00:00:01
Phoebe Judge: A quick note about today's show. Usually our episodes stand alone, and can
listen to them in any order you like, but
00:00:08
today's is a bit different. You should probably listen to our last episode,
Episode 51 — it's called "Money Tree" — first,
00:00:17
and then come back and listen to this one. Okay. Here's the show. Axton Betz-Hamilton: If my mother was a psychopath,
she didn't feel guilt.
00:00:26
Phoebe Judge: In our last episode, we brought
you the story of a woman named Axton Betz-Hamilton,
00:00:31
who was the victim of identity theft. And only a few years ago, Axton discovered
that the person who had stolen her identity,
00:00:39
and her father's, and her grandfather's, for
decades, racking up half a million dollars
00:00:44
in debt, was her own mother. [Music comes in.] Axton is still trying to make sense of how
her mother could do something so horrible
00:00:53
for such a long time, not appear to feel guilty,
or want to come clean, even at the very end
00:00:58
of her life. But Axton's been doing some research and now
believes her mother may have been a psychopath.
00:01:05
Axton Betz-Hamilton: A psychopath will cognitively
know the difference between right and wrong.
00:01:10
So I believe my mother knew, on an academic
level, that what she was doing was illegal.
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But in terms of understanding, on an emotional
level, the consequences that she was creating
00:01:23
for me and for my dad and for my grandfather,
I don't think she had a real recognition of
00:01:30
that. I don't think she could have a recognition
of that. Now, does that mean that I'm defending her?
00:01:35
No. What she did was wrong, but I do think these
psychopathic traits that she had, I think
00:01:44
are indicative of a severe psychological illness
that she was able to successfully hide for
00:01:52
her entire life. Phoebe Judge: And this led Axton to think
about herself and how over the years, people
00:01:58
have told her that she doesn't show much emotion. Axton Betz-Hamilton: I immediately saw it.
00:02:03
Okay. I am essentially 50% my mother. Her genes are in me. Do I have this? At some point, I'm going to start exhibiting
these characteristics?
00:02:15
And I went to my doctor just completely freaked
out about this and said, "I'm at risk?
00:02:23
If I am, what do
I do?" And she said, "There's no way you have psychopathy." And I said, "Well, how do you know that?"
00:02:31
And she said
Phoebe Judge: [Laughs.] That's really funny. You're trying to kind of convince her.
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Axton Betz-Hamilton: Well I did. And she said, "You can't because you have
a severe anxiety disorder and psychopaths
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don't feel anxiety." [Music comes in.] Dr. Ronald Schouten: The people who are most
sensitive to these symptoms are the least
00:02:54
likely to be psychopaths, because you're worried
about having something like this.
00:03:00
Whereas, a true psychopath wouldn't really
care. Phoebe Judge: This is Dr. Ronald Schouten,
a professor of psychiatry at Harvard Medical
00:03:07
School and the director of the law and psychiatry
service at Massachusetts General Hospital.
00:03:13
He's both a lawyer and a doctor. And he's the author of a book called Almost
a Psychopath.
00:03:20
How many people are we talking about out there
that are true psychopaths? Dr. Ronald Schouten: True psychopaths?
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Probably about 1% of the population. So if we have 300 million people in the United
States, that gives us about 3 million.
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Phoebe Judge: Three million true psychopaths
walking around. Dr. Ronald Schouten: Mhm.
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Phoebe Judge: But not all psychopaths are
dangerous. Dr. Ronald Schouten: That's correct.
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And I would argue that probably the majority
of them are not physically dangerous, in terms
00:03:44
of violent crimes. However, it's important to think about the
following distinction.
00:03:49
We consider psychopaths as either successful
psychopaths, or failed psychopaths.
00:03:56
And the failed psychopaths are the people
who end up in prison. The people that you're more likely to encounter
are the successful psychopaths.
00:04:04
Phoebe Judge: Part of what makes a successful
psychopath successful is that they're so friendly
00:04:09
and charming, the psychopathic traits can
be undetectable. Ron Schouten says that many of us will meet
or interact with a psychopath on a daily basis.
00:04:21
But how would we ever know? I'm Phoebe Judge. This is Criminal. [Music stops.] Dr. Ronald Schouten: Psychopathy was actually
referred to even before the days of psychoanalysis,
00:04:39
as moral insanity. I mean, this is a concept that's known in
multiple cultures and has been known for and
00:04:45
talked about, for at least hundreds of years. Phoebe Judge: The word psychopathy is derived
from Greek — translating to something like
00:04:52
'soul disease' or 'soul suffering' — to
describe people who are in touch with reality
00:04:58
but don't have any sense of morality. Dr. Ronald Schouten: So the idea that these
are people who know the difference between
00:05:04
right and wrong, they just don't care about
it. And their behavior is unconstrained by that.
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Phoebe Judge: So how does a psychopath become
a psychopath? I mean, are you born with the characteristics
with chemicals that...
00:05:19
What makes you a psychopath? Dr. Ronald Schouten: Nature and nurture. We have something called primary psychopathy
and it's genetically linked.
00:05:30
There's also secondary psychopathy, people
who may have some inclinations to this, but
00:05:34
because of the environment in which they grow
up, they learn that the only way to survive is a dog eat dog approach
to the world and others in it.
00:05:44
And also really just have the empathy burned
out of them. Phoebe Judge: So psychopaths are over-represented
in the prison population, right?
00:05:54
Dr. Ronald Schouten: Well, compared to the
general population, yes. Phoebe Judge: As many as 15% of female inmates
and 25 to 30% of male inmates meet the definition
00:06:04
of psychopathy. But the vast majority of people in prison
are not psychopaths. And
there are plenty of people free in the world
00:06:14
who, whether they break the law or not, do
meet the criteria. Jon Ronson: My name is Jon Ronson, and I'm
an author of a number of books, including
00:06:23
the book The Psychopath Test. Phoebe Judge: Jon Ronson spent three years
exploring how a person is diagnosed as a psychopath.
00:06:31
And he met several times with the most famous
man in psychopathy research: Robert Hare.
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Jon Ronson: Robert Hare is the father of modern
psychopathy diagnosis. He was a prison psychiatrist and a fan of
Carvey Cleckley, who was the previous father
00:06:51
of modern psychopathy diagnosis. And had devised the checklist, the PCL-R checklist,
which is the gold standard for a psychopathy
00:07:01
diagnosis. It's a 20-point checklist that's now used
all over the world. Phoebe Judge: It's used by hospitals and prisons
and parole boards, and can be used to predict
00:07:11
whether someone will re-offend. The checklist consists of 20 items. A person is scored with a zero, one, or two.
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If the trait is not present, then you get
a 0. If it's partially or possibly present, then
you get a 1.
00:07:28
And if it's definitely present, then you get
a 2. The maximum score you can get is 40.
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People who are in the 30 to 40 range are characterized
as true psychopaths. We asked Jon Ronson to walk us through the
20 items on Robert Hare's checklist.
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Jon Ronson: Item one is glibness, superficial
charm, and then item two grandiose sense of
00:07:51
self-worth. [Music comes in.]. I remember when I met a CEO called Chainsaw
Al Dunlap, we both looked up because he was
00:07:59
standing underneath a giant oil painting of
himself. Item three, need for stimulation, proneness
to boredom.
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Item four, pathological lying. And they're not in the least bit embarrassed
when they're caught lying.
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Item five, cunning, manipulative. Item six, lack of remorse or guilt. Item seven, shallow affect, which is an inability
to experience a range of emotions.
00:08:32
Item eight is the big one. That's callous, lack of empathy. The lack of empathy I suppose, is the main
psychopathic trait from which all others follow.
00:08:45
Item nine, parasitic lifestyle. Item 10, poor behavioral controls. Item 11, promiscuous sexual behavior.
00:08:56
Actually that one always surprised me a bit
because I mean, my promiscuous days are a
00:09:02
long, long time in my past, but I look back
on them with some fondness. Item 12, early behavior problems.
00:09:10
Again, this is quite a big one because the
symptoms begin to manifest themselves around
00:09:14
the ages of 10 to 12. So kind of extreme aberrant behavior, like
breaking another kid's arm in the school yard,
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or torturing animals, or setting fire to the
house, getting yourself expelled from school.
00:09:31
So big stuff. Item 13, lack of realistic long-term goals. Item
14, impulsivity. Item 15, irresponsibility.
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Item 16, failure to accept responsibility
for own actions. Item 17, many short term marital relationships.
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Item 18, juvenile delinquency. Item 19, revocation of conditional release,
which means if you're a criminal psychopath
00:10:06
and you get released, you go back to jail
because you violated the terms of your parole.
00:10:14
And item 20 is criminal versatility. Phoebe Judge: What does that mean? Jon Ronson: Just you do a whole range of crimes.
00:10:26
Phoebe Judge: It kind of seems rather subjective. Jon Ronson: I'm glad you brought this up,
because it's incredibly subjective and it's
00:10:35
prone to massive confirmation bias. And the reason is, is because as human beings,
we love nothing more than to declare other
00:10:45
people insane. So we want to define other people are psychopaths,
especially people that we don't like.
00:10:51
Many only have to look at what's happening
in this election cycle. The thousands of articles: Donald Trump is
a psychopath.
00:10:58
In fact, it's kind of psychopathic to declare
somebody a psychopath from afar. But of course, everybody's ignoring that.
00:11:05
I remember one guy who was diagnosed a psychopath
said to me, "It's so frustrating because I
00:11:11
say, I feel terrible remorse for what I did." What he did was beat up a homeless man.
00:11:17
He said, "I feel terrible remorse for what
I did. But when I say that to people, they say, well,
that's typical of
00:11:24
the cunning manipulative psychopath to pretend
to feel remorse when they don't."
00:11:28
He said it's like witchcraft, it turns everything
upside down. Phoebe Judge: One of the reasons Jon Ronson
knows the checklist so well is because he
00:11:36
attended one of the diagnostic training courses
taught by the creator of the checklist, Robert
00:11:41
Hare. Jon Ronson: It was just fascinating. It was in a Marquis in West Wales. Obviously I was the only journalist there.
00:11:49
Journalists tend not to go on these courses. Robert Hare was very generous to allow me
to sit in on this course.
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It's usually prison officers, care workers,
people who have huge power over people's lives,
00:12:06
over their freedom. So, yeah, so I was in this Marquis and it
was just great. It was exciting.
00:12:14
We'd watch these videos that Bob Hare would
show us of interviews with people in prison,
00:12:20
these case studies. I remember one time Robert Hare surprised
us. He was just giving a talk about something.
00:12:27
And he surprised us by flashing onto the screen
behind his head, a close-up of a man who had
00:12:33
been shot in the face, and his face was just
decimated. And all of us in the crowd went, "Ahh!"
00:12:43
Because our amygdala shot signals of fear,
and distress, and remorse up and down to our
00:12:49
central nervous system, which shows that we're
not psychopaths. I suffer from anxiety, which means I have
an over-performing amygdala.
00:12:59
My amygdala is constantly shooting signals
of fear and distress up and down to my central
00:13:04
nervous system. Anxiety, I think, is the neurological opposite
of psychopathy. Because with psychopaths, neurologists say
their amygdala underperforms.
00:13:16
So when a psychopath sees a picture of a blown-apart
face, they don't respond, like I did, with
00:13:24
horror. They respond with something else, which is
curiosity. They respond with curiosity.
00:13:30
Phoebe Judge: So that's the part of the brain
that matters here. Will you explain that, the amygdala?
00:13:35
Jon Ronson: Yeah. The amygdala, it's the part of the brain that
registers fear and distress, and remorse,
00:13:43
and anxiety and guilt. It shoots these signals up and down to the
central nervous system.
00:13:49
Which always makes me think that fear, distress,
remorse, guilt. [Music comes in.]
00:13:53
These are the feelings that keep us good. And psychopaths don't have those feelings,
which is the reason why it's not a problem
00:14:02
for them to transgress. It always makes me think that psychopathy
is one of the most pleasant-feeling of all
00:14:10
the mental disorders. [Laughs]. Because all of those feelings that we have
that keep us good, they're unpleasant feelings.
00:14:17
Phoebe Judge: This brings us to the question
of treatment. Can you teach distress, remorse, guilt?
00:14:25
Can you teach empathy? Back in the '60s, an eccentric young doctor
named Elliott Barker set out to try.
00:14:34
He traveled all over the world, exploring
different therapeutic approaches. Nude therapy in Palm Springs and radical psychiatry
programs in London.
00:14:43
And he went on to get a job at the Oak Ridge
Psychiatric Hospital in Ontario. Jon Ronson: Elliott Barker's idea was that
psychopaths bury their madness beneath the
00:14:56
veneer of normality. And if you could somehow get the madness to
the surface, you could treat it.
00:15:03
So his idea, having been on this odyssey,
were LSD-fueled mammoth naked psychotherapy
00:15:11
sessions. So he got a whole bunch of people who had
been diagnosed as psychopaths in this ward
00:15:19
in a hospital in Canada, and he made them
strip naked. He quite often tied them to each other, and
he'd give them these high doses of LSD.
00:15:33
And they would go through these long LSD sessions. And the idea was hopefully that the LSD and
the nakedness and just the kind of extremity
00:15:42
of the situation would bring the madness to
the surface. He had straws protruding from the wall.
00:15:49
So if any of them got hungry, they could suck
liquid foods through the straws in the walls,
00:15:56
while they were naked and tied to each other
and high on LSD. Anyway, amazingly enough, after all of these
sessions, a change began to come over these
00:16:07
people who had been diagnosed as psychopaths. They started to seem much more empathetic.
00:16:14
And in fact, some cameras were allowed into
Oak Ridge and they filmed the psychopaths
00:16:19
saying to each other, "There's such beauty
in your eyes and I love you so much."
00:16:24
And it really seemed as if they'd become much
more empathetic. And then they were released into the world.
00:16:31
And a number of years later, I think about
10 years later, somebody did a long-term recidivism
00:16:37
study on how many of these people who had
gone on to reoffend. And usually, high-scoring psychopaths would
go on to re-offend 60% of the time, but the
00:16:51
ones who had been through Elliott Barkers
naked LSD psychotherapy sessions went on to
00:16:57
reoffend 80% of the time. So it actually made them worse. And one of them, a guy called Peter Woodcock
was asked, "Well, how come it made you worse?"
00:17:06
And he said, "Well, it taught us how to fake
empathy better." Phoebe Judge: Elliott Barker's program was
shut down.
00:17:13
And since then, treatment approaches have
been controversial. Turns out there's no pill for empathy.
00:17:20
A 2015 article in the Journal of Behavioral
Sciences and the Law reads, "Many clinicians
00:17:27
have boycotted the idea of even attempting
to treat high-risk psychopathic offenders.
00:17:33
And a number of corrections authorities have
taken the position of quote 'sanctioned untreatability.'
00:17:39
"
[Music comes in.] Pretty much everyone acknowledges that we
will recognize ourselves in a couple of the
00:17:47
items on the Hare checklist. How could we not? Who isn't prone to boredom at times, or a
little self-involved?
00:17:52
But what if you recognize yourself, or someone
you know, in more than just a couple?
00:17:59
This is the subject of Dr. Schouten's book,
Almost a Psychopath. He uses a list of 10 indicators that you,
or someone you know, could be what he calls
00:18:09
an almost-psychopath. Here they are. Superficially charming and glib with an answer
for everything.
00:18:17
An impaired ability to understand and appreciate
the emotions of others. When faced with a decision, you rationalize
a choice that's in your own self-interest.
00:18:27
Lying repeatedly, even when it's not necessary. Conning and manipulative. When you're criticized, it's always someone
else's fault.
00:18:37
A lack of true remorse when you cause harm
to others. Limited capacity to express feelings or maintain
relationships.
00:18:47
You easily ignore responsibilities. And finally, people and situations exist solely
for the purpose of your needs and wants.
00:18:57
Dr. Ronald Schouten: And the idea is that
there are people who have collections of symptoms
00:19:02
of various types that don't meet the full
criteria for a diagnosis as it's officially
00:19:09
listed, but in fact, suffer greatly — and
the people around them suffer, as well — because
00:19:16
of those symptoms. Phoebe Judge: If we think that our wife or
boss might be an almost-psychopath, what should
00:19:28
we keep in mind here? Dr. Ronald Schouten: Protect yourself. Keep track of what's going on.
00:19:35
You maybe keep some notes about behaviors,
experiences that you've found odd. This notion of gaslighting, these folks will
often gaslight their victims, the people in
00:19:50
their relationships, so that you're left scratching
your head saying, "Oh, well maybe I did screw
00:19:55
that up. Maybe I did forget that. Maybe I was supposed to do whatever the task
was involved, or to behave in a certain way."
00:20:04
If someone else is putting blame on you in
that relationship, you want to keep track
00:20:10
of those things, so that you can go back at
a later date, especially if you get some help
00:20:14
and get some consultation, so you can walk
through these events. Because most of us tend to brush these
things off.
00:20:22
Again, our better nature is to think the best
of other people and certainly not to think
00:20:27
negatively. And so we'll tend to dismiss some of these
events, some of these experiences that we
00:20:33
have, and then only much later, when you look
at the whole issue, oh my goodness, look what
00:20:38
has been going on here this entire time. Jon Ronson: One time, I asked Martha Stout,
who's a leading Harvard psychologist in this
00:20:50
field. And I said, "If you're married to a psychopath,
what's your advice?" And she said, "My advice is leave.
00:20:59
Just leave them." She said, "You can't hurt their feelings,
because there aren't any feelings to hurt."
00:21:04
[Music comes in.] Phoebe Judge: But, how could you ever know
for sure that there aren't feelings to hurt?
00:21:13
And how in the world do you make that decision
when it's someone you love? If I had met you back in 2005, would you have
said... if I asked about, your relationship
00:21:26
with your mother, would you have said, "Yeah,
we're close. She's a great mother.
00:21:30
She was a great mother growing up." What would you have said? Axton Betz-Hamilton: I would have agreed to
all of that.
00:21:35
I would have said we're very close, she's
supportive of me, that we talk every day,
00:21:42
and you know, that it was a normal relationship. And based on what I knew growing up, I thought
what we had was normal.
00:21:55
Phoebe Judge: Criminal is produced by Lauren
Spohrer, Nadia Wilson, and me. Audio mix by Rob Byers.
00:22:13
Alice Wilder is our intern. Julienne Alexander makes original illustrations
for each episode of Criminal.
00:22:20
You can see them at thisiscriminal.com. Criminal is recorded in the studios of North
Carolina Public Radio, WUNC.
00:22:27
We're a proud member of Radiotopia from PRX,
a collective of the best podcasts around.
00:22:35
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00:23:02
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00:23:10
I'm Phoebe Judge. This is Criminal. Jingle: Radiotopia. From PRX.