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.
🙂
Skylar, right back atcha 🙂 Makes me think of EB.
Just a note, in the table above, item 11 (sexual promiscuity) is not present though is alluded to in the article. *Sorry not to have any help regarding P-traps!
*Pitifully, I am in the midst of trying to see if there is any potential treatment either in psych- or physio- that can help this marriage I am in. I do feel good having recognized things pretty quickly though, I guess. (Trying to see bright side, and trying hard to see how much of this terrible condition I may also have especially being called names by husband and his ex (who sounds like “none” above, also an exec). I do fear that spending more time here is encouraging my own abusive behaviors to grow, anger, sometimes name calling, which I have asked my husband and his ex to stop. I initially was shocked, never having encountered such juvenile methods of expressing anger in adults, and ones with such high-powered jobs.
I haven’t seen others writing this here, though has anyone else found themselves showing ugly behaviors in at frustration being ignored/yelled at/called names? It’s a struggle at this point to be solely kind asking for respect. I do fairly well at keeping that up mostly, but feel weak when I also get angry.
I used to laugh and try to support everyone around me, sticking up for respect + love, and mocked for it by kids’ spath mom, and even my husband. I feel… dead, and angry, here. My husband defends his ex to me, and my new friends defend her too, even after she admits to lying about me to her kids and to my friends. I continually ask for respect, and after doing so on occasion my husband will say I’m right, he did a wrong thing, but his ex wife goes calls me names when I ask her for that and attacks me to my husband. I just feel like I’m involved with The Abusive Family. And I may be catching it. 🙁
I’ve read so many books on marriage and friendship, and I try my best to –do– recommended paths. My husband has often stonewalled or yelled just by my using, “I feel… ” statements, and my friends just ignore me. I feel lost.
I feel so confused and lost. I have seen counselors who tell I’m fine, nothing wrong. Yet I feel very non-connected and am trying to do my best while I’m being yelled at or ignored often by people “close” to me. *sigh*
Hi newstepmom:
I am very glad that you are still here and looking up articles that can help you and continue to share what is going on in your life with at least one sociopath attacking your mind.
I was once a new step mom. I had married a man 9 years older when I was 28. He told me a ton of lies (including having a purple heart during Viet Nam when he was in the end of the war in Hawaii during his whole three year stint). He was jealous. He was controlling. He was a drunk. He was abusive. I took care of his children when they visited…often while he was gone for no reason. I had to make a rule that he couldn’t hit his children in our home and knew that talking to intelligent kids works much better than a drunk hitting them for lying of all things!
Let me tell you that you will probably leave at some point. And let me also tell you to use every form of birth control you can, so you are never anewstepmom and a newmom with this person you are describing as a sociopath. Mine begged me to have a child with him and I refused.
We all do what we do for different reasons. It is time for you to think only of yourself and why you aren’t leaving and then go to counseling and see if a good therapist can get you to figure out why you aren’t leaving and, hopefully, get you to the point where you are realizing you need to make a plan to leave. Because you will leave or you will be dead inside for the rest of your life as these people suck out your very essence. You are already losing sight of yourself. He took you away from your support system to a system that fits with how he wants to live and how he wants you to live. If you are in a region where your female friends are all being abused and have to keep their mouths shut, they are not going to be of any support to you. They are afraid of their own husbands.
I left my first husband who was a sociopath after 5 years. I was sick and underweight and exhausted. I had just lost my job and was on unemployment. I was scared. He had also made sure I had no friends except him and one sister he couldn’t get rid of. Here is why I left. I had been going to domestic violence counseling. The counselor told me to read “The Verbally Abusive Relationship: How to Recognize it and How to Respond” by Patricia Evans. I read it in secret, kept going to my therapist, and then began “responding” using Evans’ suggestions. The more I responded to his crazymaking verbally and emotionally abusive words and behaviors, the more he didn’t know how to respond. The more I read about the insidious types of abuse there are and how he used almost every one of them, the more empowered I became in who I really was and what I didn’t deserve.
Read books to help yourself. You will never help him. He is never going to treat you any better than he does now. And, he may be like mine in that he may bring home gifts, shower you with compliments and act as if he can’t live without you….when he can see a light in your eye that says you can’t take another moment of his crazy making.
Go buy the Patricia Evans book today. Read it when he is gone. Hide it somewhere he will never find out about it. NEVER say a single word to him. Don’t try to make him understand what he is doing to you thinking that if he looks at the book, he will “see the light” and change. He will not ever change. You are the only person in this group who is going to change. You will never be consistently happy in this mess of people. You will be lucky if you feel happy 20% of the time which isn’t enough.
They are eroding your self esteem and they are not going to stop until you are sick and have become their servant. There is no medication he can take. There is no counseling he is ever going to get. When you get out, he will find someone new. He is not a human being. He is a feral brain always searching for a new victim, a new target, and to abuse the hell out of all of you.
I am not going to tell you to get out now or run or to make a quick decision because I believe that will make you feel you can’t share here when you need to share here badly.
I am going to just tell you that as you read books about how to protect yourself from these people, about how to become empowered and back to being the you that is stuck inside right now, and read more about what YOU don’t deserve to live with, you will leave because you will know that it is the right time for you to leave. I hope you will continue to educate yourself about sociopaths and about how to raise your own self esteem rather than trying to work on a marriage that will not work because he is a sociopath.
The most difficult part at this point may be leaving your step children. It was for me. I wrote them a letter and told them the best part of my marriage to their father was knowing them, but that I had to leave the marriage because it was not working out for me. I wrote a short paragraph telling them each something special I admired about them. That was painful, but they were not my kids and it wasn’t my job to save them from their parents either. My spath took great care to make sure his ex and I hated each other. The one time we talked, I found out about his many lies. But, I didn’t respect the way she was raising their children either.
My ex-husband spath was crazy about me. He was possessive and jealous and I didn’t think he would let me go. He even tried letting me know that a no-stalking law had been voted down recently during one of our final conversations. This was 25 years ago. Through maneuvers and a promise that if neither of us were with another person in 10 years, we would get married again, I got the house (which had no equity), I changed my phone number, and he moved on to the next one.
Again, from what you are describing, you know there is something very wrong and as you continue to investigate and read and educate yourself, you will end up leaving him. Now, the only question is “When will you leave him?” That is up to you and I respect that. I do, however, completely agree with the no contact rule when recovering from a sociopath. I had no contact with him for nearly 10 years. He wanted to make “amends” as per his AA program. I let him. He came to town to take me to lunch. I talked to him a few times on the phone and thought, “What in the world did I ever see in that yahoo?” As soon as he found out I was not going to be re-victimized and I saw how dumb he was and I had a great education by then, etc., he married wife number 4 about a year after he tried again with me. He lives far away and doesn’t bother me any more. He has a new victim now and I didn’t want him anymore. He was so unattractive to me. It was like looking at a stranger and talking to someone I knew, but would never marry again.
I went through life’s up and downs since then as we all do. Went through upsetting situations with a couple of spaths and a borderline husband (much easier to handle them as they are capable of empathy, but still an ex now and only a friend who knows my boundaries and follows them 80% of the time) and have a spath lodger who used to be a boyfriend and whom over I have a ton of leverage because he is old and disabled and around for my own personal reasons….but not love. Not a marriage. Something else for convenience as I am older and disabled.
Please get the Evans book and start reading. She will make it more clear than I can about how much better every human being deserves than what you are getting. She explains in depth about abusive tactics spaths use and how to handle them TO PROTECT YOU – NOT TO CHANGE THEM. She also has a book that can answer your questions about whether or not he will change. The answer is NO for 99% of all abusers and NO for 100% of all sociopaths…especially one who has already refused counseling. He doesn’t think anything is wrong. He is getting everything he wants. He owns you and you are confused and are trying to do anything to please him and his people.
You will run. But, it is entirely up to you to plan that and figure out when you are going to do it. Please keep sharing here. You will find respect here. It is a safe place. Keep reading and keep sharing. Then, share your plan with us unless it is possible he has your computer bugged.
Sexual promiscuity is out spaths biggest red flags. That and how she has no friends, abuses her elderly mother, and is now accusing her elderly step father of molesting her, when he refused to give her MORE money for frivolous things.
The sociopath I am speaking of is very sexually promiscuous. She has slept with every single man, or married man in the small town we live in. she is now about 48 years old, and after a lot of alcohol, cigerattes and drugs. Her looks are worn out, and she is not attractive. So her sexual escapades have slowed down. She is on her 5th marriage. Her current husband is older than her, and she has emotionally beat him down to submission. The poor guy. He had no idea what he was getting into when he married her. Like the man before him, he is just another victim. I feel bad for this guy.
Many people who went to high school with her say how awful she was then. She actually went off to college and people said the same. She was always very smart though. But it is true that drugs mess up your brain. Because now she barely knows what day of the week it is. She is bossing everyone around telling them they have to due this and that ASAP because it has to be done by Wednesday. And it will be Friday after that wednesday. At this point we ignore her. We have no contact of any sort with her because it is to stressful. We are dealing with a ruthless person, who seems to be losing her mind.
Okay, Stepmom. Stop reading books. Stop trying to be nice. Stop feeling disconnected…just stop. It’s not working. It will never work. You are spinning your wheels and going nowhere. Do not waste on more iota of energy on it…not one more what if, not one more heartache or tear. My advice? Just stop. Get out. Move on.
Run Newstepmom RUN!!!
You have a group of spaths trying to turn you into one of them. They want you to get angry and confused and defensive. They want you to react emotionally and call them names. They are FEEDING off your emotions.
I would not even recommend gray rock in this case. They’ve got your number and your only option is escape. There are too many of them Get out of there before you become pregnant and are stuck.
If he suspects that you have decided to run, he will do everything possible to prevent it. Don’t give any warning, prepare everything you need to depart, including contacting an attorney, and then do it when there is nobody around.
NewStepMom
If you have to ask for respect from your husband, you already have all the info you need. He’s the kind of guy who would EVER be disrespective of a wife. He’s Not a Keeper, and definitely NOT something that can be resolved. For your own wellbeing, do as advised above.
RUN! FAST! NOW!
newstepmom,
What is happening to you – becoming the person you hate – is exactly what happens in the relationshit with a spath. It will only get worse… you’ll hate him, you’ll hate yourself, and he hates you already (always had). I’ve never called someone names, but I did in some fights with the ex… and felt horrible over it.
You’re trying to fight a losing battle… and what you stand to lose is of priceless value: your mind and yourself… He ain’t worth it. He just isn’t.
Dear New Step mom.,
YOU SAID: specially being called names by husband and his ex (who sounds like “none” above, also an exec). I do fear that spending more time here is encouraging my own abusive behaviors to grow, anger, sometimes name calling, which I have asked my husband and his ex to stop. I initially was shocked, never having encountered such juvenile methods of expressing anger in adults, and ones with such high-powered jobs.
So it seems like the problems in the marriage has escalated into more than dealing with a dysfunctional X and some dysfunctional kids….
I agree with the poster above: YOU ARE FIGHTING A LOSING BATTLE.
Yes, many of us in frustration, anger and pain have struck out at the abuser…but the only solution is to GET AS FAR AWAY FROM THEM AS POSSIBLE, AND AS FAST AS POSSIBLE.
Get down on you knees and thank your God that you don’t have kids with him and haven’t been there 30 years. Pack your bags and get out.
Thank you. I know it’s true, that it’s what I need to do. How does anyone find that strength though, especially if they are otherwise, essentially alone, and leaving this guy will in large part ruin him (he and his ex, highly successful, some eyes on them, etc). Then again, he asked me to leave everyone I knew and didn’t give it a second’s thought, regarding making sure I felt okay arriving in his life. So, that alone is my reason, I do see that. I am afraid of the great unknown. I had waited so long to get married, and jumped in in spite of this jamoke having told me he would not go to pre marital counseling. Now I see that as only control. But, do emotionally intelligent men even exist? I am not sure I have ever met one, though I have heard of them. Maybe my whole life I have only met the non ones. Are my new girl friends here, who are not answering my emails, also threatened by my identification of this situation? I am shocked to have met so many women living my same life here, also. Is everyone in the world, these people? One of my “friends” is also friends with the ex wife and has a husband who yells so much his kids worry about keeping their dad from yelling at their activities instead of trying to do well at activites he attends. I say nothing to her about that but support her voiced opinion, and she defends her friend (my husband’s ex) saying, “well she did that (lied about me) a long time ago,” (8 mo), to which all I say is, “Well to me that indicates character.” So everyone is shooting me the messenger rather than supporting my views. I’m not getting any support in this, only people abandoning me. I feel entirely alone. Thank you for understanding, here. But out in real life I feel like I am the only one who doesn’t want to pretend it’s not there. What a monster to hide. I have been doing my best to treat it respectfully while I am being bashed. And to defend these friends of mine (3) who are going through the same, but seem eager to dismiss me nonetheless. I feel tremendously sad, and pretty darned hopeless, even if I do leave. (And, I don’t think the husand will try to stop me. He has been threatening, I’m embarrassed to say, divorce since the 3rd day, that first time because I was angry that he had forgotten and refused to spend 1/2 hour with me on our first day married after forcing me to move to his house in spite of his leaving on a business trip that day, giving the day to his kids, parents and refusing to say no to his ex wife’s demands, instead. How pitiful… I’m really depressed about this whole thing.
newstep mom, it sounds like you are involved with a GROUP of people who are all dysfunctional…these people are NOT your FRIENDS….finding “support” from a group like this is impossible, and the ONLY thing you can do is take care of YOURSELF.
Leave, get away, get away from them ALL….move to another town, another venue, find new friends…..this man and his Ex are still emotionally “married” and you are just an intruder….in their DRAMA RAMA.
YOU have to take charge of YOUR life and get out of their DRAMA….just disengage entirely from it and from them and their friends.
Don’t discuss this with any of them. Don’t expect support or validation from any of them. Just LEAVE AND TAKE CARE OF YOURSELF. Start life over.