I had a nice conversation with a friend today. She said that part of healing from a relationship with a sociopath is getting to the point where one realizes that sociopaths deserve pity for being disordered. In that regard, we both hope that science will progress to the point where sociopathy is preventable and fully treatable. In this blog I will discuss treatment options for those diagnosed with antisocial personality disorder. Following the format of the book I am reviewing, this disorder is called sociopathy or ASPD and the personality traits that give rise to the disorder are called “psychopathic personality traits.”
Regarding whether sociopathy and psychopathic personality traits are currently treatable, Sandy Brown and I had a bit of a disagreement when we wrote Women Who Love Psychopaths. Although I told her the literature indicates sociopathic behaviors are to some degree treatable she was very insistent we emphasize that psychopathic personality traits are not treatable. She won out because she convinced me of the need to communicate to women that men with these personality traits usually do not change. In her experience, giving a woman any hope her man could improve, discourages her from leaving the relationship. I offer this book review and discussion of treatment of sociopathy/psychopathy to keep you informed, NOT to encourage you to stay.
I also recognize that spouses may choose to stay married to those with ASPD for any number of legitimate reasons. There are also people who have sons, daughters, parents, uncles, aunts and cousins with ASPD. All want to know if there is any effective treatment for the disorder. People want to know what treatment gives their loved one the best shot at improving.
If you have a close family member who is a sociopath and are involved in that person’s treatment, I strongly recommend you read Antisocial Personality Disorder: A Practitioner’s Guide to Comparative Treatments. Although the book is written for mental health professionals, I believe any person with some background in psychology can understand most of it. What you don’t understand, you can look up and so become better able to communicate with therapists. This book is an absolute must read for all professionals who deal with sociopaths and their families.
To give you an idea of why I give this book 5 stars, I will describe it and discuss the content. The book is edited by two psychologists experienced in the treatment of sociopaths, Drs. Rotgers and Maniacci. In the second chapter, they give detail s of the case of Frank a classic sociopath. Although they do not say so in the book, Dr. Rotgers told me that Frank was an actual person he evaluated.
I was very impressed with the way the authors presented Frank and his history. In particular, the clinicians interviewed Frank’s wife. Her statements about him and their relationship are characteristic of the kinds of things spouses of sociopaths say. Frank’s aunt and brother were also interviewed. The editors agree with me that the best sources of information regarding the nature of sociopaths and sociopathy are the family members of the disordered person.
Frank’s wife Jennifer says the following, “ The most exciting year of my life (was the first year of our relationship). He was so spontaneous and full of energy. His charm and good looks just swept me off my feet. Being with him was just so exhilarating. “ and later, “it suddenly dawned on me that I didn’t know anything about him.”
Having presented the case of Frank, the editors then invited 8 professionals representing 8 different treatment approaches to answer a series of explicit questions about their formulation of the case, understanding of the disorder and approach to treatment. The contributors were as follows:
1. Debra Benveniste, MA., MSW; Putnam, CT-Psychodynamic Approach
2. Michael Maniacci, Psy.D.; Chicago, IL-Adlerian Psychotherapy
3. Darwin Dorr, Ph.D.; Wichita, KS-Million’s Biosocial Learning Perspective: Personologic Psychotherapy
4. Glenn D. Walters, Ph.D.: Schuylkill, PA-Lifestyle Approach to Substance Abuse and Crime
5. Arthur Freeman, Ed.D. & Brian Eig; Fort Wayne, IN and Philadelphia, PA-Cognitive Behavioral Treatment (CBT) Approach
6. Robin A. McCann, Ph.D., Katherin Ann Comtots, Ph.D., & Elissa M.Ball, M.D.; Denver, CO-Dialectical Behavior Therapy
7. Joel I. Ginsberg, Ph.D., C.A. Farbring, M.A., & L. Forsberg, Ph.D.; Stockholm, Sweden-Motivational Interviewing
8. Sharon Morgillo Freeman, Ph.D., MSN, RN-CS, & John M. Rathbun, M.D.; Fort Wayne, IN- Integrating Psychotherapy and Medication
In the last chapters the editors compare and contrast the different treatment approaches. Family members of sociopaths should be aware of two important points. First all but one of the therapeutic approaches (psychodynamic) involves family members in the treatment. Family members are considered by the 7 to be important sources of information. Given the importance of family to the treatment, do not expect therapists to discourage you from being involved in a sociopath’s life. Therapists often encourage family members to stay with the sociopath and support him/her. This may benefit the sociopath at the expense of his/her family.
The chapter on medication discusses medication that can help the poor impulse control and aggression seen in sociopaths. I completely agree with the recommendations made and think that if a person with ASPD is willing medication should be tried.
What about prognosis then, and how long does it take to treat a sociopath? The CBT chapter gives some interesting statistics. The authors state, ”Psychotherapy is associated with a sevenfold faster rate of recovery compared to the naturalistic studies”¦ Without treatment, estimated recovery rates are about 3.7% per year, and with active treatment the rates increase to 25.8% per year.” Also the longer the treatment continues the more improvement there is. They also say, “Unfortunately, people with ASPD have a very high drop out rate.” It makes sense then for family member to encourage those with ASPD to stay in treatment. Don’t expect that treatment to turn a sociopath into a loving, empathetic person, though. All of the authors say that is not a realistic treatment goal. When professionals say a sociopath “has improved,” they mean he/she is not as dangerous and is less impulsive. As Dr. Rotgers’ email to me said, “Harm Reduction: ‘80% of something is better than 100% of nothing’ Alex Wodak”
Adendum
Donna sent me the following comment. Your post today leaves a huge question in the mind of a reader: What can treatment accomplish? Can you please address this?
I will address this question in detail next week. For now I wanted to introduce the names of the psychotherapies. To cover all in one week would have been too much.
Blondie,
I believe as Oxy says, as the bible states to rid yourself of the bitterness in your heart caused by nefarious people so as to not cause eternal suffering, consuming anger and vengence seeking for yourself.
I have forgiven all of the PDIs in my life. Not for them, but for me, so I can focus on my own spiritual, intellectual, emotional growth. So I can strive to be a better person.
But will I forget the hard earned, painful lessons I was forced to learn? Heck no! I will not allow myself to be a victim of abuse ever again. I think I may be one of the lucky ones in regards to being an introvert. I simply don’t need a man in my life to feel content, fulfilled but it is very NICE to be with one. I enjoy the sharing of ourselves, being together physically as well as emotionally.
And I also would like to quote Irina Dunn’s cheeky expression..”that a woman needs a man like a fish needs a bicycle.” No. We don’t NEED them per se. We can accomplish anything we set our minds, hearts to without needing validation, support from men. But, boy, they are such fun to be around (the mentally heatlhy ones, that is)
You’re doing wonderful, blondie. You have come so far in such a short amount of time. Which amazes me as it’s taken me 20 plus years to “get with the program” and realize I am a good woman and I deserve the best in life without suffering abuse. **hug**
What we need to remember is to ask God to handle our problems for us. God – then guides us to where we need to go. Ask God to guide you to forgiveness. He takes it from there … guides you on the path to forgiveness. There are many lesson to learn on any path you ask God to take you through.
Everything we do in life is a learning lesson. How we learn those lessons is to ask God for guidance.
As for Jane Smith figuring how to stay away from the spiritually stunted. Good luck. They, like us, are God’s children. For every thing we think we (in human form) figures out … God’s puzzle is still in our path to unravel.
Enjoy your journey. I for one am glad I got to chat and travel this path with everyone’s heart being so open. I will continue to do so. It’s nice to have company as we travel. I hope you agree?
Peace.
OK I admit I haven’t read the posts yet. I am consumed with what was written about the book review. I am intrigued to read it. I have been aware of pyschodynamic therapy but the problems I have are the S client’s who won’t bring family in or give consent to even contact them. That is like working in the dark with these folks. I’ve tried other modalities but have not reallly had any success.
I know my previous posts about not pitying them have been direct. I say that for much the same reason that Sandy Brown held to her argument to say they’re untreatable. I want people out that to understand that their love CANNNOT effect change going at it on their own and even with therapy the drop out rate is high, the damage done to others is great and the ability to teach empathy or compassion to these folks goes wanting. To live with these individuals is to sacrifice yourself and your needs in many ways….as we all know too well.
At times therapy teaches Ss how to be better at manipulating others and feigning emotions to con others as well so it’s a catch 22. I do want people to be weary. There is ongoing research and more stuff developing but it’s something to be managed by and with professionals and not alone. I have seen the damage it’s done to me and others who were conned in relationships and sucked in before knowing who and what they were dealing with.
I’ve said that this is the Lord’s battle and I primarily see it as such as I don’t know any human (including professionals) who has been able to break through an egosyntonic personality disorder to effect the type of change that makes these individuals less dangerous to others…even to themselves. I’m not saying one can’t modify behavior but the commitment is often lacking unless there is a strong motivation on behalf of the S. I have yet to see that motivation last long enough to truly explore themselves and to stop blaming and projecting or to create lasting change. It’s incredibly hard work for therapists and family members. I have not given up and won’t give up. BUT that’s what I do professionally. In my personal life I have a chance to walk away. Especially when the S has no insight into their illness and, even when they do, choose not to do anything about it. That was my ex.
I also say the battle is the Lord’s because I do believe that we are more than just our thoughts as we are spiritual beings. Ss are spiritually lost. They do not trust or believe in God. They are fighting to have control in a worldly way that constitutes the essence of evil. To say they have no conscience is to say they have no spirit. It is not alive in them or acknowledged by them. Though some do pretend. I think psychology can only go so far looking at this from a scientific perspective and leaving out the spiritual component. Although the field is coming closer to accepting spirituality in counseling (as it should) it is still very far away from merging the two into treatment. There are counselors out there who’s practices are more spiritually based in the private sector. In the public sector where I work, it is not fondly looked upon to discuss spiritual matters with clients. Recently I had a co-worker point out that she’s surprised I haven’t gotten into trouble for having a cross on my shelf in my office. I also have a Bible on that shelf. I believe it is unethical not to discuss one’s spirituality be it whether their belief is Buddhist, Christian, Jewish or any other religion. It is part of who we are. Moreso, not what belief system we have regarding church doctrine but the belief in a higher power beyond ourselves, connecting us all to each other spiritually.
On a separate note, I have to say that the names of the couple in the case study are freaking me out.
I hope everyone had a great weekend. God bless.
Dear takingmeback: I suggest that you read Tolle’s book “A New Earth”. This man hits the nail right on the head what is going on with EGOs in this world. Incredible insight. He also explains how a person can go into a humble space and be in the “now”. Also, incredible insight. I think learning what this man has to offer … mixing it with the psychology concepts … hand in hand, we can get through to the spiritually challenged of the world. The have to be incarcerated though because everyone knows their egos won’t do this theory on their own. Of course, expect them to fight it – that’s the ego roaring it’s ugly head. With practice, by being spoon fed the techniques they can get comfortable with the changes … gradually, step by step. The have to be watched and analyzed as they are going through the process. Then into group therapy, so they too, can brain storm and get through their pain (it’s buried so deep within them that they don’t even realize there is pain … but their pain is projecting them along in life along with living in their egos). Group therapy takes thoughts from your subconscious into the conscious. Their new location could be called … going to SPIRITUAL AWAKENING CLASSES – for x amount of years. Depending how hard a nut they are to crack (sorry for the pun). Then gradually … work them back into society … and none of this out on the street … a gradual process because they are children … step by step, halfway house after half way house. Each halfway house is reinforcing what they learned via Tolle’s, other techniques and of course the Word of God (no matter what the book is called).
P.S. If you read as many different books by God, you’ll find more of the puzzles. Each piece, step by step as you journey and search for Truth. Talking with the “Elders” in different communities is also a plus.
Peace.
Takingmeback,
I too agree that humans have seemed to always, regardless of how widely separated they developed in culture, had some form of “higher power” and sprititual aspect. Like some how it is a necessary part to our “selves.” I believe that a spiritual aspect to life gives “meaning” to life.
I just finshed reading Plato’s Republic, in which the “arguments” and “logic’ of whether justice or injustice in a person or a community (city, state, etc) is more beneficial and why. It is of course a long, convoluted argument and at times boring and repetative, and other times appears overly simplistic. Back to the “what is success” what is “good” etc. But it boils down to the fact that the psychpath or personality disordered person or totally egocentric person does not have the SAME VALUE SYSTEM that we have.
How can any two people, or any two countries for that matter, who do not have the same “value system” function together without one taking advantage of the other?
How can anyone who has become a victim of a person with a totally egocentric value system recover? It must be in the spritual aspect as well as the logical one, and the emotional one. Otherwise, the exchange will lead US to become bitter and angry at the unjust injury done to us, and we will become no “better” than them, turning our bitterness into hate, which in my estimation poisons us like a toxin, depriving us of peace within ourselves.
“Forgiving” them is cleansing our systems of the toxins. Forgetting the lesson is “stupidity!”
Hey Oxy: When you get through reading about the Greeks and the Romans (beautiful countries too) … read anything you can get your hands about “YHVH” … keep searching until you see it.
Peace.
Oxy and Wini,
I agree that healing requires many aspects of ourselves. The emotional, rational/logical, physical and spiritual. It reminds me of DBT where the focus is on merging the emotional and rational minds to the “wise mind”. It feels like teaching someone about intuition-to tap into what is beyond our obvious thoughts into a realm where we cease to function strictly in one “mind” or the other. Mindfulness is a large part of that and it’s taught through meditation.
What I personally find so awesome is every time I read a post about someone who’s found healing by turning to God. That was such a pivotal point in my recovery. As you said Oxy, spirituality gives us meaning (go Victor Frankyl!). I believe that meaning is recognizing that we’re not here for ourselves and our own agendas. For you Wini that would be like tapping into the one universal conscience or however Tolle describes it. Basically moving beyond the big E for ego. There is a part of us that is beyond the physical we see and the thoughts in our heads. One of my favorite plaques I picked up right after the S experience last year says, “Don’t believe everything you think”. It’s a favorite!
I do believe that aside from the spiritual, the emotional component of recovery is very important and very physiological in nature. Our minds have that instinct to send us into fight or flight mode from the abuse and the reality of what occured. It’s nice to know that we have an internal mechanism designed to ultimately protect us but ouch is it painful when it gets stuck! Hence the common dx of PTSD following the abuse of an S. To manage emotions we need to figure out how to settle that amygdala down so we can process and function while managing the various emotions and recurrent, often obsessive, thoughts stemmed from triggers and such.
What I’ve recently found helpful is being prescribed medication for ADD. Anti-anxiolytics didn’t help but a stimulant calms me down, keeps my mind on the here and now and not on the past. I just recently started it but I can’t believe how much it’s helped. I am finally able to do things I had no patience for before as I couldn’t sit still and my thoughts were all over the place. The anxiety I felt is virtually gone.
This is NOT a recommendation for anyone. My doctor, therapist and I look at it as treating the symptoms so I can function. AND what works for me isn’t necessarily what will work for others. I was diagnosed with PTSD two years before the relationship with the S. I have experienced multiple traumas from being carjacked at gunpoint to shockingly finding a client dead from ODing to the mental and emotional abuse of an S. Who knows how this has affected my brain chemistry over time. I look at the medication as an aid to the work I do in therapy which I consider the “undoing” of the result of trauma.
I do want to say something about anger and it’s role in recovery as well. I whole-heartedly believe that it’s important to ultimately get to the place of understanding that the S is ill. For me this helped me through my anger. What happened was not OK but to be bitter forever would harm me more than help me. We’ve dealt with seriously disordered folks who unfortunately can pull off “normalcy as we consider it” and blend in. But as we know stuffing anger leads to depression (another common dx following interactions with Ss). It leads to all kinds of chronic health problems and it can very dangerously lead one to become more like the S. I believe that’s why they say narcissism can be somewhat contagious.
S’s, themselves, who are narcissitic by nature of the disorder, are full of pain and anger suppressed at their very core. I believe it is what drives them to do what they do. They pick the loving and caring people to prey on (those whom they wish they could be but resent that they aren’t) and exploit them and turn them into enemies in their game of war. Gosh, I remember how mind-numbing it was when my ex started to talk about sides and tell me who I could “have” as they were on “my side”. I had no idea that a war had begun. He was in it by himself and I refused to play so he flat out called it.
The bottom line is if I engage in that war I am no better than him. At my core is love and forgiveness not anger and hatred and jealousy. The Ss projection onto me had me feeling horrid about myself. I didn’t want to live anymore. I can say I have a taste of what his life is like and what he feels about himself as he accused me of being and doing exactly what he is and does in reality. He was a master manipulator and gaslighted me to keep me ever confused and distort my reality. Although I wouldn’t wish his life on anyone that does not excuse him for what he did. He chooses to live in darkness as he knows what’s wrong with him. I, however, choose to live in light and to walk in the Truth. I lost myself momentarily in this lifetime but I’m finding myself again day by day.
Bottomline, I am not now, never was and never will be like him. None of us are like them or else we wouldn’t be on here seeking healing and anwers. As for forgiving them- that has been a challenge for me. But that’s where God’s grace kicks in. What I can’t do alone He can do. But through forgiveness I do not pity my ex even knowing how truly miserable he is. It is not my fault that he is pathologically ill and I did not deserve what he did. None of us has deserved what was done to us. None of us should let our guards down in a moment of compassion and forgiveness either. Instead I think we should be aware of the Ss that exist out there and not be paranoid but more confident in seeing the pathology and not being sucked into to their vortex of madness.
Anyhow, to end my thoughts on anger, I believe that we are socialized that anger is bad. Expressed and dealt with in a healthy way is freeing. I remember reading that denial in mentally healthy people quickly turns to rage. I laughed so hard I cried because I thought, “Sweet! I’m mentally healthy”. I was so angry at what had happened. I am thankful to be further and further away from that each day. I recognize the opportunity I have to not only get back to a life I loved before the S but to have a more abundant one indeed!
OK, I’m done with my novel for tonight. Gosh I write a lot! As always I appreciate you all for sharing your discoveries and thoughts along the way. It has been so healing to be able to chime in and share as I make my way through this journey. Not that I’d wish the S experience on anyone but it’s so great to have food for thought from your posts and to know that I’m not alone. Thanks everyone.
Well said takingmeback: Now concentrate of your breathing. In-hale listen to the air going into your lungs, exhale … listen to the air coming out from your lungs. Do this for at least 5 minutes. You will go into the “now”. Practice this technique of just listening to your breathing. The more you practice it, the more comfortable you get with it … the quicker you will get into the “now”. When you are in the “now”, you’ll have everything you need, you and God.
P.S. We blogged some pretty interesting concepts in all these blogs … if you care to find them. I forgot which sites there on … but they are there.
Peace.
Thinking out loud again..What do (I) believe? What do (I) know for sure?
Lots of great comments again today,
I would like to believe that you can heal these people….that there is some tiney thread of hope….but I think that hope is a miracle and that it should be left to God….because as Oxdrover said you sometimes give them more amunition with therapy….they can become more manipulitive.
I am a Reiki practioner…on my way to a master practioner….and we learn that humans have the physical body, the mental body, the emotional body and the spiritual body. In healing a person you are dealing with the mental emotional and spiritual body in the “Aura” of the person which can be extended 4 feet or more from the physical body. They believe a sociopath can be healed in the emotional mental and spiritual body. I know this can be way out there for alot of people. But what is not way out there is the power of prayer and the power of miracles.
How many times have you heard about or seen miracles! Believe in them. The lessons I have learned from these P’s, N’s and S’s is to be strong in life. Live with the conviction of my faith in God yet be strong enough to know what is what.
You may ask for miracles all your life and for some reason God doesn’t give it to you. God was listening….you were learning….but you didn’t receive that shiny blue bicycle…the miracle you were asking for…..why? Because you didn’t understand how to ask for a miracle. You have work to do….you just don’t get to walk through your life without making changes in yourself. Sometimes you have to have that blind faith that God will answer your prayers….and if you have been walking in your convictions with God he sometimes shows you the miracles. When I don’t see the miracles….I have learned it is usually because I am too attached with my ego and than I am not supposed to….and God knows when you get it and you are being “real”….Business always gets taken care of. It is what it is.
My point is that I have learned that I must always pray daily for others…even the “bad” ones…..probably moreso. Have I…not alot! Sometimes it is hard. I know how difficult it is to pray for the P’s…etc. I just left it to God….but I realize now, after reading this post, that was my anger in the way of healing. Maybe our prays to God about the tread of life that may be there for them…that through that thread Gods light can enter them and expand them and change them in a way they cannot recognize who they were and are now becoming through God. That they can receive healing through our prayers with God. They may turn it away and choose their evil ways….and that is why you don’t see the miracle….but they may wake up and smell the coffee.
You don’t get to see everything because it’s not possible….if you think about it….but you can learn from everything “good or bad” and you can walk away a better stronger person with a stronger faith and conviction in God.
You know I moved away from where I lived past and moved into a city area…and I have seen more “phoney” people here than where I used to live…and it bothers me….It’s all about money, how you look and present yourself, how you talk, what you have, and how positive you are!
“POSITIVE”…..like everyone here has read the book “The Secret”…let me tell you how taken out of text that can be by people….Yes, it is great to be positive in life…..but P’s and N’s and S’s know that better than anyone how great it is….but what is beneath that act. And I mean “act”…because most people are not “being” positive they are acting positive for a desired result.
“Being” positive entails so much more than the smile on your face and speaking in a sweet tone of voice and politely asking for what you want from someone. What is underneath all of that is who you are being.
It is a state of Being….it takes sheding your ego….becoming all or some of the following….
being strong
being happy
being joyful
being playful
being transformational
being assertive
being intelligent
being great
and I am sure you can add to that list
what I am trying to say is that regular people are getting lost in the ACT. Then they go home and wonder why it is that they are not happy. They can have many things….but they do not have themselves because they are living in the Act of being rather than “being”.
Here is a simple tool to change it. When you are upset about something…ask yourself what am I upset at. You are being upset…you are being angry…or being resentful….all the negatives….so what do you do to change it….instantly for healing!
LOOK at yourself for that moment…without feeling anything take a birds eye view of yourself and ask yourself how other people may be looking at you….don’t make them right or wrong….leave that to God….Tell yourself at that moment that you are Great! What does it take to be great…to be positive…what it takes is something you may be lacking in. Maybe it takes being compasionate….maybe something else. Be in the suffering at the time it began…sometimes it flashes way back to other circumstances. But at least be in the circumstance that caused your being Off…and float above it and ask yourself how you have been. Alot of times being great or being positive means being understanding and compassionate when someone is being bad to you.
I had a russian boss who was not easy to work for…but she did have a sweet side to her…but because there was so much ACt going on I couldn’t take it. I believe, after looking at all of it in hindsite…she was suffering from her background. Working for her was like stepping into Russia past…if you can imagine what I mean…she was molding everyone like they were puppets….and she held your job over your head….she didn’t pay you for training….she changed her mind a ton of times….and when she was working on molding you if you stood up to her you got fired…which is what I did….I stood up for myself and what was right….while another girl would take a different approach with her and joke and call it the torcher chamber and tell her we are not in Russia anymore and they would laugh….but her approach seemed to heal the situation. Mine might have later…but I will never know….I was fired…..
But when I look at the bigger picture I could have been more compassionate. Yes strong but also with compassion. That might have worked better…for all. Life is not perfect and she was not that bad a person.
Got to go to work now. Thanks for all your thoughts and wonderful insight. It does help me so much to read and sometimes to post to you all.