The neuroscientist who wants us to be nicer to psychopaths

Think of a psychopath and you probably picture someone dangerous, someone whose ruthless self-interest leads to great harm for others and considerable success for themselves. Perhaps unsurprisingly, while only around 1 per cent of people in the general population have psychopathy, roughly 1 in 5 men in prison show signs of it, and research has also found a link between corporate leadership and psychopathic traits.

But just as it is painful to know a psychopath, it isn’t necessarily fun to be one either. Abigail Marsh, a professor of psychology and neuroscience at Georgetown University in Washington DC, studies those with psychopathic traits who largely lead ordinary lives among us. She has uncovered something surprising: many don’t want to be psychopathic at all.

Researchers are still honing the precise definition, but psychopathy is characterised by callousness, a lack of empathy, glib social charm and impulsivity. Checklist screening tools assess for behaviours including pathological lying, a sense of grandiosity, manipulative tendencies and a constant need for stimulation.

Studies have found psychopaths are hyper-focused on their goals and don’t automatically recognise others’ perspectives the way most people do. And scientists including Marsh have discovered that the brains of psychopaths are physically different.

Marsh investigates the roots of psychopathy by selecting people with very high scores from the general population, rather than prisons. Last year, her team published a study in which they were able to quantify, for the first time, how people with psychopathy value others’ welfare. Speaking to New Scientist, Marsh reflects on the surprising findings and what it is like to feel compassion for people with psychopathy.

Sabrina Weiss: How do psychopaths tend to experience life?
Abigail Marsh: In general, they report not feeling strong experiences of emotions like fear, guilt, remorse and love. Some believe that lacking these emotions makes their lives easier. But in other ways, their lives are harder. Many spend their lives “masking” their true selves – sometimes to manipulate others, sometimes just to make social interactions smoother.

They experience a lot of stigma. Psychopathy is seen more as a permanent moral stain rather than a psychological disorder that has similar roots as any other psychological disorder, namely a mix of genetics and life experiences that change the way someone’s brain develops and how they behave. These are not mysterious processes caused by supernatural forces. They’re biological processes that can be treated.

What do we know about the brains of people with psychopathy?
It’s impossible to “diagnose” psychopathy or any other psychological disorder from a brain scan. However, when we look at groups of people with psychopathy versus people without it, we do see differences, on average. The first are pretty consistent differences in an area of the brain called the amygdala. In both children and adults with psychopathy, it tends to be smaller than average.

My lab’s research finds that children with smaller amygdalas tend to show worsening traits and behaviours relevant to psychopathy over time. The amygdala is also less active in response to information that other people are frightened or in danger, which may help explain why people with psychopathy are more likely to threaten and harm others. Other studies have found that people with psychopathy have anatomical or functional differences in other brain regions like the striatum, which coordinates our response to expected rewards, and parts of the frontal cortex, which use emotional information to make decisions and regulate behaviour.

How can we treat psychopathy?
One study found that three years of therapy can help those with psychopathy to moderate their emotions, but there are very few public health resources that go into treatments for personality disorders, especially those characterised by antisocial behaviour. Most people don’t care about what happens to people with psychopathy because they don’t elicit sympathy. But we have a moral obligation to provide care, just like for people with any other disorder they did not choose. It’s tragic to think that there are people who struggle to find anybody who can treat them. But we’ve talked to a few people who have managed to figure out ways to improve on their own.

How can psychopaths change?
We found several who sort of hacked their way into long-term behaviour change. In some cases, this was because of a relationship they didn’t want to lose. One very memorable person told us he just faked it until he made it. He acted like he thought a nice person would act. After about a year and a half, it started to feel natural and even enjoyable. I found that very encouraging. That’s exactly what clinical psychologists recommend: practise the behaviours you want to adopt until habit kicks in. Several people we talked to had also cobbled together their own moral codes, not out of remorse or shame, but because they wanted to become a certain kind of person.

What sort of moral codes did they create?
One really interesting example was a person who had very aggressive urges, but decided it was only acceptable to act on them in support of social justice-related causes. Sometimes, he would go out looking for people saying or doing offensive things, like making a sexist comment, or even goading them to do so. But for the most part, he could effectively regulate his behaviour through the rules he had created for himself.

How common is it for psychopaths to want to change?
It’s hard to put a number on this. In interviews, many people say they are unhappy with how their lives are going and recognise that they are engaging in persistent maladaptive behaviours. They would love to change, but struggle to find treatment.

I should add that most of these people reached out to us after taking a screening test on the website of an organisation I co-founded, so they already had some degree of insight. We don’t yet have formal data on what proportion of people with psychopathy recognise that something is different about them. Research on other neurological and personality disorders suggests that many lack this insight – a phenomenon known as anosognosia.

I’ve noticed that you don’t use the word “psychopath”. You say “people with psychopathy”.
I used to, just like everybody else. But clinical psychology has moved toward a more person-centred approach, where we avoid defining people by their disorder. We now say a person with depression or a person with schizophrenia, rather than depressives and schizophrenics. But many people don’t apply this logic to personality disorders. Referring to people as psychopaths or narcissists is unfortunately still quite common.

What drew you to study psychopathy?
It started with my curiosity about what leads people to care about others’ welfare. Part of my research focuses on very altruistic people and my interest was sparked by a personal experience I had when I was rescued by a stranger after a car accident. I had been driving late at night to my hometown of Tacoma, Washington – incidentally, also the hometown of Ted Bundy, the Green River Killer and one or two other very famous serial murderers. A dog ran in front of my car as I crossed an overpass and I swerved to avoid it, which sent my car spinning until I ended up in the fast lane with nowhere to go, and the car engine died.

I almost certainly would have been hit and killed by another car, except that a stranger appeared out of nowhere. Later, I figured out that he had pulled over at the exit ramp on the opposite side of the freeway and ran across to help me. He hopped in my car, got my engine started again and drove me to safety. It was one of those experiences that profoundly changes your view of human beings.

So that incredible experience got you interested in studying the good in people – and ultimately also sparked your interest in the bad?
Yes. About four years later, when I was in Las Vegas with some friends for New Year’s, I had another incident. A stranger groped me, and when I slapped him, he punched me in the face and broke my nose. It was a deeply shocking moment that changed my appreciation of what humans are capable of.

How do you find participants for your studies, other than the screening test?
My latest study focused on just over 700 people, of which 288 had very high psychopathy scores and participated in the experiment after taking a screening test via the Society for the Prevention of Disorders of Aggression. The website helps people with disorders of aggression and their families, and those who get a very high score get a pop-up inviting them to take part in research.

For studies that require people to come to the lab to do brain imaging, we use flyers with phrases like “Are you adventurous?”. This type of language was first used in newspaper ads in the 1970s to recruit people with psychopathy. We have used it and actually had quite good success with it.

In your new study, you measured how people with psychopathic traits value others’ welfare. Why focus on that?
Antisocial behaviour involves getting something at somebody else’s expense. This includes theft, assault, even risky driving behaviour, which was the most common form of antisocial behaviour we recorded among high-psychopathy participants. People do this because it’s fun, they’re in a hurry and don’t care about the potential risks and costs to other people. But the difference in how much people with psychopathy value what happens to others relative to themselves hadn’t really been explicitly measured before.

Were there any results that surprised you?
The pattern of results was more extreme than expected. A “social discounting task” assesses how much someone values rewards depending on who gets them. For most people, a reward does not lose much value if someone close gets it; it’s almost as good if a loved one gets $50 as if they did.

In our task, we asked people to choose between keeping the whole amount to themselves and splitting a slightly larger amount with somebody else. Generally, we find people value the welfare of people they love, but, by the time it comes to a total stranger, most people are not willing to sacrifice much. The social discounting curve, which shows how the value of others’ welfare declines, drops off steadily. When we looked at people with psychopathy, I was fairly stunned at how quickly the slope dropped off. They value the welfare of people in their close circle as much as most people value total strangers. In other words, they just don’t seem to value the welfare of anyone.

How does psychopathy affect life for the rest of us?
We all know someone with psychopathy. If the average person has a social network of 150 people and about 1 in every 100 people has clinically significant psychopathy… well, you can do the math. But people don’t always recognise psychopathy. They might be aware that they have a certain neighbour, colleague or family member whom people don’t quite trust, who frequently manipulates or uses people or whose behaviour scares people.

If someone in your circle is like this, particularly someone in your close circle, you may have been conned, threatened or exploited by them. If it’s your child, sibling or partner, you might be living in fear of them on a daily basis. That’s not everyone’s experience, but it’s pretty common.

What should you do if you believe that you or someone you know has psychopathy?
Know that psychopathy is a real psychological disorder and it can be treated. People with psychopathy are less healthy, have worse relationships, worse job outcomes, earn less money and even die younger than people without psychopathy, in large part because their behaviour causes so many problems in their lives. But those behaviour patterns can be changed with treatment from a knowledgeable therapist. The Society for Disorders of Aggression website provides information and resources for people affected by disorders of aggression, including screeners and information about types of therapy that work and how to find them.