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What if the brains of sociopaths could be fixed?

2012 Andrea Zanchi

A new, riveting study from the University of Chicago, published in JAMA Psychiatry, has shown that people with psychopathy—who lack empathy, are likely to engage in criminal behavior and who are much more likely to be violent—have abnormal brain function.   

Researchers examined 80 prisoners in a U.S. correctional facility with “functional MRI,” which shows brain activity, by measuring things like blood flow and oxygen use by brain cells.  

They showed them pictures in which people were being attacked or were obviously in pain.  And, for the prisoners with high levels of psychopathy, less than normal activity was found in a critical part of their brains linked to emotion—called the amygdala.

This finding does not mean the prisoners were born with less neural responsiveness to viewing suffering; they certainly could have ended up that way by being exposed to trauma as children or drug abuse as adults.  The amygdala may well be sensitive to stress.  

It also does not mean the prisoners had no responsibility to avoid being destructive and landing in jail to begin with.  They had the responsibility to optimize their brain capacity.  

Nonetheless, by the time they were examined in prison, their brains were literally less responsive to the suffering of others.  And that does make one wonder whether, for example, an abused, abandoned boy, perhaps born with a vulnerable amygdala, then exposed to drugs in his neighborhood, might have lost his capacity to care for others—neurologically.

I have long believed (and have written many times) that empathy—the ability to appreciate the suffering of others—is the single greatest hurdle to one human being inflicting pain on another.  Laws help.  Punishment has its place.  But nothing comes close to the inborn, normal capacity of people to imagine other people hurting and, therefore, resist causing that hurt.

Psychopathy is present in 20 to 30 percent of the U.S. prison population, but only 1 percent of the general population in the U.S.

It should now be a priority of researchers to develop methods of restoring function to the amygdala during prisoners’ periods of incarceration.  If functional MRIs can guide us in determining whether antidepressants or psychotherapy or essential fatty acids or repetitive transcranial magnetic stimulation or listening to music or having a pet (to give a range of possible interventions, some arguably more credible than others) bring back normal activity in the amygdala, we may be able to very significantly heal our prison population and reduce recidivism to jails.  

One therapeutic modality I would predict, which may have extremely positive effects, would be Ketamine infusions. I've written about this before; Ketamine seems able to renew neural networks that have lapsed into inactivity.

We have long known our prisons are filled with mentally ill individuals.  We may soon be able to deploy treatments that actually heal criminals, by restoring their empathy, rather than just keeping them locked up for a time, then returning them to the streets, potentially unchanged or even changed for the worse.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com.