Uncovering the Brain of a Psychopath What makes someone a psychopath? Can these traits be passed through family lines? Neuroscientist James Fallon, and author of The Psychopath Inside: A Neuroscientist's Personal Journey Into the Dark Side of the Brain, discusses his scientific and personal exploration into the antisocial mind.

Uncovering the Brain of a Psychopath

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This is SCIENCE FRIDAY. I'm Ira Flatow.


FLATOW: That music clip, of course, comes from the famous shower scene in "Psycho," the story of Norman Bates. Bates set the stage for Hollywood's romance with deranged killers and led to Dexter, Hannibal Lecter, Patrick Bateman. We seem to have a fascination with psychopaths. On the outside, they all seem like normal people. You have a motel manager, a police detective, a doctor and a banker. But they hide a dark side.

Just how does the brain of a real psychopath work? Could we be hiding a dark side ourselves? My next guest found, to his surprise, that his own brain matched brain scans of known psychopaths, and he has not murdered anyone, as far as we know. James Fallon is professor of psychiatry and human behavior at the University of California, Irvine, author of the new book "The Psychopath Inside: A Neuroscientist's Personal Journey Into the Dark Side of the Brain." Welcome to Science Friday.

JAMES FALLON: Thanks for having me, Ira. That soundtrack gave me all warm fuzzies, I'll tell you.


FLATOW: How accurate are the Dexters and the other psychopaths that we've seen from Hollywood?

FALLON: Well, most are conglomerate characterizations of really a mix of real characters. But it's also a mix of different syndromes. Usually, what is portrayed as a psychopath is somebody that may have antisocial personality disorder, the criminal side of psychopathy. But also maybe malignant narcissism and sadism. So there's usually a mix, and it's really not the most - really not the common psychopath that's on the bus with you or in your office.

FLATOW: But you think that there are common psychopaths walking amongst us.

FALLON: Oh, yeah.

FLATOW: How many, or how do we know them?

FALLON: Well, for the people who are - you know, go over the line - that is, they're really clinically psychopaths - there's about 1 to 2 percent. About 2 percent of men, about 1 percent of women, in most societies. Once you go to the borderline people, the people who don't quite get over the test scoring for a full-blown psychopath, then you start to get up to 5, 10, 15 percent of the population who may be near psychopath or prosocial psychopath that can navigate their way very well through society without ever being caught.

FLATOW: What is the definition, then, of a psychopath?

FALLON: Well, one of the problems is there is no accepted definition. You know, the DSM-5, you know, that psychiatrists and psychologists use, it doesn't even recognize it as a syndrome. And that's true for a number of these personality disorders. They're not accepted by everybody because - for several reasons. Some is that the traits of, let's say, a psychopath overlap with the traits of somebody with malignant narcissism, or overlaps with somebody with these other - some other disorders.

So it's not a clean description. And so the physicians tend to reject it, even though it's used very - you know, in forensics, in law and in regular conversation.

FLATOW: But, in general, how would you characterize somebody?

FALLON: Well, the key things - I wouldn't include the criminality part of this, or, you know, the - you know, the fire-breathing, angry sort of psychopath that's portrayed that's so interesting in a two-hour film. It's more of somebody who really doesn't care about the other, the other person. And they will - almost all their actions are directed toward pleasing themselves. And so they don't have - they may perceive what may be the other person, but they end up acting like they don't care at all.

So they kind of look right through you, but they use you, and they will manipulate you either to play a game or to get money out of you or to get sex or whatever. So they're very manipulative, and they don't show this sort of manipulation, because they're quite clever about it. So they know how to model or mirror behaviors very well. They can look like they're normal. That's what's so insidious about it.

FLATOW: James Fallon, author of the new book "The Psychopath Inside." And, of course, the most fascinating part of this book to me is your discovery that you match the brain scans of other psychopaths, and your discovery that you might be one.

FALLON: Yeah, Ira, that was pretty wild. You know, it was - I had started studying PET scans and some other scans of killers, serial killers, psychopathic killers, impulsive killers from about the early to mid-'90s on. It was not my main area of study but as a neuroanatomist I'm able to read patterns of these scans, which I do for many syndromes. And that was going along, one or two a year from different laboratories. And then I was given a large bolus of scans in the mid-2000s.

And when I looked at it, after a couple of months, I realized that there was an underlying pattern. And I didn't know who was who. Some were normal. Some were - had schizophrenia, etcetera. But they clearly jumped out at me. So there was this common underlying pattern of low brain activity in the emotional brain, the limbic system of these killers, in psychopaths.

And so having that, about the same time we'd done a - we were doing a study in Alzheimer's disease to discover genes for Alzheimer's. And I put my family into it, because my wife's family, her parents died of Alzheimer's. She has a lot of family members with it. But she's normal, right. And so I said, look, why don't we get all of us - get my brothers involved, and get, you know, some of our kids - and we'll see if we're OK.

And so as part of that - it had nothing to do with psychopathy, but as part of that I - you know, we did the PET scans. And it came back, and there was one - they're all normal, except for one. And I thought - I said, you've got to check this, because it looks just like the scans that I had of all the - kind of the worst killers I had looked at. And they checked several times on the machine and everything, and the technician said, no it's for real.

And when I pulled back the code, it was me. So I looked at that, and I kind of chuckled and I said, well, you know, what do you say to yourself? Well, I first said to myself, have I killed anybody? You know, what - because I had known the pattern, or am I just wrong about, you know, this idea?

Well, over the ensuing time period, I had all of our genetics tested. And, again, all my family - they had a nice balance of high aggression, low aggression, high and low empathy genetics. Mine was pushed all the way - almost all the alleles we looked at for high aggressiveness, low empathy - low interpersonal empathy, and all the things that we think of genetically as being associated with a psychopath. So that was two - there were two things, the genetics and the brain pattern. And then it started to go downhill after that.

FLATOW: Wow. So, why are you not a killer? What pushes some psychopaths - or people who are like them, like yourself - over the edge?

FALLON: Well, in a way, you might think of me as a born potential psychopath, because I have all the brain and genetics, a prime for that. When I started looking at this, Ira, I realized that compared to everybody I knew - I had this incredibly wonderful, nurturing growing-up period. You know, from the time I was born, I looked at all the movies and pictures, and I was always with my family and friends. I was a happy kid, and I was kept happy.

And, you know, part of that may have been through serendipity because - or for a real reason - part of it is maybe because after my older brother was born, my mother had four miscarriages. And then I was born. I was like the golden child, just because I was born. I didn't die, you know. And then I was followed by several other miscarriages. So I'm in the middle, in a larger family of 10 years of no kids. And I think I was treated special at first because of that. So I was carried everywhere and just loved.

And then, when I was a little older, right before puberty, my mother saw something, and she was very disturbed with some of my behavior. I went into a depression and got very strange. And she didn't get me to a psychiatrist at that time. That was, you know, a very negative thing, to have to go to a psychiatrist. Not anymore, thank God. But she said, I'll just - you know, I'll just make sure that he's, you know, covered.

And my whole extended family took care of me. And I think that's what did it. And then in the past couple of years, we find out that some of the genes that I have, it turns out that they're high risk for psychopathy. But also - that's if you're brought up in an abusive, you know, childhood. But if you have these alleles and you grow up in a positive one, it negates the other effects.

So, in a way, I'm just mirroring - if you have these genes, I'm mirroring what the environment I was born into was going to be, and which turned out to be quite sweet.

FLATOW: So, you were lucky, in that sense, but there might be other people who have your kind of profile who are not as lucky or...

FALLON: Absolutely. And this really - you know, Ira, I have always really been a proponent of genetics driving all behavior.

FLATOW: Right.

FALLON: But when this came up, I had to eat some crow, because I said, I might be wrong about this. And then we really started looking - you know, the whole thing about epigenetics, how an environment interacts with the genetics you have to turn on and off certain genes, works, then it made sense. And so I began to respect the role of early environment on who you become, that's for sure.

FLATOW: This is Ira Flatow, on SCIENCE FRIDAY, from NPR. Talking with James Fallon, author of "The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain." Really - it's really interesting. And you were very honest in this book about your feelings about being, you know, a psychopath and the journey through your life and how you've dealt with it.

You seem to be saying that it might just take a shove. Could there be people who are psychopaths who are not acting out on their psychopathy sitting next to you in the park bench just waiting for the right shove? I don't mean physically, but that breaking or the snapping point?

FALLON: Yes. Ira, that right shove is usually a very early stimulus. The closer to the time of birth that the abuse occurs, or the abandonment, the more profound the epigenetic effect on sort of catalyzing the psychopathy. So even though I have very strange thoughts, I don't act them out. You know what I mean?


FALLON: And so I think that there are - and I have very, you know, really kind of bizarre dreams and thoughts, but I think because, look, and I don't need money, I don't need sex, I don't need power, you know, I don't need those things. But I was thinking, what if I did?


FALLON: What if I was broke; what if I was - didn't have the love and support of a very large, wonderful family? Where would I be? And I've really got to wonder what I might've become.

FLATOW: Yeah. You have an interesting story about the scan of Eli Roth, who makes those "Hostel" movies, and he - it's almost like he has found an outlet for him...

FALLON: Yeah. It...

FLATOW: ...being a psychopath.

FALLON: I was contacted by the Discovery Channel. I didn't know Eli and they said Eli Roth wanted me to test him genetically with, you know, fMRI brain imaging and I said don't tell me anything else. And I said, in fact, I know who Eli Roth is because I saw him in "Inglourious Basterds." He was the Bear Jew, and I thought he was great in it. So I actually voted for him, you know, for Best Supporting Actor.

And that's all I knew. So when he came in, first of all, we did the scans; I talked to him. And when they came out - came back, I talked to my colleagues. I said this guy, I said this actor, whenever he sees some emotionally disturbing image - because we tested him with emotionally disturbing images (unintelligible) - he wants to throw up and his heart rate goes way up and he's absolutely terrified, more than the average person.

And I said, but when he looks at something like a flower, he's, like, in ecstasy. And I said, it was a very different pattern. And I said when this is going on, he does not - he can't tap into it. He has no self-awareness of it. And the way I inferred this is because of the circuitry that was inferred from his fMRI. I was guessing, right?

FLATOW: Mm-hmm.

FALLON: And I got his genetics back and looked at the type of empathy-related genes, alleles he had. And then when he came back for the second taping, I said here's what I think you are. And he just about - he just turned white, you know, whiter. And he - and he goes - he says that's exactly what happens. He said the first movie I saw, the scary movie, was "Aliens." He says I threw up. Whenever I see something unnerving, I get nauseous, my heart races. And so I said my guess was that he's self-medicating. So, he immerses himself in all this imagery which terrifies him. Which some people do, right?

They go after the thing that terrifies them. We do this as kids. And by that way, he can control it because it's his imagery he's creating in these movies. So we got back to my house, he goes - he says, I've got to have a beer. He says I'm not a drinker, but I've got to have a beer.

And so we called his father at my house right after the taping and said, Dad, this guy, he said everything you always said. As it turns out, Eli's father is a psychoanalyst from Harvard. So we had a fun time with that.

FLATOW: I'll bet you did.

FALLON: So anyway, I was able to go through those traits based on his images, brain images, and the genetics. Either one alone, I wouldn't quite have been able to do it.

FLATOW: This is SCIENCE FRIDAY from NPR. Talking with James Fallon, author of "The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain." There are Asperger's, people with Asperger's who don't - you know, we don't consider them psychopaths. They have troubles with empathy. Is there a difference there?

FALLON: Yeah. Well, there's - the empathy circuit connects to other circuits. It connects to the mirror neuron circuit. Now, it appears that in people with - like with Asperger's, there's a poor connection between those mirror neuron areas, that is the ability to understand what others are doing, okay, and what the meaning of what they're seeing is. So they have a problem with that.

But in - the connection to the empathy-related areas like the insula is also, because of that, faulty. But that doesn't mean they act anything out in violence.


FALLON: Because their amygdala, etc., the other parts that induce this control of violence, there's not - they're normal. So, you know, they may not be able to see it or understand it in such a way but they don't act it out like a psychopath.

FLATOW: What percentage of the population do you think has psychopathic traits?

FALLON: Well, full psychopathy, it's one to two percent in any population.

FLATOW: Mm-hmm.

FALLON: And it's pan-cultural. So it occurs in all cultures. And it's very interesting that, you know, our genome - that we've kept this so close to us. You know, why?

FLATOW: Could this serve - could famous people, you know, leaders, is this something - a positive trait for them to have? If a general, you know, if a general is ordered to go into battle, you know, and he says I've got to get the job done and I can't let my feelings get in the way of it.

FALLON: That's right. If you're a surgeon, if you're a leader, a president, a CEO, you've got to do brash things. And it turns out that people with psychopathic traits can - are very successful at taking chances. Somehow they're able to read things without reference to negative emotion. Right? They don't sense negative emotion and - or pain that much, really.

But people - if you look at it in a more general way, those sorts of traits - bravado and this manipulativeness and glib - and the willingness to take chances, risks, it's important. Because most people will not take risks. Most people are safe, so things stay static. And if that's true, you know, how does a company or how does a country or how does a family protect itself?

Because there's always others out there that are predators on...


FALLON: ...your group or your family or you. And so it's important, probably, to have people with those traits because they have not only the lack of fear and they're willing to take chances, but, you know, how many people have the energy to do this? How many people have the energy to be a president or a CEO every day? To go out and say things that they could get nailed on.

So you've got to have a healthy dollop of narcissism, you know, to really...


FALLON: ...pull this off. So it's probably important or else you couldn't do those jobs on a day-to-day basis anyway.

FLATOW: James Fallon, thank you for being with us today. It's a really interesting book, "The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain." And good luck to you.

FALLON: Thank you, Ira. Good talking to you.

FLATOW: You too.

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