TIME PTSD

Here’s What Happens To The Mind After 5 Years of Captivity

Captured US Solider
Sgt. Bowe Bergdahl in an undated image provided by the U.S. Army. U.S. Army/AP

Sgt. Bowe Bergdahl has a lot of healing to do after five years of captivity. The physical scars may fade, but the emotional ones can sometimes be too deep to heal completely

U.S. Army Sergeant Bowe Bergdahl, the last known American POW, was finally returned home over the weekend after five years held in captivity in Afghanistan. Since Bergdahl’s return, curious details have emerged about his mental state before and after capture. And it all begs the question: What does five years in captivity do to the human mind?

Bergdahl’s repatriation is going to be a challenge, and piecing together the psychologically and physically broken veteran is a delicate process. After all, an abduction is the ultimate exchange of power, spurring the start of a complicated relationship based on both deep distrust and reliance, say experts. “He’s to some degree merged with those who held him,” says Brian Engdahl, professor of PTSD Research and Neuroscience at the University of Minnesota. “He was totally dependent on them for food, shelter, clothing. It can reduce a person to a weak state where their entire life revolves around how their captors are treating them.” A morsel of food becomes a generous gift, only to be withheld at the next feeding.

Many POWs find physical and mental strength by relying on their fellow captured soldiers, but Bergdahl was alone. Speculation about whether he suffered from Stockholm Syndrome—the phenomenon where captives identify with their captors—are not unwarranted, though so far evidence hasn’t suggested this to be true.

Studies of POWs from the Korean War show that the psychological injuries from captivity stem from two types of trauma. The first is physical and usually short-term, caused by malnutrition and injury. The more persisting trauma is, of course, psychological. At Landstuhl Regional Medical Center in Germany, which treats U.S. vets from Afghanistan and Iraq, Bergdahl is likely being tested for depression, anxiety, and PTSD, says Engdahl. “Beyond that, he could be feeling deep guilt, shame, bewilderment, and a lost sense of identity,” says Engdahl. If his English is poor, as has been reported, it’s likely from lack of speaking.

Once home, psychological challenges won’t likely abate overnight, says Barbara Rothbaum, the associate vice chair of clinical research in the department of psychiatry at Emory School of Medicine. “But even if the trauma is over, it’s not really over,” she says. POWs often experience flashbacks, and will wake up in the middle of the night thinking they are still in captivity. Many victims become avoidant and don’t want to talk about their experience because they are afraid it will trigger memories, she says. It’s one of the reasons many will forgo treatment.

“I’ve had veterans tell me they were drunk for a year,” says Rothbaum. But avoidance is one of the worst ways to deal with the harsh return, and Rothbaum’s research has shown that talking about experiences early can actually help prevent the onset of PTSD.

“People want to avoid talking about the worst parts, the most shameful, the most embarrassing,” says Rothbaum. “But it will help.”

MONEY Careers

Reading This From Behind a Desk? You’re More Likely to Have a Fatter Wallet—and a Fatter Waist

While better paid, office workers are more likely to be overweight than their non-desk jockey peers. Use these tips to make sure your wallet is the only thing that's plump.

Spend most of your workday behind a desk? First, the good news: You probably make more money than someone who doesn’t, according to a new survey. CareerBuilder has found that workers in desk jobs are twice as likely to make more than $100,000, compared to those who do not work behind a desk.

Now for the not-so-good news: You’re also more likely to be overweight.

Nearly six in 10 of desk jockeys identify as overweight vs. five in 10 non-desk workers. And 46% report that they have gained weight in their current jobs.

Researchers have long known that sedentary work puts adults at a higher risk of obesity. But desk workers also told CareerBuilder about the psychic toll. Half of the respondents say that they feel “stuck inside,” and 56% say they spend most of their time staring at computer screens.

If you’re tied to a desk, here are some ways to stay fit and fight burnout:

Work on your feet

Citing the long-term dangers of sedentary work, the American Medical Association urges employers to let workers use standing desks or isometric balls. Ask your boss if you can make some changes to your workspace and spend more time on your feet.

Take a hike

Researchers have found that even short breaks from sitting are associated with better health outcomes. Every once in a while, remember to get up and walk around the office.

Do some desk exercises

One study suggests that workers today burn about 100 fewer calories than workers did in 1960. Adding short periods of exercise—such as these that you can do without leaving your workspace—to your daily routine could help keep off the extra pounds.

TIME psychology

The Importance of Daydreaming

Your best thinking occurs when your mind wanders

Last year’s great book was Daniel Goleman’s Focus: The Hidden Driver of Excellence. In it, Goleman shows how keeping your eye on the ball, focusing your undisciplined mind on the tasks at hand, is the key to success in life. Focus enables us to solve problems, to achieve goals.

But this is my encomium to the glory of a mind adrift. Your best thinking occurs when your mind wanders. Cognitive scientists say you have an incorrigibly distracted mind. The wandering mind is our brain’s default mode. Left to their own devices, our brains go to the beach when they’re not working on calculus or Angry Birds.

See? Even now your mind wanders. I’m desperate to stimulate your cerebral cortex in focusing on the wonders of neuroscience, and the lower functions of your brain are dragging you to think about what’s in the refrigerator.

A 2009 neurological study shows that half of your thoughts are daydreams. Even as your mind drifts away from neuroscience, Goleman says, maybe it is wandering toward a consideration of pressing personal problems or unresolved dilemmas. Sometimes we are so intimidated by the magnitude of a problem that we dare not consciously think about it. But then, when we’re half asleep or bored by an op-ed piece, our minds wander toward intimidating mental challenges. And it’s then that we unthinkingly do our best thinking.

True, sometimes mind wandering impairs focus on a task at hand. Yet Goleman says the time a distracted brain spends tackling tough challenges makes up for diminished productivity. Sorry, you math nerds who excel at cognitive control and disciplined attentiveness — you test poorly in creativity. Among the benefits of mind wandering, Goleman lists generating future scenarios, self-reflection, navigating complex social situations and incubating new ideas, to say nothing of giving your brain a rejuvenating vacation.

As G.K. Chesterton said of his deductive detective, Father Brown, “In that instant he lost his head. His head was most valuable when he had lost it. In such moments he put two and two together and made four million.”

The most brilliant research chemist I’ve ever known had a pathologically wandering mind. Each afternoon graduate students helped him hunt for where he had parked — not easy since he couldn’t remember the color or make of his car. The theory in the department was that he made amazing discoveries because his disordered mind, unconstrained by cherished hypotheses, made unexpected connections and stumbled upon serendipitous solutions.

But I digress.

Daydreaming can be the mind’s incubator. When we’re hyperfocused, the possibility of the mind reaching into its reservoir and making an “Aha!” diminishes. In daydreaming there’s no controlling censor to whisper, “That’s ridiculous” or “Completely impractical.”

Here’s good news: 10% of you are ADD, even though half of you are undiagnosed. A 2011 study showed that we adults with attention deficit disorder show higher levels of original creative thinking and more actual creative achievements than you bean counters who are good at attentiveness. Richard Branson, creator of Virgin Air, said the secret of his spectacular entrepreneurial success was that “I’m ADD. I kept being distracted by ideas for making money that nobody else would waste time on.” When asked the source of his comedy, Bill Cosby replied, “I’m ADD.”

Sadly, only 4% carry our ADD into adulthood; we’re doomed to get focused, buy a minivan, go to Harvard and vote Republican.

In 2011 a bunch of brain scientists got a government grant to study the brains of rappers as they freestyled, improvising tunes and lyrics in the moment. The rappers showed unusually heightened activity in the mind-wandering circuitry of the brain, “allowing fresh connections between far-ranging neural networks.” I digress.

The challenges before us present a puzzle. Global warming. National debt. Justin Bieber. Sadly, we focus on short-term, immediate payoffs. The future belongs to those who go beyond facts and think globally and synthetically, make serendipitous associations and devise surprising, novel combinations.

Daydreamers, time wasters, goof-offers, attention-deficited — unite! Throw off the chains of in-the-box, focused, well-disciplined attentiveness! Kick off your shoes. Go skinny-dipping in the fountain. Take a pointless detour to Detroit or Des Moines. Dare your imagination to roam, thereby to come up with the “Aha!” that will enable our civilization to stumble upon a brighter future than can be had merely through clear thinking.

I read a book on the history of scientific discovery (though it has nothing to do with anything I do for a living) and noted not the importance of a good graduate-school education but rather the value of a walk in the woods, an overly long bath, hours wasted in a garden. That playful, legendary daydreamer Einstein said, “The intuitive mind is a sacred gift; the rational mind is a faithful servant. We have a society that honors the servant and has forgotten the gift.” Both Play-Doh and Silly Putty were discovered by mistake.

It’s the 100th anniversary of the neurasthenic Marcel Proust, who dips a cookie into a cup of tea, lets his mind wander and then writes the world’s greatest novel — 1,000 pages of literary digression.

I digress.

Willimon is a prolific writer, retired United Methodist bishop and professor at Duke Divinity School in Durham, N.C. This piece is a version of his graduation address at Durham Academy on May 23.

TIME mental health

Bad News For Ivy Leaguers: ADHD Drugs Hurt Your Memory

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Cultura/Frank and Helena—Getty Images

Smart drugs used to boost performance in the short term have long term damage for the young brain, a new study says

Prescription drug abuse is rampant, and for a third of Americans, the first drug of any kind that they take—including illicit drugs—is an Rx that has not been prescribed to them. That’s not surprising when you consider how many students abuse ADHD drugs for performance. But new research shows that recreational use of smart drugs comes at a cost.

Researchers from the University of Delaware and Drexel University College of Medicine reviewed the latest research on the effects of medications like Ritalin and Proviigil on the juvenile brain and discovered smart drug use is certainly not benign. The new research published in the journal Frontiers in Systems Neuroscience shows that while a drug like Ritalin may offer a boost in mental performance, it’s a short-term crutch that can actually adversely impact the brain’s plasticity, interfering with people’s ability to plan ahead, switch between tasks and be overall flexible in their behaviors.

For instance, the researchers looked at one of the most popular smart drugs on the market: Methylphenidate (otherwise known as Ritalin and Concerta). The drug is meant to treat ADHD, and about 1.3 million U.S. teens have reportedly used the drug without a prescription in the last month. Rat studies have shown that young brains are very sensitive to methylphenidate and that even low doses can harm nerve activity in the brain as well as memory and complex learning abilities. For a drug that’s supposed to offer better mental performance, the long term effects appear to do the opposite.

The study also took a look at the drug modafinil, also known as Proviigil which is used for sleep disorders like narcolepsy. The drug can help boost memory and is abused for various mental tasks, especially tasks related to numbers. But once again, the drug has very similar long-term effects on the young brain.

Finally, the researchers looked at a lesser-used class of drugs called ampakines, which are being studied by the military to increase alertness. They are known to improve memory and cognition, but for young people, unsupervised use can result in an overstimulated nervous system which could actually kill nerve cells.

“The desire for development of cognitive enhancing substances is unlikely to diminish with time; it may represent the next stage in evolution—man’s desire for self-improvement driving artificial enhancement of innate abilities,” the authors write.

And there’s no arguing with that. Other recent research looking at the use of smart drugs among Ivy League students found that many use ADHD drugs for academic performance, and they don’t think it constitutes as cheating. The study found that a third of the students in the study said using ADHD drugs for performance enhancement did not count as cheating, 41% said it was cheating, and 25% said they were not sure. People who used ADHD meds were also more likely to think it was a commonplace on campus.

The use of ADHD and other smart drugs has long been an ethical issue, and a growing one at that. Increasingly more people are being diagnosed with ADHD, even adults. The amount of adults taking ADHD drugs rose by over 50% between 2008 and 2012, according to a recent report. But now, emerging research shows the issue is also a biological one, and the early findings are not pretty.

The researchers of the latest study conclude that scientists and the medical community have a responsibility to very carefully evaluate and research each no drug to gain a greater understanding of drugs’ impact on the brain.

 

TIME Smoking

The Weird Link Between E-Cigarettes and Mental Health Disorders

US-HEALTH-TOBACCO-E CIGARETTE
This September 25, 2013 photo illustration taken in Washington, DC, shows a woman smoking a "Blu" e-cigarette (electronical cigarette). PAUL J. RICHARDS—AFP/Getty Images

A new study finds elevated rates of depression, anxiety and other mental disorders among users of e-cigarettes

A new study has found that people suffering from depression, anxiety and other mental disorders are more than twice as likely to spark up an e-cigarette and three times as likely to “vape” regularly than those without a history of mental issues.

Researchers at the University of California, San Diego drew their findings from an extensive survey of American smoking habits. Among 10,041 respondents, 14.8% of individuals suffering from mental health disorders said they had tried an e-cigarette, compared with 6.6% of individuals who had no self-reported history of mental disorders.

The e-smokers’ elevated rates of mental disorders reflected the elevated rates of mental illness among smokers in general. The authors note that by some estimates, people suffering from mental disorders buy upwards of 50 percent of cigarettes sold in the U.S. annually.

Many respondents said they switched to e-cigarettes as a gateway to quitting. The FDA has not yet approved e-cigarettes as a quitting aide.

“People with mental health conditions have largely been forgotten in the war on smoking,” study author Sharon Cummins said in a university press release. “But because they are high consumers of cigarettes, they have the most to gain or lose from the e-cigarette phenomenon.”

The study will run in the May 13 issue of Tobacco Control.

TIME U.K.

British Charity Sees Rise in Afghanistan Vets Seeking Mental Health Help

A U.K. veterans mental health charity reported a 57% increase over one year in Afghanistan veterans seeking support

The number of British veterans of the war in Afghanistan seeking help for mental health issues increased sharply from 2012 to 2013, a charity group said Monday, warning that need would continue to rise as the country ends its involvement in the war.

Combat Stress, a U.K. veterans mental health charity, said the number of veterans seeking its help went up 57% in the course of a year. The group received referrals for 358 veterans last year, compared to 228 in 2012. Its caseload now includes more than 660 veterans. The increase is linked to the withdrawal of British troops in Afghanistan from all but two bases in Helmand province.

The charity said it found that veterans wait an average of 13 years after serving before seeking help, but the average time has now fallen to 18 months for Afghanistan veterans. Combat Stress also reported that their total caseload of 5,400 veterans across the country was the highest number in its 95-year history.

“We have had great support from the Government and the public over recent years and we simply could not operate without the generosity we have experienced, ” said Commodore Andrew Cameron, chief executive of Combat Stress. “We cannot allow the ex-Service men and women who suffer from the invisible injuries of war to go unnoticed and untreated.”

TIME

Police: Naked Man Doing Push Ups in the Street Hit and Killed by Car

A naked man doing push-ups in the middle of the street in Portland, Oregon, was struck by a car and killed, according to police.

Portland Police began receiving reports about a naked man running down the city streets around 4 a.m. on Sunday, according to a news release. While the police were on the way to respond to the call, they received another alert that the man had started doing push-ups in the middle of the lane of traffic on Columbia Boulevard in north Portland.

By the time they arrived on the scene, they had received a third call reporting that the man had been hit by a car.

The driver, who, according to police, was not impaired by alcohol or drugs, remained on the scene and was cooperative with the investigation, police said.

Police said the Oregon State Medical Examiner’s Office will conduct an autopsy, including a toxicology report, to determine contributing factors to the pedestrian’s death.

(h/t The Oregonian)

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TIME Education

Students File Title IX Sexual Assault Complaint Against Columbia University

Student Loan Rates Double After Congress Fails To Agree On Legislation
People walk past the Alma Mater statue on the Columbia University campus on July 1, 2013 in New York City. Mario Tama—Getty Images

After months of advocating for changes in the way the administration handles cases of sexual assault, 23 Columbia and Barnard students have filed a federal complaint that alleges violations of Title IX, Title II and the Clery Act by the university

Twenty-three Columbia and Barnard students have filed a federal complaint that alleges violations of Title IX, Title II and the Clery Act by the University. The complaint comes after months of students advocating for changes in the way the administration handles cases of sexual assault.

The 100-page complaint alleges that the University allows accused perpetrators of sexual assault to remain on campus, has too-lenient sanctions for perpetrators, discourages victims from reporting assault and denies accommodations to students with mental health disabilities (which they say result from their attacks). The students also claim that LGBTQ students are discriminated against in advising, counseling and Greek Life.

Title IX protects students from gender-based discrimination, including sexual assault, on campus. The Clery Act requires all colleges and universities to disclose information about crime on or near their campuses. Title II protects students from disability-based discrimination. By filing all three complaints, the students hope to hold the university responsible for not only allegedly mishandling rape cases but also for the way they deal with students who have mental health issues after being attacked.

“We’ve seen two town halls and a couple of emails, and as a survivor and an ally to survivors, that’s not enough,” Marybeth Seitz-Brown, a senior and one of the students who filed the complaint, told the Columbia Spectator. “That’s not enough to make me feel safe. We’re afraid, to be honest, that when the summer comes, that’ll be an excuse not to follow through on these promises.”

She added, “The thing to highlight here is how much this is not just about sexual violence but mental health as well.” One of the complainants said that she was placed on disciplinary and academic probation because she was a “mental health liability” after she was allegedly assaulted.

The filing also says that the University failed to accomodate a transgender student. The student—who remained anonymous but uses “they,” “them,” “their” pronouns—says there is a “general ignorance and hostility towards my gender identity … even [the] dismissal of my rape because it didn’t fit the normative ‘boy-rapes-girl’ narrative.”

In January, student Anna Bahr interviewed three sexual assault survivors in Columbia’s Blue and White. All three women alleged that they were assaulted by the same man, and all said they had bad experiences with the administration after reporting their assault. One student said she was raped anally and her testimony was questioned by a “specially trained panelist” who didn’t “understand how it’s possible to have anal sex without using lubrication first.”

Columbia’s President called for increased sexual assault transparency after the story was published. He claimed that several initiatives were already on the way.

But that’s not enough for students. “I don’t trust the University to take my experience or my safety more seriously than they take their own public image,” Cami Quarta, one of the Columbia complainants said in the filing.

If Columbia is found in violation of the Clery Act, it will have to pay $35,000 per violation. If it is found in violation of Title IX and Title II, it will be subject to federal review and could lose federal funding.

Students at Columbia join several of their peers at other schools in filing Title IX complaints: sixteen students filed a complaint against Yale University in 2011; complaints were filed against University of North Carolina, Vanderbilt, Amherst, UConn in 2013; and a student filed a Title IX lawsuit against Northwestern in February—to name a few. The proliferation of complaints has prompted a White House task force to protect students from sexual assault.

[Columbia Spectator]

TIME Environment

Lead Didn’t Bring Down Ancient Rome—But It’s Still a Modern Menace

Roman aqueducts led to lead contamination
Aqueducts like this one contaminated Roman tap water with lead Moment via Getty Images

Lead levels were high in ancient Rome's tap water—but not high enough to cause the collapse of its civilization

You could fill a book with theories on why the ancient Roman Empire declined and fell—which, in fact, is what the 18th British historian Edward Gibbon did in his magisterial Decline and Fall of the Roman Empire. But if you don’t have time to read the 3,000 or so pages in Gibbon’s full work, here’s one very simple theory: it was lead. Canadian scientist Jerome Nriagu published an influential 1983 paper arguing that high levels of the neurotoxin lead—which contaminated water and other beverages through lead aqueducts and lead cups—caused mental disabilities and erratic behavior among members of Roman high society. Nriagu even reviewed the personalities and habits of Roman emperors between 30 B.C. and 22o A.D.—a list that includes notorious nutjobs like Nero and Caligula—and concluded that two-thirds of them suffered from symptoms of chronic lead poisoning. It’s hard to keep an empire going when your living god of an emperor has been brain-poisoned.

An empire brought down by one of its signature innovations, the aqueduct — it’s a theory that has stuck with the public, although experts have long been skeptical of its merits. It turns out that the theory was half-right: In a new study in the Proceedings of the National Academy of Sciences (PNAS), a group of French and British researchers report that the tap water in ancient Rome was indeed contaminated with lead, with levels up to 100 times higher than those found in local spring water at the time. But while Roman tap water might not have passed modern-day standards, it’s almost certain that the contamination wasn’t extensive enough to be responsible for the collapse of Roman civilization.

As lead author Francis Albarede of Claude Bernard University in Lyon told the Guardian:

Can you really poison an entire civilization with lead? I think it would take more than lead piping in Rome to do that.

Still, any amount of lead can pose a danger to the human brain, especially those of young children, so Rome’s contaminated water couldn’t have helped. In fact, the more researchers learn about lead, the more dangerous it seems—and the more important it becomes to get lead out of the environment. There’s a fascinating body of research, summed up in this excellent piece by Mother Jones‘s Kevin Drumm, that links the drastic drop in violent crime in the U.S. over the past two decades to the phasing out of leaded gasoline in the early 1970s, which greatly reduced lead levels in the environment.

The theory is that children in the 1940s, 50s and 60s were exposed to high levels of lead in leaded gasoline and lead paint. High blood lead levels are directly correlated with a loss of IQ points. But more than that, lead seems to particularly damage the parts of the brain linked to aggression control and executive function. Lead seems to affect boys more—and men, of course, make up the vast majority of violent criminals. When those lead-exposed boys became young adults in the 1970s and 80s, it wasn’t surprising that so many of them fell into violent crime. But once they aged out by the 1990s, that cohort was replaced by a generation of children who largely hadn’t been exposed to high levels of lead, and violent crime dropped.

But while most—though not all—American children are no longer exposed to high levels of lead, it’s still a major problem in poorer countries around the world. NGOs like the Blacksmith Institute are working to clean up lead contamination, though far more needs to be done. Lead may not have brought down the Roman Empire—you’ll need to go back to Gibbon for that—but two thousand years later, it’s still a public health menace.

TIME The Weekend Read

Face-to-Face With a Psychopath

Photo from Trapped, a series on mental illness in American prisons, intended to increase the dialogue about prison reform and the mental health crisis in America.
Photo from Trapped, a series on mental illness in American prisons, intended to increase the dialogue about prison reform and the mental health crisis in America. Jenn Ackerman

'Shock Richie' lived up to his name—but did he also point toward a new way of looking at the psychopathic mind?

My Sunday morning began with a 60-minute commute through the rain to the home of the maximum-security treatment program for Canada’s most notorious violent offenders. This was a special day as a new cohort of inmates was being transferred in to start treatment. I was excited about the chance to interview 25 new inmates and get them signed up for my research studies.

An inmate had exited his cell completely naked and started walking up the tier.I arrived at the housing unit before the inmates had left their cells. I entered the nurses’ station and fired up the coffeemaker. The inmates’ cells opened and they rushed for the showers or the TV room. It was football season and the East Coast games were just starting. The inmates crowded into the TV room. I leaned against the door frame, watching the TV to see if I could catch a glimpse of the latest highlights. And then suddenly there was tension in the air. I felt it on the back of my neck before I was even conscious of what was happening. The inmates milling around had slowed, the sound of their feet hit­ting the cold concrete floor halted, the TV seemed to get louder, and all of a sudden I was acutely aware of the steam from the hot coffee in my mug spiraling up toward my nose.

An inmate had exited his cell completely naked and started walking up the tier. I noticed him out of the corner of my eye. He passed the TV room, shower stalls, and empty nurses’ station and proceeded down the stairs to the doors that led to the outside exer­cise area. Some of the inmates turned slightly after he had walked by to take a look at him. Others tried not to move or look, but I could see they noticed. The inmates were as confused as they were anx­ious. What was he doing?

The naked inmate proceeded outside into the rain and walked the perimeter of the short circular track. He walked around the oval track twice. The TV room was on the second floor and the inmates had a good view of the track. Some of the inmates peered outside and watched him. Everyone was distracted; no one spoke. We were all in shock.

The inmate returned, still naked, and walked up the stairs to the second-floor tier and then down to his cell. The tension around the TV room grew. The inmate quickly emerged from his cell with a towel and proceeded to the showers. He walked down the middle of the tier as inmates slowly moved out of his way or retreated into their cells. Other inmates appeared to talk to one another, but they were clearly trying to avoid any direct eye contact with him. I no­ticed one of the biggest inmates had subtly slowed his pace so that he would not cross the path of the new inmate.

The naked inmate took a quick shower and returned to his cell; there was a slight swagger to his stride. He was not particularly big, but his physique was ripped.

I had to interview him. I took a gulp of coffee and then walked toward his cell.

The first name written on masking tape above his door was “Richard.”

“Good morning. I’m the research guy from the University of British Columbia. We are con­ducting interviews and brain wave testing on the inmates in treat­ment here. Would you be interested in hearing more about it?” I asked.

“Sure” came the reply out of the dark cell.

“All right, then. Why don’t you get dressed and grab a bite to eat, and I’ll come get you in about thirty minutes. We’ll do the interview downstairs in my office.”

I returned to the nurses’ station and had a couple more cups of coffee. I wanted to make sure I was fully awake when I interviewed Richard.

‘Shock Richie’ Pushes My Button

Richard had dressed in classic prison garb: blue jeans, white T-shirt, and dark green jacket. He sauntered down the stairs and through the covered outdoor walkway to the mess hall for breakfast. He returned to his cell after about 15 minutes. I couldn’t wait; I went down early to get him.

He followed me to my office and he plopped down in the chair opposite from me.

Over a minute later, we heard doors being slammed open in the distance and the unmistakable sound of running footsteps.Before I could get the consent form out of the drawer, he stared at me and said: “You ever need to push that red button?” He was refer­ring to the silver-dollar-sized button in the middle of the wall; when depressed, it signaled distress. A buzzer would go off in the guard bubble down the hallway.

We were both about the same distance away from the button. I realized that I might not be able to reach the button before he could get to me. My mind quickly turned to figuring out a new way to or­ganize the office so that I was closer to the button than the inmates being interviewed.

“No,” I replied. “In the five years I’ve worked here, I’ve never had to push the button.” I threw the five years in to let him know that I had some experience behind me.

Without saying another word, he leaped up and slammed his hand on the button. I didn’t have time to react. He returned to his seat as quickly as he had jumped up.

“Let’s see what happens,” he said calmly, leaning back into his chair.

Over a minute later, we heard doors being slammed open in the distance and the unmistakable sound of running footsteps.

I had thought about getting up and opening the door for the guards, but I would have had to pass by Richard to get to the door. So I just sat in my chair and waited. The guards’ response time felt glacial.

A key was jammed into my door and then it was flung open; two guards entered, panting and out of breath, and stared at us.

Richard turned calmly in his chair and said to the guards: “What’s the problem?”

“Someone pushed the alarm button,” the guard stammered. “Ev­erything okay?” His question was directed at me.

“Oh, I must have accidentally pushed it when I took my coat off,” Richard answered. “Everything is just fine; we are just doing the research interview here.”

“Okay,” the guard said. “Don’t do that again.”

I just nodded. I was having trouble speaking.

The guards pulled the door closed and Richard turned and looked at me.

“They call me Shock Richie,” he said. “And I’m going to shock you too.”

Mustering as much inner strength as I could, I replied: “I’m looking forward to it; I’m here to be shocked. Take your best shot.”

Shock Richie smiled.

Prison is never boring, I thought.

‘You ever tried to carry a body?’

We completed the consent form and then I started the Psychopa­thy Checklist interview with a question I would never ask any other inmate in my career.

“Why did you walk naked out in the rain?”

Nike probably never envisioned a psychopathic in­mate embracing their slogan ‘Just Do It’ in a manner quite like this.“Well, I arrived last night. You have to make an impression on the other inmates right away when you get shipped to a new place. I saw you standing there by the TV room. You noticed how all the other inmates got a bit nervous when I walked by. Even the big ones get nervous when you do shit like that. You just got to establish your­self right away. If you don’t, then inmates think they can test you.” He stared quite matter-of-factly at me; the emptiness in his eyes was unnerving.

“When I do stuff like that, inmates don’t know what to think. I’m unpredictable. Sometimes I don’t even know why I do what I do. I just do it.”

My mind was racing again. I completely agreed with his logic, albeit twisted; he had already established his dominance at this prison. He was going to score high on at least a few psychopathic traits. Nike probably never envisioned a psychopathic in­mate embracing their slogan Just Do It in a manner quite like this.

“You’ve been working here for five years?”

“Yes, since I started graduate school,” I replied.

“Interviewed lots of guys, right?”

“Yes, hundreds of them.”

“Well, you ain’t never met anyone like me,” he said.

“Really? What makes you so special?”

“I’ve done shit you can’t even imagine. I’m gonna shock you like I shock everyone,” he stated calmly. “Let’s get on with it.”

Richie enjoyed doing bad things. He was only in his late 20s when I interviewed him, but he had a rap sheet like no one I had ever interviewed before. As a teenager he had committed burglary, armed robbery of banks and convenience stores, arson for hire, and all kinds of drug-related crimes from distribution to forcing others to mule drugs for him. He would force women to hide plastic bag­gies of cocaine in their body cavities and transport them across bor­ders and state lines and on plane flights. One of Richie’s girls got a baggie stuck in her vagina. Richie used a knife to “open her up a bit” so he could retrieve his drugs. He said he didn’t use her again after that. When I asked him what he meant by that, he said that he didn’t use her for sex; she was too loose now, and she lost her nerve about carrying drugs.

Richie smiled as he told me a story of a prostitute he had killed for pissing him off. He actually seemed proud when he described wrapping her up in the same blanket he had suffocated her with so he could keep all the forensic evidence in one place. He put her in the trunk of his car and drove out to a deserted stretch of road bor­dered by a deep forest. Chuckling, he told me he was pulled over by a highway trooper because he was driving erratically as he searched for a dirt road to drive up so he could bury the body in the woods.

“So the cop pulls me over and comes up to the window and asks me if I have been drinking alcohol. I lied and said no. I told him that I just had to take a piss and I was looking for a place to go. But the cop gave me a field sobriety test anyways. I figured that if I didn’t pass the test, I would have to kill that cop. Otherwise, he might open the trunk and discover the body. The cop didn’t search me when I got out of the car, and I was carrying a knife and a handgun. I’m surprised that I passed that field test since I had had a few drinks that night. I was planning to beat the cop senseless and then I was going to put the girl’s body in the backseat of the cop’s car. Then I would shoot him in the head with his own gun and make it look like a suicide after he accidentally killed the prostitute while raping her in the backseat of his cruiser. Everyone would think it was just another sick dude.”

The irony of his latter statement was completely lost on Shock Richie.

The cop proceeded to point out a dirt road just up the way where Richie could pull over and take a piss. It was fascinating that Richie could remain calm enough not to set off any alarm bells for the cop that something was amiss. After all, Richie had a body decomposing in the trunk of the car. Yet apparently, Richie showed no anxiety in front of the cop. Most psychopaths like Richie lack anxiety and ap­prehension associated with punishment.

Richie turned up the dirt road the cop pointed out to him and drove in a ways. He pulled over, parked, and removed the body from the trunk.

“I had all these great plans to carry the body miles into the woods and bury it really deep so nobody would ever find it. But it’s f—ing hard to carry a body. You ever tried to carry a body?” he asked.

“No, I don’t have any experience carrying dead bodies,” I told him.

“Well, it’s a lot of work, let me tell you. So I only got about a hundred yards off the road and just into the trees before I was ex­hausted. Then I went back and got the shovel from the car. I started digging a huge hole.”

He looked up at me with those empty eyes and asked: “You know how hard it is to dig a hole big enough to bury a body?”

“No,” I answered, “I don’t have any experience digging holes to bury bodies.”

“Well, it’s harder than you might think.” He starts laughing. “I had all these great plans to carry her miles into the woods and dig this monster hole so nobody would ever find her.”

A couple weeks later, a couple of hikers discovered the body. Shock Richie read about it in the newspapers, but he was never charged with the murder.

Not His Brother’s Keeper

Richie admitted that he had no need for friends. He’d really never been close to anyone in his life. He preferred to do everything on his own. He also didn’t trust anyone.

I believed him. Richie had no friends in prison, he had no visitors, and all the other inmates said he could not be trusted and he knew not to trust them in return.

While he was having sex with the prostitute in the living room, she said she smelled something funny.He had lived a life supported by crime, never had any vocational training, and never made even a passing attempt at any other life­style. He made most of his big scores by taking down rival drug pushers. He would set up deals in different towns and then rob and sometimes kill the other person. Richie had no fear or hesitation with killing. Richie also had more than a dozen fake names and ac­companying identification.

For a long time he was a pimp. He used to corral runaways into working for him. He would get them hooked on drugs and then make them work the streets. He’d killed more than a few prostitutes. He saw people as objects, things to be manipulated; we were there just for his entertainment.

When Richie had been released the last time from prison, he was taken in by his older brother. His older brother was not a criminal. He was on the straight and narrow. After a few months of Richie bringing home prostitutes and doing drug deals at the house, his brother had told Richie he had to stop or he was going to kick him out. They argued, but Richie never tried to change his behavior. Fi­nally, his brother had had enough. He picked up the phone to call the police to have him arrested for drug possession. “I was high,” said Richie, “but not more than usual. I got the jump on him and beat him with the phone. While he was lying there dazed on the floor, I ran into the kitchen and grabbed a knife. I came back and stabbed him a few times.” He looked up at me intently to see if I was shocked.

“Continue,” I said.

“I figured that I would make it look like somebody had come over and killed him as part of a drug deal gone bad. Then I thought that maybe I should make it look like my brother had raped one of my girls and one of them had stabbed him.” By girls he meant the prostitutes in his “stable.”

After killing his brother, he went out and partied for a day or two. Then he came back home with a prostitute whom he planned to stab, and then put the weapon in the hand of his dead brother. He was going to put them both in the basement and make it look like his brother died quickly during the fight and the girl died slowly from stab wounds.

While he was having sex with the prostitute in the living room, she said she smelled something funny.

“You ever smell a body after it’s been decomposing for a couple days?” he asked.

“No,” I replied, “I don’t have any experience smelling decompos­ing bodies.”

“Well, they stink. I recommend getting rid of them fast.”

After having sex, he intended to lure the girl down into the base­ment. But the prostitute excused herself to use the bathroom and she jumped out the window and ran away. Later that evening the police showed up at his door and asked to come inside. Apparently, the prostitute recognized that odd smell to be that of a decomposing body. She had good survival instincts.

Richie told the cops he had been away from the house partying for a few days. He didn’t know that his brother had been killed. Con­fessing to being a pimp and drug dealer, Richie told the officers that he owed a lot of people a lot of money. He gave them a list of a dozen or so names of potential suspects.

The police eventually arrested Richie. Through his attorney, Richie received a plea deal. He pleaded guilty to manslaughter and was sentenced to many years in prison.

No More Little Richies?

Richie had a few more zingers he hit me with that day. He had indeed met my challenge. When I got home that evening, I opened a bottle of wine; it was empty before I knew it.

If Shock Richie’s brain has been abnormal since he was a child, is he responsible for his actions as an adult?Richie and I have both spent the last 20 years in prison. Richie as an inmate, me as a scientist trying to understand the mind and brain of the psychopath. Richie scored in the 99th percentile on Hare Psychopathy Checklist-Revised (PCL-R), the test we use to assess psychopathic traits. There are 20 psychopathic traits on the Hare PCL-R, including Lack of Empathy, Guilt and Remorse, Callousness, Irresponsibility, and Impulsivity. Richie fit the classic definition of all of those traits.

Richie was also the first psychopath to receive an MRI scan of his brain. Since that first MRI study my laboratory has scanned the brains of more than 3,000 other inmates, many of them psychopaths like Richie. This MRI data is the world’s largest forensic neuroscience repository and it is starting to yield some startling discoveries. We know for example, how Richie’s brain differs from the rest of us. His limbic system, the area of the brain that controls emotion and affect, is reduced in both brain structure and function. Additional research has found these same brain abnormalities in incarcerated youth with emerging psychopathic traits. Indeed, some scientists argue that emotional and behavioral antecedents to psychopathic traits can be recognized as early as age 6.

If Shock Richie’s brain has been abnormal since he was a child, is he responsible for his actions as an adult? Does Richie have the same free will as the rest of us?

Finally, the latest science of psychopaths has also illuminated a path that might remedy these problems before they even get started. Indeed, studies are showing that early treatment might prevent little Richies from ever developing.

Excerpts adapted from The Psychopath Whisperer: The Science of Those Without Conscience (Crown), by Dr. Kent Kiehl, available Apr. 22.

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