The Psychopath Inside

Reading Challenge Book 38 – a Memoir

The Psychopath Inside: A Neuroscientist’s Personal Journey into the Dark Side of the Brain, by James Fallon

Amazon link here

For this category in the challenge, I started off reading Hillary Clinton’s Living History, but it was pretty plastic and suffered hugely from telling, not showing. Deciding that life was too short and that I wanted to read a memoir that I would actually be interested in, I found The Psychopath Inside. Incidentally, in his memoir, James Fallon happened to hypothesise at one point that Bill Clinton is a psychopath. Convenient linkage.

Anyway, the opening story behind this memoir is amazing. James Fallon is a neuroscientist, who assisted in a number of scientific studies by analysing human brain scans. He was working on two studies  – one looking for psychopathic traits in the brains of convicted felons, and another analysing the brains of patients suffering from Alzheimers – when he found that one of the felons’ brain scans had accidentally ended up in the Alzheimers’ pile. Except it wasn’t in the wrong pile; James himself had been a member of the control group for the Alzheimers study, and the scan was his.

This incident a) makes a wonderful story, and b) initiated his interest in psychopathy.

How is psychopathy defined?

Although “psychopath” is a term which is frequently used, it lacks a formal psychiatric definition. However, there is a formally defined test (the PCL-R, or Psychopathy Checklist, Revised) which is used for the purposes of diagnosis. It interrogates four personality factors:

  • The interpersonal factor (including traits of superficiality, grandiosity and deceitfulness);
  • The affective factor (including lack of remorse, lack of empathy, and refusal to accept responsibility for one’s actions);
  • The behavioural factor (including impulsivity, lack of goals and unreliability); and
  • The antisocial factor (including hotheadedness; a history of juvenile delinquency, and a criminal record).

One of the manifestations of psychopathy is a difficult or inability to connect with others.

Does that mean that there are similarities between psychopath and autism?

Although superficially there is a common factor between the conditions- a difficulty or inability to connect with others – it manifests in very different ways.

People with autism are able to feel empathy, the fundamental connection with the pain of others, but cannot consider the thoughts and beliefs of other people. A while ago, I watched a documentary about people on the autistic spectrum and they filmed a situation where a toy was hidden from a boy and his mother. After the mother left the room, the child was shown the toy’s hiding place. When the mother returned, it was clear that the boy expected the mother to be able to find the toy. He did not understand that a different individual had a different point of view, and didn’t automatically share his knowledge.

In comparison, someone with psychopathic tendencies can connect with other people’s thoughts and beliefs, but won’t feel any empathy toward them. It’s chilling to try and comprehend that someone can know they’re causing extreme pain to someone else but still not care.

What does a psychopath’s brain look like?

In short, switched off. Specifically, it is likely to present reduced activity in areas responsible for empathy, ethics and preventing impulsivity. This probably doesn’t sound particularly exciting, but The Psychopath Inside included several comparisons of ‘normal’ brain scans to those of psychopaths and visually I found the differences shocking. You can see the scans, as reproduced in a Business Insider article, here. In black and white, the image of a psychopath’s brain appears as if the frontal cortex has been completely scooped out.

The Psychopath Inside includes some high-level explanation of the functions of different parts of the brain, mapping it as a ‘rubix cube’ in segments of 3x3x3. With my GCSE biology and ignorance about the names of areas of the brain, I found this really difficult to follow, but following this in detail isn’t a pre-requisite for the rest of the content.

Is psychopathy hereditary?

Certain genes are associated with aggressive behaviour (including one known as the ‘warrior gene’), and these are commonly found in people with psychopathic traits.

James Fallon and and his family consented to genetic testing to look for the warrior genes and other aggression-related genes. It was found that his family members had around half the full complement of identified-aggressive genes, whereas James himself had almost the full set.

Other research implied a hereditary link: Research into JF’s patrilineal line included a handful of murderers and suspected murderers, all of whom had been accused or convicted of killing a close family member.

This led to a really interesting discussion of nature v.s. nurture. One concept I found intriguing was a genotype-environment correlation, and how interpretation of behaviour can be strongly influenced by bias. Imagine observing a household where the father is belligerent and hostile and his son shows aggressive behaviour. What’s the cause and what’s the consequence?

Possibly there are no apparent reasons for the son’s aggressive behaviour, and the father’s own belligerence is a direct response to living with his son’s aggressive behaviour, which he can’t influence.

But there’s another possibility. Suppose that the father has genes which predispose him to hostile and aggressive behaviour and that he has passed these on to his son. The father acts in line with his genetic predisposition and creates a hostile home environment. This hostile environment exacerbates his son’s own tendencies to aggressive behaviour. This would be a genotype-environment correlation. There’s a good chance that if the son has his own children in the future, the cycle will continue down another generation.

This leads very neatly into a discussion of epigenetics, which is something I was completely unaware of, but found really fascinating and, yes, really difficult to follow. Wikipedia is my friend. My dodgy summary is that at a really high level, in addition to having genes, we have random ‘tags’ floating around our chromosomes. In certain environmental conditions, these tags attach to our genes and affect the way that our cells read the genes. Therefore although two identical twins have identical genes, if they grow up in different environments this may affect how their cells read their genes and therefore may have a biological impact on their behaviour.

James Fallon himself had always been a strong believer that one’s genetic code influenced personality and behaviour far more than environment. It was very interesting during the course of this book to see JF become more self-aware. He went through a process of self-discovery, where the results of testing he undertook led him to accept elements of his behaviour, but also he then managed to use his knowledge of his past and behaviour to predict genetic abnormalities.


On a personal note, improving my toe-deep knowledge of genetics and anatomy has given me food for thought. I always used to believe in the supremacy of willpower and, simplistically, that determination was a quality that anyone could develop. Between what I’ve read about brain chemistry and behaviour in The Psychopath Inside, and certain well-being webinars run my behaviour, which made connections from nutrition to brain chemistry, my viewpoint is now a little less binary. (I want to say it’s more sophisticated than it was, but that’s possibility overstating things!)

I still believe that willpower and resilience are qualities that you can nurture and develop, but for me, your brain chemistry is another piece of the puzzle as it influences your predisposition to certain behaviours. That doesn’t that I think individuals don’t have responsibility for their behaviour; but I think that recognizing and accepting your innate biases and behavioural tendencies is fundamental to making any lasting change.

Could it be that this was one of my blind spots: a revelation that was really striking to me, but obvious to everyone else? I think so. Let’s move on!

How can a psychopath have a family?

James Fallon married his high-school sweetheart. He describes how, at the age of twelve, he felt an instant attraction to her, for her confidence, wit and intelligence. They dated for part of college, he hitch-hiked 400 miles (each way) to see her every weekend, and they had common interests and viewpoints. But. The next paragraph, where JF wrote how he really feels, socked me in the jaw:

You might be wondering how this story gels with someone who ostensibly lacks empathy or the ability to connect emotionally with others. The truth is, I say “in love,” but I’ve never truly felt fully emotionally connected to Diane. My connection with her emerged partially because I didn’t connect empathetically. I never understood her. She was fascinating to me, and still is. We have common goals and values – family, Libertarianism, agnosticism – so there’s a like-mindedness, but she always felt like someone from outer space. Fortunately, that has always been more than enough for me.

JF’s comments on his relationships with his family are equally disturbing.

I feel massive sympathy for his wife, as I can’t imagine having a  relationship with someone on the premise that he’s described. It’s hard for me to conceive, despite all of JF’s intelligence and sociability and other great qualities, that when Diane married James, she did anything other than settle.

Does a psychopath know that he or she is a psychopath?

This is a question that my husband and I discussed when I told him that I was reading this book. The answer seems to be no, not necessarily.

James Fallon was not aware of his own psychopathic tendencies. He worked closely with neuroscientists and psychiatrists during his career, and over the years a number told him that he was a sociopath (for example, after he blew off a presentation to go partying). He automatically dismissed what they were saying, assuming that they were joking.

A key question becomes: How does one know if one lacks empathy? If you lack it, there’s a good chance you have no idea you lack it, because you don’t know what “it” is…

For the first sixty-plus years of my life, I never thought I lacked empathy at all.

In the course of the research which underpinned this book, and after discovering that he had bipolar disorder, JF started to ask friends, family and colleagues exactly what they thought of him and how he treated people, and he asked them not to pull their punches. The responses were beyond blunt. JF’s description of his reaction on this feedback fascinated me:

After a year of hearing what my family and colleagues thought of me, I said to myself for the first time in my life, “What the hell have I done?” I wasn’t despairing, just coming to terms with my cluelessness… About three minutes later another, different feeling took over. And with all the honesty I am capable of, I admitted to myself, “I don’t care.” That’s right, “I DON’T CARE.” At that moment, I realized for the first time in my life that what they had been intimating, then whispering, then yelling to me all along, for all those years, was true.


In summary…

I found this a really interesting read – mostly very easy to follow, with the occasional detour into ‘hard’ biology. Psychopathy strikes me as being one of those topics that shares similarities to ‘tragiporn’ – it’s highly removed from the average person’s day-to-day life, creating a fascination that would be lost if it was something we seriously expected to come face-to-face with.

The prologue to The Psychopath Inside reminds me of long gone-by English lessons – it very much says what the rest of the book will say. From a marketing point of view, this must be successful – reading the introduction in isolation draws you in – but I found this slightly off-putting at times. In some chapters, an explanation of how JF’s biological traits influenced his behaviour was presented as a big reveal… but I’d already had the reveal in the prologue. This was however less of an issue in the second half of the book.

A question I’m left with is how honest a memoir was The Psychopath InsideThat’s hard to answer. Psychopaths are, according to JF, ‘champion liars’. He also says ‘I can monitor what’s right and wrong, but I don’t feel it and I don’t care about it, and it doesn’t change my behavior’. Therefore I definitely believe that he’d be fully capable of manipulating the reader and wouldn’t suffer any ethical qualm at doing so. However, the book ties into his professional field, where he’s extremely high-achieving. There’s no immediately apparent reason for him to misrepresent his own experiences and research, particularly in this area. But, who knows? Maybe that’s part of what makes The Psychopath Inside interesting.

In case I haven’t been explicit enough, The Psychopath Inside was total catnip for me. I have a number of topics to mull over and to research. I do think that it wouldn’t necessarily be everyone’s cup of tea, but as one of my friends used to say, if it’s not, then that must mean you’re a bad person. Sorry.


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