When we usually think of psychopaths, we picture the likes of Ted Bundy, Hannibal Lecter and Jeffrey Dahmer. Considering those characters that pop in our head, the next logical step would be to try to cure their psychopathy or lock them up from society, right? Well, it’s a bit more complicated. Trying to cure psychopathy would fall into a similar realm as trying to cure introversion in a sense that psychopathy is understood as a dimensional personality trait. That means that all of us have some psychopathic features to some degree, and some of them can be useful. The problem arises when someone has too much of them. There’s a so-called psychopathy threshold after which we clinically consider someone’s psychopathy as psychopathology. To that person, his or hers psychopathic tendencies limit them in everyday life, and it puts them at odds with the society.
When looking for people that we consider psychopaths in a psychopathological sense, we turn to prisons. It is not surprising that we can find them in prisons since psychopaths are described as callous people with impulsive behavior and are known to get into high-risk situations. Of course, it’s important to note that not every criminal is a psychopath, as well as not every psychopath is a criminal. For individuals and society that distinction is important as the population of criminal psychopaths is the one we are most concerned about and the one we want to either cure or keep away. That is why a lot of practicians are trying to do just that, but unfortunately a lot of treatments don’t work, or even worsen their condition (D’Silva, Duggan, & McCarthy, 2004, as cited in Wilson, & Tamatea, 2013).
This didn’t discourage Wilson and Tamatea (2013) when they conducted their experimental treatment on psychopathic inmates in New Zealand. What they decided to do was stop focusing on treating their personality and focus more on the damaging behaviour they are exhibiting, specifically on their criminal behaviour with the goal of reducing reoffending. Their program lasted for 44 weeks, where every week consisted of three group therapy sessions, one-hour individual therapy, and a two-hour group therapy that involved culturally-informed therapeutic activities, all in all over 450 hours of psychological interventions for each participant (Wilson & Tamatea, 2013). The program, called High Risk Personality Programme (HRPP), was conducted in three stages. In the first stage therapists and participants discussed past treatment failures, about what to expect in HRPP and they focused on identifying personality issues to stimulate self-awareness in participants and bring to light possible barriers in treatment (Wilson & Tamatea, 2013). The second stage focused on developing techniques for understanding and managing aggression with methods from Cognitive-Behaviour Therapy (Wilson & Tamatea, 2013). Last stage dealt with preparing the participants for their release from prison and reintegration into everyday society (Wilson & Tamatea, 2013).
All of this sounds very lovely, but what are the results? Questionnaires showed that all participants were eager to participate in the programme and were responsive to the knowledge they learned there. Also, on questionnaires participants showed reduction in violent behaviour. But what about observed behaviour? All 11 inmates that were in the HRPP reduced their violent behaviour during the 44 weeks of the programme. 10 inmates were released from prison after the treatment and in the 4-year follow-up 5 of them did reoffend but with minor crimes and less often or didn’t reoffend even once, 2 fluctuated with frequency and seriousness of crimes, and 4 had more serious and frequent offences, out which 3 were imprisoned again (Wilson & Tamatea, 2013).
Looking at these results, they are far from ideal, but considering that all of the offenders were at first imprisoned on very serious offences such as rape and murder, minor crimes look like a big step in the right direction on a long path ahead of them. Galietta and Rosenfeld (2012) in their paper about Dialectic Behaviour Therapy adjustments for treatment of psychopathy describe many challenges that clients and therapists face during the treatment. One of the most important things is that therapist has a support system so he or she can deal with fluctuation in treatment success and to focus on noticing small changes and small improvements (Galietta & Rosenfeld, 2012).
It seems that the right approach has been taken in shifting from curing psychopathy to learning more adequate behaviours, and unlearning violence. We are trying to reduce crime and reintegrate offenders into society. So, can we cure psychopathy? Well, no, but why should we? We are certainly on a beginning of the right path to help them live a life they will enjoy, without hurting others.
References
Galietta, M., & Rosenfeld, B. (2012). Adapting dialectical behavior therapy (DBT) for the treatment of psychopathy. International Journal of Forensic Mental Health, 11(4), 325-335.
Wilson, N. J., & Tamatea, A. (2013). Challenging the ‘urban myth’of psychopathy untreatability: the High-Risk Personality Programme. Psychology, Crime & Law, 19(5-6), 493-510.