Evil Genes
Page 15
Cognitive Criteria
Frequent paranoid ideas or severe dissociative symptoms [dissociative symptoms can include hallucinations or a sense of depersonalization or unreality].
Identity disturbance: markedly and persistently unstable self-image or sense of self.
Behavioral Criteria (Forms of Impulsivity)
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge eating). (This does not include suicidal or self-mutilating behavior.)
Interpersonal Criteria
Frantic efforts to avoid real or imagined abandonment that do not include suicidal or self-mutilating behavior.
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. [This also includes the concept of “splitting,” where a person is either “good” or “evil,” with nothing in between.]
Milosevic liked to compartmentalize his activities, never giving any one subordinate too much control or understanding of the bigger picture. He took extra care to keep a formal distance, to make it seem as if others, outside his control, were responsible. He was the type of politician who leaves no traces. He never wrote an article under his name; his short speeches contained no plans; his interviews were slogans designed for the primitive nationalist ear. His style was conspiratorial. Everything was moved by word of mouth—without a paper trail. He never delegated to those around him defined areas of responsibility that could be regulated by a clear-cut statutory code.18
In relation to the characteristics of impulsivity and inability to control anger, biographer Slavoljub Djukic noted that Milosevic was “extremely impulsive, never [making] any effort to strike a balance between what he wants and what can actually be accomplished. Many of his decisions have been poorly considered, either premature or devastatingly belated, and lacking in foresight.”19 After the war began and NATO bombing sorties contributed to the ongoing destruction around him, Milosevic began “to crack, staging temper tantrums, screaming at aides, and throwing documents in the air.”20 Even under less extreme conditions, Milosevic's outbursts could be brutal. “I always knew you were a cunt!” Milosevic hissed in livid anger at an Albanian Communist who understandably refused to deliver a large block of votes to Milosevic.21 (The only way to influence Milosevic, apparently, was to “threaten force, which he respected and feared.”)22
The criteria related to feelings of abandonment and suicide also have bearing on Milosevic's life. After Milosevic reached adulthood, his father, mother, and a much-admired maternal uncle each died by their own hand. (Recent research has implicated a region on chromosome 2 in a genetic tendency toward suicide—this region is also associated with alcoholism, major depression, and bipolar disorder.)23 Forensic psychologists “have speculated that Milosevic was a depressive, scarred by a family history of suicide and abandonment.”24 Indeed, Milosevic's parents separated not long after he was born, which could undoubtedly have placed stress on a boy with a certain genetic predisposition. (Interestingly, Milosevic's brother Borislav grew up with a very different personality—he “not only excelled in high school but thoroughly enjoyed life, and effortlessly went on to establish a prominent career.”)25
Milan Panic, a Serbian-American, Yugoslavian-born businessman whom Milosevic seduced into serving as prime minister in an effort to avert sanctions against Serbia, related an anecdote that was more to the point. Soon after Panic was invited into the government, Milosevic became surprised and increasingly nervous at Panic's burgeoning popularity. One evening, Milosevic arrived unannounced at Panic's house, where they moved to sit out on the veranda overlooking Belgrade and drink wine. Panic laid forthrightly into Milosevic:
“You are responsible for what is happening in Bosnia. You are responsible for the catastrophic economic conditions in Serbia. Resign. You have to resign!” Milosevic listened in shock, unused to such direct and hyper-critical talk. Then, as Panic relates the story “suddenly he looks at me and says, ‘Enough.’ I have never seen him so despondent. So he takes a revolver—he always carries a revolver—and hands it to me. ‘Shoot me,’ he says. ‘Get it over with.’ And I am stunned, of course. I can't believe my ears.”
“‘Are you crazy?’ Panic cried. ‘You've got to be sick! You have children, you have family. You want me to shoot you? You are sick. Resign!’”26
In general, Milosevic's emotions were poorly regulated. In times of stress, he turned to alcohol. When sanctions against Serbia were imposed by the West and domestic opposition was reaching a crescendo, he watched
huge crowds of protesters on television and asked Dusan Mitevic, his friend and propaganda chief, with genuine incredulity, “Who are those people?”…Rumors began to circulate about his state of mind. Some attributed his mood swings to diabetes, type II, from which he had suffered since the early 1980s, but in reality few people saw him in his black moods, when he would hurl streams of profanities at those around him. He was given to seizures of apoplectic fury when crossed or when confronted by the brutal stupidity of his proxies which he thought gave him a bad name. He was exceedingly vindictive, his soul full of one black passion—to get even, to avenge…
Several of his former friends and classmates also spoke of pathology. The man, they said, was subject to serious depressions, sometimes staying at home for a couple of days to hide the condition.27
Milosevic was “a man who wanted to be in total control of every detail…. And by all accounts he took great pleasure in the misery he brought to others and in the sense of power and control this afforded him.”28 This taking pleasure in the misery he brought others was more characteristic of psychopathy, or outright sadism, than borderline personality disorder. In point of fact, Milosevic ignited wars in Slovenia, Croatia, Bosnia, Kosovo—and ultimately would set Serb against Serb.29
Milosevic also exhibited the frequent narcissistic and antisocial characteristics of a pattern of grandiosity, need for admiration, and lack of empathy; Serbian psychologist Zarko Trebjesanin described him as a “cold narcissus.”30 Oddly enough, the exaggerated sense of self-importance associated with narcissism—the slippery twin sister of both antisocial and borderline personality disorder—can motivate Machiavellian manipulation and lying. After all, for many people—even normal people with no personality disorder—a laudable end can justify many means. And for a narcissist, nothing is more laudable than the grandiosity of the narcissist himself.
As the Economist pointed out prior to Milosevic's death: “Mr Milosevic may be facing 66 separate charges of the gravest crimes imaginable, including genocide, at the UN's war-crimes tribunal in The Hague, but he appears to be enjoying himself nevertheless. Berating or bullying prosecution witnesses with relish, and peppering the judges with objections, he has turned his right to act as his own lawyer into a bravura performance…. Richard May, the presiding judge, constantly reminded Milosevic to stick to the issues: ‘Attacking the other side is not a defense,’ he has repeatedly explained to the defendant.”31
WAS MILOSEVIC A BORDERLINE?
The Machiavellian Milosevic had significant issues related to at least five of the criteria of borderline personality disorder, according to the DSM-IV. He also possessed a number of related borderline-like coping mechanisms. But, perhaps surprisingly, that does not make Milosevic a borderline. To be so judged, one's symptoms must each be found “clinically significant”—that is, a trained clinician must determine that five of the nine criteria in question are severe enough to cause significant distress or impairment. This is not quite as straightforward as it might seem.32
Say, for example, a person throws a phone occasionally, or curses someone out in traffic. Is this enough to classify him as having difficulty controlling anger? Probably not. But what if he loses his temper frequently at his son for the pettiest of reasons but spoils his wife
and daughter no matter what they do? That's perhaps a little more problematic—worthy of further investigation by a therapist. Now, what if this person loses his temper, chews out his boss, subsequently loses his job—and does this three times over a period of a year? Does he now have difficulties controlling his anger? Probably. But it's important to note that these facts might never come to the attention of a clinician unless our man gets a divorce or goes to jail.
The bottom line is that, if one uses a categorical DSM-IV approach to analyzing borderline personality disorder, a person has to be so severely disabled to achieve a definitive diagnosis that he essentially can't function effectively in society. Diagnosis exists primarily to facilitate treatment in a clinical setting, but a number of problematic individuals—even if they do have symptoms that would reasonably qualify as clinically significant—just don't come into a clinic to receive the attention of psychiatric or forensic services.33
Another problem with diagnosing borderline personality using the DSM-IV criteria relates to the fact that the criteria are written in clinical, dispassionate fashion that obscures as much as explains borderline symptoms. And there is yet another problem: the DSM-IV assumes that “all nine criteria are equally contributory, and allows for the seeming paradox that someone with the supposedly enduring diagnosis of BPD could suddenly be ‘cured’ of the illness by overcoming even one defining criterion.”34
THE DIMENSIONAL APPROACH TO DESCRIBING BORDERLINE PERSONALITY DISORDER
A number of psychologists and psychiatrists have advocated a different method of diagnosing BPD and subclinical BPD, one that involves a dimensional, or symptom-based approach, similar to that of the PDQ-4+ test McHoskey used for his seminal Machiavellian study. A fairly typical dimensional approach to BPD (advocated by BPD specialist Robert Friedel, whom we noted earlier regarding his borderline sister Denise), involves identifying varying degrees of the following four symptoms:35
poorly regulated emotions
impulsivity
impaired perception and reasoning
markedly disturbed relationships
As you'll notice, these four dimensional symptoms are quite similar to the typical borderline symptom complexes we described in the last chapter. In fact, those four dimensions appear to relate to something integral to our basic humanity, because all of the ten personality disorders of the DSM-IV show up as deviations from normal in a very similar list of traits.36
Milosevic would register “tilt” on all four of Friedel's dimensional symptoms of borderline personality disorder. Three of Milosevic's personality traits—those involving poorly regulated emotions, impulsivity, and markedly disturbed relationships—have already been discussed in relation to the DSM-IV criteria for BPD. But the fourth dimensional symptom—impaired perception and reasoning (a more general form of the frequent paranoid thoughts or severe dissociative symptoms)—deserves special attention.
As it happens, Milosevic showed impaired perception and reasoning on a number of different occasions. For example, while international outrage about the brutality of Serbian ethnic cleansing was turning Yugoslavia into an outlaw state, US Ambassador Warren Zimmermann met with Milosevic one evening to attempt to negotiate a reversal of the cleansing and a withdrawal from Bosnia. Shockingly, Milosevic denied that the Serbs were even in Bosnia. LeBor notes: “It is hard to know what Milosevic was thinking. Did he really believe that the ambassador of the most powerful country in the world, with extensive intelligence services, and spy satellites that could read a numberplate, did not know what was happening in Bosnia and who was responsible?” Zimmermann was left speechless as the gaslighting Milosevic pleaded, “I'm not so bad, am I? Am I such a black sheep?”37 Later, at The Hague, Milosevic would smugly testify that “the 1995 massacre of 7,000 unarmed Muslims at Srebrenica was carried out not by Serb militiamen, but by French intelligence.”38
Milosevic's chief of the general staff, General Perisi, would later describe Milosevic as “not living in reality, rejecting ‘competent opinions and proposals,’ and resorting to ‘fraud and lies…to change and shape the people's perception of reality.’” Milosevic had completely convinced himself that the West was bluffing about bombing. When the US ambassador to Macedonia, Christopher Hill, suggested that bombing was a wholly realistic option, Milosevic retorted: “Anyone who does that—bomb—is going to spend the rest of his life on a psychiatric couch.”39
Milosevic would constantly repeat the statement that “Serbia is not at war,” even as the death notices of Serb soldiers killed in Bosnia filled up newspapers and were pinned to trees all over Yugoslavia.40 The mayor of Belgrade, Zoran Djindjic, recalled telling Milosevic: “‘You really have problems; there are one hundred thousand people on the street demonstrating against you.’ [Milosevic] looked at me and said, ‘You must be watching too much CNN. There aren't.’”41 Congressman Rod Blagojevich, a Serb American from Chicago's Northwest Side who was helping to negotiate the release of three American servicemen, said that Milosevic reminded him of “a defendant who had prepared himself never to admit anything and who had repeated his version of events consistently so that he essentially came to believe in it.”42 (The idea that Milosevic could have reprogrammed his memory may be possible; a recent study has demonstrated that people can consciously choose to forget certain memories. It turns out that the same neural circuits that are used to consciously suppress movement can also be used to suppress memories.)43 Another former associate observed that Milosevic “decides first what is expedient for him to believe, and then he believes it.”44 Biographer LeBor describes Milosevic's thinking, which bordered on delusional: “Confronted with the disastrous reality of his policies, Milosevic reverted to denial, outright mendacity and fantastical talk of wonderful economic opportunities.”45 Even on a personal front, Milosevic's thought processes could conflict notably with reality: after his father committed suicide, Milosevic avoided all mention of it, except for one occasion—in which he denied that the suicide had occurred.46
The dimensional approach to understanding borderline personality disorder is useful because it relates much more directly to what is going on neurologically. And neurological research related to the disorder has made significant breakthroughs over the past few years. Most researchers agree that a dysfunction of the emotional regulation system is a core component of the disorder and that this emotional dysregulation manifests itself most often, and dramatically, as a pattern of unstable and intense interpersonal relationships.47 It is thought that a dual-brain pathology in both the prefrontal and limbic circuits might underlie borderline symptoms.48
WAS MILOSEVIC A PSYCHOPATH?
But, you might say, not so fast. Doesn't Milosevic look to be an ideal candidate for a diagnosis of psychopathy rather than borderline personality disorder?
Yes and no. It's clear that Milosevic was “compassion-impaired” with regard to anyone who wasn't one of his lockstep supporters. But at the same time, he was “well regarded for his loyalty to his relatively small circle of friends,” although that loyalty was contingent on absolute loyalty to him.49 More than that, Milosevic was so infatuated with his wife that, even when the two were sixteen-year-olds, they were dubbed “Romeo and Juliet.”50 Decades after they first met, while imprisoned at The Hague, Milosevic would spend the lunch hour together with his wife, “holding hands, kissing each other, and stroking each other's faces.”51 Milosevic's brother, Borislav, related how: “[Milosevic] is a man of strong will, he has his own beliefs, his own positions, but on the other hand he is a man devoted to his friends and family, he is a very good paterfamilias. He is a good father and he is not a cruel person, as he is portrayed.”52 For his children, Milosevic would do anything. British diplomat David Austin noted that Milosevic once ended negotiations at five o'clock sharp because he had to go home for his daughter's birthday party.53
Fig. 7.1. The “Butcher of the Balkans” returns from Dayton in winter 1995 with a big hug for his wife, Mira.
It seems, then, that
Milosevic might have had some characteristics of a psychopath—but not all. We can get a better handle on this by looking at the dimensional-like traits of psychopathy. They are defined by researchers David Cooke and Christine Mitchie as:54
arrogant and deceitful interpersonal style
deficient affective (emotional) experience
impulsive and irresponsible behavioral style
You can see there is quite an overlap in the dimensions of psychopathy and those of borderline personality disorder. Moreover, each of these dimensions is intentionally a bit fuzzy—after all, how can a few words of definition catch the full range of possibilities of neural behavior that might be associated with a certain personality characteristic? In the end, the two disorders can shade into each other. People like Milosevic might have an arrogant and deceitful interpersonal style and an impulsive behavioral style; yet they could also sometimes act quite responsibly, and their emotional experience could be deficient only toward some—not all—people.
Two British psychiatrists, Nicholas Swift and Harpal Nandhra, see so many patients with combined borderline and antisocial traits that they coined a new term for the syndrome: borderpath—a fusion of borderline and psychopath.55 Many others have noted that psychopaths who experience anxiety—so-called secondary psychopaths—have a symptom set that solidly overlaps with borderline personality disorder.56 (Secondary psychopathy doesn't necessarily mean that the symptoms are any less severe—several studies have shown that secondary psychopaths are more aggressive and disruptive in institutions than are primary psychopaths.)57