Reflections on Personality Disorders from the Google Chinese Engineer Murder Case
Over the past few days, a news story has shocked the Chinese-American community. A young Chinese couple—both graduates of Tsinghua University as undergraduates and of the University of California, San Diego, as master's students, and both later working as engineers at Google—suffered a family tragedy. The husband, surnamed Chen, beat his wife, surnamed Yu, to death and was arrested by U.S. police.
Chen and Yu were classmates at Tsinghua as undergraduates; both were born in 1996. Chen graduated from a famous Chengdu high school, and Yu was the top gaokao scorer in her region—both were elite "chosen ones of heaven." After dating and marrying, both worked in the San Francisco Bay Area and together bought a house there.
But the couple did not get along well after marriage. The relationship had problems of emotional control and domestic violence, so the wife asked for a divorce. In a fit of rage, the husband beat her to death. Insiders revealed that both partners may have had emotional instability; in daily life they were poor communicators and could not show mutual consideration, which ultimately led to the tragedy.
Yet in dealings with others, the two gave a very good impression, and their academic and professional abilities were also outstanding. Only in intimate relationships did they show an inconceivable side. Emotional instability in intimate relationships, fear of loss, irritability, and high aggression—these keywords are all closely tied to personality disorders.
Low-functioning personality-disorder patients show marked maladaptation in dealings with anyone: either highly avoidant or highly aggressive, like walking bombs ready to explode at any moment. Some high-functioning patients behave well with outsiders but have all kinds of problems with those close to them, causing their spouses or children great suffering. Usually, when their relatives tell friends how the patient has hurt the family, the friends find it hard to believe, because the patient's external behavior is so good that friends suspect the relatives of slander.
Anyone who habitually hurts others in life, even to the point of killing, has antisocial personality traits. No matter how deeply they hide it, they are essentially antisocial personalities. Antisocial personalities are, at their core, people lacking empathy; they cannot perceive others' suffering as normal people do. In a rage or when defending their interests, lacking empathy, they will crazily use violent means (verbal violence, cold violence, or physical violence) to harm others.
But after their rage subsides, some of them can return to a normal state; they feel ashamed, guilty, and remorseful for what they did while impulsive, and some turn against themselves, even self-harming or committing suicide. Others feel no guilt at all for what they have done, and may even derive pleasure from it—that is the classic antisocial personality, as seen in serial killers.
In fact, these personality traits that undermine mental health are a serious mental illness, collectively termed personality disorder. There are many types; currently there are 12 major categories, and many patients have comorbid multiple personality disorders, as well as comorbidity with mood disorders (depression, anxiety, fear, etc.).
Many personality-disorder patients and their families do not know they are ill. They usually visit general hospitals because of somatic symptoms triggered by the disorder (most typically headache, stomachache, angina, etc.). Statistics show that about 30% of visitors to general hospitals have such problems, but more than half are not recognized by physicians, because most non-psychiatric physicians lack the ability to identify mental illness, leading to misdiagnosis.
People with personality disorder are usually in a state of unawareness; they generally have poor interpersonal relationships and frequent conflicts when dealing with the outside world or with relatives. Yet they tend to think the problem lies with others, not themselves; in their own view, the ones with problems are others, and they are the ones being hurt and let down. Personality-disorder patients are sensitive and suspicious and low in tolerance; trivial oversights by others are infinitely magnified and taken as slights or insults, triggering a cascade of inappropriate emotional reactions.
Personality disorder is a mental problem that usually begins in childhood, adolescence, or early adulthood, with behavior markedly deviant from the norm and deeply entrenched. Patients are ruled by emotion and act without purpose; some even lose memory of their behavior during episodes. Patients lack insight, and their self-control is poor; every conflict with others is an instinctive, unconscious act rather than a rational one. Even when patients fully understand that their emotional reactions are wrong, once they are in an episode they cannot control themselves. Some describe their episodes as being like going mad—"eight horses could not pull them back"—and when lucid they wish they could slap themselves.
Usually we only think such patients are odd or bad-tempered, rarely realizing they are in an illness state. And once patients themselves are regarded as having a personality-disorder-type illness, they also show strong resistance and stigma. Most personality-disorder patients have highly tense marital and family relationships; their divorce rates are generally high, and crimes of passion are mostly committed by personality-disorder patients.
As psychiatry and brain science have advanced, scientists have come to realize that a person's personality disorder results from the combined action of innate genes and postnatal environment. In other words, those "bad-tempered" people who frequently clash with others have a physiological or pathological problem, not something their subjective will can decide. Many of their behaviors are not conscious violations of public order but simply completely uncontrollable physiological or pathological reactions, instinctive responses they cannot master.
Correcting their behavioral patterns requires professional psychiatric treatment, not moral education. A partner's understanding, tolerance, and care can lead some personality-disorder patients to recovery, though it requires a fairly long process. These patients actually badly need their family's understanding and support; patients with supportive family members recover more easily. But personality disorder itself is an illness that damages intimate relationships, so many patients easily fall into isolation and helplessness, and their condition worsens.
Certain brain regions in personality-disorder patients are impaired; their amygdala is usually more active than normal, while their prefrontal cortex is underdeveloped, resulting in poor emotional control. Some neurotransmitters in their brains differ from normal people, which prevents them from normally handling the life stresses they face; they often live in oppressive negative emotions and suffer greatly.
Highly aggressive people generally have borderline, narcissistic, or antisocial personality disorder, or a combination of several. They are easily provoked; in a rage they disregard others' feelings, because during episodes they lack the ability to perceive others' pain. At such moments they appear cold-blooded and extremely aggressive.
Recent studies show these patients were already in a tense life state in the womb; they usually could not absorb adequate nutrition like normal fetuses. Lacking sufficient glucose supply during the fetal period, they felt even then that their surroundings were unfriendly and unsafe.
That is, our usual view that lack of security stems from childhood lack of love may be flawed; the problem of insecurity must be pushed back to the fetal period. Insecure people were more likely than normal fetuses to face survival crisis in the womb, leaving them in a state of high sensitivity from then on. It may even be that from the moment the fertilized egg was formed, it was destined to become an insecure person. Personality disorders are commonly hereditary because of underlying genetic defects.
These latest findings overturn the old view that such patients' aggressive behavior stems from insufficient love in childhood, making people realize that these personality traits may be more determined by genes, with the postnatal environment only reinforcing them. In fact, a large body of research shows that many borderline and antisocial personalities received adequate love in childhood; their sensitivity and aggression may have nothing to do with childhood trauma and result purely from genetic defects.
A study of binge-eating disorder (which many borderline personalities and depression patients have) showed that most such patients were premature or low birth weight; their mothers may have been in poor health during pregnancy and unable to supply enough glucose. The oxytocin levels in both mothers and fetuses were also low, making it hard for the fetus to form a close bond with the mother. Labor is a process of cooperation between mother and fetus; difficult or premature infants, from the very start of life, have trouble cooperating with their mothers and later with their intimate partners.
Oxytocin is a catalyst of love; it bonds mother and child and fosters closeness. People with high oxytocin levels are more capable of loving others; those with low levels are more prone to distance or tension in relationships and find it hard to trust and rely on their partners durably and stably as normal people do.
So personality-disorder patients universally have relationship problems. Most frequently push their partners away while dating and often want to end the relationship, because personality disorder triggers both fusion anxiety and separation anxiety. Patients want close relationships, but once closeness is established they are often at a loss, frequently clashing with intimate partners or, for no reason, growing tired of and fearing the relationship.
With the advancement of modern psychiatry, humanity's understanding of mental problems has deepened; we now recognize personality disorder as a physiological illness requiring treatment, not simply a bad temper or low moral cultivation. Psychiatry has been exploring treatments to help patients reduce harm to themselves and others and lead more satisfying lives, but the general public still lacks understanding of this group. Many people do not know how to get along with personality-disorder patients and lack understanding, attention, and sympathy, ultimately leading to many similar tragedies.
Returning to this case: judging from Chen's various behaviors, he may have been a high-functioning comorbid borderline and narcissistic personality disorder patient, a type very easily provoked. If Yu had known the relevant knowledge—how to avoid provoking Chen, how to communicate better, and had taken him in time for professional psychiatric help—this tragedy could have been avoided.
But because the public is generally ignorant of personality disorders, even a top Tsinghua graduate knew almost nothing about them—neither that he had one nor that those around him might have one. Thus the lives of two high-IQ "chosen ones of heaven" still ended in tragedy. Had they received relevant popular-science education, things would have been entirely different.
Therefore, learning the relevant knowledge of psychiatry can not only make our inner lives calmer but also help us better sort out our own lives.