It's all in your head
Abby... Abby Normal
Warning: Contains #Hannibal Lecter, #Brains, #Psychopathology #Snark
Several decades ago our immediate family was gathered together for the unpleasant purpose of possibly watching my father suddenly pass away in a hospital. As these things go, it was certainly on no one’s schedule or by any means convenient, but there are numerous reasons I remember it well.
By the time I arrived, he was in multi-organ failure, which at that time meant about a 90% mortality rate. As it turned out however, the offending infection was from a tick-borne bacterium, Ehrlichia, which is easily and very effectively treated with an old, cheap antibiotic – if the diagnosis is suspected.
Ehrlichia chaffeensis
While there I stayed with some nearby friends, but they did not know my evangelical family and had no interaction with them – it was just their guest room to stay in and I did not even mention to any of my family where I was staying. It simply wasn’t relevant.
As my father was doing better by the end of the week we were all there, and I was on my last T-shirt, it was time to go back into the closet to my Navy residency safely several states away.
Soon afterwards my father had near-full recovery, attributed to divine magic of course rather than the doxycycline he was given. I knew better than to argue their point. It simply wasn’t relevant. For those who believe, no proof is necessary, but for those who do not believe, no proof is possible. Such was the stalemate of our fantasy-lopsided family, and I’m afraid, much of this country.
Doxycycline has been in commercial use since 1967 and is included in the World Health Organization’s List of Essential Medicines.1 You may recall the United States at one time participated in the WHO.2 Without insurance, doxycycline currently costs on average around $0.35 per capsule, or less than $15 for an extended 3-week course for severe cases.
With most of the dust settled by a month later, I punctually sent a birthday card to my evangelical brother-in-law, to remain pleasant and keep up appearances, at least on my end. I was completely unprepared for the hateful letter in response, in his perfect architect handwriting so the missing signature was irrelevant. “How dare you flaunt your lifestyle choices in front of us. Like Rush Limbaugh says, you are going to hell.” A month sure seems like a fairly long time to carry that anger. Glad I could help out.
Then it flashed on me, that single offending T-shirt I had worn last day. Plain black T-shirt with plain white lettering: “Prejudice Is All In Your Head.”
Well, alrighty then.3 Clearly, the message had “struck a nerve.” And if the shoe fits, get three extra pairs for later, right?
But seriously, what if you strike a nerve, can it feel pain?
No, that nerve simply relays a message to the CPU (Central Processing Unit) known as our brain, which may or may not interpret that signal as noxious. Snark aside, biologically, it is a fact that all higher processing of information occurs in our head. All pain is in your head. Psychologically, this is also a fact though the responses are predominantly learned on some level.
In contrast, reflexes do not involve the brain but occur at the spinal cord level. Describing someone’s witty retort as a reflex is therefore an appropriate figure of speech to describe a rapid emotional response with no apparent thinking involved.
Interestingly enough, our brain itself is defenseless. It cannot sense pain, so it’s a good idea to have it encased in rock with special blood vessels to keep out many dangerous substances. The coverings of our brain however, known as the meninges, and the blood vessels within the brain do have nerves with the ability to relay a sense of pain.
This is not to be confused with someone who is a “headache.”
“A mind is a terrible thing to lose.” - Dan Quayle
Now to consider what we learn about the brain from injuries, the resulting deficits are all about location. If the damage is somewhere in your motor cortex, the corresponding muscles on the cortical homunculus pictured below do not work, and you may not be able to move your limbs, see, swallow or make rude gestures. If the damage is in the sensory areas, you may no longer be able to taste, see, smell or hear, and/or may possibly have seizures. Other areas of possible damage concern memory and coordination of muscle functions, so your rude gesture makes no sense. (This is obviously not meant to be an exhaustive review, but I do have a point to make)
Cortical homunculus
Perhaps one of the most interesting areas of the brain is the frontal lobe. You don’t need it for any of the above mentioned functions.
Take for example, fictional-yet-corrupt Deputy Assistant Attorney General Paul Krendler, while very much awake being fed parts of his own frontal lobe, sautéed with shallots and white wine, of course. As grotesque as Hannibal has seemed to me since 2001 and counting, the science was not altogether as far-fetched as you might have thought (no, I do not watch these types of movies though I occasionally read reviews).
If you found yourself in Krendler’s position, you could actually talk and chew with your mouth full and probably would because you might be eating the part of your brain that previously provided you with manners, that is if you had ever learned them.
Anthony Hopkins, Ray Liotta, in Hannibal
So why does Trump keep bringing up the Hannibal Lecter reference? Many have speculated, as they should, but the explanations I have seen range from lazy to lame to ludicrous to silly to just completely unserious.
“They’re coming from everywhere. They’re coming from all over the world, from prisons and jails, and mental institutions and insane asylums. You know, they go crazy when I say, ‘The late great Hannibal Lecter,’ OK? They say, ‘Why would he mention Hannibal Lecter? He must be cognitively in trouble.’ No no no, these are real stories. Hannibal Lecter from Silence of the Lamb [sic]. He’s a lovely man. He’d love to have you for dinner.”
As a reminder, no, medical professionals cannot medically or ethically diagnose anyone without having personally evaluated them and been given authorization to divulge the findings. This is a “cannot,” not a “should not.” This principle is known as the Goldwater Rule.
Identity
Humans and even animals desire some social identity, a sense of belonging. Yes, even the narcissists. So not surprisingly, there is sufficient research indicating that psychopaths often admire other psychopaths though this is rarely amorous but primarily out of a sense of understanding or shared perspective for their manipulative and callous behaviors.
Psychopathic traits have also been associated with objectifiably different brain structure, whether developmentally or secondary to injury.4 What’s known as the limbic and paralimbic areas appear to be the areas of the brain most closely associated with psychopathic behavior (The amygdala is an important part of the limbic system, controlling emotions, behavior and memory). Temporal lobe epilepsy for example, is associated with as high as 70% incidence of psychopathic-like antisocial behavior.5
fMRI scans
Hannibal Lecter was a fictional psychopath of course, and as a well-written and well-acted psychopath, showed consistent demonstrations of
Emotional shallowness
Impulsivity
Irresponsibility
Risk-taking
Grandiosity
Entitlement
Manipulation, even to the point of appearing charming
Disregard for social norms
Disregard for laws
Disregard for others’ autonomy
Lack of empathy
Lack of remorse
Aggressivity/Violence
Lack of regard for consequences
And if psychopaths identify/admire other psychopaths, what better way to signal to the psychopaths within the aggrieved masses than to repeatedly mention someone that others of the same mindset would admire, even if fictional, well, say like Hannibal Lecter?
Stand back and stand by….
OK, that’s nice, but how to address this problem?
Behavioral medicine generally considers psychopaths a lost cause, not for lack of trying. The few types of interventions which have been tried with minor successes all require a willingness to participate, which for all the same reasons is essentially nonexistent.
The “Decompression Model,” developed by researchers in Madison, WI, however, operates on positive reinforcement.6 Punishment means nothing to a psychopath and does not discourage further criminal behavior but even reinforces it. To wit, psychopaths are six times more likely to commit new crimes following release.
So, it does appear by the Decompression Model that juvenile psychopaths do respond to consistent, positive reinforcement, even for the smallest of efforts. There is relatively little study of this model among adult psychopaths.
And while I’ll admit that I’m generally averse to rewarding people for behavior that should have its own reward and should not require encouraging, perhaps I’ve been wrong all this time.
Yay Susan Collins for your sternly worded letter!! Yay Justice Barrett for asking if trans people have ever been discriminated against! Yay Tom Lubnau, Wyoming attorney and former Republican speaker of the state house, for telling other Republicans to “butt out of my decisions and let me take care of myself.”7
My plan, likely much easier written than accomplished, is to repeatedly bite my tongue and give positive strokes to the psychopaths in my life, now realizing that criticism in all its forms is useless. With this positive approach and even one psychopath at a time, the world might just survive the Pied Piper summoning his vermin.
As Hannibal said to the young boy in the closing scene,
Always try new things.
Having overcome the inertia of Christian love, several more hateful, unsigned letters and postcards arrived over the next few months which I copied and mailed back to my parents and brother. Crickets. The restraining order I finally threatened seemed to stop the unsolicited vitriol from coming my way. WWJD?
The convicted criminal in the White House, upping his criminality from there: certainly a psychopath.
I like the bit about positive reinforcements from Johnny's column today. It won't help any of us deal with the orange felon, or at all stem his rising waves of criminality and destruction. But, if applied where it should be applied, positive reinforcement could assuage many of the tens of millions whose MAGA support drives on the orange felon, convicted criminal.
That positive reinforcement should come as many new, many more references from teachers in classrooms to good books, films, even songs that probe the tens of millions of working-class Americans who've felt so bitterly abandoned since elites offshored their jobs that they all flocked to the psychopath, sociopath.
Arlie Russell Hochschild's "Stolen Pride" affirms how these tens of millions have long needed attention, sympathy, and respect from our elites -- all "educated" never to see much less care for any of them.
U.S. schools need major reaffirmation of our humanities. Our fellow citizens need us to be literate of them, literate to how other elites raped them, stole their jobs, set them to opioids and junk food, with a few million extra AR-15s thrown in, too.
Positive reinforcement. Yes.
Abby Normal, Indeed!!