The Molecule of More

THE MOLECULE OF MORE

medications, the delusions, along with the risk of violence, usually go away

in about a week.

But the patient who sat across from Dr. Jones, with his eyes still drill-

ing into hers, wasn’t psychotic.

Dr. Jones faced a dilemma. She knew that the patient wouldn’t ben-

efit from an inpatient stay, and admitting him to the unit would put other

patients at risk. On the other hand, he had a history of violence. She admit-

ted him, fearing for the safety of the victim he refused to name, but feeling

guilty for potentially endangering the patients on the ward.

Violence is sometimes the result of dysfunction or pathology. But most

of the time, violence is a choice—a coercive and calculated way to get the

thing you want.

Force, often expressed as violence, is the ultimate tool of domination,
but is it dopaminergic?
Violence comes in  two  flavors: planned violence inflicted for  a  pur-
pose, and  spontaneous violence set  off  by  passion. Violence for  a  pur-
pose, designed to get something the perpetrator desires, might be as
prosaic as mugging someone on the street, or as earth-shattering as
launching a  global war.  The  emphasis in  each case  is  on  effective strat-
egy, planned in advance, sometimes in excruciating detail, and always
aimed at gaining resources or control. This is dopamine-driven aggres-
sion, and it tends to have a low emotional content. It is cold violence.
Think of dopaminergic calculation and instinctive response as
opposite ends of a seesaw: when one is high, the other is low. The abil-
ity to suppress emotions such as fear, anger, or overwhelming desire
provides an  advantage in  the  midst of  conflict. Emotion is  almost 
always a liability that interferes with calculated action. In fact, a com-
mon strategy of domination is to stimulate emotional reactions in one’s
adversary to interfere with his ability to execute his plans. In sports it
comes in the form of trash talk on the basketball court or at the line of
scrimmage.
Aggression driven by passion is a lashing out at provocation.
This is not a calculated action orchestrated by the dopamine control
circuit—just the opposite. When passion drives aggression in response