HORRENDOUS best describes what these murderers did – 100% unacceptable. But it’s what they couldn’t do, that’s worse. To find out where this aberrant behaviour comes from, you need to look in the most unlikely direction. Percy, one of the lesser criminals, showed it even more clearly than most. Well hidden, regularly disguised – BUT, until it’s given centre stage, expect inhumanity to thrive.

It’s well known that too many prisoners can neither read nor write – serious social handicaps today – but talking? Surely all adults can talk? No so, when you get down to it. In fact, my work with them, all of them, consisted essentially in highlighting their gross verbal deficiencies, and asking them what they thought about it. Percy was an excellent example. He could wax lyrical on many issues. But, what he couldn’t say will surely astonish you. He was largely illiterate, which contributed mightily to his criminality – but his verbal incompetence was huge, and 100% counter-productive.

It’s easy to be bedazzled by the horror of killing – violence sells. But the depth of social and emotional deprivation that accompanies it, has to be seen to be believed. Percy had no difficulty talking to me. In fact, once he got started, it was difficult to stop him. He would chatter away, nineteen to the dozen, with a sly glance thrown in, when he knew he was winging it. He was one of the younger ones in the Special Unit, with a dollop of boyish charm, which he exploited from time to time, as it suited him.

So, with such a willing customer, I rattled away with my usual gambits – “Were you happy as a child?”, “What sort of people were your parents?” Standard opening questions, which served more to indicate where I wanted the conversation to go, rather than seeking concrete information. Percy didn’t come up with many useful pointers from these initial skirmishes. He was good at skirting round subjects, at dodging questions he thought were too pointed. It was what came next which took me completely by surprise. I had not expected it, and it brought our work together, to a sudden, and apparently irretrievable halt.

We’d been talking for a while, when I ventured to suggest that Percy’s view of himself was negative. This was present in every prisoner I examined – poor self-esteem went with the territory. He nodded vigorously. Yes, he agreed, he didn’t think much of himself – never had, probably never would. So here I risked a deliberate intervention . “Percy”, I said, “I don’t think you're rubbish” – I told him, clearly, eye to eye, and inescapably.

Well you might have thought it inescapable – but Percy had other ideas. He shot to his feet, and was out of the door before you could take breath. Not what I’d thought would possibly happen. Nor very conducive to my approach – how could you do talk-therapy, if they refused to stay in the same room? Enough to confound the best of us.

Now you could have expected this abrupt cessation if I’d been rude, or offensive. If I’d picked on one of his sore points, a hurt from long ago, which still rankled. But this was not the case. Indeed it was the opposite of the case. I was being friendly, supportive, even generous. Yet this was clearly what had triggered his explosion. Talking about generalities was fine, even castigating him for his impulsivity would not have gone amiss – but this was none of these. This was positive. It was focussed and it was warm. It was solely intended to build, to help, to add something that had clearly been lacking throughout his entire life. And it didn’t work. What to do?

Should I chase after him? Try to apologise? Admit that I’d blundered, and done something wrong? It wasn’t at all clear what I’d done. It had just seemed natural to me. It slipped into the conversation, in the same way that I’d told Little David (#1) that his mother, being dead, would not return – it just seemed entirely real to me, and I would have said it in exactly the same tone of voice.

But Percy reacted as if I’d threatened his life. He was incensed. He was powered up to stop me at all costs. Well, not all – he didn’t have the background, nor the training to threaten to garrotte me, as Alec (#2) had done, thank goodness – but he used what weapons were readily available to him to do what he judged would be just as effective – he tried to get me sacked. He knew enough to know that that would stop any further suggestions from me to him that he was not 100% rubbish.

What? I pay him a compliment, and he takes it as an insult? A mortal insult at that. Make no mistake about it – I was being social, and being social was anathema to him. I can prove this, by what happened later – but here it is essential to emphasise that he had decided that the best thing for him was to terminate my career. You might have half-guessed it, if I’d hit him, or hit him verbally – punching him in his weak spots – yes, that might have brought on this devastating reaction – but to have me sacked, because I was beingfriendly – where did that possibly come from, and why did it remotely precipitate an emotional explosion?

He may have had a limited verbal vocabulary, but he knew enough about how things worked in large institutions, especially prisons, which is where he’d spent much of his adult life. So he wrote to my superior authority. He contacted the Area Medical Officer, responsible for medical care in prisons in the South East of England. His complaint was that I was inflicting treatment on prisoners without their consent. Compulsory treatment infringed his human rights and he demanded that I be stopped.

Well, I’ve met more serious attempts to undermine my medical position, indeed they’ve proved rather too frequent for comfort, but there’s no doubting the energy behind this one. Percy didn’t want to hear he was not rubbish. He needed to stop positive things being said in his presence. Worse, if you got under his defences, and said he was a nice man, good to know – then you deserved all that he could throw at you.

Just let that sink in. It’s so counter-cultural, it’s so unexpected, and yet, it is the key to all antisocial actions, from snubs, to revenge, to murder.

Here we have a disadvantaged man, a man in a miserable position, chatting away to the friendly doctor – when suddenly, I became the enemy. Why? Unless we solve this, we’ll solve nothing. I was being social, and it provoked him into being anti-social. My being benign not only did not assist, did not coax him into more positive social functioning – it stopped it dead.

A lack of social skills on his part could not be corrected by positive social skills on mine. The more friendly I was, the more hostile he became. Can you credit that? The common-sense approach is to counter ill-temper with friendliness, social withdrawal with social invitations, compliments, praise-worthy statements.

Stalemate.

I wanted Percy to be more open socially, to gain more confidence in his social dealings. His reaction was 100% contrary. He did not consent to respond to friendly overtures. He reacted powerfully against.

So where does this come from? And how can it be remedied? This is a crucial human question. Enemies and anti-social behaviours cripple much of our world – family, social, national and global. Could it be that the seeds for inhumanity are sown early? Is what Percy displayed the key to prejudice, hostility, social and real violence? Well, that’s my conclusion – and the evidence, as I saw it, confirms it with little difficulty.

Alec had a blackhole in his thinking. He didn’t know that he had. He continued through life as if nothing was wrong, as if killing people was as normal as saying hello. Well, it’s not. And it was then my job to find a solution, just as it currently is for all of us, for all the other social frictions which seem to abound on this beautiful blue planet.

Now a blackhole in Percy, would perfectly account for it. No one had ever told him, to his face, that he was OK, he was of value, that he was not rubbish. The Criminal Justice System had done its utmost to reinforce his negative view of himself. But it was pushing at an open door. A door that had been put there decades before, when Percy was a toddler. Unhappy, insecure toddlers lead to unhappy insecure adults. Why should that be such a radical departure from common sense? I go further – any anti-social acts you encounter, you can be sure they emanate from long ago. Revenge was mentioned with Harvey (#6). Here we have a type of self-inflicted revenge. It might sound an odd contraption – but so is exploding when someone is saying nice things about you. Odd to the point of irrational.

So what would you have done? Percy doesn’t know how to relate socially – he asks for what he doesn’t want, not for what he does. These are negative social skills. He also has a negative self image – he sees himself as rubbish, everything in his life has confirmed this. And this scenario fitted the same pattern – even “telling” him the opposite, incomprehensibly made matters worse. “You're not rubbish” provoked exactly the opposite effect than the one I was aiming for. You might say this was a challenge. How would you have responded? More, how do you respond when what you intend evokes the opposite of what you’ve wished for?

Well, I was not working on religious principles – I wasn’t trying to save his soul. Nor was I judicial, inflicting punishments “to teach him a lesson”. No, the fact was, I was a doctor. I regarded his inability to socialise as a symptom – a potent one, since it had landed him with a life sentence – but, as with all symptoms anywhere in the world – it was merely a signpost to deeper damage. And if, as a doctor, I failed to dia-gnose – from the Greek, dia “through” and gnose “to know” – that is find out what was really going on, then any and all interventions would get neither me, nor him, anywhere. Which was exactly what was going on, in this case.

It’s the same with every problem we humans encounter. Unless you know what you're dealing with, you are liable to make it worse. Suppose your car won't start. So you conclude, on no evidence, that it’s out of fuel, and over-fill the tank – which achieves nothing, since the problem was a flat battery all along, which calls for a different strategy altogether.

Here was something directly similar with Percy. I saw the symptom of poor self-esteem. I tried going through the front-door, and correcting his image verbally. But despite my best intentions, this had achieved precisely the opposite of what I wanted. What would you have done?

Well by this time I knew that Percy had not been born evil. None of us are. This may conflict with a number of religions, and certainly with vast swathes of medical and judicial opinion – but it no longer carried water with me. Genes were important, but ‘intent’ mattered more. Nature and nurture may contend for some – but not for me. Percy had been misprogrammed. His lack of sociability was not genetic – it came from a cause that was 100% hidden, not only from him, but from everyone he’d so far come across. It was his blackhole. The underlying cause, the real diagnosis was that the matter had been foreclosed long ago, and was therefore 100% unavailable for reconsideration today. Though with him walking out like that, it might just as well have been genetic, for all the good an orthodox approach would do.

And here Percy confounds the norm. Every medical consultation across the globe consists of people, known as patients, bringing problems, known as symptoms, to someone with medical experience and training, known as doctors. When this works, it’s healthy. When it doesn’t, it’s futile. Here Percy thought he was rubbish. He didn’t say so. He couldn’t say so. To verbalise it, made it worse, making it far too painful to contemplate – as witness the speed with which he departed my office. He didn’t start by saying something along the lines of “I’ve had a miserable upbringing, ever since I was a toddler, all those around me have treated me like dirt, so that’s my hangover”. This is the real symptom. It is what his real “problem” was. But, like all deeply traumatic events, it had inflicted a blackhole – and as such, scuppered any rational thinking about it. Hence his contrary reaction to hearing the opposite.

Being of “value” had become too dangerous for him. I didn’t know his parents. I had no direct evidence of his childhood. The evidence I saw today, was of non-thinking, or rather of reverse thinking – someone tells you that you are valuable, so you hit out and stop them as hard as you can. Not sensible. Irrational.

So how to resolve it? Well, first of all, you have to have 100% confidence that Percy, and his ilk, would prefer to be “valuable”. That despite all they say and do, that deep down social delight is what they are really after. The front door is closed, so you go round the side. Which, happily for me and him, happened in this case. And again, not what I expected at all – something turned up which I hadn’t prescribed.

But before we go there, the point cannot be overstressed. You go to your doctor because you can’t walk very well. That’s the symptom. Unlike with Percy and his ilk, you have no difficulty in talking freely about it – no blackholes with regard to leg symptoms. Your doctor hums and haahs, diagnoses one sort of leg disease, or another, and sends you on your way.

What happens next? Well if the diagnosis is real, and correct, then the treatment is likely to mend your disease, thereby removing the symptom. The proof of cure, from your point of view, is that can you now do what you couldn’t before – you can walk where you want to. Neither you nor your doctor regard leg disease as something to be ashamed of, covert about, or generally both inexplicable and incurable. No, legs are used for walking about, no one doubts that that is what they’re for, and everyone can understand why you want to be able to do that.

Simple in general medicine – utterly at odds in psychiatry. Percy did not know that his mind would not let him go where he wanted – or rather he knew, vaguely, that something was wrong, but the last thing he could see was his blackhole. Even to think about it, let alone talk about it, landed him in such “danger” that he blocked it off, or, as above, he vamoosed as fast as he could.

But as a doctor, I assumed that a healthy mind was there, however well hidden, just as I would assume a healthy leg was. So when the “normal” way through was blocked, in this case because Percy couldn’t see because of his blackhole – then, undeterred, I looked for workarounds, just like any other engineer would.

In Percy’s case, this came via an unexpected route as follows. Shortly after Percy had stormed off, and launched his administrative assault on my professional credentials, I happened to be interviewed on the local radio. I was discussing how my work was going in the local prison, what I was finding, and what I was doing about it. In the course of which, I described not only gross emotional deprivation, but I even cited Percy’s case, anonymously of course, to illustrate the depth of emotional paralysis. “He walked out, simply because I had told him he wasn’t rubbish”. This is as striking now, as it was then.

What followed was a bit like a fairy-tale – but real enough. The following week, I was sitting demurely in my office as usual, when to my surprise and delight, Percy winds his way round the door post, with his characteristic nonchalance, saying “you were talking about me, weren’t you”.

This broke the ice, and we resumed where his blackhole had ensured we broke off before. Local radio interviews are too infrequent to be relied on. Time we gave the whole system a good long heave. Agreed?

~~o0o~~ ~~o0o~~ ~~o0o~~

#7 : Percy tried to get me sacked – I was to…

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