Should We Reward Psychopaths?

Psychopaths frequently make the news and rarely for good reasons. Take, for instance, the recent case of Becky Watts, a 16-year old girl who was abducted and murdered in Bristol; her body parts were discovered by the police at a house in Barton Court, Bristol. While her murder remains unsolved, it is hard not to suspect that there is a person with psychopathic tendencies behind it. And this is not unreasonable. Between 25 to 30 percent of crimes are committed by psychopaths, despite them representing only 1 percent of the population. The percentages are especially high for extremely violent crimes such as rape and homicide. Given the detrimental effect psychopaths have on society, is there a way to cure them or at least to reduce their negative impact on society?

Most philosophers, psychologists and psychiatrists assume that there is no effective therapy for psychopathy. This skepticism is based on findings that show high stability of psychopathic traits over the life time, a strong genetic component and structural brain differences between psychopaths and non-psychopaths in regions such as the amygdala and the orbitofrontal cortex (more here). The latter might help to explain why, for instance, psychopaths don’t learn from punishment, no matter how severe. And sometimes, therapy might actually make things worse (for an example); therapy might increase recidivism instead of decrease. Walter Sinott-Armstrong illustrates why this could be the case with an anecdote in which a psychopath comes back to prison group therapy (listen to it here). This person regularly took part in the group therapy the first time he was incarcerated. Soon after being released from prison, he was convicted of a new crime and sent back to prison. When the therapist asks him if he learned anything in therapy, the psychopath says yes. For example, he says, in one session a guy was sad that his sister was dying of cancer, and while the psychopath didn’t understand why the guy was sad about his sister, he learned that you can get something out of people by threatening their siblings. This anecdote suggests that classic cognitive therapy, which provides insight into others’ thoughts and feelings, might give psychopaths more material to work with.

However, in the last decade, evidence of an effective way to treat psychopathy—a way that does not rely on empathy (imagine how you would feel if somebody did this to you) or punishment (imagine what will happen when you do this)—began to emerge. This new approach utilizes rewards. Implemented in the Mendota Juvenile Treatment Center as part of a research program led by Michael Caldwell, this approach to treatment rarely includes punishment despite the fact that the center’s inhabitants are dangerous criminals with extremely high scores on the Youth Psychopathy Scale, often send to the center because they caused too much trouble in other juvenile prisons. As Caldwell describes them “They represented an unusual population that seemed to consistently respond to deterrent sanctions with an escalation of illegal and violent behavior” (p. 577). So, instead of punishment, the juvenile offenders receive continuous rewards for either not doing anything bad or for behaving in line with the norms of the community. Furthermore, the level of rewards for a day is based on yesterday’s ratings of behavior, and consistent positive behavior yields even greater rewards.

Studies evaluating the long-term effects of this form of treatment on recidivism for the psychopath-like juveniles (there is a considerable debate about whether or not juveniles should be labelled this way) show promising results. In one study, for instance, the behavior of the psychopath-like juveniles in the treatment group was compared with psychopath-like juveniles in a conventional therapy group (i.e., control group) after two years. Juveniles in the control group were twice as likely to violently recidivate during the 2-year follow-up. Furthermore, juveniles in the control group committed 16 murders, while juveniles in the treatment group committed zero. Caldwell and colleagues used these results to make a cost-benefit analysis of the treatment for the state of Wisconsin, where the center is located. A murder, for instance, would cost the tax-payer about $12,230, including the cost of the perpetrator’s arrest, prosecution and so forth.  They found that for every $10,000 invested in the treatment center, the taxpayer saves $70,000. Note that these costs do not include any estimation to reflect how much suffering a murder, for instance, causes for relatives and friends or the economic costs of robbery.

If the main idea behind this treatment approach turns out to work, then society might face some complex questions about whether or not we should start to reward psychopaths wherever we can. An early diagnosis of psychopathy-like traits in a child or adolescent should imply changes in the reward and punishment structure of daily life. The child would be spared punishment since this most likely leads to increases in bad or illegal behavior. In schools, different punishment rules would apply to those with and without psychopathy-like traits. And children with psychopathy-like traits would receive constant praise and rewards for behaving within the rules and norms of the school and community. A child with psychopathy-like traits, for instance, might get a reward of some sort for arriving on time, while a child without psychopathy-like traits would receive nothing. Similar principles would apply to prisons, producing different treatments for criminals with and without psychopathy-like traits, which would continue once they were released. It is not only hard to see a politician campaigning for such a treatment of psychopaths, but also hard to forecast other side-effects.

Would criminals start to try to get a diagnosis of psychopathy? In the U.S., for instance, high psychopathy scores often prevent people being released from prison on parole, or thward their chances of shortening a prison sentence. With the treatment in place, being labelled a psychopath might come with a lot of advantages in prison and thereafter. Such problems might be avoided by utilizing objective diagnosis criteria such as amygdala size or amygdala responses to fearful faces. Yet, people might still feel that such a treatment of psychopathy violates our intuitions about justice and fairness, since the least virtuous people reap the most rewards. Cost-benefit analyses strongly suggest that societies should start investing into such treatments, yet our moral intuitions might prevent us from doing so.

 

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9 Responses to Should We Reward Psychopaths?

  • Cellar says:

    I don’t mind the idea, but I do think that such a regime is very hard to keep up when there are lots of others around that don’t constantly get rewarded. So you would end up keeping these people separated, and never let loose in society again. In that case this method would still make the keepers’ job easier, so it’s still a win.

    But I suppose there will always be people who don’t really get that sociopaths aren’t really normal people so we will get to learn the hard way just how much of this method will stick after the patient is declared cured and is let loose in society again.

  • Thinker says:

    Very interesting perspective. Many the issue brought up by Cellar has more to do with labeling people who are “wired” this way as psychopaths. In Eng. people who in this country would probably be labeled mentally disturbed are called “eccentric” which I don’t think is nearly as pejorative as calling someone a psychopath. Conceivably if people with this mental issue were covered by the ADA (American Disability Act) and a different type of non-pejorative label were used, others could understand why they get different treatment. The reality is that if society could identify psychopaths at an early age (say in school or by physicians), perhaps a large amount of future crime, anguish and harm could be avoided by them as well as by others. It has taken many years for us to deal with people who have lower than average intelligence and physical handicaps (we are still learning) so doing this would be more of a goal than a current reality.

  • Romons says:

    The real question is whether this positive reinforcement would work for the non-psychopaths too. If so, everyone wins.

  • Raistlin says:

    I agree with Romons, I think the real issue here is wether it is effective in the non-psychopathic population.

    Not just effective but equally or more effective to currently used strategies. If it is equally effective, is that cause enough to try and implement it generally? If it is more effective in general, then there isn’t really an issue is there? I suppose one might want to know if the approaches could be used side-by-side without loss of efficacy in either or both populations and if an absence of negative reinforcement in the non-psychopathic population might have any negative consequences of its own, but those are more questions for science i suppose.

    With regards to Cellar/Thinker’s comments – if the intervention is generally efficacious, might you not need to separate the populations? That might in turn enhance the interventions efficacy since the separation might be seen as a form of punishment itself. Relatedly, might such an approach simply encourage different sorts of antisocial behavior (I’m thinking bribery or manipulation, which might not technically be anti-social and is propably preferable to violent crime at any rate)

  • Andreas Kappes says:

    Thanks for all the comments. In general, there is no reason to assume that the reinforcement treatment should not also work for the rest of the inmates, that is something worthwhile pointing out; I agree. And ‘m quite surprised that it appears that none of you have an issue with that. Obviously, from a utilitarian perspective, there is no reason to object – having a reward-based prison system should only be judged on the basis of the consequence. But would people feel that this is going too far? Some might argue that rehabilitation is just one aspect of prison terms, others might see punishment (e.g., having an unpleasant time) as another (moral) reason.

    • Robert Monsen says:

      The obvious answer is that the purpose of prison is to further the ‘general welfare’ of the population. Retribution holds no value if it does not work towards that end.

      However, one problem would be if rewards were good enough to draw people who were down on their luck into the prison population. That would be a shot to the foot, I think. Any rewards should be calibrated to prevent this.

      • Andreas Kappes says:

        Very interesting. In other words, you would suggest that some poor people might be willing to give up freedom in order to live in a prison that rewards good behavior. That appears to be possible.

        • Raistlin says:

          Maybe I’m oversimplifying (or just generally off base), but isn’t that the gist of social contract theory?

    • Katherine says:

      I thought you were talking about using it in school. In that case using rewards only for everyone is certainly better than doing it for psychopaths only. The latter would mean playing favorites, which is how you provoke “an escalation of [antisocial] behavior” in normal children.

      If you use it in prisons it might be better to do some kind of two stage sentences. The first year or first 10% of the sentence is punitive/deterrent and should be as unpleasant as possible. If this provokes guff from the psychopaths that’s ok, just put them in solitary until they calm down or until the punitive phase is over.

      Then the rest of their sentence, probably served at a different facility, is all about preparing them to be released back into society. And then you use the methods from this program on everyone.

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