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of all psychopaths that includes non-criminal or successful psychopaths. It is the record they leave and often their confinement that make criminal psychopaths the best scientific subjects for anyone who wants to see into the psychopathic brain.
    If you hope to come away with useful insights by studying human beings, you have to know what kind of human beings you are studying. We have already seen that similar violent actions do not reflect the functioning of similar brains. You have to know who you have invited into your laboratory and who you have slid into your brain-imaging machine as you watch their brains in action. It’s important to know their background, gender, age, weight, medical history, ethnicity, and drinking and drug use habits, for a start, because many factors can influence behavior, behavioral responses, and even the structure of the brain. And it is most important that you have a way to identify who is a psychopath and who is not. You have to know, as best as you can determine, where on the spectrum of psychopathy the person you are studying lies.

Chapter Seven
    Missing Fear and Empathy
    T HE HAUKELAND UNIVERSITY HOSPITAL in Bergen, Norway covers a lot of land. The trees lining the streets of Bergen can’t hide its buildings, which cover over two million square feet of space. The single main building alone covers more than 1 1 / 3 million square feet. The Hospital employs around 11,000 people who treat or assist in the treatment of nearly 600,000 patients per year. If you find yourself in Norway and incur severe burns, develop a brain tumor, or experience decompression sickness or the bends while scuba diving in a fjord, this is where you should ask to be taken for the best specialist care. The Hospital also has a Center for Research and Education in Forensic Psychiatry and a Regional Security Unit. If you are a criminal psychopath and volunteer for a brain scan, you might have it done at Haukeland.
    This is where LTK, a 25-year-old Norwegian man who impressed researchers as “somewhat grandiose” as well as manipulative, conning, and superficially charming in his social interactions, had his brain scanned. Like most individuals described in medical case reports, LTK is known to readers only by his initials.
    It would be nice for his fellow Norwegians if LTK’s psychopathic profile were limited to the classic traits of manipulative conning behavior,superficial charm, and the grandiose sense of self-worth his doctors saw in him. Sadly, his score of 36.8 out of 40 on the Hare Psychopathy Checklist (PCL–R) reflects some far more troubling traits—and convictions. The worst was for rape. Helge Hoff, who works at Haukeland University Hospital’s Center for Research and Education in Forensic Psychiatry, and his colleagues described LTK, who agreed to have his brain scanned while processing emotional information as part of an experiment, as a “prototypical criminal psychopath.” 1
    We know that a key way in which LTK and other criminal psychopaths differ from non-psychopaths is the way their brains deal with emotions. They don’t respond to emotional images or situations in the same way people who lack psychopathic features do. For the most part, they have impaired ability to process or personally relate to the emotional content of words or emotional experiences.
    For example, consider the following scenarios or situations. You are waiting to be called into a dentist’s office for a procedure you fear. You discover that a creepy insect is under the bedcovers with you. You see a companion run down by an automobile. You hear sounds of a break-in when you are in the shower.
    If your brain processes emotions like most people, seriously considering all of these scenarios is liable to produce some subtle but predictable and measurable effects. This ability to re-create or feel someone else’s discomfort is not “just in your head.” Your body responds as well. Your heart beats a little bit faster and