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Old Dec 27, 2010, 06:22 AM
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pegasus pegasus is offline
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Originally Posted by Myers View Post
Worked with how? Therapy? Volunteer work? Sponsoring? I have already answered this question, worked with people in halfway houses and day centres as a facilitator/ therapist doing group and individual therapy.

Have you applied any of these methods to antisocial or psychopathic patients? If so, which proved most effective? You described knowing all parts of the personality. But how do you achieve this when the psychopaths constantly lie and feel the overwhelming desire to manipulate and argue with the therapist? And if by chance the patient decides to try to be honest, how do you deal with his or her lack of insight?
I have listed the methods that I prefer already but I will say that transference based therapies are a no no. One has got to get to know the person before knowing which are lies and which are truth. Clear boundaries have to be set by the therapist. Honesty is a step in the right direction.
And how do you teach them those skills?
Coping strategies take a long time to practice. Trust takes a real long time to be gained but it is possible.
Psychopaths can and do engage in therapy sessions (usually as a court ordered alternative to a prison sentence). The problem many therapists have is the psychopaths' desire to manipulate. There was one case study of a psychopathic patient, an unemployed highschool drop-out, who completely obliterated his psychologist's mental health. The poor man fell into depression after that experience. Antisocials and psychopaths see therapy as a game of wits. (Clearly, in the aforementioned case, the psychopath won that particular game.) It really has nothing to do with trust.
I beg to differ here. Any therapist who's own mental health declines is nothing to do with the patient, that would come from their own stuff and as I said before trust does come into it.
When I say antisocials and psychopaths get worse with therapy, I mean they learn emotional cues and the importance of remorse. They then use that knowledge to sharpen their manipulation techniques. It really has nothing to do with feeling better or worse. And their behavior never improves. The therapist might find that their mental health is gradually declining though...
This is your own experience. In my experience the behaviour can and does improve. The therapist is responsible for his/her own mental health and have their own supervision.
So you do practice... But you're not a doctor...
Myers, I have noted the length of time you have been here at PC and have seen no manipulative or threatening behaviour. I have seen an improvement in you in the time that you have been here. How do you feel about that? No doubt you will say that it is just one of your masks, we all wear masks from time to time and that's ok. What is it that you feel you need to change in your life? And how can we support you in this?
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Thanks for this!
phoenix7