Murderous Minds (4 page)

A major problem is that people frequently confuse psychotic with psychopathic. Psychopathic and psychotic are two different terms used by professionals to describe people with very different mentalities.

Psychotic
refers to psychosis, a key feature of serious mental illnesses like the one that afflicts Jared Loughner: schizophrenia. During and before his shooting spree, he displayed classic symptoms of psychosis. They included mental derangement with a loss of contact with reality, hallucinations, delusions, and disorganized thought, speech, and behavior.

In popular culture, the word “psycho” is thus an inaccurate and confusing mixture of an offensive word for someone with a mental illness and/or someone who is a psychopath. Psychopathy is not madness. People with undeniable and striking psychopathic traits, people like Eric Harris, remain sane in the eyes of the law. They appear quite sane too, even to experts who know they are different from you and me, because of their complete lack of empathy and conscience. They can easily fool family, friends, court officials, strangers, and even mental health professionals who haven’t had a chance to examine them closely.

Part of the confusion stems from the fact that, as we have seen in the cases of Jared and Eric, people with psychosis sometimes commit the same kinds of crimes that some criminal psychopaths commit. The difference is
that a psychopath on a killing spree knows what he (the killer is usually a male) is doing and he knows it is wrong. He is in touch with reality and very likely enjoying what he is doing. Witnesses heard Eric laughing during his shooting spree and appearing to have a great time.

A psychotic person, by contrast, acts in response to delusional, often paranoid thoughts, as when Jared became obsessed with Giffords because he perceived a personal slight after she failed to respond to his question: “What is government if words have no meaning?” A psychotic person is out of touch with reality. He or she cannot distinguish between what is going on in the outside world and what is going on inside their heads. Theoretically, in a legal sense, psychotic individuals should not be held accountable for their actions. Medically, they are mentally ill and suffering from a brain disorder. In the real world, violent psychotic individuals are often convicted as if they were in touch with reality and aware they were committing crimes society agrees are abhorrent. In courtrooms in the real world, mentally ill killers are often treated like psychopaths, who actually know better but don’t care.

If we ever hope to prevent such tragedies in the future, we will have to intercept the Erics and Jareds and Adam Lanzas of the world before they make their murderous plans. To do that, educators and mental health professionals will have to make better use of mental-illness screening programs. And neuroscientists will have to find out more about brain abnormalities that are present before the killing starts if they are to make a contribution to deterring criminal behavior in society.

Jared’s violent behavior started with his pulling out a 9-mm pistol and emptying its ammunition clip into a group of people gathered in front of a grocery store in Tucson, Arizona. The reason he did it lies somewhere in, or perhaps throughout much of, his brain, which was deranged by paranoid schizophrenia.

We know where and when Loughner obtained his murder weapon. He legally purchased it from a gun store near Tucson on Tuesday, November 30, 2010. We are not so sure where or how he acquired his mental illness. We do know it developed long before the day he used his semiautomatic handgun to shoot nineteen people, killing six of them.

Jared’s mental disorder may have developed more than twenty-two years earlier as his fetal brain grew and developed. By the time he was in his late
teens and early twenties, the overt symptoms of paranoid schizophrenia began to become obvious.

However the disorder developed in his brain, it was there long before he became violent. In the months before the attack, his behavior and thought processes became erratic, his anger troubling.

“My concern was like, meth or something … because his behavior and his, was, um, odd,” his mother said later.
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He was disruptive in his college classes and eventually expelled. His behavior led his father to confiscate his shotgun and at times to prevent him from using the family car. But when he tried to talk to Jared on the day of the attack, his son walked out.

“Sometimes you’d hear him in his room, like, having conversations,” his mother recalled. “And sometimes he would look like he was having a conversation with someone right there, be talking to someone. I don’t know how to explain it.”
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The explanation is, of course, that Jared was hallucinating because he had a brain disease. The illness that twisted Loughner’s thought processes is a very familiar, poorly understood, complex disease which typically begins to show in the late teens or young adulthood. His illness was there that Tuesday in 2010 when he purchased his Glock handgun. It was certainly there a little over a year and a month later, on January 8, 2011, when he took a cab to the parking lot in front of the Safeway grocery store in Tucson. It was there when he inserted earplugs, to protect his ears from what he was about to do. It was there at 10:10 a.m. that Saturday when he opened fire, shooting U.S. Representative Gabrielle Giffords in the head before turning the gun on the crowd.

It is possible that it had been developing a long time before it became apparent to his friends and family. Many things Jared and his mother possibly were exposed to—for example, flus and other viruses—could have interacted with the genes he inherited to result in paranoid schizophrenia. The possible factors that might have transformed Jared’s predisposition to schizophrenia into the tragic, crippling reality of severe mental illness range from exposure to maternal infections and stress before birth to exposure to stress during childhood.

While the cause of schizophrenia is unknown, many researchers believe it is a neurodevelopmental disorder, which could be one reason its symptoms
become apparent in late adolescence or young adulthood. Interactions between some of the genes people like Jared are born with and things they are exposed to in the environment are suspected of producing abnormalities in brain function and structure.

For example, in 2013 when Jong H. Yoon and his colleagues at the University of California-Davis used functional magnetic resonance imaging (fMRI) to measure activity in the brains of 18 individuals with, and 19 without, schizophrenia, they saw
decreased
activity in the prefrontal cortices of those with the mental disease.
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The cells in this part of the brain, located behind the forehead, are closely associated with higher mental functions. They influence your ability to set priorities, make plans, figure out strategies, and predict the consequences of your actions. Brain scientists call these “executive functions.” It is a part of the brain, as we will see, that is also implicated in psychopathy and other disorders.

At the same time that the prefrontal cortices of people with schizophrenia appear to have
decreased
activity, another part of the brain appears to have
increased
activity. This is the substantia nigra and it is located deep in the brain, in a subdivision called the midbrain. The researchers found that communication between the prefrontal cortex and the substantia nigra was weaker in the group of people with schizophrenia.

Latin speakers can readily figure out that brain cells in the substantia nigra are pigmented; the translation is “black substance” or “black body.” The color comes from melanin, a pigment produced when the neurons make dopamine, a neurotransmitter closely associated with schizophrenia. Antipsychotic medications prescribed to treat schizophrenia interact with dopamine-signaling mechanisms in the brain.

Another condition linked to the substantia nigra is Parkinson’s disease, in which these pigmented neurons are lost. The loss of dopamine-producing neurons in the substantia nigra affects a neighboring part of the brain called the striatum, whose cells depend on dopamine to function properly.

The connection between the striatum and the substantia nigra may also play a role in schizophrenia. The results suggest that communication between these regions is “out of sync”
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in the people with schizophrenia.

Furthermore, the research turned up evidence of a correlation between

how psychotic a person was and how closely connected his or her substantia nigra was to the nearby striatum.

The study needs to be reproduced with more subjects before we can be sure the results represent a general finding in schizophrenia. But they raise the possibility that the communication pathway, or neuronal circuit, that connects the prefrontal cortex with the basal ganglia may be a route through which psychoses are linked to the disordered thought patterns that characterize schizophrenia. Distinct pathways that connect the same brain structures but which follow different routes are being implicated in other mental illnesses and with personality disorders like psychopathy.

Our society’s routine failure to examine people like Jared is a wasted opportunity to increase our insights into abnormal behavior. No one knows if Jared’s prefrontal cortex would have looked less active while his basal ganglia looked more active compared to healthy individuals. We don’t know if, like some people with schizophrenia, he has slightly less gray matter in parts of his cerebral cortex or if he has slightly larger-than-normal, fluid-filled spaces called ventricles in the middle of his brain, as some people with schizophrenia do. He and other prisoners can’t be forced to volunteer for scientific study.

At first thought, you might suppose that smaller brain volume must be due to loss of brain cells. But it might be due to neurons being smaller in these brains. Decreased volume in the cerebral cortex also might be due to decreased density in the mass of intertwined contacts and connections among brain cells.
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The projections of neurons, which receive and send signals to other brain cells, are called axons and dendrites. Together with a second type of brain cell called neuroglial cells or glia, these projections form an intricate and very complex network of interwoven processes in your brain called the neuropil. It is in this meshwork that much of the cell-to-cell communication that underlies thinking and feeling is somehow realized. It’s easy to imagine how reducing this crucial area of brain cell interaction and communication could severely compromise thought processes.

Jared had never been treated with antipsychotic medications before he attacked. One caveat of research on people with schizophrenia is that many of them, unlike Jared, have received antipsychotic drugs before and during
the time they are examined by scientists. Could long or short-term exposure to these powerful medications be responsible for the brain changes we see in people with schizophrenia? Researchers in this field, like Yoon and his collaborators, acknowledge the possibility that such drugs could make a difference and that their work should be extended to include people who have not yet received medication.

Yet we also know that in the past four decades, more than 120 studies have reported neurobiological abnormalities in the brains of people with schizophrenia who have never received a single dose of antipsychotic medication.
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There seems, therefore, to be strong evidence that the brains of people with schizophrenia are physically different from the brains of people without schizophrenia. But it’s not quite that simple.

It turns out that the brain abnormalities associated with schizophrenia are not really limited to schizophrenia. We are more likely to find them in people with schizophrenia, but you can also find them in people with other brain diseases, such as Parkinson’s disease, and even in people with no brain disease at all.
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Later we will see that some of the differences associated with the brains of psychopaths can sometimes be found in the brains of people with few psychopathic traits. Biological results often fall short of being completely black or white.

However Jared’s brain differs from that of an average healthy person, we do know that it does respond to antipsychotic medication, the only means we now have for treating the delusional thought processes that led to six deaths, thirteen disrupted lives and intense suffering for family and friends of the victims. Jared’s apprehension eventually led to his being forced, under court order, to take antipsychotic medication. Only under its influence would he begin to get a sense of the horror he had perpetrated.

Jared was charged with murder, attempted murder, and the attempted assassination of a member of Congress. A psychiatrist and a psychologist diagnosed paranoid schizophrenia following a total of sixteen hours of interviews. Loughner, they reported, was delusional and hallucinated. His thoughts were disorganized, random and bizarre. In August 2012, he pled guilty to nineteen charges to avoid the death penalty. Given a life sentence, he is now receiving court-ordered antipsychotic medication at the U.S. Medical Center for Federal Prisoners in Springfield, Missouri.
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Forensic psychologist J. Reid Meloy has studied the crimes of people like Jared and other mass murderers, both adolescents and adults, which have occurred over the past half-century. “The majority of adult mass murderers typically are individuals who have a psychiatric history and typically a majority is psychotic at the time that they’re actually carrying out the killing,” Meloy said in a 2007 interview on NPR.
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The minority who are not psychotic include rare depressive individuals like Dylan Klebold who want to take others with them on their suicidal journey. Another minority are individuals with many psychopathic traits, like Eric.