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.
Dear Tryingtorecover. Yes it is very difficult when they live in the same proximity, its like having to be reminded of the pain constantly. I have even tried putting my place for sale in order to move to another part of the UK, which is not to get away from him, as I had planned to do that, but that is an element of it. But we have done nothing wrong, why should we feel like an outcast in our own communities. This is one of the unpleasant issues that we dont realise will come up, when breaking up with someone with PDs. I am determined to keep my dignity, no matter what he has said to people that we mutually knew in local bars, I know what the real truth is.
Having been a t one time a professional photographer, I have tons of photographs–lots framed and on the walls, sitting on desks, etc. I went through them and took out all the ones that reminded me of my P-son after abot 10 or 12 years old, all the teenaged years, etc. when he was so negative.
I took all the beautiful photographs I had taken of my mother and put them away. I took most of the ones of X-BF and did the same though there are a couple of them which were taken on a vacation where he was in a group shot I kept because I wanted the other people’s photos in the group.
I put letters and cards either away in boxes in deep storage or threw them away. I actually kept the huge boxes of 20 years of letters from my P-son, but they are in storage. I haven’t reread any of them except the most recent and they are also in storage now too.
I gave away certain gifts that my mother had given me to people who would appreciate them. My mom was after her retirement one of the award winning quilters here in our state, and had won many best of STATE SHOWS, and she had given me quilts from those, and I gave them away because Id didn’t want them any more to remind me of her every time I went to bed.
My whole farm had a misma of sorts seeming to hang over it like a black pall for a while, when the Trojan Horse P was here, but since his arrest a year ago and since I have been home that seems to have lessened and the feeling of comfort from this place is coming back.
No, you never “forget” but for me, reminders of them don’t do anything to make me feel “better” so I just get rid of them or put them away where I will not have to see them daily or even weekly.
I can understand Henry digging up the lilies.
As far as “running into” them in town, the only time I have “run into” the Ps was years and years ago I ran into my biological father on the street, and I shook for days. Then a few months ago I ran into the X-BF unexpectedly in MY territory (400 miles from his home) when I went to the local auction on Saturday night that I frequently go to, and lo and behold! He was there! The last place in the world I expected to see him. It unnerved me I think more because it was so unexpected–I cut him the cold shoulder and didn’t respond when he tried to “be friendly”—I had run into him once before at a living history event, but I had expected to see him there and it didn’t upset me. I think the “suprise” part was the worst of the “bumping into” them.
In the future, I think should I run into any of them I will not be so bothered or suprised. Sooner or later I will probably run into my mother in a store somewhere, but if it happens I will just “nod” and move on. Not make a nasty public scene, but not stand and chat for sure.
Tryingtorecover, I am sorry for both you and your son that your X has moved back to your town, but I think you should be proud of your son for calling your X on the lies. It shows to me that your son is not falling under the “spell” of the FOG put off by his father. Good for you for not answering the telephone too. You are a strong woman and have taken back your POWER. You are not letting the P control you, and you know I thinkk that is the WORST punishment that we can inflict on them, it makes them furious that they can’t get a response out of us. The letters and calls to others that my P son has made over the last year since he is not getting either money or letters from us show that my son is actually SUFFERING from the frustration of not being able to con us, not to get a response. He is like a roast on a spit, turning over the fire of NO CONTACT, and the heat is cooking his backside. LOL You know that isn’t a great deal of satisfaction but it is something that “money can’t buy” it is JUSTICE. It is the only way we can “inflict pain” on them. The pain they experience when they have NO CONTROL over us. I think that is the worst “emotional pain” that they can have.
Congratulations! Tryingtorecover! You and your son scored a direct hit!
Beverly, my biggest fear I think about running into them is not keeping my dignity. Either turning white and going the other way or starting to cry and seeing his smug satisfaction. I just got off the phone with a friend and she said to walk right up to them and shake her hand and thank her because my life is so much better now. She said just watch their chins drop. It’s a nice fantasy, but i don’t think I could pull that off – at least not yet. I also was going to go to the grocery store when they should be at work, but I have come so far in taking back my life that i can’t do that. I stopped there today and it felt good.
Thanks Oxdrover and I truly love all your analogies.(roast on a spit) I am very proud of my son. Thank you for putting it the way you did about the spell and fog. It helps. I know my son is aware, but I always have a fear he’ll get sucked in. Hearing it that way – I know my son is not in the fog now and I can’t see him ever being in the fog. I did not raise him like that, for the most part. I did smooth things over with his dad in the past before I found out the truth. I told him his dad was truly sorry about something when my “smarter than me son” didn’t believe him. I was raised to be in the fog and when I tried to break out of it as a kid my mom blamed me. Even when I was engaged to my ex and I emerged from the fog on one occasion my mom defended him and gave me a lecture in front of him. He had “worked late” again and you know you have to be understanding when a guy is working so hard to put food on the table. I agree if he’s really working. I couldn’t put my finger on it, but my gut said there was something wrong. It didn’t add up that he was working because he never had anything to show for it.
I agree not having control over us is the worst and only punishment you can inflict on them. The only problem is now he needs to gain control again – which means let the games begin. I will be strong. I haven’t come this far to let him win his sick game.
This is such a great place to be able to come. When I felt alone in the beginning it was here. Now well into the process and having a setback it’s here. To everyone, thank you.
Dear Tryingtorecover,
You know, having your son not fall for the gaslighting and the FOG is so reassuring, because so many times they PLAY the kid like a good fiddle, to get back at you.
I am so happy and thankful that your son isn’t falling for that, and since he has seen the lies and deception, etc. he is not, in my opinion, likely to fall in the future—“forewarned is forearmed” and when you don’t trust someone it is difficult for them to EARN that trust, and especially for a P so if he sees through it now (you didn’t say how old he was) he is not in my opinion likely to be sucked by in because the P can’t keep up a good front for too long at a time. Besides, kids are NOT stupid, they I think can see through the words and look at the actions more than we adults can because we have trained ourselves to listen to the words and not the body language and the actions so much. People SPEAK more with body than mouth and are much more honest with their actions than their words. Good KID@....... AND GOOD FOR YOU FOR RAISING HIM RIGHT!
Although my own adopted son is 31, he has been discvoering recently that some “friends” of ours are taking advantage of his and my good nature. I set some boundaries for these people and distanced my self from them. My son is also seeing for the first time, these people in the TRUE light of how they are not only taking advantage of me (which I have now put a halt to) but would take advantage of him as well. Since he has always idolized these people from his childhood, this was a tough lesson for him. I am so glad that he is “catching on” to this. He is finally getting it that their ‘poor planning does not constitute and emergency on his part, and that he doesn’t have to drop everything to “fix” their self-caused problems.
There are so many lessons for us all, adults and chldren alike, in dealing with these people and there are some very good ones that if we will learn them will benefit us the rest of our lives. I am so glad when I see a young person learn the lessons that I wish I had learned when I was young. I think of all the problems I could have avoided by knowing what I know now about psychopaths. Of course I obviously was a “slow learner” and had to re-take the class until I finally “got it” but it will benefit me the rest of my life. I am just glad though when young people catch on at a much earlier age, because it will save them tremendous grief in this world for the rest of their lives.
Just hearing your good news about your son, and then my son coming in and talking about how he had “finally gotten” it about our “friends” has MADE MY DAY! Baby steps add up to MILES AND MILES.
OxDrover, my son will be 15 next month. His dad left last year. He is starting to remember things and figure them out. A couple of weeks ago he asked me if I remembered an incident from when he was little. He was riding his bike in the street, which he wasn’t allowed to do, and when I saw him he told me his father said it was OK. I went in and asked Bad Dad if he told him it was OK. He said he didn’t, so I went back outside and my son got in trouble for not only riding in the street, but for lying. I don’t really remember this particular time, but I know stuff like this happened more than once. It’s just so unbelievable to me still the extent of the lying. Something so “everyday life”, so trivial, but he still had to lie about it.
I’m glad you had your day made! You deserve lots of good days!
Tryingtorecover, your kid is SMART!! And kids don’t forget that kind of stuff! As long as he never gets to trusting your X he will protect himself. At 15 he has learned a valuable lesson, and at this point maybe you can give him a copy of Robert Hare’s book “without conscience” and let him read it. I think it might be a real eye opener to hiim to see that his dad is not unique and that there is a NAME for the condition.
It is so refershing to me to see a smart kid catch on to the P and not believe them. To see through the FOG. And, it also looks like your son escaped the genetic curse too! That’s good as well. You are a fortunate and blessed lady. Give that boy a big hug for me and tell him that His “auntie Oxy” thinks he is an awesome young man!
Thanks Oxy, I’ll tell him!
I’ve been wondering when will it be time to explain the disorder to him. I’ve talked to my counselor and she said she would talk to him if I wanted. She also feels he has a good handle on things. He has also gone to his own counselor and she doesn’t pull any punches with him. She says to him it is what it is. Although she has not named the disorder to him, she talks to him about handling the lying and manipulation.
He still wants to see his dad so far, so I just want to equip him with the tools he needs to handle himself. I also want him to know when to stand up to him and when it’s time to stay quiet. I worry every time he goes with him because when he gets angry he drives extremely aggressively.
I think when the time is right for him to read about the disorder, it will help him to know his dad is not unique.
I just remembered why my counselor told me she would explain the disorder to him. I told her what he calmly and rhetorically asked my mother after talking to him – Why is my dad such an a$$ h*le? I guess that sums it up.
I think the way the P targets the child is the biggest abuse of you of all. As teenagers they are so vulnerable. I was a single parent for a long time before the P came into my life. He was, of course, all of my dreams come true, the icing on the cake plus the cherry on the top! For three months i was the happiest person thinking at last i had found my soul mate. Nothing and no-one can prepare you for the absoulte devastation they cause but when your child is affected that is when they really do the ultimate damage. He was the first man i had allowed to live in my home in 12 years as i trusted him to be with me and my son. He ended up subjecting me to the most horrendous and soul destoying emoitional and verbal abuse. After 6 months i no longer recongised the person looking back at me from the mirror. It happens that fast and they are so good it destroys you. At the time i did not even know what a narcassist/sociopath was. I felt sorry for him, he was always caught up in a cycle of abuse followed by showing me so much love and tenderness, it totally destroys your ability to think, reason and at times even function but when its affects your child thats when you know you have to find the strength and courage form somewhere to stop him. I am so ashamed that my son was witness to me being abused. I had always been strong for him and we had a brilliant close relationship but the P started to poison my sons mind against me. It would start with commnets like ‘yours mums really cruel isn’t she’ when i was out later than expected through work or late back with the shopping. When i went out with a friend one night, which he could never cope with, i would come back to both of them sitting in scilence with accusing looks on their faces because i had actually go and ‘left’ them, and that had made me, in the P’s eyes so horrible and bad. He would side with my son when i was trying to discipline him totally undermining all i was trying to do to make him look the good guy. I came to a head when i would have to ask my son to stay in his room at times if the P was in full blown emotional strop. I would just sit on the end of the sofa shaking, hoping against hope that he would fall into a drunken sleep so i could be allowed to get into the kitchen to get my son something to eat. I found an empty wine bottle in the P’s bag once and he said it must have been my sons. He was always berating him, saying he was lazy, spoilt etc whilst all the time he was jsut being a typical teenager. The damage he did to me was immense but when it comes to your child thats where the damge is really done and thats when you need the strength to get out and away.
Dear Tryingtorecover
You will never ever undertand the lies, as you said they lie about the most bizzare things. My ex-P was going round telling everyone his new girlfriend, now wife, was really rough, covered in tatoos, ugly etc but when i met her the poor woman was none of these things! Why lie about it? You will never be able to make any sense out of the whys because thats part of the illness. It is there to manipulate, control, confuse and dumdfound you until in the end you doubt your own sanity and reasoning and this is exactly the effect they intended to create. Clever aren’t they?
Tryingtorecover.. you are lucky your son is seeing clearly. My kids are still pretty confused about it all, though I can’t understand why.. seeing as I’m here for them every day of their lives, while their father can’t even be bothered to send them so much as a christmas card for the last 12 years.
BUT… I do not know why it is, but my first husband followed me wherever I moved until his new gf put a stop to it. He said it was to be near the kids, but I found that ludicrous as he never took them for visits. In fact, I liked being far away because it made it easier for the kids to understand why he couldn’t come to see them. It was one of the most painful and upsetting things he did.
Years later after I thought there was no way he could hurt me anymore, he supposedly had his vasectomy reversed and fathered another child.. it was like a sucker punch in the gut. ( I found out later that was all a lie anyway and now there is another little boy out there who wonders why his dad never comes around… sigh)