From January, Randi Rosenqvist will retire from her job as a senior adviser and specialist in psychiatry at Ila Prison and Detention Centre. But she will continue to pursue her interest in criminals and teach students about them at Oslo University Hospital.
From January, Randi Rosenqvist will retire from her job as a senior adviser and specialist in psychiatry at Ila Prison and Detention Centre. But she will continue to pursue her interest in criminals and teach students about them at Oslo University Hospital.

We should spend more time studying successful psychopaths, says forensic psychiatrist Randi Rosenqvist

Upon retiring, forensic psychiatrist Randi Rosenqvist talks to ScienceNorway.no about abnormalities in the brains of psychopaths, how it would be interesting to study successful psychopaths, and why she doesn’t actually like the term psychopaths.

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Randi Rosenqvist, a well-known psychiatrist in Norway, has worked throughout her professional career at the interface between psychiatry and criminal justice. Her most famous case involved Anders Behring Brevik, the Norwegian terrorist who killed 77 people in 2011.

As of January 2020 Rosenqvist is retired from her job as a senior advisor and specialist in psychiatry at Ila prison and Detention Centre.

But she will continue to pursue her interest in criminals and teach students about them at Oslo University Hospital.

Doesn’t like the term

She has liked working with aggressive men, which has meant she has had to work with psychopaths.

But Rosenqvist doesn't like the term psychopath very much.

“Psychopathy is a collection of personality traits. We all have personalities that consist of many personality traits. I prefer the term ‘having many psychopathic traits’,” she says.

We all have psychopathic traits, but it only becomes a problem when there are many of them.

And not everyone with these traits ends up in prison, Rosenqvist says.

Smart psychopaths can go very far in today’s society.

Brain abnormalities

Like Rosenqvist, Marianne Kristiansson has a long professional career in forensic psychiatry.

Not a diagnosis

Psychopathy has been described in psychiatry since the 18th century, but it is not a diagnosis. Psychopathy as we use it today is a psychological concept that was developed around 30 years ago and that falls outside the two diagnostic systems found in Europe and the United States.

Modern psychopathy research has developed a clinical checklist called the Psychopathy Checklist - revised (PCL-r). It lists 20 perceived personality traits and recorded behaviours that are used to predict risk of psychopathic behaviour.

She works as a consultant at the Swedish National Board of Forensic Medicine and as a researcher at the Karolinska Institutet. She recently published the book Psykopaten - Verkligheten bortom myten. - The Psychopath - The Reality Beyond Myth, written with her colleague Karolina Sörman.

In a lecture in Stockholm recently, Kristiansson talked about new brain research on psychopathic individuals.

She says a lot of research is now being done using modern imaging techniques that will give us a better understanding of what psychopathy is.

Preliminary findings from these studies show that there are abnormalities in the brain that can be linked to psychopathic traits.

No sure conclusions

It’s not yet possible to draw conclusions from this research, Kristiansson says.

“But it is interesting that we find changes in areas of the brain that deal with emotions, such as the amygdala, in people with psychopathic traits. This is an area that, above all, handles negative emotions and threats,” she says.

Marianne Kristiansson says that the amygdala in the brain is a hub for processing emotions. She believes that modern brain research will give us a better understanding of people with psychopathic traits.
Marianne Kristiansson says that the amygdala in the brain is a hub for processing emotions. She believes that modern brain research will give us a better understanding of people with psychopathic traits.

It also appears that psychopathic people process things more in cognitive areas of the brain, compared to emotional areas, she says.

“Those who have pronounced psychopathic traits do not care about human emotions. But they may find that they can exploit them.”

Good with control

The brain also has an area called the insula. This part of the brain monitors and controls the body’s various organs.

Some studies indicate that people with pronounced psychopathic traits have increased activity in this area. They can be good at controlling their own behaviour, says Kristiansson.

Kristiansson does not believe that future brain research will find a specific place in the brain that could explain complex behaviours like psychopathy. This is not how the brain works, its many networks are simply too complicated.

And research in this area is also very difficult, she says, because it is difficult to control for other background and environmental factors.

Should they be given stricter penalties?

The more we learn about the brain, the more we will understand why some brains work differently. This opens up exciting, but also frightening perspectives, Rosenqvist believes.

“The more we know, the more we can manipulate the brain. This could open the door to a lot of provocative things,” she says.

Rosenqvist says if it can be demonstrated in the future that people with psychopathic traits have brains that are different than others, it could have consequences for the justice system.

“It’s possible to imagine that people would make the argument that individuals who are unable to feel empathy should face stricter penalties,” she says.

Unlikely to be relevant in Norway

Norway has a type of detention called a custodial sentence. The courts can impose this sentence if they find that ordinary prison sentences will not be sufficient to protect society from the individual.

“In traditional Norwegian criminal law, the thought is if you are convicted 18 times for violence, ordinary punishment does not help. Then you might get a custodial sentence instead,” she explains.

It’s not outside the realm of possibilities that there might be a requirement for first-time offenders convicted of violent acts to have an image taken of their brain to see if they have any abnormalities, Rosenqvist says.

“Some people might think that young people with a brain defect should be imprisoned while they are still young. This is more relevant to American justice. I don’t think this will be relevant in Norway or Europe,” she says.

Rosenqvist herself thinks this form of screening would be a bad idea.

They also have a choice

Just because you have psychopathic traits doesn’t mean that you will commit criminal acts, the forensic psychiatrist says.

“We know that personality traits are something that are stable in us. We can't do anything about them, but the vast majority of us can choose how we act,” she says.

Psychopathy is both inheritance and environment, Rosenqvist believes.

“Everyone who is the parent of more than one child knows that each child has different personality traits, but that their upbringing can adjust things. It's not that the introverts get extroverted. But introverts can become a little more extroverted if they have a safe upbringing. If their upbringing inhibits their development, they may continue to be very cautious,” she says.

If you are married to a psychopath: Run!

A good number of people believe that the person they fell in love with and have loved for many years suddenly develops ‘psychopathic traits’ in connection with a divorce. “That does not mean that this person is a psychopath,”says Rosenqvist.

“But we can all be quite destructive if we are sufficiently pressured,” she adds.

She says if you've truly been so unlucky as to marry a psychopath, you should get out of that marriage.

“You can't win if you're in a conflict with a psychopath. But understanding that something is wrong with your spouse's brain may help you understand that it is not your fault that he or she is an asshole,” she says.

Smart psychopaths can go far

One problem with research on psychopathy is that it largely only deals with criminals. Rosenqvist believes it would be very interesting to spend more time studying successful psychopaths.

She thinks it's important to say that psychopathic traits can be found in successful people, too. Some people with lots of psychopathic traits may just be very good at not getting caught. They can be both con artists and stock speculators.

“When journalists refer to some people as ‘financial acrobats’, I think it's a simple way to refer to psychopaths,” she said.

We need psychopaths

“Society also needs people with psychopathic traits,”Rosenqvist says.

Some of these traits can be useful in various aspects of society. It may be that only people with these traits are willing to do things that are high risk. They don’t have the same concerns as others.

“When the British Royal Airforce tested bombers during World War II, they wanted people with slightly psychopathic traits. These individuals could fly over a village and drop a bomb without thinking that there were women and children in that village as well. Those who were more concerned with these things couldn’t tolerate the stress,” she says.

But these young men do not fit all roles.

“It’s very effective in wartime if dropping bombs doesn’t distress you. But these individuals shouldn’t be so immune to violence that they don’t care about their fellow pilots,” Rosenqvist said.

More psychopaths in the United States

Popular culture is full of psychopaths. Films, television series, books and popular science all tell us that we are surrounded by psychopaths.

Rosenqvist and her Swedish counterpart Kristiansson say this is simply not true.

“Probably one to two per cent of the European population have so many psychopathic traits that it can be reasonably said they are psychopaths. That’s the same as the number of twins. But there are slightly more in America, maybe three to four per cent,”says Rosenqvist.

She says it might be that people who emigrated to America and provided the gene pool to the New World might have had more of the genetics that made them develop psychopathy.

“I can’t discount that,” she says.

Another possible explanation is that American society is much tougher on people than European society, she believes.

“People in the US may not ‘grind down’ their childhood psychopathic traits in the same way as in Europe. They may be encouraged to flourish in the United States. It’s easy to think of one famous American individual right now who has many psychopathic traits,” she says.

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Read the Norwegian version of this article at forskning.no