Can psychopaths suffer from addiction

brain research : Psychopaths sympathize - if necessary

Five years. It took that long before the neuroscientist Harma Meffert was able to convince 18 psychopaths to lie down in a brain scanner for research. She and her colleagues had repeatedly given lectures in Dutch forensic psychiatry clinics and addressed violent criminals individually. "These contemporaries are not exactly helpful," says Christian Keysers, who heads the Social Brain Lab at the University of Groningen. Only when they had the leaders on their side did the others come too. “She was probably attracted to being the center of attention.” Patient 13 kept interrupting the experiments because he supposedly had to go to the toilet. Testing the researchers' patience was a change from everyday life behind bars.

Keysers are interested in the biological basis of compassion. He researches mirror neurons, those nerve cells that not only fire when you do or feel something yourself, but also when you observe it. For a while they were celebrated as the basis of all humanity. Now the hype is ebbing, the euphoria was followed by criticism: The cells are only responsible for perceiving a situation, not for real understanding and empathy. “The criticism helped devise better experiments,” says Keysers. This also includes taking a closer look at the brains of those people who seem to have a problem with compassion: autistic people and psychopaths.

The trouble was worth it. As Keysers and his colleagues now write in the journal "Brain", psychopaths can very well feel compassion. But only if you want to.

Perfectly adapted predators

That cannot be taken for granted. Robert Hare, a Canadian who has studied psychopaths since the 1960s, believes that they lack empathy. He has developed a test, the PCL-R, which is used worldwide when it comes to diagnosing “psychopath”. In interviews lasting several hours and based on the life story, the tendency to aggressive narcissism is analyzed and fathomed out whether the person in question has a very unsocial lifestyle. Since psychopaths lie notoriously, the information is checked whenever possible and backed up with appropriate documents. Patient 13 achieved a 40 in this test. More is not possible.

Psychopaths aren't crazy, says Hare. Just different. You are sometimes very intelligent; they know what is right and what is wrong. You can also put yourself in the shoes of your counterpart in a purely rational way and adopt their perspective. But because they seem to have diminished feelings like fear or love, their ability to feel compassion, guilt, or remorse is also limited, says Hare. You look charming, but you are ruthless. They instinctively find the weaknesses of their fellow human beings and exploit them: "They are perfectly adapted predators."

His student Kent Kiehl at the University of New Mexico has scanned the brains of countless psychopaths. Kiehl's result: Your paralimbic system - a horseshoe-shaped structure deep in the brain that colors experiences emotionally, but is also responsible for impulse control and moral decisions - is less active and sometimes even structurally weaker. Other researchers found fewer connections between the amygdala, the center of fear, and other parts of the brain.

A switch for compassion

Still, Keysers thinks it is a fallacy that psychopaths have little or no empathy: "They just don't normally use it." But when it comes to wrapping a victim around their finger, they could turn on empathy for a moment, and especially so appear convincing.

For their study, Keyser's team played short films with hand movements in the scanner for the 18 psychopaths and 26 control persons: once one hand slapped the other, once caressed it, once it made a repulsive movement and once it remained neutral. The researchers later repeated these situations with the subjects' hands.

As expected, the parts of the psychopaths' brains with which they process feelings, movement and touch were much less lit up if they only observed the situations instead of being affected themselves. Your mirror neuron system then hardly started, says Keysers. When they were asked to empathize during the films, that changed: Now the scans hardly showed any difference between the psychopath and the control group. “So you can empathize. If necessary, ”says Keysers. He does not believe that the brain regions only lit up because the psychopaths understood the situation on a purely rational basis. Then there would ultimately have to be greater differences between one's own experience and observation.

"The question now is: Can you train psychopaths so that compassion is automatically activated?" Asks Keysers. Niels Birbaumer from the University Hospital Tübingen, who has been studying psychopaths for a long time, also believes that they can be treated: "Keyser's results confirm that one can influence brain deficits through learning." The fundamental problem of psychopaths, however, is their fearlessness, which is the only result of their lack of empathy. But no matter what a training program is aimed at, one problem remains: they may not have any interest in changing. Or - in the words of Hare: "From a psychopath's point of view, it is we who are malfunctioning."

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