Creating Conscience, Part 3: A history of treating the psychopath

We're all familiar with the idea of the "bad seed". Incorrigible children and unruly adolescents who later commit terrible crimes. Over the last decade, they've increasingly been referred to as psychopaths. But unlike the way their adult counterparts are viewed, there's renewed hope that younger people with psychopathic traits can be redeemed. This is episode3 of a 3-part series by Mary O'Connell.

• Listen to Creating Conscience, Part 1
• Listen to Creating Conscience,Part 2

In recent decades, more and more studies have focussed on criminal adolescents and in fact many youth have been measured for psychopathy, using a world-wide tool.University of New Mexico neuroscientist Kent Kiehl hasscanned the brains of 500 youth.Five years later, their brains will be scanned again. Kent Kiehl and his team will be looking for many things, including brain changes.

The psychopathic brain has about sevenper cent less gray matter in a crucial part of the brain connected to the limbic system.Kiehl says, "it is the seat of emotions and is also connected to moderating behaviour."Other ways to measure whether criminality and psychopathy still exist will depend on interviews, new case material and whether the adolescent has reoffended.

But studies tell us that, unlike the adult psychopath, adolescents seem to be able to "dial back"criminal activity. Jennifer Skeem is an Associate Dean of Research in Social Welfare at the University of California, Berkeley.She says many youth stop reoffending because some of their typical teen behaviour, like "stimulation seeking, poor impulse control, a parasitic lifestyle and anti-social behaviour tends to wane." These traits are also measures for psychopathy.Why do adolescents move away from delinquency?She believes, in some cases treatment helps, in many cases, the brain is maturing.

Why do some youth NOT become psychopaths even when they seem headed that way? I think it could be inflated diagnoses. Maybe mislabelled. Their brains mature. In some samples, up to 85 per cent just stop offending.- LorraineJohnstone

That's what Lillyth Quillan is hoping for her son, whom we're calling "Kevin". She says that when Kevin was an infant, she was never really sure if he was bonding with her. As a toddler and preschooler, he began regularly fighting with other children. Kevin would steal things, choke kids, lie constantly. By the time Kevin reached puberty, he'd been kicked out of five elementary schools.

"One day, he came up to me and said, 'mom, I think I'm like Dexter. I have no soul.'It was a heartbreaking moment but I said, 'you are like Dexter. But you are not a murderer and you do have a soul. But you are a sociopath.'"Lillyth says it is almost impossible to get treatment for kids like Kevin. "The best you can hope for is that they get caught up in the criminal justice system and then, maybe, treatment may start happening how sad." Kevin did spend time in a residential treatment facility and is now living on his own.

Guests in this episode:

• Lillyth Quillanis themother of a son with conduct disorder, co-founder of STOPP: Society for Treatment Options for Potential Psychopaths.
• Kent Kiehl ispsychology professor and neuroscientist at theUniversity of New Mexico and author of The Psychopath Whisperer.
• Lorraine Johnstoneis aclinical and forensic psychologist at theCentre for Youth and Criminal Justice at the University of Strathclyde, Glasgow, Scotland.
• Joshua Buckholtz isAssociate Professor of Psychology atHarvard University.
• Jennifer SkeemisAssociate Dean of Research in Social Welfare at theUniversity of California, Berkeley.
• Jeffrey Smalldon is a forensic psychologist inColumbus, Ohio.
• Mark Daddsisdirector of the Sydney Child Behaviour Research Clinic in Australia.

Further reading:

• The Mask ofSanitybyHerveyCleckley, Echo Point Books and Media, originally published 1941.
• Without Conscience: The Disturbing World of the Psychopaths Among Usby Robert Hare, The Guilford Press, Jan. 1999.
• The Psychopath Whisperer: The Science of Those Without Conscienceby KentKiehl, Broadway Books, 2015.
• The Psychopath: Theory, Research and Practiceby John C.Yuille, HughesHerve,Routledge, 2017.
• How Psychopaths See the Worldby Ed Yong, The Atlantic, March 12, 2018.
• Crazy at the wheel: Psychopathic CEOs are rife in Silicon Valleyby Olivia Solon, March 15, 2017.
• Programmed to Kill: The Cold Aggression of a Mass Murdererby Cinthea Briseo, Spiegel, July 26, 2011.
• New Findings Spur Debate: Are Some Psychopaths Curable?by Cynthia Fox, Bioscience Technology,August 7, 2013.
• Creator Of Psychopathy Test Worries About Its Use, NPR "All Things Considered", May 27, 2011.
  

**This episode was produced by MaryO'Connell.