How to educate a psychopath

31st August 2012 at 01:00
Can children without a conscience ever be taught to be good? Joseph Lee speaks to psychologists who say incredible changes can be wrought by reinforcing and rewarding good behaviour

A few months after two teenagers had murdered 12 students and one teacher in the deadliest high school massacre in US history, supervisory special agent Dwayne Fuselier publicly revealed his conclusions about the killers for the first time.

The killings at Columbine High School in 1999 were intended by the perpetrators, Eric Harris, 18, and Dylan Klebold, 17, to exceed the death toll of the Oklahoma bombings and become one of the worst terror attacks in US history. Only faulty wiring of the propane bombs set underneath the school cafeteria saved more than 500 students who were gathered there.

The massacre sparked a desperate search for the root cause of Harris and Klebold's crime, out of a fear of motiveless malignity or a hope that future atrocities could be prevented. But Fuselier, a clinical and experimental psychologist as well as an FBI investigator, found the key to the personality of Harris, the ringleader of the pair, in a much lesser crime.

The year before the massacre, Harris and Klebold had been caught breaking into a van. They avoided prosecution through a "diversion programme" involving counselling and community service. Each wrote a letter of apology, with Harris stressing his empathy for his victim: "I believe you felt a great deal of anger and disappointment."

But Harris' journals revealed his true feelings: "Isnt america supposed to be the land of the free? how come If im free, I cant deprive a stupid fucking dumbshit from his possessions If he leaves them sitting in the front seat of his fucking van out in plain sight and in the middle of fucking nowhere on a Frifuckingday night. NATURAL SELECTION. fucker should be shot (sic)."

The combination of a shallow, unconvincing pretence of empathy, manipulation and lack of guilt led to one conclusion. Fuselier stood in front of an audience of mental health professionals at a conference on school shootings and delivered his verdict that Harris was "a budding psychopath". Someone said, "I disagree", and Fuselier braced himself for resistance. "He was a full-blown psychopath," the dissenter said.

In your classroom

It is estimated that one in a hundred adults is a psychopath, and virtually all of them as children pass through our schools. A history of childhood antisocial behaviour is one of the criteria for adult psychopaths, but until relatively recently the public and many professionals were reluctant to identify the traits of lack of empathy, shallow emotions and lack of guilt in children.

Part of the taboo was that the experience of decades working with psychopaths had shown that such individuals rarely respond to treatment. No one wanted to consign children to a future of endless suspicion.

But in the 1990s, Paul Frick, a former family therapist turned research psychologist, published his first work on a group of children he described as having "callous-unemotional" traits. As a therapist, he realised that some children did not respond to any of his methods. He knew they needed new tools, and that meant a new understanding of children with the most persistent antisocial behaviour. "You have to understand what's going on in a psychological, cognitive, social and environmental sense," he said.

Now, after nearly two decades of research by Frick and others around the world, the condition is being considered for inclusion next year in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the internationally recognised guide.

About 2 to 4 per cent of children have conduct disorders, and about a third of them show the callous traits Frick has defined. "We came up with four central features," he says. "One is lack of guilt. They just don't seem to show remorse or guilt. A person doesn't feel bad or guilty, unless they're expressing guilt when they're caught.

"Second, a lack of empathy. They have a disregard for the feelings of others. Third, they are unconcerned about how well they do in their school work. And fourth, shallow and deficient affect. They don't show emotions except if emotions will get them something. These kids are often described as cold."

The difference between children with conduct disorders and this particular group lacking in empathy can be seen in two referrals that he recalls. Both had been cruel to animals. One child had shot and killed a cat in a tree, in a reckless attempt to get it down. The second had, little by little, cut pieces from a cat's tail to see how it would respond.

Viewed in terms of severity, the first child is worse, having killed the cat, Frick says. But it is the dispassionate cruelty of the second that indicates callous-unemotional traits.

"To me it seems a no-brainer," says Essi Viding, professor of psychology at University College London. "Nobody's going to get psychopathy as a present when they turn 18. Of course you're going to see some precursors.

"The good news is that these sorts of traits are still open to change and development. Adult psychopaths are quite resistant to intervention. We need to take them seriously in childhood."

Potential for change

The potential for change in children without remorse offers hope for a group whose similarity to psychopaths may lead some to write off their chances. "If you're labelling someone a psychopath, it does seem to assume that there's nothing we can do for them, that they're going to grow up to be a criminal, and that you might as well just lock them up," Frick says. "But you can teach a child to recognise the effects of their behaviour."

The methods of changing behaviour that are emerging pose a challenge to received wisdom about discipline and behaviour in schools. Faced with some of the most serious misbehaviour, teachers and parents are asked not to reach for their most instinctive response: punishment.

Laura Warren is an educational psychologist who, like Frick, became frustrated that the methods she had been taught were increasingly failing on children with conduct disorders.

At the time, teachers would universally attribute bad behaviour to low self-esteem, she says. "What I was finding was that usually the children who were the most disruptive didn't have low self-esteem. If anything, it was over-inflated. They thought they were fantastic. Overly high self- esteem is a bigger predictor of aggression than low self-esteem."

A grandiose sense of self-worth is in fact one of the characteristic traits of adult psychopaths. Viding points to an anecdote from Robert Hare, a psychologist who developed one of the leading tests for psychopathy. He met a prisoner who insisted that he was going to swim for Canada in the Olympics, despite the disadvantages of being overweight, unfit and serving a life sentence.

Warren says that when she began her career, behaviour interventions were based around two theories. One, attachment theory, said that children's poor behaviour was a result of inadequate experiences in family life, which left them unable to trust others. The other, social learning theory, held that children needed positive feedback about their behaviour and clear boundaries.

"What they assume is that children have the motivation to shift their behaviour. That their primary social motivator is the relationship," says Warren.

She interviewed more than 1,000 children with behavioural problems, aged eight to 18. "I was beginning to see children who weren't responsive to these interventions, who weren't interested in what adults, parents, educators, think," she says.

"If a child or group of children isn't interested in pleasing someone, doesn't care about sanctions, what they're driven by is pleasure or reward. They will take the pain of the consequences but won't change their behaviour."

Her research led her to Viding and her colleague Alice Jones, now at Goldsmiths, University of London.

Over the past three years, a programme devised by Warren has been used at a primary school in the Home Counties for children with emotional and behavioural disorders. A forth-coming evaluation conducted with Jones is under peer review.

"It was chaos," says Jones of the school at the time. "There was a lot of aggressive behaviour, lots of trashing of classrooms. We were told how much the school was spending on running repairs, on windows, buildings, teachers' cars: it was about pound;40,000 a year, before you've taught anything."

The programme, called Let's Get Smart, replaces sanctions with rewards. Some teachers were uneasy. "Some teachers felt that punishment happens in the real world; if they misbehave in the real world they will still go to prison. Why are we setting them up for unrealistic expectations?" says Jones. "Our point is that it doesn't work."

By offering regular rewards, perhaps three times a day, controlled by the adult in authority, it aims to provide a rational, self-interested motivation for pleasing adults where that motive is emotionally absent. "The adult becomes the clear intermediary between the child and what the child wants," Warren says. The rewards are tailored to each child's interests.

These children often have a strong desire for control and teachers have to resist attempts to negotiate, because any concession just leads to more demands. "I teach parents and teachers to say, `It's not open for discussion, go away.' Adults don't like to dismiss children," Warren says.

All this is backed by role play and other exercises that are intended to build children's capacity to pay attention to and respond appropriately to others' emotions. Video playback helps the children to see their behaviour as others do, often to their surprise. ("I do swear a lot," one girl told Warren.)

Dramatic improvement

Jones says the evaluation has shown dramatic improvement. "These kids are still having quite significant problems: they are not cured. But they are improving. Some have gone back to mainstream school, which is incredible," she says.

In interviews, the teachers reveal: "I feel like I'm in charge of my classroom." "I like coming to work now." "I have a group of kids who I quite like."

The measured improvement is about 10 percentage points, Jones says. This means that children whose behaviour was once worse than 99 per cent of the population have moved up to 89th place.

It seems to make all the difference to the budget for broken windows, too. "A year ago they spent something like pound;1,200 on damages. They've basically saved the cost of a new teacher," Jones says.

The programme also allows teachers to be more creative, by incorporating the behavioural lessons into their national curriculum work. Sometimes, though, this startled the researchers, such as when one teacher said she intended to let her pupils plan a Viking raid on another class. "I said, `That seems like it can only go wrong'," Jones recalls.

The children constructed horned helmets and were asked to plan their raid on the five- and six-year-olds. But their teacher asked them to think through the consequences of what they were doing. How would others react? How should they behave?

"It ended up being the most polite Viking raid ever," says Jones. "`We are Vikings, we have come for your highlighter pens'. In the end, they handed over their Viking helmets to say thank you."

Warren has worked with about a dozen schools in total, and next year her programme is due to be implemented in a mainstream secondary. But she says that there is huge resistance to confronting behaviour, and in some of the schools she does not even use the term "callous-unemotional" because some parents find it hard to accept. (The term was in fact taken by Frick from parents' own descriptions.)

"People really feel uncomfortable," she says. "If you mention behaviour, they won't come near you. I did a presentation for huge numbers, they all came up and said, that's incredible, but how do we talk to parents about that?"

Another concern is whether teaching children who are manipulative and lack empathy about emotional responses will just make them better manipulators. But Warren says that other techniques such as circle time and restorative justice are more of a risk.

"(In circle time) children say what makes them scared and children who have callous-unemotional traits think, `This is a useful piece of information to have'," she says.

Restorative justice tends to give them opportunities to fake empathy and concern without changing behaviour, just as in Harris' letter to the man whose van he broke into.

Whether children ever really learn greater empathy or just learn to manage their behaviour is not clear. "My personal gut feeling is that you can modify behaviour perhaps more readily than you can improve the empathy response," Viding says.

Frick says that in much of psychology, improving behaviour and well-being is the goal, even if the underlying problem remains. "What we want is them to be able to be more empathetic, we want to reinforce behaviour so they're treating people better, and we'll have to see over the long run," he says.

Reducing the risk

Other research suggests that greater emotional engagement from parents can have an impact in early childhood. David Hawes, lecturer at the University of Sydney, last month revealed the findings of a three-year study of 113 boys aged two to four, which suggest that maintaining a warm and engaged parenting style can reduce the risk of future antisocial behaviour.

"The children's callous and unemotional traits cause parents to become harsher in their discipline and to emotionally disengage," Hawes told the Sydney Morning Herald. "This is the opposite of what parents should be doing."

Mark Dadds, a professor at the University of New South Wales, has shown how children with psychopathic traits have reduced eye contact, contributing to their blindness to others' fear. He is investigating how increased eye contact with emotional engagement can help young children to become more empathetic.

Warren's experience with parents suggests that with older children, it might be hard to regain the emotional warmth until the behaviour improves first. She recalls one mother who suffered from depression as she struggled to cope with a son who routinely called her a "bitch" and was violent at school.

"She didn't realise that the reason she had struggled so much wasn't because of her, it was because he gives nothing back," Warren says. "Mothers who have got kids with callous-unemotional traits find it very difficult. It has a massive effect on them and their sense of their ability as a person."

And no one will want parents to feel that they are the cause of their children's bad behaviour. As recently as 1995, some parents of autistic children were being told that they were contributing factors to their children's condition. "At the time we were still at the tail end of autism being put down to what was called at the time `frigid parenting'. A whole generation of parents were told their kids were autistic because they didn't give them enough love," Warren says.

It is clear that our growing understanding of callous-unemotional traits in children presents a massive challenge to schools: to accept that children can be without remorse or regard for others' feelings, and that they are only made worse by punishment.

Responding to the public mood after the riots last year, London Mayor Boris Johnson announced "tough love" boot camps to "instil a firm sense of purpose, focus and motivation", while education secretary Michael Gove promised more powers for teachers.

Warren, however, thought back to a child she was working with a couple of terms ago. At six years old, he was being cared for by his grandmother; his mother, a drug addict, died before he ever knew her. His father had just been released from prison. "From everything that the grandmother said, the son was acting like the father," she says. "The father came home and said he just can't wait to go back to prison. He gets three meals a day and he's left on his own. He's rigid and inflexible in his thinking."

The best chance for such children is to intervene early in life, when behaviour is more malleable, Warren says. "After the riots, exactly what I predicted happened: calls for more discipline, more sanctions. We can't carry on with more of the same."

Photo credit: Corbis

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