I have long been stumped, frightened and intrigued by psychopathic persons since encountering them in adolescence in my sheltered growing up years. Then in college, I began to see them in action in observing some arch manipulators and charismatic leaders in the circles of campus radicalism around me in the late 19060’s and early 1970’s. I attended a large university that was one of the national hotbeds of student radicalism. I was fortunately naive and protected by this in a sense though I did not realize this at the time. What I did realize was the ideas advocated by most student radical leaders, both local and national, were in my view “just plain nuts.” Then I began to realize their effect on surrounding students, some of whom I knew. The followers were almost ‘converted’ by the charisma of these charlatans. One speaker/leader I particularly remember was an acclaimed author of one of the Bibles of those years, but he had a very checkered personal and legal background that everyone who endorsed his ideas, ignored. He was actually instated by the university as a writer in residence for a semester, holding seminars and colloquia. He as incredibly smart, clearly of superior, genuine intellect, and many of his student attendees ate up what he had to say. However, I am happy to be able to say that many of us had a totally different take on him as a showman, manipulator, a ‘false prophet’ as the Christian or Jewish community might term him, and intellectually dangerous. Fortunately, the program that he was operating under as a guest temporary faculty, permitted open separate discussions by students who were exposed to him. It was in a sense reassuring that many of us saw through his entire view of the world and realized he was in his own way dangerous. But he was really good at carrying off his “schtick” as some in the entertainment industry would call it. So good that he was famous on the basis of his one book he had produced that had charmed millions I would expect and was a best seller for years, and still is standard fare for the college student for the last forty years.

As a medical student, I was exposed to psychopaths a few years after mulling over my attendance at the above-described author’s seminars. These persons continued to stump me. I recall interviewing once a copycat killer who emulated Ted Bundy (still alive at the time, but imprisoned and very famous). This man was designated a “criminal psychopath” under that state’s forensic laws and serving an “indeterminate sentence,” a sentencing category that largely does not exist because of unconstitutional issues. I recall this man had applied for admittance to the nearby state university’s law school. Of course, he was turned down as unfit, but that did not stop him. He sued the law school briefly on the grounds that since he felt then President Nixon was a “psychopath,” and was a lawyer himself, this man could also become one. My encounter with him and his absurd lawsuit occurred during that later stages of the Watergate hearings and President Nixon’s downfall. But the grandiosity and anti-social conviction and self-justification of this man astounded me and further added to my almost locked in interest in this subject.

Years later in the 1990’s, I encountered in a periodic moonlighting prison consultation job the story which I confirmed to be true through public press stories, the tale of a father and son that jolted my thinking about psychopathy into an entirely new direction.

I should give the reader additional contextual background of my psychiatric training and general orientation at the time. I was moonlighting to pay the bills of a growing young family, in residency, and also in psychoanalytic long-term training and my own analysis. My salary as a resident in psychiatry barely paid my psychoanalytic fees and I had to moonlight most weekends at various jobs to make our family’s living monies. So I was highly steeped in clinical psychiatry, psychotherapy and as a child psychiatry fellow in that level of training at the time, very developmentally oriented. Psychopathy did not fit into anything I had learned, been taught in residency, except that psychopaths were “future felons,” and were untreatable for some reason by conventional psychiatric-psychological means. Little did I know at the time that research in other centers, perhaps especially in British Columbia at Simon Frasier University was starting to study psychopathy in new ways and by the 1990’s began to produce a different and useful set of new paradigms through which to understand psychopathy. I am largely referring to the seminal work of Robert Hare and his circle of researcher-clinician trainees whose collective works now known and accepted,

The tale of the imprisoned father and son was quite unique. Both were imprisoned for murder, though in different states’ penal systems. The father was somewhat famous in public circles at that time in the early 1980’s. His son had never known who his father was. He happened to see a news account of his father’s legal appeals in the news at his prison and saw a photography of his father. He immediately saw the uncanny resemblance of himself to the photo of this man and realized that this man was his biological father. He wrote his father in the father’s prison and they started up a relationship by mail. Much was made of the similarities of their cases. They committed murders in their early 20’s by way of robberies. Both were serving life sentences. They resembled each other to an almost astonishing degree. The implication in research and forensic circles was these two men, being father and son, related so closely genetically, were living examples of one view of psychopathy, that it was more genetically determined than some development or psychiatric mental illness. By then, it was standard fare that one of the outstanding clinical features of psychopathic persons was the innate, from at least childhood onward, the total lack of empathy toward others.

By then, it was standard fare that one of the outstanding clinical features of psychopathic persons was the innate, from at least childhood onward, the total lack of empathy toward others. Other almost universal characteristics included the perversion [meaning serious change] of their reward brain systems, that heinous acts of hurting other creatures [such as animal killing in childhood] and persons gave them thrills or pleasure. In the rest of us, these sorts of things elicit the more common and ordinary reactions of disgust, fear, shock, fright and so on.

In an article in the June issue of the magazine, The Atlantic, entitled “When Your Child Is A Psychopath,” author Barbara Bradley Hagerty, writes of an 11-year-old girl in a residential treatment who was diagnosed as a child to be psychopathic. The article chillingly describes the very early behaviors as a toddler that this girl displayed that in retrospect were clear indicators of the psychopathy to come. Her story confirms some of the points I referenced above, lack of empathy, cruelty to persons going so far as to start choking her younger infant siblings repetitively and other intentional acts to harm and even kill. Also, what points again to a genetic origin to her ‘behavioral set’ as a psychopath was that she was reared in a good sounding family and that she was adopted.

Our growing understanding of the differences in psychopathic persons in the last several decades has produced a raft of books in popular literature such as The Psychopath Among Us, Without Conscience: The Disturbing World of the Psychopaths Among Us, The Psychopath Whisperer: The Science of Those Without Conscience, and The Sociopath Next Door  and many other popular titles. Also, the new recognition of mass shooters and their personal histories and behaviors have heightened to some extent the workings of the psychopathic personalities. Televisions that tell of investigations and profiling of such persons have also made the general notions about psychopaths and serial killers more familiar in the lore of current culture and discussions.

Finally, brain imaging research is beginning to identify the structural and operational differences in the brains of psychopaths. Whether all this in the decades to come will lead to truly definitive and effective treatments will be an open question and challenge for the foreseeable future.