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Authors: Adrian Raine

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Let’s start with lying. And please do not protest your innocence any further, because as
Mark Twain rightly put it, “everybody lies—every day, every hour, awake, asleep, in his dreams, in his joy, in his mourning.”
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You do lie—honestly you do. So how do we probe your antisocial mind? What instruments can we use to detect when people are telling whoppers?

“Oh, Agent
Starling, you think you can dissect me with this blunt little tool?” Hannibal
Lecter in the classic thriller
The
Silence of the Lambs
had a point, and Clarice Starling, the
FBI agent interviewing him, should have known better. The paper-and-pencil questionnaire tools she was using on the
serial killer Hannibal “the Cannibal” Lecter in his prison cell have been traditionally used by forensic specialists to
probe the minds of murderers. But they have been ineffective in revealing much that is fundamentally wrong with psychopaths like Lecter. After all, psychopaths have been known to tell a white lie or two about themselves, so do you really think they will tell the truth in a simple questionnaire? We need something far sharper than a blunt pencil and paper questionnaire to learn when people are fibbing.

A big fat sixty-ton magnet of the type used in
MRI does not sound very sharp, but it’s not a blunt tool. When it comes to discerning truth from fiction, it’s as sharp as a razor. My academic friends
Tatia Lee, at
Hong Kong University,
Sean Spence, at the University of Sheffield,
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and
Dan Langleben, at the
University of Pennsylvania, are a triumvirate of pioneering scholars who each independently stumbled onto a sublime truth about
lying—the prefrontal cortex is critical.

Tatia Lee took normal individuals—just like you—and put them into a scanner. She then gave them tasks during which they had to either tell the truth or lie. Sometimes they lied about themselves, just as we do in life. So a question might be, “Were you born in Darlington?” “Yes,” I would say. “No,” you would say. We are telling the truth. And while that is happening, Tatia collects data on what the
brain is doing. Then she reverses the situation. “Were you born in Darlington?” “No,” I say. “Yes,” you say. This is an
autobiographic lie—similar to when you sometimes lie to your friend about whether you are free to meet up tonight or not.

In another task, subjects were given a simple
memory task to complete in which a three-digit number—like 714—was quickly followed by either the same or a different set of numbers. The subject had to say whether the sets of digits were the same or different. Sometimes they were instructed to tell the truth, while at other times they had to deliberately lie and feign memory impairment—just like some people feign injury after a claimed accident to financially gain from medical insurance.

It did not matter what the task was, Tatia found that lying was consistently associated with
increased
activation in the prefrontal cortex as well as areas of the
parietal cortex.
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At just the same time as Tatia was doing her work in Hong Kong, Sean Spence
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and Dan Langleben
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independently found essentially the same pattern of findings in England and the United States, results that span three different continents and cultures. In stark contrast, telling the truth was not associated with
any
increase in cortical activation.

What’s going on here? The bottom line to deceit is that this antisocial act is a complex executive function that requires a lot of frontal lobe processing. Telling the truth is actually very easy. Telling tall tales is much harder and requires much more processing resources and
brain activation. Deception involves
theory of mind. When I lie to you about where I was at eight p.m. on Wednesday, January 27, I need to have an understanding of what you know about me—and what you do not know. Was I really celebrating my birthday with my family? I need to have a sense of what you think is plausible, and what is not. For this “mind reading” we need to recruit a number of brain regions that form connections between the
frontal cortex and subregions in the
temporal and parietal lobes.

Yesterday it was paper-and-pencil tools. Today it’s becoming brain-imaging paraphernalia. By combining brain-imaging methodology with
machine learning—equally new sophisticated statistical techniques—Dan Langleben and
Ruben Gur, at the
University of Pennsylvania, have been demonstrating accuracy rates upward of 88 percent in detecting deception. The disconcerting question is, How much longer will our lying minds remain stubbornly private to the latest investigative lie-detection tools? The current view is that
lie detection based on functional imaging is not sufficiently developed for use in courts of law,
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although that could conceivably change in the future. For now, however, let’s turn to another antisocial arena that we frequently find ourselves caught up in and conflicted by—making
moral decisions.

COMPARING YOUR MORAL BRAIN WITH THE ANTISOCIAL BRAIN

You know
cannabis is illegal, but you’ve taken it anyway. You know you should not download movies from the Internet, but you persist in breaking
copyright laws. And now you are reporting your taxes and wondering if you should nudge up those tax-deductible charitable contributions a hundred or two.

We’ve all had those moments of being torn between right and wrong—between heaven and hell. The devil and the angel are battling it out hell-for-leather inside our hot heads, beating out the eventual choice with hammer and tongs. You’ve wondered what on earth to do.

But you’ve never wondered what’s going on inside your brain during
these moments, have you? That’s what a lot of social scientists and philosophers have been pondering for over a decade. And now we have some fairly clear-cut answers.

It goes like this. We slot you inside a brain scanner and present you with a series of
moral
dilemmas using visual scripts. We’ll start with what is called a “personal” moral dilemma—one that’s really up close and personal. This one could almost have been plucked from a page in the life of
Phineas Gage, a railway worker whom you’ll meet in a later chapter. You’re standing on a footbridge looking down on a railway track. Below you, farther back along the track, is a runaway trolley that is about to plow into a group of five unsuspecting railway men working farther ahead on the track. Standing next to you is a rather corpulent gentleman.

Here’s the deal. If you do nothing, five innocent men are going to die right before your eyes. Alternatively, you can push the big bloke off the bridge. He’s a goner, but his big body will block the runaway trolley and save the lives of five men. What do you do?

You only have two choices. You are out there on that bridge, hearing the death rattle of the oncoming trolley and envisioning the gory carnage that will occur. No, you’re not allowed to throw yourself off the bridge instead—saint that you are. You’re just not big enough to block the trolley. Calling out to the railway workers won’t work either.

Put this book down and reflect on your decision—to do nothing or to push the man off the bridge.

It’s difficult, isn’t it? And we can push and pull our minds in different directions. Are you really going to stand idly by and let five innocent men die? Look, the obese guy is likely to die early from heart disease anyway—why not give his life a dignified and worthwhile ending by saving five innocent men?

Then again, isn’t it sort of wrong to kill? But at the same time it’s five for one—surely you cannot ignore those odds? This dilemma is damned difficult—it’s very personal and involves a high degree of conflict.

Josh Greene, an amazing philosopher and neuroscientist at
Harvard, published the first study to describe what happens at a neural level during personal moral dilemmas like this.
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Compared to more “impersonal” moral dilemmas that do not bring you face-to-face with someone else, your brain shows increased activation in a circuit that comprises the medial prefrontal cortex, the
angular gyrus, the posterior
cingulate, and the
amygdala. This makes sense, as these brain areas contribute to complex thinking, and the ability to step outside of yourself and evaluate the bigger social picture.

But let’s get back to how you actually processed the dilemma. I’m not as interested in exactly what decision you came to as I am in how you
felt
. Wasn’t it awkward? Didn’t you feel uncomfortable? You may have even physically squirmed in your seat a bit just as one undergraduate student did in my class earlier this week when I described this dilemma. This is where that amygdala and other
limbic activation comes in, contributing to the emotional “conscience” component of
moral decision-making alongside some subregions of the pre
frontal cortex.

What your actual answer was is not entirely uninteresting either. About 85 percent of you felt you could not bring yourself to push that man off the bridge. About 15 percent, however, would have sacrificed him. These numbers are obtained in large-scale surveys of moral dilemmas. In contrast, if you put the same question to patients who have lesions to the
ventral prefrontal cortex—people who as we’ll later see are more
psychopathic than the rest of us—that “push-him-off” rate triples to about 45 percent.
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If these same patients with ventral prefrontal lesions are with other villagers hiding in a cellar from invading troops above, and if their baby starts crying, they are three times more likely to smother their baby to prevent the enemy from finding and killing everyone. This is a high-conflict dilemma. They are making a utilitarian moral decision—the greater good of the greater number.

Don’t worry too much if you chose to push the man off the bridge or smother your own baby. The seventeenth-century English philosopher
Jeremy Bentham, who espoused
utilitarianism, would have been proud of you. It does not necessarily mean you have a frontal brain lesion or that you are a psychopath—although you may have a slightly different way of thinking about life than others.

Josh Greene was not able to image the ventral prefrontal cortex back in 2001 when he conducted his groundbreaking study, due to what we call “
susceptibility artifact,” but many other studies have replicated and extended Greene’s findings and shown activation of this region during moral-dilemma tasks.
65
,
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The ventral prefrontal region is critical for making “appropriate” moral decisions—or at least passive decisions that result in no harm to others.

We’ll come back to
morality very soon, but here I want to recap
where we stand with our murderous minds. I’ve been arguing that the
prefrontal cortex and
limbic system are misfiring in violent offenders. We also found that our murderers had poorer functioning in the
angular gyrus. We’ve seen that other studies of antisocial individuals reveal abnormalities in the
posterior cingulate, the
amygdala, and the
hippocampus, while others document abnormal functioning in the
superior temporal gyrus in violent offenders,
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psychopaths,
68
and antisocial individuals.
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Let’s now compare this hit list of brain areas in antisocials to the hit list activated when normal people contemplate a moral dilemma. What are the areas most commonly activated across studies in moral tasks? They are none other than the
polar/medial prefrontal cortex, the ventral prefrontal cortex, the angular gyrus, the posterior cingulate, and the amygdala.
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There is an undeniable degree of overlap.

Let me make the point visually for you.
Figure 3.5
, in the color-plate section, puts together these two sets of findings—the antisocial brain and the moral brain—to create a neural model of morality and antisociality. The top scan slices the brain right down the middle from front to back—you can see the nose on the left. The middle scan slices the brain head-on. The bottom slice is a bird’s-eye view looking down on the brain. Brain regions implicated in both offending and moral decision-making are colored yellow. Areas found to be abnormal only in offenders are colored in red, and areas linked only to moral-judgment tasks are colored in green.

You can see that there are substantial areas of overlap between antisocial/psychopathic behavior and making moral judgments. Brain regions common to both include the ventral prefrontal cortex, the polar/medial prefrontal areas, the amygdala, the angular gyrus, and the
posterior superior temporal gyrus.

It’s not a perfect match by any means. Furthermore, while the posterior cingulate is activated during moral judgment, evidence implicating this region in antisocial behavior is sparse to date, although studies have indeed found abnormalities in the posterior cingulate in psychopaths,
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impulsively aggressive patients,
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and spouse-
abusers.
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Nevertheless, there are commonalities we cannot ignore. Some parts of offenders’ brains critical for thinking morally just don’t seem to be functioning very well.

JOLLY JANE’S VOLUPTUOUS BRAIN

We have been learning what brain areas are activated when normal people make moral decisions. But what happens in the
brains of psychopaths when given the same moral dilemmas?

Historically, psychopaths have been viewed as “morally insane.” On the outside they seem normal, and can even be very pleasant, sociable, and likeable.
Ted Bundy is a classic example of a
serial killer who had a
charismatic personality that allowed him to lure young female victims into his deadly trap.
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Yet when it comes to having a sense of morality, there is something missing in psychopaths. Here we’ll take a closer look at what this
“moral insanity” is like from a real-world case. What exactly is broken in the brains of psychopaths at the moral level?

My sister
Roma was a nurse. My wife,
Jianghong, is a nurse. My cousin Heather is a nurse. So allow me to pick the case of a nurse for our discussion of a breakdown in the moral brain.
“Jolly” Jane Toppan cheerfully killed at least thirty-one people in Massachusetts during a six-year period, from 1895 to 1901. Like Randy
Kraft, she was not caught for several years. Nicknamed “Jolly Jane” by hospital staff and patients due to her gregarious and happy demeanor, she became one of the most successful private nurses in Cambridge.

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