THE PSYCHOPATH; A NEW LOOK

THE ROOT CAUSE OF PSYCHOPATHY

AND WHAT WE SHOULD DO ABOUT IT

By Stephen A. Sheppard, M.D.

shepp@wavenet.net

After twenty five years as a board certified surgeon in private practice, I turned my full attention to psychiatry.  I had used hypnosis and other psychiatric techniques as a surgeon but in 1968, I undertook a three year psychiatric residency at the Napa State Hospital.  Upon its completion I joined the staff of the California Medical Facility in Vacaville where I soon rose to the level of Senior Psychiatrist.  CMF was a psychiatric hospital within the California Department of Corrections.  In Sacramento, CDC Director, Raymond Procunier, became concerned about the number of inmates who were housed in maximum security units throughout the state.  He built a special high security facility within CMF to be known as the Lister Unit and asked me to run it.  Later, in 1993, I became a Senior Psychiatrist at Pelican Bay State Prison in Crescent City, California.  While there, I came across a revolutionary book called The Imperial Animal, which explained much, if not all, regarding the cause of mental illness.

Two anthropologists, Lionel Tiger and Robin Fox, authored The Imperial Animal published in 1971.  In this book, they demonstrated that in the central nervous system of all vertebrates--especially mammals--many faculties develop during specific times prior to birth and soon after.  They concluded that mammals develop the power of sight and other critical functions during infancy.  They also found that once the time for a certain stage in development passed, there is no chance for development of those faculties later in life.

Tiger and Fox concluded, "The further we move from the governance of primary instincts into the arena of learned abilities, the more it becomes essential for the slowly growing young animal to get its learning right.  A great deal of its most important learning occurs early and involves those experiences that will provide the foundations for further learning."

The authors expanded on their observations employing monkeys, ungulates, wolves, birds and many other animals.  They then concluded that certain imprinting for learning must happen during 'critical periods' specific to various species.  They said, "Even if the 'learning' involved is not of this rather dramatic and rigid character--as is the case with higher mammals--it is nevertheless like it in that it must take place at certain times and in certain ways, and that its outcome determines to a large extent the future performance of the creature."

Tiger and Fox wrote, "The mammalian mother has to suckle the child so that it can live, flourish, and eventually breed.  But again, the higher we mount the scale of mammalian complexity, the more it becomes true that something other than simple feeding is involved in the mother-child relationship."  In humans and other mammals, mother-child bonding is part of this simple feeding process.  However, this bond goes far beyond nourishing young.  Tiger and Fox also stated, "Since early learning and development needs to happen when the young will be intensively suckling, nature has no option but to make the mother-child bond the matrix for the basic learning process of the maturing animal."

Tiger and Fox explained, "Ultimately the 'nonbreeding' bond with the mother has to be transformed into a 'breeding' bond with a member of the opposite sex.  In other words, an infant's first bond with the mother teaches it how to bond with others of its species to survive, socialize, and ultimately procreate.  In their observations, new-born mammals did not thrive if they were deprived of the nurturing normally provided by parents or surrogates.  Nor did these deprived infants fit into their own species when they were later returned to their natural habitats.  The investigators concluded mammals deprived of the mother-child bond as their matrix for learning will not develop the capacity for bonding at all.  Therefore, we can predict that if the mother-child bond does not go right, the unfortunate youngster may never get any other bonds right.

In their examination of this bonding process, the authors found the critical time for an infant's first bonding occurs during the first 6 months of infancy.  Therefore, if the mother fails to nurture the infant by feeding it, holding it, and forming emotional attachment with it, it is unlikely the infant will bond with its mother.  In this way, the infant misses the crucial period in which humans learn the process of bonding.  As demonstrated by observations of other mammals, as well as humans, failure to bond prohibits social integration and significantly decreases the potential for survival and breeding.

Furthermore, Tiger and Fox found that under normal circumstances all mammals nurture their young, with the exception of some humans.

LINK BETWEEN THE IMPERIAL ANIMAL AND PSYCHOPATHS

Extrapolating from The Imperial Animal, I have come to believe that a mother's failure to adequately nurture her infant and its subsequent failure to establish bonds within society describes the root cause of psychosis and possibly other mental illnesses.

I was electrified by the idea that much of the Pelican Bay inmates' psychopathy resulted from inadequate care when they were infants during the first six months of life.  I began to think that many major mental illnesses were caused by a failure in the bonding process and that many if not all of the paraphilias (sexual deviations) were the result of a lack of nurturing and the effect of imprinting.  I reasoned that in cases of inadequate nurturing during the first six months of life the ability to bond with other humans is lost.  The crucial period during which bonding occurs has passed and will not return.  Such individuals are doomed to go through life alone, pretending at times, if it appears to be in their best interest, to care for others but there is never any real feeling in their relationships.

This inability to bond--and its repercussions--is reflected in both Conduct Disorders and Antisocial Personality Disorders--otherwise known as Psychopaths.  The American Psychiatric Association (APA) describes psychopathy as a pervasive pattern of disregard for and violation of the rights of others, as indicated by three (or more) of the following:

In addition, the occurrence of antisocial behavior does not exclusively occur during the course of Schizophrenia or a Manic Episode.  The individual must be at least 18-years-old and there must be evidence of Conduct Disorder with onset before 15-years-old.

Conduct Disorders are defined by the activity of individuals less than sixteen years of age and are identified by the APA as repetitive and persistent behavior patterns in which the basic rights of others or major societal norms or rules are violated, as manifested by extreme aggression towards people or animals; deliberate destruction of property; deceitfulness or theft; serious violation of rules indicated by such behavior as running away from home overnight and often skipping school, beginning before age 13 years.

So what is the difference between Conduct Disorder and Antisocial Personality Disorder?  Years ago the criteria for both consisted of enuresis (bed wetting), fire setting and cruelty to animals.  It is my opinion that the disorders--essentially differentiated by age--are one and the same.

DEPENDENT PERSONALITY DISORDER

The APA criteria for this condition follow:   A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

What more perfect example of inadequate nurturing.

My first glimpse of the contempt which psychopaths hold for the law abiding, productive members of society was revealed by a patient named Tommy at the California Medical Facility in Vacaville.  Tommy waited for the other patients to leave after one of the group counseling sessions and said to me, "You know something Doc?" He grinned,
"You're not like the lames."
"Who are the lames?" I asked.
"All the straight dudes on the staff who come and preach to us all the time.  They tell us we're sick and need their help.  Let's face it, they're the ones who are handicapped."
"How do you mean handicapped, Tommy?? I asked.
"Well, I guess I mean they have a conscience and that keeps them from doing what they really would like to do.  We don't have that problem so we don't hold back.  We just do it, no matter what."

Tommy was describing psychopathy.  The psychopath has no self-restraint, doesn't learn by experience, is impulsive and doesn't hesitate to exploit others.  The psychopath feels no guilt when he robs, rapes, murders, kidnaps, lights fires, beats his wife, abandons his children, or is arrested for a DUI.  What is the psychopath saying by his behavior, according to the basic premise?  "I am unlovable.  No one really cares about me.  I will grab whatever I want.  Catch me if you can."

I have always thought it strange that none of my patients ever manifested signs of depression nor complained of such feelings.  Over the years while practicing psychiatry, I have come to believe that depression, in many cases, is caused by repressed hostility and anger.  I realized it makes sense that psychopaths don't feel depression because they don't repress their anger.  Since they feel no emotional attachment to other humans, they express their anger without limitations often ignoring social morals and breaking laws in the process.  Even if their offenses have horrendous results, psychopaths who have never developed the ability to bond, do not show remorse or depression.

In any event, although diagnostic criteria are interesting and desirable for the purpose of obtaining remuneration for treating the untreatable, there has been minimal attention devoted to etiology and prevention of the aforementioned conditions.  In The Imperial Animal, Tiger and Fox have demonstrated that immeasurable physical and emotional damage to human infants results from a lack of nurturing during the first six months of life.  It follows that if a newborn child is cared for by its mother, suckled, cuddled, loved and nurtured in every way, the child-mother bond establishes a matrix of learning by which the child can develop into an empathic adult with the capacity to bond with those around him.

Unfortunately, many newborns prove to be unacceptable to mothers who give birth to unplanned pregnancies and to those who may have wanted a child but find they are not equipped emotionally, financially, or otherwise to provide the loving care every human infant requires in order to develop the ability to bond.  In the absence of the child-mother bond, further bonding does not take place and it is likely the child will develop behavior described as Conduct Disorder until age eighteen and become Psychopaths thereafter.  More often than not, these people end up in prison, where, they are subjected to all sorts of treatment by well meaning psychiatrists, psychologists, art therapists, physicians, nurses, recreation therapists, school teachers, correctional officers and a host of others.  Inmates play the game of psychotherapy:   attending group and individual therapy sessions, taking prescribed medication and cooperating in many ways to qualify for parole.  When paroled he comes back into society but is still a psychopath.  Before long he breaks the law and is incarcerated demonstrating that psychopaths are not amenable to treatment.  Thus demonstrating the general futility of our penal system and explaining the rate of recidivism.

So if mental disorders are all a matter of failed bonding why do psychotropic drugs work and why do they work so well on some patients and not well at all on others?  The cardinal symptoms of the schizophrenic conditions are delusions and hallucinations.  These symptoms are caused by extreme anxiety.  The human mind requires an explanation for these symptoms.  In the absence of any apparent cause for the anxiety, the mind creates frightening delusions and hallucination.  Some auditory hallucinations are in the form of orders which must be carried out (command hallucinations) directing the patient to do certain things which would ordinarily be unacceptable to him/her.

I had a patient while I was working at Napa State Hospital who complained about being under constant surveillance by his mother who was no longer living.  I entered his delusions and agreed that he was being watched.  At one point I asked him what he would do if he were not under surveillance at which he thundered, "I'd kill the son of a bitch!"  Further discussion revealed that it was his brother whom he resented and who remained alive only because of his delusions.

Psychotropic drugs relieve this extreme anxiety at which point the delusions and hallucinations go away.  The patient is relieved and appears to be cured as long as he takes the medication.  The problem is that many such patients become convinced they no longer need the medication and stop taking it.  The anxiety recurs and the symptoms of psychosis return.

This is not to say that the major tranquilizers and other medications such as Lithium are useless.  In fact, they are very helpful but they do not cure mental disorders.  Because the central nervous systems of these patients have never matured or properly developed since they were not nurtured during the first six months of their lives, they are incurable.  Interestingly enough, those children who are nurtured (as described) above during those crucial first six months can often survive all sorts of mistreatment thereafter without becoming mentally ill.  If people do not use illicit drugs or alcohol to excess and do not develop organic problems, they are inclined to lead normal productive lives without experiencing the crippling effects of major mental disorders.

Some experts believe psychopaths are indeed treatable.  In 1949 Andrew Salter published a book entitled Conditioned Reflex Therapy.  As an aside Salter wrote, "To call someone a psychopath usually implies that he is unamenable to therapy, when actually, with a little effort, he can often be helped.  To which Cleckley, a renowned psychiatrist, in essence replied:   'If he's amenable to treatment, he is not a psychopath.'  He continued, "My definition [of a psychopath] refers to a carefully delimited group of intelligent, emotionally shallow, self defeating personalities.  In our present stage of knowledge it would be best to keep them confined in mental institutions."¹

Despite disagreement in this arena and our persistent attempts to treat psychopaths, Tiger and Fox have set forth a premise in The Imperial Animal that rules out the possibility of rehabilitation.  Just like the kittens that never gain their sight after being blindfolded during the crucial stage for sight development, infants that miss the stage for learning bonding will never develop that capacity.  No therapist or drug can bring a person back to infancy and apply the necessary nurturing to form the matrix of the mother-child bond.  The patient has long passed this crucial step and will never learn attachment and bonding processes which enable humans to care for one another, survive, and/or procreate.

BABYMAKING

In our 'advanced society' many women seem more concerned with weight loss and getting their figures back to 'normal' or returning to professional careers than nurturing their babies.  Under continuing government polices, still others are being paid to produce more offspring, which has nothing to do with nurturing.  Other moms are still kids themselves.  When they tire of playing, they hand the child to grandmother, park the baby in a crib or lock it in a closet.

In contrast, pregnant women who abort realize they do not want to have a child for innumerable reasons fundamentally based in their lack of desire or inability to nurture and care for a child emotionally and financially.  Since abortions were declared legal by the U. S. Supreme Court, the crime rate has greatly diminished.  I theorize that less unwanted--and therefore under-nurtured babies are being born since the legalization of abortion.  This results in a mentally healthier population and lowers the incidence of mental illness.  Certainly we must stop paying women to have babies.  What we should be doing is paying them NOT to have babies.

Due to the importance of an infant's early development and bonding with the mother, babies must be adopted at the moment of birth and breast fed if at all possible.  A pervasive education program focused on the responsibility and importance of nurturing for newborns should be emphasized rather than sex education.  The failure of infant care in this regard should be clearly spelled out.

After linking the findings in The Imperial Animal with my own experience with the futility of treating psychopaths, it became quite clear to me that we were spinning our wheels in our attempts to treat and cure most of our charges.  Psychopaths should only be imprisoned when they commit major felonies such as murder, rape, armed robbery, kidnap, arson, automobile hijack, air liner hijack or similar offenses.  For lesser offenses they should be confined to mental hospitals.  They should never be paroled because they will repeat their crimes until being apprehended again.  Frequently these individuals commit increasingly serious crimes as if they are seeking arrest and punishment.  Those who have been sentenced to life without parole should be executed without delay.  There is nothing cruel or inhumane about execution by lethal injection.  There is much more cruelty and inhumanity in connection with locking a person in prison for life.  All reasonable efforts should be made to determine the guilt of the accused prior to execution.

The massive amount of money, effort and training devoted to psychotic individuals should be expended on other pursuits--especially education, family planning and education on the importance of nurturing during infancy.  

_____________
          ¹Hervey M. Cleckley was a world renowned psychiatrist who wrote 'The Three Faces of Eve' with Corbett H. Thigpen, M. D., among many other books and professional articles.

To view the original page with font face Times New Roman click here

To view this page with font face Arial click here