Psychological treatments aimed at developing insight into our darker side are not meant for everyone. Analyzing our actions before rushing to critically judge ourselves is a responsible course—but difficult for many people. For example, I have treated patients whose harsh self-criticism, though very painful, was easier for them to bear than facing their dreaded inner demons. Often with such patients, the therapy was unsuccessful. A prickly conscience provided excellent cover against self-discovery.
Insight psychotherapy is just one of many therapies available. Currently, there are over 450 different psychotherapies that individuals can choose from. Psychotherapies have been scientifically proven to be effective.
The purpose of insight psychotherapy is to identify conflicts and develop new ways of coping and resolving problems. When successful, it frees the individual from being stuck with automatic, reflexive reactions to life’s stresses. A fundamental tenet of insight therapy holds that, in general, the more realistic a person’s perception of oneself and the world, the more harmonious that person’s adaptation to life. When a person has experienced an important insight, she or he is never the same. However, much depends on how the person uses the insight, if it is used at all. One patient analogized the psychotherapeutic process to a worm that enters a cocoon, and, in time, emerges as a beautiful butterfly that flies away free. Another patient, an intractable curmudgeon, used the same metaphor to insist that his transformation process in therapy was from a worm to an ugly moth with a flame fixation. Individuals who respond favorably to insight therapy are able to replace reflexive responses by choices. Also, positive changes in character structure generally improve prospects for a more inner-driven destiny.
The list of attributes of the hypothetical healthy person could go on and on, but ultimately any such list must end with the succinct summation about mental health once made by William Sloane Coffin, former Chaplain of Yale University, who said, “I’m not okay, you’re not okay, and that’s okay.” Perfect mental health is a fiction. It is also undesirable and downright inhuman. Mental health and illness exist on a continuum, and in delicate, dynamic balance—and perfection is entirely off the scale. Much depends on the context. A noise that barely catches our attention in the morning after a good night’s sleep can, later that evening, when we are tired, frighten us terribly.
Born Unto Trouble
As can be readily appreciated, much hard work, sustained effort, and loving care go into raising good women and men. Socialization and character appear to develop best within an intact family providing good enough care, preferably with both parents present. In many instances, good parenting can overcome or inhibit inherited antisocial tendencies. In others, the best parenting and family situation available may not be sufficient to control innate destructive behaviors, particularly if alcohol and drug abuse are involved. So even under optimal circumstances, parenthood is an impossible task. There are neither perfect parents nor perfect children.
Many of the mentally healthy attributes previously described play a role in the fashioning of sound character. No one can go beyond his or her character. In many ways, our character foretells our future. In this sense, character is destiny—who we marry, if we marry, our relationships, what sort of work we do, how we live, who we are, whether we are good or bad. Obviously, many things happen in life over which we have no control. But how we respond, whether adaptively or dysfunctionally, is directly related to our character. The murderers, rapists, and psychopaths in this book represent the end stage of character development gone awry. The answer to prevention of antisocial behavior does not reside in adding more police and building more jails. These solutions can only address the end-stage problem, which, of course, is still important. But effective prevention will occur only when society undertakes to provide and protect those elements that foster the development and continuity of stable, caring families.
It is also quite clear that the bad men and women depicted in this book failed miserably in the areas of character, conscience, impulse control, reality testing, and interpersonal relationships. Compared with people with the hypothetically “normal” character profile, these bad men and women are riddled with debilitating emotional and mental deficiencies. When a psychiatrist has the opportunity to examine these persons, their severe psychological conflicts and developmental problems are displayed in excruciating detail. They hardly are the stuff for even the lowest grade of Hollywood movie.
Why bad men do what good men dream is explained to a certain degree when one has the opportunity to psychiatrically examine antisocial persons. But the answer to the good men–bad men conundrum must go beyond psychiatric examination. Even when the psychiatrist has been able to spot glaring psychological conflicts and deficiencies that led to a destructive act, the origins of these dysfunctions often remain obscure. The need for certainty where none is possible unrealistically places unfounded reliance on psychological theories. We are all born with a darker side. Good men—for reasons only some of which are known—are able to contain that dark side. Bad men live it.
Empathy
Taught by time, my heart has learned to glow for other’s good, and melt at other’s woe. —Homer
One difference between bad and good people may have to do with empathy. This is a core character trait that enables us to understand our fellow human beings and to feel compassion. It has something to do with an anatomical structure that has been found in monkey brains and human brains, called mirror neurons. The cells are located in the brain’s motor cortex, where muscle movement and control are initiated. The mirror neuron circuitry allows us to step into the shoes of others, to feel their pain. The more empathetic the person, the stronger is their mirror neuron response. Although science has discovered this neuronal basis for empathy, it can only be a foundation upon which personal experiences of love and caring build. Adverse life experiences can interfere with or disable the functioning of mirror neurons. Psychopaths, for instance, do not feel empathy. Presumably their mirror response is very weak or nonexistent.
The lack of empathy may be an important reason why psychopaths are untreatable. In previous chapters that have analyzed all sorts of “bad men,” from serial killers to heads of state, we have seen how spectacular failures in empathy drive the engines of evil.
For psychotherapists and other providers of health services to be effective, they must be empathetic. But excessive empathy may cause these providers to live too much in another’s shoes, and thus share the patient’s destiny. To be truly effective, the healthcare provider must also be able to step out of those shoes.
Empathy allows us to feel the pain of others, but also to experience their joy. As such, empathy can combat envy, a pernicious character flaw that can destroy relationships and make life miserable for everyone.
Are We Hard-Wired for Trouble?
What causes our destructive behaviors? Is it genetics, one’s family of origin, terrible experiences, bad brain chemistry, or all of these? Have our brains been hard-wired through the evolutionary process for inevitable trouble? Is dysfunctional behavior attributable to factors that are beyond our control? And how much of good mental health is the blind luck of the draw? For example, what does the future hold for children who are born addicted to cocaine and whose mothers are teenaged and unwed? What opportunities will these children have to learn how to channel or control their antisocial impulses?
What we do know is that the brain of every individual—his or her “computer hardware”—is genetically distinct from all others. The human genome (an organism’s complete set of DNA) contains 3.1 billion DNA pairs. The opportunities for genetic aberrations are great. J. D. Watson, the codiscoverer of the double helix structure of DNA, observed, “We used to think our fate was in our stars. Now we know, in large measure, our fate is in our genes.” Adding yet another level of complexity, environmental and other factors may also influence the gene expression. As in a computer, the brain’s capacity to process information correctly and to adequately
perform various complex psychological tasks depends on the circuitry. It is estimated that the human brain contains approximately 30 billion neurons that have 100 trillion interconnections. Into this “hardware” goes important “software”—for instance, the individual’s personal experiences with caregivers and with the world in general. The possible combinations of a person’s unique hardware with the permutations of this software are infinite. We know this because even identical twins with identical brain hardware and the same parents have different software experiences. These twins appear identical on the surface, but their characters are not identical. Suffice it to say that malfunctions in either or both modalities, hardware and software, are what lead to psychological limitations and to trouble. With all this genetic and neuronal complexity, it is incredible that most of us come out reasonably whole.
Good computer hardware combined with good software allows good men to dream. But again there are no perfect computers, and there is no perfect software. In fact, even apart from our inherent limitations as human beings, there are too many places for things to go wrong, to even contemplate the possibility of a hypothetically “normal” person who has all of the attributes described in this chapter. Our dark side is a fundamental part of our personality—of our brain-computer hardware. In so many instances, it is the software of our personal experiences with our parents, family, and the world that fashions our character and our destiny. Many of the persons depicted in this book were destined for trouble by aberrations in both their brain-computer hardware and their software experiences. Many of us may escape a similar harsh fate because we have either good enough hardware or good enough software, but not necessarily both. For the troubled, modern psychiatry has developed a wide variety of beneficial treatments for mental disorders, which can help substantially in controlling destructive, antisocial ideas and impulses.
Fortunately, the majority of humankind does tolerably well in rising above the inherent limitations that we have as human beings. I find it truly remarkable that we have so many good people in this world, even if they are all limited in their goodness. Although, as Job says, we are all born unto trouble, we are not condemned to miserable lives. Good people are able to dream and to contain the impulses that bad people act out. Taming our demons and acknowledging our humanity with its attendant dark side can be empowering. Those who become psychologically resourceful may be able to put the demons to useful work, in the same way as humankind has learned how to tame and use fire, though the sparks inevitably fly upward. It is the essence of the human condition that we struggle against our dark demons, that our spirit strives to harness these demons in the pursuit and the fulfillment of our human destiny.
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