Episode 003: Psychopathy with Michael A. Cummings M.D.

In this episode, Dr. Cummings and I discuss psychopathy: the fearless, empathyless people, who see others as objects, and have the inability to attach within relationships. Dr. Michael Cummings recently contributed to a book called “Violence in Psychiatry,” detailing the biological aspects of psychopathy, edited by Stephen Stahl. Dr. Cummings works at Patton State Hospital, one of the biggest forensic hospitals in the world. He is the Yoda of the psychiatric world, with many other psychiatrists bringing him their most complex and difficult cases.   

By listening to this episode, you can earn 1 Psychiatry CME Credits.

Other Places to listen: iTunes, Spotify

Article Authors: David Puder, MD

There are no conflicts of interest for this episode.

In this episode we cover:

  • History of psychopathy

  • Influence of early life traumas

  • Prosocial careers of psychopaths

  • The emotion psychopaths fail to see

  • Biological components in psychopathy

    • BDNF (brain-derived neurotrophic factor)

    • Prefrontal area (parent of the brain that warns us “that is not a good idea”)

    • Amygdala

  • Why psychopathy has not been bred out of existence

  • Advice when you are in a relationship with a psychopath

  • What drugs make someone look psychopathic

  • Effect of alcohol and methamphetamines on the brain

  • Influence of cocaine on the brain

  • Why more men are violent psychopaths

  • And treatment of this group of people (clozapine’s influence on glutamate)

  • The Story of Phineas Gage

We also wrestle with how to increase the percentage of psychopaths that end up helping society vs the percentage that become criminals.

Warburton, K and Stahl S (Editors).  Violence in Psychiatry.  The Neurobiology of Psychopathy. Cambridge University Press 2016), pp. 200-05

CV of Dr. Michael A. Cummings     

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Episode 004: Inpatient Child and Adolescent Suicidality, “Culture of Death”, “13 Reasons Why”

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Episode 002: Cognitive Distortions and Practicing Truth