Psychopathy is a unique form of mental illness characterized by amorality. Psychopaths experience little sympathy or empathy which makes them unable to truly love others. Also, they are relatively fearless, experiencing little guilt and shame. They experience shallow and unstable emotions (Maibom, 2014). It is the lack of empathic orientation towards others that psychopaths manipulate, exploit and parasitize other people around them without respect. Psychopaths tend to regard others as means or tools to their ends (Maibom, 2014). As a result, they can cheat, steal, mistreat or harm members of their families without being hurt. Whereas psychopaths may appear to be dangerous to others, the condition is not treatable; however, some modifications can be introduced into the treatment programs to improve treatment efficiency in reducing criminal violence among the victims.
Characteristics that Make Psychopaths Challenging to Treat
According to Maibom (2014), recent evidence does not support the idea that psychopaths can be treatable anytime soon. This is because psychopathy is a disorder that is rooted in an individual's worldview, including the moral and social outlook, thus, cannot be treated in a piecemeal fashion (Maibom, 2014).
Psychopathy is an antisocial or a moral disorder whose treatment is much unclear. Whereas other mental illnesses such as depression can easily be treated by ingesting substances that elevate the moods, little can be done to impact on antisociality or amorality (Maibom, 2014). Psychopathy characterizes a global dysfunction or socio-moral deficit which makes it difficult to target by way of neuroscientific methods as in the case of depression. Psychopathy is a mental condition that diverges from the statistical norm. It is a psychological subtype which was adaptive either genetically in the ancestral environments or is currently genetically adaptive in an evolutionary sense (Maibom, 2014). Its genetic adaptation complicates treatment.
Also, it is understood that psychopathy is characterized by the unity of a subject's moral outlook or weltanschauung. Weltanschauung is diffuse of assumptions, beliefs, attitudes and affective depositions that are related to a vision of how to live. In fact, it is a condition that reflects a genotypic variation leading to an abnormality or a deviation from the ordinary functioning of an individual (Maibom, 2014). It means that the condition constitutes the entirety of the psychopath's norm, character or personality and that treatment aimed at such a condition imply a treatment aimed at changing an individual's norm. It is difficult if not impossible to initiate a treatment attempting to change a norm which makes it challenging to treat psychopathy. Treating psychopathy is equivalent to attempting to remove a handful of weltanschauung which is hardly sufficient to alter the individual's set of norms that determine his or her disorder (Maibom, 2014).
Furthermore, psychopathy is a cluster B personality disorder which means that for treatment to work, a moral commitment is required because such a condition is moral, not medical. The implication is that the psychopath should demonstrate a moral willingness to therapy and intended changes. However, the reality is that psychopaths deem self-interest, excitement and a sense of power as being much relevant. This makes it difficult for them to form a moral commitment at all. Thus, since treatment relies on a commitment for it to work yet making and upholding commitment is plausibly a moral activity, it is expected that psychopaths can least achieve that (Maibom, 2014).
Warburton and Stahl (2015) propose that instead of focusing violence as a result of mental illness, it can be conceptualized as a dimension of mental illness to allow addressing the issues of psychopaths from a humanistic and scientific approach. However, as the authors press on, it emerges that they propose "treating the treatable" as a way of moderating criminal violence fronted by psychopaths. To propose treatment of the treatable is a way that the authors concede that psychopathy is untreatable because they are in one way suggesting that some of the symptoms, but not all, can be treated. It leads one to a conclusion that psychopathy is a complex condition that attempts can treat but not amicably.
Suggested Programs for Treating Psychopathy and Changes to Make Them More Effective
Maibom (2014) reviews various studies that propose neuropharmacological treatments for psychopathy. For instance, one of the suggestions was increasing serotonin in the psychopath because serotonin can increase an individual's judgment which can allow him or her to reason out unacceptable behaviors. However, the problem with such treatment is that low-empathy scorers will hardly respond. This is because an individual's judgment is mediated by not only serotonin but also beliefs, attitudes, propensities, and many others. To make such a treatment more effective requires a combination of neuropharmacological treatments and behavioral therapies that target modification of attitudes and beliefs such as cognitive behavioral therapy (CBT). When both approaches are integrated, serotonin treatments will induce a sense of judgment which can be enhanced with behavioral therapy and focus the individual to judging his or her attitudes and beliefs and modify them to be rational.
Law Enforcement: Lack of Resources for Mental Health in Iowa a Major Problem (2016) suggested a modern community-based approach for treating psychopaths. The rationale is that mental services will be more accessible to psychopaths than when they are institutionalized. In fact, Warburton and Stahl (2015) agreed that treating psychotic behaviors within the community would work in preventing criminalization and that deinstitutionalization of mental treatment has created a new type of psychiatric patient approach that is more responsive. To improve this program, therefore, the focus has to be placed on early treatment of the treatable symptoms of psychopathy to reduce criminalization and violence. The primary causes of psychopathy should be treated as early as possible among the community members that may evolve into psychopaths. This program can be enhanced by empowering the community-based facilities with experts that can diagnose and identify symptoms of psychopathy among community members at earlier stages and immediately initiate treatment for the treatable to avert full-blown psychopathy that is hard to treat. Community-based mental health facilities should be expanded to ensure that they are easily accessible by members of the community and that the mental health experts should be many enough to be integrated within the communities.
Psychopaths are difficult to treat and in most cases untreatable. However, treatment programs can be modified in a manner that optimally addresses the underlying conditions that impede treatment for psychopathy. The first approach to treating psychopathy should focus on integrating neuropharmacological treatments with behavioral therapies to enhance the outcomes by focusing on both neurological aspects as well as the behavior. This way, it may be possible to positively alter the moral and social aspects of the psychopaths. In community-based mental health facilities, the focus should be on early identification of psychopaths and initiate treatment of the treatable symptoms and prevent full-blown criminalization and violence.
Law Enforcement: Lack of Resources for Mental Health in Iowa a Major Problem. (2016, October 08). Retrieved from https://whotv.com/2016/10/07/lack-of-resources-for-mental-health-in-iowa-a-major-problem-according-to-law-enforcement/
Maibom, H. L. (2014). To treat a psychopath. Theoretical Medicine and Bioethics, 35(1), 31-42. Retrieved from https://www.researchgate.net/profile/Heidi_Maibom/publication/259956573_To_treat_a_psychopath/links/5707c5dd08aea660813318f9/To-treat-a-psychopath
Warburton, K. D., & Stahl, S. M. (2015). Treat the treatable: a comprehensive and optimistic approach to treating psychiatric violence. CNS spectrums, 20(3), 170-171. Retrieved from https://pdfs.semanticscholar.org/7a7a/f00c1d359d10a27425a578b6f7db81543648.pdf
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