A review by rbruehlman
The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain by James Fallon

4.0

News at 11: psychopath writes an autobiography in which he is obnoxiously glib and self-aggrandizing and hard to like.

Not sure what I was expecting...

This is a very weird book to review / rate. On one hand, James Fallon is a jerk, and reading an autobiography where you don't like the author is always pretty tough. I viscerally cringed throughout the book.

On the other hand, all of that is sort of the point: James Fallon is a psychopath. He's not supposed to be likable, so does it really make sense to ding the book for delivering on the promised content? What was I expecting, Mother Teresa? A redemption arc? It's a book about a person who lacks empathy and a conscience, and the book demonstrates exactly that. Complaining is like going to a horror movie and being upset it was scary.

Ultimately, even with the recognition that the book is hard to read by design, I can't say I enjoyed the book. The lack of enjoyment isn't driven by the book being poorly written or not thought-provoking; it was fairly well-written and did make me think. The problem is, the second-hand visceral cringe was too much. I kept wanting to argue with the guy on principle and make him see why he was wrong. If I could just shake the guy by the shoulders and put some empathic sense into his head. (I guess on the plus side, confirms I'm not a psychopath?) Despite the book making me think, I'm not sure I'm better off having read it. I'm left with this unsettled feeling instead...

The book is split in two interleaving parts: a discussion of the brain, and a personal account of James Fallon himself. I'll address the two separately.

Insofar as James Fallon's discussion of the brain goes, this part of the book was quite good and made me think. Credit will go where credit is due: this subject can get very academic, but he makes the brain very accessible for non-academics.

It gave me a better appreciation than probably any book I've ever read about how different aspects of the brain work in concert with one another. I was a psychology major, so no strange to the brain and its parts, but I feel like textbooks always approach the discussion of the brain in discrete parts with discrete jobs. The amygdala processes emotion and fear. The hippocampus manages memory. Etc. What is not really ever discussed is: if X part of the brain and Y part of the brain are activated in a particular way, they produce result Z, but if X is overactive, X+Y=A; underactive, X+Y=B, and any number of combinations thereof. Brain regions are not independent units, but actually capable of any number of possible permutations. It sounds obvious writing it now, but popular literature on the brain has always been so categorical in nature that it is easy to adopt that simplified view. Fallon explores this expertly by discussing the interaction between the different brain regions that aren't quite right with psychopathy. It's clear how as one lever gets out of whack, others overcompensate (or undercompensate) and create different behavior patterns.

Finally, someone actually explores serotonin correctly! I was very pleasantly surprised to see Fallon's nuanced exploration of serotonin, which is best-known for its relationship with depression, but is so, so, so, so much more than that. It is exceptionally common to see depression reduced down to "not enough serotonin," which is a gross undersimplification of what happens in the brain. Maybe you don't have enough serotonin receptors in the brain. Maybe your serotonin transporters are long or short. Maybe you don't respond normally to serotonin. Maybe you don't make enough, or too much. We understand vanishingly little about the brain. There are a million subtle ways for things to go wrong, with different subtle effects. Oh, and there are over 15 different serotonin receptors. They do different things.

Epigenetics are wild! Our genes are not static; genes will turn on and off in response to the environment, which is why identical twins can have very different personalities, heights, weight, etc. I've heard of epigenetic changes before, of course, but I did not know they could be inherited. Fallon notes children and grandchildren of famine survivors can have an increased tendency to gain weight, whereas siblings who were born before the famine do not see such an impact. I instantly thought of the Holocaust--starvation and unimaginable emotional misery. The families of Holocaust survivors absolutely bear generational trauma, but, surely, then, they also carry genetic trauma.

Nature and nurture are equally important. There's a saying in the psychology field: genetics loads the gun, and environment pulls the trigger. The psychology field itself has swung between polar opposites of the spectrum for decades like a pendulum, unsure which has more impact. There is an awful lot that is set in stone by genetics; I will never be tall or blond-haired, for instance. But our environment shapes a lot, too; there is nothing genetic that makes Japanese people more reserved and Israelis famously blunt. Raise an Israeli child in Japan and a Japanese person in Israel, and their personalities would differ vs. those in their home country. Some people are inclined towards psychopathy, but whether they commit robberies and murders has a lot to do with environment. Abuse a psychopathic child, and you wire a brain predisposed towards callous aggression to act out.

So, yeah, brain stuff, all well and good. But half of the book was dedicated to James Fallon himself. That bit was ... rougher.

I know people like James Fallon, to varying degrees. We all probably do, really. They're not common, but they're not uncommon, either. I've met various people where I have thought to myself, you are not wired right. You're a blast to hang out with, but, at the end of the day, you don't care. Those people can be generous; they can be thoughtful; they can have morals. But empathy is subtle. You can sense when it's not there. There is something cold and self-centered about them.

It's not that I think the people I know like this are psychopaths, per se. Like all behaviors, I think psychopathic tendencies exist on a spectrum. In a different environment, though, perhaps raised in an abusive home, or in a highly tense war situation ... As they say: nature loads the gun, and nurture pulls the trigger.

This is probably part of what was very unsettling to me about the book, to be honest: some of the "psychopath-lite" people I know very intimately, and I couldn't help but read James Fallon's description of his thought process and think: That is exactly how XYZ person thinks. I knew about them before reading the book, but I hate being reminded of it. I want everyone to have morals and be empathic and kind, and I try to convince myself they're not as cold as I know they are. But no, their thought process is that cold and logical. It makes me feel sick.

The psychology behind people who remain in James Fallon's life is fascinating to consider. James Fallon sounds like a complete jerk of a husband. He states bluntly that he doesn't love his wife; his wife is intellectually fascinating to him. I think tending to her needs is kind of like tending to a plant, maybe; a plant in your house makes the room look nicer, so you water it, but ultimately, you're not doing that for the plant's benefit. You're doing it for your benefit. Your room would look less nice without the plant. Superficially, it seems like he cares about his wife, but he only cares about her needs to the extent they service his own needs.

You have to wonder: what on earth does Diane see in this dude? Of course you can be superficially charmed by someone like James for a while, but eventually, the mask slips. Why is she married to this guy? He never explores her motivations. Does she think she can fix him? Does the intellectual connection make up for the lack of emotional connection? Does she have some kind of psychic wound that makes her think she doesn't deserve better?

Other people in his life are much the same. James keeps them in his life because they provide some kind of value: intellectual stimulation, entertainment, career benefit. His friends seem well-aware he has significant flaws. Their reasoning for remaining friends is far easier for me to grok: I imagine those people keep him in their life because they, too, have turned the relationship transactional: James is fun to be around. They just wouldn't ever rely on him for anything. We're all party to that kind of friendship-making: that one friend you don't have much in common with, but enjoy going to the theatre/sports games/etc. with, or that friend who is fun, but only in limited doses.

James Fallon tries really hard to come off as an "enlightened" psychopath, but he's not very good at it. I think James Fallon tries very, very, very hard to impress on the reader what a good guy he is. He's gregarious! He's the life of the party! He has a moral code! He donates to the poor! Everyone loves him!

It's almost (truthfully, is) annoying how much he praises himself. But you kind of want to believe it--surely a guy with this many friends is a good guy? And, hey, he's taking ownership for being a psychopath and that he doesn't always treat people nicely. That fits nicely into a normal person's redemption arc, admitting a deep and vulnerable flaw. You want to like him, at first.

Except, the problem is, even admitting he is a psychopath is just part of James Fallon's psychopath game. He's not admitting he's a psychopath because he wants to be better, even though he makes sympathetic noises about how he should treat people better and shouldn't do this and that. He admits he's a psychopath because it's a badge of pride. Look at me, I'm a psychopath and I'm not a murderer! I work the system benignly! I'm great! Tellingly, he calls people who lie and steal "losers." It's not that he feels bad for their victims; he feels smugly superior to the psychopaths who transgress the system and get caught. James Fallon gets a high off socially manipulating people. The fact that people don't realize and that it doesn't break any "official" rules is the entire thrill and point. He's obviously an incredibly smart guy, and he uses his intellect to play games with people who have no idea they are participating.

By admitting you're a psychopath and should treat people better, it makes it sound like there's hope for redemption, that you're not such a bad guy. Manipulation at its finest!

He's not as smart as he thinks he is, though. He constantly reminds the reader everyone loves hanging out with him, and, also, he doesn't ever break the law. He has principles and a moral code. He is a prosocial psychopath. Yeah, true, he's not as bad as he could be. He hasn't committed any crimes. He assumes he's still a good person if he "only" manipulates people or is callous towards their feelings. And he makes the assumption everyone else will assume so, too. His reality distortion field is somewhat effective, yes, but I don't think he pulls the wool over other people's eyes as effectively as he thinks.

James Fallon never really explains what exactly in detail he does to warrant being called a psychopath by so many, but so many people comment on it, you start getting a sense he's a lot worse than he implies. I suspect he doesn't talk about some of it to preserve his own self-image, but I also suspect he literally doesn't realize the extent of his own deficits, either.

Interestingly, the longer the book goes on, the more the mask starts to slip, and cracks appear in his story of "not being that bad". For instance, earlier in the book, he goes on about how he's a great father with a great relationship with his kids. Later, he mentions his daughter writes him a letter accusing him of being a horrible person who has never been there for her. He cracks it up to him forgetting to bring his grandson to a dinner event one night. No, dude ... that obviously must have simply been the straw that broke the camel's back. Nobody writes a letter accusing their father of being emotionally neglectful their entire lives over one incident. James Fallon thinks he's a good father and is invested in maintaining that story, but that one anecdote spoke volumes.

Ultimately, towards the end, James admits: he doesn't care. He can go through the motions, and he can superficially care about the consequences if they negatively impact him, but, truly, at the end of the day, he just doesn't care. Yup. This is correct. The only thing James cares about is how things impact him. Everything else, meh. That's what differentiates someone on the psychopathy spectrum vs. someone who is simply mean or hot-headed; they can both do horrible things, like murder or hurt someone's feelings, but ... psychopaths just don't care. About any of it. Whatever.

It's the same conclusion I've come to about the people I know who aren't psychopaths, but certainly flirt on the edges of the spectrum: at the end of the day, they just don't care and won't ever. If you're not close to them, no big deal; if you are, expecting any different will just be an exercise in folly and hurt. Accept them for what they are, take what they give, and expect nothing more.