Criminal - The Checklist

Episode Date: October 7, 2016

SPOILER WARNING: Please listen to Episode 51: Money Tree before you listen to this one. While working on our last episode, we became curious about the nature of psychopathy -- how it is defined, and what to do if someone close to you meets the criteria of the Hare psychopathy test. We spoke with Dr. Ronald Schouten, author of Almost a Psychopath, and Jon Ronson, author of The Psychopath Test. Say hello on Twitter, Facebook and Instagram. Sign up for our occasional newsletter, The Accomplice. Follow the show and review us on Apple Podcasts: iTunes.com/CriminalShow. We also make This is Love and Phoebe Reads a Mystery. Artwork by Julienne Alexander. Check out our online shop.  Episode transcripts are posted on our website. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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That's BotoxCosmetic.com. That's BotoxCosmetic.com. A quick note about today's show. Usually our episodes stand alone, and you can listen to them in any order you like. But today's is a bit different. You should probably listen to our last episode, episode 51. It's called Money Tree, first, and then come back and listen to this one. Okay, here's the show. If my mother was a psychopath, she didn't feel guilt. In our last episode, we brought you the story of a woman named Axton Betts Hamilton, who was the victim of identity theft. And only a few years ago, Axton discovered that the person who had stolen her identity

and her father's and her grandfather's for decades, racking up half a million dollars in debt, was her own mother. Axton is still trying to make sense of how her mother could do something so horrible for such a long time, not appear to feel guilty or want to come clean, even at the very end of her life. But Axton's been doing some research and now believes her mother may have been a psychopath. A psychopath will cognitively know the difference between right and wrong, so I believe my mother knew on an academic level that what she was doing was illegal. But in terms of understanding on an emotional level the consequences that she was creating for me and for my dad and for my grandfather,

I don't think she had a real recognition of that. I don't think she could have a recognition of that. Now, does that mean that I'm defending her? No, what she did was wrong. But I do think these psychopathic traits that she had, I think, are indicative of a severe psychological illness that she was able to successfully hide for her entire life. And this led Axton to think about herself and how, over the years, people have told her that she doesn't show much emotion. I immediately thought, okay, I am essentially 50% my mother. Her genes are in me. Do I have this?

At some point, am I going to start exhibiting these characteristics? And I went to my doctor, just completely freaked out about this and said am I at risk if I am what do I do and she said there's no way you have psychopathy and I said well how do you know that that's really funny you're trying to kind of convince her well I didn't she and she said, you can't because you have a severe anxiety disorder and psychopaths don't feel anxiety. The people who are most sensitive to these symptoms are the least likely to be psychopaths because you're worried about having something like this, whereas a true psychopath wouldn't really care. This is Dr. Ronald Schouten, a professor of psychiatry at Harvard Medical School

and the director of the Law and Psychiatry Service at Massachusetts General Hospital. He's both a lawyer and a doctor, and he's the author of a book called Almost a Psychopath. How many people are we talking about out there that are true psychopaths? True psychopaths, probably about 1% of the population. So if we have 300 million people in the United States, that gives us about 3 million. 3 million true psychopaths walking around.

But not all psychopaths are dangerous. Correct. And I would argue that probably the majority of them are not physically dangerous in terms of violent crimes. However, it's important to think about the following distinction. We consider psychopaths as either successful psychopaths or failed psychopaths. And the failed psychopaths are the people who end up in prison.

The people that you're more likely to encounter are the successful psychopaths. Part of what makes a successful psychopath successful is that they're so friendly and charming, the psychopathic traits can be undetectable. Ron Shoughton says that many of us will meet or interact with a psychopath on a daily basis. But how would we ever know? I'm Phoebe Dredge. This is Criminal. Psychopathy was actually referred to, even before the days of psychoanalysis, as moral insanity.

I mean, this is a concept that's known in multiple cultures and has been known for and talked about for at least hundreds of years. The word psychopathy is derived from Greek, translating to something like soul disease or soul suffering, to describe people who are in touch with reality, but don't have any sense of morality. It's the idea that these are people who know the difference between right and wrong, but they just don't care about it, and their behavior is unconstrained by that. So, how does a psychopath become a psychopath? I mean, are you born with the characteristics, with chemicals that, you know, what makes you a psychopath? Nature and nurture. We have something called primary psychopathy and it's genetically linked.

There's also secondary psychopathy, people who may have some inclinations to this, but because of the environment in which they grow up, they learn that the only way to survive is a dog-eat-dog approach to the world and others in it, and also really just have the empathy burned out of them. So psychopaths are overrepresented in the prison population, right? Well, compared to the general population, yes. As many as 15% of female inmates and 25 to 30% of male inmates meet the definition of psychopathy. But the vast majority of people in prison are not psychopaths. And there are plenty of people, free in the world, who, whether they break the law or not, do meet the criteria. My name is John Ronson, and I'm an author of a number of books,

including the book The Psychopath Test. John Ronson spent three years exploring how a person is diagnosed as a psychopath, and he met several times with the most famous man in psychopathy research, Robert Hare. Robert Hare is the father of modern psychopathy diagnosis. He was a prison psychiatrist and a fan of Harvey Cleckley, who was the previous father of modern psychopathy diagnosis. And Hare devised the checklist, the PCLR checklist, which is the gold standard for psychopathy diagnosis. It's a 20-point checklist that's now used all over the world. It's used by hospitals and prisons and parole boards and can be used to predict whether someone will re-offend. The checklist consists of 20 items.

A person is scored with a 0, 1, or 2. If the trait is not present, then you get a 0. If it's partially or possibly present, then you get a 1. And if it's definitely present, then you get a 2. The maximum score you can get is 40. People who are in the 30 to 40 range are characterized as true psychopaths. We asked John Ronson to walk us through the 20 items on Robert Hare's checklist. Item one is glibness, superficial charm.

And then item two, grandiose sense of self-worth. I remember when I met a CEO called Jane Sorrell Dunlap. We both looked up because he was standing underneath a giant oil painting of himself. Item three, need for stimulation, proneness to boredom. Item four, pathological lying. And they're not in the least bit embarrassed when they're caught lying. Item five, cunning manipulative. Item six, lack of remorse or guilt. Item seven, shallow affect, which is an inability to experience a

range of emotions. Item eight is the big one, that's callous lack of empathy. The lack of empathy, I suppose, is the main psychopathic trait from which all others follow. Item 9, parasitic lifestyle. Item 10, poor behavioural controls. Item 11, promiscuous sexual behaviour. I'm always surprised me a bit because, I mean, my promiscuous days are a long, long time in my past, but I look back on them with some fondness. Item 12, early behaviour problems. Again, this is quite a big one because the symptoms begin to manifest themselves around the ages of 10 to 12. So kind of extreme, um, aberrant behaviour like breaking another kid's arm in the school yard or torturing animals or setting fire to the

house, getting yourself expelled from school. So, you know, like big stuff. Item 13, lack of realistic long-term goals. Item 14, impulsivity. Item 15, irresponsibility. Item 16, failure to accept responsibility for own actions. Item 17, many short-term marital relationships. Item 18, juvenile delinquency. Item 19 revocation of conditional release which means if you're a criminal psychopath and you get released you go back to jail because you violated the terms of your parole. And

item 20 is criminal versatility. What does that mean? Oh, just you do a whole range of crimes. It kind of seems rather subjective. I'm glad you brought this up because it's incredibly subjective and it's prone to massive confirmation bias. And the reason is, is because, you know, as human beings, we love nothing more than to declare other people insane. So we want to define other people as psychopaths, especially people that we don't like. I mean, you only have to look at what's happening in this election cycle,

the, you know, thousands of articles, Donald Trump is a psychopath. In fact, it's kind of psychopathic to declare somebody a psychopath from afar. But of course, you know, everybody's ignoring that. Yeah, I remember one guy who was diagnosed a psychopath said to me, it's so frustrating because I say I feel terrible remorse for what I did. What he did was beat up a homeless man. He said, I feel terrible remorse for what I did. But he did was beat up a homeless man. He said, I feel terrible remorse for what I did. But when I say that to people, they say, well, that's typical of the cunning, manipulative psychopath to pretend to feel remorse when

they don't. He said, it's like witchcraft. It turns everything upside down. Support for Criminal comes from Apple Podcasts. Each month, Apple Podcasts highlights one series worth your attention, and they call these Series Essentials. This month, they recommend Wondery's Ghost Story, a seven-part series that follows journalist Tristan Redman as he tries to get to the bottom of a ghostly presence in his childhood home.

His investigation takes him on a journey involving homicide detectives, ghost hunters, and even psychic mediums, and leads him to a dark secret about his own family. Check out Ghost Story, a series essential pick, completely ad-free on Apple Podcasts. I just don't get it. Just wish someone could do the research on it.

Can we figure this out? Hey, y'all. I'm John Blenhill, and I'm hosting a new podcast at Vox called Explain It To Me. Here's how it works. You call our hotline with questions you can't quite answer on your own. We'll investigate and call you back to tell you what we found. We'll bring you the answers you need every Wednesday starting September 18th. So follow Explain It To Me, presented by Klaviyo. One of the reasons John Ronson knows the checklist so well is because he attended one of the diagnostic training courses taught by the creator of the checklist, Robert Hare.

Oh, it was just fascinating. It was in a marquee in West Wales. Obviously, I was the only journalist there. Journalists tend not to go on these courses. Robert Hare was kind of generous to allow me to sit in on this course. It's usually prison officers, care workers, people who have huge power over people's lives, over their freedom. So, yeah, so I was in this marquee and it was just great. It was exciting.

We'd watch these videos that Bob Hare would show us of interviews with people in prison, these case studies. I remember one time Robert Hare surprised us. He was just giving a talk about something and he surprised us by flashing onto the screen behind his head a close-up of a man who had been shot in the face. And his face was just, you know, decimated. in the crowd went, because our amygdala shot signals of fear and distress and remorse up and down to our central nervous system, which shows that we're not psychopaths. I suffer from anxiety, which means I have an over-performing amygdala. My amygdala is constantly shooting signals of fear and distress up and down to my central nervous system. Anxiety, I think, is the neurological opposite of psychopathy, because with psychopaths, neurologists say their amygdala underperforms. So when a psychopath sees a picture of a blown apart face, they don't respond like I

did with horror. They respond with something else, which is curiosity. They respond with curiosity. So that's the part of the brain that matters here. Will you explain that, the amygdala? Yeah, the amygdala. It's the part of the brain that registers fear and distress and remorse and anxiety and guilt. It shoots these signals up and down to the central nervous system, which always makes me think that, you know, fear, distress, remorse, guilt, these are the feelings that keep us good. And psychopaths don't have those feelings,

which is the reason why it's not a problem for them to transgress. It always makes me think that psychopathy is one of the most pleasant feeling of all the mental disorders because all of those feelings that we have that keep us good, they're unpleasant feelings. This brings us to the question of treatment. Can you teach distress, remorse, guilt?

Can you teach empathy? Back in the 60s, an eccentric young doctor named Elliot Barker set out to try. He traveled all over the world exploring different therapeutic approaches, nude therapy in Palm Springs and radical psychiatry programs in London. And he went on to get a job at the Oak Ridge Psychiatric Hospital in Ontario. Elliot Barker's idea was that psychopaths bury their madness beneath the veneer of normality. And if you could somehow get the madness to the surface, you could treat it. So his idea, having been on this odyssey, were LSD-fueled, mammoth-naked psychotherapy sessions. So he got a whole bunch of people who had been diagnosed as psychopaths in this ward in a hospital in Canada, and he made them strip-, he'd quite often tie them to each other,

and he'd give them these high doses of LSD. And they would go through these long LSD sessions. And the idea was hopefully that the LSD and the nakedness and just the kind of extremity of the situation would bring the madness to the surface. He had straws protruding from the wall, so if any of them got hungry, they could suck liquid food through the straws in the walls while they were naked and tied to each other and high on LSD. Anyway, amazingly enough, after all of these sessions, a change began to come over these people who had been diagnosed as psychopaths. They started to seem much more empathetic.

And in fact, some cameras were allowed into Oak Ridge and they filmed these psychopaths saying to each other, you know, there's such beauty in your eyes and I love you so much. And it really seemed as if they'd become much more empathetic. And then they were released into the world. And a number of years later, I think about 10 years later, somebody did a long-term recidivism study on how many of these people who had gone on to re-offend. And usually high-scoring psychopaths would go on to re-offend 60% of the time. But the ones who had been through Elliot Barker's naked LSD psychotherapy sessions went on to re-offend 80% of the time. So it actually made them worse. And one of them, a guy called

Peter Woodcock, was asked, well, you know, how come it made you worse? And he said, well, it taught us how to fake empathy better. Elliot Barker's program was shut down and since then, treatment approaches have been controversial. Turns out, there's no pill for empathy. A 2015 article in the Journal of Behavioral Sciences and the Law reads, Many clinicians have boycotted the idea of even attempting to treat high-risk psychopathic offenders. And a number of

corrections authorities have taken the position of, quote, sanctioned untreatability. Pretty much everyone acknowledges that we will recognize ourselves in a couple of the items on the hair checklist. How could we not? Who isn't prone to boredom at times or a little self-involved? But what if you recognize yourself or someone you know in more than just a couple? This is the subject of Dr. Shoughton's book, Almost a Psychopath. He uses a list of ten indicators that you, or someone you know, could be what he calls an almost psychopath.

Here they are. Superficially charming and glib, with an answer for everything. An impaired ability to understand and appreciate the emotions of others. When faced with a decision, you rationalize a choice that's in your own self-interest. Lying repeatedly, even when it's not necessary. Conning and manipulative. When you're criticized, it's always someone else's fault. A lack of true remorse when you cause harm to others.

Limited capacity to express feelings or maintain relationships You easily ignore responsibilities And finally, people and situations exist solely for the purpose of your needs and wants. And the idea is that there are people who have collections of symptoms of various types that don't meet the full criteria for a diagnosis as it's officially listed, but in fact suffer greatly and the people around them suffer as well because of those symptoms. If we think that our wife or boss might be an almost psychopath. What should we keep in mind here?

Protect yourself. Keep track of what's going on. Maybe keep some notes about behaviors, experiences that you found odd. This notion of gaslighting. These folks will often gaslight their victims, the people in their relationships, so that you're left scratching your head. It's like, oh, well, maybe I did screw that up. Maybe I did forget that. Maybe I was supposed to do whatever the task was involved or behave in a certain way. If someone else is putting blame on you, I mean, in that relationship, you want to keep track of those things so that you can go back at a later date,

especially if you get some help and get some consultation, so you can walk through these events. Because most of us tend to brush these things off. Again, our better nature is to think the best of other people and certainly not to think negatively. And so we'll tend to dismiss some of these events, some of these experiences that we have. And then only much later, when you look at the whole issue, oh my goodness, look what has been going on here this entire time. One time, I asked Martha Stout, who's a leading Harvard psychologist in this field, and I said, if you're married to a psychopath, what's your advice? And she said, my advice is leave. Just leave them.

She said, you can't hurt their feelings because there aren't any feelings to hurt. But how could you ever know for sure that there aren't feelings to hurt? And how in the world do you make that decision when it's someone you love? If I had met you back in 2005, would you have said, I asked about your relationship with your mother, would you have said, yeah, we're close. She's, you know, a great mother. She was a great mother growing up. What would you have said?

I would have agreed to all of that. I would have said we're very close. She's supportive of me. That we talk every day. And, you know, that it was a normal relationship. And based on what I knew growing up, I thought what we had was normal. Criminal is produced by Lauren Spohr, Nadia Wilson, and me. Audio mix by Rob Byers.

Alice Wilder is our intern. Julianne Alexander makes original illustrations for each episode of Criminal. You can see them at thisiscriminal.com. Criminal is recorded in the studios of North Carolina Public Radio, WUNC. We're a proud member of Radiotopia from PRX, a collective of the best podcasts around. Shows like Love and Radio. Their new season is just out.

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