OPINION INTERVIEW

Photography: Mark Peterman for New Scientist

Portrait of the psychopathic brain

When Kent Kiehl visits some of the most dangerous prisoners in US jails, he doesnt just go to talk. Hes there to find out whats different about the way their brains work. He tells Samantha Murphy what insights this has revealed about the origins of psychopathic behaviour and what they could mean for future treatment

How did you become interested in working with psychopathic criminals?

I wanted to know how some individuals come to be psychopaths. One thing that motivated me was that I grew up just down the street from the serial killer Ted Bundy. I was always fascinated that a person with a seemingly normal background if there is such a thing could end up on that sort of trajectory.
What symptoms lead to someone being classified a psychopath?

part of the brain involved in the processing of emotions and impulse control is abnormal. Finding out that the brains of psychopaths are different shouldnt surprise anybody. Only now, with the help of the imaging studies, we have been able to describe how they are different.
Why do you use prisoners as your subjects?

A lack of empathy, guilt and remorse; callousness, impulsivity, promiscuity, hotheadedness and pathological lying, among others. Each of these traits is scored on the Hare Psychopathy Checklist, which is compiled from an interview and an extensive background report. The scale goes from 0 to 40. The average prisoner scores 22. We consider a score of about 30 as indicating that someone meets the criteria for the disorder. When someone scores 34 or higher, we find that we are dealing with a person who is fundamentally out of the ordinary. It is palpable in their clinical presentation. They are completely different from other inmates. And it turns out that their brains are different too, both in structure and in function.
What exactly have you found that makes them so different?

Individuals with psychopathy have a large impact on the criminal justice system. Between 15 and 35 per cent of prisoners in US jails meet criteria for the disorder, compared with about 1 per cent in the general population.
Why is it so important to study psychopaths?

In most places in the US, the way we treat psychopaths is to incarcerate them. We put antisocial people with antisocial peers, and guess what happens? They get more antisocial. Its a system that doesnt work. The estimated social cost of crime in the US is $2.3 trillion a year, and psychopaths are thought to be responsible for 20 to 40 per cent of that. Imagine if you could treat or remediate psychopathy. You would be able to save billions of dollars per year. The goal here is to use the very best science to understand and treat some of the most enigmatic and complex personality disorders that are associated with the worst crimes, to hopefully be able to prevent them.
Have you ever found yourself afraid of someone you worked with?

We have now done more than 1500 scans of prisoner volunteers, using a mobile fMRI (functional magnetic resonance) scanner. In general, what we find in the brains of individuals with psychopathy is that one or more aspects of the paralimbic system
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inmate who had killed people before and he still had a crew that was out in the community killing for hire. He was on a life sentence for one murder, but he told me in our interview about all the other people he had killed. A while later, he was charged with another murder and he told his cellmate that he suspected me of breaking confidence and ratting on him. So the police came to my house and said they wanted to put me in protective custody until everything got sorted out. It made for an interesting day. Eventually, his lawyer told him that one

I wouldnt say Ive been afraid, but there certainly are a few occupational hazards. There was one time I worked with an

Most psychopaths have a glibness and a superficial charm to them

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Profile Kent Kiehl is a principal investigator at the nonprofit Mind Research Network and an associate professor of psychology and neuroscience at the University of New Mexico, Albuquerque. His research focuses on the neuroscience of mental illnesses, particularly criminal psychopathy

Is this true of all people with psychopathy? What about those who manage to forge successful careers?

Psychopathy, as I understand it, is not typically associated with long-term success. Rather, psychopaths normally get into so much trouble, are so impulsive and fail to consider how their behaviour impacts others, that it is unlikely they would become highly successful. Nevertheless, I dont think it is impossible for an individual with psychopathy to have a successful career.
When one pictures a psychopath, the image is almost always of a man. What do we know about psychopathic behaviour in women?

My lab is undertaking the first ever brainimaging study of female psychopathy to be funded by the National Institute of Mental Health. Clinically, we are finding that they do tend to present very similarly to the men, but that it is just so much less common to see it in females. Its estimated to be onetenth as common. We dont yet have a good understanding why it is so rare, but were in the throes of finishing our first 100 brain scans of female offenders, so hopefully well be able to say more soon.
How is a better understanding of psychopathy going to help us do something about it?

of his crew had squealed on him, so he told his cellmate that I could be trusted. Things like that can happen, but Im generally comfortable working with prisoners.
Ive heard that psychopaths such as Ted Bundy are likeable people. Do you find this as well?

the person again, theyll often say: I didnt want to talk about the old me; I thought Id tell you about the new me. So, I definitely find them clinically interesting and sometimes even entertaining, but not somebody Id want to be friends with.
Are all psychopaths dangerous?

Well, most psychopaths have a glibness and a superficial charm to them. It does sometimes happen that, if we dont get a chance to read a case file before we do an interview, we might walk away thinking, Wow, what a nice guy! I cant believe hes in here, because, basically he hasnt told you the truth about anything that has happened in his entire life. Then when we actually do get a chance to look at the file, its like you are reading about a completely different person. When you see

No. There are probably many psychopaths out there who are not necessarily violent, but are leading very disruptive lives in the sense that they are getting involved in shady business deals, moving from job to job, or relationship to relationship, always using resources everywhere they go but never contributing. Such people inevitably leave a path of confusion, and often destruction behind them.

Thats exactly the question: what medicines and/or therapies are likely to help? We certainly know that some forms of therapy have been shown to make psychopaths worse. Group therapy, for instance, in some studies has been shown to actually make psychopaths more likely to reoffend than if you didnt treat them at all. So its critical that we identify the psychopathic offenders and put them in a treatment programme that is made for them.
Do you have hope that psychopathy can be cured?

Absolutely. Brain imaging is just one tool to help us understand things. I dont think its a panacea but it does help us to know that, yes, behaviour originates in the brain and yes, its malleable and treatable. So theres a lot of hope. n
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