Murderous Minds (8 page)

The fourth category concerns Antisocial factors: Poor Behavioral Controls, Early Behavioral Problems, Juvenile Delinquency, Revocation of Conditional Release, and Criminal Versatility. This dimension,
David Kosson and Robert Hare maintain, “is associated not with criminal behavior per se, but with early, versatile, and persistent antisocial behavior that often is extremely distressing and frustrating for others.”
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The final two topics look like they should fall into one or more of the above categories, but statistical analysis doesn’t support this: Failure to Accept Responsibility and Many Marital Relationships.

Dixon scored high enough on the test of the above items to be considered a psychopath in the eyes of the legal system. Spiegel’s NPR piece made it clear she believed Dixon’s test result would condemn him, perhaps unfairly, to prison for life despite the change for the better his family and friends had seen in him in recent years. His evaluation should have considered the fact that as a youth he had threatened to kill his father and commit suicide, and that he had been convicted of assaulting a woman and raping another during a date. It’s not unusual for people with high psychopathy scores to mellow with age, to turn down the antisocial behavior, if not the attitudes associated with it. It’s also not unusual for them to manipulate the system and act however they need to act to get what they want. In some cases, it is possible that the perception of “mellowing with age” is simply an act.

From 1956 to 1957, Peter Woodcock, for example, killed three children in Toronto, Canada. He was seventeen years old at the time and had endured a tragic childhood, although he impressed his high school teachers as being intelligent and charming. After thirty-four years of treatment in a psychiatric institution, and now aged fifty-one, he managed to convince the staff that he should receive his first day pass. Within hours, he killed a fellow inmate, twenty-seven-year-old Dennis Kerr, on the perimeter of the hospital grounds by beating him with a pipe wrench. He said he would have killed another man too, but was too tired.
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There is no scientific way to balance forgiveness and wariness. Many researchers remain convinced that high-scoring individuals can never be treated, trusted, or changed, while others say that change is possible. But no parole board or judge wants to risk taking the blame if someone they release commits a heinous crime. They don’t want to have critics point at them and say “You released a psychopath?! What were you thinking?”

When Hare, a pioneer of modern psychopathy research, began to study psychopathy in the late 1960s, there was no reliable—or even generally
accepted—way to measure the degree of psychopathy in a person. The best measurement systems then available were “inventories” like the Minnesota Multiphasic Personality Inventory, which had been developed in the 1930s. These have the drawback of depending on the word of the subject; that is, they are self-report inventories. Needless to say, people with strong psychopathic traits are not the most reliable sources of insight into their thoughts and motivations, since deception and lying are often prominent features of psychopathy. Many people with this type of personality—or, in the opinion of some, personality disorder—can and have figured out what is being tested and adjusted their answers to sway the results.
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A better way to measure a person’s degree of psychopathic traits was necessary if scientists were ever going to understand the subjects they wanted to study.

During the development of his groundbreaking measurement instrument, Hare was influenced
³⁹
by psychiatrist Hervey Cleckley’s 1941 book,
The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality
.
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The anonymous, mostly favorable review of the book in the
Journal of the American Medical Association
(JAMA) began: “As a psychiatrist in the United States Veterans Administration, the author became interested in that nosological [disease classification]
wastebasket
known as ‘psychopathic inferiority’ and its diagnostic variations [emphasis added].”
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Now a classic in the field, the book included 15 detailed case histories and descriptions of patients with psychopathic traits, whom Cleckley—then a professor of neuropsychiatry at the University of Georgia School of Medicine—had encountered during his career.

In gathering together these case histories and describing the personality disorder of psychopathy in 1941, Cleckley took a fresh look at a subject to which scattered references had been made for hundreds of years, and which had been described in various ways since the end of the 19th century.
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French physician Philippe Pinel, a key figure in the history of psychiatry, used the phrase
manie sans délire
in 1801 to describe people he recognized as having “insanity without delirium.” People lacking consciences came to the attention of at least one eminent physician in North America too: just a year before he died in 1813, Dr. Benjamin Rush, a pioneer of American psychiatry and signer of the Declaration of Independence, described them as people with a “moral derangement.”

You can spot familiar aspects of the psychopathic personality in people who were later described as suffering from “psychopathic inferiority,” “psychopathic personality,” and one now-quaint but descriptive phrase: “moral insanity.”
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English psychiatrist James Pritchard introduced the term in 1835 to describe individuals whose moral judgment was absent or flawed but whose intellectual judgment was intact. Moral insanity captures the unique and troubling blend of seemingly rational thought processes—free of hallucinations and thought disorder—and the depravity of criminal psychopathic crimes.

It is the kind of murderous depravity that makes the morally sane mutter “Whoever did that
has
to be insane.” But it would be more accurate to mutter, much less succinctly, “Whoever did that has to be insane, or has to have a personality disorder referred to as criminal psychopathy.” Both Pinel and Pritchard warned their readers that people with insanity without delirium or moral insanity were next to impossible to treat, a belief that would be shared by many mental health professionals into this century.

The 19th-century psychiatrist and “criminal anthropologist” Cesare Lombroso liked the phrase
moral insanity
too. As far back as 1876, Lombroso tried to convince the world that criminal behavior had its roots in biology. Here’s how his adoring daughter Gina summarized his description of one type of criminal in Lombroso’s files:

“No one, before my father, had ever recognized in the criminal an abnormal being driven by an irresistible atavistic impulse to commit antisocial acts, but many had observed (cases of the kind were too frequent to escape notice) the existence of certain individuals, nearly always members of degenerate families, who seemed from their earliest infancy to be prompted by some fatal impulse to do evil to their fellow-men. They differed from ordinary people, because they hated the very persons who to normal beings are the nearest and dearest, parents, husbands, wives, and children, and because their inhuman deeds seemed to cause them no remorse. These individuals, who were sometimes treated as lunatics, sometimes as diseased persons, and sometimes as criminals, were said by the earliest observers to be afflicted with moral insanity.”
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Lombroso insisted that criminals had distinguishing, often inherited, physical and mental abnormalities. Today, scientists are comfortable
entertaining the possibility of mental anomalies and genetic influences.

They long ago discounted Lombroso’s suggestion that born criminals could be distinguished from decent folk by the shape of their skulls, facial bones, projecting ears, receding foreheads, badly shaped teeth, and other physical markers he called “stigmata.” An intriguing and complex character, the Father of Criminal Anthropology was typically racist for his time but also supported more humane treatment for criminals, whom he saw as primitive evolutionary throwbacks.

Lombroso was only ten years old in 1845 (a decade after Pritchard described moral insanity), when the word
psychopathy
, used in the modern sense, first appeared in print. It showed up in
The Principles of Medical Psychology, Being the Outlines of a Course of Lectures by Baron Ernst von Feuchtersleben
, by whom else but Baron Ernst von Feuchtersleben.
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After this work was translated four decades later, von Feuchtersleben’s label became more common in English speaking countries. The concept of psychopathy, however, would remain a wastebasket diagnosis in the U.S. until Cleckley wrote his classic.

“With a flair for the literary,” the JAMA reviewer noted, Cleckley presented key behavioral patterns and personality traits characteristic of psychopathic personalities to his fellow psychiatrists. He provided evidence that psychopathy was worthy of more serious study than it had received.

The Gold Standard or the 800-Pound Gorilla

Unfortunately, fellow psychiatrists failed to follow up on the insights into psychopathy that Cleckley offered. Psychologist Hare recognized the value of Cleckley’s work and used it as the basis for the earliest versions of what was to become the Psychopathy Checklist, which he introduced in 1980. He issued a revised version, the Psychopathy Checklist–Revised (PCL–R), in 1991. The second edition of the PCL–R was published in 2003.
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Some researchers aren’t happy with the status of the Antisocial factors in the PCL–R. David Cooke, Professor of Forensic Clinical Psychology, and his colleagues at the Glasgow Caledonian University, for example, conclude that “antisocial behavior is best viewed as a secondary symptom or consequence of psychopathy.”
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Hare and his colleagues disagree. They point out that a psychopathic offender’s tendency to botch the opportunities
afforded by parole and probation—like “LTK,” a prototypical criminal psychopath we’ll meet in Chapter 7 and rapist/murdered Brian Dugan, whom we’ll meet in the last chapter—as well as his tendency to get into trouble when behind bars and to engage in criminal activity, “appear quite useful in identifying psychopaths within offender samples.” They also acknowledge that not enough studies examining the importance of antisocial features in non-offenders have been done, but they add “the available research is consistent with clinical lore about individuals with psychopathic personalities who do not break the law.”
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Hare also notes that critics ignore the fact that the shorter screening version of the PCL–R is a parallel instrument that is designed for use in people who are not criminals, and yet, research results show, that it does exactly the same thing PCL–R does.

This and other criticisms surrounding the use of the PCL–R inspired Adrian Raine, a professor of criminology, psychiatry, and psychology at the University of Pennsylvania, to mischievously ask a provocative question at the 5th Biennial Meeting of the Society for the Scientific Study of Psychopathy. It was, he said, a question that many psychopathy researchers were gossiping about. “Does the psychopathy checklist have too much of a stranglehold on research in psychopathy?” he asked the two hundred or so psychologists, neuroscientists, psychiatrists, students, and journalists gathered in the grand ballroom of the L’Enfant Plaza Hotel in Washington, D.C., on June 6, 2013.

Was the PCL–R, he continued, “the 800-pound gorilla” in this field?
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An important inspiration behind his controversy-spurring challenge to the attendees was a 2011 paper by Jennifer Skeem of the University of California, Irvine and her colleagues.
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That monograph, Raine said, implied that the checklist has done a wonderful job in the past twenty or thirty years of promoting progress in the field, but there is a “worry that psychopathy, the construct, is getting equated with a measurement instrument.”

Raine here indeed touched on a sensitive issue in the field: when many people say PCL–R, they mean psychopathy. “And that really rankles a lot of people,” according to Hare.

Perhaps, the review suggested to Raine, other ways of measuring and rating psychopathy should be more widely tested and used. To Raine, it
seemed like a call to “not get ourselves blinded by always using the psychopathy checklist.”

Many psychologists might not agree, but it might be useful to compare the concern—that a measure of psychopathy is being confused with psychopathy itself (or the construct of psychopathy, as psychologists would put it)—to the study of another controversial topic: intelligence. Early tests of intelligence were once confused with the nature of intelligence itself—that is, the construct of intelligence.

Psychologists continue to refine intelligence tests and develop new theories of intelligence. For example Howard Gardner’s IQ test measures what he refers to as “multiple intelligences.” In addition to verbal and mathematical skills, he tests mechanical, physical, musical, and social skills. The cognitive psychologist Robert Sternberg suggests that intelligence involves three components. His triarchic (a fancy word for three-component) model includes creative, analytical, and practical or common-sense intelligence.
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Everyone has an intuitive sense of what intelligence is, but measuring it clearly is not a simple matter. Different measures of intelligence seem to bring us closer to different aspects of the essence or the construct of intelligence.