I was a new forensic psychiatrist at Broadmoor and had to visit one of the wards my first week. I stood at the bottom of a staircase and let a group pass. I was joined by another staff member, who waited while the men descended silently, their hands skimming the bannister or leaning on it for support. I was attracted to one man because of his large white beard and resemblance to Father Christmas. My companion looked at me after they'd left. Do you recognize that person? I shrugged. Peter Sutcliffe, you know, The Yorkshire Ripper.
With a deep breath I thought, "So that's him." He was a notorious patient, one of the most dangerous offenders, and he was a serial killer. After feeling shaken for a while, it occurred to me that there was nothing I could see. He was a man and not a monster. Detectives in Yorkshire tried desperately to solve a series brutal murders of women. They interviewed Mr Sutcliffe seven more times before they identified him as the suspect. Evidently, they didn't see anything that would distinguish him from other men.
After meeting Peter Sutcliffe it became clear to me that there was nothing I could see.
It is a paradox that we are so eager to put violent offenders in the public domain in frightening mug shots and true crime recreations while trying to avoid looking at our own cruelty as much as we can. People who do a terrible thing assume they are different and won't change their mind. Our culture and media encourage us to be our best selves, while at the same time, we are constantly encouraged to transform. People who make positive changes in their bodies, change their careers, overcome disabilities, or learn new skills are celebrated. There seems to be a misconception that violence perpetrators are encapsulated in dark amber.
I was greeted by Mr Sutcliffe at the staircase, and that marked the beginning of a long road. I would be able to let go my preconceptions about evil and learn how our cruelty can be understood with enough time and effort so that the risk of suffering might be diminished. I would have the opportunity to learn how to change and open my mind, much like I ask my patients.
Many people have asked me how it is possible to work alone with violent offenders, in small rooms and giving therapy. People assume my job involves constant fear and revulsion. However, I tell them that I feel the strongest emotions in the company of my patients when they are sad or pityful. Radical empathy is a delicate balance between compassion and detachment. Radical is Latin for root. Therapy aims to go deep into the past of people and uncover difficult memories. While it is their job to judge them, and not mine, I can't lose sight of their crime and the terrible consequences. As we unravel their complicated emotions and experience, I must keep my faith. This is the key to risk reduction. Carl Jung said it best when they suggested that evil is caused by people being unable to share their stories.
Radical empathy does not necessarily mean something new or urgent. It has taken years of practice and discipline, as well as the support of a group of colleagues, to develop radical empathy. Eileen Horne and me explore this learning curve together in our book, The Devil You Know - Stories of Human Cruelty and Compassion. We use stories that follow the path of my career to take you into therapy rooms, where I assess or treat people we call monstrous. This includes a serial killer and stalker, child sex-abuser, and a girl who murdered an older man as part a teen gang. These stories show how radical empathy is different from regular empathy. I'm not trying to be like them. I am instead a companion on their difficult journey to greater self-knowledge and help them understand the consequences of their violence. It is not always easy. Without the ability to self-reflect, one will be unable to recognize other people's pain. One such patient said, "I have multiple masks. I don't really know who you are." Others claimed that their actions were dreamlike and that they didn't realize they were being hurt. In one instance, they thought they only woke up when the victim began screaming.
My long-term training in psychotherapy and psychiatry has been devoted to helping me understand my blind spots. One example is the belief that those who have killed once will always want to do it again. Growing up, I read a lot about crime fiction. This probably encouraged the idea that murderousness is a permanent state of mind. It was only by digging into real-life stories that I discovered the complex reasons behind homicide. This crime is rarely repeated. It was common for murder to involve people who know each other well. This was not an attack by a stranger, but a story about relationships that went wrong. It is a sad fact that many people are killed in peaceful settings by someone who, according to WH Auden, eats at their table, and shares their bed.
Most people are killed when someone eats at their table, shares their bed, and, according to WH Auden, eats with them.
My training. In my training, I learned to ask the question: What problem does this person solve? We would find that homicide made sense to them at the time as a way to deal with some uncontrollable emotions like shame and despair. It began to make sense as I listened. It was clear to me how their dark thoughts, ordinary emotions running riot, culminated into a decision to kill someone. These distorted thoughts thrived when they were accompanied with ideas of entitlement and judgement about the victims. Ex-lovers or prostitutes should be eliminated. One story in our book shows how a man's murderousness was rooted in his need to attack people who were vulnerable.
In my initial assumptions, I believed women were naturally less violent than men. However, a recent UK survey found that 93% of all homicides were committed by men. It doesn't necessarily mean that women are better or kinder than men, and that the Y chromosome makes them more likely to commit murder. My experiences have convinced me that female violence has the same emotional roots as male violence. It seems that women need to be pushed harder to reach the point of committing suicide.
Since childhood, I wanted to share what I know about human nature with the world. However, my patients and I have learned that stories are only as good as the people who tell them. As I observed the rise in polarization in the United States and around the world in recent years, I was struck by the fact that, although Homo sapiens has made many advances, we still can be blind to the fundamental truth that we are more alike that we are different. Although mindfulness and tolerance of difference are common topics today, it is difficult to practice them.
It is possible to correct the current imbalance between compassion and condemnation if the methods we use when working with violent offenders could be applied at a societal level. This could mean more listening, less condemnation, fewer assumptions, more curiosity, and the willingness and ability to get up close, while still maintaining detachment.
While I understand that some may find a call to radical empathy, which anyone can achieve with practice, offensive, I also appreciate it. Some might think I'm trying to excuse cruelty. As a therapist who works with violent offenders, I have found that many perpetrators can also be victims. The two identities can not be separated, much like the idea of good and evil. My colleagues and I are willing to listen to the actions of people we don't like. This is what our work together, investigating the roots and causes of violence, involves. It is not always easy but I have found that this is the way we change the world, one mind at time.
Faber & Faber publishes The Devil You Know: Stories of Human Cruelty and Compassion, by Dr Gwen Adshead and Eileen Horne at 16.99. Or you can buy a copy at guardianbookshop for 14.7
