Testosterone makes for maleness (women have levels of the hormone too, but it is much lower than in men). The bottom line in this discussion of the male hormone and violence is this: there is no clear-cut evidence that having higher levels of testosterone makes certain men extremely violent, though having higher levels may make certain men socially dominant-like the alpha males that become leaders in various groups (not just of men but of mammals in general). So the lopsidedness in male versus female aggression (including the extreme examples we associate with "evil") stems from the way male brains are configured from the earliest months in the womb.
As compared with the female brain, the male brain is-on averagereadier for aggression (whether defensive or predatory) but less capable, oftentimes, in the matter of empathy. Now take this generally more aggression-prone, generally less-empathic postpubertal male and add on some of the factors we have been discussing here: maternal neglect, parental brutality, less favorable gene components for some of the neurotransmitters, alcohol and substance abuse, hereditary predisposition to antisocial or psychopathic personality (of which, more below) or mental illness. Given some or all of those add-ons, you may indeed end up with a killer of uncommon cruelty, prone to commit the acts we call evil. And this type of killer is more likely-7 or 10 times more likely-to be a male. But in men of this sort, we are talking about predatory aggression (the kind more associated with violent crime and, at the outer edges, "evil"), not the social (and ordinarily nonviolent) aggression associated with being dominant." To become a predatory aggressor, the usual formula is maleness coupled with other factors-such as genetic risk for psychopathy and being brutalized in a violent household. Psychopathy carries us into the next topic: personality. But before we discuss personality, there is one more note about being male and violent: the matter of the XYY chromosome pattern.
It used to be thought that men who were born with the abnormal chromosome pattern XYY-that is, with an extra male (Y) chromosome-were particularly prone to violence. The condition is rare (perhaps one man in a thousand in the general population), so that even if the relationship were true, XYY couldn't be responsible for much of the violence we see in everyday life. Later, the notion that XYY men were likely to become violent criminals was seriously questioned.67 A few XYY men were found in prisons, but for some time there were no large-scale surveys of how many XYY men were living peacefully in the community. Recently, a group of forensic psychiatrists in Germany looked at the chromosome pattern in a group of 13 men (out of a total of 166) arrested for sexual sadistic homicide. Three of the men were XYY (1.8 percent of the 166), which was higher than the percent found among men in general prison populations: about 0.8 percent, and much higher than for men in general.68 So perhaps XYY does count for something in the arena of violent crime after all-but if so, these men are museum pieces. XYY has little explanatory value for violent crime, let alone for the phenomenon we call evil.
Personality
Thus far we have been looking at factors-mental illness, chronic drug abuse, head injury, and the like-that affect personality in ways that heighten the risk for criminal behavior. In extreme cases, the effects may be so great as to make aggressive impulses ungovernable. Or, empathy and compassion may be so seriously impaired that crimes that horrify us (and reach the level of "evil") lose all their shock value for the perpetrator. But in some persons who commit evil acts, these factors are either absent or of only minor proportions. Personality all by itself, with no "help" from mental illness or head injury, can account for the tendency to commit crimes of exceeding violence.
In general, personality is an amalgam of many different forces, some within us, some from our interaction with the environment. A useful equation in thinking about personality is that which we inherit accounts for about half of our personality; environment makes up the other halfespecially the much larger portion of our personal lives that we do not share with our parents and siblings (as when brothers and sisters are in different grades in school, have different friends and different interests, etc.). In dealing with violent crime and evil, self-centerednessnarcissism-is common to almost all persons of either sex who commit serious crimes, the point being that they care only about themselves and care little or not at all about their victims. Because personality is the outgrowth of all the brain's intricate machinery operating at once, and is shaped by our ever-expanding bank of memories about all the experiences of our lives, it cannot be localized conveniently to this or that segment of the brain. The more normal and socially integrated the personality, the harder it becomes to "explain" the personality by pointing to certain areas of the brain, not even the bottom-up and top-down regions we looked at earlier. But in abnormal personalities, including those we confront again and again in criminal work and in reflections on evil, the search for underlying peculiarities of the brain often proves rewarding. Before we examine these peculiarities in detail, a word of caution.
The focus of this book is on evil in peacetime. In times of war and group conflict it is by no means "necessary" that the combatants exhibit abnormalities of personality. Some do, of course, and so do many of their leaders (Hitler, Stalin, Mao, Saddam Hussein, Slobodan Milosevic, to pick just a few in recent history). Below the category of the leaders in war or group conflict is the group composed of gang members, mafiosi, drug runners, professional kidnappers, terrorists, and the like, for whom violence is a key ingredient in their everyday business. Many such men (and we are usually dealing with men here) are antisocial but not psychopathic. Some show the features of what Otto Kernberg has called "malignant narcissism."69 In this personality we see "antisocial behavior, egosyntonic sadism, and a paranoid orientation," yet with the capacity for loyalty to the group and for concern for other people. Here is an example where malignant narcissism, evil, and "business as usual" come together: Kidnapping is all too common in countries where poverty is rife. In Mexico, Maria Elena Morera, a dentist, recently spearheaded a large group of protesters demonstrating against the rash of kidnappings in her country. She had been touched by the crime personally. Her businessman husband had been abducted in 2001 and held for ransom by kidnappers, who, to speed up their extortion, severed a finger each week and sent each one to her house. Four weeks (and four fingers) later, the police were finally able to free her husband. One of the assailants was a medical doctor who had done the amputations.70
Some of the Common Disorders
Among the people we have encountered up to this point, almost all could be said to have a personality disorder of some sort, but in many instances the disorder was one not usually associated with violent crime, much less evil. The outburst of violence was usually a once-in-a-lifetime episode, not preceded (nor followed) by other such outbursts. John List (chapter 4) was obsessive-compulsive, for example; Nancy Kissel (introduction) was narcissistic; Robert Rowe (chapter 2) was depressive; Susan Wright (chapter 2) was histrionic; Gang Lu (chapter 2) was paranoid; Richard Minns (chapter 4) was hypomanic and narcissistic. Susan Smith, who pushed her car into a lake in South Carolina-causing her two sons in the backseat to drown so that she might be free (unencumbered by children) to marry the boss's son-had the features of borderline, narcissistic, and histrionic personalities all at once.71 Contemporary neuroscience has not probed these disorders very extensively, partly because the brain-imaging techniques now available would probably not show much abnormality, and partly because the crimes connected with these personality types are usually not so extravagant and repugnant-not as evil, if you will, as to generate special interest in brain-research professionals.
Personality Disorders with a Connection to Violence and Crime
Three personality disorders have a close relationship to crime, particularly to violent crime. The evil actions described throughout this book are often the by-products of these disorders, whether singly or in combination. The three disorders are antisocial, psychopathic, and sadistic. A fourth-schizoid-deserves consideration as well because schizoid personality is seen in about
half of the men committing serial sexual homicide. In the general population, schizoid personality is present only in about 1 percent. Among serial killers the situation is a little more complex: some of the men show autistic-spectrum disorders, including Asperger's, which resemble schizoid personality because of such qualities as aloofness and inability to form close relationships with other people.
If we set apart what we regard as evil from what we do not, the trait that really makes the difference is empathy. Here I am using the word empathy in the way it is often used both in everyday speech and in the lan guage of psychiatry. Two different ideas are often merged as if they are synonymous. Strictly speaking, empathy refers to the ability to read correctly the emotions another person is experiencing, as telegraphed to us by the person's facial expression and gestures.72 For this capacity, the mirror cells in the insula play a prominent role.
The other idea concerns compassion, which relates to the ability most people have: to feel distress at the distress or suffering of another person, and to feel moved to do something to alleviate that person's suffering. This particularly human sentiment probably requires an adequate capacity for empathy-as an initial step. Compassion is akin to sympathy, one of the four sentiments that are ingredients of the moral sense of which James Wilson speaks so eloquently in his book The Moral Sense,73 the other three being fairness, self-control, and duty.
We see the division between these ordinarily coexisting concepts of empathy and compassion in the psychopath. Many psychopaths are rather good at reading people's expressions accurately, but they lack compassion. This empathy sans compassion allows them to take advantage of the tearful child who has gotten separated from his mother, the fragilelooking woman in the bar, and so on. Many autistic/Asperger persons and certain persons with schizoid personality (whose main trait is aloofness) lack both empathy and compassion. These handicaps make it difficult to form intimate relationships with other people, particularly with potential sexual partners. As a result, they live as loners or misfits. Half the men committing serial sexual homicide show this extreme inability to get emotionally close to anyone. Examples are numerous. One of the most moving accounts of a schizoid serial killer lacking the merest trace of compassion is that of Edwin Snelgrove Jr. M. William Phelps uses the word evil on many occasions in his book I'll Be Watching You74-one of the best of its genre-in describing the cruelty of Snelgrove, who, although raised in a unremarkable home alongside a normal brother and sister, experienced sexual arousal at the fantasy of murdering women since well before his adolescence.
In essence, the closer you are to having zero empathy and (especially) zero compassion, the easier it is to carve up a person as though you were whittling wood. We saw this with David Parker Ray and his Toy Box; John Ray Weber mutilating his sister-in-law while she was still alive; and Theresa Knorr torturing her daughters. I have occasionally encountered people who, while not devoid of compassion, exhibit this quality in an extremely constricted sphere of interpersonal contact. David Parker Ray, for example, was assisted in his torture of the women immobilized in his Toy Box by his much younger girlfriend, Cindy Hendy. In my bloodchilling interview with Hendy, she referred to their victims (all of whom were female), in her utterly expressionless manner, as "packages"-that is, as objects to be whipped, tortured, mutilated, and then tossed aside as packages (as one tosses out the garbage after a meal). When I asked her how she was able, as a woman herself, to treat victims of her own sex with such indifference and contempt-as not even human, she reiterated: they were just packages. But she was eager to be released from prison one day so she could be reunited with her daughters and grandchildren.
It is the actions of killers such as these to which we are least hesitant in applying the term evil. In the last few years, neuroscience has had a great deal to tell us about what is missing or malfunctioning in the brains of antisocial persons, especially those with the added characteristics that qualify them as psychopaths. If we wanted to narrow our focus to single out the personality configuration that is connected with particular closeness to our concept of evil, it would be at the place where psychopathy, sadistic personality, and schizoid/autistic-spectrum disorders all come together. We can show this as a map, as in figure 9.1, where psychopathy itself is seen as a "special case" of antisocial personality, since only perhaps a fourth of antisocial persons are also psychopaths. A few psychopaths manage to walk, without falling, the fence between breaking the law and not breaking the law-so a small part of the circle for psychopathy lies outside the large circle for antisocial personality. The same applies for sadistic personality: there are some cruel and demeaning parents, spouses, and bosses who are sadistic but who are not necessarily antisocial or psychopathic.
Turning our attention now to antisocial personality, and especially to that "inner circle" where psychopathy, sadism, and schizoid/autisticspectrum disorders overlap, we can peer into this extreme, and sometimes evil, psyche-through the lens of neuroscience.
Figure 9.1
CONTEMPORARY RESEARCH
Adrian Raine and his colleagues have published a number of important papers over the past fifteen years touching on antisocial and psychopathic personalities and on criminality. In one such study they looked at the rates of adult violence in men who fell into one of three categories: one group had only obstetrical risk factors (pregnancy and birth complications); another group had grown up amid poverty risk factors. A third "biosocial" group had experienced early neuromotor deficits and unstable family environments. It was this last group that showed the greatest tendency to adult violence; the biosocial group accounted for 70 percent of all the crimes committed in the entire sample of almost four hundred men.7'
Raine turned his attention to murderers of two different types: the predatory versus the "affective." This is akin to the distinction made in this book between those who kill methodically and with malice aforethought, and those who kill on impulse during some emotional crisis. As Raine and his team suspected, the affective (more impulsive) killers showed lower prefrontal functioning and heightened subcortical function. This suggested that in these men their drives were stronger and their "brakes"-their ability to monitor and inhibit violent ambitionswere weaker. The predatory killers had prefrontal function that was nearer to normal, though their "drive strength" was abnormally high, as in the impulsive killers. The predators, in other words, were more able to plot and scheme successfully, lowering their risk of doing something rash and getting caught.76
In a later study, Raine used magnetic resonance imaging to measure the white and gray matter in the prefrontal cortex in antisocial men and in several control groups. The antisocial men showed a substantial (11 percent) reduction in prefrontal gray matter. This deficit-the first evidence found for structural changes in the brain of antisocial menhelped to explain the low arousal (and tendency to boredom, the need for novelty and thrill seeking) in these men, along with their inadequate response to fear, their lack of conscience, and their poor decision-making skills. These features are characteristic of antisocial men; even more so, of psychopathic men.77 Actually, the low arousal as a risk factor for antisocial behavior had been known for a long time. It is associated with low resting heart rate-the most reliable biological indicator of antisocial behavior in children and adolescents. This is presumably an inherited tendency, and when present it nudges the person in the direction of sensation seeking and risk taking-by way of spicing up a life that would otherwise be boring and flat.78
Taking the neuroscience approach a step forward is the recent work on the way children react to pictures that show people in a state of fear. Certain children show very little reaction to emotional stimuli and don't show remorse for doing bad or hurtful things. These "callousunemotional" children seem in many instances to be the psychopaths of the future. When they are shown the fearsome pictures during an fMRI exam, it turns out that their amygdala response is notably reduced when compared with the responses of normal children or even children with just atten
tion-deficit disorder (some children have both callousness and attention-deficit, and they do show the lowered amygdala response).79
Under ordinary circumstances, the amygdala communicates rewardexpectance to the ventromedial prefrontal cortex: a bottom-up region "talking" with a top-down center that must decide whether the impulse to action is a good idea or a bad idea; whether the intended action is moral or immoral.80 This connection is operating only weakly in the callous-unemotional children (and the same remains true in adult psychopaths). In a related study, children with psychopathic traits showed abnormal responses in the ventromedial prefrontal cortex-this seemed unique to them, since the abnormality was not found in healthy or even in attention-deficit children.81
We already know that callousness (which we can understand as the "negative" of which compassion is the positive) and lack of remorse are the hallmarks of the psychopath. It is likely that these children have strong inherited tendencies in this direction.82 This does not condemn them to become violent criminals, but they are more likely than ordinary children to end up in trouble with the law for offenses that may include violence and even sadism. We know also that there is a stronger genetic influence operating in children who show early-onset delinquency in contrast to late-onset delinquency;" the same is true for aggressive versus nonaggressive children.84 Yet, as Anderson underlines, the best antidote for a surplus of genetic predisposition to aggression is being raised in a stable, nurturing home.85 We have of course no way of reducing the aggression, let alone the extremes of aggression that may get labeled as evil, by magically inserting children at risk into these optimal homes. In very rare circumstances, we may encounter a child with such genetic disadvantage, perhaps aggravated by perinatal complications, that his aggression cannot be curbed even by the most tender and devoted parents.
The Anatomy of Evil Page 37