Program: Serial killers: answering your questions about how they think

Sana Qadar: Hey, I'm Sana Qadar. This is All in the Mind, Mailbag Edition. It's a version of the show where you send us your burning questions on a topic we've covered and we put them directly to an expert. And this week we're talking about serial killers. This is our very first attempt at this mailbag format. It's a different style to our main show, as you'll notice, and we're pretty excited to try it out for a few reasons. One being that a couple of months ago you might remember we ran a listener survey and quite a few of you responded. Thank you for that. And a lot of you said we should try out a mailbag format because it's really popular with other shows and often our episodes leave you with a lot of follow-up questions. So that's one reason. The second is we recently wrapped up our series on criminal psychology. It was very popular and our final episode in that series was on serial killers, a topic that seems to endlessly fascinate. And so we thought this would be a good time to try a mailbag episode. And I think we were right because so many of you have sent us questions that, oh my gosh, I don't think we will get to them all but we will try. And to help us answer your questions we have brought back Dr. Rajan Darjee onto the show. He was in that serial killers episode and he is a forensic psychiatrist who has worked in the UK and Australia where he is now the clinical director of forensic behavioral assessment and consultation services in Melbourne. So let's get into it.

Sana Qadar: Cool. Shall we go? Well first of all thank you for coming back on the show.

Dr Rajan Darjee: You're welcome. Thanks for having me back.

Sana Qadar: We have had so many questions come in but I thought before we get to the questions it might be useful for listeners to know a little bit about you. Like how you got into this line of work, why you chose forensic psychiatry and then we'll launch into the questions.

Dr Rajan Darjee: Okay yeah I can, I'll give you the honest answer and I've said this previously to people which is not an answer I used to give when I went for job interviews when I was starting because that would become apparent. Basically what happened is when I was at medical school in the early 1990s Silence of the Lambs came out.

Sana Qadar: Oh yeah.

Dr Rajan Darjee: And I was in third year of medical school and I thought it was a great film. At that point I had no idea about anything to do with psychiatry but I thought wow, you know, people who do these things are horrendous but very interesting. So I got a book about a British serial killer called Dennis Nilsen and the thing that was interesting wasn't the blood and gore and the nasty details of crimes. It had like, it was a really good book by a man called Brian Marston. It had sections on trying to understand Dennis Nilsen but also on his trial because he put forward a defence of diminished responsibility and for me naively I was like well how can someone like Dennis Nilsen not be mentally unwell? Yeah there are arguments about whether he was or wasn't and I thought that was fascinating. So like the geek I am I then went to the Medical Library at Edinburgh University in Scotland and got a huge textbook of forensic psychiatry out and read it and I was like this is just absolutely fascinating and I decided at that point that's what I wanted to do and yeah so that's the reason I went into it. It wasn't just I saw Silence of the Lambs I thought serial killers were like interesting. That sparked that interest but I also really enjoyed working with people in difficult situations and difficult circumstances and trying to take things forward.

Sana Qadar: I do love that Silence of the Lambs plays a role in your origin story and the issue of criminal responsibility is interesting because we do have a question that relates to that that we'll get to later but let's start with demographics. We had quite a few questions come in on the demographics of serial killers so let's start there. Danielle asks why are men overrepresented as serial killers? Is it that they are physically stronger and therefore more able to kill or is there something to do with brain structure or hormones or something else?

Dr Rajan Darjee: Yeah like all things it's probably a combination of those things with other things. I mean the thing is men aren't just overrepresented amongst serial killers. They're overrepresented amongst violent offenders. They're overrepresented amongst people who commit homicide. They're overrepresented amongst people who commit sex offenses. So I mean I think you've got to look at the questions to do with why are men more likely to be violent and aggressive and I think you have to look at all the different levels so you know there's clearly something biological about men. You know like men have got a Y chromosome, women have got an X chromosome or two X chromosomes and men have got an X and a Y. There are differences in brain development. There are differences probably related to testosterone. We know that testosterone is related to aggression and dominance in males but then there's also issues to do with socialization, development of boys, social and cultural expectations of men and then important point that's been made about physical strength. So when we look at how males and females kill when they do kill, for example men use strangulation whereas females don't tend to use strangulation. So for example if you look at sexual homicides you don't get many sexual homicides committed by women but when you do get them they're often associated with shooting whereas in men even in America sexual homicide is much more likely to be associated with strangulation. And that's there is this thing called the kind of I think it's called the physical strength hypothesis but also you need to think about what are these offenses about for the perpetrator. For men when they commit crimes like this they want to get, this is horrible to think about, they want to get up close and personal with the victims whereas women, you know that's a classic thing but I think it bears up is that you know there's a number of females who commit serial murder who poison their victims and that's very hands-off.

Sana Qadar: I just want to go back to something you said at the beginning of this answer. I would have thought testosterone plays a huge role in it but you also mentioned the Y chromosome potentially. What would the Y chromosome have to do with this?

Dr Rajan Darjee: The difference between males and females genetically is you know women have two, well most of the time women have two X chromosomes and men have an X and a Y chromosome. So all the things that come intrinsically when we're born that are to do with being male versus female are all to do with that because that's the only difference.

Sana Qadar: Alright another demographic question Maya asks, I've noticed that many well-known serial killers are white men often driven by sexual gratification. Is it true that most serial killers are Caucasian?

Dr Rajan Darjee: Look I think you know that there used to be a thing that all serial killers were white. That's clearly not the case. If you look in other countries you know so there are serial killers for example I know of cases in South Africa where they're committed by black men. You get serial killers of all races. One of the things that does seem to hold up is that most serial killing is intraracial.

Sana Qadar: To people killing within their own race?

Dr Rajan Darjee: Yeah especially sexual serial killing and that might basically be because people tend to be sexually attracted to people of the same race. So if you're developing sexual fantasies about hurting or killing people that's going to be towards people who you're attracted to. So one of the things we found when we looked at serial sexual murder in Australia is they were all committed by white men against white victims. Even though we did have some indigenous and non-white people who are committing sexual murder none of the serial sexual murderers were non-white.

Sana Qadar: Moving on we also heard from an American listener who wants to know what would mass shooters be considered? Are they technically serial killers as well or are they different?

Dr Rajan Darjee: I think they're very different. If you look at people who commit mass shootings they build up to do this one terrible thing at a point in time. Sometimes they die themselves either at their own hand or at the hand of law enforcement and quite often they're driven by an ideology. That doesn't mean they're driven by religion or religious ideology. It might be a very personal ideology.

Sana Qadar: Like a hatred of women? We've had incel mass shooters.

Dr Rajan Darjee: A hatred of women? A hatred of a racial groups? Yeah absolutely. You know there's a whole area in terms of what we call grievance fuelled lone actor violence. And also your mass shooting actually overlaps to some extent with people who commit atrocities as part of extremist organisations or terrorist organisations. So there's a bit of an overlap. But when you look at people who commit mass shootings or mass stabbings as we have in other countries there's a whole different dynamic about that because it's often to do with targeting a particular group or getting the person feeling intense hatred and alienation from society or wanting to get attention for their cause or perhaps wanting to terrorise. Whereas with serial killers some of them are operating over a decade, longer than a decade. It's not about this build-up towards one event. It's about they derive some sort of satisfaction or pleasure from killing and they put that into effect because they don't have feelings for other people. And they're also able to get away with it. You're never going to get away with a mass shooting. Yeah. But that's not the purpose of a mass shooter. So that there are a number of differences, different things that drive the two behaviours.

Sana Qadar: That's interesting because that kind of answers a question I had after our initial chat and episode went out which is that you know the question we asked in that episode was why are there fewer serial killers now than there were before? And you know we talked about DNA, we talked about surveillance, we talked about all sorts of reasons. And I wondered whether it was the case that people who might have become serial killers in another era might be more inclined to become mass shooters now because it's easier in a sense to pull off. Like we talked about how people get caught after one kill and they don't get get a chance to go on to become serial killers. And so if the goal is to kill people maybe you know mass shooting does that job you know sadly more effectively. And I wondered specifically with the sexually motivated serial killers you now have incel type mass shooters. I wondered if there is an overlap but it sounds like the motivations are quite different that you're talking about.

Dr Rajan Darjee: Yeah absolutely and actually it's very... the thing with incel ideology and incel thinking is that you don't necessarily come across that in people who commit serial murder. We haven't got much research on it but again that would indicate that even though there is some overlaps in terms of hatred of women there are other things going on that means that when they're violent the violence comes out in particular ways. The other thing you find with a lot of serial killers particularly sexual serial killers they start doing it when they're very young. I mean I know of people who started committing sexual violence and even sexual homicide in their teens and then continue. So serial killing seems to be a kind of a career as opposed to mass shooting which is an event. And I think that there were therefore kind of key differences between what would make someone want to make a career out of killing versus wanting to get as you said potentially more killings kind of done.

Sana Qadar: You mentioned a lack of feeling for others a moment ago and we've had a few questions on empathy. So I want to ask you about empathy. Daniel asks where does a lack of empathy come from? Is it nature, nurture or both? And if nature plays a part have we been able to isolate a gene mutation that might be responsible?

Dr Rajan Darjee: Yeah that's a great question. Let's think about two situations where people might lack empathy. One is psychopathy where people are callous. Now that's classically seen as people who they can easily put themselves into someone else's shoes but they don't have feelings for other people. Most of us if we hurt someone one we can pick up that we've hurt someone based on their emotions and two that feels horrible and that stops us doing it. Now that empathy deficit that we come across in people who might be seen as psychopathic we know there is importantly a high genetic component to that. And we actually know about some areas of the brain that seem to be functioning differently. Now this is going to be a massive oversimplification but there's a part of the brain called the amygdala which is on the inside of your temporal lobe and we know for example that in people who are callous or lacking empathy because they're psychopathic that doesn't light up in the same way that it normally lights up in other people in these situations. Now interestingly you think of another situation. Children who are mistreated and abused when they're younger often develop an overactive amygdala rather than underactive because it's a threat system. And actually there's broadly there's two different types of people who are chronically antisocial and aggressive. There are psychopathic individuals where this system's turned down. And then there's people who are impulsive, emotionally unstable where this system's turned up. So it's interesting because some people are like okay it's clearly childhood abuse that causes psychopathy. Unless you've got the underlying genetic and brain disposition you're not going to turn into someone who's callous. Now having said that not everyone who's got the disposition to be callous becomes callous because all that having no empathy does is it means that you just do what you want to get what you want. Now if you grow up in an environment where you can get the things that you need or things you want without hurting people then despite not having feelings for other people you're not going to necessarily hurt people. But if you grow up in an environment where you see dad getting what he wants all the time by being aggressive and being violent, if you've got no empathy you're gonna go down that road.

Sana Qadar: Yeah and so just to come back to the question of whether empathy is genetic inherited or nurture, a result of nurture, it sounds like as with many things it's a bit of both.

Dr Rajan Darjee: Yeah but I think the inherited brain bit is really important. Whether it actually then becomes violence I think depends on other factors but you have to have the inherent predisposition. Okay. You can't take a child who's functioning completely fine in the first years of life and then turn them into someone who has a complete callous lack of empathy. You can't abuse a child into being psychopathic if they don't have the predisposition.

Sana Qadar: The final question on empathy I'll ask is, one person wrote in to ask, are there effective treatment methodologies to establish some sense of empathy or is it a lost cause?

Dr Rajan Darjee: Look the research evidence at the moment is if you've got that callous lack of empathy as an adult and you've already been committing violence you can't change that. And so if you go back people used to try and help people develop empathy, teach people empathy, do exercise and treatment where you try to like see the impact on your victim. And with people who have that psychopathic lack of empathy it just doesn't work. You can't suddenly rewire someone's brain and so when you're working with people who might be psychopathic what you do is you don't try and do that. It's partly about the fact these people do what they want to do for themselves. They're very self-centered. When I'm working with people who have those traits what I'm trying to do is get them focused on wanting to do things that don't involve hurting other people. Sometimes people call this working with that self-centeredness but trying to get people to turn that towards things that aren't going to harm people.

Sana Qadar: What else can they do? What would be the other thing that you could turn them towards?

Dr Rajan Darjee: Yeah so let me give you a really simple example. So this is a man that I worked with in the UK who's passed away now. I won't say his name obviously or anything but he committed multiple violent and sex offenses. I think it was only by luck really that he hadn't killed anyone. And when he came out for the first time ever in his life he had a horrendous background. He had a nice place to live in the middle of a nice city. He had a nice sofa. He had a nice TV. Now some people will go these criminals they don't deserve all that stuff. But actually he was like wow this is amazing. For the first time in my life I like this. And he actually sat down with me. I won't swear and use the exact words he said but I sit down with him and said I'm not doing it for you. I'm not doing it for the effing police. I'm not doing for the effing social workers. I'm definitely not doing it for my victims because they deserve everything they got. I'm doing this for myself. And I was like that's fine if you want to carry on for yourself having a nice place to live. You know I'm not gonna change you. No one was ever gonna change him. By the time I worked with him he was 45 years old. And some people hear him saying that go oh he you know but but surely if we can just turn it around and make him one to do with the victims. Like they're not gonna do that. And that's why when I see these true crime shows and and when he was facing trial he showed no remorse and no empathy. And I'm like yeah of course he didn't. You know like if he did he wouldn't have done this in the first place.

Sana Qadar: Right. For the next few questions I wonder if we can do a couple more like quickfire answers.So we can get through some. On treatment with sexually motivated killers. Helen asks apart from chemical castration for sexually motivated killers and presumably other violent or serial sexual offenders are there effective rehabilitation strategies for serial killers? Those either motivated by sexual factors or others like the angel of death type of killer?

Dr Rajan Darjee: Yeah look there may be but because of the nature of these individuals we're always going to want to keep a very close eye on them. What we know in general with violent sex offenders there are programs psychological treatment programs that we can use that reduce reoffending. So in general with violent sex offenders you can treat individuals and reduce the recidivism rate. The problem you've got with people commit serial murder is that they are particularly dangerous individuals. If I told you that these programs you know reduce reoffending by 50% you'd be like okay that that's great. Now what does that mean for a specific serial killer who's already killed 10 people? If we've got a program that might do that is that good enough to actually say that that person's been treated? We're not going to cure these people. So I think even with serious violent sex offenders you have to a combination of psychological treatment sometimes pharmacological treatment but also ongoing support supervision and monitoring. And with individuals who've committed multiple homicides you're never going to not supervise and monitor them closely. And there will be some people who just aren't gonna be safe to release ever.

Sana Qadar: Wendy asks what do you make of the theory that decriminalization of abortion in New York reduced the crime rate 18 or so years later? This idea I think is what was popularized by Freakonomics.

Dr Rajan Darjee: Yeah yeah it's um it's fascinating. I actually after the last show I read a bit about other things that people think might be responsible for the reduction in crime. This idea that if you have less unwanted children then you're not going to end up with as many damaged individuals. I think it's plausible that that might have contributed but like all of these things I think it's gonna have contributed alongside other things. It's a bit like the lead crime hypothesis you know. I read another paper on that that said basically if it has contributed it's contributed a tiny bit yeah. So all these things may have contributed a little bit but I don't know to what extent.

Sana Qadar: Okay finally you've talked a little bit about how you approach your job and a couple of people asked questions related to how you do your job so I'll put these to you. Aaron wants to know when someone commits a crime wouldn't the individual be deemed mentally unwell as it's not a normal thing to do excluding some rare outliers such as self-defense or accidents? If none of these behaviors are normal how do psychologists and psychiatrists determine who is criminally insane?

Dr Rajan Darjee: Yeah in terms of criminal responsibility we tend to call it the mental impairment rather than sanity now just because of terminology but really to get that type of finding you have to have a very severe condition you usually have to have something like schizophrenia, psychosis, a severe brain injury or a quite marked intellectual disability. So these are conditions that regardless of whether someone's committed a crime or not we recognize these as being serious conditions that affect someone's ability to function someone's ability to behave so and sometimes serial killers have those conditions but most people who commit serial murder because they enjoy killing or they want to kill for pleasure. Even though that's statistically abnormal we wouldn't see that as a severe mental illness. Now what you're now getting to is a realm of people who have things like personality disorder or sexual deviation. Now the thing with personality disorder and sexual deviation unlike schizophrenia you you kind of either have schizophrenia or you don't whereas with personality problems and sexual deviance it's a spectrum all of us are somewhere on that spectrum and at certain point. For example with psychopathy everyone is somewhere on the psychopathy spectrum most of us aren't at the top end but if you're at the top end and you're callous then you might it might predispose you to serial killing. All of us to some extent and again this might sound weird but are sexually into things that might be kinky or coercivebut most of us aren't at the point where we're going to actually force and hurt other people and most of us aren't at the end of spectrum we want to kill people for sexual pleasure. So these things are a matter of degree. Now some people go well at the top end those people are clearly insane or mad but what we what we do is psychiatrists psychologists they look these people have abnormal personalities and abnormal sexual functioning but these aren't mental illnesses right that's the kind of the way that we view them otherwise everyone who does anything that's terrible or bad is not responsible and you know you take that further you go well no one who kills someone's responsible for killing them.

Sana Qadar: To finish Charlotte asks in the serial killers episode you described your approach to maintaining positive relationships with offenders in order to work with them effectively how do you go about maintaining unconditional positive regard with the most challenging individuals as a budding mental health professional I would love to know if you have any tips for the rest of us.

Dr Rajan Darjee: I think what you have to do is really be focused on them as an individual you're interested in you've got to be also focused on the fact you want to stop this behavior happening and as I've said there by judging them or having this kind of gut reaction to them that's not going to help you stop the behavior happening and also one of the things is no one chooses to have lack of empathy no one chooses to have been abused as a child now people choose whether they're going to do bad things or not. But one of the things I find helpful is I can empathize for this person's earlier development into what they've become but also the other thing is I know by actually having good positive relationships with people I work with I'm much more likely to get the kind of results I need to get so all of those things help me kind of have a positive relationship. It's not necessarily unconditional positive regard, I've got a colleague who talks about it says it's unconditional neutral regardbecause you don't want to become best friends but that's not what you do with anyone you know like forget about forensic or criminal work as a therapist you're not trying to be best friends with your patient and I think that the other thing I mentioned in the last episode is I think there's some people who are more able to do this because they can keep a safe distance you know not not be too detached but not get too close to it and I think if you can't do that then it's not necessarily the work for you.

Sana Qadar: Dr Darjee it's been fascinating talking to you again thank you so much for coming back on.

Dr Rajan Darjee: Thank you you're welcome thank you for having me again and yeah hopefully people have found that interesting.

Sana Qadar: That is Melbourne-based forensic psychiatrist Dr. Rajan Darjee. That is it for our very first episode of All in the Mind Mailbag Edition. Thank you to everyone who sent in questions we literally could not have done this episode without you so thank you. We're going to see how many people listen what kind of feedback we get and then we'll decide whether it's worth doing these mailbag shows more regularly. If you have any feedback and you want to share it you can email us on mind_rn@abc.net.au we always love hearing what you have to say but just note we get a lot of messages so we can't always reply but we do always read your messages. Thanks to senior producer James Bullen, producer Rose Kerr and sound engineer John Jacobs. I'm Sana Qadar, thank you for listening I will catch you next time.