Psychopath or Sociopath? Personality Disorders in Leadership Roles According To Neuroscientist James Fallon

As a writer who has a passion for narrative, I regularly listen to storytelling podcasts. A few months ago, I was listening to my personal favorite, The Moth, when I heard an extraordinary story by neuroscientist, James Fallon, Professor Emeritus at UC-Irvine in southern California. During the podcast, he detailed his familiarity with psychopathic brain patterns and behavior — as well as his accidental discovery that he is himself the owner of a psychopathic brain and some of the corresponding conduct and expressions associated with it. He said that he eventually learned that there’s evidence in one line of his family tree suggesting that many of his ancestors shared this particular trait for at least the last few hundreds of years, some of them going so far as to kill their own family members. The most famous of these ancestors was Lizzie Borden herself. Indeed, Dr. Fallon found that he carries fifteen allele forms of the aggression and violence related “warrior genes”, including the notorious MAO-A genes, which are correlated with psychopathy. He went on to theorize that the thing that has prevented him from expressing the violent behavior we so often associate with psychopaths is that he never suffered any sort of extreme childhood trauma. He is what’s known as a “pro-social psychopath”. This type of psychopath might hurt you emotionally or mentally, but not physically. It seems that severe emotional or physical trauma during early childhood is a required ingredient for creating violent psychopathy, suggesting that the extreme version of the disorder isn’t merely biological, but a combination of nature and nurture.

As I listened, I knew that Dr. Fallon was the right person to talk to. I’d been working on a screenplay inspired by the enormous problem of self-serving corruption I’ve seen in many corporate leaders in our country — people who have a grotesquely disproportionate or exaggerated income while paying slave wages to their employees, sometimes driving their companies into the ground. My story revolved around a character I considered to be a psychopathic CEO who incurred a radical transformation in personality after suffering a head trauma during a plane crash.

When Dr. Fallon’s story drew to an end, I scurried off to find contact information for him online. Bingo! On July 12th, I sent him an email explaining who I was and why I wanted to meet with him. I even included an excerpt from my screenplay. The next day he left me a voicemail saying that he’d read my excerpt and that the basic idea could work, however, there would be limitations as to how my character’s disorder would be expressed after his injury. As Dr. Fallon would be traveling overseas for the next month, we agreed to meet sometime after his return. Meanwhile, I bought and began reading his book, The Psychopath Inside: A Neuroscientist’s Personal Journey Into the Dark Side Of The Brain, and watched his TED Talk as well as various interviews he’d given both nationally and internationally. I couldn’t get enough of the brain stuff.

Finally the day arrived and I pulled up to his house. I was greeted by his lovely wife, Diane, who offered me a cup of coffee. Dr. Fallon dug in, launching into a fascinating and complicated discussion of the brain, some of its disorders, diseases, and behaviors. I scrambled to start my recorder and almost completely gave up taking notes for fear of missing what he was saying as I wrote. Although my main reason for visiting Dr. Fallon was to learn enough to make sure that the storyline for my character and screenplay was credible, I was eager to explore other avenues of interest as well. As we discussed my character within the context of both plot and brain disorders, I learned that he was more likely to be a sociopath rather than a psychopath, for a variety of reasons.

Wait a second… Weren’t sociopathy and psychopathy interchangeable terms for the same thing? Nope. According to Dr. Fallon, they’re two separate conditions that often have overlapping qualities. He categorizes them into primary psychopaths and secondary psychopaths (sociopaths).

Primary psychopaths are born with the tendencies to develop into the individuals who can do real harm — both psychologically and physically. These are the people who have the warrior genes and particular brain patterns visible in PET and fMRI scans, specific to the disorder. If they also suffered physical or emotional trauma in childhood, they’re highly likely to be a real threat to family and society at large. As noted in the definition of psychopathy in the PPI (or Psychopathic Personality Inventory), many of them exhibit “fearless dominance”. This type of trait makes them charismatic and self-confident. These people are glib fast-talkers, easily able to manipulate others. They’re immune to stress and lack any true emotional empathy or warmth. Fearless dominance is a trait we admire in our leaders — our politicians and corporate CEOs. We perceive these people as being strong and capable. They’re comfortable making the difficult decisions the rest of us go out of our way to avoid. Dr. Fallon pointed to Teddy Roosevelt, FDR, JFK, Bill Clinton, and George W. Bush as examples of politicians who displayed this quality. These types of people tend to score high in the Factor 1 traits on Robert D. Hare’s Psychopathy Checklist, suggesting that they might have partial pro-social psychopathy, like that of Dr. Fallon. Those individuals who also score thirty points or more in both Factor 1 and Factor 2 traits on the Hare Checklist tend to be full-blown psychopaths linked to ASPD (antisocial personality disorder) — or criminality, and aren’t able to maintain a stable persona long enough to be a politician or CEO of a large corporation. They like jobs where they can blend in — where they can hide. As Dr. Fallon says, these are the types of psychopaths who engage in “the shit that people really hate”.

“So, what about Hitler?” I asked.

“When he was really young, one of the psychiatrists thought he had some psychopathic traits,” said Dr. Fallon, “but I don’t know of any external analysis of Hitler that said he was a psychopath. Clearly a sociopath. Clearly, he had ASPD and criminal tendencies — all that, but he seemed to be able to get tight with people. That thing with Eva Braun and people that were close to him — he was able to have close-knit relationships — primary psychopaths cannot have that. So on the basis of that, it makes him a sociopath.”

According to Dr. Fallon, unlike primary psychopaths, secondary psychopaths (sociopaths) are not born that way. Although they can score high in ASPD and be just as dangerous as a primary psychopath, the genesis of their behavior excludes biological factors and hinges entirely on early childhood trauma. Other important differences between sociopaths and psychopaths are that they can sometimes feel remorse and empathy, as well as show signs of stress under confrontation. Dr. Fallon says that sociopaths are people who want to get even with the world for something that they perceive was done to them. He went on to illustrate this point by saying that there are probably a lot of sociopaths in the ISIS movement. “The young guys are pissed off. They feel like they’ve been made losers by the world and society, by Western capitalist systems, and now this is get even time.” He said that psychopaths don’t behave like that — they engage in manipulative and violent behavior, often just for fun.

Dr. Fallon explained another factor for me to take into consideration when shaping my character’s story and disorder. If, as I originally thought, my character was a primary psychopath, the low functioning areas of his brain would not suddenly fire correctly just because of a brain injury. For example, a psychopath won’t suddenly become empathic. Why? Because as he put it, “You can’t turn on an engine that’s not wired to begin with. It’s easier to release behaviors than to add behaviors. Even though you can somewhat change the expression of this stuff, you can’t add these complex things. I don’t think you add real goodness. The primary psychopaths — nobody knows how to treat them. They don’t get better, but sociopaths can be helped.”

Dr. Fallon explained that psychopaths don’t have the sense of dualism that the rest of us have — the inner concepts of right and wrong, or the layers of self and Self. For example, he shared how people who don’t have psychopathy can experience different layers of themselves within the context of a conversation. You can have an awareness of your core self while you’re talking to someone, but also a sense of the two of you conversing together, as well as a sense of your memory forward in the conversation. In addition, you can have an awareness of your inner self, outer self, and soul, but a psychopath experiences none of that — he does not have a separation of self. This is due in part to the fact that the medial limbic or emotional cortex surrounding the corpus callosum is switched off in individuals with psychopathy, as is their orbital cortex. The orbital cortex contains the circuitry that controls impulsivity, choices, ethics, and morality, while the medial cortex contains the circuitry that communicates the emotional and social brain with the left and right hemispheres that process the external, “real” world. In normal brains, the medial cortex switches on and off. When it’s on, there is a sense of self-awareness and internal reality, and it’s never active when the outer cortex (the area surrounding the left and right hemispheres) is turned on. When the outer cortex is active, there’s a sense of what’s happening around you, but the medial cortex and outer cortex can never be switched on at the same time. They alternate. So like the orbital cortex, it seems that the medial cortex may be turned off when an individual is engaging in behavior that can be construed as psychopathic, although for a psychopath, the orbital cortex is never turned on.

He went on to explain that primary psychopaths are really good at reading people. They score high on cognitive empathy, but low on emotional empathy. Basically, this means that they understand your feelings, but not only do they not share them, they don’t care about them. However, since they can read your emotions and understand them, they know how to act like they have empathy and can mirror your behavior. This is one of the things that make them so frightening. Their ability to seem normal gives them an advantage in manipulation — in playing with people and seeing what they can get away with and how far they can go.

The picture was beginning to come into focus. I saw that my character was not a primary psychopath with violent tendencies or a true lack of empathy. He had normal brain patterning and function prior to the plane crash. Nor did he have any genetic predispositions. Could there be an incident in my character’s backstory that triggered sociopathy? He already had all of the characteristics of a charismatic secondary psychopath, with the glib tongue, self-confidence, ability to easily persuade others, and lack of conscience in regard to how his actions affect lives other than his own. A head injury with subsequent damage to both the frontal and temporal lobes might provide the changes to his personality that would drive his story in the direction I was hoping for.

I was excited. I thanked Dr. Fallon for taking the time to answer my questions and share his information with me. I drove north back to Los Angeles, my head spinning as I contemplated all of the new information that filled the Wernicke area of my brain. It had a lot to process.