Psychopathy And The Brain

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Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression ...Read More

I like to listen to audiobooks on my commute.  The most recent book I listened to was “The Sociopath Next Door” by Psychologist Martha Stout.  The book came out in 2005, and although one might consider it slightly dated by now, it gives a vivid description of the problem of sociopathy.  Of note, while some experts distinguish between sociopathy and psychopathy, Stout does not seem to make that distinction in her book.  For the sake of keeping things simple, I will mostly stick to the term psychopathy for now, since most of the current research on the topic uses that term.

Most people think of psychopaths as the character of Hannibal Lector in Silence Of The Lambs, or they think of someone like Jack The Ripper or Batman’s Joker – sadistic, violent, creepy, and quite a bit larger than life.  In contrast, real-life psychopaths can be much more inconspicuous—charming, convincing, and seductive, they manage to influence and exploit others to get their way.  The sociopaths Stout is talking about do not only include serial killers or mass murderers, or high-powered psychopaths that became politicians or high-level executives, but they include those “average” people that get pleasure out of exerting whatever power they can.


Amongst the key features of psychopaths are a lack of empathy and a lack of conscience. That means they don’t feel empathy for others and don’t experience remorse when they harm or hurt others.  In her book, Martha Stout gives ample examples for this lack of remorse and empathy, for instance, the highly-functioning executive who sexually harasses his assistant. When she tries to fight him off, he breaks her arm. Instead of remorse, the psychopath responds by claiming the assistant broke her own arm, because she fought back.  This characteristic of a lack of remorse is something that is very difficult to grasp for people who do have a conscience, and I think this can make it hard to identify psychopaths. It is the charming, nice, glib, and seductive exterior that can make it difficult to realize when you are dealing with a psychopath.

In listening to the Sociopath Next Door, I was reminded of the 2008 paper by researchers Abigail Marsh and James Blair who reviewed several studies that investigated  psychopathy in relation to the ability to recognize the affect expressed in other people’s faces.  People with psychopathic characteristics did not show any consistent deficits in recognizing the expression of happiness, anger, or disgust in the facial expressions of others.  However, interestingly, they had significant deficits in recognizing fear in other people.  The authors concluded that it is not that people with psychopathic traits have difficulty reading other people’s facial expressions in general, but there’s something that’s related specifically to identifying the affect of fear in others.  Since there is some evidence that the function of recognizing fear-expression is located predominantly in an area in the brain called the amygdala, Marsh and Blair concluded that there must be some deficits in psychopaths that have to do with neurocognitive functions in that area of the brain.  This hypothesis receives further support through a 2009 brain imaging study by Yaling Yang and colleagues that demonstrated that the amygdala of people with psychopathy had reduced volume compared to a non-psychopathic control group.

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It’s quite fascinating what our modern technology of brain imaging and our modern research methods enable us to do.  However, even though there is some indication that there may be some identifiable deficits in the brain that are related to psychopathy, much is still unknown and mysterious about it.  We still know little about the mechanisms of how a psychopathic personality develops, and what can be done in order to offer effective methods of prevention and treatment.  And this is what ultimately will help to reduce the harm done by the sociopath next door.

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