL-R,” Chasity Shalon Norris gives him a 33, the highest in her comparative study. And trusty Wikipedia will tell you Bundy scores an almost perfect 39, so you can make of that what you will…

  Psycho Killer, Qu’est-ce que c’est?

  So far in this chapter we’ve talked about how psychopathy is predominantly genetic, but now the question is: Does having psychopathy really make you more likely to be a killer?

  Well, the stats are immediately far more interesting than with the warrior gene. For example, studies estimate that around 1 percent of the general population are psychopaths, and that about 16 percent of incarcerated males and around 7 percent of incarcerated females are psychopaths—so that’s quite an overrepresentation. But the issue is the latter figures include non-murderers and even nonviolent offenders, so let’s consider another study to understand the extent to which murder and psychopathy are linked.

  In 2018, the international study “Psychopathic Killers: A Meta-Analytic Review of the Psychopathy-Homicide Nexus” found that all the murderers in their sample had a higher tendency toward psychopathy than the average person, and that using the PCL-R checklist, just over a third of convicted murderers could be considered psychopaths.

  The study also went a step further and found that the more violent and extreme the murder (if it involved sexual and sadistic elements, for instance), then the higher on average the psychopathy score of the killer. This isn’t the only study to show this link; according to a study by psychiatrist Dr. Michael Stone—“Serial Sexual Homicide: Biological, Psychological, and Sociological Aspects”—a massive 86 percent of serial killers are psychopaths.

  In multiple studies, a clear link has been shown between psychopathy and violent crime, particularly murder. We think it’s fair to say that psychopathic traits—callousness, recklessness, impulsivity, a lack of empathy, and being driven by your own pleasure and self-interest—can lead to certain people committing horrific crimes. However, psychopathy on its own does not explain all the things that make a killer tick, as we will see over the course of this book.

  “Curing” Psychopathy?

  Is psychopathy curable? Short answer: no. Long answer: Also, kinda no…

  Hear us out, though, because this is a really important consideration. In the Bradley Waldroup case, we saw jurors’ hesitation to convict a man of murder if his genetics had played a significant role in driving his behavior. But on the flip side, there are many more cases in which the prosecution will successfully argue that a killer who has a personality disorder, or is psychopathic, can’t be cured or rehabilitated, so they should be locked up indefinitely. This doesn’t strike us as fair, and we don’t think that genetic conditions like this should play such a big role in sentencing either way (though obviously we’re not talking about conditions that affect a person’s intelligence, agency, or comprehension, which can of course influence culpability).

  So how do we tackle this? Well, there is no magic fix for psychopathy, but some behavioral studies have found that people with psychopathic traits can be made “functionally successful.” We’ll talk about this in more detail in the next chapter when we discuss children who display signs of psychopathy, but for now we’ll focus on the rehabilitation possibilities for psychopaths who have already offended.

  Let’s look mainly at the research of Dr. Kent Kiehl, neuroscientist at the University of New Mexico. Dr. Kiehl—after confirming his career-long suspicions that psychopathic brains are built differently from birth—decided to find out if that really meant that psychopathic people had no choice but to be bad. What he discovered was that while a carrot-and-stick approach works for most people, it doesn’t work for psychopaths. Psychopaths generally don’t care about consequences (or sticks), so punishment doesn’t make them act “better.” In fact, it usually makes them worse.

  Psychopaths are six times more likely than other criminals to reoffend after they are released from prison, and no one, including Dr. Kiehl, thought there was any way around that. Indeed, psychopathy seemed utterly untreatable until the Mendota Juvenile Treatment Center (MJTC) in Wisconsin started a groundbreaking program they called the “decompression model.”

  This center for juvenile delinquents trialed a revolutionary approach to rehabilitation based on positive reinforcement rather than negative. Decompression is the opposite of punishment. Three hundred kids at MJTC had good behaviors positively reinforced by the staff at every possible juncture and were rewarded with candy bars and video games when they met targets. The study recorded that in the group of boys rehabilitated using the decompression model, recidivism was reduced by 34 percent.

  On top of that, the young people who had been treated with positive reinforcement at MJTC were 50 percent less likely to later commit a violent crime, and none of them went on to kill people. Prior to their exposure to this model, almost all of the boys sent to MJTC were “deemed uncontrollable at other institutions,” and most of them had at least 12 charges filed against them and high PCL-R scores (well, the baby version of the test given to people under 18). These results showed that the decompression model significantly improved behavior in juvenile boys who had been diagnosed as psychopaths. Which is, as Kiehl put it, “staggering.”

  More staggering than that, though, is the fact that those subjects of the study who did not receive the decompression treatment went on to commit 16 murders between them. These findings are hard to argue with, and it looks pretty likely that when it comes to psychopaths, early intervention and more carrot than stick are key.

  2

  CHILDHOOD AND ADOLESCENCE

  Mommy Issues, Morbid Knights, and Murder Prodigies

  IT FEELS LIKE A GLARINGLY OBVIOUS POINT TO MAKE THAT a killer’s childhood has a massive impact on their future murder-y ambitions. But let’s talk about it anyway, because it’s fascinating—and there are still some surprises to be had and debunking to be done.

  From birth to age five, a child’s brain develops more than at any other time in life. So early brain development—and anything that may interfere with this, such as neglect, abuse, and trauma—can have an intense and lasting effect on a child’s future, including, in some cases, the possibility of them growing up to be the next Ted Bundy. (Well, minus the bell-bottoms and the unibrow, unless of course these things make a comeback. In a post-2020 world, anything could happen.)

  But it’s not just early childhood that’s important; what about the teenage years? Is there a more horrifying time in one’s life than the transition to adolescence? The acne, the puberty, the crippling social pressure, the Dream Matte mousse foundation, and the fact that the teenage brain is actually drawn to danger and risky behavior. This can make even the most run-of-the-mill adolescence a time of impulsivity, low empathy, and stress, leading to such terrible decisions as playing chat roulette with strangers on the internet, giving oneself aggressive blonde cap highlights, and perhaps most disturbingly of all, thinking white pedal pushers are acceptable.

  Now imagine the same hormonal changes and poor decision-making happening in an individual who is already genetically predisposed to psychopathy and who experienced an abusive childhood; we start to see the recipe for a killer emerge. But in these cases, how can one distinguish red flags indicating that perhaps something sinister is afoot from just normal teenage angst? And what, if anything, can or should be done about it? Most murderers don’t kill until their late twenties or beyond, but is it possible to discern killers, especially serial killers, as children? And if somehow we could, should children be labeled and diagnosed if they appear to show a tendency toward violent, destructive, or psychopathic behavior? Could this prevent a child from growing up to be a killer, or would it simply create a self-fulfilling prophecy and a way in which society further disadvantages a child who has already had a rough start in life?

  There is a lot to discuss when it comes to killers and their childhoods. In this chapter, we’re going to examine different types of killers based on early childhood abuse and trauma, and whethe
r labeling individuals who have psychopathic warning signs in childhood and adolescence is the right move.

  Kids Don’t Come with a “Factory Reset”

  Now, before we jump into the impact of abuse on future behavior, it is important to stress that, of course, the vast majority of people who have suffered some form of trauma in their childhoods do not grow up to become violent, let alone killers.

  And while not all killers are victims of abuse, most studies do agree that the majority of killers share a common backstory of past childhood trauma. For example, Heather Mitchell and Michael Aamodt’s 2005 study, “The Incidence of Child Abuse in Serial Killers,” showed that at least 26 percent of serial killers had experienced childhood sexual abuse, 36 percent had experienced physical abuse, and a whopping 50 percent had been psychologically abused as children.

  The same report also found that serial killers were six times more likely to have been physically abused and nine times more likely to have been sexually abused than the general population.

  Research shows what we already logically suspected: abusing a child most certainly increases the likelihood of that child growing up to be more violent. And before you’re like, well, duh, as obvious as this point feels, the reasons for this link are multilayered and worth talking about.

  Why does childhood abuse drive a killer? There are two reasons.

  First, abuse may cause brain damage. And that damage can cause actual structural changes to the child’s brain, which can lead to cognitive processing problems and lowered impulse control, two key traits often linked to killers. This brain damage can also be a result of an accidental head injury; killers like Fred West, Edmund Kemper, John Wayne Gacy, Richard Ramirez, Jerry Brudos, Gary Heidnik, and Ed Gein, to name just a few, all suffered serious head injuries as children or adolescents.