Research into nature and causes of human violence

Press, Volume CXI, Issue 32524, 6 February 1971, Page 12

Research into nature and causes of human violence

(By

HAROLD M. SCHMECK, JUN.)

He was a policeman in Boston, well-liked in his community and known as a good husband and father.

One night at home he handed his wife his pistol and told her to lock it up. He felt that his self-control was washing away in a surge of unreasoning rage that he could not explain and might not be able to control. He was afraid that he might shoot someone. Then he went to his bedroom, handcuffed himself to the bed and stayed there until the rage had burned itself out. The experience was terrifying. It was followed, at intervals, by others just as bad. Then, one day, the same feeling began to sweep over him again while he was riding in a police car with two other officers. He told them what was happening and begged them to lock him in the back and take him home. They took him to a hospital instead. Study by group Now anti-convulsive drugs keep his attacks largely under control, and he knows why they occur. He had been knocked unconscious in a motor-cycle accident six months earlier and his brain had been injured. The attacks of violent rage were the results of brain damage. It had not occurred to him that his rages were a health problem. The Boston policeman is one of more than 200 episodically violent men and women who have been treated and studied by a group of medical scientists at Massachusetts General Hospital. Like many other research teams in today’s angry world, this group is trying to understand the nature and causes of human violence. In recent years there has been a sharp increase in scientists’ emphasis on studies of crime and aggression. It is now one of the three top priority subjects in programmes of the National Institute of Mental Health. The others are mental health of children and mental health programmes for minority groups. Study of brain While many scientists are studying the social, political and economic causes of crime and aggression, the group in Boston is among the relatively few that are concentrating on the biology of human violence. The Boston group is trying to trace the origin ana nature of violence to the place where it all begins—the depths of the human brain. In a few patients who had temporal lobe epilepsy, violent outbreaks have been eliminated, perhaps permanently, by delicate brain surgery. In these operations, small clusters of cells are destroyed by heat from strong electrical stimulation delivered through implanted electrodes. More often, anti-convulsive drugs have been prescribed. The doctors have turned human attack behaviour on and off with an electric switch. They made a motion picture of one patient who erupted into arm-flailing violence when weak, non-des-tructive electric current was deliberately sent through an electrode planted deep in her brain. The attack stopped just as abruptly when a nearby spot was stimulated. The behaviour was not entirely automatic but was modulated by circumstances of the moment. Dr Frank R. Ervin, director of the hospital’s Stanley Cobb Laboratories of Psychiatric Research, said that the young woman maintained her self-control when her doctors were present but reacted violently when she was alone in the hospital ward. The stimulation was delivered by radio telemetry. On 12 occasions before she was sent to hospital, the

young woman had violently assaulted other persons, once almost killing another woman who had accidently brushed against her arm in a restaurant powder room. The doctors think that natural, although abnormal, discharges in a damaged brain produced the same effects as the deliberate electrical stimulations. The latter were administered to pinpoint the areas of damage in the patient’s temporal lobe in the lower, forward area of the brain. Another patient, a brilliant engineer, went to the hospital’ because of epileptic attacks and episodes of rage in which he sometimes threw his wife across the room. He stayed free of violence for three months, during which time a small spot in his brain was stimulated periodically. While thus calmed he was persuaded to agree to an operation designed to end the epileptic seizures and the rages. Later, when these effects nad worn off, he angrily rejected surgery. It took a long time to persuade him while he was in his natural state. The surgery, destroying only about one-eighth of a cubic inch of brain tissue, was done several years ago. Since then the patient has had few epileptic seizures and no known episodes of uncontrollable violence. In finding the groups of cells to be destroyed, the doctors made a sort of brain map of the patient’s subjective responses to the little jolts of electric current. Stimulation in one place produced a pleasant feeling, leaving the patient confident, creative and calm. In another, it gave him a strange, detached sensation of “looking on” at the world. Twinges of pain In yet another, his teeth ached; there were twinges of pain in his face, and he felt that he was losing control—that everything was “going wild.” There were no physical sensations in the brain itself. That organ cannot feel pain in its own tissues. Like the police officer, the engineer had suffered brain damage long before his attacks began. In his case, the damage was caused by illness. These are isolated cases and some experts believe that they are rarities having little direct bearing on the huge, complex problem of violence in today’s world. Others, including the group in Boston, do not question the importance of social conditions in promoting violence. They believe, however, that the role of brain damage may be seriously underestimated, and that the effects of this may be tragic. Dr Vernon H. Mark, director of neurosurgical services at Boston City Hospital, and Dr Ervin make this case in a recent book, “Violence and the Brain,” published by the medical department of Harper and Row.

The authors cite estimates that there are six million Americans who suffer from mental retardation; two million with convulsive disorders, half a million with cerebral palsy, and a substantial, although poorly defined, number of children who are thought to suffer from serious behaviour disorders because of impaired brain function. No exhaustive studies One major study by the Cornell Aeronautical Laboratory showed that about half of those hurt in traffic accidents suffered injuries to the head. Except in rare cases like that of the Boston man, the long-term effects of these injuries are simply unknown. It is true that many head injuries produce no changes in behaviour, and that many, probably most, people afflicted with epilepsy or other known brain disorders or with mental retardation show no violent tendencies. The scope of the brain injury problem, as related to violence, has not been studied exhaustively. Yet some of the doctors who deal with human brain disorders note these points: many of the people who commit violent crimes are repeat offenders; many of the conditions that go with poverty and social deprivation are conducive to brain damage. Child care For example, there is a greater risk of brain damage in childbirth when good obstetrical care is lacking. Infection and severe malnutrition, either before birth or after, can compromise the brain. Monkeys deprived of their mothers’ care from birth onward usually grow into frightened, irritable adults incapable of getting along well with other monkeys. Human babies deprived in much the same way exhibit some of the behavioural quirks of the infant monkeys. Recent studies of the animals suggest that the effects are not purely psychological in the common sense of that term but reflect abnormalities in the function of the brain itself. Childhood in the harsh conditions of an urban slum involves ample opportunity for brain injury through fights, beatings and accidents. Implications great A doctor at Johns Hopkins Hospital in Baltimore who, with his colleagues, has seen more than 300 brain injured children, said that the doctor’s impression was that these injuries were more common in the slums than in the rest of the community. In short, there is some evidence to suggest that a life of poverty in the slums could be contributing more than simply social pressure

and frustration to the picture of human violence. While this point may be debatable, its implications', if it is true, are great. If a prisoner with a record of violent crime suffers from a brain disorder that contributes to his violence, it does little good to "rehabilitate” him by teaching him a trade. Thus, some specialists see a pressing need for studying the relationships between the human brain and violence. Both among laymen and in the medical world there is often a tendency to think of the mind and the emotions as somehow apart from the body. In ■ fact, there is abundant evidence, as well as logic, to show that these human attributes are incredibly complex functions of that mcrediby complex organ, the human Ipain. Built-in triggers The triggers of violence are built into the brains not only of men but of all mammals. They have to be there for self-preservation. And the brain has to be equipped to override the impetus to violence. That, too, is important to species survival.

Two of the radio-control experiments of Dr Jose Delgado of Yale have become famous. In one, he stopped a bull in mid-charge by sending a radio signal to an electrode planted in the animal’s brain. The electrical stimulation turned off the attack behaviour instantly. In the other experiment, one monkey learned to turn off the aggressive acts of another monkey in the same cage by working a lever to send the pacifying signal. Dr Carmine D. Clemente of the University of California, Los Angeles, has made cats drop the rats that they were in the very act of killing. Electrical stimulation of just the right place in the brain made the cat forget entirely about its prey, curl up in a comer of the cage and go to slep. The. rat’s reaction to this has not been reported. One interesting feature of these experiments is that the animal’s behaviour appears to be controlled, not by influencing the brain areas that mediate attack behaviour, but by something that controls sleep. The scientist concluded that he was stimulating an inhibitory system that tended to push the brain toward sleep while a companion system worked toward wakefulness. Multiple roots Animal research concerning the brain and behaviour has a long history and is being pursued today in many laboratories. Nobel prizes have been awarded for some aspects of the work. Behaviour of the type called aggressive and violent has only been one part of this effort. Sometimes world events have been a trigger for new effort in brain research. In 1968, the assassinations of the Rev. Dr Martin Luther King jun., and Senator Robert F. Kennedy prompted 23 research workers at Stan-

ford University to start a broad-ranging study of violence. The result was a thorough survey of research, published this year by Little. Brown under the title ' Violence and the Struggle for Existence.” One of the authors, Dr Frank M. Ochberg, now of ’ the National Institute of Mental Health, said, during a recent interview, that the roots of violence were clearly multiple and complex. Man’s potential for behaving violently has not changed much over the milJenia, he said, but circumstances now make the dangers of violence much greater and its usefulness much less. Slippery definition Although the word . violence is a rather slippery and unsatisfactory definition of the behaviour involved, scientists have come to know something of its geography and its chemistry in the brain. The reflexes that generate attack arise from the brainstem. The behaviour that modulates it, either permitting the attack to occur or choking it off, seems to come from several areas of the brain, notably in that ancient part called the limbic system. This includes the temporal lobes and the amygdala Damage here can produce the kind of epilepsy called temporal lobe epilepsy. ~ T “® limbic system is thought to be a prime seat of the emotions. Dr Paul D. Mac Lean of the National institutes of Health notes that the system is an ancient part of the mammalian brain concerned with body functions related closely to selfpreservation salivating feeding, procreation and killing. The almond-shaped amygdala seems particularly concerned with attack behaviour and killing. In animals, electrical stimulation ® area can bring on attack behaviour. Surgical removal of the amygdala and the related cortex usually has a pronounced taming effect. 6

Surgery used Some medical centres in the United States and abroad have been resorting to surgery to treat some cases of intractable violence clearly related to brain damage. Among the pioneers in this has been Dr H. Narabayashi in Japan who has been using the treatment for carefully selected patients since 1965 with some promising, although not always totally successful, results. A group at Johns Hopkins ha ® been treating some episodically violent temporal lobe epilepsy patients with a hormone-type drug. Dr Dietrich P. Blunter, psychiatrist in the group, said that the treatment appeared promising in some Patients. The drug is a chemical antagonist of the male sex hormone testosterone, used because of the observation elsewhere that this hormone plays a role in aggressive as well as sexual behaviour. Dr Blumer said that the drug had been given in relatively low doses and had no feminising effect in the male patients. He said that the results had been surprisingly good and the co-operation from the patients excellent. Their natural personalities have tended to be those of good nature and responsibility, Dr Blumer said, and they have proved co-operative and conscientious except during their random episodes of violence. The group in Boston is preparing to try an even more unconventional mode of treatment for some of their patients. The doctors will try to train patients consciously to keep their brain waves normal. Special centre The rationale for this Is the evidence from other studies that a person can be trained to control some features of his brain’s electrical activity specifically, the brain signal called alpha waves. If, through training, a patient could prevent his brain from having the abnormal discharges that go with an epileptic seizure or with some episodes of violence the two are separate it is conceivable that the symptoms could be avoided, too. The same group also hopes to establish, through a small foundation called the NeuroResearch Foundation, a special centre for the treatment and study of violent patients. One big problem that has limited this kind of research in the past has been the reluctance ’of many hospitals to keep patients who may be dangerously violent. In an ordinary hospital setting, they are likely to be disruptive and dang erou s to themselves, the staff and the other patients.

Prevention better in this unusual field of medicine and research, as in many more conventional areas, there is general agreement that prevention would be a far better answer than any kind of treatment. And, in one crucial matter related to prevention, there is virtually complete agreement among those who see brain damage as an important facet of the problem and those who believe that the social and environmental aspects are the only significant ones. Both camps agree that the best way to start is through an all-out attack on poverty and the slums— Copyright, “New York Times” news service.