Seventh Seal death


Reflecting on the Newtown tragedy in a thoughtful and emotional column, John Kass writes:

We busily assigned blame, thinking we can use reason against the unreasonable.

It's a natural human impulse, this desperate need to control what terrifies us, and we bring our personal politics to such things. Words and arguments often help us feel secure when, deep down, we must know that no argument can keep us safe.


But look at that boy's eyes. He's not arguing. He's not employing reason. He's not thinking of rights or policy. He can't. What he has learned early in life is you can't reason with madness. You can't argue with evil.

But what if we could?

The phone has been ringing off the hook for journalist Dave Cullen, author of Columbine (which I've been rereading this week). And deservedly so. His meticulous book, published a decade afterwards, is reminder of how much misreporting and misinterpretation was done in the wake of that incident—something that was replayed over the past few days, when a surprising number of important details (the identity of the alleged assailant, his relationship to the school, his mother's relationship to the school) were incorrect as initially reported, through the fault of reporters, witnesses, or the police.

It's also a reminder of how long it took to understand. It wasn't until several years later that a full psychological portrait of the killers was released, the work of a team of psychiatrists and psychologists assembled by the FBI, as Cullen wrote in 2004 on the fifth anniversary of the incident:

Eric Harris and Dylan Klebold were radically different individuals, with vastly different motives and opposite mental conditions. Klebold is easier to comprehend, a more familiar type. He was hotheaded, but depressive and suicidal. He blamed himself for his problems.

Harris is the challenge. He was sweet-faced and well-spoken. Adults, and even some other kids, described him as "nice." But Harris was cold, calculating, and homicidal. "Klebold was hurting inside while Harris wanted to hurt people," Fuselier says. Harris was not merely a troubled kid, the psychiatrists say, he was a psychopath.

They concluded that Klebold "would never have pulled off Columbine without Harris. He might have gotten caught for some petty crime, gotten help in the process, and conceivably could have gone on to live a normal life." Harris, on the other hand, "was irretrievable," as a pure psychopath.

(Side note: After Newtown, autism was quickly dragged into the discourse, but in some ways it's the opposite of psychopathy: "the research literature has confirmed what we've been saying for the longest time: we experience empathy at the same levels as the neurotypical population, even if the outside world doesn't always understand our ways of communicating it." Psychopaths, on the other hand, can recognize and communicate empathy for the purpose of achieving their goals, but rarely or dimly experience it.

As to what may have actually happened in Newtown, Cullen's experience suggests that we won't know for years, and any suggestions to motive or cause that arise quickly should be greeted with skepticism.)

Psychopathy has long bedeviled psychiatry, from the time the term was coined in the 1880s, to the time it was fleshed out as we know it in the mid-20th century, to the time Cullen was writing in 2004. The psychologist most responsible for defining the disorder, Dr. Robert Hare, had written that no treatment works, and that typical therapy can make it worse, by giving psychopaths advanced training in deception.

But between the time Cullen broke the news of the FBI's Columbine report in 2004 and the time his book came out in 2009, our understanding of the problem had already changed, enough that the author was able to tenuously reconsider the irretrievability of psychopaths:

When Eric [Harris] was in high school, a juvenile treatment center in Wisconsin began a program developed independently but based on [Dr. Hare's] approach. It also addressed the psychopathic drives for instant gratification and control: subjects were rated every night on adherence to rules and rewarded with extended privileges the next day. The program was not designed specifically for fledgling psychopaths, but it produced significant improvements in that population. A four-year study published in 2006 concluded that they were 2.7 times less likely to become violent than kids with similar psychopathy scores in other programs.

For the first time in the history of psychopathy, a treatment appears to have worked. It awaits replication.

Since then, more encouraging work has come out of Wisconsin on the subject and treatment of psychopathy. For decades researchers at the University of Wisconsin have had unusual access to the incarcerated population there, and it's generated a lot of work on psychopathy (it's estimated that 20-25 percent of the national prison population can be defined as psychopathic, compared to one percent of the general population), much of it the work of Joseph Newman:

The conventional theory on psychopaths is that they lack emotion, be it fear, empathy or guilt, that would otherwise inform decision-making. Newman doesn't deny that but insists on the importance of attention.

"It feels like I'm trying to identify a learning disability," he says.

Our minds unconsciously monitor us. It happens in secret. Our conscious minds don't know of it until the unconscious sounds an alarm — such as when a nagging suspicion of "having forgotten something" turns out to be true (the oven is still on; the keys were left on the car seat).

The psychopathic brain may be very bad at automatically diverting attention to these types of cues if the psychopath is locked into "goal-driven" behavior, a kind of tunnel vision.

Phrased differently:

He believes that psychopathy is essentially a type of learning disability or "informational processing deficit" that makes individuals oblivious to the implications of their actions when focused on tasks that promise instant reward. Being focused on a short-term goal, Newman suggests, makes psychopathic individuals incapable of detecting surrounding cues such as another person's discomfort or fear.


"People think (psychopaths) are just callous and without fear, but there is definitely something more going on," Newman says. "When emotions are their primary focus, we've seen that psychopathic individuals show a normal (emotional) response. But when focused on something else, they become insensitive to emotions entirely."

In a 2010 paper, Newman devised a test to examine the fear response of psychopaths, who were given a small electric shock when they were shown red letters on a screen, but not when they were shown green letters, and asked to signal if the letter was a "threat" or not, thus conditioning them to fear the red letters—which they did. Then the task was changed: participants had to signal whether the letter was upper-case or lower-case letter.

When that happened, they stopped fearing the shock.

It's a bit like how regular people can be callous when overwhelmed or completely consumed by one thing—negligent, distracted, rude—but the bar is set at a clinically low level. And there's neurological research to back up the lab experiments:

Newman calls this an early attention bottleneck, a specific process in the brain that underlies psychopathy. The theory holds up when researchers use brain scans to look at what parts of the brain become more active or “light up” in inmates who are psychopaths, and those who are not, while performing these kinds of tasks. Scans showed that the amygdala, a region located deep within the brain that responds to fear and threats, was activated as much or more so for psychopaths — compared to non-psychopathic inmates — when they were asked to focus on the part of the task linked directly to threat of a shock.

This has compelling implications, including the possibility that psychopaths could be trained to compensate for the "information bottleneck," in ways that could become more permanent over time. So experiments like the juvenile-treatment one Cullen mentions are ongoing, this time with prison inmates:

The idea, says Baskin-Sommers, is that “the brain is plastic, and if you train certain pathways that might be weak, you can build up or strengthen those pathways.”

Three groups have gone through the training so far, with encouraging results: when tested on how well they are paying attention to context, psychopaths who were trained in ways specific to their condition showed improvement.


“I actually feel like we have a better understanding of this mechanism than most other disorders,” Baskin-Sommers says. “I think we’re a lot further along, certainly on the psychopathy front, than [we are with] disorders such as depression or anxiety.”

This reminded me of a study that recently came out of the University of Chicago, from Jean Decety, a neuroscientist who specializes in the study of empathy and moral reasoning. Decety looked at how quickly we can recognize the moral basis of a situation, i.e. how fast the brain does "moral computations." Decety showed subjects someone being accidentally harmed (like being hit with a golf club) and someone being intentionally harmed (like being beaten with a baseball bat). The brain figures out which is which very quickly:

The intentional harm sequence produced a response in the brain almost instantly. The study showed that within 60 milliseconds, the right posterior superior temporal sulcus (also known as TPJ area), located in the back of the brain, was first activated, with different activity depending on whether the harm was intentional or accidental. It was followed in quick succession by the amygdala, often linked with emotion, and the ventromedial prefrontal cortex (180 milliseconds), the portion of the brain that plays a critical role in moral decision-making.

There was no such response in the amygdala and ventromedial prefrontal cortex when the harm was accidental.

The amygdala and ventromedial prefrontal cortex is exactly where Newman and his colleagues have been looking in the brains of psychopaths:

The study showed that psychopaths have reduced connections between the ventromedial prefrontal cortex (vmPFC), the part of the brain responsible for sentiments such as empathy and guilt, and the amygdala, which mediates fear and anxiety.


"This is the first study to show both structural and functional differences in the brains of people diagnosed with psychopathy," says Michael Koenigs, assistant professor of psychiatry in the University of Wisconsin School of Medicine and Public Health. "Those two structures in the brain, which are believed to regulate emotion and social behavior, seem to not be communicating as they should."

It's accurate to say, right now, that we can't reason with evil (if by evil you mean psychopathy, which intersects with what we generally consider evil to be). This research is very much in its infancy. But it's a fascinating idea: that you can respond to evil with reason, literally a thought at a time, and perhaps rewire the brain to react to it. And it's in its infancy but developing quickly—so fast that Cullen went from abject hopelessness to tempered optimism in the space of a few years, years spent immersing himself in a great horror. One of the things that gives me hope in the wake of great tragedy is that there are people working their way through these questions: reasoning through them, and trying to reason our way out of them.