Treatment for Psychopaths: Can the Psychopath Be Cured?

Understanding that psychopaths are some of society's most dangerous people and that most commit crimes – often violent crimes – it is important to ask, is there a treatment for psychopaths? And if treatment for psychopaths exist, what is it and how successful is it? These are questions that researchers have been working on for decades and only now are we starting to answer the question of whether the psychopath can be cured.

Traditional Thought on the Treatment of Psychopaths

The traditional view on the treatment of psychopaths is that treatment just doesn't work. Study after study has shown that the behaviors of the psychopath do not change in response to psychoanalysis, group therapy, client-centered therapy, psychodrama, psychosurgery, electroconvulsive therapy (ECT) or drug therapy. In fact, in one very disturbing study in 1991, those psychopath inmates who were a part of group therapy actually had a higher violent recidivism rate than those psychopaths who received no therapy. As one psychopath put it, "These programs are like a finishing school. They teach you how to put the squeeze on people." (20 Signs You’re With A Psychopath or You Are A Psychopath) It should be noted that the scientific rigor in these studies was far less than desirable and while it all points to one conclusion, due to the errors in methods, there may still be lessons to be learned in an adult psychopathic population with regards to treatment.

Treatment of Juvenile Psychopaths

There is hope for curing psychopaths, however, and that comes in the form of the treatment of juveniles with psychopathic tendencies ("child psychopaths" -  psychopathy can't formally be diagnosed until adulthood). In this population, a treatment that is a conglomeration of other theories and practices called "decompression treatment," has been used with some success.

Initially, in 2001, decompression treatment was tried in a small number of children with psychopathic behaviors (10 received decompression treatment, 10 received group therapy, 10 received no therapy). In the two year follow-up period:

• 70% of the no therapy group had been rearrested
• 20% of the group receiving group therapy had been rearrested
• 10% of the group receiving decompression treatment had been rearrested

While these numbers were promising, the study size was very small.

The next, larger, study followed 248 incarcerated boys all considered to be "unmanageable" for 54 months (4.5 years) with 40% of them receiving decompression treatment, the rest receiving group therapy. In this study, again, the results were positive:

• The recidivism rate in the decompression group was only 56% as compared to 78% for those receiving traditional group therapy.
• The violent recidivism rate dropped to 18% as compared to 36%.

Additional study has seen similar results and shown that decompression treatment is highly effective in reducing institutional misconduct and recidivism.

However, the issue with decompression therapy is that in order for it to be successful, it must be applied for a very long period of time and this is part of the reason for the lengths of these studies. It appears that short-term decompression treatment is not effective but this treatment used for up to and over a year, is effective, particularly in those with less severe psychopathic tendencies.

The Costs of Psychopath Treatment

Of course, any treatment that lasts up to and beyond a year is very expensive, however, the cost of criminals getting out of prison only to re-offend (recidivism) is even higher. In the computations done by the study, The Criminal Psychopath: History, Neuroscience, Treatment, and Economics, using conservative treatment effectiveness numbers, it found that if decompression treatment were to be given to just half of all incarcerated juvenile psychopaths, the savings would be $115 billion per year. And, of course, there are additional savings that cannot be measured – that of human lives.

So it seems that while a 100% cure for psychopathy has not been found, an effective treatment in the psychopath juvenile population has been.

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