Photo by Armin Lotfi on Unsplash, this article is from WeChat public account: Neural Reality (ID: neuroality) , author: Heidi Maibom (Professor of Philosophy at the University of Cincinnati)
Mentally ill, the word easily reminds us of the image of a cold-blooded killer, or a sly and relentless egoist. Ted Bundy, for example, specifically robbed women and raped their rotten bodies in the 1970s. Or Hannibal Lecter in the movie The Silent Lamb (Hannibal Lecter) , he can always be imprisoned from all kinds Cunning escapes and eventually eats down on him.
In the public’s imagination, the mentally ill (Psychopath) * is the embodiment of evil. However, more and more researchers believe that they are disease-ridden people, not evil demons-they are all victims of insanity. So what is the truth about the mentally ill? What problems did they encounter?
* Translator’s Note: Psychopath (American Diagnostic and Statistical Manual of Mental Disorders-DSM5 includes it in antisocial personality disorder). American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC.
They are so different from you and me?
Canadian criminal psychologist Robert Halle (Robert Hare) Earliest development of the Halle Psychiatric Scale -remarks “label =” Remarks “> (Hare Psychopathy Checklist) . Subsequently, the scale was revised and widely used in the diagnosis of mental illness.
The scale considers that mentally ill persons are usually selfish, superficial and irresponsible. They have a hard time controlling their urges, often exhibiting antisociality as a child, lacking empathy, guilt, and remorse. They steal, lie often, and lack respect for other people, social norms, and even laws and regulations. Sometimes they torture fragile and poor animals, attack unarmed children, and even try to kill their parents or siblings. Once arrested, they will not regret self-blame, but instead tend to shirk responsibility to the growing environment or social system.
Some recent data indicate that more than 90% of men with mental illness in the United States are punished by the criminal justice system, either in prison, on parole, or in some other form. Since only 1% of the population is mentally ill, this number is undoubtedly shocking. Because of its high relevance to criminal behavior, mental illness was once known as “moral disorders.”
Lauren Bending
This stigmatized description of mental illness dominates the minds of amateurs and professional researchers. The stigma description is both sensational and reassuring. Mentally ill people are usually sick, unconscious, and lack moral conscience. In other words, they are completely with you and medifferent.
However, this view is wrong. In general, mentally ill people do not lack many important abilities, and their deficiencies are often not obvious, or they are often confined to a specific situation. Seriously, they are not incapable of distinguishing right from wrong, nor are they incapable of making correct decisions or empathizing and empathizing with others.
Instead, they suffer from many more basic issues-such as being too opinionated, fearless, or selfish. More importantly, maybe “our” behavioral responses are more like “their” behavioral responses than we realize. Just like the mentally ill, we can move our empathy dashboard; although we praise the empathy, if we look closely at this emotion, we will find it closer than any “warm and fuzzy” empathy Self-protection instinct.
Mentally ill people do not show weird outliers, but instead reveal important facts about human morality. But are we ready to accept what they might teach us?
Is rationality the key?
When we start to debate exactly what problems people with mental illness have encountered, researchers often use two opposing moral theories to attack each other. The rationalist approach holds that judgments about right and wrong are based on reason rather than emotion. Some philosophers have claimed that the existence of mentally ill people shows that rationalism is completely wrong. Mental pathologists are as logical as you and me-in fact, they are even smarter than us. They are therefore described as subtle scams in daily life. Therefore, the fact that mentally ill persons still perform inhumane behavior under the condition of reason means that the sensitivity of morality is not only based on pure reason.
But something is wrong here. If the mentally ill are smart enough, why are they still being hunted down by the criminal justice system? In a vivid description of the mentally ill book “Span class =” text-remarks “label =” Remarks “> (Without Conscience) (1993) , Hal describes the decision of a man to attend a party Buy a case of beer. When this man with a high score on the Hall’s psychiatric scale realized that he had forgotten his wallet, he chose to rob the nearest petrol station and hit the saleswoman with a heavy wooden stick.
Simón Prades
While the mentally ill can think rationally and clearly, they behave very irrationally in their behavior. They are fighting “rational rationality” in the mouth of philosophers: When we decide to take action, we tend to consider some reasons. For example, what is the chance that what we do will achieve our goals and not conflict with other things or goals.
For example, if you hit a salesperson with a wooden stick, you can also achieve the goal of getting a box of beer, but this will cause you great pressure, and you are extremely reluctant to be arrested and jailed, You will not do this. What appears to be lacking in psychopaths is the ability to consider all factors that make the right choice, and often there is not enough reason to explain their behavior.
Evidence from psychology indicates that mentally ill persons have deficiencies in reasoning, so that their ability to make decisions is impaired. They always focus on the thing at hand (whatever it is) and ignore relevant background information. If this background information is not important, they will actually do a good job.
Other studies have found that psychopaths may have difficulty changing their reactions. They have difficulty understanding the behaviors that were rewarded but punished now, or those that were punished but rewarded now. Similarly, Hal and his colleague Jeffrey Zhutai (Jeffrey Jutai) found that the mentally ill person was on the maze task They will stubbornly carry out their original strategy, and even if they do, they will suffer a painful electric shock. And most of the normal subjects will give up the original way and look for other ways out of the maze. This insensitivity also extends to social threats like angry faces.
These findings support the views of rationalists. The unethical behavior of a mentally ill person is caused by a failure to reason reasonably. But you may have noticed that Mentally ill people may experience fear less in similar situations than ordinary people. And I think we all know that fear itself is an emotion. This brings us back to the camp of emotional orientation-the center of morality is emotion rather than reason. This camp is particularly concerned about empathy.
Can they empathize
A psychopath can empathize, provided he is explicitly told to do so.
Except for psychologist Paul Bloom, like Yale University (Paul Bloom) With the philosopher Jesse Prins of City University of New York Most attach great importance to empathy. Part of it is because it fits perfectly into the second major type of moral theory called (sentimentalism) .
The history of moral affectionism can be traced back to the 18th century philosopher David Hume ) and Adam Smith (Adam Smith) . They believe that the ability to distinguish right from wrong is based on empathy. Only when we feel empathy with others can we treat others’ misery as bad or unfair. It is because of the feelings brought about by empathy that we care about what happens to others, even if these things do not directly affect us.
The best experimental evidence to support these claims comes from social psychology research on empathic care. Psychologists working in developmental psychology, for exampleFor example, Martin Hoffman of New York University (Martin Hoffman) and Nancy Eisenberg of Arizona State University (Nancy Eisenberg) believe that empathy plays a central role in social ability and moral understanding. Dan Batson (Dan Batson) believes that empathic care is a warm, kind, and compassionate feeling for those in need . This feeling stimulates real altruism. Empathy motivates us to treat others kindly, which is the basis of moral care for others. And mentally ill people seem to prove these points: they obviously lack both moral feelings and empathic responses.
Stephan Schmitz
However, psychopaths perform surprisingly well on empathy tests. Given that these tests are often based on self-reports, and that psychopaths are experienced deceivers, this is not necessarily surprising. However, psychopaths have also produced interesting results in experiments testing physiology and brain response. For example, the physiological index of skin conductivity, by measuring the skin’s conductivity, it can indicate your emotional state well. When you sweat due to stress, fear or anger, your skin becomes more conductive.
In contrast to non-psychotics, psychopaths show lower skin conductivity when viewing photos of people in distress. There are other studies that measure the startle response: If a normal person is shown a picture where they can perceive a threat, they are more likely to be startled by a loud noise. Mentally ill people usually respond normally to immediate threats, such as pictures of sharks with wide open mouths or violent snakes that strike suddenly. But they do not respond to social threats such as people in pain or distress. And normal peopleAll responded.
Björn Öberg
Neuroscientists have also studied the empathic responses of psychopaths. In studies using functional magnetic resonance imaging (fMRI) , empathic brain regions of psychopaths do not activate as much as controls . However, in the study of Harma Meffert, a neurobiologist at the University of Groningen in the Netherlands, (Harma Meffert) and her colleagues, The ill person is explicitly asked to feel as much as possible of a hand being stroked or pushed away. At this time, the mentally ill person is able to react normally. That is to say, when explicitly telling the mentally ill to empathize, they can also empathize.
The neuroscientist Jane Desai of the University of Chicago (Jean Decety) and his colleagues found similar results. They show people who are mentally ill that their limbs are in pain: for example, their hands are stuck in the door. Researchers either tell them “Please imagine this happening to you” or tell them “Please imagine this happening to others”. When mentally ill persons imagine themselves in a painful situation, they show a pattern of brain responses that are very close to the typical brain activation of empathy; however, when they imagine others in the same situation, the brain regions associated with empathy are Activate a lot.
Is it an empathy flaw, or is it something else?
If the psychopath is deficient in empathy, this next study is confusing. Measuring brain activityAnother way to make this problem clearer. EEG (EEGs) can record the activity of the brain in full time. Unlike fMRI, this method can record a specific period of time Brain activity.
EEG research on psychopaths is very instructive: it turned out that in the beginning, their brain responses to people in distress were largely complete. Psychologists refer to this situation as “directional response,” which refers to the act of turning attention to a stimulus-in which case the stimulus is another troublesome person. This behavior is related to the sympathetic nervous system, which is able to mobilize defense responses. In this first response, there is no difference between a mentally ill person and a non-psychopathic person.
However, what happened next is different: the defense response of the mentally ill has not become stronger and stronger, and their attention to others in trouble will not be more concentrated, but gradually weakened Until it subsides. Why is that?
Other research on empathy provides more clues. The study found that when doctors face patients who are about to receive a needle injection, they show the same pattern of response as a psychopath. Because doctors are fully capable of empathizing with patients when necessary, it is believed that this reduction in response must come from the cognitive control they exert on their emotions. Because doctors must do unpleasant and even painful things to patients, they can only get used to their reactions and suppress normal empathic reactions.
Cronulla Folk
This interpretation also fits the connection between empathy and reward. Studies have found that men only get a better understanding of the need for others to pay extra for them to do so when they get paid, and for women, understanding others is a reward in itself *. Leaving aside these annoying gender differences, we can conclude that people can base their punishment, habits, orRewards to regulate their empathic response. Therefore, we can also understand the empathic response of thinking mental patients: They dull their empathic response to people in pain, but they are not inherently insensitive to the pain of others .
* Translator’s Note: The original author misreads the cited documents. The cited literature is Klein & Hodges (2001), and the main conclusions summarized by the literature author in the abstract are two. First, the advantage women have over men in the empathic accuracy task exists only when women have completed a test that requires them to assess their compassion for the goal before taking the test. Second, when both men and women were paid to motivate their performance, the gender gap disappeared.
Evidence like this forces us to rethink the role of mental illness and empathy in moral competence. First, it is a mistake to think about what psychic people lack. They are not incapable of understanding what a goal or outcome is, nor are they unable to empathize with others. Maybe they have certain ability defects, but these defects are often small and depend on the specific situation.
Similarly, in terms of empathy, mentally ill people are not completely outliers-in fact, there are still many people who describe them with grace and charm. Howl, an outstanding expert in the study of mentally ill people, described in “No Conscience” how he was tricked by a mentally ill person to give a speech at a conference. He was supposed to get a reimbursement and travel expenses, but in the end he didn’t get a penny. At the meeting, he and the man spent a pleasant evening, never doubting it. The point is, if a mentally ill person wants to fool an expert to persuade the expert to do something he wouldn’t do, they can’t look like a robot without emotion. Some people say that they are good at faking empathic reactions, but another more convincing view is that empathy can’t be faked. People with mental illness can just turn on or off their empathic reactions more easily.
What does mental presence mean?
The existence of mental illness means that our tendency to produce personal distress is an important part of morality.
What makes psychiatric problems particularly interesting and disruptive is that these patients often look more like generalPassing people. Take empathy for people in trouble. Ordinary people try their best to avoid this kind of emotion-they may look away from beggars on the road, or change channels when they see conflicts and disasters on TV.
In some cases, empathizing with the pain of others is painful, and it’s natural to avoid that pain. No matter what we do, we cannot change the fate of all suffering people. Most of us tend to become more practical after actually trying to do something. What can I personally do for the crisis in Syria? Maybe at least a little more than I do now. Most of us avoid helping others not because we can’t, but because we don’t want to spend time and resources on those things. So, maybe when mentally ill people refuse to empathize with people in trouble, they are not unusual, maybe they are just in the extreme state of most of us.
The second major result of the empathy study of psychopaths is a deep reflection on empathy itself. The empathic care that most psychologists talk about is not an aversion to people in distress, which seems to be missing from the mentally ill. We better regard this aversion as “personal distress”, which is an unpleasant experience. It can be described in terms of “sad”, “frightened”, “distressed”, and “frustrated”.
The emergence of this feeling is a defensive response to the pain or fear of others-we can feel the pain and fear of others, but try to avoid it. Most psychologists believe that this personal distress and morality conflict. why? Personal distress keeps us away from those in need. Therefore, thinking again from the beginning, the existence of mental illness shows that an important part of morality is that we have a tendency to cause personal distress. We do n’t hurt others because it is painful to witness the pain and sorrow of others, and cause us pain.
The response of psychopaths to people in distress suggests that morality may be based not only on positive, prosocial emotions, but also on negative, stressful, and self-oriented emotions. This is not a cute version of empathy, but a primitive aversive reaction that has nothing to do with our human care for others.
Stephan Schmitz
But what can expose our common human nature more than the fact that I have personally been troubled by your encounter? What else can make me understand the importance of the suffering you are suffering? Maybe it is the personal distress brought by empathy that played an important role in making me understand that hurting you is absolutely wrong. Even if I just think about it, I will be full of vigilance.
It can be said that, rather than helping people in difficulty, it is more important to suppress their desire to hurt others in order to achieve their personal goals. Research in social psychology has focused on how to encourage us to help others, but this may make us ignore important aspects of moral ethics. Relevant research on psychopathy puts personal distress back to the center of moral psychological foundations.
The last lesson we can learn is how to explain the moral flaws of the mentally ill. Who is correct about moral sentimentalism and rationalism? Relevant evidence supports both positions. We don’t have to make choices-in fact, it’s stupid to do so. The rationalists who believe that the mentally ill have no sense exaggerated how they would not fear punishment as much as we do. Such deficiencies can affect decisions made by mentally ill people: Without the proper fear of punishment, it is difficult for individuals to learn to take appropriate actions. But to the moral-emotionalist, fear and anxiety are just emotional reactions. The absence of these emotions impairs our ability to make the right decisions, which in turn fuels violence among psychopaths.
Fear therefore bridges the divide between reason and emotion. Fear plays a dual role in restricting our behavioral decisions. On the one hand, it can deepen our understanding of the pain of others; on the other hand, it can drive us to avoid certain behaviors or situations. What remains unclear, however, is whether moral philosophers can readily accept the meaning of fear. In the face of the suffering of others, the distress and anxiety we produce are unpleasant, and are unpleasant and closely related to ourselves. This is in sharp conflict with our usual understanding of morality: moral care should be warm, broad-minded, and others-oriented. The existence of a mentally ill person forces us to face a core paradox of moral ethics: My concern for your encounter is actually based on my concern for myself.
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