"A Shocking Discovery- 'I'm A Psychopath!'"

"A Shocking Discovery- 'I'm A Psychopath!'"

 by Michael Mosley

"Why do we behave the way we do? What really makes us tick? These questions have traditionally been left to philosophers and theologians but now scientists have come along with machines that can probe our brains in ways we never dreamed possible. Their work has led to discoveries that are often surprising and sometimes disturbing. Until recently, if you wanted to really understand what made someone tick, you would have had to rely on their own account of themselves, or perhaps guess what they were really like by close observation.

However, the study of the human brain has been transformed by scanners which can go beneath skin and bone, revealing what is actually going on inside our heads when we are thinking and feeling. Last summer I went to Holland to get hands-on experience of the latest research for my new BBC series, "The Brain - A Secret History."

In the city of Groningen, scientists are doing particularly interesting work on empathy, the capacity to share thoughts and emotions with someone else. We all know what empathy is. When you watch a James Bond film you may be aware that your heart has started to beat faster as our hero jumps from a plane or dangles over a precipice. Or perhaps you see a child fall, and hurt their arm. You wince. You touch your own arm in sympathy, then feel the urge to go over and try to help. It is instinctive; something we are all born with. If we didn't feel empathy we wouldn't behave altruistically, recognizing what others are going through.

Empathy is what binds societies together and its absence leads to many of the problems we see in the modern world. People who don't have empathetic responses, who don't have any feelings when they see somebody else in pain, are called sociopaths and psychopaths. They have long been a staple of thrillers, and throughout history there are countless real examples of the evil that happens when such people get into positions of power.

But is empathy something you can study and measure? Professor Christian Keysers, based at the Neuro Imaging Centre in Groningen, thinks it is. 'When you see someone accidentally hurt themselves you don't just realize that the other person is in pain in a rational way, you also embody the pain of the other,' he told me. 'We are trying to find out what gives us these insights.'

I had volunteered to take part in Christian's research, investigating the extent to which our own feelings of pain are important in understanding the pain of another. I was warned before I arrived that to do this it would be necessary for Christian's team to inflict pain on me. 'Basically, there are two phases to the experiment,' explained Christian. 'First we will ask you to watch some movies inside a brain scanner, and then you will experience pain. It will not be excruciating.' 'How are you going to create this pain?' I asked anxiously. 'I want you to find that out a little bit later on,' Christian replied enigmatically. I was taken into a basement to be strapped into an fMRI (functional magnetic resonance imaging) machine, which would measure the activity of different parts of my brain. Christian's assistant, who was wielding a fierce-looking plastic ruler, got me settled into the machine.

The first part of the test was a film of people's hands being hurt, which was quite surreal. All I ever saw were the hands. Sometimes the hands were pinched, sometimes slapped with a plastic ruler, occasionally twisted into unnatural positions. There was no commentary and no sound. Watching it I could feel myself wince. This, I thought, was good. It clearly showed I was a warm, sympathetic character. After a break we moved on to the more brutal part of the test.

Every so often, and without warning, Christian's assistant would hit the back of my hand with the ruler. It started off mildly painful and then, as my skin got more tender, it became uncomfortable though never excruciating. After about an hour I was released from the machine and given a questionnaire designed to measure how empathetic I think I am. It consisted of questions where I had to give a high or low score depending on how strongly I felt the statements applied to me. They were scenarios such as: 'Unhappy movie endings haunt me for hours afterwards'; 'I share the joys and pains of people around me'; 'I detect other people's moods quickly and easily.'

Afterwards I went back to my hotel and waited for my results. I hadn't realized until then just how anxious I would feel about the outcome. I have this picture of myself as a compassionate person. Perhaps the fMRI machine would reveal my ideas about myself were wrong. Would it show I was warm and empathetic? Or a secret psychopath?

When I met Christian the following morning, he had my results up on a computer screen in the form of a series of brain images. He explained that what they and others had discovered is that many of the same areas of the brain light up whether we are experiencing pain or watching someone else in pain. He and his team have tested a wide range of people, from volunteers like myself to convicted killers. His studies have shown people display very different responses to seeing others in pain. There are some people who are truly empathetic. When they say: 'I feel your pain,' their brain activity shows they mean it. There are others, notably the sociopaths and killers, whose brain scans suggest they feel nothing but indifference.

The first results Christian showed me were my brain's response to getting slapped. 'These are reasonable results,' he said. 'When you get slapped, four brain regions get activated. The first two process sensation, then the activity goes into two brain regions that add an emotional flavor.' So far I was normal, but what Christian said next, made me lean forward. 'This is the part where you may want to distract your wife or ask her to fetch something from another room,' he said. 'When it came to responding to your own pain you were average. But while we were showing you the movies of others in pain, none of the expected areas were activated.'

My face must have registered shock, because he added: 'It's OK, what we then did was lower the threshold a bit, looking for weaker activity. When we did that we saw that you do have activity, but it's lower than average.' What made it more embarrassing was that the results from the brain images did not match the answers I had given on the questionnaire, which had suggested I am soft-hearted. I asked Christian if my results might have been biased by the fact that I was tired, or by my prior knowledge of what to expect. He looked sceptical.

'When we scan psychopaths, their brain images suggest they aren't all that empathetic, but their questionnaires make it look as if they are model citizens,' he said. 'Oh my God, so I am a psychopath?' 'Well, maybe that's pushing it,' Christian reassured me, 'a little bit.' He grinned, so I knew he was joking, but it was still unsettling. The technology Christian uses is still quite crude, but improving all the time. It is possible that in future it could be used as a screening test for people joining, say, the police or Army. It is, after all, important that people who wield authority or guns should have some sensitivity to other people's feelings.

But Christian believes its real value will come from helping us understand how emotions, reason and sensation interact in our brains. 'While I'm witnessing you go through some experiences, my brain doesn't just make me see what is going on in you, it makes me share all the different senses,' he said. 'And the fact that we can now measure this reminds us that everybody is not just around us, but in us.' Technology such as Christian's has opened a new window into our minds. But there is another way we have come to learn more about ourselves. Some of the most fascinating insights have came about as a by-product of accidental damage to the brain.

A few years ago I met a young man, Philip, who had been in a car crash and afterwards developed something called Capgras syndrome. He appeared normal, except for the fact that he was now convinced his mother had been replaced by a look-a-like. From being a loving son, Philip now treated her like an unwanted interloper. There is an explanation for what was going on inside Philip's head that I find strange but satisfying. If true, it tells us something profound about how our own brains work. When you see someone you know, two different systems in the brain are activated. One puts together the features, roots around in memory, finds a match and says: 'Those features are familiar... it's John.' The other part of the recognition system is an emotional one.

In all of us there is a link in the brain between the visual system and the limbic system, which is involved in the generating and processing of emotions. When you see something you attach an emotion to it. It was vital for our ancestors' survival that when they saw something they decided, extremely rapidly, whether it was to be feared, eaten, ignored or mated with. Even before the word 'lion' popped into your ancestor's consciousness, the emotional part of the brain would have released adrenaline into the body, preparing it for fight or flight.

In Philip's case the link between his visual and limbic systems had been damaged by the car crash. Before the accident, when he looked at his mother he not only recognised her features, but also felt affection. Now when he looks at her he feels nothing. His brain, faced with this contradiction, had made up an explanation: 'If she looks like my mother but she doesn't feel like my mother then she must be an imposter.' Philip's case adds to a growing body of research that suggests our brains are dominated by our emotions far more than we imagine. Just as in the story of Jekyll and Hyde, it appears we have several different selves within one brain, one body, all jostling for supremacy.

Like Philip, Dave Wilson from Wisconsin, USA, appears normal. He is anything but. In 2002, he had surgery to remove a brain tumor. What neither he nor his wife, Lisa, fully appreciated was the operation would involve removing the frontal lobe, an area of the brain crucial for processing emotion. Lisa told me the changes in Dave were immediate and dramatic. 'Before the operation he was a very affectionate and loving husband,' she said. 'When he woke up after the operation he was completely different. Angry and cold. He didn't want me to touch him or talk to him.' Surprisingly, the surgery had no effect on Dave's core intelligence and he has returned to his job as an animal psychologist. But he himself is aware of being changed. 'I am emotionally dead,' he told me. 'I no longer have concern for others. This must be what serial killers are like. Not that I would ever become a serial killer, but I don't think that watching someone else die would bother me.' Dave has not just fallen out of love with Lisa, he is no longer capable of having feelings for anyone. They have divorced but she remains devoted to him.

Dave's case is being studied by Dr Michael Koenig, who trained under the famous American neuroscientist Antonio Damasio. In the Nineties, Damasio started researching patients who had, like Dave, damaged their frontal lobes. He was struck by the difference it can make, not just to a patient's emotional life but also to their decision-making. Dr Koenig, a neuroscientist at the University of Wisconsin, is also continuing Damasio's research into the impact of emotions on our capacity to reason. He rejects the idea that we'd make better decisions if we were like Spock in Star Trek, devoid of emotion and ruled by logic.

To make his point Dr Koenig suggested Dave and I played a computer version of an ingenious gambling game developed by Damasio. Damasio had discovered that most people unconsciously learned how to win the game before they had consciously done the calculations. It's an emotional decision. To play the game, we both started with $1,000. On the computer we were offered the choice of four decks of cards to play with, some delivering consistent winnings, some not. Each card, when clicked, turned over revealing varying sums of money that were added or subtracted from the starting pot. The game was played at a furious pace and the decks were subtly arranged so that while some decks delivered consistent winnings, others did not. I finished the test $100 up, which I attributed to my mathematical skills.

Dr Koenig, however, claimed that what I saw as a set of logical decisions were actually rationalizations after the event. My gut, not my head, had been the first to decide which were the best decks to use. You'd expect Dave, who is intelligent and devoid of emotion, to do well at a gambling test. But he made catastrophic losses because he had no gut reaction and took much longer to discover how to win.

We go through life thinking the big decisions we make are the result of our ability to think rationally. But research has shown that the conscious, rational bit of the brain, the bit of which we are so proud, is just the tip of a large iceberg. We are a mass of unconsciously learnt habits, feelings and prejudices that shape how we think and behave. Some people hate this idea because they see it as an attack on free will, believing that it undermines the importance of the choices we make.

Personally, I'm not disheartened: in the end it is still my brain making the decisions, even if I'm no longer certain how these decisions are being made. But I wonder, how many people sitting Christian Keysers's psychopath test would discover, as I did, they are not quite the person they thought they were? "

- http://www.sott.net/

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"The Brain - A Secret History" is screened on BBC4 at 9pm on January 13 and 20.

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