Psychiatric disorders offer look at brain


Extreme violence generates fear and plays to big audiences. It becomes part of the specter that we visualize when gangs take over a town or a city block.

The behavior of psychopaths isn’t the explanation for a boy on a shooting rampage or most societal violence, but it opens the door to related insights and knowledge.

The Green River Killer, Gary Ridgeway, was one of those pleasant neighbors and fathers who was found to have killed more than 75 women. Many were killed during sex. Ridgeway had a low IQ, but Britain’s most prolific murderer was a physician.

Medicine struggles to put psychiatric disorders into neat categories, analogous to, say a staph infection. Any individual may react in ways codetermined by thousands of hardwire variations and innumerable combinations of internal chemical drivers, including adrenalin and testosterone.

External factors, like stability at home or the use of violent games add complexity to the mix.

Doctors are forced to match clinical features with a description in a manual and use those to create imperfect statistics and fill out forms for billing purposes.

The Human Brain Project, of the National Institute on Mental Health, has been instrumental in developing the field of neuroinformatics. The combination of new information from many disciplines and the future of massive computing power promise to resolve many of today’s uncertainties.

For now, we can use what the literature offers and be careful about clinical categories.

For those younger than I, there is a chance to participate in the growing opportunities to become researchers and to strive to improve the world we live in.

I’ll climb off the soapbox and return to the question of what we might learn from available information about the mind of a mad killer.

It can be argued effectively that the psychopath is born with wiring and chemistry that turn on pleasure centers with violent acts. They could be considered addicts. Three year olds who torture cats and other animals exhibit behavior predictive for later violence. This seems different to me (a retired oncologist) than the insensitivity of a sociopath.

One caveat is written in a paper suggesting that a caring environment improves the lives and behavior of most people but the true psychopath may use it as a classroom to learn deception. The road to understanding is full of caution signs. Read them and keep driving.

The category of mental illness that encompasses these behaviors is Antisocial Personality Disorder. An interesting opening to the ASPD issue leads us to consider empathy and the way it links to our sense of community and connectiveness and the seeming opposites, hostility and otherness.

Empathy, as I see it, is behavior that engages us with others. We share their pain and joy, and it happens without conscious thought.

Empathy is not unique to humans. It acts as a barrier to injuring others, irrespective of whether we are being observed or feel intimidated by possible repercussions.

The process seems to be intimately related to the existence of groups of brain cells called mirror neurons. While hard wiring is a useful concept, normally empathetic individuals can be programmed to identify some groups of people as “others.”

A former Whitman professor once said that most wars were caused by grandmothers. Partially, tongue in cheek, she meant that oral tradition instilled an image of past injuries or offenses that short-circuited empathy pathways.

The evidence of empathy in other species both fascinates me and offers ways for researchers to make observations that aren’t possible in humans.

Jane Goodall’s work with chimps and gorillas seemed mushy and nonscientific at one time. Clearly, she empathized with the animals. Over time, it became obvious that the animals showed empathetic behavior toward each other.

The recent Disney movie, “Chimpanzee,” should convert skeptics. Even rats and other species show empathetic behavior and rats nurtured by caring mothers function better as they develop.

Evidence supports the theory that mirror neurons are linked to caring, empathetic behavior. These specialized cells were first described in macaque monkeys. There were brain areas that showed the same response when a monkey performed an act or observed the same act in another monkey.

The experiments on mirror neurons are done mostly with noninvasive EEG studies. Humans, like animals, show altered activity involving one type of rhythm, mu, that reflects mirror activity. Functional MRI has been correlative.

We also have further evidence that brain injuries from trauma and disease can change behavior.

After years of argument, a recent article seems convincing that intense exposure to violent video games has an adverse effect. FMRIs confirm a change toward violent responses in normally functioning volunteers who have no previous experience with video games and who play them in a controlled setting.

If I go back to the original story, a 10 year old turned violent when faced with a threatening environment, a Walla Walla street where he was concerned about facing gang violence. The postulated scene was designed to look at violence and very superficially into what we know about the ways that wiring and chemistry make us different from each other.

It is my understanding that the boy on the van was merely frightened, but “merely” may disregard the seriousness of the situation he faced. Most youngsters enter gangs because they fear saying “no” or because they seek camaraderie that is usually disingenuous.

My next column will consider approaches to prevention and control of the gang problem. Beyond that, I’ll retreat to a more comfortable zone, new cancer treatments.

Dr. Larry Mulkerin is a retired clinical professor. He can be reached at


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