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…In a neuroscientist?
James Fallon, a neuroscientist for the University of California – Irvine, ran a PET scan on his brain after finding out that his family had a history of serial killers (including Lizzie Borden). He found that his brain demonstrated the exact same patterns as those of many serial killers. Check out the article below for an interesting perspective on nature vs nurture:
Individuals and systems are bound by context. For instance, although according to surveys, higher rates of domestic violence are demonstrated among African Americans than whites, when the confounding effects of poverty and racism are eliminated, that difference between ethnicities also disappears (Hamel, 2005, 30). Ethnicity as a contributing issue, therefore, is ruled out in the etiology of domestic violence and instead, classism and racism stand indicted.
As competent researchers and practitioners, we look for confounding contextual factors that speak against narrow viewpoints such as those that would suggest that “African Americans are violent” (Hamel, 2005). In short, in our investigations of individual trees we don’t miss the forest or the dirt or the sky. We want to see the detail, as well as the whole picture.
In Gender-Inclusive Treatment of Intimate Partner Violence: A Comprehensive Approach, Hamel describes individuals dealing with “psychopathy,” as “essential untreatable” (54). Although I understand the pragmatic intent of treating immediate issues of violence with an attitude of triage, I am unsure how perpetuating such worldviews positively impacts the likelihood of developing treatment methodologies in the future.
As an MFT, I believe that one of the primary limitations that competent therapists deal with is an awareness of the confines of our own sight. We can only see that which we think is possible to see. In our educational system, it is vital that we learn both the importance and efficacy of triage, but also employ significant questioning whenever an individual or their diagnosis is deemed “untreatable.” Certainly, in the present moment, some individuals live with diagnoses that are unresearched, difficult and/or impossible to treat. Antisocial Personality Disorder, the “psychopathy” Hamel refers to falls in this category. However, that is only for the present moment.
As the future of mental health and the future of many individuals without the resources, knowledge or connections to advocate for themselves or their loved ones, we have a responsibility to read any claims of “terminal” with both a skeptical eye that questions the details of validity and a wide angle lens that notices the wider contextual factors that may be contributing to that claim. For instance, Robert Foltz, a research whom I much admire, wrote regarding the treatment of Conduct Disorder (an established pre-cursor to Antisocial Personality Disorder, or “psychopathy”), its “likely that that brain changes in youth with psychiatric disturbances are actually the product of their life experiences rather than the cause of their symptoms” (2008, 7).
I appreciated Hamel’s description of assessment of domestic violence. I especially appreciated the focus toward practitioners evident by the straight-forward counsel regarding assessment tools and biases to notice. I did take issue with his description of “psychopathy” as untreatable, not because it is untrue, but because there simply are not treatments yet. It is possible to describe the extreme limitations in providing treatment for specific diagnoses without effectively describing them as terminal. In the education of future counselors, even simply stating “right now, there is not a treatment” is preferable, because it includes the “right now.”
Foltz, R. (2008). Behind the veil of conduct disorder: challenging current assumptions in search of strengths. Reclaiming Children and Youth. 16(4). 5-9
Hamel, J. (2005). Gender-inclusive treatment of intimate partner abuse: A comprehensive approach. Springer Publishing Company: New York, NY.
Research speaks about how children and adolescents “map out” the likelihood of interactions becoming violent. In response to their mental maps, children and adolescents respond appropriately to the perceived likelihood of threat. According to their research, childrens’ early experiences and witnessing violence in others are two major determinants to future violent behavior. A question the reader is left with after reading Hudley is regarding the specifics of the “age appropriate interventions” they suggest. Although they do mention neighborhood beautification and developing local leaders as tacks to change the mental maps of adolescents (Hudley 2007), the vicarious learning that children experience that teaches them that violence is the natural and expected outgrowth of certain behaviors, would seem to intuitively suggest that the learning to change those maps would also need to be in-vivo. Given that intuitive expectation, what would be effective and ethical ways to teach, in-vivo, that confrontation doesn’t necessarily lead to violence?
Another important insight gleaned from the article is that the combination of aggressive behavior and rejection by peers is particularly potent when it comes to the etiology of children who grow up to fall through the cracks. It makes intuitive sense that removing a child who already demonstrates negative coping (violent behaviors, antagonizing peers, internalizing behaviors) would lead to an increase in negative coping skills, because it removes them from their peers normative and socializing influence (Hudley, 2007). Although social consequences for anti-social behaviors is a natural and logical consequence, how can practitioners help children and adolescents who demonstrate rule-breaking and disregard for the rights of others re-engage with their social milieu? What role can or should practitioners play in manipulating the social environment to make it more fertile for reconciliation? The question regarding the “should” of reconciliation is a more complicated one than just one of forgiving individuals who make mistakes. By utilizing natural and logical consequences within a structured setting, practitioners empower victims to advocate for themselves and offenders to take ownership for their behaviors, and thusly, ownership for the ability to change them. What is appropriate given the structure of the setting? When do violent behaviors become anti-social? Is it useful to delineate a difference? It may be useful to consider brain development, yet again, when considering the timeliness of various interventions.
It is during early adolescence, approximately 9-14 years of age that the adolescent brain is involved intensely in the process of pruning. During childhood, the brain “soaks up” knowledge and builds as many connections as they have experiences. The pruning process is the process of trimming away the underutilized connections to strengthen those most commonly used (Santrock 2007). It may be during this period that external attempts to change behavioral patterns may be most effective. It is important to remember, however, that the brain maintains some plasticity throughout the rest of development. The expression, “you can’t teach an old dog new tricks” is just that, an expression. It is certainly not a statement of biological fact.
Hudley, C. & Novak, A. (2007) Environmental influences, the developing brain, and aggressive behavior. Theory into Practice. 46(2). 121-129
Santrock, J. (2007). Adolescence. 12th ed. McGraw-Hill: New York, NY