|Having worked with psychopaths for a long time, I have developed a rather sensitive awareness of the deficiencies that these
patients have. The deficits are: an inability to trust, an inability to empathize, and an inability to form affectionate relationships. These are
not qualities that we can readily see or clearly measure. They do not stand out like an education might, nor are they measurable like an
Intelligence Quotient (IQ). One cannot say, for example, "I have a Trust Quotient of 110." It is to our great disadvantage that we have
not developed a means for measuring these interpersonal qualities, for they constitute the essence of what it means to be human.
What Is Psychopathy?
A number of formal definitions exist for the psychopath,1
but let me speak colloquially about the
ways in which these deficits show up. Overall, I have found psychopaths to be a jocular bunch, usually good-natured, quick, and witty. Underneath
this, however, is an extremely pernicious view of other human beings. To a psychopath, all other people are either "suckers" or else
"onto them." There is no middle ground - no room for trust. A sucker is someone to be taken; someone you get something out of;
someone who will buy your useless junk if you sell it with a smile. On the other hand, a person who is onto you will not buy in, and is therefore
of no use. As the psychopath says, "You can do 'em all once, and you can do the easy ones twice."
Psychopaths also cannot experience good feelings from other people, nor do they know remorse. They simply do not have the developed capacity to
be intuitively moved by something that is pleasurable or sad to another person.
The psychopath is very good at faking remorse, however. I remember a young boy who had stabbed an elderly woman twelve times in front of her
home and nearly killed her. While I was examining him in the hospital, he broke into tears and described how tragic it was that this woman's life
had been interrupted by his foolish actions. As we talked further and joked around a bit, he finally said to me with a smile, "I don't know
what the old bag's upset about. All she had was a dozen scratches." Although he could play the game in a socially acceptable way when he
thought it was going to serve his ends, he betrayed his real lack of empathy in an unguarded moment.
In addition, psychopaths cannot understand affection. They are unable to form mutually satisfying, loving, and enduring relationships. This
pernicious view of life is not only to be found among severe psychopaths who are confined to mental hospitals and prisons. There are a large
number of people in society who do not have well-developed capacities for trust, empathy, and affection, and who view other human beings
with a detached coldness. The inability to put oneself in another person's situation and respond as though it matters is a very real
Psychopathy Begins in Early Childhood
Nothing is more important in the world today than the nurturing that children receive in the first three years of life, for it is in these
earliest years that the capacities for trust, empathy, and affection originate. If the emotional needs of the child are not met during these
years, permanent emotional damage can result. We are familiar with the kinds of early experience detectable in the psychopath's background. As
Selma Fraiberg has said, "These are the diseases that are produced in the early years by the absence of human ties or the destruction of
human ties. In the absence of human ties, those mental qualities that we call human will fail to develop or will be grafted upon a personality
that cannot nourish them, so that at best they will be imitations of virtues, personality facades."2
Evidence exists that psychopaths are created early in childhood. An article entitled "How to Succeed in the Business of Creating
Psychopaths Without Even Trying" chronicles the kinds of multiple disruptions in infancy and toddlerhood that are associated with later
psychopathy.3 These include the obvious disruptions, where a child has been placed in several foster
homes in the first three years of life, as well as the less extreme instances of multiple separations - all of which impair the later capacities
for trust, empathy, and affection. It is time for us to become more concerned about the frequent separations and changes of caregivers in the
lives of infants and toddlers.
Protection against these disruptions involves a number of "immunologic" factors. One is the recognition and expectation that a parent
will be on a 24-hour-a-day call schedule when a baby comes along. Another is breastfeeding, which usually ensures that a parent is on call for at
least the first several years. Any number of other measures taken to sustain closeness and contact can immunize infants and toddlers from the
damages produced by multiple separations.
The Jewish proverb that Dr. Herbert Ratner once quoted contains a great truth: "If you don't get up for your crying child when he's young,
you'll be getting up for him when he's old." I've seen this for years in the mental hospital I work in, which is a hundred miles from Toronto
and a difficult place to get to. Every weekend mothers and fathers religiously come up to meet in the visiting corridor with their sons - young
men who are incarcerated for many years because they have killed someone. Walking through the corridor, I cannot help but wonder where they were
when it most mattered. When parental nurturing matters the most, we somehow have other agendas, other things on our mind. We do not seem to
understand that there is nothing more important than attending to the nurturing of the most helpless person in our society, the person we brought
Inadequate nurturing tends to have different consequences depending on the developmental stage in which it occurs. When nurturing of the child
is not adequate in the first three years, what is at risk is the development of psychopathic traits; and when nurturing is inadequate after the
first three years, what is at risk is the development of neurotic traits. Whereas psychopathic individuals create difficulties for other people,
neurotic individuals create difficulties for themselves. They are prone to excessive worries, phobias, depression, and so on.
One of the most revealing aspects of being involved in examining murderers is seeing the injustice of it all. So often, one sees the killing of
an innocent victim - usually a well nurtured and trusting child - by a person who was not well nurtured in the earliest years. It becomes clear
that we are together on a lifeboat here on Earth, and that we all risk paying the price of someone else's misinformed nurturing of their
Obstacles to Adequate Nurturing
What gets in the way during these early years? An obvious obstacle is the perceived
lack of time. Parents are simply too busy to do the
job right. One way to overcome this is to slow down to a child's pace-to the pace of breastfeeding, the pace of a young toddler's footsteps along
the sidewalk. How refreshing it is to see parents slow down to a child's pace on the street. Simply by taking their cues from the child, parents
are less prone to rush off-to meetings, to agendas, to deadlines, to meals, to any number of less significant appointments. The amount of time
required to care for an infant empathically is greater than we tend to assume. And any dedicated parent will attest to the radical ways in which
caring empathically for an infant alters the parent's life.
Another major obstacle to adequate nurturing in the first few years is the incredible
lack of preparation for parenting. The current
elementary school curriculum should be scrapped and substituted with one that covers every aspect of child care. Some schools in Philadelphia now
include parenting education in the curriculum of every grade from kindergarten through grade 8. There is no reason why graduates of our compulsory
school system should not know everything there is to know about the one job they are almost certain to do.
A third obstacle in creating the conditions for the proper nurturing of infants and toddlers is our lengthy tradition of
dominance. I have interviewed scores of parents who subscribe to this irrational tradition. In some cases, mothers had not been prepared to
have an additional child, but fathers arrogantly decreed that there would be more children. In other cases, women had left their children with
substitute caretakers not because of real poverty - that some women should
have to do so is, in itself, an incredible indictment of our
society-but rather to gain some power vis-a-vis a husband who was steeped in this tradition.
Probably the most damaging effect of arbitrary male dominance is its carryover to arbitrary child dominance. Before we can hope to regard
children as equal beings and treat them with mutuality, we must achieve equality between men and women. When arbitrary male dominance is dead,
when women's liberation ceases to follow a male script, when physiological differences between the sexes are not confused with inequality, when
women are on a genuinely equal footing with men, then we can hope to see the nurturing of infants and toddlers as the shared endeavor of both
A fourth obstacle is the sometimes problematic close spacing
of children. When taking a history on a murderer, I try to understand the
early formative years by asking the parents what was happening in their lives beginning six months before the child was conceived. From these
histories, it appears that the close spacing of siblings almost always increases the difficulty in proper nurturing. Among families with the very
best of support systems - where both parents are equally involved and the economic base is reasonable - it is possible to cope well with closely
spaced children. But by and large, a three- or four-year spacing between children (the natural spacing of totally committed breastfeeding) tends
to reap enormous emotional benefits to individual children. This allows children a position that will not be usurped by a younger sibling before
they are capable of understanding it or before they are able to get by with less immediate attention to their needs.
The low status of parenting also gets in the way of adequately nurturing infants and toddlers. Given the importance of the task
and how much it contributes to society, it seems clear that parents ought to be venerated. Wouldn't it be nice if the amount of press coverage
devoted to industrial and sports heroes could be transferred to people who truly deserve idolization - people who are doing the quiet job of
"producing" new human beings who will matter in society, who will be safe and loving in
Perhaps there will come a time when the early years of motherhood will be regarded as an enlightened and proper endeavor for a woman to engage
in full time for a period in her life. Perhaps there will come a time when a woman will be viewed as a better person for having experienced the
total nurturing of her infant and toddler. We have already experienced a similar shift in perception toward the college student. An individual
going to college for a number of years is no longer thought to be opting out of the system or buckling under it; such an individual is now
perceived as moving toward the betterment of his or her capacity to earn money, to become a more widely educated person, to become a better
contributor to society.
The most disturbing obstacle to adequate nurturing is
consumerism and materialism. The voracious urge toward wealth and high
levels of consumption has distracted us from our most critical and intrinsic values and priorities. In terms of our social life, consumerism and
materialism ought to have the same connotation as sadism and masochism.
One approach to this problem is to consider the notion of voluntary simplicity. Richard Gregg, an American friend of Gandhi's, has written an
excellent paper on this topic.4 In 1936 he was grappling with the same kinds of issues we are facing today: What
does wealth, consumption, and an addiction to material things do to us as human beings? How does it separate us from other human beings? How does
it misdirect our energies?
Another approach is to understand that consumerism introduces an imperceptible set of values and goals. The implicit values are envy,
selfishness, and greed; and the goals are status and careerism. As acculturated as we are in these values and goals - having absorbed them since
birth in every aspect of life - we are hardly aware of their hold on us. It is as though we have mastered a foreign language but do not recognize
what the words actually dictate: how important it is to consume! Consequently, we do not perceive the downside, the soft underbelly of
Nor do we have advocates clarifying the other side of the issue. There is no force in our society saying, "Hold it now. If you're going to
buy this brand new Buick or this sequined dress, what is the cost? Not in terms of your bank account, but in terms of your personal account. What
are the hidden costs?" if a parent is planning to go out to work to earn money in order to buy such material goods, what is the cost
to the other family members?
In the quiet moments of our lives, and in moments of despair, we come back to the fact that what is important is our trusting relationships,
our affectionate relationships with others. These have nothing to do with materialism. Where is the money exchange in breastfeeding, for example?
If we could make a buck off breastfeeding, we would; we are trained to do that. But it cannot be done. Breastfeeding and similar forms of
interaction therefore have the potential to become forces in society that will keep our value systems straight about what really counts: mutuality
and human exchange.
Perhaps the most illuminating approach to consumerism and materialism is to see it
for what it truly is. Observe those who are most
wired to consumption, to the buying of goods and services. Often it seems that these are the people who are the most empty inside and the least
capable of achieving satisfaction from mutually caring, trusting, long-lasting interpersonal relationships. Could it be that they share the very
deficits observed in psychopaths, the missing qualities of trust, empathy, and affection that arise from an inadequate nurturing experience in
infancy and toddlerhood?
When life is devoid of meaningful interchanges with other human beings, then where does one get one's kicks in life? Culturally, one is
inclined to buy them, and decorate with them, and wear them, and otherwise display them. A person has to keep moving on - as in psychopathy -
constantly looking for more stimulation, constantly traveling, constantly searching for something to fill the void.
The greatest tragedy is that the void cannot be filled. Trust, love, and affection cannot ever be replaced. They cannot be purchased, and they
cannot be "put in" later. Nor can the void be therapeutically "fixed up," because therapy does not work on deep-seated
personality disorders that originate in the earliest years of life.
A child who does not receive enough love in the first three years is forever like a leaky pail. Although people may keep putting it in and
putting it in, the bucket cannot be filled; the individual's need for love is insatiable. Such a person may spend a lifetime looking for what he
or she can never achieve: enough affection. However, a child who is nurtured properly in the first three years has the gift of being able to give