Christian Bale in "American Psycho" This is your brain on murder: What the mind of a psychopath looks like What's going on behind an American psycho's eyes? Science reveals the answer

Burly, bearded James Fallon tells people he has the brain of a psychopathic killer. And he has some brain scans he thinks back up his claim.

The PET scans behind his surprising claim—and which have provided entertaining material for his lectures—were taken where he works. He’s Professor Emeritus of Anatomy & Neurobiology and Professor of Psychiatry & Human Behavior in the School of Medicine at the University of California, Irvine (UCI). There he studies higher brain functions at the Human Brain Imaging Lab. Fallon describes his interests as “the neural circuitry and genetics of creativity, artistic talent, psychopathology, criminal behavior, and levels of consciousness.”

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A neuroscientist with a forty-year-long, successful career, Fallon, now sixty-six, arranged to have his own brain scanned. He made the decision after his mother, Jenny, recalled some interesting family history during a family barbeque. She knew her son, the scientist, lectured about his research on violent offenders. His lectures covered what he saw in the brains of murderers and what the images revealed to him about the causes of violent behavior. That led Jenny, as she said on NPR, to challenge her son: “Jim, why don’t you find out about your father’s relatives? I think there were some cuckoos back there.”

She was right. There turned out to be numerous—and murderous— cuckoos back there, including Lizzy Borden and seven other alleged killers. They were all on his father’s side, to his mother’s amusement. Borden, the most infamous, was acquitted—quite controversially—of the axe murders of her father and stepmother in 1882. One of Fallon’s male ancestors, Thomas Cornell, wasn’t so lucky. He didn’t beat the rap for the crime he was accused of committing: the murder of his mother. He hung for it in 1667.

Brain scans and genetic tests of Jenny and of Fallon’s wife, son, and daughters were normal. Fallon’s family has nothing in common with psychopaths or murderers, in terms of their behavior or brain activity. Fallon’s brain, on the other hand, shows the characteristic metabolic sluggishness in the frontal lobes first observed in violent and murderous individuals back in the late 1980s. And among the family members he’s tested, only he has inherited some genes that show up frequently in violent individuals. In fact, his blood test shows he has genes linked to violent tendencies—five in all, including one called the “warrior gene” (although any gene linked to violence might deserve the same nickname).

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No single gene makes someone violent or psychopathic. Even inheriting multiple genes can’t do this. If they did, Jim Fallon might have spent more time before a judge’s bench than before his lab bench. Besides the warrior gene, Jim says he inherited genes associated with antisocial behavior, low anxiety, and low empathy. Several encode instructions for making proteins involved in the function of neurotransmitters like serotonin and dopamine. But different versions of genes do influence behavior in some people, some of it unpleasant indeed. Differences in the effect of these genes on brain development, and on the way it receives, interprets, and responds to inputs influence how likely someone like Jim is to turn violent and/or show signs of psychopathy.

The discovery of the warrior gene-violence connection goes back to the late 1980s and early 1990s in the Netherlands. Hans Brunner, a geneticist at the University Hospital in Nijmegen, learned about a family that seemed to be full of men who easily lost their tempers, were aggressive, and, worse, were adding to their rap sheet with entries related to assault, arson, rape, and murder. The women in the family asked the geneticist if their men might be behaving badly because they had inherited something bad.

In 1993, Brunner had an answer for them. It was on the men’s X-chromosome, one of the chromosomes that determine gender. He discovered that the men had inherited a version of a gene that encodes an enzyme called MAOA-L. In the brain, MAOA breaks down important neurotransmitters, such as serotonin, dopamine, and adrenaline. MAO stands for monoamine oxidase; A designates a subtype of the enzyme (sort of like a car model), and L stands for low activity. Since 1993, the low-activity version of the gene—dubbed the “warrior gene” by the press—has been linked in several studies to increased aggressive behavior. A tendency to get into fights or strike out at others is not the same as the goal-directed aggression often seen in criminal psychopaths, but the existence of the MAOA-L gene does strongly support the view that some psychopathic tendencies may be inherited.

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Another genetic variation that may be linked to the development of psychopathy affects the metabolism of the neurotransmitter serotonin. Inheriting two long versions of the gene that produces a protein that transports serotonin back into brain cells after it has been released may be a risk factor for the development of psychopathic traits.

Prior to checking the status of his own DNA and brain images, Fallon says he analyzed the brain scans of over seventy people, which according to the Wall Street Journal were sent to him by colleagues, psychiatrists, and criminal defense lawyers. It started back in the 1990s when people began sending brain scan images to Jim for him to analyze. “I knew the human brain very well but I wasn’t an expert on murderers or psychopaths or anything like that. . . . It was just a side thing,” he recalled. Then in 2005, he received a large group of scans to look at. “At this point, Jim knew his colleagues were sending him brain scans of murderers so he decided to make a story. He asked his associates not to identify the scans. He also asked them to include scans of non-violent patients along with those of murderers.”

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He easily identified ten normal brain scans. Then he saw a group of scans from patients with major depression and some with schizophrenia. “It was a mixed bag,” he said. He didn’t know there was a pattern in psychopaths, because it wasn’t his main field of study, but he did notice a group of scans that showed inactivity in the prefrontal orbital cortex. Fallon later learned he had correctly identified the thirty murderers whose scans had been included in the collection of scans.

“There was one subgroup of those that had a lot of amygdaloid and cingulate cortex type of activity, so they stood out.” When the code was broken, this subgroup turned out to be psychopaths. “I think because I am not really an expert in this area, it made it easier for me not to be biased. I did not expect any pattern,” he said. “I think that is where it helped.” The first group with prefrontal cortex differences without amygdala and cingulate involvement turned out to be impulsive or reactive murderers. These people killed in a hot-blooded emotional manner as opposed to the cold-blooded manner characteristic of criminal psychopaths.

Fallon’s observations are consistent with some small-scale experiments first published in late 1987 and early 1994. The preliminary studies demonstrated the potential usefulness of PET-scanning the brains of people with personality disorders and violent tendencies. Adrian Raine and his co-workers used the technology to look at the brains of twenty-two men accused of murder in 1994.

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The darkness they saw indicating impaired metabolism in the prefrontal cortices of murderers and accused murderers was obvious, compared to an equal number of non-murderous controls. It suggested that the lack of neuronal activity in this part of the brain was a factor in murderous behavior. A follow-up study three years later found that 41 murderers who pled not guilty by reason of insanity also had reduced glucose metabolism in their frontal lobes compared to 41 controls. This mixed group also showed signs of reduced metabolism in half a dozen other brain regions.

These pioneering early studies of violence-prone individuals led the way to current fMRI studies in which people undergoing brain scans are more likely to belong to similar groups: for example, those with psychopathy scores in the certifiable psychopathic range. The earlier studies, like Fallon’s unpublished studies, captured mixed populations of violent individuals and murderers.

Despite a general impression to the contrary among many people, not all—in fact surprisingly few—murderers are high-scoring psychopaths. Some people kill as a result of stress or an isolated, uncontrolled emotional reaction such as anger or jealousy. More than half of the nearly 13,000 people murdered in 2010 in the U.S. were killed by someone they knew. Nearly one-quarter were killed by a family member. Nearly 43 percent were killed during arguments and just over 23 percent were crime victims. Circumstances surrounding the rest are unknown.

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Many criminals have antisocial personality disorder but do not reach the amoral or immoral depths of clinical psychopathy. Others kill because their criminal lifestyle forces them into situations where they must use violence. Most criminals—75 percent or so—have antisocial personality disorder, the personality disorder the American Psychiatric Society created to include sociopaths, which the Society still equates with psychopaths. Only a quarter or so of jailed criminals with antisocial personality disorder, however, are true psychopaths as indicated by the standard diagnostic test for that type of personality. This means about one in five prison inmates are estimated to be true psychopaths.

The search database of the U.S. National Library of Medicine and the National Institutes of Health, PubMed, lists 105 articles co-authored by J. H. Fallon. His published papers reflect his scientific interests which, according to his UCI faculty profile include “Alzheimer’s disease, Human Brain Imaging, art, law, culture, and the brain.” He has made significant contributions in several of these areas, including the use of imaging technology to locate genes associated with mental disorders, and research on growth factors and stem cells. He acknowledges that he has not published in the field of psychopathy. His finding is anecdotal.

He described his intriguing anecdotal studies in a TED talk titled Exploring the Mind of a Killer and in the BBC documentary Are You Good or Evil? He has also shared his scientific expertise in different areas of his research on the History Channel, Discovery, CNN, PBS, ABC, and the Wall Street Journal.

Nevertheless, the images Fallon finds in the scans of the murderers he examines, and which he finds in his own distinguished, law-abiding brain, are often identical to those of certified psychopaths. (He has avoided releasing his scores on the Hare Psychopathy Checklist, Psychopathic Personality Inventory, and other formal psychological evaluations as well as some casual online tests, but he says they are just short of the cutoffs for psychopathy.) The results like those he saw in his own brain scans are consistent with those reported in more controlled studies that have resulted in a better understanding of the abnormalities that appear to contribute to the cold-hearted nature of the most extreme psychopaths.

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Front and Center

The same dark regions in Fallon’s neuroimaging self-portrait that shocked him and instantly captured his attention, had captured the attention of other researchers interested in biological psychiatry years earlier. When Fallon points to the section of his brain scan that looks like the brain of a murderer, he points to a part of the frontal lobes called the prefrontal cortex.

The frontal lobes have been suspects in aggressive and criminal behavior since the 19th century. If you want to find your frontal lobes, imagine you have a bad headache. Place the palm of your hand on your forehead, fingers pointing up. Position the meaty part of your palm at eye level and lay your fingers over the top of your head. Fortunately, your skull prevents you from touching your frontal lobes directly, but if it were not in the way, you would have a pretty good grasp on this tissue that is so influential in determining the type of person you are.

Your frontal lobes are located immediately behind your forehead and extend halfway back across the top of your brain. They are part of the cerebral cortex, the outermost covering of the brain that processes higher brain functions. And the cerebral cortex of the frontal lobes controls some of the most sophisticated higher brain functions. Of course, other parts of your brain contribute to the mysterious task of generating consciousness, creating thoughts, and solving problems. But if you are the type of person who is even moderately successful at, for example, planning for your future retirement, weighing the risks of challenging your boss, worrying what might go wrong if you go sky-diving with an unlicensed instructor, “reading” people and getting along with them, and sublimating your sex drive when the time is not right, then you are doing a pretty good job of using your frontal lobes.

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A lot of what distinguishes us from chimpanzees can be found in this relatively recently evolved addition to our central nervous system. We may share close to 99% of our DNA sequences with this ape, but we seem to express more of certain genes in our brains than chimps do. (The code of an expressed gene is read and used to produce a protein encoded by the gene. An unexpressed gene is not decoded and produces no protein product.) We have genes specific to our species (some of which are associated with cognitive disorders) and a much more complex pattern of gene expression in our frontal lobes compared to apes.

MRI scans show that prefrontal white matter increases during infancy dramatically in humans but not in chimps. Apparently this contributes to our ability to plan, project, and out-problem-solve our fellow primates in such a way that we can dominate the globe for better or worse. Despite their outward similarities, human frontal lobes are more complex than chimpanzee frontal lobes. The signaling pathways and connections in human frontal lobes appear to be somewhat more elaborate than those of the great apes. Less white matter in the ape’s temporal cortex might also reflect less connectivity between neurons. More connections between nerve cells is just what you want if you want to process information more efficiently and at a more sophisticated level. Such microscopic differences may be reflected in our good and bad behavior, and in our great and not-so-great accomplishments as a species.

One way to get an idea of the important function this part of the brain plays in thinking and planning, as well as in antisocial, criminal, and psychopathic behavior, is to consider medical reports describing injuries to this region. They are full of case histories of patients who suffered damage to the frontal lobe—beginning with a man named Phineas Gage. In 1848, Gage survived an accident in which an explosion sent an iron rod through his cheek and eye socket and out the top of his head, destroying portions of his frontal lobe. The Smithsonian magazine correctly referred to Gage, whose story is told in Chapter 9, as “neuroscience’s most famous patient.” He, and many unfortunate patients after him, could no longer balance their “intellectual faculties and animal propensities” after suffering damage to their frontal lobes, according to Gage’s physician, John Martyn Harlow.

Immediately above your eye sockets, behind your brow, is a subdivision of the frontal lobes called the orbitofrontal cortex and adjacent ventromedial prefrontal cortex. The term orbitofrontal cortex comes up in the scientific literature devoted to the biological basis of psychopathy and antisocial behavior the way “weapon” comes up when you read about holdups. When it is damaged by a stroke or an injury—or even, as some neuroscientists believe, when it develops abnormally in the womb and during childhood—it appears also to fail in its job of influencing a sense of ethics, morality, and social cooperation. Its dysfunction can lead to impulsiveness and aggression, traits closely linked to psychopathy and antisocial behavior.

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“The frontal lobes are the part of the brain that put a brake on impulses and drives,” Georgetown University psychiatrist Dr. Jonathan Pincus told ABC News’ Ned Potter. “It’s the part of the brain that allows us to say, ‘Don’t do that! Don’t say that! It’s not appropriate! There are going to be consequences!’”

If you know where to look, it’s easy to see that something is missing when you look at a PET scan of Fallon’s brain, and the brains of certified psychopaths. In most pictures of healthy brains, the orbitofrontal cortex glows with bright patches of red and yellow—colors added by the computer to indicate brain cells actively sucking up and burning glucose for energy as they keep nerve impulses flowing and neurons communicating with each other. That desirable glow is missing in the brains of unusual subjects like Fallon, who admits to having some non-violent psychopathic traits such as recklessness, and in the brains of people who tend to get into fights and victimize others. Their brain portraits show only a dull gray patch where the key part of the prefrontal lobe should be cheerily lit.

Even when this area is damaged, impaired, or inactive, intellectual ability is frequently unaffected. Fallon’s distinguished non-criminal academic career is one example. High intellect among criminals does not appear to be the rule, but it is certainly not unheard of.

Smart Bad Guys

Literary intellectuals Norman Mailer and William F. Buckley, Jr. learned about the disconnection between psychopathic traits and intellectual impairment firsthand. Mailer was the celebrated, controversial author of eleven novels and twenty-eight books. He won Pulitzer Prizes for both fiction and nonfiction. Novelist Joan Didion described him as “a great and obsessed stylist, a writer to whom the shape of the sentence is the story.” Buckley, founder of The National Review magazine, was a leading figure in the American Conservative movement in the second half of the twentieth century and also a prolific author of conservative political commentaries and spy novels. He was known for his dictionary-like vocabulary and his inclination to use it.

Both the conservative Buckley and the liberal Mailer befriended convicts who wrote to them from prison. The jailed correspondents impressed the two famous writers with their writing skills. Eventually, the articulate prose of the convicts convinced Mailer and Buckley that the convicts deserved their freedom.

There are, of course, precedents for literary skill and even genius coexisting with ignorance in other areas. T. S. Eliot and Ezra Pound were, in addition to being leading literary figures and poets during the twentieth century, boorish anti-Semites. Leading American journalist H. L. Mencken and the industrialist Henry Ford were, too. Ernest Hemingway also made anti-Semitic comments. Holding such hateful, ignorant, and reprehensible views has never been inconsistent with accomplishment and fame, although it may highlight the limitations of ambition with intellect in the absence of wisdom. Buckley’s and Mailer’s assumption that intelligence and evil did not co-exist in criminal minds had lethal consequences.

Buckley’s pen pal was a man named Edgar Smith. Smith was imprisoned for murdering Victoria Ann Zielinski, a fifteen-year-old cheerleader, in 1956. The murderer had crushed the girl’s skull with a forty-four-pound rock after beating her with a baseball bat. While locked up for the crime— which he denied committing—Smith wrote to Buckley. He convinced Buckley he was a good writer. Smith told the conservative maven that he had been wrongfully convicted. Buckley appreciated good writing. How could anyone so intelligent, so capable of creating such cogent, well-crafted sentences and of marshaling such insights, be guilty? Buckley believed Smith was innocent and lobbied for his release. Fourteen years after his death sentence, Smith was set free. The legal justification for his release was the improper manner in which the police obtained his statement following his arrest. It is undeniable, however, that the efforts of Buckley and others who made him a cause célèbre played a big part in the decision to free Smith.

Smith made a short career of talking and writing about the injustice done to him. He authored "Brief Against Death" before his release from prison and "Getting Out" after his release. Once freed, he lectured and made radio and television appearances while he was enjoying his fifteen minutes of fame. In his fifth year of freedom, however, he backslid. He abducted a woman and stabbed her with a butcher knife. When he contacted Buckley after the stabbing, Buckley phoned the FBI to report Smith. Fortunately, Smith’s victim survived and testified against him. Smith went back to prison; Buckley lost a pen pal.

On opposite ends of the political spectrum, Mailer, the author of "The Armies of the Night," did not have a lot in common with Buckley, the author of "God and Man at Yale," ideologically speaking, but he too was easily charmed by skillful prose. And so Norman Mailer, like Buckley, was seduced by the prose of a clever convict. He began corresponding with Jack Abbott, a lifelong criminal who had experienced neglect and abuse in the foster care system, which he had entered at birth.

After a youth spent in juvenile-detention centers and reform schools, Abbott went to prison for forgery. When he was twenty-one years old, he stabbed a fellow inmate to death. Facing more than twenty years for the murder, he escaped in 1971. He robbed a bank, was captured, and was sentenced to an additional nineteen years. Five years later, he began writing to Mailer and, as Smith had done with Buckley, succeeded in impressing the famous author. His letters to Mailer describing life in prison were published, with Mailer’s help, in Abbott’s book, "In the Belly of the Beast."

Mailer helped Abbott again by supporting his efforts to gain parole, a goal which they realized in 1981, despite serious doubts by Abbott’s jailers. Once freed, Abbott too made the rounds of New York literary society for a month or so. But then he got into an argument with restaurant employee Richard Adan over the use of a staff-only restroom. The two took the argument outside, where Abbott stabbed the 22-year-old victim—a fledgling actor and writer himself—to death. Abbott’s plea of self-defense didn’t convince anyone; he went back to prison. Mailer, like Buckley, lost a pen pal.

Hare wrote that the lack of depth in Abbott’s conscious feeling about the murder is indicated by his statements that “There was no pain; it was a clean wound” and “He had no future as an actor—chances are he would have gone into another line of work.”

Abbott hanged himself in prison in 2002. His suicide note was never published.

The naiveté of Mailer and Buckley was perhaps, at the time, understandable. They could not conceive of high intellect and verbal intelligence being associated with psychopathic or criminal tendencies. Vicious murderers were, after all, ignorant, dumb thugs—not polished, skilled writers. Although we have an extraordinary amount to learn about the neurobiological basis of psychopathic behavior, we nevertheless know quite a bit more now than we knew then. We know that intelligence and writing skills are not incompatible with criminal or psychopathic behaviors. The brain is big enough and small enough, active enough and inactive enough, to accommodate both traits. We know that a man or woman may be able to write like a sage and still be a remorseless killer.

In the classic treatise on psychopathy, "The Mask of Sanity," Hervey Cleckley placed “Superficial charm and good ‘intelligence’” at the top of his list of psychopathic traits. This might be because the typical psychopaths Cleckley saw usually did “not commit murder or other offenses that promptly lead to major prison sentences.” Buckley’s and Mailer’s friends may have been exceptions, since the scientific literature doesn’t dispute the argument that less-intelligent psychopaths get caught and sent to prison while more-intelligent psychopaths tend to move into corporate or political occupations, or else manage not to get caught. Like the rest of the population, psychopaths range widely in intelligence.

While we don’t know what their brain scans would have looked like, or what genes Smith or Abbott inherited, we know they displayed classic behavior of criminals with antisocial personality disorder and psychopathy. Neuroimaging studies of violent offenders with records similar to Smith and Abbott, along with neuropsychological test results, point convincingly to problems in the frontal lobes.

Adrian Raine and collaborators, for example, found using structural MRI that there was less gray-matter volume in the frontal cortex of people with antisocial personality disorder and high psychopathy scores around 28 out of 40. His co-author psychologist Todd Lencz said that the 11 percent difference was “modest but noticeable when comparing groups.”

Back in the year 2000, the researchers couldn’t be sure exactly which parts of the frontal lobes were short on gray matter, but later studies clearly pointed to the orbitofrontal cortex. That’s the same region Fallon was surprised to see was dark in his brain, as well as in the brains of the murderers he studied. The association of reduced activity and gray-matter volume in this part of the brain is significant because it appears so often in studies of this type of psychopathology.

Sometimes it’s easy to forget when discussing individual brain regions that the brain is a highly complex structure consisting of billions of interconnected units. What might look like a lesion causing a problem in one area all by itself might really be contributing to troubling behavior by interrupting communication pathways that run through it. So, the true source of the dysfunction might not lie in the prefrontal cortex alone, but instead in a circuit of brain regions and structures, all affected by an apparent lesion or flaw in one part of the brain.

Excerpted from “Murderous Minds: Exploring the Criminal Psychopathic Brain: Neurological Imaging and the Manifestation of Evil” by Dean A. Haycock. Copyright © 2014 by Dean A. Haycock. Reprinted by arrangement with Pegasus Books. All rights reserved.