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CHAPTER 1

Disordered Minds

Civilization's Thin Veneer

The practice of violence changes the world, but the most probable change is a more violent world.

Hannah Arendt

For anyone interested in psychology, a visit to the Freud Museum in Vienna is a chance to walk in the footsteps of one of the greatest explorers of the human mind. For students of history it is a reminder of some of Europe's darkest days. Sigmund Freud, a non-practising Jew, was allowed to leave Vienna in 1938 by the Nazi authorities after intense lobbying by friends in England. Four of Freud's sisters were not so fortunate. They died in the concentration camps of Auschwitz, Treblinka, and Theresienstadt. Mercifully Freud never learned their fate. He died at the age of 83, just days before Hitler's invasion of Poland and the outbreak of World War Two in Europe.

W.H. Auden, in his poem In Memory of Sigmund Freud, commended Freud for inventing psychoanalysis as a means of exploring the hidden regions of the human psyche. In the poem Auden compares Freud implicitly with Jesus for relieving the suffering of the afflicted by walking among the destitute and the lowly.

Freud would have been amused by Auden's implicit comparison. In Civilisation and Its Discontents, Freud took issue with Jesus for the naivety of his commandment, 'Love thy neighbour as thyself.' In light of the events unfolding around the world in 1938, particularly the brutal anti-Semitism he was observing daily in Vienna, Freud saw such a commandment as flying directly in the face of human reality. 'Not merely is this stranger in general unworthy of my love;' Freud wrote, 'I must honestly confess that he has more claim to my hostility and even my hatred ... [I]f he can satisfy any sort of desire by it, he thinks nothing of jeering at me, insulting me, slandering me, and showing his superior power; and the more secure he feels and the more helpless I am, the more certainly I can expect him to behave like this to me.'

Later in the same essay Freud concludes, 'The time comes when each one of us has to give up as illusions the expectations which, in his youth, he pinned upon his fellow-men, and when he may learn how much difficulty and pain has been added to his life by their ill-will.'

Decades after Freud's death, the philosopher Hannah Arendt, like Freud a Jewish refugee from Nazi Germany, covered the trial of Adolf Eichmann for the New Yorker magazine. Her articles created a storm of protest. Eichmann, a former SS Corporal in Dachau, was the man responsible for designing the system of transport that was used to carry millions to their deaths in the concentration camps. In describing Eichmann, she used the phrase 'banality of evil'. It is important to understand what she meant. 'When I speak of the banality of evil, I do so only on the strictly factual level, pointing to a phenomenon which stared one in the face at the trial ...' she wrote. 'Except for an extraordinary diligence in looking out for his personal advancement, he had no motives at all. He merely, to put the matter colloquially, never realized what he was doing ...' For Eichmann it seems, sending millions of men, women, and children to their agonising deaths in the gas chambers had the same emotional impact as casting wood on a fire.

Arendt's coverage of Eichmann's trial suggests that the most horrendous acts of evil can be perpetrated by the most normal-seeming people. Her phrase 'the banality of evil' implies that we all have the potential to become monsters. This is a view with which Freud would have agreed. In Civilisation and Its Discontents he wrote, ' ... the inclination to aggression is an original, self-subsisting instinctual disposition in man ...' It is also a common view among contemporary psychologists. Philip Zimbardo, Professor of Psychology at Stanford University, for example, has written, 'Those people who become perpetrators of evil deeds and those who become perpetrators of heroic deeds are basically alike, in being just ordinary, average people.'

Modern psychology, however, challenges the idea that we are all equally capable of violence and greed. While history clearly shows that ordinary people can, and do, participate in acts of atrocity, modern psychiatry is revealing that a small but significant minority have an innate and seemingly unalterable ability to treat others with brutality and disdain, of a different order to that of the majority. The presence of this minority distorts our societies and shifts the predominant values of humanity away from non-violence, compromise, and compassion, toward brutality, confrontation, and greed. In much the same way that adding a small amount of carbon to iron produces a much harder material, steel, so the presence of the small proportion of people who suffer from dangerous personality disorders fundamentally alters the timbre of humanity, at immense cost to us all.

How Early Relationships Shape Whom We Become

Since Freud's time, three core ideas have become central to psychoanalytic thought.

The first is that, as infants, we develop best in an environment of love and fun.

The second is that our internal worlds are formed in early childhood and have an enduring influence on our relationships throughout our lives.

And the third idea is that much of the suffering in the world can be traced to neglect and abuse in childhood.

Psychoanalysts since Freud have passionately believed that these ideas have the power to change our lives and reshape our world. Now neuroscience and biochemistry are showing that, on these key ideas at least, Freud was right.

Over the last few decades, neuroscientists have shown conclusively that the development of a baby's brain depends critically on the quality of the physical and emotional care it receives. As psychotherapist and author Sue Gerhardt explains, babies come into the world with a need for social interaction to develop and organize their brains. If they do not get enough empathic, attuned attention, then important parts of their brains simply do not develop as well as they should.

And the consequences of poor brain development in infancy can be severe. They can include a reduced capacity for empathy and love, difficulties in interpersonal relationships, and, in some cases, the development of dangerous personality disorders that are marked by a higher propensity for violence and greed.

So how do early relationships shape our brains? One region that plays a key role in emotional life is the orbitofrontal cortex, which is situated at the front of the brain just above our eye sockets. Our capacity to empathize and to engage in emotional communication with other people requires a developed orbitofrontal cortex. People with damage in this region cannot relate sensitively toward others. Scientists now know that the orbitofrontal cortex develops almost entirely after birth. What is more, it does not develop solely according to a predetermined genetic blueprint. Instead the way in which it develops, and the neural connections which are made within it, and between it and other parts of the brain, depend critically on caring relationships in our early years.

Pleasurable interactions – whether a loving gaze, shared laughter, or a warm embrace – arouse the infant's nervous system and heart rate, triggering the release of vital biochemicals. In this way, love and fun produce the chemicals that help the baby's brain to grow. The absence of such emotional stimulation deprives the child of the chemicals needed for normal brain growth. In babies who have been subject to early emotional or physical abuse, the orbitofrontal cortex has been found to be significantly smaller in volume.

The volume of the frontal part of the brain, however, is not the only thing that matters. How well the neurons are connected up within the pre- frontal cortex is also crucial, particularly the connections that are formed between the left and right sides of the baby's brain. Between 6 and 12 months after birth, a massive burst of synaptic connections occurs within the brain, connecting up the right and left hemispheres. The two hemispheres have different modes of operation. The left carries out specialized functions related to logic and verbal processing; the right is specialized in functions related to emotion. The interconnections formed between the two parts of the brain in infancy mean that our adult mind is able to draw on the resources of the left brain to regulate feelings. Similarly, the logical cognitive processes of the left brain can be informed by emotional reality. In the absence of love and play in our early years, however, the left and right brain will not be as well connected, resulting, once again, in adverse consequences for our emotional and mental health.

The second core idea of psychoanalysis is that our internal worlds are formed in early childhood and have an enduring influence on our relationships throughout our lives.

'Object relations' is one influential school of psychoanalysis. Psychoanalysts of this school have long argued that our internal worlds are fragmented and are comprised of multiple 'internal objects' that determine how we relate to ourselves and others. The term 'internal object' essentially means a mental and emotional image of another person, or part of another person (such as a smiling face), that has been taken inside the self. Our most important internal objects are those derived from our parents in early childhood.

According to object relations theory, when we interact with other people, these internal objects are activated. Depending on whether our internal world is dominated by images of fear and danger, or images of love and care, our internal objects strongly influence how we relate to others. Over the last few decades, neuroscientists have been discovering evidence that supports object relations theory. We have seen how the early development of an infant's brain involves an explosion of synaptic connections which link together different parts of the baby's brain. Initially these connections are made in a chaotic fashion. Then, as a result of the infant's experiences, particular connections begin to solidify. Out of the chaotic overproduction of connections, patterns start to emerge. The baby's most frequent and repetitive experiences result in well-trodden neural pathways, while those neural connections which lie unused begin to fade away. In this way, the baby's most typical experiences shape the networks of connections within its brain.

As the brain develops further, images and words accumulate within these neural networks. Between 12 and 18 months of age, when the baby begins to develop a capacity for storing images, an inner library of pictures also begins to be built up. Both positive and negative images and interactions are remembered and stored. During the baby's second year, as the child's verbal ability develops rapidly, words start to play as big a role as physical and visual communication. Words too, saturated with emotion, are stored as part of the child's neural networks. When these networks are activated through interactions with others, the dense webs of interconnections invoke rich associations of images, words, and emotions, and provide the infant with a practical guide to action. As psychoanalysts have long held, these neural networks – or 'internal objects' – underpin our behavior and our expectations of others throughout our lives, often without our realizing it.

Neuroscience, then, has shown conclusively that the absence of loving relationships in infancy can result in a smaller brain volume and a scarcity of neural connections within the brain. It has also shown that the patterns of behavior we experience in early childhood become hard wired into our brains and influence how we relate to others throughout our lives. The consequences of poor brain development resulting from adverse childhood experiences can last a lifetime and can include lack of empathy, rigidity in beliefs and behaviors, difficulties in relating to others, and the development of a host of disorders of personality.

Which brings us to psychoanalysis' third core idea, namely that much of the suffering in this world can be traced to neglect and abuse in childhood.

Three disorders of personality are now known to predispose an individual to violent or excessively selfish behavior. These disorders are psychopathy, narcissistic personality disorder, and paranoid personality disorder. While the precise cause of these disorders is still disputed, it is highly likely that physically or emotionally abusive relationships in infancy and childhood contribute to their development.

Of course, not every child who experiences neglect and abuse will develop a dangerous personality disorder. The resilience of the human spirit sees to that. But a minority do. And as we shall see, that minority plays a critical role in the violence and greed that deforms our world.

Dangerous Personality Disorders

For decades a steady stream of psychologists has been raising the alarm on the devastating effect that people with certain personality disorders are having on society. The Mask of Sanity first published in 1941 by Hervey Cleckley, Robert Linder's study Rebel Without a Cause from 1944, Theodore Millon's 1981 Disorders of Personality, and Robert Hare's more recent Without Conscience have been sounding a series of clear and persistent warnings. All of these authors warn that the destruction wreaked by psychopaths and those with certain other dangerous personality disorders is vastly underestimated.

So what are dangerous personality disorders? Up to 12 personality disorders have been recognized by the international psychiatric community. It is important to emphasize that not all of these personality disorders are dangerous and correlate with an increased risk of harmful behavior toward others. Indeed, most personality disorders result solely in distress and social hardship for the person suffering from the disorder. Such is the case, for example, with obsessive-compulsive personality disorder and depressive personality disorder.

Of all the recognized personality disorders, this book is concerned with only three. People with these three types of dangerous personality disorder – psychopathy, narcissistic personality disorder, and paranoid personality disorder – are proven to be much more likely to be involved in violence and criminality. Dangerous personality disorders are deeply engrained and enduring patterns of behavior that represent extreme deviations from the way the average person thinks, feels, and relates to others. They manifest as rigid patterns of behavior that are difficult, threatening, and harmful to others, including an increased propensity for violence and greed. In fact, people with these disorders are up to ten times more likely to have a criminal conviction than those without. People with these disorders suffer from distortions in the basic cognitive and emotional structures of their minds. These distortions include deficits in basic emotional functioning, such as the absence of feelings toward others, and cognitive distortions, such as the inability to process any information that runs counter to their inflated self- image. While everyone can manifest callous, narcissistic, and paranoid traits, depending on circumstances, it is the rigidity of their thoughts and feelings that marks people with dangerous disorders out from the majority of the population.

Psychopaths

a babe, by intercourse of touch I held mute dialogs with my mother's heart
A human being is something that evokes feelings in another human being. This fact can serve as our most basic definition of what a human being is. As we have seen, research in psychology and neuroscience is showing how the mute emotional dialogs with our mothers' and fathers' hearts, which Wordsworth describes in his epic poem Prelude, are the very process that molds the tone and structure of our minds. From our earliest days, to perceive others' feelings is to react with feelings of our own. Infants only a few weeks old react to joy in their mother's face with increased joy of their own; they react to sadness in their mother's face by becoming sad and subdued themselves; they react to anger with anger of their own. These emotional dialogs mean that, as infants, we quickly learn that the difference between people and things is that things do not engage with us in emotional communication.

However, for some people the vital distinction between the world of people and the world of things fails to develop. Such people, those with psychopathic personalities, are not capable of reacting to other people's feelings with feelings of their own. As a result, psychopaths have a terrifying ability to treat people without conscience. And what happens when human beings act toward others as if they were not people but things? The disturbing answer lies in the mindlessly violent behavior of psychopaths.

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Excerpted from "Disordered Minds"
by .
Copyright © 2017 Ian Hughes.
Excerpted by permission of John Hunt Publishing Ltd..
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