We know what the general media does with scientific research. That’s why my parents continually tell me that coffee will both give me cancer and cure my cancer on any given day. So when you take a study that offers bold statistics on a serious psychological issue you can be sure that those same publications:
- Will not have read the study
- Will draw the same black and white conclusions about psychopaths as coffee.
Unfortunately, the blowback from this particular study had most of us convinced, myself included. If you’ve ever uttered the phrase, ‘you know, therapy makes them worse’, it’s reached you too.
The Study in Question — Rice et al (1992)
The results showed that 55% of incarcerated, untreated psychopaths went on to violently re-offend after they were released, compared to a whopping 77% of incarcerated, treated psychopaths.
Huss and Langhinrichsen-Rohling (2000) looked into the results further and declared that treatment not only doesn’t work for psychopaths but choosing the wrong treatment can make them into even better psychopaths.
Terrifying stuff. So what happened here?
Defense Disrupting Therapy
Rice’s study took 176 offenders from a forensic facility and performed Defense Disrupting Therapy on them. This particular strain of therapy is considered unconventional, intense and included-
- ‘Nude Encounter’ sessions lasting up to two weeks.
- Forced intake of alcohol and LSD during sessions.
Omitting these details was a mistake. This is not conventional therapy. This is not sitting down and talking through your feelings, not CBT, not using psychiatric medication. By focusing on results from this study alone, all psychopaths became incurable, super-human monsters.
It’s no surprise that many people later claimed the only option for psychopaths was ‘Magnum Therapy’.
I’m not using this piece to tell you that ‘nobody likes Psychopaths’ and strive to convince you that we should rally together for a new ‘hug a psychopath’ day. What we often forget is that psychopaths frequently exist successfully in society; with families and high-paying jobs. Unless you encounter one — and you probably haven’t consciously — then why care about those?
So, What is a Psychopath?
May I present the PCL-R in all of its 20-point glory.
You’re looking at someone who doesn’t have the same reaction to emotion as other people. A lack of empathy and guilt. Must be pretty peaceful.
If you’ve never seen a Psychopathy Checklist, the Revised version is generally accepted — for now. There are, possibly, 2 Factors to separate these traits, some people go for 4 or more Factors and don’t even get me started on how to apply this to children. (Or do, it’s very interesting but I won’t be talking about it here.)
These characteristics, combined with an unmitigable prognosis and evidence of the ability to become a better psychopath (roll credits) had most of us cowering under the covers of our own humanity.
Thankfully, folks started to look into the research, compiling papers on criminal psychopaths — leading to some promising findings.
Salekin (2002a) Meta Analysis
The Salekin results showed that the widely-held belief that psychopaths did not respond to treatment was unfounded, and that in many cases they could benefit. Many research papers reported improvements, effective treatments and notable progress in behavior.
Unfortunately, this study didn’t rely solely on the use of the PCL-R, so was criticized for inclusivity. Because if you couldn’t agree on the definition of a psychopath, how would you know if you’d treated one?
Fair point. So we moved on.
D’Silva, Duggan and McCarthy (2004 Systematic Review)
Thankfully, this Review looked at only treatment studies that used the PCL-R, and they came to the same conclusions as Salekin.
Since then, a whole range of key components required for the treatment of psychopathy have been identified. Check out some papers by Huss, Covel et al (2006) for starters.
Boosting an already undesirable label into legendary status, it’s taking a long time to shake off the terminal stigma.
People do not choose to be psychopaths, some don’t even know they are. Rather than running scared from our fellow human, some of us have charged into the darkness, committed to find answers. Understanding is always better than fear.
But is there light at the end of the tunnel?
The answer is maybe. But at least it’s not no.