Psychopathy, empathy and moral agency: Lessons from autism

If there is one thing that gets me argumentative it is statements like this one that appeared in a recent research paper: “non-incarcerated psychopaths have an arguably equal potential to illuminate our understanding of the emotional difficulties, such as lack of empathy and lack of conscience, which underlie psychopathy and which lead to offending behaviour.” (emphasis mine)

Now I agree that we can learn from non-incarcerated psychopaths, I wrote recently about a well designed study where sociologists conducted interviews of some. But I cannot believe that statements like the one above make it through editorial review for another reason. Researchers in psychology have spent the last 50 years and untold millions of dollars uncovering the cause of behavior. There is no mystery, we know what causes behavior!

Behavior is caused by rewards and stopped by punishment. Actually rewards cause behavior a lot better than punishment stops it in most people. That is because the brain reward system is functionally stronger than the brain punishment system for most, and especially for sociopaths/psychopaths. The rewards that cause behavior do so because they increase dopamine activity in the mesolimbic dopamine system.

Offending behavior exists and persists because it is rewarding and that reward affects the activity of the mesolimbic dopamine system. To put it bluntly, nothing but desiring/liking to offend leads to offending behavior. To say otherwise is to negate all the work that has been done in this area. The evidence is so strong that genes involved in dopamine metabolism and that system have been identified as candidate genes in the familial transmission of “offending behavior”.

I will repeat, a lack of empathy does not cause offending behavior, neither does a lack of conscience. These two may cause a person to show restraint if he is tempted to aggress against another, but it is the aggressive impulse that causes aggression. So a person with empathy and conscience can still offend if he has the inclination to do so. Furthermore, there is evidence that repeated offending erodes away empathy and conscience.

There is another source of evidence that calls into question the hypothesis that lack of empathy causes the sociopath’s behavior. That source of evidence is people with autism and autism spectrum disorders.

I recently found two very impressive discussions comparing moral agency in autism and psychopathy. The first is, Autism, Empathy and Moral Agency, a paper published in The Philosophical Quarterly (52:340, 2002) written by Dr. Jeannette Kennett, Deputy Director and Principal Research Fellow, Centre for Applied Philosophy and Public Ethics, The Australian National University. Since I didn’t know to search Philosophical Quarterly for papers on psychopathy, I didn’t find that paper until I read “Moral Psychology, Volume 3, The Neuroscience of Morality: Emotion, Brain Disorders and Development” MIT Press, 2008. Dr. Kennett also has two chapters in that book. But Chapter 5, Varieties of Moral Agency: Lessons from Autism, is a discussion of Dr. Kennette’s paper by Dr. Victoria McGeer, of Princeton University’s Center for Human Values. There is a back and forth discussion of the issues raised, with several noted professors also participating.

Both sources begin their discussions by saying that moral agency has two parts two it, a thinking part and a feeling part. They trace these concepts back to philosophers Kant and Hume. Dr. Kennett concludes that Kant is right and that reason is the most important aspect of moral agency. Dr. McGeer points to emotions being important even for people with autism. I am going to summarize the arguments, then give you my own opinion.

Now like sociopathy, autism is a spectrum. A large percentage of people with autism are mentally retarded, so this discussion involves those autistic individuals who are not mentally retarded. I should point out that many sociopaths also have poor intellectual functioning. These sociopaths tend to live in prison.

Dr. Kenneth quotes the following description of autism,

The most general description of social impairment in autism is lack of empathy. Autistic people are noted for their indifference to other people’s distress, their inability to offer comfort, even to receive comfort themselves. What empathy requires is the ability to know what another person thinks or feels despite that is different from one’s own mental state at the time. In empathy one shares emotional reactions to another person’s different state of mind. Empathy presupposes amongst other things a recognition of different mental states. It also presupposes that one goes beyond the recognition of difference to adopt the other person’s frame of mind with all the consequences of emotional reactions. Even able autistic people seem to have great difficulty achieving empathy in this sense.

Autistic people also experience an “aloneness,” yet this aloneness does not bother them. They are indifferent to the presence of other people and do not require affection. One autistic adult is quoted as saying, “I really didn’t know there were other people until I was seven years old. I then suddenly realized that there were people. But not like you do, I still have to remind myself that there are people. I could never have a friend. I really don’t know what to do with other people really.”

High functioning autistic people recognize that they are very different from other people and report feeling “like aliens.”

Dr.Kenneth correctly concludes, “Both psychopaths and autistic people experience outsider status, deficiencies in social understanding and social responsiveness… Both have a tendency to treat other people as tools or instruments, (they have) a lack of strong emotional connectedness to others and impaired capacity for friendship.” She says clinicians and researchers link these impairments in both psychopathy and autism to impaired empathy. But autistic people are in fact worse off in this respect than psychopaths. Psychopaths at least can interact socially with ease and behave in a charming way.

She correctly questions, “If empathy is crucial to the development and exercise of moral agency, then why is the autistic person not worse off, morally speaking, than the psychopath?” She points out that in spite of the lack of empathy which is at the core of the disorder, “Many autistic people display moral concerns, moral feeling and a sense of duty or conscience.”

That autistic people are not antisocial is evidenced by the observation that few come to the attention of police. I did a Google news search using the terms autistic and arrest. Although there were many arrests of people for abusing those with autism, all of the arrests of autistics for aggression were for aggression that stemmed from self-defense. For example, a 10 year old boy with autism was arrested for assaulting staff at his treatment facility. The boy assaulted staff members because he was afraid and they tried to prevent his escape.

Drs. Kenneth and McGeer basically agree on the source of moral agency in those with autism, and what they say is fascinating with respect to sociopaths. The source of moral agency in autism is a preference for order and organization. Autistic people have reported that their sense of morality comes from a desire to see their world as orderly and organized. Dr. Kenneth states that this need for order gives rise to an extraordinary rationality in high functioning people with autism. She says that since morality is organized and logical that those with autism easily pick up moral principles.

I also did a search on morality in autism and can attest to several studies demonstrating normal levels of moral reasoning in autistic children who are not mentally retarded.

Drs. Kennett and McGeer also agree on the issue of the lack of moral agency shown by sociopaths/psychopaths. They both say that this group just plain doesn’t care about morality or regard moral principles as important. This is where psychopaths and autistics differ. Autistics identify with and value moral principles. Dr. Kennett states, “It is not the psychopath’s lack of empathy, which (on its own at any rate) explains his moral indifference. It is more specifically his lack of concern, or more likely lack of capacity to understand what he is doing, to consider the reasons available to him and to act in accordance with them.”

The point of disagreement of the two experts involves the relative role of emotion and reason in autistic people’s moral agency and valuation of morality. Dr. Kennett says that the autistic person is like Dr. Spock of Star Treck, and views life in purely logical terms. Since morality is logical and rational, autistics embrace it. Dr. McGeer disagrees, she states that the autistic need for order leads to an emotional connection to order and rationality. She feels that emotion does play a role in the moral lives of autistics, since she sees them as emotionally as well as rationally invested in maintaining order.

What about sociopaths/psychopaths and the need for order/organization? This disorder truly involves disorder. Psychopaths/sociopaths thrive on chaos and seem to have a dislike for order. Everywhere they go they are a source of extreme entropy as they take order and turn it into disorder. Both Drs. link the lack of appreciation for order to a lack of thoughtfulness in sociopaths/psychopaths. Sociopaths are both disordered and not fully rational or logical.

Dr. McGeer States:

This failure of reason may seem surprising. After all, our image of the psychopath is of a person who is rather good at serving his own interests without concern for the damage he does to others; hence of someone who is rather good at thinking and acting in instrumentally rational ways”¦As Dr. Carl Elliot observes, “While the psychopath seems pathologically egocentric, he is nothing like an enlightened egoist. His life is frequently distinguished by failed opportunities, wasted chances and behavior which is astonishingly self-destructive. This poor judgment seems to stem not so much from the psychopath’s inadequate conception of how to reach his ends, but from an inadequate conception of what his ends are.”

I agree with Dr. McGeer in that I believe that the emotionality associated with the need for order leads to the rationality of autistic people. The brain punishment system is relatively intact in autistics as compared to sociopaths and when an autistic person senses danger instead of being disconnected from the source of anxiety/fear, the autistic person engages thoughtfully to avoid danger (punishment).

The brain punishment/anxiety system of sociopaths is both hypofunctional and hyperfunctional in that they experience anxiety but fail to engage their thinking brains in the presence of danger. The high functioning autistic is well practiced at using his thinking brain to avoid anxiety. The psychopath rarely uses the thinking brain he has- to do anything other than get into trouble and hurt other people.

There are interesting parallels between the autistic’s use of reason to manage anxiety and normal development. It turns out that anxiety and fearfulness in the first two years of life actually predicts the development of conscience. The brain punishment system seems to be more plugged in to the rational brain in kids who are dispositionally more anxious. These kids also have a more highly developed sense of empathy later on.

I am thankful to Drs. Kenneth and McGeer for their seminal contributions to our understanding of sociopathy/psychopathy. I encourage the scholars among you to purchase their book from Amazon. However, I think they both missed a further unifying explanation for why autistics are moral and psychopaths/sociopaths are not.

That explanation involves the brain reward system, which is fundamentally different in autistics and sociopaths. Autistics do not experience social reward, maybe not even in the sexual sense. They are indifferent to relationships. The main reward autistics live for must be the love of thinking because that is all they have. I don’t see that too many are obese, so I don’t think they even turn to food for their source of pleasure. Instead their inner worlds are rich with thoughts and reason. They busy themselves with their own thoughts. Most like who they are, enjoy life and wouldn’t choose a different life if they could.

The sociopath on the other hand, is completely dependent on social reward. The sociopath cannot tolerate aloneness because he has no entertaining thought-life to fall back on. The problem with the social reward system in sociopaths is that the only social reward they experience is dominance. All of their antisocial behavior is motivated by their dominance drive. When they lie, cheat or steal it is about gaining short term interpersonal dominance over some poor unsuspecting person. Autistics can’t lie and are as indifferent to dominance reward as they are to affection reward.

Dr. Keltner and associates at UC Berkeley are engaged in important research on the effects on people of obtaining social power. It turns out that when many people get power reward they change. Self-esteem increases, empathy is suspended, and they become uninhibited and less rational. They also think more about sex and tend to use more foul language. Their moral agency is diminished.

I believe that this response to power reward is the point of connection between sociopaths and the rest of us. Sociopaths are constantly in a state of power intoxication, or are in search of their next power fix. The rest of us can manage the power reward better, but the behavior of our politicians suggests that power intoxication doesn’t only make sociopaths less rational.

I could use your help on two things this week. First, I want your opinion on the term moral agency. I have been looking for a single term that would describe the moral deficits of sociopaths. Up until now I have used the term low “moral reasoning ability” because I couldn’t find another better term. Do you think people will better connect with/comprehend the term low “moral agency” or poor “moral reasoning ability”? Actually moral agency is more precise and technically more correct, but will people get it?

The second question I have concerns successful psychopaths. When I read the autism papers, it occurred to me that successful psychopaths do one of two things that unsuccessful ones don’t do. They either have a better appreciation for order or organization, or they find someone to organize and order their lives for them. If you know a successful psychopath, can you comment on how he/she is successful in spite of the chaos he/she tends to cause?