Can Psychopaths Be Rehabilitated?

The complications of sentencing psychopathic criminals

Matti Mattila/flickr

I spend an inordinate amount of time thinking about psychopaths.

It started when I covered the trial of a sadistic kidnapper named Cameron Hooker, who grabbed a hitchhiker and held her captive for seven years, most of the time in a coffin-sized box. He tortured her in every way he could devise.

This was my first close encounter with a living, breathing psychopath. I tried on the heavy ‘head box’ he used in her abduction, visited the basement where he kept her captive, and had nightmares long after he was sent off to prison.

I thought nothing so vile would ever hit headlines again. But I was naïve. Perhaps you’re nodding your head, remembering Elizabeth Smart, Jaycee Dugard, Natascha Kampusch, three women rescued last year from an Ohio basement, and a recent case of slavery in London.

Over the years, I’ve become obsessed with this type of crime. I’ve researched psychopaths, studied captivity syndromes, and thought a great deal about punishment and retribution. Nietzsche warned that we gaze into the abyss at our peril, but it’s a primal necessity. We analyze terrible crimes in much the same way we heed other means of escaping death. We automatically put ourselves into the shoes of survivors. We scrutinize an airplane’s charred wreckage, amazed that anyone walked away, because, yes, that really could have been you or me.

Elizabeth Smart uses her experience as a cautionary tale. She recently published her memoir, My Story, and she speaks extensively, promoting a self-defense program for children called RadKids. The core message is that, no matter what your age, yelling, kicking, and fighting back is the best way to foil an abduction.

Finding other lessons in these crimes is trickier, but just as important. The victims of these criminals deserve more than a startled gasp and a breathless news cycle. And basic public safety demands that we ask how to stop those who are driven to commit such extremely heinous crimes. Kidnapping and imprisoning victims is not a rash act. It requires an extraordinary amount of dedication, planning, and effort. And the captive’s misery is either of zero consequence or is a source of pleasure.

Cameron Hooker—the sadistic kidnapper I researched years ago—is set for release in just a few years, several decades shy of his 104-year sentence. It’s galling to imagine his name simply added to a registry of sexual offenders. Such was the case with Phillip Garrido, who served a fraction of a 50-year sentence for rape and kidnapping. Shortly after Garrido’s release, he kidnapped 11-year-old Jaycee Dugard, whom he held captive—under the noses of his parole officers—for 18 years.

There’s constant deliberation over whether such men (and they are overwhelmingly male) ought to be classified as psychopaths, sociopaths, narcissists, or some subset of mentally disordered sex offender. Forensic experts analyze brain imagery and administer tests, grasping for clinical diagnoses. But whatever terminology is used, the criminal justice system is tasked with confining such criminals amid ongoing controversy over the length and conditions of their confinement.

What causes their behavior? Is it willful, or is it a symptom of mental illness? Professionals who face these criminals daily disagree.

An authority clos­e to the Hooker case blames the kidnapper’s behavior on “an accident of internal wiring.” Dr. Paul R. Lees-Haley, a forensic psychologist, confides that the most apt definition for these types of criminals is “evil.” And Dr. Bruce Gage, chief of psychiatry for the Washington Department of Corrections and clinical associate professor at the University of Washington, compares psychopathy to colorblindness, explaining that, just as some individuals cannot see the color red, others are blind to human emotions such as sympathy and compassion.

(One caveat is that psychopathy exists on a spectrum. Some psychopaths are law-abiding. Psychopaths are not necessarily sadists or kidnappers. But they make up a disproportionate percentage of the criminal population.)

Having treated and evaluated a wide range of criminals, Dr. Gage notes that psychopaths typically demonstrate a “failure to take responsibility” for their actions. They often display callous, unemotional traits and indifference to others. Further, they tend to lack fear and have a “reduced response to punishment.”

Dr. Martha Stout, author of The Sociopath Next Door, would agree. Stout says that psychopaths have a “tragic deficit” in the paralimbic system (the brain’s emotional area), which prevents them from forming bonds or caring about others. “Where emotion is concerned, psychopaths can see it in others when they make a concerted conscious effort,” Stout says. “They just don't care to do so unless they can use it to their own advantage.”

But others, such as Jennifer Skeem, professor of psychology and social behavior at the University of California, argue that psychopaths are just misunderstood and can be rehabilitated. “Psychopathy tends to be used as a label for people we do not like, cannot understand, or construe as evil,” Skeem says.

The controversy will doubtless continue. Experts disagree over how violent psychopaths should be housed and whether they can be rehabilitated. Studies are cited by both sides. But such is the subtle nature of human behavior that, while the science may be objective, the results of such studies are often open to subjective interpretation.

Meanwhile, the justice system is burdened with the practical issues of keeping these criminals behind bars. In some cases, sexually violent predators are detained not in prisons, but in mental institutions. Such confinement, termed “civil commitment,” became federal law with the Adam Walsh Child Protection and Safety Act of 2006, and is also employed in 20 states.

But this, too, is controversial. Many believe mental health institutions are not the proper place for dangerous criminals, who are better suited to correctional facilities. And some argue that their civil commitment is unfair to mental health professionals and to patients diagnosed with severe, persistent mental health problems.

Since California uses civil commitment, it’s possible that once Cameron Hooker has served his time in Folsom Prison, he’ll be deemed a “sexually violent predator” and transferred to forensic lock-up in a mental institution. But this isn’t mandatory, and no one can predict whether he will qualify for civil commitment. It’s possible that he’ll be set free to stroll the streets.

Dr. Robert Hare, who is perhaps the leading authority on the subject of psychopaths, created the most widely used tool for keeping criminals like Hooker behind bars. The Psychopathy Checklist, also called the PCL or PCL-R, is considered the gold standard in assessing psychopathy. In his book, Without Conscience: The Disturbing World of the Psychopaths Among Us, Dr. Hare states that there “is ample evidence that a careful diagnosis of psychopathy, based on the Psychopathy Checklist, greatly reduces the risks associated with decisions in the criminal justice system. Properly used, it can help to differentiate those offenders who pose little risk to society from those who are at a high risk for recidivism or violence.”

Perhaps, properly used, the Psychopathy Checklist can remove the guesswork over which individuals are most dangerous. But of course, no punishment can truly fit the crime. No pound of flesh or pile of cash can buy back years of being chained in the dark.