The Psychopath Whisperer: The Science of Those Without Conscience (36 page)

It is a symptom that is almost an oxymoron. I had been trained to believe that all behavior is motivated. But as I stared into that mirror, I truly understood for the first time what Cleckley meant when he included that symptom in describing psychopaths.

Psychopaths lack an ability to understand why they commit antisocial acts. They truly don’t have the motivation that someone else might have.

I wasn’t frustrated or angry anymore that Brian could not articulate why he committed those heinous crimes. I understood now that he lacked the capacity to understand. He was never going to be able to give a
normal
answer to the question of
why
.
⁴
There was never going to be a
logical
answer that he would argue to try to justify those terrible crimes.

When Brian was asked why he killed those girls, his mind just went blank. It’s how the rest of us might feel if we were asked to solve Albert Einstein’s field equations for the theory of general relativity—just plain emptiness.

Psychologists want to know what motivated Brian, and the millions of other psychopaths like him, to commit violent antisocial acts. But sometimes psychopaths do things without reason, without motivation. The rest of us search for some logic, albeit a morally
twisted logic, that we can use to understand why. I came to accept the fact that there is no logical answer to many of the crimes people like Brian commit—as disappointing as that might seem.

As I stared into that bathroom mirror, I knew what I had to do next. Brian himself might not be able to tell me why he did the things he did, but his brain might.

I was overcome with an intense desire to use my mobile MRI to peer inside Brian’s brain to find the answer to my burning question of
why
. I knew that Brian was unable to articulate his reasons for his actions, but unlocking the secrets of his brain might give me an answer that he could never articulate. Somewhere inside that head of his was a clue to how he became so disordered. And I was going to find it.

The idea of unlocking the mysteries of Brian’s crimes by peering into his brain may seem a bit funny. But many individuals afflicted with a mental disorder are unable to articulate why they acted the way they did.

One of my favorite examples is of an individual I’ll call “Brad.” Brad was a typical forty-year-old guy. He had no history of mental illness, no history of problems at home, work, or school. He had a master’s degree and worked as a schoolteacher, and he had recently married a woman who had a young daughter.

About two years ago, Brad developed a voracious interest in pornography. He spent hours collecting porn magazines and searching the Internet. He then started to visit massage parlors looking to solicit sex from the women working there. Brad later reported that his sex drive was so severe he felt he could hardly contain himself. Yet he felt this behavior was immoral, so he concealed it from his wife. Then one evening he made sexual advances toward his prepubescent stepdaughter.

Brad’s stepdaughter reported his behavior to her mother, who had him arrested and removed from the home. Brad was diagnosed as a pedophile and prescribed a medicine (medroxyprogesterone acetate)
designed to “chemically castrate” him. Brad was a first-time offender, and a judge sentenced him to a secure inpatient sex addiction rehabilitation program.

Brad’s sexual behavior continued to deteriorate while he was in the treatment program. He propositioned other clients and even some of the staff. He was eventually expelled. Because Brad failed the rehabilitation program, the judge was going to sentence him to prison. On the evening before he was to be transported to prison, he complained of a severe headache. The doctors ordered an MRI, and they found a huge tumor in the frontal lobes of Brad’s brain just above his eyes. This area, the orbital frontal cortex, is known to regulate impulse control and emotional reactions.

Brad’s tumor was successfully removed. After recovering, he no longer reported any sexual interest in pornography, prostitution, or his stepdaughter. He was released from the hospital, and his wife took him back into their home. All went well for over a year. Then Brad developed inappropriate sexual thoughts again. He received another MRI and discovered the tumor had grown back. He was successfully treated again.
⁵

My point is that it’s easy to understand how gross brain abnormalities, like a tumor, can radically change a person’s behavior. Yet those afflicted are unable to articulate why they are behaving badly. During interviews prior to learning that he had a tumor, Brad just said that he had a strong sex drive. Brad did not know that the reason he wanted to have so much sex was that his brain was literally being crushed by a tumor. It was only after the tumor was discovered that Brad had an explanation for his inappropriate sexual behavior.

Some legal scholars feel that Brad should still be found guilty of the crime of molesting his stepdaughter, regardless of whether his tumor caused him to do it. Indeed, some scholars argue Brad would be guilty if a little green alien in his head caused him to do it; that is, such scholars believe that if discovering the mechanism that causes a person to misbehave excuses that person from criminal responsibility, then there is no criminal responsibility, because all behavior is caused by something. University of Pennsylvania law professor Stephen Morse refers to this causal conundrum as the “fundamental psycholegal error.”

As interesting as the philosophical tenets of the doctrines of criminal responsibility are to debate, most people, including the US Supreme Court justices, argue that whereas individuals with brain differences or abnormalities might not warrant a complete exception from all criminal sanctions, the presence of such abnormalities does diminish their personal culpability. It was this language the US Supreme Court justices used when they eliminated the death penalty for youth (
Thompson v. Oklahoma
and
Roper v. Simmons
) and individuals with low IQ (
Atkins v. Virginia
).
⁶

In essence, the Supreme Court’s position is that populations of individuals with
different
behavioral profiles, and therefore
different
brain profiles, can be less culpable than healthy
normal
populations with respect to the death penalty. Juveniles who have not yet had time to reach full brain maturation and individuals with low IQ who have significant brain gray matter density are less culpable than normal adult populations because their brains are different. These positions are well supported by extensive behavioral evidence indicating youth and individuals with low IQ are fundamentally different from healthy adults, and the associated new neuroscience further bolsters this position.

The Supreme Court also has said that with respect to the doctrine of retribution—the interest in seeing that the offender gets his “just deserts” or an eye-for-an-eye—the severity of the appropriate punishment necessarily depends on the culpability of the offender.
⁷
This seems intuitive. We punish youth less than adults, and we punish individuals with low IQs less than adults because we feel they are less responsible for their behavior.

Further, the American Psychiatric Association and the American Psychological Association have argued that developments in brain science continue to support that adolescents and individuals with low IQ should not receive severe sanctions because of their behavioral and brain differences relative to healthy adults. Proponents of this view continue to support legal cases that chip away at severe sentences, like the virtual death sentence—life without the possibility of parole—for adolescent offenders. Supporters argue these severe sentences should also be abolished under the same logic as
Thompson,
Roper
, and
Atkins
. Their efforts have been successful, and in a series of subsequent decisions the US Supreme Court has eliminated some of the most severe criminal sanctions for youth under certain circumstances. There are many additional cases pending where juvenile justice reformers are using new neuroscience to make arguments for reduced culpability for adolescents.

I find the logic in these arguments compelling and yet very challenging for society in general and the legal system in particular. The new neuroscience routinely demonstrates how mental illnesses are related to brain abnormalities. Neuroscience studies are routinely showing that posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), schizophrenia, bipolar disorder, borderline personality disorder, and most other major mental illnesses are associated with impairments in brain structure, function, and connectivity. And one condition in particular that has piqued legal interest is the new neuroscience associated with psychopathy.

Lawyers who do capital litigation are required to evaluate all aspects of a defendant’s background to identify potential mitigating factors the jury will weigh in making their sentencing decision. If a lawyer fails to consider any potentially relevant mitigating factors, it can lead to successful appeals on the grounds that the counsel was ineffective in defending the client. Neither the mitigation lawyers nor the prosecution want that to happen because the former may end up disbarred and the latter may end up having to retry the case.

I gave my presentation to the Dugan legal team on the current and potential future uses of neuroscience in the courtroom. They quickly concluded there were many reasons to conduct an MRI exam on Brian.

Brian’s life history was full of facts that might indicate brain abnormalities. Birth complications, early head trauma from banging his head against the wall to silence his persistent headaches, the severity and longevity of his headaches, numerous concussive events as
a youth and at least one as an adult, and brain damage from alcohol and drug abuse were just some of the items that, in isolation or in combination, might be associated with neural trauma.

After reviewing my presentation on the latest neuroscience of psychopathy, the legal team wanted me to determine whether the structure and function of Brian’s brain fit the profile of the hundreds of other psychopaths my laboratory had scanned. The legal team wanted to make the argument that psychopathy constituted a developmental disorder of emotion, and the new neuroscience might help make their point. This, the legal team felt, was something the jury needed to consider, and they would be remiss not to present this new science.

The legal team quickly got approval from the judge to get an MRI session for Brian. The judge, and even the prosecution, had agreed there were many reasons to have a look at his brain. I think the judge and the prosecution shared my interest in knowing if there was something different about Brian’s brain.

After getting approval for the MRI scan, it fell to me to find a place where Brian could get the procedure completed. I told the legal team the MRI scanner we needed to conduct functional MRI studies would require special, and expensive, hardware that most average MRIs would not have available. Fortunately, my search was fairly easy to complete. I knew the Northwestern University medical campus in downtown Chicago had a research-dedicated Siemens MRI system like the one we used. So I called up the head physicist, Dr. Todd Parrish.

Over the phone I explained to Todd that a legal team wanted to do a brain scan of a convicted serial killer.

“Cool,” he said. “I’ve never looked at a serial killer’s brain before.”

I asked Todd if he had any concerns about doing the case study. “Nope,” he replied. “It might liven things up around here.”

“We need to install some custom code on the MRI scanner and set up our tasks on your projection system,” I said.

“Not a problem,” Todd replied confidently.

Our custom code was pretty complex. It really dug deep into the Siemens software to pull out the raw imaging data at its earliest stage. I finished the call by detailing the type of custom imaging sequences
and extraction code we would need to install on the Siemens MRI machine.

Todd is one of those rare physicists who can make an MRI machine hum any tune he desired. He installed all our custom sequences and code in a matter of minutes.

I was impressed.

Then Todd installed all the custom software needed to present the emotional and cognitive tasks Brian was going to perform while we collected images of how his brain functioned. He even set up our custom hardware for us so that we could monitor how Brian performed in real time.

I was even more impressed.

The primary purpose of the MRI scan was to make sure that Brian didn’t have some sort of gross brain abnormality, like a cyst or tumor. The next question the MRI scan might answer was whether Brian had any visible brain abnormalities from the concussions he had suffered over the course of his life.

The legal team had also asked me to do a comparison of the gray matter density of Brian’s brain to see if it fit the same pattern of abnormalities we have found in other psychopaths. And finally, I was going to examine whether the pattern of Brian’s functional brain activity during emotion and attention tasks matched the psychopathic profile we had found in prior studies.

The question was: Did Brian show deficits in brain structure and function in the paralimbic regions of his brain?

After quite a few conference calls with the DuPage County sheriff’s office, the legal team, and Northwestern security staff, we managed to arrange the transport of Brian Dugan from DuPage County Jail in Naperville thirty miles to downtown Chicago to be scanned at Northwestern’s state-of-the-art Siemens MRI scanner.

Todd had asked that we arrange the scan session on a Saturday morning so the research area would be largely vacant. He didn’t want graduate students walking into the MRI suite and bumping into a serial killer.

I flew to Chicago the night before Dugan’s scan session and had dinner with Todd. We reviewed the protocols, and Todd assured me that everything was working fine.

Todd liked our code that interfaced with the Siemens software and pulled the MRI data off the scanner in 32-bit high-resolution format, and he asked if he could keep some of it. Siemens’s engineers designed their MRI systems to collect extremely precise detail in the images. But in the United States, MRI scanners have adopted a low-resolution 12-bit radiological image standard called
DICOM
. The human eye can see only two hundred shades of gray, so radiologists thought they did not need all the extra resolution since they simply visually inspect the images to make their diagnosis. However, the algorithms we use to analyze functional brain imaging data can see many more shades of gray than the human eye, and the results are a lot better when we use the high-resolution data. I was planning to unleash the latest, most sophisticated algorithms in my neuroscience arsenal to find out what was going wrong in Brian Dugan’s brain.