"And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him."
Enough for now with the rational exuberance of the election; let us be grimly realistic. The New Yorker this week has an intriguing look at the phenomenon of the psychopath, which, as the article reminds us, means "suffering soul." This brings up the obvious question of whether they themselves do in fact tend to suffer, as opposed to those who come in contact with them.
Those who, like me, do not work in forensic or correctional settings generally encounter antisocial types who are in distress of some kind (i.e. they present voluntarily for treatment). However, it seems to me that they are usually more perturbed by the social consequences of their actions than by those actions themselves. That is, they do, much like a severe substance abuser, seem to recognize at some level that they are not "right," at least not normal, but the distress comes about as a result of legal, financial, and social results of their behavior, which in itself they often find, of course, to be quite gratifying (or as we say in the business, ego-syntonic).
For instance, I saw a guy not long ago who was superficially quite pleasant and engaging but who professed to have committed a number of highly violent acts over the years, some of which had come to the attention of the legal system, some not. On one level, he seemed to exhibit remorse for this, but he was also at great pains (so to speak) to impress me with the magnitude of his potential for violence (he was affable with me and I did not feel directly threatened in any way). He said several times, "I don't want to hurt people," but at other times he acknowledged that hurting people sometimes gives him great pleasure, and he made a point of insisting that those whom he had victimized in the past had deserved it in some way.
This man did seem dysphoric, but I'm not sure that it was necessarily related to his antisocial style (he may have bipolar disorder as well). As the aforementioned article mentions, it is quite possible for psychopaths to function successfully and without obvious suffering. Psychopaths are not inevitably violent, and in settings such as business, law, or politics they may decide that it is in their best interests not to be, but the hallmark of the condition is that this decision is based purely on self-interest, not on true conscience.
A few decades ago, cultural explanations for the formation of antisocial individuals were dominant, reflected in the term "sociopath." The pendulum has very much swung back to neurobiological explanation. To be sure, many psychopaths have awful and abusive childhoods, but that may be due as much to genes shared with their parents as to any direct result of traumas endured (after all, most people abused as children do not become psychopaths).
Brain imaging is the reigning trend now for insight into behavior, but it's hard to know how this ultimately relates to whether we treat antisocial actions as freely willed or as imposed by psychopathology. After all, we know that all subjective experience and overt behavior originate in the brain in some fashion, and the precise location and nature of this--whether the amygdala or some other region lights up on functional MRI--is of questionable relevance to legal theories of responsibility. Of course, such theories ultimately reflect social consensus, and as brain imaging and other neurobiological techniques become more commonplace in the public eye, the trend over time may favor determinism over free will.
But there is a strong visceral resistance to viewing certain kinds of violent or predatory deeds as inevitable or merely biological. This may not be rational in a strictly scientific sense--as myriad philosophers have argued, from the point of view of the universe (or the ultimate functional MRI machine), all thoughts and behaviors are determined by the brain. However, our revulsion toward the psychopath is highly rational as itself a product of evolution.
One can imagine that genes favoring psychopathy may have survived over the eons because in some contexts they may confer survival advantage. In some situations ruthlessness and comparative lack of conscience, particularly when coupled with prudence, can be remarkably helpful. However, this has had to struggle against competing genes that have favored the social cooperation and trust that bound successful groups together over evolutionary time. Groups cannot function if more than a tiny fraction of its members are psychopaths.
A severely moralistic view of antisocial behavior has therefore, for both biological and social reasons, itself seemed inevitable so far. Whether psychopaths will continue to be "corrected" in the criminal justice system as they are now, or rather according to a mental health paradigm a la A Clockwork Orange (this remains science fiction, as no effective treatments for psychopathy currently exist), is based more upon social decree than upon science. It's for the voters to decide; the neurobiologists and the moralists will make their respective cases over time. The ultimate referendum: is the serial killer evil or sick?