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PSYCHOPATH AND HIS TREATMENT

NCJ Number
57015
Journal
BRITISH JOURNAL OF PSYCHIATRY, SPECIAL PUBLICATION Issue: 9 Dated: (1975) Pages: 159-169
Author(s)
J S WHITELEY
Date Published
1975
Length
11 pages
Annotation
AN OVERVIEW OF PSYCHOPATHY--DEFINITIONS, ETIOLOGY, TREATMENT, LEGAL CONSIDERATIONS (PRIMARILY IN BRITAIN), PROGNOSIS--IS PRESENTED.
Abstract
PSYCHOPATHY IS A DIFFUSE, POORLY DEFINED DISORDER OF SOCIAL BEHAVIOR. ITS DESIGNATION AS A MENTAL DISORDER HAS ALWAYS BEEN CONTROVERSIAL. THE EXTREME CASE OF NEAR-PSYCHOTIC PERSONALITY DISINTEGRATION MAKES A MEDICAL CLASSIFICATION ACCEPTABLE, BUT SUCH CLASSIFICATION IS LESS TENABLE IN THE NEAR-NORMAL VARIANTS WHO CONSTITUTE THE MAJORITY OF SOCIAL DEVIANTS. THE SEARCH FOR CAUSES OF PSYCHOPATHY HAS YIELDED SOME DEFINITE EVIDENCE OF GENETIC, PHYSICAL, AND ENVIRONMENTAL FACTORS, BUT NO OVERRIDING ETIOLOGICAL FACTOR HAS EMERGED. IT IS LIKELY THAT MANY AGENTS INFLUENCE THE DEVELOPING PERSONALITY AT TIMES WHEN IT IS PARTICULARLY VULNERABLE TO STRESS, TIPPING THE BALANCE OF SOCIAL AWARENESS AND JUDGMENT IN THE AFFECTED INDIVIDUAL. THE SOCIAL LEARNING PROCESS CAN BE DISRUPTED AT SEVERAL CRITICAL JUNCTURES, AFTER WHICH THE PSYCHOPATH CEASES TO MATURE EMOTIONALLY AND SOCIALLY. PSYCHOTHERAPY APPEARS TO OFFER THE BEST HOPE FOR TREATMENT, ALTHOUGH WITHIN THE PSYCHOTHERAPEUTIC CONTEXT SOCIOLOGICAL RATHER THAN PSYCHOLOGICAL PROCESSES TAKE PRECEDENCE. THE TECHNIQUES OF THE THERAPEUTIC COMMUNITY HAVE BEEN WIDELY USED WITH PSYCHOPATHS, ALTHOUGH NO FORMULA FOR TREATMENT HAS BEEN FOUND. DIFFERENT TYPES OF PSYCHOPATHS RESPOND TO DIFFERENT TYPES OF TREATMENT. IMPULSIVE AND AGGRESSIVE PSYCHOPATHS CAN IMPROVE IN CONTROLLED (PRISON) SETTINGS, 'INADEQUATE' PSYCHOPATHS IN SUPPORTIVE REGIMES UNDER BENIGN AUTHORITARIAN DIRECTION, AND SOPHISTICATED, 'CREATIVE' PSYCHOPATHS IN THERAPEUTIC COMMUNITIES. ALTHOUGH PSYCHOPATHS ARE MOST OVERTLY DESTRUCTIVE IN EARLY ADULT LIFE, THEIR DESTRUCTIVENESS CAN CONTINUE INTO MIDDLE AGE WITHIN THE NARROWER CONFINES OF FAMILY AND SELF. LAWS PERTAINING TO PSYCHOPATHS TEND TO REFLECT PUBLIC OPINION AND TO LAG BEHIND THE KNOWLEDGE OF THOSE WHO WORK CLOSELY WITH THE PROBLEM. LEGISLATION DEALING MEDICALLY WITH PSYCHOPATHY IS INADEQUATE BUT REPRESENTS A STEP UP FROM THE REPRESSIVE, PUNITIVE VIEWPOINT AND MAY BE A PRECURSOR OF A BETTER SOCIOLOGICAL UNDERSTANDING OF PERSONALITY MALDEVELOPMENT. A LIST OF REFERENCES IS INCLUDED. (AUTHOR ABSTRACT MODIFIED--LKM)

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