Is it a fact that no sociopath can be helped by therapy?

Answer 1

Should society institutionalize psychopaths, even if they haven't broken the law? The United Kingdom, partly in response to the 1993 abduction and murder of two-year-old James Bulger by two ten-year-olds, and partly in response to PCL-R data, is in the process of creating a new legal classification called Dangerous and Severe Personality Disorder (DSPD). As it stands, the government proposes to allow authorities to detain people declared DSPD, even if they have not committed a crime. (Sample text from one of the Web sites that have sprung up in response: "I was diagnosed with an untreatable personality disorder by a Doctor Who saw me for ten minutes, he later claimed I was a psychopath. . . . Please don't let them do this to me; don't let them do it to anybody. I'm not a danger to the public, nor are most mentally ill people.") Hare is a consultant on the DSPD project, and finds the potential for abuse of power horrifying. So do scientists such as Dr. Richard Tees, head of psychology at UBC, a colleague of Hare's since 1965. "I am concerned about our political masters deciding that the PCL-R is the silver bullet that's going to fix everything," he says. "We'll let people out [of prison] on the basis of scores on this, and we'll put them in. And we'll take children who do badly on some version of this and segregate them or something. It wasn't designed to do any of these things. The problems that politicians are trying to solve are fundamentally more complicated than the one that Bob has solved." So many of these awkward questions would vanish if only there were a functioning treatment program for psychopathy. But there isn't. In fact, several studies have shown that existing treatment makes criminal psychopaths worse. In one, psychopaths who underwent social-skills and anger-management training before release had an 82 percent reconviction rate. Psychopaths who didn't take the program had a 59 percent reconviction rate. Conventional psychotherapy starts with the assumption that a patient wants to change, but psychopaths are usually perfectly happy as they are. They enrol in such programs to improve their chances of parole. "These guys learn the words but not the music," Hare says. "They can repeat all the psychiatric jargon -- 'I feel remorse,' they talk about the offence cycle -- but these are words, hollow words." Hare has co-developed a new treatment program specifically for violent psychopaths, using what he knows about the psychopathic personality. The idea is to encourage them to be better by appealing not to their (non-existent) altruism but to their (abundant) self-interest. "It's not designed to change personality, but to modify behaviour by, among other things, convincing them that there are ways they can get what they want without harming others," Hare explains. The program will try to make them understand that violence is bad, not for society, but for the psychopath himself. (Look where it got you: jail.) A similar program will soon be put in place for psychopathic offenders in the UK. "The irony is that Canada could have had this all set up and they could have been leaders in the world. But they dropped the ball completely," Hare says, referring to his decade-old treatment proposal, sitting on a shelf somewhere within Corrections Canada. Even if Hare's treatment program works, it will only address the violent minority of psychopaths. What about the majority, the subclinical psychopaths milling all around us?

GOOD QUESTION. Some PERSONAL observations:

Maybe part of why people won't "admit" this is that it doesn't have to remain true!!! Things are changing. And some people -- including Dr. Robert Hare of Canada -- are very strongly motivated to help sociopaths. One other thing the above info didn't mention: NO, IT IS NOT TRUE THAT SOCIOPATHS ARE PERFECTLY HAPPY AND HAVING AN ENDLESS PARTY!!! To put it crudely, being a sociopath sucks!! I am NOT having FUN!!!

Answer 2

It's true that traditional therapy makes sociopaths (psychopaths, people with Antisocial Personality Disorder) WORSE.

But specialized therapy, combined with either meds or even neurosurgery once it becomes possible, CAN.

Studies (see the masterful work "Without Conscience" by Robert D. Hare, PhD.) have now conclusively demonstrated that the way emotional information is stored in the brain of a sociopath is not at all like the way it is for others.

Instead of things being organized into those specific regions in one or other of the brain's two hemispheres depending upon the type of information it is, the sociopath has a brain that operates a little bit like a computer hard drive: it breaks all data down into tiny fragments and stores it all over the place and in both hemispheres. Thus, to retrieve any given segment is formidable and leads to omissions and errors far more often than most people experience:

(Patient in an inpatient unit, to an NP who is organizing an outing.) "No, I'm not going out with you guys this time, and I'm going to buy some magazines when I'm there." HUH???? This kind of thing, as Hare demonstrates, happens all the time.

Clinicians give numerous (including some erroneous) reasons for not wanting to treat sociopaths, and one of the more surprising ones is that it's very difficult at times to make sense of what the patient is saying.

Unlike the jumbled mess of a schizophrenic's speech, the sociopath's speech makes sense within the fragments, but when these parts of speech are strung together, they are often jarringly incompatible.

Did the sociopath in the inpatient hospital intend to go out and buy some magazines? Or did she decide to stay in? She seemed to think she could do both at the same time. If the NP who had asked her was astute enough, she might've said, "Miss Smith, if you don't want to go out, why don't you write down what you want us to pick up and give us the money to buy it?" Although that's a realistic way to do both things at the same time, one might wonder why the patient didn't just say so in the first place!

Well, we know that when you speak, your brain is going through a staggering feat of juggling and data-organization at a speed that makes broadband look like a snail trail. If your cerebral cortex is storing your vocabulary and the related ideas behind it, as well as all of the other numerous types of information it must handle, in the right places, this isn't so hard; if your brain has to fumble all over the place for tiny fragments of data and try to assemble it fast enough to keep up with your conversation, it is not going to be easy -- and trained professionals will know that something, at least, is awry.

So, now scientists know that the seemingly meaningless and frequent lies that the sociopath tells may not all be actual lies. Some are lies, particularly in sociopaths who have broken the law and are trying to charm or bully their way out of trouble. But some -- especially impulsive-sounding bragging or announcements of lofty intent ("I'm gonna get out of this bugbox and write a best-selling novel, climb Mount Everest, and go work for NASA!") -- are not intended to deceive others so much as to tell them "I want to do something with my life!" But, sadly, lacking the means and wherewithal to do this, the sociopath will undoubtedly end up in trouble all over again.

Think about it: you know something isn't right, but you can't tell other people, because you have not the slightest idea how to phrase what's wrong. Plus, for some odd reason, everyone keeps getting rubbed the wrong way by you.

You try to get ahead in life, but everybody keeps telling you about these strange rules you're supposed to obey, that they all seem to know by heart, but you don't. So you study them and try to memorize them and use them by rote, but keep messing up because you have no mechanism to tell you (from within) that you're stumbling over the line again, and inevitably, you do. Then everyone gets mad at you and among other things tells you that you know perfectly well what the rules are, so why don't you obey them? You start to secretly suspect they're adding new ones or changing the old rules around just to get you to screw up, but actually that isn't true -- however, you have no real way of knowing that, either.

As if all this isn't enough, you feel at the very least uncomfortable, and at the worst like a human bomb, most of the time you're awake, which at times can be several days in a row.

You notice that the very things that make other people happy have a very opposite effect on you: your head fills with jarring "static," like a radio playing with the tuner caught between two or more stations. Reacting instinctively to this, you try to push people away because their closeness causes the static to get worse, but then you discover a new problem: you seem to need them anyway.

You seem to need something from other people, but you don't know why. That hug each other and smile, not a phony smile but a real one, and their eyes light up. They get close and they talk to each other without having to closely study the other's eyesto try to figure out what to do in response.

This seems to be a delicious pleasure to them, much better than anything you've ever experienced. But if you try it, and if you are actually lucky enough to persuade one of them to attempt such a relationship and interaction with you, it immediately starts to turn sour on you. Their touch does not warm you; you feel colder and deader than ever. You don't know how to give back, so you end up grasping for words you've heard used by other people and trying to fake your way through it so they won't figure out how you are; you've experienced enough to know by this time that when others figure out your difference, they hate you for it; in fact, you've been told you're "not a real person" and that you "have no soul" (you're not too sure what a soul is, anyway) and that people like you "ought to be lined up and shot"!

After trying several times in this new relationship to get the pleasure other people are always basking in, and failing, you start to get angry at all of this -- and the anger builds into a terrible, towering rage that begins to make you feel like a human bomb. "I will actually, physically explode if I don't..." you're thinking, and yet under the rage there is a weird, disconsolate feeling that even your burgeoning hatred is as hollow and empty and starved as you are.

You consider taking your life, and certainly you think about taking lives of some of these lucky, smugly superior others. You settle for embezzling money, or something of the sort; you're clever and manipulative and you don't get caught. Triumph!

Or not. The things you buy please you for five minutes; a day, tops. Then...flat, meaningless, like everything else in your life.

Of course, you don't HAVE a life -- and you never will. That's starting to become increasingly clear to you by this time.

But WHY???? You see "The Others," as you're starting to think of them, studying diligently to help and even to cure other kinds of weird things wrong with people's minds, most of which seem to have to do with the brain. But no one seems to know what's going on in you. It occurs to you that to get some kind of attention from them, you might pretend you have one of those other problems they study, and then once they're paying attention to you, maybe somehow it'll lead somewhere. What have you got to lose?

You're about to find out you can still lose more.

You go into a clinical situation presenting with carefully-memorized symptoms of the mental illness you have decided would get you the attention you want. But faking whatever it is turns out very quickly to be a lot more complex than you'd thought. In fact, it turns out to be impossible. And, branded a malingerer, you are rejected yet again, told that all that's really wrong with you is that you don't want to try to better yourself.

That, and you're "evil," and it's not paranoia on your part to realize that EVERYONE HATES YOU. Once they figure you out. Yes: to know you is to hate you.

And you will go to your grave (as gloats Martha Stout of "The Sociopath Next Door" book fame) never knowing the wonders of real human interaction, meaning, and warmth.

It might just make you decide to go off the rails and kill everyone you can before turning the weapon on yourself.

Except for one thing: the mere fact that some scientists know that much about the brain of a sociopath means that solving the problem is no longer an impossible and obscure wish -- it's moving within the realm of concrete possibility.

As soon as large numbers of sociopaths begin to be treated in a way that actually helps them, that corrects as much as possible the chaos of misdirected signals in their confused and disorganized brains, and then a form of therapy that in addition to that, by necessity, teaches them to cope with the resulting maelstrom of emotion and impression that was formerly impossible, so that they can put it in order and start to develop the heretofore dormant and silent segments of their brains and better use those formerly mixed-up areas where no recognizable order ruled, THEN THE OTHERS MAY BEGIN TO NOTICE WHAT IS GOING ON...and they will know at least this much: instead of "the kiss of death," a diagnosis of ASPD (the DSM-IV way of saying sociopathy or psychopathy) will lead someplace; that there will be things done that actually make a difference.

Crippled as they are neurologically, sociopaths are yet shrewd, and they're always looking out for themselves in a way similar to that of a loner predator.

Seeing others like them actually benefiting from treatment will have to start persuading them that there's something to gain in going for help after all. Not being rejected or met with "We can't help you; you're evil incarnate," or the equivalent thinly disguised in euphemistic psychology jargon; NOT being met with a situation where they'd have to substitute symptoms of an "acceptable" illness in place of those they bear in secret -- that would almost certainly, if gradually, have an effect: if a sociopath can clearly see a benefit coming from admitting his or her real situation, there's nothing to stop him or her from doing just that.

It's already started to happen, if in a tiny, barely perceptible trickle.

Right now, all science has at the ready for them is to use various types of preexisting medication given in attempts to counteract the chaotic way the brain of a sociopath functions.

That and types of talk therapy carefully altered to avoid the pitfalls that have in the past caused regular therapies to make sociopaths worse instead of better.

But the more that scientists such as Robert Hare and his colleagues delve into and experiment with the new types of brain scans and learning what makes sociopaths tick like human bombs, the more likely that it becomes with each passing year that a means will soon be isolated to defuse those bombs.

The primary source of a sociopath's infamous rage is frustration, of a sort so alien and so extreme that almost no one else can understand what it means. Once they start getting taken seriously, that frustration, and the wild rage it provokes, will lessen, and since it is a primary source of the constant distrust that makes regular therapy fail sociopaths, the defusing of that rage and its maddening causes will be a huge step in the right direction.

And that will benefit everyone.

Just thought I'd add, to the people (besides me) who have spoken about BEING a sociopath, here and there in WikiAnswers:

First off, be sure the clinician who diagnosed you isn't mistaking you for a sociopath from prejudice or ignorance; not all people with advanced degrees in psychology have genuinely earned them! (Some psychologists are sociopaths themselves!)

Secondly, if it turns out you really are a sociopath after all, lots of people will tell you they cannot treat you because you can't be helped.

That's simply not true. They just don't have the guts, to put it bluntly. So, forget the wimps and find someone who will treat you.

It took me more than ten years. But I did.

SabrinaSingularity