The Checklist | Criminal Podcast | Forensic Files

Phoebe Judge: A quick note about today's show. Usually our episodes stand alone, and can listen to them in any order you like, but
today's is a bit different. You should probably listen to our last episode, Episode 51 — it's called "Money Tree" — first,
and then come back and listen to this one. Okay. Here's the show. Axton Betz-Hamilton: If my mother was a psychopath, she didn't feel guilt.
Phoebe Judge: In our last episode, we brought you the story of a woman named Axton Betz-Hamilton,
who was the victim of identity theft. And only a few years ago, Axton discovered that the person who had stolen her identity,
and her father's, and her grandfather's, for decades, racking up half a million dollars
in debt, was her own mother. [Music comes in.] Axton is still trying to make sense of how her mother could do something so horrible
for such a long time, not appear to feel guilty, or want to come clean, even at the very end
of her life. But Axton's been doing some research and now believes her mother may have been a psychopath.
Axton Betz-Hamilton: A psychopath will cognitively know the difference between right and wrong.
So I believe my mother knew, on an academic level, that what she was doing was illegal.
But in terms of understanding, on an emotional level, the consequences that she was creating
for me and for my dad and for my grandfather, I don't think she had a real recognition of
that. I don't think she could have a recognition of that. Now, does that mean that I'm defending her?
No. What she did was wrong, but I do think these psychopathic traits that she had, I think
are indicative of a severe psychological illness that she was able to successfully hide for
her entire life. Phoebe Judge: And this led Axton to think about herself and how over the years, people
have told her that she doesn't show much emotion. Axton Betz-Hamilton: I immediately saw it.
Okay. I am essentially 50% my mother. Her genes are in me. Do I have this? At some point, I'm going to start exhibiting these characteristics?
And I went to my doctor just completely freaked out about this and said, "I'm at risk?
If I am, what do I do?" And she said, "There's no way you have psychopathy." And I said, "Well, how do you know that?"
And she said Phoebe Judge: [Laughs.] That's really funny. You're trying to kind of convince her.
Axton Betz-Hamilton: Well I did. And she said, "You can't because you have a severe anxiety disorder and psychopaths
don't feel anxiety." [Music comes in.] Dr. Ronald Schouten: The people who are most sensitive to these symptoms are the least
likely to be psychopaths, because you're worried about having something like this.
Whereas, a true psychopath wouldn't really care. Phoebe Judge: This is Dr. Ronald Schouten, a professor of psychiatry at Harvard Medical
School and the director of the law and psychiatry service at Massachusetts General Hospital.
He's both a lawyer and a doctor. And he's the author of a book called Almost a Psychopath.
How many people are we talking about out there that are true psychopaths? Dr. Ronald Schouten: True psychopaths?
Probably about 1% of the population. So if we have 300 million people in the United States, that gives us about 3 million.
Phoebe Judge: Three million true psychopaths walking around. Dr. Ronald Schouten: Mhm.
Phoebe Judge: But not all psychopaths are dangerous. Dr. Ronald Schouten: That's correct.
And I would argue that probably the majority of them are not physically dangerous, in terms
of violent crimes. However, it's important to think about the following distinction.
We consider psychopaths as either successful psychopaths, or failed psychopaths.
And the failed psychopaths are the people who end up in prison. The people that you're more likely to encounter are the successful psychopaths.
Phoebe Judge: Part of what makes a successful psychopath successful is that they're so friendly
and charming, the psychopathic traits can be undetectable. Ron Schouten says that many of us will meet or interact with a psychopath on a daily basis.
But how would we ever know? I'm Phoebe Judge. This is Criminal. [Music stops.] Dr. Ronald Schouten: Psychopathy was actually referred to even before the days of psychoanalysis,
as moral insanity. I mean, this is a concept that's known in multiple cultures and has been known for and
talked about, for at least hundreds of years. Phoebe Judge: The word psychopathy is derived from Greek — translating to something like
'soul disease' or 'soul suffering' — to describe people who are in touch with reality
but don't have any sense of morality. Dr. Ronald Schouten: So the idea that these are people who know the difference between
right and wrong, they just don't care about it. And their behavior is unconstrained by that.
Phoebe Judge: So how does a psychopath become a psychopath? I mean, are you born with the characteristics with chemicals that...
What makes you a psychopath? Dr. Ronald Schouten: Nature and nurture. We have something called primary psychopathy and it's genetically linked.
There's also secondary psychopathy, people who may have some inclinations to this, but
because of the environment in which they grow up, they learn that the only way to survive is a dog eat dog approach to the world and others in it.
And also really just have the empathy burned out of them. Phoebe Judge: So psychopaths are over-represented in the prison population, right?
Dr. Ronald Schouten: Well, compared to the general population, yes. Phoebe Judge: As many as 15% of female inmates and 25 to 30% of male inmates meet the definition
of psychopathy. But the vast majority of people in prison are not psychopaths. And there are plenty of people free in the world
who, whether they break the law or not, do meet the criteria. Jon Ronson: My name is Jon Ronson, and I'm an author of a number of books, including
the book The Psychopath Test. Phoebe Judge: Jon Ronson spent three years exploring how a person is diagnosed as a psychopath.
And he met several times with the most famous man in psychopathy research: Robert Hare.
Jon Ronson: Robert Hare is the father of modern psychopathy diagnosis. He was a prison psychiatrist and a fan of Carvey Cleckley, who was the previous father
of modern psychopathy diagnosis. And had devised the checklist, the PCL-R checklist, which is the gold standard for a psychopathy
diagnosis. It's a 20-point checklist that's now used all over the world. Phoebe Judge: It's used by hospitals and prisons and parole boards, and can be used to predict
whether someone will re-offend. The checklist consists of 20 items. A person is scored with a zero, one, or two.
If the trait is not present, then you get a 0. If it's partially or possibly present, then you get a 1.
And if it's definitely present, then you get a 2. The maximum score you can get is 40.
People who are in the 30 to 40 range are characterized as true psychopaths. We asked Jon Ronson to walk us through the 20 items on Robert Hare's checklist.
Jon Ronson: Item one is glibness, superficial charm, and then item two grandiose sense of
self-worth. [Music comes in.]. I remember when I met a CEO called Chainsaw Al Dunlap, we both looked up because he was
standing underneath a giant oil painting of himself. Item three, need for stimulation, proneness to boredom.
Item four, pathological lying. And they're not in the least bit embarrassed when they're caught lying.
Item five, cunning, manipulative. Item six, lack of remorse or guilt. Item seven, shallow affect, which is an inability to experience a range of emotions.
Item eight is the big one. That's callous, lack of empathy. The lack of empathy I suppose, is the main psychopathic trait from which all others follow.
Item nine, parasitic lifestyle. Item 10, poor behavioral controls. Item 11, promiscuous sexual behavior.
Actually that one always surprised me a bit because I mean, my promiscuous days are a
long, long time in my past, but I look back on them with some fondness. Item 12, early behavior problems.
Again, this is quite a big one because the symptoms begin to manifest themselves around
the ages of 10 to 12. So kind of extreme aberrant behavior, like breaking another kid's arm in the school yard,
or torturing animals, or setting fire to the house, getting yourself expelled from school.
So big stuff. Item 13, lack of realistic long-term goals. Item 14, impulsivity. Item 15, irresponsibility.
Item 16, failure to accept responsibility for own actions. Item 17, many short term marital relationships.
Item 18, juvenile delinquency. Item 19, revocation of conditional release, which means if you're a criminal psychopath
and you get released, you go back to jail because you violated the terms of your parole.
And item 20 is criminal versatility. Phoebe Judge: What does that mean? Jon Ronson: Just you do a whole range of crimes.
Phoebe Judge: It kind of seems rather subjective. Jon Ronson: I'm glad you brought this up, because it's incredibly subjective and it's
prone to massive confirmation bias. And the reason is, is because as human beings, we love nothing more than to declare other
people insane. So we want to define other people are psychopaths, especially people that we don't like.
Many only have to look at what's happening in this election cycle. The thousands of articles: Donald Trump is a psychopath.
In fact, it's kind of psychopathic to declare somebody a psychopath from afar. But of course, everybody's ignoring that.
I remember one guy who was diagnosed a psychopath said to me, "It's so frustrating because I
say, I feel terrible remorse for what I did." What he did was beat up a homeless man.
He said, "I feel terrible remorse for what I did. But when I say that to people, they say, well, that's typical of
the cunning manipulative psychopath to pretend to feel remorse when they don't."
He said it's like witchcraft, it turns everything upside down. Phoebe Judge: One of the reasons Jon Ronson knows the checklist so well is because he
attended one of the diagnostic training courses taught by the creator of the checklist, Robert
Hare. Jon Ronson: It was just fascinating. It was in a Marquis in West Wales. Obviously I was the only journalist there.
Journalists tend not to go on these courses. Robert Hare was very generous to allow me to sit in on this course.
It's usually prison officers, care workers, people who have huge power over people's lives,
over their freedom. So, yeah, so I was in this Marquis and it was just great. It was exciting.
We'd watch these videos that Bob Hare would show us of interviews with people in prison,
these case studies. I remember one time Robert Hare surprised us. He was just giving a talk about something.
And he surprised us by flashing onto the screen behind his head, a close-up of a man who had
been shot in the face, and his face was just decimated. And all of us in the crowd went, "Ahh!"
Because our amygdala shot signals of fear, and distress, and remorse up and down to our
central nervous system, which shows that we're not psychopaths. I suffer from anxiety, which means I have an over-performing amygdala.
My amygdala is constantly shooting signals of fear and distress up and down to my central
nervous system. Anxiety, I think, is the neurological opposite of psychopathy. Because with psychopaths, neurologists say their amygdala underperforms.
So when a psychopath sees a picture of a blown-apart face, they don't respond, like I did, with
horror. They respond with something else, which is curiosity. They respond with curiosity.
Phoebe Judge: So that's the part of the brain that matters here. Will you explain that, the amygdala?
Jon Ronson: Yeah. The amygdala, it's the part of the brain that registers fear and distress, and remorse,
and anxiety and guilt. It shoots these signals up and down to the central nervous system.
Which always makes me think that fear, distress, remorse, guilt. [Music comes in.]
These are the feelings that keep us good. And psychopaths don't have those feelings, which is the reason why it's not a problem
for them to transgress. It always makes me think that psychopathy is one of the most pleasant-feeling of all
the mental disorders. [Laughs]. Because all of those feelings that we have that keep us good, they're unpleasant feelings.
Phoebe Judge: This brings us to the question of treatment. Can you teach distress, remorse, guilt?
Can you teach empathy? Back in the '60s, an eccentric young doctor named Elliott Barker set out to try.
He traveled all over the world, exploring different therapeutic approaches. Nude therapy in Palm Springs and radical psychiatry programs in London.
And he went on to get a job at the Oak Ridge Psychiatric Hospital in Ontario. Jon Ronson: Elliott Barker's idea was that psychopaths bury their madness beneath the
veneer of normality. And if you could somehow get the madness to the surface, you could treat it.
So his idea, having been on this odyssey, were LSD-fueled mammoth naked psychotherapy
sessions. So he got a whole bunch of people who had been diagnosed as psychopaths in this ward
in a hospital in Canada, and he made them strip naked. He quite often tied them to each other, and he'd give them these high doses of LSD.
And they would go through these long LSD sessions. And the idea was hopefully that the LSD and the nakedness and just the kind of extremity
of the situation would bring the madness to the surface. He had straws protruding from the wall.
So if any of them got hungry, they could suck liquid foods through the straws in the walls,
while they were naked and tied to each other and high on LSD. Anyway, amazingly enough, after all of these sessions, a change began to come over these
people who had been diagnosed as psychopaths. They started to seem much more empathetic.
And in fact, some cameras were allowed into Oak Ridge and they filmed the psychopaths
saying to each other, "There's such beauty in your eyes and I love you so much."
And it really seemed as if they'd become much more empathetic. And then they were released into the world.
And a number of years later, I think about 10 years later, somebody did a long-term recidivism
study on how many of these people who had gone on to reoffend. And usually, high-scoring psychopaths would go on to re-offend 60% of the time, but the
ones who had been through Elliott Barkers naked LSD psychotherapy sessions went on to
reoffend 80% of the time. So it actually made them worse. And one of them, a guy called Peter Woodcock was asked, "Well, how come it made you worse?"
And he said, "Well, it taught us how to fake empathy better." Phoebe Judge: Elliott Barker's program was shut down.
And since then, treatment approaches have been controversial. Turns out there's no pill for empathy.
A 2015 article in the Journal of Behavioral Sciences and the Law reads, "Many clinicians
have boycotted the idea of even attempting to treat high-risk psychopathic offenders.
And a number of corrections authorities have taken the position of quote 'sanctioned untreatability.'
" [Music comes in.] Pretty much everyone acknowledges that we will recognize ourselves in a couple of the
items on the Hare checklist. How could we not? Who isn't prone to boredom at times, or a little self-involved?
But what if you recognize yourself, or someone you know, in more than just a couple?
This is the subject of Dr. Schouten's book, Almost a Psychopath. He uses a list of 10 indicators that you, or someone you know, could be what he calls
an almost-psychopath. Here they are. Superficially charming and glib with an answer for everything.
An impaired ability to understand and appreciate the emotions of others. When faced with a decision, you rationalize a choice that's in your own self-interest.
Lying repeatedly, even when it's not necessary. Conning and manipulative. When you're criticized, it's always someone else's fault.
A lack of true remorse when you cause harm to others. Limited capacity to express feelings or maintain relationships.
You easily ignore responsibilities. And finally, people and situations exist solely for the purpose of your needs and wants.
Dr. Ronald Schouten: And the idea is that there are people who have collections of symptoms
of various types that don't meet the full criteria for a diagnosis as it's officially
listed, but in fact, suffer greatly — and the people around them suffer, as well — because
of those symptoms. Phoebe Judge: If we think that our wife or boss might be an almost-psychopath, what should
we keep in mind here? Dr. Ronald Schouten: Protect yourself. Keep track of what's going on.
You maybe keep some notes about behaviors, experiences that you've found odd. This notion of gaslighting, these folks will often gaslight their victims, the people in
their relationships, so that you're left scratching your head saying, "Oh, well maybe I did screw
that up. Maybe I did forget that. Maybe I was supposed to do whatever the task was involved, or to behave in a certain way."
If someone else is putting blame on you in that relationship, you want to keep track
of those things, so that you can go back at a later date, especially if you get some help
and get some consultation, so you can walk through these events. Because most of us tend to brush these things off.
Again, our better nature is to think the best of other people and certainly not to think
negatively. And so we'll tend to dismiss some of these events, some of these experiences that we
have, and then only much later, when you look at the whole issue, oh my goodness, look what
has been going on here this entire time. Jon Ronson: One time, I asked Martha Stout, who's a leading Harvard psychologist in this
field. And I said, "If you're married to a psychopath, what's your advice?" And she said, "My advice is leave.
Just leave them." She said, "You can't hurt their feelings, because there aren't any feelings to hurt."
[Music comes in.] Phoebe Judge: But, how could you ever know for sure that there aren't feelings to hurt?
And how in the world do you make that decision when it's someone you love? If I had met you back in 2005, would you have said... if I asked about, your relationship
with your mother, would you have said, "Yeah, we're close. She's a great mother.
She was a great mother growing up." What would you have said? Axton Betz-Hamilton: I would have agreed to all of that.
I would have said we're very close, she's supportive of me, that we talk every day,
and you know, that it was a normal relationship. And based on what I knew growing up, I thought what we had was normal.
Phoebe Judge: Criminal is produced by Lauren Spohrer, Nadia Wilson, and me. Audio mix by Rob Byers.
Alice Wilder is our intern. Julienne Alexander makes original illustrations for each episode of Criminal.
You can see them at thisiscriminal.com. Criminal is recorded in the studios of North Carolina Public Radio, WUNC.
We're a proud member of Radiotopia from PRX, a collective of the best podcasts around.
Shows like Love and Radio. Their new season is just out. Love and Radio is a show that doesn't tell you how to feel, it just presents you with
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No one else is doing anything like it. That's Love and Radio — go listen. Radiotopia from PRX is supported by the Knight Foundation and MailChimp, celebrating creativity,
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I'm Phoebe Judge. This is Criminal. Jingle: Radiotopia. From PRX.

SPOILER WARNING: Please listen to Episode 51: Money Tree before you listen to this one: https://youtu.be/V67gAOPL2J0

While working on our last episode, we became curious about the nature of psychopathy — how it is defined, and what to do if someone close to you meets the criteria of the Hare psychopathy test. We spoke with Dr. Ronald Schouten, author of Almost a Psychopath, and Jon Ronson, author of The Psychopath Test.

Music in the episode: “The Dinner Party (Instrumental)” by Nick Jaina “The Little Things” by Josh Spacek “Divider” by Chris Zabriskie “Am I The Devil (Instrumental)” by YEYEY “Holy Roller (Instrumental)” by YACHT “A Storm at Eilean Mor” by Jon Luc Hefferman

Criminal is a show about people who’ve done wrong, been wronged, or gotten caught somewhere in the middle. Hosted by Phoebe Judge. Part of the Vox Media Podcast Network.

Follow the show on Apple Podcasts, Spotify, or wherever you get your podcasts. https://link.chtbl.com/n33u0HsA

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We also make This is Love and Phoebe Reads a Mystery.

Artwork by Julienne Alexander http://www.yssrs.com/.

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Episode transcripts are posted on our website https://thisiscriminal.com/.

Episode 52 originally published 10/06/2016 https://thisiscriminal.com/episode-52-the-checklist

Brief Summary

Axton Betz-Hamilton reveals her mother as a lifelong identity thief, exploring psychopathy and its traits with experts Dr. Ronald Schouten and Jon Ronson.

Key points

Axton's Shocking Discovery. Axton Betz-Hamilton learns her mother stole her identity for decades, racking up massive debt.
Understanding Psychopathy. Dr. Ronald Schouten explains the traits of psychopaths and their prevalence in society.
The Hare Checklist. Jon Ronson walks us through the 20-point checklist used to diagnose psychopathy.
Failed Treatment Attempts. Elliott Barker's radical therapy for psychopaths backfires, making them worse.

Episode highlights

Episode quotes

If my mother was a psychopath, she didn't feel guilt.

Axton Betz-Hamilton reflects on her mother's actions.

0:21WatchNov 30, 2022

Tension

60/ 100Some tension

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