{"id":1524,"date":"2017-06-01T07:32:30","date_gmt":"2017-06-01T14:32:30","guid":{"rendered":"https:\/\/worldcampaign.net\/?p=1524"},"modified":"2017-06-01T07:46:14","modified_gmt":"2017-06-01T14:46:14","slug":"when-your-child-is-a-psychopath-the-atlantic-magazine","status":"publish","type":"post","link":"https:\/\/worldcampaign.net\/?p=1524","title":{"rendered":"&#8220;When Your Child Is a Psychopath&#8221;, The Atlantic Magazine"},"content":{"rendered":"<p>Barbara Bradley Hagerty, June 2017 Issue<\/p>\n<p>The condition has long been considered untreatable. Experts can spot it in a child as young as 3 or 4. But a new clinical approach offers hope.<\/p>\n<p><span class=\"smallcaps\">This is a good day,<\/span> Samantha tells me: 10 on a scale of 10. We\u2019re sitting in a conference room at the San Marcos Treatment Center, just south of Austin, Texas, a space that has witnessed countless difficult conversations between troubled children, their worried parents, and clinical therapists. But today promises unalloyed joy. Samantha\u2019s mother is visiting from Idaho, as she does every six weeks, which means lunch off campus and an excursion to Target. The girl needs supplies: new jeans, yoga pants, nail polish.<\/p>\n<p><em class=\"letter-writer-info\">Listen to the audio version of this article:<\/em><iframe loading=\"lazy\" id=\"iFrameResizer0\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/322550608%3Fsecret_token%3Ds-s22f4&amp;color=ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\"><\/iframe><a href=\"https:\/\/goo.gl\/cO6bLE\" data-omni-click=\"r'article',r'link',r'0',r'524502'\"><em class=\"letter-writer-info\">Download the Audm app<\/em><\/a><em class=\"letter-writer-info\"> for your iPhone to listen to more titles.<\/em><\/p>\n<p>At 11, Samantha is just over 5 feet tall and has wavy black hair and a steady gaze. She flashes a smile when I ask about her favorite subject (history), and grimaces when I ask about her least favorite (math). She seems poised and cheerful, a normal preteen. But when we steer into uncomfortable territory\u2014the events that led her to this juvenile-treatment facility nearly 2,000 miles from her family\u2014Samantha hesitates and looks down at her hands. \u201cI wanted the whole world to myself,\u201d she says. \u201cSo I made a whole entire book about how to hurt people.\u201d<\/p>\n<p>Starting at age 6, Samantha began drawing pictures of murder weapons: a knife, a bow and arrow, chemicals for poisoning, a plastic bag for suffocating. She tells me that she pretended to kill her stuffed animals.<\/p>\n<p>\u201cYou were practicing on your stuffed animals?,\u201d I ask her.<\/p>\n<p>She nods.<\/p>\n<p>\u201cHow did you feel when you were doing that to your stuffed animals?\u201d<\/p>\n<p>\u201cHappy.\u201d<\/p>\n<p>\u201cWhy did it make you feel happy?\u201d<\/p>\n<p>\u201cBecause I thought that someday I was going to end up doing it on somebody.\u201d<\/p>\n<p>\u201cDid you ever try?\u201d<\/p>\n<p>Silence.<\/p>\n<p>\u201cI choked my little brother.\u201d<\/p>\n<p>Samantha\u2019s parents, Jen and Danny, adopted Samantha when she was 2. They already had three biological children, but they felt called to add Samantha (not her real name) and her half sister, who is two years older, to their family. They later had two more kids.<\/p>\n<p>From the start, Samantha seemed a willful child, in tyrannical need of attention. But what toddler isn\u2019t? Her biological mother had been forced to give her up because she\u2019d lost her job and home and couldn\u2019t provide for her four children, but there was no evidence of abuse. According to documentation from the state of Texas, Samantha met all her cognitive, emotional, and physical milestones. She had no learning disabilities, no emotional scars, no signs of ADHD or autism.<\/p>\n<p>But even at a very young age, Samantha had a mean streak. When she was about 20 months old, living with foster parents in Texas, she clashed with a boy in day care. The caretaker soothed them both; problem solved. Later that day Samantha, who was already potty trained, walked over to where the boy was playing, pulled down her pants, and peed on him. \u201cShe knew exactly what she was doing,\u201d Jen says. \u201cThere was an ability to wait until an opportune moment to exact her revenge on someone.\u201d<\/p>\n<p>When Samantha got a little older, she would pinch, trip, or push her siblings and smile if they cried. She would break into her sister\u2019s piggy bank and rip up all the bills. Once, when Samantha was 5, Jen scolded her for being mean to one of her siblings. Samantha walked upstairs to her parents\u2019 bathroom and washed her mother\u2019s contact lenses down the drain. \u201cHer behavior wasn\u2019t impulsive,\u201d Jen says. \u201cIt was very thoughtful, premeditated.\u201d<\/p>\n<p>Jen, a former elementary-school teacher, and Danny, a physician, realized they were out of their depth. They consulted doctors, psychiatrists, and therapists. But Samantha only grew more dangerous. They had her admitted to a psychiatric hospital three times before sending her to a residential treatment program in Montana at age 6. Samantha would grow out of it, one psychologist assured her parents; the problem was merely delayed empathy. Samantha was impulsive, another said, something that medication would fix. Yet another suggested that she had reactive attachment disorder, which could be ameliorated with intensive therapy. More darkly\u2014and typically, in these sorts of cases\u2014another psychologist blamed Jen and Danny, implying that Samantha was reacting to harsh and unloving parenting.<\/p>\n<p>One bitter December day in 2011, Jen was driving the children along a winding road near their home. Samantha had just turned 6. Suddenly Jen heard screaming from the back seat, and when she looked in the mirror, she saw Samantha with her hands around the throat of her 2-year-old sister, who was trapped in her car seat. Jen separated them, and once they were home, she pulled Samantha aside.<\/p>\n<p>\u201cWhat were you doing?,\u201d Jen asked.<\/p>\n<p>\u201cI was trying to choke her,\u201d Samantha said.<\/p>\n<p>\u201cYou realize that would have killed her? She would not have been able to breathe. <i>She would have died<\/i>.\u201d<\/p>\n<p>\u201cI know.\u201d<\/p>\n<p>\u201cWhat about the rest of us?\u201d<\/p>\n<p>\u201cI want to kill all of you.\u201d<\/p>\n<p>Samantha later showed Jen her sketches, and Jen watched in horror as her daughter demonstrated how to strangle or suffocate her stuffed animals. \u201cI was so terrified,\u201d Jen says. \u201cI felt like I had lost control.\u201d<\/p>\n<p>Four months later, Samantha tried to strangle her baby brother, who was just two months old.<\/p>\n<p>Jen and Danny had to admit that nothing seemed to make a difference\u2014not affection, not discipline, not therapy. \u201cI was reading and reading and reading, trying to figure out what diagnosis made sense,\u201d Jen tells me. \u201cWhat fits with the behaviors I\u2019m seeing?\u201d Eventually she found one condition that did seem to fit\u2014but it was a diagnosis that all the mental-health professionals had dismissed, because it\u2019s considered both rare and untreatable. In July 2013, Jen took Samantha to see a psychiatrist in New York City, who confirmed her suspicion.<\/p>\n<p>\u201cIn the children\u2019s mental-health world, it\u2019s pretty much a terminal diagnosis, except your child\u2019s not going to die,\u201d Jen says. \u201cIt\u2019s just that there\u2019s no help.\u201d She recalls walking out of the psychiatrist\u2019s office on that warm afternoon and standing on a street corner in Manhattan as pedestrians pushed past her in a blur. A feeling flooded over her, singular, unexpected. Hope. Someone had finally acknowledged her family\u2019s plight. Perhaps she and Danny could, against the odds, find a way to help their daughter.<\/p>\n<p>Samantha was diagnosed with conduct disorder with callous and unemotional traits. She had all the characteristics of a budding psychopath.<\/p>\n<div class=\"ad-boxright-wrapper\" data-pos=\"boxright\">\n<section id=\"article-section-5\">\n<p class=\"dropcap\"><span class=\"smallcaps\">Psychopaths have always<\/span> been with us. Indeed, certain psychopathic traits have survived because they\u2019re useful in small doses: the cool dispassion of a surgeon, the tunnel vision of an Olympic athlete, the ambitious narcissism of many a politician. But when these attributes exist in the wrong combination or in extreme forms, they can produce a dangerously antisocial individual, or even a cold-blooded killer. Only in the past quarter century have researchers zeroed in on the early signs that indicate a child could be the next Ted Bundy.<\/p>\n<p>Researchers shy away from calling children psychopaths; the term carries too much stigma, and too much determinism. They prefer to describe children like Samantha as having \u201ccallous and unemotional traits,\u201d shorthand for <a href=\"https:\/\/books.google.com\/books?id=oemMDQAAQBAJ&amp;pg=PA192&amp;lpg=PA192&amp;dq=%22items+of+the+youth+psychopathy+checklist%22&amp;source=bl&amp;ots=WtGynO2T6t&amp;sig=w1dhWktYGuMktEisxrWanbyZ-2c&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwio3sqcu9nTAhUCKyYKHZ99DBUQ6AEIIzAA#v=onepage&amp;q=%22items%20of%20the%20youth%20psychopathy%20checklist%22&amp;f=false\" target=\"_blank\" data-omni-click=\"r'article',r'link',r'1',r'524502'\">a cluster of characteristics and behaviors<\/a>, including a lack of empathy, remorse, or guilt; shallow emotions; aggression and even cruelty; and a seeming indifference to punishment. Callous and unemotional children have no trouble hurting others to get what they want. If they do seem caring or empathetic, they\u2019re probably trying to manipulate you.<\/p>\n<p>Researchers believe that nearly 1 percent of children exhibit these traits, about as many as have autism or bipolar disorder. Until recently, the condition was seldom mentioned. Only in 2013 did the American Psychiatric Association include callous and unemotional traits in its diagnostic manual, <i>DSM-5<\/i>. The condition can go unnoticed because many children with these traits\u2014who can be charming and smart enough to mimic social cues\u2014are able to mask them.<\/p>\n<p>More than 50 studies have found that kids with callous and unemotional traits are more likely than other kids (three times more likely, in one study) to become criminals or display aggressive, psychopathic traits later in life. And while adult psychopaths constitute only a tiny fraction of the general population, studies suggest that they commit half of all violent crimes. Ignore the problem, says Adrian Raine, a psychologist at the University of Pennsylvania, \u201cand it could be argued we have blood on our hands.\u201d<\/p>\n<\/section>\n<div class=\"ad-boxinjector-wrapper\">\n<p>Researchers believe that two paths can lead to psychopathy: one dominated by nature, the other by nurture. For some children, their environment\u2014growing up in poverty, living with abusive parents, fending for themselves in dangerous neighborhoods\u2014can turn them violent and coldhearted. These kids aren\u2019t born callous and unemotional; many experts suggest that if they\u2019re given a reprieve from their environment, they can be pulled back from psychopathy\u2019s edge.<\/p>\n<p>But other children display callous and unemotional traits even though they are raised by loving parents in safe neighborhoods. Large studies in the United Kingdom and elsewhere have found that this early-onset condition is highly hereditary, hardwired in the brain\u2014and especially difficult to treat. \u201cWe\u2019d like to think a mother and father\u2019s love can turn everything around,\u201d Raine says. \u201cBut there are times where parents are doing the very best they can, but the kid\u2014even from the get-go\u2014is just a bad kid.\u201d<\/p>\n<p>Still, researchers stress that a callous child\u2014even one who was born that way\u2014is not automatically destined for psychopathy. By some estimates, four out of five children with these traits do not grow up to be psychopaths. The mystery\u2014the one everyone is trying to solve\u2014is why some of these children develop into normal adults while others end up on death row.<\/p>\n<\/div>\n<\/div>\n<div class=\"ad-boxinjector-wrapper\">\n<section id=\"article-section-7\">\n<p class=\"dropcap\"><span class=\"smallcaps\">A trained eye can spot<\/span> a callous and unemotional child by age 3 or 4. Whereas normally developing children at that age grow agitated when they see other children cry\u2014and either try to comfort them or bolt the scene\u2014these kids show a chilly detachment. In fact, psychologists may even be able to trace these traits back to infancy. Researchers at King\u2019s College London tested more than 200 five-week-old babies, tracking whether they preferred looking at a person\u2019s face or at a red ball. Those who favored the ball displayed more callous traits two and a half years later.<\/p>\n<p>As a child gets older, more-obvious warning signs appear. Kent Kiehl, a psychologist at the University of New Mexico and the author of <i>The Psychopath Whisperer<\/i>, says that one scary harbinger occurs when a kid who is 8, 9, or 10 years old commits a transgression or a crime while alone, without the pressure of peers. This reflects an interior impulse toward harm. Criminal versatility\u2014committing different types of crimes in different settings\u2014can also hint at future psychopathy.<\/p>\n<p>But the biggest red flag is early violence. \u201cMost of the psychopaths I meet in prison had been in fights with teachers in elementary school or junior high,\u201d Kiehl says. \u201cWhen I\u2019d interview them, I\u2019d say, \u2018What\u2019s the worst thing you did in school?\u2019 And they\u2019d say, \u2018I beat the teacher unconscious.\u2019 You\u2019re like, <i>That really happened?<\/i> It turns out that\u2019s very common.\u201d<\/p>\n<p>We have a fairly good idea of what an adult psychopathic brain looks like, thanks in part to Kiehl\u2019s work. He has scanned the brains of hundreds of inmates at maximum-security prisons and chronicled the neural differences between average violent convicts and psychopaths. Broadly speaking, Kiehl and others believe that the psychopathic brain has at least two neural abnormalities\u2014and that these same differences likely also occur in the brains of callous children.<\/p>\n<p>The first abnormality appears in the limbic system, the set of brain structures involved in, among other things, processing emotions. In a psychopath\u2019s brain, this area contains less gray matter. \u201cIt\u2019s like a weaker muscle,\u201d Kiehl says. A psychopath may understand, intellectually, that what he is doing is wrong, but he doesn\u2019t <i>feel<\/i> it. \u201cPsychopaths know the words but not the music\u201d is how Kiehl describes it. \u201cThey just don\u2019t have the same circuitry.\u201d<\/p>\n<p>In particular, experts point to the amygdala\u2014a part of the limbic system\u2014as a physiological culprit for coldhearted or violent behavior. Someone with an undersize or underactive amygdala may not be able to feel empathy or refrain from violence. For example, many psychopathic adults and callous children do not recognize fear or distress in other people\u2019s faces. Essi Viding, a professor of developmental psychopathology at University College London recalls showing one psychopathic prisoner a series of faces with different expressions. When the prisoner came to a fearful face, he said, \u201cI don\u2019t know what you call this emotion, but it\u2019s what people look like just before you stab them.\u201d<\/p>\n<p>Why does this neural quirk matter? Abigail Marsh, a researcher at Georgetown University who has studied the brains of callous and unemotional children, says that distress cues, such as fearful or sad expressions, signal submission and conciliation. \u201cThey\u2019re designed to prevent attacks by raising the white flag. And so if you\u2019re not sensitive to these cues, you\u2019re much more likely to attack somebody whom other people would refrain from attacking.\u201d<\/p>\n<p>Psychopaths not only fail to recognize distress in others, they may not feel it themselves. The best physiological indicator of which young people will become violent criminals as adults is a low resting heart rate, says Adrian Raine of the University of Pennsylvania. Longitudinal studies that followed thousands of men in Sweden, the U.K., and Brazil all point to this biological anomaly. \u201cWe think that low heart rate reflects a lack of fear, and a lack of fear could predispose someone to committing fearless criminal-violence acts,\u201d Raine says. Or perhaps there is an \u201coptimal level of physiological arousal,\u201d and psychopathic people seek out stimulation to increase their heart rate to normal. \u201cFor some kids, one way of getting this arousal jag in life is by shoplifting, or joining a gang, or robbing a store, or getting into a fight.\u201d Indeed, when Daniel Waschbusch, a clinical psychologist at Penn State Hershey Medical Center, gave the most severely callous and unemotional children he worked with a stimulative medication, their behavior improved.<\/p>\n<p>The second hallmark of a psychopathic brain is an overactive reward system especially primed for drugs, sex, or anything else that delivers a ping of excitement. In one study, children played a computer gambling game programmed to allow them to win early on and then slowly begin to lose. Most people will cut their losses at some point, Kent Kiehl notes, \u201cwhereas the psychopathic, callous unemotional kids keep going until they lose everything.\u201d Their brakes don\u2019t work, he says.<\/p>\n<p>Faulty brakes may help explain why psychopaths commit brutal crimes: Their brains ignore cues about danger or punishment. \u201cThere are all these decisions we make based on threat, or the fear that something bad can happen,\u201d says Dustin Pardini, a clinical psychologist and an associate professor of criminology at Arizona State University. \u201cIf you have less concern about the negative consequences of your actions, then you\u2019ll be more likely to continue engaging in these behaviors. And when you get caught, you\u2019ll be less likely to learn from your mistakes.\u201d<\/p>\n<p>Researchers see this insensitivity to punishment even in some toddlers. \u201cThese are the kids that are completely unperturbed by the fact that they\u2019ve been put in time-out,\u201d says Eva Kimonis, who works with callous children and their families at the University of New South Wales, in Australia. \u201cSo it\u2019s not surprising that they keep going to time-out, because it\u2019s not effective for them. Whereas reward\u2014they\u2019re very motivated by that.\u201d<\/p>\n<p>This insight is driving a new wave of treatment. What\u2019s a clinician to do if the emotional, empathetic part of a child\u2019s brain is broken but the reward part of the brain is humming along? \u201cYou co-opt the system,\u201d Kiehl says. \u201cYou work with what\u2019s left.\u201d<\/p>\n<p class=\"dropcap\"><span class=\"smallcaps\">With each passing year, <\/span>both nature and nurture conspire to steer a callous child toward psychopathy and block his exits to a normal life. His brain becomes a little less malleable; his environment grows less forgiving as his exhausted parents reach their limits, and as teachers, social workers, and judges begin to turn away. By his teenage years, he may not be a lost cause, since the rational part of his brain is still under construction. But he can be one scary dude.<\/p>\n<p>Like the guy standing 20 feet away from me in the North Hall of Mendota Juvenile Treatment Center, in Madison, Wisconsin. The tall, lanky teenager has just emerged from his cell. Two staff members cuff his wrists, shackle his feet, and begin to lead him away. Suddenly he swivels to face me and laughs\u2014a menacing laugh that gives me chills. As young men yell expletives, banging on the metal doors of their cells, and others stare silently through their narrow plexiglass windows, I think, <i>This is as close as I get to <\/i>Lord of the Flies.<\/p>\n<p>The psychologists Michael Caldwell and Greg Van Rybroek thought much the same thing when they opened the Mendota facility in 1995, in response to a nationwide epidemic of youth violence in the early \u201990s. Instead of placing young offenders in a juvenile prison until they were released to commit more\u2014and more violent\u2014crimes as adults, the Wisconsin legislature set up a new treatment center to try to break the cycle of pathology. Mendota would operate within the Department of Health Services, not the Department of Corrections. It would be run by psychologists and psychiatric-care technicians, not wardens and guards. It would employ one staff member for every three kids\u2014quadruple the ratio at other juvenile-corrections facilities.<\/p>\n<p>Caldwell and Van Rybroek tell me that the state\u2019s high-security juvenile-corrections facility was supposed to send over its most mentally ill boys between the ages of 12 and 17. It did, but what Caldwell and Van Rybroek didn\u2019t anticipate was that the boys the facility transferred were also its most menacing and recalcitrant. They recall their first few assessments. \u201cThe kid would walk out and we would turn to each other and say, \u2018That\u2019s the most dangerous person I\u2019ve ever seen in my life,\u2019\u2009\u201d Caldwell says. Each one seemed more threatening than the last. \u201cWe\u2019re looking at each other and saying, \u2018Oh, no. What have we done?,\u2019\u2009\u201d Van Rybroek adds.<\/p>\n<p>What they have done, by trial and error, is achieve something most people thought impossible: If they haven\u2019t <i>cured<\/i> psychopathy, they\u2019ve at least tamed it.<\/p>\n<p>Many of the teenagers at Mendota grew up on the streets, without parents, and were beaten up or sexually abused. Violence became a defense mechanism. Caldwell and Van Rybroek recall a group-therapy session a few years ago in which one boy described being strung up by his wrists and hung from the ceiling as his father cut him with a knife and rubbed pepper in the wounds. \u201cHey,\u201d several other kids said, \u201cthat\u2019s like what happened to me.\u201d They called themselves the \u201cpi\u00f1ata club.\u201d<\/p>\n<p>But not everyone at Mendota was \u201cborn in hell,\u201d as Van Rybroek puts it. Some of the boys were raised in middle-class homes with parents whose major sin was not abuse but paralysis in the face of their terrifying child. No matter the history, one secret to diverting them from adult psychopathy is to wage an unrelenting war of presence. At Mendota, the staff calls this \u201cdecompression.\u201d The idea is to allow a young man who has been living in a state of chaos to slowly rise to the surface and acclimate to the world without resorting to violence.<\/p>\n<p>Forming attachments with callous kids is important, but it\u2019s not Mendota\u2019s singular insight. The center\u2019s real breakthrough involves deploying the anomalies of the psychopathic brain to one\u2019s advantage\u2014specifically, downplaying punishment and dangling rewards. These boys have been expelled from school, placed in group homes, arrested, and jailed. If punishment were going to rein them in, it would have by now. But their brains do respond, enthusiastically, to rewards. At Mendota, the boys can accumulate points to join ever more prestigious \u201cclubs\u201d (Club 19, Club 23, the VIP Club). As they ascend in status, they earn privileges and treats\u2014candy bars, baseball cards, pizza on Saturdays, the chance to play Xbox or stay up late. Hitting someone, throwing urine, or cussing out the staff costs a boy points\u2014but not for long, since callous and unemotional kids aren\u2019t generally deterred by punishment.<\/p>\n<p>I am, frankly, skeptical\u2014will a kid who knocked down an elderly lady and stole her Social Security check (as one Mendota resident did) really be motivated by the promise of Pok\u00e9mon cards? But then I walk down the South Hall with Ebsen. She stops and turns toward a door on our left. \u201cHey,\u201d she calls, \u201cdo I hear internet radio?\u201d<\/p>\n<p>\u201cYeah, yeah, I\u2019m in the VIP Club,\u201d a voice says. \u201cCan I show you my basketball cards?\u201d<\/p>\n<p>Ebsen unlocks the door to reveal a skinny 17-year-old boy with a nascent mustache. He fans out his collection. \u201cThis is, like, 50 basketball cards,\u201d he says, and I can almost see his reward centers glowing. \u201cI have the most and best basketball cards here.\u201d Later, he sketches out his history for me: His stepmother had routinely beat him and his stepbrother had used him for sex. When he was still a preteen, he began molesting the younger girl and boy next door. The abuse continued for a few years, until the boy told his mother. \u201cI knew it was wrong, but I didn\u2019t care,\u201d he says. \u201cI just wanted the pleasure.&#8221;<\/p>\n<p>At Mendota, he has begun to see that short-term pleasure could land him in prison as a sex offender, while deferred gratification can confer more-lasting dividends: a family, a job, and most of all, freedom. Unlikely as it sounds, this revelation sprang from his ardent pursuit of basketball cards.<\/p>\n<p>After he details the center\u2019s point system (a higher math that I cannot follow), the boy tells me that a similar approach should translate into success in the outside world\u2014as if the world, too, operates on a point system. Just as consistent good behavior confers basketball cards and internet radio inside these walls, so\u2014he believes\u2014will it bring promotions at work. \u201cSay you\u2019re a cook; you can [become] a waitress if you\u2019re doing really good,\u201d he says. \u201cThat\u2019s the way I look at it.\u201d<\/p>\n<p>He peers at me, as if searching for confirmation. I nod, hoping that the world will work this way for him. Even more, I hope his insight will endure.<\/p>\n<p class=\"dropcap\"><span class=\"smallcaps\">In fact, the program<\/span> at Mendota has changed the trajectory for many young men, at least in the short term. Caldwell and Van Rybroek have tracked the public records of 248 juvenile delinquents after their release. One hundred forty-seven of them had been in a juvenile-corrections facility, and 101 of them\u2014the harder, more psychopathic cases\u2014had received treatment at Mendota. In the four and a half years since their release, the Mendota boys have been far less likely to reoffend (64 percent versus 97 percent), and far less likely to commit a violent crime (36 percent versus 60 percent). Most striking, the ordinary delinquents have killed 16 people since their release. The boys from Mendota? Not one.<\/p>\n<p class=\"dropcap\">\u201cWe thought that as soon as they walked out the door, they\u2019d last maybe a week or two and they\u2019d have another felony on their record,\u201d Caldwell says. \u201cAnd when the data first came back that showed that that wasn\u2019t happening, we figured there was something wrong with the data.\u201d For two years, they tried to find mistakes or alternative explanations, but eventually they concluded that the results were real.<\/p>\n<div class=\"ad-boxinjector-wrapper\">\n<p>The question they are trying to answer now is this: Can Mendota\u2019s treatment program not only change the behavior of these teens, but measurably reshape their brains as well? Researchers are optimistic, in part because the decision-making part of the brain continues to evolve into one\u2019s mid\u201120s. The program is like neural weight lifting, Kent Kiehl, at the University of New Mexico, says. \u201cIf you exercise this limbic-related circuitry, it\u2019s going to get better.\u201d<\/p>\n<p>To test this hypothesis, Kiehl and the staff at Mendota are now asking some 300 young men to slide into a mobile brain scanner. The scanner records the shape and size of key areas of the boys\u2019 brains, as well as how their brains react to tests of decision-making ability, impulsivity, and other qualities that go to the core of psychopathy. Each boy\u2019s brain will be scanned before, during, and at the end of their time in the program, offering researchers insights into whether his improved behavior reflects better functioning inside his brain.<\/p>\n<p>No one believes that Mendota graduates will develop true empathy or a heartfelt moral conscience. \u201cThey may not go from the Joker in <i>The Dark Knight<\/i> to Mister Rogers,\u201d Caldwell tells me, laughing. But they can develop a <i>cognitive<\/i> moral conscience, an intellectual awareness that life will be more rewarding if they play by the rules. \u201cWe\u2019re just happy if they stay on this side of the law,\u201d Van Rybroek says. \u201cIn our world, that\u2019s huge.\u201d<\/p>\n<p class=\"dropcap\"><span class=\"smallcaps\">How many can stay<\/span> the course for a lifetime? Caldwell and Van Rybroek have no idea. They\u2019re barred from contacting former patients\u2014a policy meant to ensure that the staff and former patients maintain appropriate boundaries. But sometimes graduates write or call to share their progress, and among these correspondents, Carl, now 37, stands out.<\/p>\n<p>Carl (not his real name) emailed a thankful note to Van Rybroek in 2013. Aside from one assault conviction after he left Mendota, he had stayed out of trouble for a decade and opened his own business\u2014a funeral home near Los Angeles. His success was especially significant because he was one of the harder cases, a boy from a good home who seemed wired for violence.<\/p>\n<p>Carl was born in a small town in Wisconsin. The middle child of a computer programmer and a special-education teacher, \u201che came out angry,\u201d his father recalls during a phone conversation. His acts of violence started small\u2014hitting a classmate in kindergarten\u2014but quickly escalated: ripping the head off his favorite teddy bear, slashing the tires on the family car, starting fires, killing his sister\u2019s hamster.<\/p>\n<p>His sister remembers Carl, when he was about 8, swinging their cat in circles by its tail, faster and faster, and then letting go. \u201cAnd you hear her hit the wall.\u201d Carl just laughed.<\/p>\n<p>Looking back, even Carl is puzzled by the rage that coursed through him as a child. \u201cI remember when I bit my mom really hard, and she was bleeding and crying. I remember feeling so happy, so overjoyed\u2014completely fulfilled and satisfied,\u201d he tells me on the phone. \u201cIt wasn\u2019t like someone kicked me in the face and I was trying to get him back. It was more like a weird, hard-to-explain feeling of hatred.\u201d<\/p>\n<p>His behavior confused and eventually terrified his parents. \u201cIt just got worse and worse as he got bigger,\u201d his father tells me. \u201cLater, when he was a teenager and occasionally incarcerated, I was happy about it. We knew where he was and that he\u2019d be safe, and that took a load off the mind.&#8221;<\/p>\n<p>By the time Carl arrived at Mendota Juvenile Treatment Center in November 1995, at age 15, he had been placed in a psychiatric hospital, a group home, foster care, or a juvenile-corrections center about a dozen times. His police record listed 18 charges, including armed burglary and three \u201ccrimes against persons,\u201d one of which sent the victim to the hospital. Lincoln Hills, a high-security juvenile-corrections facility, foisted him on Mendota after he accumulated more than 100 serious infractions in less than four months. On an assessment called the Youth Psychopathy Checklist, he scored 38 out of a possible 40\u2014five points higher than the average for Mendota boys, who were among the most dangerous young men in Wisconsin.<\/p>\n<p>Carl had a rocky start at Mendota: weeks of abusing staff, smearing feces around his cell, yelling all night, refusing to shower, and spending much of the time locked in his room, not allowed to mix with the other kids. Slowly, though, his psychology began to shift. The staff\u2019s unruffled constancy chipped away at his defenses. \u201cThese people were like zombies,\u201d Carl recalls, laughing. \u201cYou could punch them in the face and they wouldn\u2019t do anything.&#8221;<\/p>\n<p>He started talking in therapy and in class. He quit mouthing off and settled down. He developed the first real bonds in his young life. \u201cThe teachers, the nurses, the staff, they all seemed to have this idea that they could make a difference in us,\u201d he says. \u201cLike,<i> Huh!<\/i> <i>Something good could come of us.<\/i> We were believed to have potential.&#8221;<\/p>\n<p>Carl wasn\u2019t exactly in the clear. After two stints at Mendota, he was released just before his 18th birthday, got married, and at age 20 was arrested for beating up a police officer. In prison, he wrote a suicide note, fashioned a makeshift noose, and was put on suicide watch in solitary confinement. While there, he began reading the Bible and fasting, and one day, he says, \u201csomething very powerful shifted.\u201d He began to believe in God. Carl acknowledges that his lifestyle falls far short of the Christian ideal. But he still attends church every week, and he credits Mendota with paving the way for his conversion. By the time he was released, in 2003, his marriage had dissolved, and he moved away from Wisconsin, eventually settling in California, where he opened his funeral home.<\/p>\n<p>Carl cheerfully admits that the death business appeals to him. As a child, he says, \u201cI had a deep fascination with knives and cutting and killing, so it\u2019s a harmless way to express some level of what you might call morbid curiosity. And I think that morbid curiosity taken to its extreme\u2014that\u2019s the home of the serial killers, okay? So it\u2019s that same energy. But everything in moderation.\u201d<\/p>\n<p>Of course, his profession also requires empathy. Carl says that he had to train himself to show empathy for his grieving clients, but that it now comes naturally. His sister agrees that he\u2019s been able to make this emotional leap. \u201cI\u2019ve seen him interact with the families, and he\u2019s phenomenal,\u201d she tells me. \u201cHe is amazing at providing empathy and providing that shoulder for them. And it does not fit with my view of him at all. I get confused. <i>Is that true? Does he genuinely feel for them? Is he faking the whole thing? Does he even know at this point?<\/i>\u201d<\/p>\n<p>After talking with Carl, I begin to see him as a remarkable success story. \u201cWithout [Mendota] and Jesus,\u201d he tells me, \u201cI would have been a Manson-, Bundy-, Dahmer-, or Berkowitz-type of criminal.\u201d Sure, his fascination with the morbid is a little creepy. Yet here he is, now remarried, the father of a 1-year-old son he adores, with a flourishing business. After our phone interview, I decide to meet him in person. I want to witness his redemption for myself.<\/p>\n<p><span class=\"smallcaps\">The night before <\/span>I\u2019m scheduled to fly to Los Angeles, I receive a frantic email from Carl\u2019s wife. Carl is in police custody. His wife tells me that Carl considers himself polyamorous, and had invited one of his girlfriends over to their apartment. (This woman denies ever being romantically <a id=\"Carl\" name=\"Carl\" data-omni-click=\"r'article',r'link',r'2',r'524502'\"><\/a>involved with Carl.)<a href=\"https:\/\/www.theatlantic.com\/magazine\/archive\/2017\/06\/when-your-child-is-a-psychopath\/524502\/#clarification\" data-omni-click=\"r'article',r'link',r'3',r'524502'\">*<\/a> They were playing with the baby when his wife returned. She was furious, and grabbed their son. Carl responded by pulling her hair, snatching the baby out of her arms, and taking her phone to prevent her from calling the police. She called from a neighbor\u2019s house instead. (Carl says he grabbed the baby to protect him.) Three misdemeanor charges\u2014spousal battery, abandonment and neglect of a child, and intimidation of a witness\u2014and the psychopath who made good is now in jail.<\/p>\n<p>I go to Los Angeles anyway, in the naive hope that Carl will be released on bail at his hearing the next day. A few minutes before 8:30 a.m., his wife and I meet at the courthouse and begin the long wait. She is 12 years Carl\u2019s junior, a compact woman with long black hair and a weariness that ebbs only when she gazes at her son. She met Carl on OkCupid two years ago while visiting L.A. and\u2014after a romance of just a few months\u2014moved to California to marry him. Now she sits outside the courtroom, one eye on her son, fielding calls from clients of the funeral home and wondering whether she can make bail.<\/p>\n<p>\u201cI\u2019m so sick of the drama,\u201d she says, as the phone rings again.<\/p>\n<p>Carl is a tough man to be married to. His wife says he\u2019s funny and charming and a good listener, but he sometimes loses interest in the funeral business, leaving most of the work to her. He brings other women home for sex, even when she\u2019s there. And while he\u2019s never seriously beaten her up, he has slapped her.<\/p>\n<p>\u201cHe would say sorry, but I don\u2019t know if he was upset or not,\u201d she tells me.<\/p>\n<p>\u201cSo you wondered if he felt genuine remorse?\u201d<\/p>\n<p>\u201cHonestly, I\u2019m at a point where I don\u2019t really care anymore. I just want my son and myself to be safe.\u201d<\/p>\n<p>Finally, at 3:15 p.m., Carl shuffles into the courtroom, handcuffed, wearing an orange L.A. County jumpsuit. He gives us a two-handed wave and flashes a carefree smile, which fades when he learns that he will not be released on bail today, despite pleading guilty to assault and battery. He will remain in jail for another three weeks.<\/p>\n<p>Carl calls me the day after his release. \u201cI really shouldn\u2019t have a girlfriend and a wife,\u201d he says, in what seems an uncharacteristic display of remorse. He insists that he wants to keep his family together, and says that he thinks the domestic-violence classes the court has mandated will help him. He seems sincere.<\/p>\n<p>When I describe the latest twist in Carl\u2019s story to Michael Caldwell and Greg Van Rybroek, they laugh knowingly. \u201cThis counts as a good outcome for a Mendota guy,\u201d Caldwell says. \u201cHe\u2019s not going to have a fully healthy adjustment to life, but he\u2019s been able to stay mostly within the law. Even this misdemeanor\u2014he\u2019s not committing armed robberies or shooting people.\u201d<\/p>\n<p>His sister sees her brother\u2019s outcome in a similar light. \u201cThis guy got dealt a shittier hand of cards than anybody I\u2019ve ever met,\u201d she tells me. \u201cWho deserves to have started out life that way? And the fact that he\u2019s not a raving lunatic, locked up for the rest of his life, or dead is <i>insane<\/i>. \u201d<\/p>\n<p>I ask Carl whether it\u2019s difficult to play by the rules, to simply be <i>normal<\/i>. \u201cOn a scale of 1 to 10, how hard is it?\u201d he says. \u201cI would say an 8. Because 8\u2019s difficult, very difficult.\u201d<\/p>\n<p>I\u2019ve grown to like Carl: He has a lively intellect, a willingness to admit his flaws, and a desire to be good. Is he being sincere or manipulating me? Is Carl proof that psychopathy can be tamed\u2014or proof that the traits are so deeply embedded that they can never be dislodged? I honestly don\u2019t know.<\/p>\n<p>A<span class=\"smallcaps\">t the san marcos<\/span> Treatment Center, Samantha is wearing her new yoga pants from Target, but they bring her little joy. In a few hours, her mother will leave for the airport and fly back to Idaho. Samantha munches on a slice of pizza and suggests movies to watch on Jen\u2019s laptop. She seems sad, but less about Jen\u2019s departure than about the resumption of the center\u2019s tedious routine. Samantha snuggles with her mom while they watch <i>The BFG<\/i>, this 11-year-old girl who can stab a teacher\u2019s hand with a pencil at the slightest provocation.<\/p>\n<p>Watching them in the darkened room, I contemplate for the hundredth time the arbitrary nature of good and evil. If Samantha\u2019s brain is wired for callousness, if she fails to experience empathy or remorse because she lacks the neural equipment, can we say she is evil? \u201cThese kids can\u2019t help it,\u201d Adrian Raine says. \u201cKids don\u2019t grow up wanting to be psychopaths or serial killers. They grow up wanting to become baseball players or great football stars. It\u2019s not a choice.\u201d<\/p>\n<p>Yet, Raine says, even if we don\u2019t label them evil, we must try to head off their evil acts. It\u2019s a daily struggle, planting the seeds of emotions that usually come so naturally\u2014empathy, caring, remorse\u2014in the rocky soil of a callous brain. Samantha has lived for more than two years at San Marcos, where the staff has tried to shape her behavior with regular therapy and a program that, like Mendota\u2019s, dispenses quick but limited punishment for bad behavior and offers prizes and privileges\u2014candy, Pok\u00e9mon cards, late nights on weekends\u2014for good behavior.<\/p>\n<p>Jen and Danny have spotted green shoots of empathy. Samantha has made a friend, and recently comforted the girl after her social worker quit. They\u2019ve detected traces of self-awareness and even remorse: Samantha knows that her thoughts about hurting people are wrong, and she tries to suppress them. But the cognitive training cannot always compete with the urge to strangle an annoying classmate, which she tried to do just the other day. \u201cIt builds up, and then I have to do it,\u201d Samantha explains. \u201cI can\u2019t keep it away.\u201d<\/p>\n<p>It all feels exhausting, for Samantha and for everyone in her orbit. Later, I ask Jen whether Samantha has lovable qualities that make all this worthwhile. \u201cIt can\u2019t be all nightmare, can it?,\u201d I ask. She hesitates. \u201cOr can it?\u201d<\/p>\n<p>\u201cIt is not all nightmare,\u201d Jen responds, eventually. \u201cShe\u2019s cute, and she can be fun, and she can be enjoyable.\u201d She\u2019s great at board games, she has a wonderful imagination, and now, having been apart for two years, her siblings say they miss her. But Samantha\u2019s mood and behavior can quickly turn. \u201cThe challenge with her is that her extreme is so extreme. You\u2019re always waiting for the other shoe to drop.\u201d<\/p>\n<p>Danny says they\u2019re praying for the triumph of self-interest over impulse. \u201cOur hope is that she is able to have a cognitive understanding that \u2018Even though my thinking is different, my behavior needs to walk down this path so that I can enjoy the good things that I want.\u2019\u2009\u201d Because she was diagnosed relatively early, they hope that Samantha\u2019s young, still-developing brain can be rewired for some measure of cognitive morality. And having parents like Jen and Danny could make a difference; research suggests that warm and responsive parenting can help children become less callous as they get older.<\/p>\n<p>On the flip side, the New York psychiatrist told them, the fact that her symptoms appeared so early, and so dramatically, may indicate that her callousness is so deeply ingrained that little can be done to ameliorate it.<\/p>\n<p>Samantha\u2019s parents try not to second-guess their decision to adopt her. But even Samantha has wondered whether they have regrets. \u201cShe said, \u2018Why did you even want me?,\u2019\u2009\u201d Jen recalls. \u201cThe real answer to that is: We didn\u2019t know the depth of her challenges. We had no idea. I don\u2019t know if this would be a different story if we were looking at this now. But what we tell her is: \u2018You were ours.\u2019\u2009\u201d<\/p>\n<p>Jen and Danny are planning to bring Samantha home this summer, a prospect the family views with some trepidation. They\u2019re taking precautions, such as using alarms on Samantha\u2019s bedroom door. The older children are larger and tougher than Samantha, but the family will have to keep vigil over the 5-year-old and the 7-year-old. Still, they believe she\u2019s ready, or, more accurately, that she\u2019s progressed as far as she can at San Marcos. They want to bring her home, to give it another try.<\/p>\n<p>Of course, even if Samantha can slip easily back into home life at 11, what of the future? \u201cDo I want that child to have a driver\u2019s license?,\u201d Jen asks. To go on dates? She\u2019s smart enough for college\u2014but will she be able to negotiate that complex society without becoming a threat? Can she have a stable romantic relationship, much less fall in love and marry? She and Danny have had to redefine success for Samantha: simply keeping her out of prison.<\/p>\n<p>And yet, they love Samantha. \u201cShe\u2019s ours, and we want to raise our children together,\u201d Jen says. Samantha has been in residential treatment programs for most of the past five years, nearly half her life. They can\u2019t institutionalize her forever. She needs to learn to function in the world, sooner rather than later. \u201cI do feel there\u2019s hope,\u201d Jen says. \u201cThe hard part is, it\u2019s never going to go away. It\u2019s high-stakes parenting. If it fails, it\u2019s going to fail big.\u201d<\/p>\n<div class=\"ad-boxinjector-wrapper\">\n<div class=\"ad-boxright-wrapper\" data-pos=\"boxright\">\n<hr \/>\n<p><small><em><a id=\"clarification\" name=\"clarification\" data-omni-click=\"r'article',r'link',r'4',r'524502'\"><\/a><a href=\"https:\/\/www.theatlantic.com\/magazine\/archive\/2017\/06\/when-your-child-is-a-psychopath\/524502\/#Carl\" data-omni-click=\"r'article',r'link',r'5',r'524502'\">*<\/a> This article has been updated to clarify the relationship between Carl and the woman who visited his apartment.<\/em><\/small><\/p>\n<p><em class=\"letter-writer-info\">Listen to an interview with the author, Barbara Bradley Hagerty:<\/em><iframe loading=\"lazy\" id=\"iFrameResizer1\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/322793673%3Fsecret_token%3Ds-XkjG6&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\"><\/iframe><\/p>\n<p><a href=\"https:\/\/www.theatlantic.com\/magazine\/archive\/2017\/06\/when-your-child-is-a-psychopath\/524502\/\">The Atlantic Magazine<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<div class=\"ad-boxinjector-wrapper\"><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Barbara Bradley Hagerty, June 2017 Issue The condition has long been considered untreatable. Experts can spot it in a child as young as 3 or 4. But a new clinical approach offers hope. This is a good day, Samantha tells me: 10 on a scale of 10. We\u2019re sitting in a conference room at the [&hellip;]<\/p>\n","protected":false},"author":1001004,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[],"_links":{"self":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/1524"}],"collection":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/users\/1001004"}],"replies":[{"embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1524"}],"version-history":[{"count":7,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/1524\/revisions"}],"predecessor-version":[{"id":1531,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=\/wp\/v2\/posts\/1524\/revisions\/1531"}],"wp:attachment":[{"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1524"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1524"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/worldcampaign.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1524"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}