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.
You can’t tell me a small part of you wouldn’t get satisfaction out of a sociopath’s suffering. You are no better if you would, just less inclined. You need to clean up your backyard in that case. I am no better and dont claim to be. I understand
Have you ever enjoyed watching someone get caught doing something wrong, losing money, etc etc? There you go. You better think about how you need to change before you go trying to change them
If I seem guarded I apologize but have been reamed by many sociopaths on boards like this so am wary of talking to anyone.
I’m having plumbing problems. My kitchen sink is leaking underneath (the hot water), The P-trap is leaking, The garbage disposal stopped working.
This is at the cabin I haven’t lived in for 3 years and everything is falling apart. So… the first thing is to remove the Badger 5 garbage disposal. Then I’ll have room to maneuver and get the other stuff fixed. I unscrewed those mounting screws and everything is loose, but I have no idea how to actually disconnect the stupid Badger.
Does anyone have any ideas on how to disconnect that garbage disposal? How about a link with instructions?
Yes, I already turned off the power.
I’ve been sitting outside on a gray rock pondering the conundrum, I don’t want to hire a plumber for what should be a simple fix.
I’ve already bought a new unit but it mounts very differently than the Badger. The new unit is a Titan 1060 from Costco. I was there yesterday and bought groceries and other stuff, including the Titan 1060.
Also, I have purchase a replacement p-trap thingy. It’s a new kind, that is green and rubbery. If stuff gets stuck in it you just squeeze it and mush it around until the clog moves along. pretty cool huh?
Well my hair is turning gray with worry about this plumbing job. If someone can help it would really rock. I’d even accept help from a spath. Most spaths are good plumbers in my experience.
We aren’t dogs and we aren’t animals!
Troll
Garden gnome….I love mumms in the garden, especially this time of year, all the beautiful fall colors.
Skylar, I hate that you’re having plumbing problems…don’t know much about plumbing but I can tell you this: It isn’t hard to disconnect the badger…you JUST DO IT.
It seems according to you that I am wrong about everything but it is the marking of a sociopath to make someone feel that way. It is belittling. You are also very negative. You are adament that they know what they are doing. Tell me something. If a retarded person set fire to a house would you blame them? There have been many cases of slow people who are quick to anger and destruction and damage and assault. They can’t help it. Same with the sociopath. They DONT KNOW WHAT THEY ARE DOING OR THEY WOULD NOT DO IT!!!!
I doubt would ever get a straight answer from you,. A yes or no would be good but hasnt happened so far so case closed. I am not interested in your redundant answers. Thnx
Sky,
Don’t know about a kitchen sink, but a couple of weeks ago my toilet wasn’t flushing anymore, or only very slowly. And the next day I’d have a worker coming to do some work in the apartment. Had to get the shit flushed, no?
I found good links to solve the problem though. One of the tricks was to pour some liquid dishwashing soap in and then pour heated water in there. You then have to let it sit for 10 minutes… the warm water with the soap can help loosen whatever plugs the toilet.
Well that trick totally rocked! Just simply dishwasher soap and hot water, and it flushed perfectly again after that! It would have flushed grey rocks! All clean and tidy after that, and never had to make my hands dirty over it!
Always preferred to remain clear from shit and be clean. 🙂