Greg Miller: What It’s Like to Spend 20 Years Listening to Psychopaths for Science

People tend to discuss psychopaths (aka sociopaths) as if there were a sharp division between them and normal people. It seems as if it were, when you just look at the extreme end of the spectrum but, as in most traits, there's a spectrum. 

Educated people often make doctors’ worst patients: anti-vaxxers, cancer treatment rejecters, herbal remedy enthusiasts. Why do otherwise brilliant minds ignore science and reject modern medicine?

Read the article. I think people tend to be skeptical because "the science" is always in flux so many would rather go with their relatively-uninformed judgement than with the expert judgement of the day which may be obsolete next year. Remember the big scare about hormone replacement? Remember when they claimed that broccoli was good for you? Etc. People do know that physicians are smart and well-educated, but they like to make their own decisions for better or worse.

In recent history, sexual interests and inclinations outside of bourgeois Judeo-Christian monogamy have been labeled as immoral and "perversions" in the Western world, and in Western Psychiatry. Western Psychiatry has even categorized them in detail but some (such as homosexuality, which I find to be often a dubious categorization of people) have fallen out of favor due to political pressure.

Among the things which the Western world has relatively-recently and variously considered antisocial (lacking in normal conscience) or perverse (defined as outside local social norms) and/or illegal are polygamy, adultery, promiscuity, nymphomania, rape, incest, pedophilia, necrophilia, miscengenation,  internet pron, homosexuality, orgies and wife-swapping and related debaucheries, cross-dressing, childrens' pre-pubertal sexual interests, transgenderism, paraphilias and many fetishes like masochism, etc, prostitution, whoremongering, zoophilia, and so forth.

These are all culturally and/or religiously-determined categories of the wacky and disorderly, Bonobo-like vicissitudes of the human sex drive and of human psychology. Many humans successfully repress their inner Bonobo and happily adhere to their local cultural and moral codes, more or less. Many others lack a strong Bonobo streak, but it's not as if normal people never have wacky and aberrant fantasies and "curiosities".

As a Psychiatrist in the Western world, I can easily accept that many such things are statistically abnormal (ie at ends of bell curves), but high IQ is "abnormal" too.

I recently read this: 'Pedophilia is natural and normal for males'. Not "normal," I think, but certainly culturally-normative in parts of the Arab and Asian worlds. Some of our readers are quick to label perversions as "sick" if not just plain appalling or revolting. So is my natural inclination, but I think that inclination is culturally- and religiously- determined. Many human cultures view things otherwise.

Is there a Western socio-cultural trend to normalize previously-perverse and antisocial behaviors and to abnormalize conventional morality? I think so. In Psychoanalysis, we think of these things as embedded in problematic personality structures, but we could be wrong.

More:

Planned Parenthood Teaches 15 Year-Old on Bondage, Whipping, Gagging & Defecation

British Academics: ‘Paedophilia is natural and normal’

A judicial move to normalize incest

I am not claiming that I do not make moral or social judgements about behavior. All I claim is that it's complicated because living in a culture is part of being human, so "natural" loses meaning.

I will await discussion, but I may need to tie you up with duct tape and whip you. Here's your fun fetish joke du jour:

 Four friends spent weeks planning a perfect desert camping and riding trip. Two days before the group is to leave Rob's wife puts her foot down and tells him he isn't going. Rob's friends are very upset that he can't go, but what can they do?

Two days later the three get to the camping site only to find Rob sitting there with a tent set up, firewood gathered, and supper cooking on the fire. "Dang man, how long you been here and how did you talk your wife into letting you go?"

"Well, I've been here since yesterday. Yesterday evening I was sitting in my chair when my wife came up behind me, put her hands over my eyes and said 'guess who'?" I pulled her hands off and she was wearing a brand new see- through nightie. She took my hand and took me to our bedroom. The room had two dozen candles and rose pedals all over. On the bed, she had handcuffs and ropes! She told me to tie and cuff her to the bed so I did. Then she said, 'Now, you can do whatever you want.' So here I am."

Dr. Friedman blames it on the hormones and slow brain maturation: Why Teenagers Act Crazy:

... most adolescents do not develop anxiety disorders, but acquire the skill to modulate their fear as their prefrontal cortex matures in young adulthood, at around age 25. But up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences. The prevalence of anxiety disorders and risky behavior (both of which reflect this developmental disjunction in the brain) have been relatively steady, which suggests to me that the biological contribution is very significant.

A few links:

Rabbi Boteach wants women to get lustier in marriage (video)

When women earn more, promiscuity is more accepted

Why marriages fail: Romance just isn’t enough

Childless Elite, Spouseless Poor

Casual Sex Is Actually Excellent for You, If You Love Casual Sex

Mental Illness And Crime: What The Legacy Of Dorothea Dix Hath Wrought:

 Dorothea Dix was the activist whose efforts led to the first generation of American mental asylums. At the age of 39, she happened to visit a local jail to do a Sunday school sermon for female inmates. She found that criminals, retarded people and the mentally ill all lived together in terrible, unheated conditions. When she asked why, she was told  "the insane do not feel heat or cold" (Viney&Zorich, 1982).

People he wants to help, but can not: Evil and the Conservative Mind.

We’re a bit slow in maintaining consistency, although I suppose we will eventually succeed in making everyone equal. That means treating someone with a serious mental illness as if her preferences are merely preferences. It means only allowing for a voluntary commitment, a non-secure transport, and a facility from which you are free to leave at any time. It is one thing to remove gender so that sexual delusion can find itself comfortable in a nondescript stall… but it seems quite another thing to remove sanity so that all the world can be an asylum. It seems terribly obvious to look at prisons and madhouses and recidivism, to observe that this system of ours is broken in the sense that it is imperfect in its attempt to create a utopia; almost as obvious as to look at the results of closing them all down, and observe that Eden is no closer, and the world is still broken. But like the Bolsheviks who rallied for change and destruction, rightly pointing to existing flaws, we stand staring at Chesterton’s fence; we see the cracks and want to remove it, wholly unable to articulate why it was placed there to begin with.

I have no answer. There are many people who can not be helped. The world is an asylum, and life is tragic.

When it comes to sex, will humans ever be liberated from the basic biological needs that drove our evolutionary past?

Let's hope not. Actually the article is a critique of behavioral genetics, aka evolutionary psychology, as much as anything else.

Humans are a highly-sexualized sort of ape, with no estrus period as most mammals and even monkeys have (except for the "great apes" of which we are one). It's difficult if not impossible to determine what sexual behaviors are "natural" for humans because mental activity, fantasy, relationships, and culture are such major parts of being human. After all, rape, murder, theft, violence, pedophilia, etc. are all sort-of "natural" for humankind, and there are cultures in which monogamy is considered a mental illness or a form of infantile behavior. It's safe to say that the Western bourgeois ideal of lifelong monogamous marriage and the nuclear family is very far from "natural" despite being fairly effective for child-rearing and overall life stability in Western culture.

It also is safe to say that humans are the horniest of animals and, with our capacity for wild imagination and strange (by animal terms) sexual desires and fantasies, a rather insane species.

Freud explained a lot of that.

It's about brain scans, mind-body, and mechanical reductionism: The Limits of Neuro-Talk:

 I would like to make the case for giving due deference to ordinary human experience as the proper guide for understanding human beings. Such deference may be contrasted with the field of “neurophilosophy” (most famously, the work of Paul and Patricia Churchland), which is intent on replacing “folk terms” — such as “reflection” and “deliberation” — with terms that describe brain states. Needless to say, brain states are objective facts, whereas our introspective experience of our own mental life is inherently subjective. But this divide between the objective and subjective, between the brain and the mind, does not map neatly onto cause and effect, nor onto any clear distinction between a layer of reality that is somehow more fundamental and one that is merely epiphenomenal. For example, if you are told your mother has died, your dismayed comprehension of the fact, which is a subjective mental event, will cause an objective physiological change in your brain.

In light of this causal power of the mental over the physical, we begin to wonder if it is right to think of these two types of reality as layered, in the sense that one is more causally effective than the other. It would follow from this doubt that re-describing our introspective experience of our own mental life in terms of brain states is optional, in this sense: the choice of description ought to depend on what you’re trying to explain. Each description answers to a different sort of “explanatory request,” issuing from different realms of practice. The “folk” description answers to the realm of everyday human experience, and the brain description answers to the realm of physiological investigation.

Joy Pullmann on her Dad: Here's to the strong, silent types who nevertheless feel deeply inside.

Nicholas Wade’s credible new book challenges conventional wisdom about genetics.

There is nothing new there in the age-old nature-nurture game. Does it really need saying that people who are more closely related likely have more traits in common? "Race" and "ethnicity" are just words for common ancestry, like "distant cousins." Early humans spread around the earth, and bred with others in their own neighborhoods just like Darwin's finches. Naturally, differences happened but not to the extent of new species, but enough so that people recognize their cousins.

AA is a wonderful thing which has helped countless people, and countless patients of mine.

I have no idea why our internet friend thinks that we shrinks do not appreciate it immensely: Does AA Work? In fact, I have often said that there should be an AA for non-alcoholics. Its general approach could help people grow up even if they aren't drunks.

As we have posted in the past, the format of AA was based on a Methodist program for personal spiritual growth, and spiritual and emotional maturity.

From Condemned to Joy - The Western cult of happiness is a mirthless enterprise:

 The Western cult of happiness is indeed a strange adventure, something like a collective intoxication. In the guise of emancipation, it transforms a high ideal into its opposite. Condemned to joy, we must be happy or lose all standing in society. It is not a question of knowing whether we are more or less happy than our ancestors; our conception of the thing itself has changed, and we are probably the first society in history to make people unhappy for not being happy.

- The Neuroscientist Who Discovered He Was a Psychopath

No, he did not. You cannot make a diagnosis based on brain imagery.

- An entertaining site, found via AVI: Neuroskeptic

At Maggie's Farm, we are always skeptics

- Does hyper-parenting damage marriages? Of course it does.

Marriage must always come first. It's the job of kids to adapt to the family, not vice-versa.

- Another link re Schneiderman's book: "The Last Psychoanalyst"

Have not read it, but I can sort of guess where he is coming from. However, many of us are still transforming lives with psychoanalytic principles.

How many times have I said that here? Life is traumatic, at times it is a vale of tears. That's not illness.

From Lynn Jones, Each scar is different - PTSD has come to signify the moral, social and political suffering of war. But not all suffering is a mental illness

I have mostly exhausted my interest in posting about the complexities of the "mad or bad" topic but in this case, based on minimal evidence, I'd guess "bad."

Psychiatry has little influence over evil. That's for theology. Evil fantasies are things we (and everybody, pretty much) deal with routinely, but actions are another matter. The devil is stronger than we doctors are. Some evil is everywhere, from boardrooms to government to priests and pastors to teachers to cities to campuses. Please do not tell me that this kid had "PTSD," or an "anger management problem." Some people lack a moral compass almost entirely, but that moral compass spectrum spans from none to spotty to obsessionally scrupulous and fearful. We can deal with the latter relatively easily, but not the former.

The truth is that some people are "born to be hanged," and, at the least, removed from the gene pool. We too often piously imagine that happy and good are default settings for humans as if we could get everybody there with a rearranged psyche and a right environment (we term that "psycho-utopian"). It's an evil lie and an evil vision because it denies the existence of evil itself. My life, and history, have taught me that sin has great power. For all we know, violence, deceit, and destruction of good cheer are the default settings, and civilized behavior a special, difficult undertaking. That happens to be what Freud concluded, and he was smarter and a deeper thinker than I am. Not to mention many prophets, and Christ himself.

It is a positive comment on our level of Western civilization that we are surprised by gross acts of evil rather than taking them for granted. Quite remarkable in human history.

Good and evil remain the basics, as they always have done.

Addendum: I realize that my metaphors sounded as if I believed that evil is genetic. What I mean is that some people simply seem destined for trouble.

Re-posted

It is not only true in medicine, it applies to all statistical research. Here's Why Most Published Research Findings are False.

1 Boring Old Man has been devoting himself to uncovering the Pharma-Psychiatric research cabal, but nobody is really listening. My rule of thumb is to take everything I read with a a few grains of salt.

I agree with some of this, disagree with some of it. For one thing, she ignores insulin physiology. For another, she ignores menopause. She is right that losing weight is difficult given all of the abundant and cheap carbs available to everybody, and she is surely correct that people without weight issues are those who hear an internal signal that says "That's enough."

In the end, though, carb "addiction" is the main challenge for anyone who is overweight.

This is your brain on murder: What the mind of a psychopath looks like.

The neuroscientist discovers that he has a sociopathic brain:

The same dark regions in Fallon’s neuroimaging self-portrait that shocked him and instantly captured his attention, had captured the attention of other researchers interested in biological psychiatry years earlier. When Fallon points to the section of his brain scan that looks like the brain of a murderer, he points to a part of the frontal lobes called the prefrontal cortex.

In an era when Americans tended to be straight-laced if not Puritanical in their mores, the upper-class Brits were having midnight adventures: It’s Not Only the Poor Who Need Moral Leadership.

This seems to have been culturally normative, at least for their class, and accepted by all. Did they need moral leadership?

Every person has such impulses of course, but it has often seemed to me that the wealthy and powerful often come to believe that the rules apply to the little people. That is true in America today.

NEUROPSYCHOANALYSIS - An Interdisciplinary Journal for Psychoanalysis and the Neurosciences

Neuropsychoanalysis is a hot new area in Psychiatry. Even Nobel Laureate Erik Kandel is into it.

Oliver Sachs on The Mental Life of Plants and Worms, Among Others.

He begins:

Charles Darwin’s last book, published in 1881, was a study of the humble earthworm. His main theme—expressed in the title, The Formation of Vegetable Mould through the Action of Worms—was the immense power of worms, in vast numbers and over millions of years, to till the soil and change the face of the earth. But his opening chapters are devoted more simply to the “habits” of worms.

It's always a good idea to vet the people in your life for many reasons, but especially to rule out psychopathy. How can you spot one?

A few points: not all psychopaths (sociopaths) have been in jail and not all are glib and charming. Do they target people? Yes. Does Psychiatry have anything to offer them? No.

Still no links found. No links found for diet and heart disease, either.

Nutrition remains folklore, magic, superstition, and there is essentially no science in it except to avoid scurvy and Beriberi. Of course, being overweight predisposes to almost all medical ailments except starvation. If you do not want to be fat, quit those tasty carbs and try to satisfy yourself with something else like reading blogs, or sex, or doing unto others. If you want to be strong, exercise hard or do physical labor. Otherwise, quit with the magical thinking and accept that death will arrive (unbidden usually) no matter what you do.

People hate to accept that reality because it feels powerless. Well, people don't dine on sacred offerings to gods anymore, and food is no longer magic medicine.

Vegetables and fruit? I do not particularly enjoy them so I am always pleased that they supposedly don't matter. For me, vegetables are just an excuse to eat the olive oil or butter. About fruit, when I get the impulse, I will occasionally eat a whole lemon or a whole lime, skin and all. Oranges are too sweet for me. Otherwise, fruit is good only for cheese. Pears, especially.

Somebody recently told me that they refused to donate to the American Heart Assoc. because she preferred to go by heart attack rather than by cancer. Well, those are the two main choices on life's menu these days, with the eradication of many infectious diseases. Carpe diem, and pursue what your soul needs before it's too late.

I am grateful that my needs are simple other than Jimmy Choos, that my life is rich and complete, and that food is not very important to me other than Shad Roe and caviar.

My friend Debbie Cabaniss et al got around to writing this book before I got around to it: Psychodynamic Formulation.

I have written about Psychiatric diagnosis often here, and I re-post my pieces each year. It is a complicated topic, because Psychiatric complaints originate from all sorts of sources and usually multiple sources, and an exhaustive psychodynamic formulation is not always relevant to minor life problems.

When it is relevant, a serious formulation is a difficult thing to do unless one just casually links history to current complaints. That's not a real formulation.

The current fad in Psychiatry is the DSM, which a robot could do. In many situations a DSM "diagnosis" is nothing more than a list of complaints useful only for an insurance claim and has nothing to do with understanding an individual person.