Part of the application process for Medicine involves memorising the definition of “empathy” and being able to offer several scenarios in which you’ve demonstrated your inherently empathetic nature. It is a concept that we are constantly reminded of during our studies and in practise, it is difficult to feign. Antisocial personality disorder – more widely known as psychopathy or sociopathy – is the antithesis of what one would expect of a healthcare professional. The Psychiatry Bible recognises characteristics such as “callous unconcern for the feelings of others”, “gross and persistent attitude of irresponsibility” and “incapacity to experience guilt” as the basis of diagnosis; i.e. an intrinsic lack of empathy.
A recent study published in Time magazine reassuringly identified most members of the healthcare profession as having the least psychopathic traits. I say ‘most’ because surgeons were conversely recognised as one of the top-five professions to which psychopaths are attracted, placing them in the same bracket as CEOs and lawyers. This doesn’t suggest that all surgeons are psychopaths (despite the popular beliefs of countless medical students) or that all psychopaths choose to become surgeons. As with every psychiatric disorder, it is not a case of “you are” or “you aren’t”, it is more about how far along the spectrum you sit. A profession, which relies on purely clinical judgement in stressful situations, requires individuals who are able to make decisions uninfluenced by emotion. A moment’s hesitation could cost a patient their life and in such circumstances, a self-assured, impulsive surgeon may be just what the doctor ordered.
Feeling emotion is something I have never struggled with and years of crying over John Lewis Christmas adverts are testament to this. Psychopathy, to most people, is therefore an absolute enigma. It is understandably difficult to feel sorry for psychopaths – is it even possible to feel pity for someone who shows no remorse? I am intrigued however by the notion that psychopaths are born, not made. A psychiatrist I encountered on placement theorised about three types of crying-baby:
- The physiological crier – this baby will only cry when they need something basic, such as food or a nappy change. This is the calm, docile baby that all parents pray they’ll have.
- The attention-seeking crier – this baby will also cry when they want love or affection. This baby is generally amenable and can be easily placated, once they’ve received a little focus from their carer.
- The pathological crier – this baby cries relentlessly despite the better efforts of their carers.
Of course, every baby is different and crying is a purely subjective measurement. It has been suggested however that the ‘pathological crier’ that may grow up to be a psychopath. An absolute deficiency of emotional understanding prevents these babies from responding to their carers’ attempts to pacify them. As toddlers, they may exhibit violent or cruel behaviour with a remarkable disregard for punishment. The film adaptation of We Need To Talk About Kevin portrays the journey of a sociopath from birth to adolescence by revolving around the strained relationship between a reluctant mother and her very disturbed son. It is unnerving, coarse and perhaps over-stylised – but its premise fuels the ongoing debate of “nature vs nurture”, making it near impossible to stop watching. Research suggests that reduced activity in the amygdala – the part of your brain responsible for emotional response and fear conditioning – gives rise to psychopathy. The “nurture” camp would argue that negligent parents do not give their children enough attention, eye contact or love and therefore prevent the amygdala from developing. Team “nature” suggest that it is a congenital amygdalal deficiency, no different from Type I Diabetes or cystic fibrosis, and these children have no hope.
Horror has been making a big comeback to the small screen. Shows like The Walking Dead, The Vampire Diaries and American Horror Story have surprised audiences with their success. My newfound favourite is Hannibal and whilst I am terrified by the prospect of watching it by myself (I wait until my brother’s around to do a series catch-up), I am hooked. It is an exquisitely haunting and unexpectedly witty visual marvel and I challenge you to find a drama on TV with a more captivating cast. Although Hannibal has received universal critical acclaim, it has failed to be as commercially successful as shows like True Blood. Indeed parts of episodes were banned in America for being brutally graphic but wouldn’t that only attract more viewers, desperate to see what all the fuss is about?
Vampires may sparkle in the sunlight but they are essentially serial killers that use exsanguination as their preferred method of murder. As former humans themselves, their choice to drink human blood makes vampires reminiscent of cannibals. The difference is of course that vampires are a supernatural entity, which explains why it is more than acceptable for your 13-year-old daughter to lust after the Salvatore brothers. Hannibal is a psychological horror that deals with reality, a much scarier place than the paranormal world. Psychopathy lies at the heart of Hannibal and every week, the writers laugh at your darkest nightmares and offer you a murderous Grand Design that is at least ten times worse.
Hannibal is no more gory than its supernatural counterparts but it centres on a highly stigmatised mental health disorder and pays little heed to social convention. It is therefore conceivable that Hannibal’s failure to reach a mass audience stems from a deeper societal fear of mental health issues and the realities psychopathy presents.