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license plate December 19, 2013 Psychopathy is a loaded term in today s society, often misused and misunderstood. With all of the recent gun violence, the term is often used to describe the shooter. But its true meaning, and its true effect on a person, their family and their community is often obscured. We Need to Talk About Kevin , the 2011 Lynne Ramsey movie, tries to deal with this issue on a personal level. We Need To Talk About Kevin was based on a book by Lionel Shriver, and follows Eva Katchadourian, played by Tilda Swinton. Told out of order, we see Eva s life before and after a serious tragedy. The troubles she had connecting with her son, Kevin, played by Ezra Miller (so different from his sweet character in The Perks of Being a Wallflower ), the incident when she breaks his arm in anger, and the problems she has with his behavior throughout his teenage years are recounted. We also see how Kevin s behavior differs with his oblivious father, Franklin, who teaches him how to shoot a bow and arrow. The birth of his little sister Cecelia causes more problems within the family, and makes Kevin s behavior problems focus more on Eva. Cecelia is blinded in one eye by an incident that could have been an accident or could have been as a result of Kevin. We also see Eva visit Kevin in prison, where he isn t scared or angry or apologetic. Eventually, we learn that Kevin killed 14 people in his high school with his bow and arrow before turning himself in, and has killed Franklin and Cecelia. The movie is devastating as we see Eva s life before Kevin s birth, during his childhood and her life after the killing spree. Her ambivalence to his birth leaves enough of a question as to his behavior, but by the end of the story, it s obvious that something more is going on. Eva is shown having a hard time getting Kevin to stop crying as a baby, before finally standing next to a jackhammer to drown out the noise. He resists all attempts to potty train, having accidents well into his toddler years. One incident causes Eva to throw him against the wall, breaking his arm. Kevin uses her guilt as a way to control her, blackmailing her into doing what he wants her to. We also see him continue to masturbate when she catches him in the bathroom, unashamed. All of these incidents taken alone don t necessarily mean anything, but when put together with his killing spree, create a vivid picture of the evolution of psychopathy. Interestingly, the movie never uses that term. The term psychopath was first used in 1847 in Germany (the synonym sociopath was first used in 1909, also in Germany), and is widely used in the criminal justice setting. In the clinical psychological setting, common traits are diagnosed as Antisocial Personality Disorder. Symptoms include grandiosity, lack of remorse or guilt, need for stimulation, impulsivity and poor behavioral controls. The illness is diagnosed using a test called The Psychopathic Personality Inventory. In 2008, a study found that roughly 1.2% of the United States population had antisocial personality disorder. The term psychopath is commonly used incorrectly in the media to describe someone who has done something considered evil. Terrorists, mass killers and bombers often get labeled with this term before anyone has caught them, let alone had time to make an assessment of them. It s become shorthand for people who do terrible things, and that disconnect from the reality of the situation is a problem in the way we view people and their actions. By labeling someone a psychopath, it s easy to write them off as evil and never look at the actual factors that go into their actions. We can ignore what s going on without really taking a good hard look at why people act the way they do. That shortsighted view is limiting, especially in the case of people with antisocial personality disorder. With a better understanding of the brain through imaging and genetics, we can now look at what is going on inside the person with antisocial personality disorder. Studies have found that people with the diagnosis have less reaction to pain stimuli and have less of neural connection when learning right and wrong. Certain parts of their brain react less strongly to emotion, and they have stronger reactions to hormones in their systems. Other studies are testing whether they have less capability for empathy, that their ability to understand what others are going through is limited by the brain structures. What they are also finding is that genes that mark aggression and antisocial behavior are more likely to be present. None of these traits determine that someone is going to be dangerous, or completely unaffected by their environment. In fact, Dr. James Fallon, doing a neurological study to look at the structures of the brain in people with antisocial personality disorder, realized that he shares many of the traits. He goes as far as diagnosing himself with the illness, but says I was loved, and that protected me. Being raised in a happy, healthy family, he was able to learn different ways to cope with his symptoms. He still has all of the traits, but has found more appropriate ways to handle them. (Read his fascinating story here: http://blogs.smithsonianmag.com/science/2013/11/the-neuroscientist-who-discovered-he-was-a-psychopath/ ). In his book The Psychopathology Test , Jon Ronson argues that many Fortune 500 CEOs would be considered psychopaths who have found legal ways to deal with their symptoms (though his book is controversial to say the least). We Need to Talk About Kevin is a great look at the legal system s view of psychopathology. It covers many of the traditional symptoms often shown, but it s a shallow view of what medicine knows about people with antisocial personality disorder. It is a wonderful movie about parental guilt, but I would look further to learn about the illness it shows. It jumps to many of the same conclusions that the media often does, and that s disappointing. I recommend it, but with caution. We ll be taking the next two weeks off, returning January 2 with a look at Hamlet. Have a wonderful holiday season! Mental Health America Blog most luxurious


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