Psychopaths may only make up about 1% of the general population, but they make up a disproportionate share of violent crimes.
Unlike other conditions such as sociopathy and antisocial personality disorder, psychopaths tend to exhibit traits such as a lack of remorse or guilt, a lack of empathy, and a charming and manipulative interpersonal style.
It can be difficult to imagine how someone with less empathy could change. And early psychotherapy was unsuccessful. However, advances in research indicate that a deeper understanding of psychopathy may help create more effective interventions.
Psychopathic people typically exhibit problems in responding to the suffering of others, such as difficulty recognizing facial expressions of fear or sadness. If you’ve ever seen someone hurt themselves badly, you were probably disgusted.
Your brain will respond to their pain and your body will likely be showing signs of physiological arousal. Your heart rate may have increased or you may have started sweating.
These are common signs of physiological arousal that occur in response to the suffering of others. But they often lack psychopathy.
When my colleagues and I asked people in prison with a history of violence to view photos of emotional facial expressions of others, those who reported more psychopathic traits also showed blunted physiological arousal. Our 2019 study found that when people looked at photos of fearful people, the size of their pupils (the small dark holes in the center of the eye that let in light, but also increase in size during physiological arousal) did not differ significantly among people higher in psychopathic traits.
These differences mean that some people with these traits may have a hard time understanding how their actions cause pain or fear to others.
In prisons and secure forensic hospitals, people with psychopathic traits often undergo treatment programs designed to reduce their risk of reoffending. Cognitive-behavioral programs offered to people in prison with and without psychopathy or other personality disorders have been reported to reduce general recidivism slightly.
However, not all criminal behavior programs are successful. for
In the UK, for example, in 2017 there was much publicity over the failure of the Core Sex Offender Treatment Program, designed by the Royal Prisons and Probation Service (HMPPS) and approved for use in 1992 to reduce reoffending.
HMPPS has since introduced a new program called Building Choices. We use a strengths-based, skills-focused approach to improve emotional management, healthy relationships, and a sense of purpose. Unlike previous courses, this program is not designed to address specific crime types, but it shows some promising signs.
Historically, researchers have assumed that offering such programs to people with mental illness is less effective at reducing recidivism. In fact, some studies even suggest that psychopathic people get worse after treatment.
One of these programs, offered from about 1965 to 1978 at the maximum-security Oak Ridge division of the Mental Health Center in Penetanguishene, Ontario, Canada, utilized the so-called “Total Encounter Capsule.”
These results have caused great pessimism among scientists and experts alike. But that pessimism may be misplaced.
It is perhaps no surprise that the Total Encounter Capsule was not effective. The capsule was “a small, self-contained room fed through tubes in the wall, from which group members never left during sessions lasting up to two weeks.”
Participants were reportedly nude and did not participate voluntarily. There were few professional therapists, and the use of violence and humiliation was permitted.
Historically, there has been a lot of pessimism regarding the treatment of other personality disorders as well.
This partly reflects the stigma against these disorders. However, this is also because personality difficulties can make it difficult to build relationships, including with the person in charge of treatment.
However, a treatment known as dialectical behavior therapy has been shown to be successful in reducing self-harm in people with borderline personality disorder (unrelated to crime). This type of therapy is designed to help people deal with intense emotions and learn interpersonal skills.
In another recent study, a mentalization-based treatment that targeted the ability to understand and regulate the negative effects of thoughts and emotions led to a reduction in aggressive behavior in people with antisocial personality disorder. These findings suggest that customized interventions may be more effective when it comes to personality disorders.
Do you have the ability to empathize?
One important consideration when treating psychopaths is that psychopaths are often thought to be incapable of empathy. However, this assumption has been challenged by some interesting research, suggesting that they may instead lack the motivation for empathy.
In a 2013 brain-scanning study, a group of scientists at the University of Groningen in the Netherlands showed that criminal psychopaths do not automatically feel empathy for the pain of others depicted in videos, but when asked to feel what the people in the videos are feeling, their brains generate empathic responses similar to those of non-psychopaths.
If they could better understand how their behavior hurts others, it could be an important step toward helping people with psychopathy.
Perhaps the most promising research suggesting that psychopathic people are capable of
Changes have been made with young people. Although children and young people under the age of 18 cannot be diagnosed as psychopathic, the characteristics of psychopathy, called callous-unemotional traits, can be reliably assessed in children as young as 2 years old.
A 2018 study tailored parenting interventions to be more effective for children ages 3 to 6 in this high-risk group. The children subsequently showed significant reductions in problem behavior, callous unemotional traits, and aggression. The researchers coached parents to show more warmth, sensitivity, and responsiveness. Parents were also asked to focus on reward-based rather than punishment-based strategies to make their child participants more sensitive to the pain of others.
A 2022 study also reported positive results showing improved youth behavior and relationships after an intervention that focused on strength-based (helping children understand what they are good at) rather than punishment-based parenting strategies.
As such, recent research offers a glimpse of a more optimistic future for reducing aggressive and antisocial behavior associated with psychopathy. Perhaps the question is not whether psychopaths can change right now, but whether we can help them change.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
