Did results discussed at the conference support your hypothesis?
The neuroscientists at the meeting were not working directly on the phenomenon of repetitive killing, but they reported findings from their research that are compatible with a ‘cognitive fracture’. For example, Lasana Harris from the University of Leiden in the Netherlands, who works on hostilities between social groups, has used fMRI and EEG to show that 'ordinary' people can suppress their social-brain cognitive network, so that 'enemies' could be perceived as dehumanized objects rather than people, and thus detached from emotion.
Do you agree with sociologists at the meeting, who argued that it was not appropriate to medicalize a social problem?
I don’t see it as medicalizing the problem so much as formulating it in a way that I know is useful in the medical world. As a doctor, you always work with a degree of uncertainty, and you try to minimize that uncertainty by setting out the observable signs and symptoms in the hope that understanding will emerge. This seems a good way to provide a framework for interdisciplinary discussion.
Did it work to have such different disciplines come together?
The sociologists’ concept that people draw 'symbolic borders' around others resonated with me. Other concepts were more difficult to get across because we all use different vocabulary; I don’t quite understand what sociologists mean when they talk of us having 'different selves’ in different situations. And it is true that sociologists were nervous about us saying that everything is brain-based, particularly when it comes to talking about behaviours of individuals within groups.
Did neuroscientists feel uncomfortable when asked to consider how their research could be used to understand the minds of repetitive killers?
We were all out of our comfort zones. I knew that I was going out on a long limb that could break at any time! It was far removed from my daily life as a neurosurgeon. But it is such a huge problem that causes such a large loss of life — think of the Islamist terrorist group ISIS today — that we all have a responsibility to start talking about it.
If mass murder happens because of activity in the brain, what does this say about personal responsibility?
Perpetrators of repeated killings have the capacity to reason and to solve problems — such as how best practically to kill lots of people rapidly. Proposing the existence of a syndrome does not absolve them of responsibility.
Even if we understood the neural mechanisms involved, what could we do about it?
It is hard to imagine how this could be controlled at a political level. But understanding things at a fundamental, biological level will encourage policy-makers to focus on the right sort of education about this. A small number of people don’t make the transition to become killers in these critical situations. Early education might help to increase the number of those who are not susceptible.
What does the ‘E’ stand for in Syndrome E?
A 1996 editorial in The Lancet3 championed the hope that, one day, an inquisitive scientist “will come across evil … and recognize it for what it is”. I made a decision not to use the word 'evil', as I thought it invited metaphors and biased the inquisitive mind. But I stuck with the ‘E'.