Psychopaths have been on my mind recently.

It started with This American Life’s program this week on the psychopath test). And of course, the New York Times Sunday Magazine article: Can You Call a 9 Year Old a Psychopath. And then there was the Opinion piece about how we shouldn't be surprised that 10 percent of the people who work on Wall Street are "clinical psychopaths": Capitalists and Other Psychopaths.

How can you not be chilled and horrified by the tale of a 9-year-old who would throw a toddler in a pool so he could satisfy his curiosity about what it’s like to drown? That is what it means to be evil.  

But my thinking about dangerous, unemotional, and hurtful children had started before that, two weeks ago when I was talking to a friend of mine who teaches special ed in a local elementary school. She has a student in her class who she’s afraid for. For years he’s been hard to handle – spitting, punching, running around, and saying the crudest and most sexually repugnant things that might emerge from anyone’s mouth, never mind that of a child not yet close to puberty. And hurtful too – grabbing and twisting a breast, pinching an arm or kicking. 

But suddenly he’s much worse. Look aside for a moment and he’s gouging at another child’s eyes. Medication that is supposed to keep him calm makes him more violent and hysterical. And there seem to be no beds – anywhere – for a very young psychiatric patient, even to watch him while they try to find the right medication combination to bring his behavior within manageable levels. His mother is at wits end and fearful for her younger children.

How do his parents and his teachers cope with a child like that? There are no easy answers

I have also been struck by people’s reactions to the idea of a dangerous child. When my sister posted the NYTimes article about “callous, unemotional” children (as child psychopaths are called) on her Facebook page, a friend said that those kids just needed to be “broken” – that they were in control of their environment and they needed to be exhausted to the point of compliance. Haven't we tried that? Isn't that why jails are disproportionately full of adult psychopaths? And has it helped? Don't we want to stop people before they've gotten to the point where they need to be incarcerated?

The strengths and limits of parenting

I’m a parenting researcher. I believe in environmental influence on human behavior and believe that for most children, the single most important influence is a parent or parent substitute. 

I also believe in brains. As the author of The Amygdala Made Me Do it wrote, there is a wealth of research out there that tells us that:

  • Our biological predispositions shape how we react to our environment and how it reacts to us
  • Our interactions with the environment shape the structural and organizational characteristics of our brains

When I say good parenting makes kids smarter, more trusting, and kinder to others, I am not surprised that neuroscientists find that those changes can be documented with an fMRI showing structural and organizational changes in the brain. In fact, in the late 50s we found changes in much cruder measures of brain weight in studies using mice. Nor am I surprised when I can see differences in parenting and child behavior reflected in changes in cortisol and alpha amylase levels during social interactions between parents and their children.

What do you think causes behavioral and cognitive change – fairy dust? Observed behavior has biological underpinnings.

But that does not mean that biology is destiny. It means that we are different from one another and that behavior is hard to change. Ever tried to quit smoking, lose weight, or stop yelling at your kid?  Then you already knew that.

Good consistent interactions with adults and children and structured environments that limit the range of opportunities for negative interactions and reward positive behaviors can help teach kids new, more effective, and less hurtful ways of interacting with their environments. But it takes time.

Programs that teach children to recognize emotions in others and to respond appropriately to them (see the PATHS program, for example) can also help to develop the ability of children who do not naturally respond to the pain of others to do so. It is feeling the pain of those who we hurt that helps stop us from doing so. 

There is a reason that Elmo on Sesame Street labels emotions for us and shows us what they look like. Some kids don’t know what it looks like to be sad or to be hurt. And some kids don't feel what it feels to be sad or hurt, so they don't know what those words mean. We can be born blind to emotions too. 

For some children, programs like PATH try to teach them what they already know – what other people feel. They know that because the mirror neurons in their own brains respond to the emotions of others so they feel their pain. Feeling someone else’s pain makes hurting others painful to you.

Other children don’t feel that. They have few mirror neurons and the pain, empathy, and fear centers  in the amygdala are stunted. 

Corrective experience in the environment may be helpful there. 

  • First, they can cognitively learn to recognize what they can’t feel, just as someone who can’t see red may be able to learn to distinguish it from other colors from contextual cues. And they may be able to be taught strategies that help them meet their needs - reward them - without hurting others. 
  • Second, exercise  helps. Brains are not infinitely malleable, but they do change and grow depending upon experience. If you use an area of your brain, it expands its capacity.  For example, the hippocampus of London cab drivers grows as they use it to navigate. (It is the hippocampus that is the loci for remembering locations.) The hippocampus of birds changes size seasonally as they use it to remember where food is stored. Thus using an ability will strengthen it and encourage the development of brain structures and connections that foster performance.
  • Third, lack of exercise causes atrophy. We begin life with many more neurological connections than we will eventually use. Those that are not used are trimmed, making us  more efficient. But that also means if we fail to get normal environmental experiences that will maintain functioning in particular area of the brains, we will become increasingly worse at it over time. Thus people whose behavior keeps them from having normal social interactions will tend to lose ground over time.

Gene environment interaction.

All of which brings us back to child psychopaths. 

In Waddington’s famous model of a gene-environment interaction, he talked about a creode as a hill filled with little valleys and rivulets that a ball would roll down.  Who we were at the end and where we wound up was the path of the ball. The rivulets represented our natural genetic (e.g., biological) tendencies. Pressure could be exerted to move us from one path to another – especially at junction points. If pressure was hard enough – think about traumatic brain injury or horrible environmental deprivation – we could jump from one valley to the next. Where we wound up was mutually determined by genetic and environmental factors.

One important part of Waddington’s model is the depth of those valleys.  Some are shallow and represent much more malleable characteristics. Some are very deep and are difficult or impossible  to get out of. Children who grow up in normal environments and lack empathy may be closer to the latter than the former. It will take extraordinary efforts to get them to change. As these people may grow up to be some of the most damaging members of our society, however, it may be to our advantage to put in that effort.  We should all pray that the psychologists who have dedicated their lives to finding ways to exert those pressures are successful in doing so.

Another important part of Waddington’s model is that there are several ways to get to the same place at the bottom of the hill. Thus we may find that children who are callous and unemotional are never able to develop the normal capacity for empathy. But they may learn, cognitively, how to behave in ways that are not hurtful to others or to themselves. And from a societal perspective, that may be good enough.

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