http://www.abc.net.au/radionational/programs/allinthemind/the-psychopath-within/5415302#transcript

Sunday 4 May 2014 5:00PM 

When neuroscientist James Fallon was studying the brain scans of serial killers he noticed that his own scan looked remarkably like one of his psychopathic subjects. When you hear about some of his character traits, and his seemy family background – it begins to make sense. Plus, can we prevent so-called 'callous and unemotional' kids from becoming psychopathic adults?

 
Transcript

Lynne Malcolm: Welcome to All in the Mind on RN, Lynne Malcolm with you, and today, an insight into the mind of a psychopath.

James Fallon: So I'm like a borderline pro-social psychopath, I guess, but I'm a lucky one.

Mark Dadds: So there's children lacking in empathy—cold, tending to use predatory type bullying and aggression, and have no sense that they're to blame, and if something goes wrong they just don't care.

Lynne Malcolm: Mark Dadds, professor of clinical child psychology at the University of NSW, and more from him later.

Now though, let me introduce you to James Fallon, professor of psychiatry, neuroscience, human behaviour and neurobiology at the University of California, Irvine, and a self-confessed psychopath.

How did he come to that realisation? Well, in 2005 he was juggling two research projects; one was investigating the likelihood of Alzheimer's disease in his own family, and the other was researching psychopathic tendencies in serial killers. For both he was using brain scans, and one day all the images were piled up on his desk, then, as he describes it, Gandalf showed up at his door.

James Fallon: I found out that the pattern that was in those scans, one of the people, right at the bottom of the pile, was extremely abnormal and it looked exactly like one of the murderers' brains that I'd been looking at. It was like the pure form of the murderer. It didn't have the other sort of damage you would see from head trauma or drug abuse. So it was just kind of this pure thing that I'd just started to lecture about and write about. And so it was in the wrong pile but it turned out that it was me. And that was Gandalf.

Lynne Malcolm: Right! You include the images of the scans in your book, yours compared to what is called a normal scan, and they really are distinctly different. How did you feel when you first realised that they were correct?

James Fallon: I laughed. I just kind of laughed it off. I didn't think anything of it, because I briefly thought to myself, well geez, I'm not a psychopath, I haven't killed anybody, I'm not a rapist. And when that week I brought them home to show my wife, I said, 'You've gotta check this out.' And she said, 'It doesn't surprise me.'

Lynne Malcolm: And then, James Fallon's mother was on the case.

James Fallon: And she's going, 'You've got to see this book.' And it was called Killed Strangely. And it was about the first case—in the American colonies anyway—of matricide, where a son kills a mother, and that was 1667. So she says, 'That's one of your grandfathers.' I say, 'Oh, come on…' Of course it was on my father's side, she was very happy to report that. And she says, 'No, read further.' And at the end of the book there were more killers. Two people were discussed and one was Ezra Cornell, who founded Cornell University. I was ecstatic, that's cool. But the other one was Lizzie Borden, who was a famous accused axe murderess at the end of the 19th century. So they're both cousins. And since that time I've got two cousins who are really archivists and historians, and they found three other lines that are direct grandfathers and grandmothers to us, and me, that had murderers in the family. So there was like a convergence of these four lines on my father's side.

So anyway, that was kind of a curiosity. I just considered it a parlour game. Then the genetics came back and I had a lot of the alleles associated with violence, aggression, low anxiety, low emotional empathy. So I had both biological markers, the genetics and the brain pattern of a psychopath, and the ancestral background of a lot of these guys converging in our family. So that made it more interesting, certainly academically.

Lynne Malcolm: That's an understatement in my mind, but it did inspire James Fallon to write his book The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain, and it got him thinking about how he might come across to others. His mother, who'd been a teacher and had a lot of experience with teenagers, revealed to him that when he was going through puberty he turned unusually dark and introverted and she was really worried about him.

And what about his colleagues?

James Fallon: I asked a number of psychiatrists who knew me really well, including some of my bad behaviours. I said, 'You've got to tell me what you really think about me.' And they all said the same thing, they said: remember last year you did this, two years ago you did this and this year you did this, ten years ago you did this? And I said yes. They said, 'Well those are psychopathic.' And I said, 'No, no, you said I was crazy.' They all said, 'You're not crazy, but you're a borderline psychopath.'

Lynne Malcolm: Psychopathy itself is not recognised as a category in the DSM—the Diagnostic and Statistical Manual—partly because the concept of personality disorders is controversial, as so many of the symptoms overlap, such as narcissism, antisocial behaviour and lack of empathy.

Canadian psychologist Robert Hare developed the best known psychopathy checklist of traits, which has been updated over the years since the 1970s. This list was developed more in relation to a prison population than a general one. Now the traits of a psychopath tend to be divided into two sets of factors, and one is to do with how you relate to people, such as manipulativeness, lack of empathy, glibness and pathological lying, and the other covers antisocial behaviour and criminality.

James Fallon says he falls into the first group.

James Fallon: People who are like me who are kind of borderline psychopaths are not criminals, right? But we're kind of…we can be real jerks. And we're very manipulative. There's glibness, superficial charm, there's narcissism, pathological lying, lack of guilt, and callousness. You basically look at people as things to use and not as people.

Lynne Malcolm: I'd just like to get some examples of you in that regard. One example that you wrote about in your book was about taking your brother to a cave in Kenya, Africa, a place that was known to be the place of origin of the deadly Ebola and Marburg viruses and HIV. You knew that and you didn't tell him.

James Fallon: You know, I wanted to go to the caves because I've always been a thrill-seeker ever since the first bull chased me as a kid through a farm field. So with my brother Tom, when I was living in East Africa, I convinced him, I said, 'Look at these elephants. They go in and they dig out the cave to get these mineral salts. And we can go see that.' And I said, 'The wildlife's kind of dangerous and everything,' but he'd like that. And I said, 'We can go visit the cave.'

Now, I knew that that park was just about closed down for nine months, both because of the place I was working at, the University of Nairobi Hospital, that the guy had stumbled in there bleeding out from Marburg. And I knew the trip he took, I knew where he stayed, and I wanted to follow that. They also told me that there were Ugandan rebels at the time and they had started holding up and really harassing and stealing from any tourists. So because of those two reasons nobody had been there. And I thought this was a great opportunity to have the mountain to ourselves.

And so we went up there and I spent a night at a camp fire, and of course I had him lay around me a bit because all night long we could hear leopards and hyenas and a couple of lions and water buffalos, I mean it was everywhere. And we spent most of the night jumping up and down screaming at them, holding the embers of the fire to chase them away. It was kind of exciting. He was freaked out and my heart was pumping, it was great.

Next day we went in to the cave, and I told him not to touch the bat droppings, the guano in the cave, because I knew that might have been part of it, but I said it was okay otherwise. So we went in there and he had a fantastic time and he said even though it was kind of dangerous because of the animals everywhere and all that.

We got home, and about a year later he saw the Dustin Hoffman film about the Marburg virus at that cave that he and I were running around in. He called me up and he goes, 'You SOB,' he says, 'You knew that, didn't you?' I said, 'Well yeah, but you wouldn't have gone in.' And he's never really trusted me so much ever since then, and it's been a while.

Lynne Malcolm: And you say, you confess that you get a buzz out of manipulating people and you talk about living in an 'empathetic flatland'. Now, lack of empathy is quite a distinguishing feature of psychopathy, isn't it?

James Fallon: Yes. You kind of get a sense that when everybody's crying about something and you're not even moved by it and you're supposed to be, you start getting a sense of that. And I never paid any attention to it, I just thought I was always under control. But when I saw the genetics and the area of the brain that codes for empathy and I started asking people, I realised that I live in kind of an emotional flatland. But you know, I'm involved with so many charities and what I consider to be good works, it's not like I treat everybody poorly, I just don't treat people close to me in any special way. That's quite a bother to them. Psychopaths can have cognitive empathy. They understand the problem, and they can be sympathetic in the sense that they'll actually do charitable works. But that's different than actually feeling somebody else's pain or happiness, you know, and that I don't seem to have at all.

Lynne Malcolm: So let's have a look at what the difference is between someone with a brain scan like yours and perhaps genetics like yours…but you didn't turn out to be a murderer, a serial killer, like the stereotype of psychopaths. What do you know now about what makes a difference to the way somebody ends up behaving?

James Fallon: You know, I couldn't figure out…I said, well, maybe my theory's wrong about the biology and the genetics, because I had it to the maximum and yet here I am, like, a fairly normal successful guy. And then I was watching my mother prune some plants. She was sitting on this wooden, three-legged stool, and I said, 'My God that's it! She's the third leg of the stool.' And I really got to thinking what a wonderful childhood I'd had. And I was treated like a golden child. And it wasn't until I found this article, and I had always assumed that this set of genes I had, one in particular called the serotonin transporter, and this a risk allele for psychopathy and for aggression, but the thing is…and two papers came out, it was both done in monkeys and in humans, that if you have that allele and you're brought up in an early abusive or violent environment, then that's how you grow up. But if you have the same alleles and you would be at risk a little and you're treated really well, it kind of negates some of the negative effects of others…aha, that's it!

And so probably only about 20% of people are really genetically susceptible to the effects of the early abuse. So if you have those particular genes, then the environment has a huge effect on it. Your genetics are in a way protective of you. Now, on the other end of it there are some people that go through violent situations and they actually go through growth. It's called post-traumatic or post-warrior, post-combat growth. And so at one end you may have 20% of people who are very susceptible. In that case the environment is so important. And in the other case, where you're protected, the genetics mean so much in the protection of you. And in the middle it's kind of a mix.

So the percentage answer with this nature-nurture question, it depends on your genetics, because, as we say, the genetics load the gun but the environment pulls the trigger. But the trigger it pulls depends on the bullets that are in there, as it turns out.

Lynne Malcolm: So do you think that there is a valid argument for introducing some sort of genetic screening very early in life to determine who is going to be most vulnerable to early abuse?

James Fallon: I have a lot of conflict about this, because in a sense people think that neuroscience and genetics is going to answer a lot of questions for the law, for public policy. But it's only going to make things worse, because there are no categorical answers. Nobody is the average person. And some of these people who do it can't control themselves. Some don't even understand right from wrong, et cetera. The thing is I think we have to have in place professionals that understand what a psychopathic kid, a young, potential primary psychopath is, their behaviour. You can prevent it. You get somebody who may grow up with some of these traits, but they could be very functional traits, as long as they're not abused.

Lynne Malcolm: Professor James Fallon from the University of California.

You're listening to All in the Mind on RN, Radio Australia and online, I'm Lynne Malcolm, with an insight into the mind of a psychopath.

If you ever read the book or saw the movie based on Lionel Shriver's chilling book We Need to Talk about Kevin you must have wondered how you might feel as the parent of a child whose behaviour leaves you cold.

Mark Dadds is professor of clinical child psychology at the University of NSW and the director of the Child Behaviour Research Clinic. He has devoted his career to helping families deal with extremely challenging child behaviour, and encounters kids, mainly boys, who are often described as 'callous and unemotional'.

Mark Dadds: So in our clinic we get children that are coming in with very high rates of daily aggression towards parents and siblings. They won't follow instructions, they're antisocial, they fight with other children and so on. So they're just classic management problems. Now, most of those are kind of emotional and out of control.

We do see these children that come in and we ask the parents and the teachers just a number of very simple questions:

Does the child feel guilt when they do something wrong? Now, even when kids have got behavioural problems, most parents say yes, they get very emotional and upset and so on. But these kids, it's like no, they don't care.

Do they feel remorse? No. Are they kind to people younger or needier than themselves? No. Other features that are correlated with that are that their aggression may be more proactive. In other words they're kind of bullying and using aggression for their own needs rather than fighting what they perceive as a hostile world.

So there's children lacking in empathy, cold, tending to use predatory type bullying and aggression like that, and just have no sense that they're to blame and if something goes wrong they just don't care.

Lynne Malcolm: So you've done some research on children like this, and you've come up with a particular profile with the idea of working out how these children might be able to be treated, or how to inform the parents about how to treat them.

Mark Dadds: Absolutely. We originally said, okay, the best treatment in the world that exists for kinds with conduct problems is really, really good parenting. When we do that with the children with high levels of these callous traits we still get a shift, but it's not as strong and it's not as durable.

So the question we started asking is what's different about them? One of the things that comes up is that they're very reward-driven. They're maybe less sensitive to punishment. They don't care about getting punished. And one of the things we found about these kids is that they don't pay attention to the deep emotions or the deep concerns of other people. They can just look at it in the face and go…whatever…and move on.

So what we're moving towards now is how can you use a parenting intervention but kind of get the warmth and the love back between the parents and these kids such that these kids care about the discipline?

Lynne Malcolm: And another thing you've looked at is eye contact, that there's something different about the eye contact between these kids and their parents or other people.

Mark Dadds: That's right. It's pretty much sure, shown around the world now that these kids pay less attention to the eyes and the fundamental features of other people they care about. Now, I found this just fascinating, because everybody working in this area is going: what we need to do with callous kids is find a way to give them more warmth and love and reconnect them. So my question was, well, what exactly is warmth and love? How do you turn that into something that you can point a stick at and say 'that just changed and it got better'?

We found that this idea of connecting someone deep into their eyes, sharing a little bit of space in a positive way is fundamental to people that are close, and in love, or in parent-child relations and so on. And so we hypothesise if these kids aren't really connecting with their parents through this mutual eye gaze and so on, discipline, love and all that is not going to get through. So what we're doing is playing with these little radical techniques where as well as trying to correct these kids' misbehaviour, we get the parents to do this eye-gaze engagement daily. So it's not a big deal, it's just like little 30-second things here and there where they get into the same zone as each other and kind of tune in and so on. Do it ten, 20 times a day in small doses and it's not long or intense enough to go wrong.

Lynne Malcolm: And what sort of results are you getting so far?

Mark Dadds: We're up to the point where we've treated a handful of families at this point, intense videotaping of everything that moves, and parents' reportings. So we're getting a lot of information. So far we're getting very good feedback. And we're seeing relationships being rebuilt that are making me feel very positive. And after 20 years of working in this field I'm seeing changes that are much more about deep love processes than just kind of 'time-out' and praise and all of those things we do with these kids.

Lynne Malcolm: So is the idea that with this eye contact, it's such a basic form of communication that this may eventually actually change the neural pathways?

Mark Dadds: Yes, that's right. The first thing a child is interested in is the eyes of the caregiver. As soon as the caregiver locks in to that, that beautiful dance starts where the mum or the dad will gaze into the eyes of the child, use all sorts of lovely mother-ese type sing-song talking. And parents naturally make a kind of a surprised face where they bulge their eyes and smile and so on. And this turn-taking is really fundamental to setting up and activating neural systems in the child associated with being alert, recognising fear stimuli, recognising the importance of emotions and things like that. Now, if those things are missing I think it's probably likely there's cascading errors through the child's neural development, if you like, that are going to impair their ability to develop a moral conscience and empathy.

So our hypothesis is that rather than just giving fuzzy love and stuff, we go in there and we give this human connection through this reciprocated eye gaze that's going to turn on these fundamental limbic systems, emotional processing systems in the brain.

Lynne Malcolm: Is there any suggestion that in these families perhaps that eye contact wasn't as great as it might have been in a family where the eye contact was more emphasised?

Mark Dadds: Yes, that's a very good question. From our own data so far we've watched a lot of families do this. Interestingly we have not been able to find any deficits in the mothers of these children. They seem to express emotion and eye gaze equally. We have found that the deficit in eye gaze occurs in the fathers of these children, as the same as in the children themselves. So whether there's something being passed on in the male side of the family I don't know.

I've also had a lot of clinicians watch my videos of these families and put forward an alternative hypothesis: that is, that mum and that dad is not comfortable and they are not looking at that child in the same way, and therefore the child is just reacting to a very subtle but slightly rejecting eye contact environment. Now, that's very hard to test. And if I had my wish I would have lots of videos of kids from the time they were very young and following them through, looking at this eye contact. But at this point we don't know how to tease it out. Is it coming from the parents? Is it likely Mum or Dad was a bit depressed, or people on medication or drugs that took them down? Is that possible? I don't know the answer to that.

Lynne Malcolm: So you obviously still hold hope that kids that might have a future leaning towards becoming a psychopath as an adult can be prevented from having that sort of a future?

Mark Dadds: Oh, absolutely I do, yes. I mean I've worked in the clinical treatment of children with behavioural problems for a long time now, and I've seen changes that are very heartening and quite extraordinary. You do get big changes with children. They're resilient. They're flexible. They can change. All we have to do is get the right environment in place for them.

Lynne Malcolm: You must have seen many really difficult family dynamics. Does it upset you when you see what some parents have to deal with?

Mark Dadds: Well, that's very interesting the way you've asked that, you're asking about what parents have to deal with. Because most people always ask what children have to grow up with, you know, which can be very upsetting. But I like your question, because one thing I've learned over 30 years in this field is that the kids are having just as much effect on the parents as vice versa.

And we've got a real thing these days about parenting causes the child's problems, and we've got to be very careful of that. The data is that people influence each other to an equal regard. And I see plenty of parents where they come in with a child with massive behavioural and emotional problems and you look at their parenting of that child and you go, 'Oh my goodness, look what's happening! This is what's caused it.' That can be a causal fallacy, because the parents are just responding to a child that's very hard to parent. And they may have three or four other children who they did absolutely really well with.

So we've got to be very careful about what's the origins of this. And my way is to say how can you empower people and give them the skills to get themselves out of it? And you know, most families and most parents want to make things better. The idea of these horrible parents we read about that are abusive and all that, they really are a very small minority. Most people want to do the right things by their kids and so on.

Lynne Malcolm: So what is your main interest in future research in this area, what would you like to investigate next?

Mark Dadds: Well, at the level of the clinician, I'm absolutely fascinated with this idea that in child psychology and psychiatry we talk about praise, and instructions and consistency and authoritarian parenting and all that, but we don't really talk about love and these kind of issues. And you can still get through with a child without feeling deep levels of love, but what about when that goes wrong, when a parent looks at a baby and feels like, oh my goodness, it's not happening for me now? This is incredibly common, and it goes off the rails and we can't talk about it. And I would like to know what can we do to turn that into something real and changeable that's really going to help. I'd also like to think, 'Gee, wouldn't it be great if we could get these really evidence-based parenting programs and so on out there so everybody in the community has access to them, and look at what a difference it makes.' Because, you know, in Australia now it's only like one in four at the absolute most children that have these problems and need it that get evidence-based help. And in a rich country like Australia, to me that's not good enough.

Lynne Malcolm: Professor Mark Dadds, director of the Child Behaviour Research Clinic at the University of NSW.

Now back to self-confessed borderline psychopath James Fallon:

James Fallon: I'm always on the make. My close friends, they're saying you're always on the make, don't you understand this? And I said, 'Yeah, but I'm not trying to get sex or anything.' 'It doesn't matter,' they said, 'you're always trying to build this world to control people, and this intellectual story-telling world.' And they're right. I absolutely do do that.

Lynne Malcolm: There must have been a fair bit of fallout because of your behaviour, with your family and friends over your lifetime. Are you compelled at all to try and change some of those more difficult ways?

James Fallon: Yes. But I had to rely on a bit of I guess narcissism to do it, because I really believed that if you have an adolescent or adult psychopathy there's almost nothing you can do about it, right? But I said, 'Okay, I bet you I can do it though.' And see this is where the negative trait of narcissism can help you out, because I said, 'I can beat it. Nobody else can.'

So what I did, Lynne, and this is starting about two years ago, I said I am going to start treating my wife, first of all, differently. And every time I'm about to do something, it can be very simple, who I hand a glass of wine to first. Do I go out with her or do I go out with my friends to some bar all night going crazy? And I realised in any sort of interpersonal interaction with my wife that my natural instinct was to do the absolute most selfish thing at the moment.

So I slowed my behaviour down and after about a month or two she says, 'I don't know what you're doing but,' she says, 'I like it.' And I did it to people in my family, my mother, my brothers, and they all liked it. And I said, 'You understand it's not sincere.' They said, 'If you're trying enough just to change your behaviour, that's enough.' And my mother, she is still in denial, she's still, 'Oh you're still a good boy, you've got a good soul,' but everyone else, 'Oh man, you're a rat and you know it.'

But I lost one very close friend. And this person finally contacted me and she said she wouldn't be alone with me anymore. She said, 'My husband's got to be there.' It's not as if I've ever hit on her or anything like that, but because she knows I'll get her in trouble, you know? And that's what I do. Some other people who didn't like me said, 'See? I knew it. You're an SOB, you're a rat, you're…' I say, 'Yeah.' But frankly, after I'd found all this out I didn't care. So fundamentally I don't care, and I'm still the same person. I'm trying to use my narcissism to manipulate myself into becoming a regular guy.

Lynne Malcolm: Okay. Regular guy…most of the time. Professor James Fallon from the University of California, Irvine, and author of The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain.

Details about the book, and other information are on the All in the Mind website, and you can catch up on all the past programs from there too. Go to abc.net.au/radionational. Leave a comment there and join us on the All in the Mind Facebook page as well.

I'm Lynne Malcolm, thanks for your company, join me next week at the same time.

 
Guests
Professor James Fallon
Professor of psychiatry , neuroscience, human behaviour & neurobiology at the University of California, Irvine
Professor Mark Dadds
Professor of Clinical Child Psychology at the University of N.S.W
Director of the Child Behaviour Research Clinic at the University of N.S.W.

Publications
Title
The Psychopath Inside - a neuroscientist's personal journey into the dark side of the brain
Author
James Fallon
Publisher
Penguin Group
ISBN
978-1-101-60392-5

Music
Track
Suite No
Artist
Yo-Yo Ma
Album
The Cello Suites Inspired by Bach

Further Information
Child Behaviour Research Clinic University of NSW
James H. Fallon University of California
The psychopath next door
Credits
Presenter
Lynne Malcolm 
Sound Engineer
Louis Mitchell 

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