Tuesday, 17 May 2016

Psychopathy: Madness or Badness?

This post is by Marion Godman (pictured above), researcher at the Academy of Finland Centre of Excellence in the Philosophy of Social Sciences (TINT) at Helsinki University. In this post she draws on a discussion she lead at the Moral Psychology Interdisciplinary Workshop, CRASSH, on 9th October 2015. 

As intriguing as reasoning about psychopathy is, it is also bound to make us uneasy. People with the condition commit a disproportionate number of crimes compared to other psychiatric groups (Coid et al. 2009) and are also over-represented in the criminal statistics concerning recidivism, predatory violence and serial killings (Hare 1999). So for legal and policy purposes, it is imperative to think about these far from perfect minds prone to manipulation and violence. But at the same this makes it difficult to keep one’s head cool when approaching psychopathy. How do we think about the disorder without disapproval and disdain clouding our judgment? Or could it be that these moral attitudes are actually unveiling something important?

In my recent work I have been puzzling over whether something systematic can be said about what makes people with psychopathy more prone to do bad things. Research into this area suggests that if there is anything that seems more distinctive for this group in their violent and criminal tendencies (as compared to, for example, groups with anti-social personality disorder), it is their proactive aggression. Briefly, proactive aggression can be distinguished from reactive aggression, where the former aggression is instrumental or encouraged by the agent and the latter is a reaction to a threat or provocation (Crick and Dodge 1996).

Recent work also suggests distinctive neurological correlates behind this proactive aggression and fearlessness commonly displayed in psychopathy. In psychopathy, there is a particular prediction error about the implications of one’s actions: it seems that past punishments – but not rewards – does not inform the decision-making and planning as compared to controls and individuals with anti-social personality disorder (without psychopathy) (see Gregory et al. 2015). If this is right, different forms of punishment and social sanctions, like blame and condemnation will fail to get a proper grip in minds of people with psychopathy. As a result we have a mechanism that can explain why individuals with psychopathy will be less deterred from using aggression and violence in pursuit of their ends.

The implications of this research are however not straightforward. Actually I think it suggests a dilemma that might lie at the heart of our unease concerning psychopathy. At first we might think that findings about the instrumental aggression due to insensitivity to past punishments demonstrates something unfortunate for individuals with psychopathy. Normally the effects of punishment, blame, and falling in to disrepute would inhibit subjects from engaging in aggressive and violent behaviour, but individuals with psychopathy are not so lucky. Any punishments imposed by the community will have little effect on future behaviour, contributing to a vicious circle of bad behaviour. This suggests not only that individuals with psychopathy are disabled in this way, but also that the rest of us are really assisted in refraining from bad conduct by different social sanctioning practices that restrain and correct our bad behaviour.

Of course we cannot always count on our cultural environment to do this for us. We do not have to look very far in the literary canon to find it densely populated with examples of culturally condoned forms of instrumental aggression, like dueling, honor killings and gang violence. Even today aggression remains an integral and celebrated means towards certain ends in some circles. The difference is that those with psychopathy do not even have a fair chance to be corrected by their culture. However, the implication of this thought is bound to make us ill at ease: are we really willing to accept that the general population is, on balance, equally prone to do these bad things as those with psychopathy – is it just aversion to punishment and being brought into ill-repute that stops most of us?

We may then want to consider the other horn of the dilemma. Instead of accepting that individuals with psychopathy are continuous with most of us, just less deterred by punishment; we may want to dig in our heels and claim that this has got things the wrong way around. Psychopathy refers to a group that, putting things bluntly, are rather bad people. This group seems to be in the possession of fundamentally different values from most of us (say, they find violence and harm to others rather thrilling, and because of this do not suffer from their conscience).

The fact that punishment and sanctions in the past fails to impinge on their decisions, on this view turns out to be really fortunate to these individuals because it just means that they confront fewer obstacles in their pursuits. More than anything psychopathy then turns out to group individuals together in terms of their particular moral bankruptcy, not by an underlying disorder or prediction error. While we might certainly hold these individuals accountable for their crimes and misdemeanors, they will be ultimately be able to shrug it off – not just because of their fearlessness but probably also because of holding a immoral (or amoral) outlook in the first place (Godman and Jefferson forthcoming). So on this view psychopathy turns out to be a moral disorder rather than psychiatric disorder (Maibom 2008).

But this kind of view might trouble us for other reasons: is there even empirical evidence that there are bad motives associated with the condition studied in psychology and neuroscience? Maybe the assumption of the link between psychopathy and morally corrupt values is just due to a selection bias, given that most diagnoses of psychopathy occur post incarceration. To be sure this view accords with our moral disapproval of the stereotypical deeds by psychopaths, but perhaps this just means we are clinging too hard to those very moral attitudes.

I am not going to try to (re)solve this dilemma for you; I rather raise it to provoke some thoughts of your own (maybe, there are alternatives, or as my friend has suggested, there is a mid-way position between the two horns sketched here). There is plenty of empirical research into psychopathy and probably there will be many more findings deserving philosophical reflection in the coming years. Yet I suspect that this research will not completely settle this matter for us and we will continue to be torn between a view that either undermines our own moral self-image as non-psychopathic, or else, leaves that image intact, but perhaps unfairly completely expels certain individuals from it.

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