The Anatomy of Evil

by Michael H. Stone

  Before that dream, I had also been reading the case histories of adolescent sex murderers in Niels Habermann's book Jugendliche Sexualmorder- (Juvenile Sexual Murder). Most of these young men had committed their first rape-murder after having been rejected by a girl. Some were psychopaths and went on to become serial killers. Others, antisocial (but not psychopathic) while young, spent time in prison, were released, and did not reoffend. I had also seen a patient earlier that day who complained that, as far as she was concerned, most people weren't really "human." To her way of thinking, they were just animals. She asked if I didn't agree with her, especially since I worked with prisoners and forensic patients. I tried to make her understand that even those whose actions descended to evil were every bit as human as the rest of us. Or, as Nietzsche would have added, "Human, all too human." In his famous essay Thus Spake Zarathustra, Nietzsche created a powerful image relating to our task as human beings.41 We pass through the years of our lives like a tightrope walker perched precariously on his rope. "Man," as he put it, "is a rope stretched between animal and the superior man; the rope lies over the abyss." We can fall back to the animal level-or we can strive toward the goal of self-transcendence and moral superiority. I am a little uncomfortable with the "animal" image. It is only we humans, not our animal cousins, who are capable of evil, though people (referring to some evil act) are accustomed to say, "He behaved like an animal." Perhaps a more up-to-date analogy might be: We are a rope stretched between Bundy and the Buddha. And the abyss is the descent to the evil of Ted Bundy and his like, where all regard for the welfare of one's fellow man evaporates, leaving one capable of immeasurable cruelty and harm. Harm that shocks us. Evil.

  AFTERWORD

  by Dr. Otto F Kernberg

  he present volume, I believe, is destined to become a classic in psychiatry and a landmark in our understanding of severe antisocial behavior and criminality. The early understanding of the psychopathic personality provided by Hervey Cleckley in his 1941 book The Mask of Sanity has evolved, in Michael Stone's book, to a comprehensive, updated, detailed, sophisticated analysis of what is implied in our intuitive concept of Evil. Dr. Stone provides instruments with which to differentiate evil actions from evil purpose, and a conceptual etiological frame that incorporates genetic and constitutional as well as environmental influences, personality structure, and psychiatric pathology. Stone defines, in the process, a broad spectrum of threatening, violent, and criminal behavior, pinpointing its severity and mapping out potentially preventive and prognostic features.

  The nature of evil emerges as the shocking expression of primitive aggression, destructive behavior toward others that, in its violence, evinces a widely excessive quality, a radical callousness, and a lack of compassion that seem to defy the basic nature of humanity. Stone proposes a twenty-two-point scale that provides a fine differentiation of severity of antisocial behavior, with prognostic implications built into it. His proposed classification corresponds largely with the present DSM-IV system of the American Psychiatric Association, applying the concept of antisocial personality, in a broad sense, to refer to persons with chronic aggressive and/or exploitive behavior toward others. Within that broad spectrum this diagnostic scale further refines our understanding of the most dangerous and malignant group, the psychopathic personality, characterized by a total incapacity for compassion, combined with total lack of concern for others and self.

  Because the entire spectrum of patients with severe antisocial behavior usually present an underlying narcissistic personality structure, I have preferred to classify this field into the narcissistic personality with antisocial behavior, the syndrome of malignant narcissism (referred to by Stone as occupying the intermediate zone of severity of his classification system), and the antisocial personality proper, using the latter term in a restrictive way that corresponds to the psychopath in Michael Stone's classification. He convincingly points to the fact that patients with schizoid and sadistic personality features also may enter the most severe group of psychopathy, and we do agree that the large majority of psychopaths present strongly predominant narcissistic features.

  The great importance of Michael Stone's contribution resides not only in the detailed description of antisocial behavior along its entire spectrum but in the careful attention and updated review of the contribution to severe psychopathology of genetic factors, severely traumatic childhood experiences, and the social environment. He points to the mutual influences of genetic and environmental features that culminate in a personality structure that lacks a capacity for concern for self and others, for guilt feelings and remorse, and, in the worst cases, presents a fused experience of violence and lust as a fundamental pleasurable excitement in making others suffer.

  Stone raises important questions regarding our present management of these cases in terms of a protection of both the civil rights of patients and those of the community. Patients with severely antisocial behavior who enter psychiatric inpatient services often prevent the hospital from obtaining crucial information about them from external sources. Confidentiality laws interfere with the possibility of gathering such information in order to arrive at an accurate diagnosis and an optimal treatment of that particular case. The need for protective, possibly lifelong custody for the most dangerous cases of those patients who enter the forensic system is hampered by the absence of the principle of "indeterminate sentencing," which would allow the legal system to individualize imprisonment and custodial treatment in terms of a realistic assessment of the dangerousness of patients along the dimensions specified by Stone. There are a few cases where psychiatric treatment, long-term psychotherapeutic engagement, and social rehabilitation may be effective, but in the immense majority of psychopathic criminals the possibility for successful treatment approaches zero. As Stone rightly observed, although we do not have absolute prognostic certainty at this time, we do have sufficient knowledge to decide what the optimal protective treatment should be once all the facts can be gathered and analyzed over a period of time.

  Evil exists; it presents itself in the form of psychopathy, of blind violence geared to destroy without reason, often accompanied by an orgy of pleasure. But it also exists, as Stone points out, in the context of socially sanctioned mass murder and genocide, which, in turn, we have begun to understand in terms of the regressive nature of certain group processes, a psychological development in groups for which a potential exists in every individual. There are extreme social circumstances in which ordinary citizens, or rather, those with significant personality disorders that ordinarily would not show antisocial behavior, do become violent and destructive, evincing a total loss of compassion for an entire social group or oppressed minority. Here again, we have to differentiate social, political, and historical features from personality predispositions, and come to terms with the fact that our present-day understanding may exceed by far our capacity to influence those phenomena.

  The core enigma of the psychopath, as Stone underlined, relates to the striking incapacity of compassionate reaction, of emotional empathy, and of concern for self and others. Neurobiological studies have pointed to certain cortical-limbic structures of the brain, particularly the complex relation between prefrontal and preorbital cortex, the anterior cingulum and the insula, with deeper layers of brain structures, particularly the amygdala and nucleus accumbens. While our knowledge of neurobiological systems and their specific functions is rapidly progressing, these structures and their functions may be indirectly related to complex behavioral, intrapsychic symbolic structures, with all of them implicated in influencing the capacity for empathy and for the internalization of moral values. As Stone points out, we have to advance simultaneously in research on the pathology of psychic structures embedded in the personality, and research on the personality determinants embedded in neurobiological structures.

  This book is indispensable reading for all concerned citizens and all mental health professionals, particularly, of course, all those who deal wit
h personality disorders at the boundary with forensic psychiatry. By the same token, it is hoped that all those in the legal system who deal with the social and legal problems involved in the management of antisocial behavior and criminality will find clear, updated information about an area that, unfortunately, still shows much discrepancy between our evolving level of new knowledge, on the one hand, and the practicality of dealing with the criminally ill, on the other.

  ACKNOWLEDGMENTS

  ajor thanks, more than I can easily express, go to Linda Regan, executive editor at Prometheus Books, whose wisdom and guidance have been invaluable not only in matters of style but more importantly in matters of content. The subject of evil is problematical and sensitive, arousing strong emotions and inviting acrimonious disagreements. Some question whether a psychiatrist should broach the subject at all. Linda helped me avoid Scylla and Charybdis, keeping me in clear waters. Gratitude, also not easily expressed or measured, goes to Ben Carey of the New York Times, who featured my work on evil in a Science Times article he wrote in February of 2005. His article gave me a presence in this field that granted me access to journalists and to professionals in mental health and law enforcement around the world. Within a few months after the article was published, I was invited to serve as the host of a television program dedicated to educating the public about the often neglected "why" question of evil: What are the forces that prompt persons-civilians in peacetime-to commit the kinds of acts we label as evil? Through the program I had the opportunity to interview some of these men and women. Through these personal contacts it became more clear to me what were the ingredients that underlay the possibility of redemption and what were the ingredients that militated against it.

  Even before Ben's article appeared, I had received encouragement to pursue this topic from leaders on psychopathy research: Dr. Robert Hare in Vancouver, and Dr. David Cooke in Glasgow. More recently I shared views and learned a great deal from some of the major writers on violence: Dr. Debra Niehoff and Dr. Katherine Ramsland. A number of prominent writers of true-crime biography gave me information about some of the high-profile murderers about whose crimes, designated evil by the public, I had only scanty knowledge of before. Among these writers: Carol Rothgeb-Stokes, Peter Davidson, Kieran Crowley, and Diane Fanning.

  Thanks go to Mary O'Toole of the FBI, who invited me to participate in the First International Congress on Serial Killers, held in San Antonio in 2005. There I became reacquainted with Roy Hazelwood of the FBI, who taught me the fine points about sexual sadism-a topic that overlaps closely with the public's understanding of evil. There are a number of forensic specialists-Dr. Paul Fauteck, Dr. John Hume, and Dr. Norbert Nedopil-to whom I am indebted for more accurate biographical data about some of the persons mentioned in the book.

  I owe great thanks to Dr. Charles Smith, former clinical director of the Mid-Hudson Forensic Psychiatric Hospital and my mentor in forensic psychiatry. It was through my work in forensics over the past twenty years that I developed a scale-the Gradations of Evil-by which I have attempted to place evil acts according to the degree of suffering of the victims and to the degree of horror evoked in the public.

  As human beings, we are a members of a social species whose survival is threatened now and again by the forces of nature but to a much greater extent through the actions of other human beings. As a result, we have developed a rich vocabulary to depict the subtleties of badness. Our vocabulary for goodness is much skimpier. We do not distinguish between a dozen gradations of honesty, sweetness, amiability, since these qualities merely enhance rather than threaten our survival. But for someone immersing himself in the subject of evil, it is comforting to be surrounded by goodness as a counterbalance to the horror stories I confront daily. It is comforting to be reminded-daily-that there is much more goodness than evil in the world, even though evil is more apt to garner the headlines.

  And it is here that my boundless love and gratitude go to my wife, Beth, who-were there a comparable Gradations of Goodness scalewould occupy a spot at its farthest end reserved for the very best of the Good. Beth's virtues are not confined to the spiritual; she read the manuscript as it evolved, made corrections, suggested changes in tone-all that were in line with Linda's recommendations and that contributed to a better manuscript. Better. Not perfect. The imperfections are mine.

  NOTES

  INTRODUCTION

  1. Galatians 2:19-21.

  2 . As in Sura 10:27-"As for those who have earned evil, the punishment of an evil is the like of it ..."

  3. Mani was a third-century CE Persian religious preacher who emphasized two separate powers of Good and Evil. Derived from his name and influence was the heresy in the Christian world of "Manichaeism." St. Augustine had briefly been Manichaean before converting to Christianity.

  4. Zoroaster, a Persian prophet of perhaps the seventh century BCE believed in a God of Good and Light (Ahura Mazda) and a God of Evil and Darkness (Ahriman).

  5. Cf. The Teachings of Buddha: Bukkyoh Dendoh Kyohkai (Tokyo: Kosaido Printing Company, 1966).

  6. Susan Neiman, Evil in Modern Thought (London: Transaction Publishers, 2002).

  7. Ibid., pp. 8-9.

  8. Andrew Delbanco, The Death of Satan: How Americans Have Lost the Sense of Evil (New York: Farrar, Straus & Giroux, 1995), p. 10.

  9. Sura 4:79.

  10. Brian Masters, Killing for Company: The Case of Dennis Nilsen (New York: Stein & Day, 1985).

  11. Ibid., p. 19.

  12. This is because there are no "evil genes." As we shall see in chapter 9, there are certain genetic factors that predispose to poor impulse control, low empathy, and certain other negative personality factors. But none of these are powerful in and of themselves to condemn one to behave in ways we consider evil. These factors heighten the risk that the person may later on behave in such ways, but they are not determinative.

  13. Masters, Killing for Company, p. 187.

  14. Lengthy biographies of mental patients begin to appear in the late eighteenth/early nineteenth century, such as Christian Spiess's Biographien der Wahnsinnigen (Leipzig, 1796), or in K. W. Ideler, Biographien der Geis- teskranken (Berlin: Schroeder, 1841).

  15. Leviticus 19:15.

  16. Ezekiel 7:3.

  17. Matthew 7:1.

  18. Matthew 7:3.

  19. Ludwig Wittgenstein, Philosophical Investigations, trans. G. E. M. Anscombe (Upper Saddle River, NJ: Prentice Hall, 1999 [1953]).

  20. Deuteronomy 22:25-30.

  21. Elaine Pagels, Adam, Eve, and the Serpent (New York: Knopf, 1989).

  22. Leviticus 18:21.

  23. Many examples are recorded in George Ryley Scott's History of Torture (London: Bracken Books, 1940). Examples are the burning of the Albigensians in Provence in the thirteenth century and of the Jewish converts to Christianity during the Spanish Inquisition in the sixteenth century. In 1545 Calvin ordered twenty-three people burned at the stake for supposed witchcraft. To cite all such examples would require a separate book of considerable length.

  24. This was the fear that inspired the witch trials in Salem and in other Massachusetts towns in 1692 during the judgeship of Cotton Mather. Cf. Cotton Mather, Discourse on the Wonders of the Invisible World (Roxbury, MA: WE Woodward, repr., 1866).

  25. Neuroscientist Jean-Pierre Changeux supports this view, as he made clear in his discussion with philosopher Paul Ricoeur in Changeux, What Makes Us Think: A Neuroscientist and a Philosopher Argue about Ethics, Human Nature, and the Brain (Princeton, NJ: Princeton University Press, 2000), p. 284.

  26. This topic is addressed in detail in the chapter 9.

  2 7. Many of these we now call "psychopaths." I will have more to say about these in the next chapter.

  28. Related words in German are fiber ("over," "atop"-as in "bber- mensch") and libel ("bad," "wicked").

  29. Insane is no longer a medical term; it is a legal term meaning that the person in question, because of mental derangement, did not know the nature of his acts,
not that these acts were wrong.

  3 0. By no means are all mentally ill persons, even those with a poor hold on reality, "insane." Very few are, actually. For even when seriously mentally ill persons commit horrendous crimes, they usually know that what they have done was considered wrong by the community at large. Such persons are often viewed in the courts as being responsible, of course, yet with a lesser degree of responsibility, and are often sent to a secure forensic hospital rather than to a conventional prison.

  31. Stephanie Stanley, An Invisible Man (New York: Berkley Books, 2006), p. 343.

  32. Ron Franscell, The Rape and Murder of Innocence in a Small Town (Far Hill, NJ: New Horizon Press, 2007). Attorney Gary Spence made the comment about evil (on the back cover of Franscell's book), alluding to the author's experience as a child growing up in Wyoming who had heard about the murders and then wrote about them.

  33. Chuck Hustmyre, An Act of Kindness (New York: Berkley Books, 2007), p. 223.

  34. Joe McGinnis, Never Enough (New York: Simon & Schuster, 2007), p. 336.

  35. Tina Dirmann, Vanished at Sea (New York: St. Martin's Paperbacks, 2008), p. 171.