Treatment and Psychopathy
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To date, the mental health management of psychopathy has not been significantly successful. Some studies suggests that traditional psychotherapy is typically not productive or helpful for a person with this condition. However, there are other findings that support the presence of improvement with respect to specific behaviors.
From a neurobiological standpoint, emotions cannot be developed within an adult if they do not have the emotional capacity available to generate and feel those emotions.
Medications can potentially treat a few of the symptoms for those with psychopathy who have significant emotional dysregulation. However, this seems to be of minimal benefit for the symptoms of callousness, arrogance, antagonism, low empathy, and immorality.
Current interventions (medication/ non-medication) do not significantly reduce the core symptoms of psychopathy. Research indicates that this disorder far exceeds antisocial behavior alone, but rather is significantly associated with emotional processing problems.
They do not process emotional information and social experiences in the same manner as a non-psychopathic individual. For example, they use people, rather than connect with them and often view interactions or situations as
winners versus losers smart versus dumb powerful versus weak.
At this time, we do not have an intervention that can consistently generate emotional states such as empathy, bonding, or caring. Hence, when partners expect a change from a significantly psychopathic partner through the process of love or pointing out his/her hurtful behaviors, the outcome tends to be further violations and manipulation from the disordered individual.
It is extremely difficult to modify brain functions when there are neurobiological limitations of this complexity (e.g., inability to process empathy, lack of bonding, incapable of remorse).
With that said, it is not impossible to modify some of the behaviors of psychopathy. This is a high risk population with the requirement of intense treatments with a specialist (Skeem, Monahan, & Mulvey, 2002). Specific behavioral changes do not necessarily require alterations in emotional processing. Skeem and colleagues (2002) found that those with psychopathy, who demonstrated a history of violence, actually benefited from frequent and consistent therapeutic interventions.
“…our findings that psychopathic patients tend to become less violent after receiving adequate doses of treatment suggests that psychopathic patients might be appropriately reconceptualized as high risk case in need of intensive services.” (Skeem et al., 2002, p. 599)
‘There’s Nothing Wrong with Me!’
Unfortunately many individuals with psychopathy tend to be disinterested in treating their condition. Most tend to be arrogant and consider their personality status a reflection of superiority. It is not uncommon that they view those who are ’emotional’ or have capacity for a full range of emotions, as weak in comparison to them.
There are several researchers working on creating treatment interventions. This would benefit us all, as there would be a chance of making our society a little safer.
The symptoms of psychopathy can place the public, particularly unknowing, trusting romantic partners, at great risk. Without treatment there are no global tools to protect our society (even to a small degree) from the impact of psychopathic behavior, thought styles and influence. This presents a problem, because that means there will be more innocent victims who will wind up requiring legal and/or mental health assistance to deal with victimization.
Chronic infidelity, neglect, intimate partner violence, random & mass shootings, child abuse, corporate crimes, mass murders, child abductions, serial killings, pedophilia, rape, verbal aggression & intimidation are often committed by those with strong psychopathic traits.
There is not much the public can do until the crime has been committed or the loss suffered. Although we may not be successful at protecting ourselves from the random criminal acts or influence of individuals with psychopathic traits (e.g., mass shooter, corporate criminal, politician), psychopathy education can help increase awareness that individuals who lack key components of humanity are within our community. Perhaps for some, such awareness and education will limit or prevent intimate involvement with an individual with psychopathy.
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Skeem, J., Monahan, J., & Mulvey, E. (2002). Psychopathy, Treatment Involvement, and Subsequent Violence Among Civil Psychiatric Patients. Law and Human Behavior, Vol. 26, No. 6, 577 – 603.