The Bad Apple: Looking into the Neuropathology of a Psychopath

A Bad Apple: Looking into the Neuropathology of a Psychopath

A psychopath is similar to a bad apple.  One must go beyond the skin and the surface level of the fruit to get to the rotten part.  Sometimes the rotten part is so close to the core of the apple that it takes several bites of what appears to be a good apple to finally realize that the apple is actually rotten. Like a bad apple, most psychopaths appear normal and perhaps may even display what looks like robust mental health, but underneath what Hervey Checkley (1976) calls “the mask of sanity,” one finds a minimally to excessively disordered atypical brain.

Depending on the level of brain impairment, coupled with the interrelationship between  biological and  environmental factors (which are not discussed in this paper), the psychopath’s behavior may range from the immoral philandering husband,  the crooked used car salesman,  the white collar criminals (CEO, doctors, lawyers, clergy), to the sadistic wife abusers, child molesters and  serial killers.  Just like a bad apple, they all look good on the outside. And just as a bad apple cannot change back to a good apple, the psychopath cannot make permanent changes to his behavior. If he does make some changes, they will be superficial and short lived at best.   Change is never truly sustained with a psychopath.     (Checkley, 1976)

For the sake of this paper, the reference to “psychopath” includes personality disorders in which individuals exhibit low or no conscience.  These low or no conscience personality disorders are on a continuum and may include Anti-Social Personality Disorder and Narcissistic Personality Disorder (Brown, 2009).  Please note that this paper is not describing the sociopath’s brain.  To clarify, the sociopath exhibits all of the characteristics as does the psychopath; however, this term denotes that the condition is a result of environment and not caused by the brain differences discussed here. What are the brain differences in the psychopathic mind?

Let’s take a look inside of a bad apple.

The limbic system is comprised of the amygdala and the hippocampus.  The limbic system of the brain is responsible for emotional interpretation and expression.  In psychopaths, the limbic region is weak which renders them unable to regulate their emotional responses and truly understand emotions in all of their complexities.  Psychopaths are adept at mimicking emotional responses as little takes place below the surface.  As a result of the weaker amygdala found in the psychopathic brain, psychopaths are incapable of deep emotional connections and lasting insight.  One might call them “shallow swimmers.” They never truly move beyond surface level functioning with others or self.       (Brown, 2009)

The hippocampus is involved in memory, regulating aggression and impulsivity, and in the process by which one learns what to fear.  Weakness in this area accounts for the psychopath’s potential for endangering others, inability to sustain change, and inability to make new, lasting memories.  This helps explain why many psychopaths appear unaffected about the prospect of being caught in their heinous acts.  They cannot emotionally understand the impact of their behavior on others or think in terms of future adversity.

(Brown, 2009)

The corpus callosum part of the brain is responsible for the integration between the two hemispheres of the brain (Brown, 2009).  The left hemisphere of the brain is analytical and language oriented.  Dialectical Behavioral Therapy (DBT) refers to this part of the brain as the “reasonable mind” (Linehan, 1994).   The right hemisphere of the brain is responsible for emotional processing and creativity.  DBT refers to this part of the brain as the “emotional mind.”  DBT posits that mental health is best accomplished when one functions from the “wise mind.”  Wise mind is the integration of reason and emotion.  Although most people are hard wired to view life predominantly through just one of these lenses, healthy people are capable of recognizing their innate temperament, yet not be enslaved by it.  That is, they exercise flexibility of mind which allows them to be fully integrated using both their emotions and intellect to guide their behaviors. In the psychopath, the corpus callosum is 23% larger and 7% longer than normal brains (Brown, 2009).  The rate at which information is transferred from one hemisphere to the other is highly accelerated in psychopaths. This condition makes information and emotional processing skewed, therefore resulting in mistakes in reading situations and responding appropriately (Brown, 2009).  This may also partially help explain the impulsivity in psychopaths.  They are deficient in their ability to think before they act.

The most baffling and precarious result of an enlarged corpus callosum is the dualistic nature that it produces in the psychopath.  This increased size of the corpus callosum and lack of information processing between the two hemispheres of the brain creates a split, or dichotomy of character. Hence, psychopaths are often referred to as Dr. Jekyll and Mr. Hyde (Brown, 2009).

The amygdala is less reactive and slower to react in psychopaths, and its function is to regulate impulsivity and the fight or flight response.  The fight or flight response is a hard wired anomic nervous system response system that ensures our survival.  When it is triggered, the body prepares for action.  Blood pressure increases, heart and breathing rate increases, and digestion slows down.  These changes allow one to fight off the “predator” or run away from it (flight).  When survival is not at stake, the body conserves energy by slowing down the heart rate and blood pressure, and resuming digestive functions.   This impairment in the amygdala produces restlessness in the psychopath coupled with a high need for excitement and risk taking.  Although psychopaths experience some fear and anxiety, it is very minimal and short lasting.  The inability to truly process and experience fear combined with the failure to learn from experience, underscores the psychopath’s failure to avoid harm or punishment. Psychopaths’ restlessness also sets the stage for their never ending need to act on their every whim and impulse.   They take what they want, when they want it, without regard for others or personal consequences.       (Brown, 2009)

The orbitofrontal region of the brain is related to motivation, empathy, insight, the organization of behavior, impulsivity, irresponsibility, and it aids in the process of learning from adversity or punishment (Brown, 2009).  We now know that the psychopath’s failure to respond to punishment is directly related to defects in this part of the brain (Brown, 2009).  The orbitofrontal cortex interacts with the limbic system’s emotional responses in that it modulates the bodily functions associated with emotions, such as getting “butterflies” in your stomach when anxious, or feeling heaviness in chest when sad, or a racing heart when afraid(Brown, 2009).  In the psychopath, the sensory cues that accompany emotion and direct behavior are absent or only very slight. This impairment leads to the aforementioned lack of learning from experience or punishment, and to impulsivity.  The diminished ability to process, experience, and express emotions as well as an absence of emotional sensory cues, manifests in a lack of empathy and conscience.  Empathy is needed for survival.  It evolved in humans to the extent by which one cooperated in a group and, as a consequence, survived (Kellner, 2009).  As a result, our brains developed mirror neurons which allow us to literally feel, perhaps to a lesser extent, the sensory responses of another person’s emotions (Siegel, 2003).  They allow us to experience one’s emotional pain.  The psychopath does not have the basic brain structure necessary for empathy.

In conclusion, the behavior of the psychopath is largely determined by the gravity of his brain damage.  The neurological aspects of this disordered brain help to shed light on the incomprehensible behavior of the psychopath and offer enlightenment to the befuddled people who find themselves in relationships with psychopaths.  And lastly, like the shiny, bright colored, perfectly rounded apple, the charming, good looking, charismatic man or woman who sweeps you off your feet is not always what he/she appears to be.  Look beyond the mask of sanity.

Julie Discenza M.Ed., M.S., LMFT



Brown, Sandra L.  (2009). Women who love psychopaths: Inside the relationships of inevitable harm with psychopaths, sociopaths, and narcissists.  Penrose, NC: Mask Publishing.

Checkly, Hervey M.  (1976). The mask of sanity.  St. Louis, MO: Mosby.

Kellner, Dacher (2009). Born to be good: the science of a meaningful life. New York, NY: Norton & Company.

Linehan, Marsha M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York, NY: The Guilford Press.

Siegel, Daniel J. (2003). Parenting from the inside out.  New York, NY: Penguin.

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