It turns out that Sandy Brown, M.A. is quite correct in stating that any talk of treatment of sociopathy makes people (particularly women) reluctant to give up on a dangerous relationship. We received a note this week from a woman asking for more info about treatment and wanting to know if there was any hope for her man. He was the only man she had ever loved and she was actually still grappling with the meaning of his diagnosis.
This week, I will discuss medications that can be used to treat sociopathy. But before I do I want to make it clear that I encourage people to break away from sociopaths. Remember that the sociopath’s doctor and therapist will want you to stay with the sociopath to assist in the treatment. Sociopaths “do better” with treatment and when they stay married. So let me explain what “do better” means. Also this discussion will help you if you are still grappling with the meaning of your sociopath’s diagnosis.
One of the ways to assess sociopathy is with the Psychopathy Check List-Revised, developed by Dr. Robert Hare (PCL-R). The PCL-R is a 20 item psychological evaluation that professionals with training complete on a person using an interview and a review of criminal/ psychiatric records. When someone scores above 30 on the PCL-R that person is “a psychopath.” Most people who psychiatrists would consider “sociopaths” score above 20 on the PCL-R.
Researchers have used the PCL-R to evaluate large numbers of people. They have found that some items of the 20 item test are correlated with each other. That means that say a person who scores high on item 1 is also likely to score high on items 2, 4, 5, but not necessarily item 20. On the basis of these item correlations, researchers have grouped the items into two “factors” each having two “facets.” I will use these factors and facets to discuss with you what aspects may respond to medication. Two items of the PCL-R do not belong to either Factor 1 or 2. These are Item 11, Sexual Promiscuity and Item 17, Many short term marital relationships. These items stay part of the PCL-R because they are so integral to psychopathy as you already know!
Factor 1 Interpersonal/Affective |
Factor 2 Lifestyle/Criminality |
Facet 1 Interpersonal Symptoms | Facet 3 Lifestyle |
1. Glibness/superficial charm
2. Grandiose sense of self worth 4. Pathological Lying 5. Conning/manipulative |
3. Need for Stimulation
9. Parasitic Lifestyle 13. Lack of realistic long term goals 14. Impulsivity 15. Irresponsible Behavior |
Facet 2 Affective (emotional) symptoms | Facet 4 Criminal Behavior |
6. Lack of Remorse/Guilt
7. Shallow Affect 8. Callous/Lack of Empathy 16. Failure to accept responsibility for actions |
10. Poor behavior controls
12. Early Behavior Problems 18. Juvenile Delinquency 19. Revocation of conditional release 20. Criminal versatility |
Look at the Table above and consider that you are interested in the two items that are not part of either factor and Factor 1. These are the symptoms that are most concerning to family members. The criminal justice system and professionals are most interested in Factor 2.
Look at the list again and imagine a person with a great deal of energy either because he or she is manic or because he or she is on speed. In that case Items 1, 2, 5, 3, 13, 14, 15, 10, 19, 20 and 11 would be most affected. In fact this is why there is overlap between bipolar disorder and psychopathy.
Anything that increases a sociopath’s energy level makes him or her worse. Anything that reduces his or her drive leads to “improvement.” That is why, medications for mania like lithium, anticonvulsants and antipsychotic drugs have been used “successfully” to treat sociopathy. In this case success is defined in terms of fewer arrests and aggressive acts.
Also look at the list and notice that Items 3, 14 , 15, 10, 19 and 11 are related to poor impulse control. These symptoms may respond to antidepressants that work on the serotonin system. Defects in the serotonin system are thought to underlie impulsivity. The problem is that many people become manic when they take antidepressants so these can also make a sociopath worse.
Okay, now see what was left off the list, and you will conclude with me that medication will not turn your sociopath into someone you want to spend your life with. Many people say that the sociopath’s energy and spontaneity are what they find attractive. If that is the case for you, then medication which reduces a sociopath’s energy level will make him or her less attractive to you. All the “fun” part of the sociopath may disappear, leaving you with a boring parasite.
Nothing will make a sociopath loving and empathetic or build a conscience. A loving person takes care of his/her family, is trustworthy and doesn’t lie. Medication cannot make a person loving; it can only reduce dangerousness. Focus on the use of the term reduce, as I did not say eliminate dangerousness. In a hypothetical research study, a 50% reduction in the battering of family members and a 50% reduction in arrests would be considered “improvement.” That does not mean sociopaths are turned into people you want to share your life with.
So why do I even discuss treatment? Only to keep you informed and for those who for whatever reason choose to share life with a sociopath.
Next week psychotherapy for sociopathy.
I agree to leave them alone but dont stop looking for a cure cause that is the only way this world is going to be helped. The only way.
You may be right in that they like what they are doing, but that is part of the disorder (chemical imbalance) mental problem. Who, in their right mind, likes to hurt people? I don’t know how to make you see that but is not my job. There are many who want to find a cure and am glad for that. Hare has run his course if he is not doing something to cure this.
I know sociopaths who run off everyone who wants to help them or get close to them or love them. I know sociopaths who help create their own demise or monetary loss. I know sociopaths who yell over nothing. The list is endless as to how they self destruct. They DONT know what they are doing and have no control!
I am not comfortable with the chicken analogy. Too violent. They have no control over their behavior.
None, I suggest that you read more about the disordered personality. They are not without “control” over what they do, they have “choices” just like the rest of us, they know right from wrong, just llke you and I do, the difference is, they don’t care.
While there may come a day when their problems can be controlled with medication and they can live lives without violence and manipulation, I sincerely doubt it will be a “cure” (i.e. take a pill and get “well.”) LIke taking antibiotics for pneumonia and getting “well” It is most likely if it is ever found to be something that must be taken continually for life. Unfortunately many many people with mental disorders of all kinds refuse treatment (I am a retired nurse practitioner and except for people who are court ordered and report for medication injections on a regular basis or face jail, many people who would benefit from medications for bi-polar and other serious mental problems that CAN NOW be helped or controlled deny they a have anything wrong, or refuse to take the medicine even if they do know. Generally unless they are violent they are not compelled to take medication.
Psychopaths, do have control though, and they make choices based on what they want, even knowing it is wrong.
None,
They have control, choice and even enjoy destruction and hurting people.
I’ve witnessed myself with my own very eyes how the ex-spath grinned with duping delight behind people’s backs. Of course I never saw him grin that way behind my back, because it was behind my back. But I have no doubt now that he grinned behind my back, because I was no more diffrent to him than any other person – his father, and about everyone who was trusting and willing to give him a chance and help him.
There is too long a trail of references, events, actions, etc that show he was fully conscious of what he was doing, that he enjoyed it, that he masked it and that he cared not one jot about it. Oh, and he still does to other people, just not me anymore.
None, I can understand your defense of sociopathic behaviors as being a “disorder” that can be treated and cured. But, it can’t. Plain and simple. It’s NOT a disorder. It’s a CONDITION – a “human condition” where a person, for whatever reason, does not have a conscience, and they do not feel remorse.
You wrote, “They can’t help it.” Oh, yes, they can. They KNOW that forging someone’s signature on private checks is ILLEGAL. They KNOW that talking people into feeling sorry for them so they’ll have a place to live, food to eat, and a vehicle to drive is “wrong.”
OxD is spot-on Read and learn. Perhaps, you haven’t experienced the whole-self destruction of a socipathic entanglement, and that explains your beliefs. Until you do, all of the “research” and reading that you undertake will never sink in. And, I hope that you never experience the carnages of a sociopathic entanglement – it will “rock your world” to its very core and leave you as a skeleton of your former self.
Brightest blessings
None, in re-reading the thread of posts that followed your initial response, I have to wonder why you believe that you – that “None” – can help somone become cured of something that is a series of choices and why you believe that you are mandated to.
You questioned whether it was appropriate to simply write them off and walk away, or not. The answer to your question is that they are written off, and walked away from.
What compels you to believe that there’s some sort of “cure” or “help” that can be rendered? I don’t know if you’re a pet-owner or have ever worked around livestock, or not, but this is how it is in Nature: sometimes, there are species that enter into the world that are simply bad. A dog that has such a genetic predisposition for agression that it attacks and kills members of its own pack, without any “pack” behaivor – it simply kills to kill. Sometimes, human beings develop and, by their choices in behaviors, are 100% predatory, and it doesn’t matter whether it’s genetic or environmental – these people will never, ever, EVER be “cured.”
Is this your first visit to LoveFraud? Did you find this website via an internet search for information? Have you experienced a sociopathic entanglement, yourself, and possibly suffering cognitive dissonance in order to avoid the emotional discomfort of the truths?
I hope that you found this website for the purposes of recovery and healing. If that was your intention, you’ll not find a better source outside of individual counseling therapy with someone that “gets it” about these deliberately predatory individuals.
You don’t have all the answers and neither do I. If you did there would be a cure. What makes you think you are better than a sociopath? I know I am not. We ALL have negative promensities. You are no different. In fact, sociopaths don’t know the difference between right and wrong and have an excuse, but we do. We just choose to do bad. I am thinking about sleeping with a man who is in a relationship or says he is. He has talked about sleeping with me. What does that make us? Human. All these human traits are possessed by every human being. Lying, stealing, etc. If you have ever stolen, lied, said something you knew would hurt someone etc you are no better and cannot judge their behavior. In fact, in that regard, we are exactly like a sociopath. Tell me what bad things you have thought about or done. See? Case closed
I’m sorry but I feel I have surpassed you in my perceptions and you just dont get what I am trying to say.