I spoke with a psychiatrist I know from New York and asked him what he thought of Jason. He told me he wasn’t stupid enough to try to pass a diagnosis on a child he’d never met; but that he would tell me a little bit about mental illness if I didn’t use his name. He told me he had run into a lot of “problem children,” especially when he was working in the emergency room of a busy urban hospital. “All children are a little self-centered, especially when they are stressed,” he said. “But you can tell which ones don’t care about anyone other than themselves.”
He told me that kids who show many of the same symptoms Jason did may be lucky if all they have is ADHD, as it generally fades as the child gets older and they always have the Ritalin option. The same symptoms, the doctor told me, could be a reflection of something worse—something potentially much more dangerous and even less likely to respond to any form of treatment. And sadly, something statistically just as likely to occur as ADHD. The doctor from New York began to tell me about Antisocial Personality Disorder, or APD.
As the name obliquely implies, sufferers of APD have a problem with other people. While the existential philosopher Jean-Paul Sartre once famously wrote, echoing the frustrations of millions, that “hell is other people,” people with APD don’t occasionally get fed up with society; they just don’t get it at all.
But it’s more than that; specifically, APD is defined as a disregard for social rules, norms and cultural codes, along with impulsive behavior and an overall indifference to the rights and feelings of others. The Diagnostic and Statistical Manual of Mental Disorders (DSMMD), the bible of modern clinical psychiatry, indicates that a diagnosis of APD may be safely made if a patient shows just three of the following seven symptoms:
1. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain steady work or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
Basically, a person with APD lacks empathy—the ability to care for or identify with others. He or she feels no guilt, no pangs of conscience after he or she has caused harm to others. Of course, if a person feels no guilt, it’s much easier for them to commit crimes. And, not surprisingly, many serial killers and others who have profoundly offended society have been diagnosed with APD. But the DSMMD makes it perfectly clear that APD can not legally be diagnosed in patients younger than 18. Of course, this is to prevent confusing APD with ADHD, and to keep a child’s life from being unfairly stigmatized by an incorrect diagnosis.
But that doesn’t mean that children can’t have APD, or show signs they’ll develop it later in life. Back in 1963, a psychiatrist named John MacDonald published an article in the American Journal of Psychiatry called “The Threat to Kill.” In it, he wrote about the data from his studies that showed that the overwhelming majority of murderers—and the frequency was higher among the more sadistic killers, the ones most likely to exhibit the traits of APD—shared three particular and peculiar traits. MacDonald found that the people who later exhibited severe criminal behavior and/or APD often wet their beds, set fires and exhibited significant cruelty to animals as children. While many children may experiment with animals—say, pull the wings off a fly to impress or repulse their peers—MacDonald made it clear that what he was talking about was real zoosadism, acts of cruelty to larger, more human-like animals such as cats and dogs, often alone and with the intent of pleasing the self and not others.
While any of these behaviors by themselves could be attributes to a lack of self-discipline or an excess of curiosity, when the three are seen together, they set off red flags among psychiatrists. They should; such notorious killers as Albert “The Boston Strangler” DeSalvo, John Wayne Gacy, Jeffrey Dahmer and others exhibited all of them.
But not everybody with APD exhibits the symptoms of the MacDonald triad, admits to them or is caught at them. The condition can be much stealthier than that. And those affected can be great liars. Often, a person with APD can blend into the rest of society seamlessly—or almost so. It can take the form of the overaggressive, nitpicking manager; the constantly interrupting and one-upping aunt; the co-worker who blames everyone else for his mistakes; or the housemate who raids the communal fridge at night. Since recent studies show that about 5.3 per cent of men and 1.8 per cent of women show the symptoms that indicate APD, it’s not out of the question to surmise that we all know at least one, and most of us have one or even some in our family.
Traditionally, our culture has recognized two types of people with APD. The medical community, which nowadays shies away from calling people names, has largely abandoned these titles, but they are familiar to most people—sociopath and psychopath.
The difference is in presentation. A sociopath is someone who—often unashamedly—makes it clear that he or she has APD. We’ve all seen them. While lots of people will adopt outward signs of rebellion such as piercings, tattoos or a mode of dress, sociopaths usually make it pretty obvious they’re not interested in your opinion of them, so much as they are interested in their own opinion of themselves. Our society has built up some collective and tacit knowledge of sociopaths—while there’s no guarantee that a guy with a swastika tattooed between his eyebrows is dangerous, pretty well everyone is going to give him a little extra room on the subway.
But not all sociopaths are obvious by appearance. Some look very much like everyone else, but have clear behavioral cues. The doctor from New York acknowledges the difference between sociopaths and psychopaths, even if he doesn’t use the names professionally any more. He tells me that if I want to see the difference between the two types, I should research the histories of two killers—Seung-Hui Cho and Ted Bundy.
If you hadn’t known him, Cho would have appeared at first glance to be a fairly ordinary guy—a bit intense and aggressively nerdy, but within the bounds of what most people would call normal. But it became abundantly clear to Julian Poole, who encountered Cho in September 2005 when they were both juniors at Virginia Tech University, that Cho was anything but “normal.” It was the first day of an American literature class and the prof was trying to break the ice and get to know his students by asking them to introduce themselves. Some were nervous, especially at first, and tried to get it over as quickly as possible. But most tried to get a laugh or sincerely offered some insight into their personality. When it came to be Cho’s turn, he merely stared angrily at the prof. It was a horrible, awkward silence that seemed to last for a very, very long time. Finally, with a nervous chuckle and a long-forgotten disarming comment, the prof moved on to the next person. Later in the same class, the students were obliged to write their names on a seating assignment map. Poole, curious to learn the name of his silent and defiant student, noticed that Cho put a question mark where his name should have been. It apparently didn’t escape the prof ’s notice, either. According to published reports, the school’s faculty started referring to Cho as the “Question Mark Kid.”
And he wasn’t just that way in class. Karan Grewal, an accounting student who lived in the same undergrad suite as Cho in Harper Hall, knew him for months before he realized Cho could speak English. “It was weird that he never spoke, but we’d all got used to it,” said Grewal, who only finally found out Cho spoke English when he peeked over his shoulder while he was furiously typing away on his laptop. “If you talked to him, he would stare down at his lap.”
He generally didn’t go to class either. Grewal couldn’t recall much of C
ho’s behavior other than staring at the walls, typing away on his laptop and continuously riding his bicycle in circles in a nearby parking lot.
While Cho was strange as a junior, he was frightening as a senior. An aspiring writer, he took a poetry class taught by the distinguished poet Nikki Giovanni. While Giovanni is no stranger to tough situations, having been an important player in the civil rights movement and in early black activism, she was decidedly scared of Cho. She described him as having a “mean streak” and admitted that she was intimidated by him. She went to her department head, fellow poet Lucinda Roy, and complained about his habit of photographing female classmates’ legs under their desks and of his “violent and obscene” poetry. Giovanni was so concerned that she threatened to resign her position if Cho was not removed from her class. Roy took these concerns to the school’s chancellors, but they—ever mindful of litigation—told her there was nothing they could do unless Cho made a direct threat to someone, including himself.
A new Harper Hall roommate, Andy Koch, noted much of the same behavior from Cho that Grewal did. He saw the same repetitive, obsessive behavior—such as stabbing carpets and listening to Collective Soul’s 1994 hit “Shine” continually for hours on end. The unusual conduct became even more apparent once Koch realized that Cho had taken something of a shine to him. One morning, he woke up to find Cho taking photographs of him. Later, he received a barrage of rambling, incoherent cell phone calls from Cho, who claimed to be an imaginary brother named “Question Mark.” This was the same name Cho used when talking to girls he was attracted to, though he invariably creeped them out enough to make them want to have nothing to do with him.
Women were a big problem for Cho. Koch described a number of run-ins Cho had with uniformed Virginia Tech security guards, each of them the result of a woman’s complaint that Cho was stalking her. When Cho finally did talk one day, the first thing he told Koch was that he had a girlfriend. At first, Koch was relieved, until Cho told him that his girlfriend was a supermodel named Jelly and that she lived in outer space. He wasn’t joking; he wasn’t being sarcastic; Cho really did expect Koch to believe in his extra-terrestrial paramour.
Things got worse when Cho intercepted an instant message address of one of Koch’s female friends. He sent her a few incoherent messages and then he nailed a piece of paper with a quote from William Shakespeare’s Romeo and Juliet to her door. It said: “By a name, I know not how to tell who I am. My name, dear saint, is hateful to myself, because it is an enemy to thee. Had I it written, I would tear the word.”
The young woman thought nothing of it until she received a message from Koch, warning her about Cho. He told her all about his prior stalking arrests and wrote to her: “I think he is sch[iz]ophrenic, or however you spell it.” Alarmed, the young woman called campus security. Familiar with Cho, the campus cops dropped by and gave him a verbal warning. Cho then texted Koch, threatening to commit suicide.
Unsure of what to do, Koch called his dad. Astutely, his dad told him to call campus security, which he did. Just to be sure, Koch’s dad called them too. The security officers apprehended Cho, served him with a temporary detention order and escorted him to the New River Valley Community Services Board, a mental health facility in nearby Blacksburg.
Cho did everything to convince the doctors there that he was mentally healthy and not suicidal, but they determined he was “an imminent danger to himself and others” and referred him to detention at the larger, more intensely secure Carilion St. Albans Behavioral Health Center farther along the road in Christiansburg. The psychologist who treated him there, Dr. Roy Crouse, considered him “depressed,” but noted that he denied thoughts of suicide and decided that “His insight and judgment are normal.” He recommended Cho be treated on an outpatient basis. On the strength of Crouse’s findings, Special Justice Paul M. Barrett signed a judgment that Cho be freed on the condition that he accepted follow-up treatment. He visited the facility just once after that, and no progress on his condition was reported.
Cho got up for school early on the morning of April 16, 2007. He had big plans that day and, to accomplish them, he brought along two handguns and hundreds and hundreds of hollow-point rounds of ammunition—the type of bullet that does by far the most damage to human tissue. While a normal bullet will pass through anything it hits largely intact, hollow points collapse on impact, creating large, flat surfaces that bulldoze their way through the human body. The difference in damage is enormous.
A few hours and hundreds of shots later, Cho had killed 32 Virginia Tech students and faculty and wounded another 25, before killing himself.
While Cho’s case is complex and interesting for a number of reasons, there are two aspects of his story that make his a very good example of sociopathic behavior. The first is that he didn’t think he had done anything wrong. In fact, it appears that he considered himself something of a hero.
During a break in his shooting spree, Cho sent a package via FedEx to NBC. It contained a number of photographs and videos of him posing with his guns and knives and trying to look cool; but, more important, it included a manifesto of sorts. In it, he wrote: “All the shit you’ve given me, right back at you with hollow points.” He railed against what he considered the sinful habits of his classmates and compared himself to Jesus Christ. He absolved himself of all responsibility, writing:
When the time came, I did it. I had to. You had a hundred billion chances and ways to have avoided today, but you decided to spill my blood. You forced me into a corner and gave me only one option. The decision was yours. Now you have blood on your hands that will never wash off.
Later, investigators found a note in his dorm room that denounced the other students at Virginia Tech as “rich kids” and “deceitful charlatans” whom he felt he had to punish for their “debauchery.” In a sentence that appears to sum up his motive, he wrote: “You caused me to do this.”
While the world was horrified by the day’s events, there were those at Virginia Tech who weren’t surprised at the killer’s identity. “I knew when it happened that that’s probably who it was; I would have been shocked if it wasn’t,” Giovanni told reporters after the massacre.
“That’s the thing about Cho,” the doctor from New York said, when I spoke to him later. “Everybody knew he was different, he was strange, he was even potentially dangerous; but what could they do about it?”
It’s true, after the murders, nobody—not even Cho’s family—really tried to deny his sociopathy, nobody pretended he was just a misunderstood guy. It was universally acknowledged that he was a very sick young man and that his sickness was abundantly obvious, but there was little anybody could do to help him. He wouldn’t seek help because he was convinced there was nothing wrong with him; it was, in his opinion, everybody else who was at fault. Because of privacy laws and other civil liberties concerns, there was little the university could do but encourage him to seek help. The nature of his problem meant that he was unlikely to trust, tell the truth to, or confide in the medical professionals trying to help him—which, of course, defeats the purpose of therapy. His family, though, repeatedly tried to intervene. Deeply religious people, they prayed for him and brought him to church regularly, but to no avail. “Mental problems aren’t like other physical problems,” the doctor told me. “You can’t just clean the wound and apply pressure like you would a hemorrhage; it’s much more complicated than that—and, unlike a hemorrhage, you can almost always deny it.”
As much as Cho is a definitive example of a sociopath, Ted Bundy was a classic psychopath. Invariably described as handsome, charming, articulate and educated, Bundy used his superficial charm to seduce or at least temporarily gain the trust of women. Once they were alone with them, he would bludgeon, strangle and rape them, often after they died. While he eventually confessed to 30 murders, some—particularly those in law enforcement—are convinced there are more.
Bundy, originally from Vermont, had a childhood love of skiing that led to a
habit of shoplifting items he couldn’t afford. He started by stealing small items, then moved up to skis and other equipment, eventually developing the nerve to forge ski passes and even lift tickets. He was arrested twice as a minor, but those records have been destroyed and he appears to have done no time in jail.
He was popular as a youth, despite being a compulsive liar and admitting, “I didn’t know what made people want to be friends. I didn’t know what underlay social interactions.” This sort of revelation is not uncommon among psychopaths. Without the ability to care about other people, psychopaths are unable to understand or express many common emotions like grief. This was well illustrated when Nicole Kidman was preparing for a role as a psychopath in the film Malice. She turned to Dr. Robert Hare, a professor emeritus at the University of British Columbia in Vancouver and one of the world’s leading authorities on psychopaths. Hare, who has written extensively on the subject and has consulted with the FBI, RCMP and other agencies on criminal investigations, told her to imagine a scenario:
You’re walking down a street and there’s an accident. A car has hit a child in the crosswalk. A crowd of people gather round. You walk up, the child’s lying on the ground and there’s blood running all over the place. You get a little blood on your shoes and you look down and say, “Oh shit.” You look over at the child, kind of interested, but you’re not repelled or horrified. You’re just interested. Then you look at the mother, and you’re really fascinated by the mother, who’s emoting, crying out, doing all these different things. After a few minutes you turn away and go back to your house. You go into the bathroom and practice mimicking the facial expressions of the mother. That’s the psychopath: somebody who doesn’t understand what’s going on emotionally, but understands that something important has happened.
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