“Psychopaths are vastly over-represented among criminals; it is estimated they make up about 20% of the inmates of most prisons. They commit over half of all violent crimes and are 3-4 times more likely to re-offend. They are almost entirely refractory to rehabilitation. These are not nice people. So how did they get that way? Is it an innate biological condition, a result of social experience, or an interaction between these factors? Longitudinal studies have shown that the personality traits associated with psychopathy are highly stable over time. Psychopathy seems to be a lifelong trait, or combination of traits, which are heavily influenced by genes and hardly at all by social upbringing.” (Craig)
As I delved deeper into the world (and diagnoses) of Antisocial Personality Disorder, the same theme continually reemerged, refusing to go unacknowledged – the lack of a conscience or “moral compass.” At first, I shoved this aside as an obvious part of the disorder – after all, it is one of the defining keys of the disorder. Then in it brought me up short. After all, what is a conscience? What is a moral compass? These were doctors using these terms, not the usual type of person you would expect to use a term tied to religion – a moral code, after all, implies both right and wrong, both of which must eventually lead to a god.
I read (or rather, have not yet finished) a book entitled “What We Can’t Not Know,” by J. Budziszewski (Bud-ah-ches-ski), on how we are unable to escape the code of morality written within us. The author states that no matter who we are, or in what culture we live, there is the notion within us that some actions are better or worse than others – that we all have within us the ruthless drive of moral law and God-given conscience, whether we choose to deny the existence of the giver or not. (Budziszewski). I had not questioned that notion until now. Though the DSM-IV-TR does not directly state that those with Antisocial Personality Disorder have no conscience, the consensus of expert psychologists seems to murmur it in a low undertone. (DSM-IV-TR) Are the sociopaths of our world those who were born without that internal compass? Was Budziszewski wrong in his diagnosis of the moral code woven within us all, or do some of those in our world manage to lose that compass and create something new for themselves? It is a question that bears pondering.
There are not many suggested treatments for those with Antisocial Personality Disorder, and even fewer with any rate of success. I attribute this partially to the nearly complete lack of interest that the people termed “sociopaths” have towards any form of treatment. I have gleaned many things of interest from the blogs of self-purported sociopaths, key here being that they see the disorder as something of a “super-power,” and disdain we the “empaths” for our lack of it.
What treatments are there? There are two known sociopaths in my extended family, and the suspicion of another, so I’ve had ample opportunity to observe and ponder possibilities. When I asked my mother (sister to one of the above mentioned) about possible treatments unearthed in her research, her response was “a lobotomy.” You may gather from this that our family has been put through a lot from these two.
Icepicks aside, there are very few detectable symptoms of Antisocial Personality Disorder that can be found physiologically. Professor Adrian Raine of the University of South Carolina has unearthed some interesting potential clues heretofore unnoticed.
In a retrospective study, Raine and colleagues studied 101 50-year-olds, 17 of whom had antisocial behavior as adolescents but had stopped criminal behavior. Seventeen others with antisocial behavior as teens continued criminal activity into adulthood.
Those who desisted from criminal behavior had the higher electrodermal and cardiovascular arousal, while the group that continued the criminal behavior had low autonomic arousal. In psychoanalytic terms, he said, this suggests a physiologic marker for the presence or absence of a superego. “If you are anxious about doing something wrong or afraid of hurting someone, getting caught, or being the subject of parental disapproval, you would have a higher autonomic response,” he said. “Somebody who is physiologically different probably does not have that kind of anxiety in response to doing something criminal.” (Raine 25) However, he gives no suggestion for the treatment of said disorder.
It is difficult, to say the least, to offer help to anyone who does not wish to receive it. It is infinitely moreso to offer help to one who strongly believes that they are in no need of help and have no logical reason to submit themselves to it. Now imagine that the person that the person you are endeavoring to help has no internal conscience and may very well live to manipulate people. By standing firm in your desire to help this patient, you place yourself in potential harm’s way. Having taken this into account, Glen O. Gabbard, M.D., at APA’s 2003 Institute on Psychiatric Services in Boston suggests that the clinician immediately moves to correct the patient’s downplay of antisocial thought patterns and behaviors, taking immediate action to also tie external actions to internal states of being and mind, as well as internal states of mind to external surroundings and interactions. As with most personality disorders, there are frequently situational factors that worsen or increase certain behaviors and reactions.
Outside of Gabbard, I have found almost no one else with a possible solution to offer. Antisocial Personality Disorder is a strange and dangerous disorder to deal with. If fact, there is only one other mode of treatment I have found – one that I whole-heartedly promote, but would be laughed out of any medical school for. This is prayer.
It sounds strange, foolish to some. But I honestly believe that the grace of God is the only true cure for sociopathy. The story of John Newton comes to mind here, and of the stories he told after his conversion, stories that fairly reek of an absent superego (in the words of Dr. Raine). The grace of God turned his life around and made him a new man with a powerful message and of great use to God. “I am not what I ought to be, I am not what I want to be, I am not what I hope to be in another world; but still I am not what I once used to be, and by the grace of God I am what I am.”
I found another quote from ZKMsocio, the self-admitted sociopath and blogger. He has allowed me quite the glimpse into his unique mind through the elegant words put on paper. This from November of the year twenty-eleven. “I'll admit, I feel a bit lost. Not myself. A stranger in a strange mind. Two and two never quite equals four for a sociopath, but we sure can be damned convincing it's five. Morphing people into my reality is half of my survival. Yet the further I spiral into this rabbit hole of self-delusion the more I have to question if my reality really is in my control at all.” He went on to say, “It's hard to write from behind a mask when it's begun clinging to your skin. I can't show you what's beneath when I can't pry the damn thing off.” He speaks of himself as a hollow shell of humanity and I feel pity within me. Is this what he wants? Mayhaps. But still, whether he cares to admit it or not, he was created in the image of God. Loving ZKMsocio and my uncles is not a safe thing to do – there is a good reason why I love these relatives of mine from an increasing distance – but it is something that must be done. There is only so much that Gabbard’s methods will accomplish, but God can soften the hardest heart and fill the emptiest vessel. So until Christ comes again, I wait, I watch, I hope and I pray.