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#1
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As I've stated many times before, it can be very difficult for those with ASPD, psychopathy, CD, or ODD to find therapists who are willing and able to help with that particular disorder. Many therapists are not even willing to treat those with Cluster B personality disorders since the prognosis is so poor and many with such personality disorders are not willing to receive help. Also, there are few therapy methods that have proven effective in the treatment of people with these conditions. In fact, some therapists have found that, in certain cases, people with these conditions get worse with therapy.
So, for anyone who has had experience either as an antisocial or psychopath receiving therapy or a therapist or counselor who had an antisocial or psychopath as a patient or client, it would be much appreciated if you'd share what methods you found to be most effective, if any, if you found therapy to be helpful at all and in what ways, or how therapists could be more efficient in treating antisocial and psychopathic patients. Also, pegasus... Quote:
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I'd also like to point out that, just because one is or has been in prison, that does not mean one does not wish to change. Many convicts do wish to change, they just don't know how. |
![]() Emotional Ninja, Gus1234U, pegasus
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#2
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You speak with much wisdom Myers, thank you.
A little about me - I've spent much of my working life with people with a variety of disorders having worked with people with severe personality disorders in 'halfway' houses and day centres. I don't want to say too much about that as that would not be good for confidentiality etc. I've also worked with learning disabilities adults and children, and people with physically disabilities with psychological problems. My favourite therapy methods are Motivational Interviewing, Rational Emotive Behaviour therapy and CBT and holistic therapy. I have a great fondness for transactional analysis as knowing about all parts of the personality lead to a better understanding of self. Physical exercise has been shown to be very beneficial in the early stages of treatment. I'm not saying that someone with a severe personality disorder will suddenly become a different personality, I'm saying that there is a way to cope with it, once able to cope and have learnt strategies to deal with feelings/or lack of! You are right in that some therapists will not work with particular people with a certain diagnosis and there is the fact that many antisocials/psychopaths won't engage in the process or drop out. Therapy can take years. In my view and from experience many are extremely intelligent and will try all sorts of ploys and threats but I look on this as testing the trust (or lack of) of the therapeutic relationship. You said that some antisocials become worse with therapy. Actually you'll find that an awful lot of people (pretty much anyone) get worse before they start to feel better! You can see where that drop out rate is coming from yeah? Regarding your questions about testing, I don't do testing, I'm a psychologist, not a psychiatrist. In my country that's the psychiatrists job, I just do therapy, sorry. ![]()
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![]() Pegasus Got a quick question related to mental health or a treatment? Ask it here General Q&A Forum “Everybody is a genius. But if you judge a fish by it's ability to climb a tree, it will live it's whole life believing that it is stupid.” - Albert Einstein |
![]() phoenix7
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#3
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"I'm not saying that someone with a severe personality disorder will suddenly become a different personality" I do too.. leave us DIDers outta this! LOL
![]() I do have to agree to at least the potential (I am not ASPD, nor am I up to date on current research) of therapy making some with anti-social tendancies worse. While a do work regularly with a T, studied a great deal of psychology and work on the outskirts of the field (just so that I don't come off as total anti-therapy). Therapy is a paid relationship of condoned manipulation within a given set of parameters. I would assume therfore that a great deal could be learned in therapy were one to coose to "study" the therapist rather than engage in the therapy (not that I would ever have done such a thing ![]() Dinner calls... I shall return!
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There’s been many a crooked path that has landed me here Tired, broken and wearing rags Wild eyed with fear -Blackmoores Night |
![]() Gus1234U, phoenix7
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#4
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![]() Gus1234U, phoenix7
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#5
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there is nothing more interesting than a good dissection, as long as it isn't mine~! thanks for the thought food... Gus
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![]() phoenix7
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#6
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"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."
OMG That was so me with some poor masters student in her last year of her degree... she left the degree program completely, never finishing her last semester and last I heard she is a receptionist or something! OK, but I had graduated high school... only because the teachers wouldn't let me fail, and I was doing well in college... It helped that I was good friends with her advisor/supervisor and he didn't have a clue about triangulation. Ahhh the blissful days of college. Hmmm perhaps I belong here more than I first gave myself credit for! LOL.
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There’s been many a crooked path that has landed me here Tired, broken and wearing rags Wild eyed with fear -Blackmoores Night |
![]() Gus1234U, phoenix7
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#7
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![]() Pegasus Got a quick question related to mental health or a treatment? Ask it here General Q&A Forum “Everybody is a genius. But if you judge a fish by it's ability to climb a tree, it will live it's whole life believing that it is stupid.” - Albert Einstein |
![]() phoenix7
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#8
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Myers i hope yo dont mind me butting in as i am neither ASPD or have treated someone with that diagnosis - but this conversation has caught my attention and im ver yinterested in the following.....
ive read a little of Albert Ellis Rational emotive therapy - discussed it wiht my therapist (past) who gave me some tapes to listen to and a book to read - he seems to advocate saying what you feel - wouldnt this be bad for an ASPD? if there feelings were less than cordial..... they say a little knowledge is a dangerous thing - perhaps i have read a little and possibly misunderstood so some clarification on this would be good. Quote pegasus : I have a great fondness for transactional analysis as knowing about all parts of the personality lead to a better understanding of self. :end quote I agree that would be helpful in any case - and if the person was actively looking for help (and Myers you can help me wiht this part ) would they then be honest wiht the therapist and this would work or would they stil feel compelled to test their wits agains t the therapist - i guess each case is different ... if it was court ordered i can see a problem in that they may never let the Therapist know them if they do not wish to be helped. just a few thoughts and questions...... P7
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Its not how many times you fall down that counts ![]() its how many times you get back up! ![]() ![]() (Thanks to fenrir for my Picture ![]() When you have come to the edge of all light that you know and are about to drop off into the darkness of the unknown, Faith is knowing One of two things will happen: There will be something solid to stand on or you will be taught to fly. by Patrick Overton, author and poet |
#9
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Hi Phoenix, REBT is about accepting the raw truth and accepting what is difficult to take in. I've used it to help people that found CBT to be too mamby pamby. (Sorry I couldn't think of a better way of putting it.) It's helpful for facing reality head on. ie. facing all thoughts, actions and consequences. Got to be done with skill though...
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![]() Pegasus Got a quick question related to mental health or a treatment? Ask it here General Q&A Forum “Everybody is a genius. But if you judge a fish by it's ability to climb a tree, it will live it's whole life believing that it is stupid.” - Albert Einstein |
![]() phoenix7
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#10
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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. Ok, but you never said which ones you prefer specifically for antisocials and psychopaths, nor did you say if any were successful. I'm not sure how you can determine the difference between truth and lies. A lie detector can't determine truth from lies with a psychopathic subject. Maybe it's possible with an in-depth background check to determine the patient's history. But finding out how they're truly feeling or if they're actually improving has to be a challenge. 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. Ok... And how do you teach them coping strategies and gain their trust? 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. Obviously, you've never had a psychopathic patient. ![]() 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. In my experience, the antisocials and psychopaths merely try to manipulate the system by claiming desire to "change" and become productive members of society... when, in fact, they're only trying to get the good, gullible doctor to convince the judge that they're remorseful for their actions and should be set free. Or, in some cases, they're seeking meds or disability benefits. 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? Apparently you haven't been talking to me enough... I feel irritated. I want a challenge in my life. And I want clarity. Insight. You can support me in this by answering my questions... honestly... |
#11
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In my experience with other psychopaths and antisocials as well as my own experience with therapy... They're always trying to outwit or outdo someone, especially therapists. Since most of them are in therapy under less than innocent circumstances, they see the therapist as either an enemy (who could recommend that they be thrown in prison) or an obstacle (that they need to manipulate in order to get meds or money). Or, like the psychopathic patient who drove his therapist insane, they might just do it for fun. I actually have a few accounts of psychopaths and antisocials in therapy, but I'll have to ask their permission before I can post it... |
#12
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I'd love to see some of the accounts. I hope you don't mind me joining the conversation either even though i don't have ASPD. I'm finding the conversation very interesting.
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#13
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gratefully being neither therapist nor dx with ASPD, i have only these qualifications: I have lived with and known well more than one person who was either Psycho- or Socio-path, and others with significant deviant and anti-social behavior patterns. this was before i ever knew of psychiatric diagnoses, the DSM 1,2, 3, 4,, etc,, or even about counselors and therapists. what i did know was that there did not appear to be any way of reaching the core of said persons to help them to change in any genuine, socially helpful way. every act of kindness was seen as milk from the cow; every object desired was a puzzle and a challenge; there seemed to be no engagement in time, no past or future to bind them to consequences~ the only time i could see any way to safely interact was when they were raised with a minimum of violence and frustration, and were cognizant and aware of their difference from the "norm".... having said all that,, i'm pretty sure that people with an ASPD Dx don't come here for therapy~ but for open-eyed and honest reflection and discussion... i could be wrong tho,,, Gus
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AWAKEN~! |
#14
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So....it's not just me ....lol....it is interesting
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#15
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Oh yeah, I'm not saying I can give you therapy over the internet, that would be unethical. I can support though, like I said support comes in many forms.
Myers, I work for social services and all the agencies work together in sharing information. I worked in halfway houses which are places that people go when nobody else will have them. You ask me which therapies I use, I told you my preferences. I can't pinpoint one in particular because different methods work for different people. Everyone is different you know. And yes I have truly helped people otherwise I wouldn't be sharing this with you now would I. My concern is that if I share all tricks of the trade that you will just use that to your advantage with your own therapist. (Ah, I know what my therapist is doing now, I can manipulate this...) Coping strategies are different for each person but I've already touched on the fact that you will need a safe physical outlet. Walking, running, boxing, going to the gym etc because the anger will come out and you'll need to let that go in a safe way. Trust comes from knowing that your therapist is actually on your side and is not going to dump you in the nearest prison.
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![]() Pegasus Got a quick question related to mental health or a treatment? Ask it here General Q&A Forum “Everybody is a genius. But if you judge a fish by it's ability to climb a tree, it will live it's whole life believing that it is stupid.” - Albert Einstein |
#16
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#17
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*MAY BE TRIGGERING* PLEASE READ WITH CAUTION.
Hi Myers, Had to drop a line......(mods, if this is a little too graphic, feel free to edit ![]() Sorry, didn't have the eye stamina to read all of this thread, but being someone who was treated for psychopathic anti-social behavioural issues in the past, I do have some firsthand experience in the "treatment" I received. Since the Aspergers dx, I have waxed and waned tremendously between ASPD, Psychopathy and AS. I dicounted the psychopathy/ASPD traits dx vehemently only because at times I did feel great remorse or guilt, I can feel empathy and I love deeply, in my own strange way. So, did I really feel none of those things and pretended to just to get out of tricky situations, or do I really experience them? Who bloody knows ![]() I digress. My BEHAVIOUR is what clinched it for me. I have experienced rage so severe that I have been hospitalised for it. I have made death threats against people with such intent that the police have sectioned me. I have had hospital staff and others treat me with disdain and fear. And who could blame them? My T of the past occasionally had security with her during a session when I was hospitalised. She was a rarity though. She kept helping me, even though I was a right nightmare to treat. I was often non-compliant, would argue and rage around constantly and berate her. Test her boundaries to the limit. I wanted to see if I could TRUST her. I wanted to see if she would treat me as a pariah. But she pursued my humanity to the best of her ability and I attribute a lot of my enduring freedom, to her therapeutic ministrations. So, as my psychiatrist has said to me recently "Who says you cannot have psychopathy/ASPD traits as well as Aspergers? They are not the same wiring neurologically and you have a rather unusual and terrifying childhood to account for. Being an autistic child with all the fear and confusion that comes with it in certain respects, coupled with occasions of violence, would manifest itself in a myriad of ways" and I am inclined to agree with him now. Such complex creatures we are. Who knows? So, I started to embrace it. I brought "the Dark" as I call it closer to me, rather than pushing it away in fright and loathing. I give it a voice, but do not act on it. I REASON with it, and love it anyway. I am not saying it is easy, but it is the path of least resistance. To deny it exists, is to deny a part of myself, and all that did was make me worse. Apologies for blabbering on, but this is something I have been thinking about for a while. Any questions? Feel free to pick my brain..... ![]() Michah |
![]() Gus1234U, pegasus
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#18
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![]() pegasus
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#19
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Very well spoken michah
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![]() Michah
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#20
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So, if you don't mind me asking, how do you go about reasoning with your darker side? |
#21
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Myers, I wonder......and please forgive me if I have all of this wrong.....are you seeking new avenues to "heal thyself"? Is that the purpose of this thread.....to discuss therapeutic outcomes, or is it that you question being in therapy? Like, is it helping you?......
Do you believe in forgiveness of self? If not, that is cool, it is just something I found that kind of helped more than therapy did really. I mean, I have anger management skills coming out of the wazoo, but none of them help when it is REALLY bad. I get complacent with practicing anger management, yet I have been told by my current psychs that I am not an "angry person" in general. I am actually quite pleasant most of the time, but there is always The Dark, just under the surface and I am only just able to start recognising it for what it really is. I have replaced the idea of "getting rid of The Dark once and for all" to accepting the idea that it may never go. I may live with this for the rest of my life, so how do I take whatever remnants of good from this and apply it to achieving some joy in my life?......that is the question. Impossible maybe, but I have not given up. .........the one thing that I remind myself of is that I have been both a victim and a perpetrator......and my journey is be neither...... Take care, dear one... Michah |
![]() Gus1234U
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#22
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[/QUOTE] So, if you don't mind me asking, how do you go about reasoning with your darker side?[/QUOTE] I acknowledged it. I stopped trying to therapy it away, if you know what I mean. My AS psych says to me "despite what you experience, you actually have a lot of self-control" which I probably do, but it comes at a price. I gave The Dark a name and a face. He is a werewolf......and the reason this is, is based on my love of wolves and so on, but the mythology of a werewolf and the way that man battles the inner animal in all of us, is what drove me to this manifetsation of The Dark. I have written much about Wolfie. I have been writing about wolves since I was a child and after seeing the movie, Wolfman it seemed only instinctive to create The Dark in this fashion. I mentally created a platform for us to talk on. I imagined myself patting him and stroking him. I came to the conclusion that he is both my greatest enemy and best friend, for as much as he has tried to destroy me, he has also saved me. I realised that he is the child within me and has the same needs and validation as anyone. He makes me cry and laugh. He creates courage, fear and torment. He does not like to be ignored and placed on a shelf. He occasionally likes to be visited by The Light. He cripples me and releases me the same and the more I have to do with him, the more noble and terrifying he becomes. For one state cannot exist with out the other, and that is what I am learning. Hope that explains a very complex and enduring method ![]() Michah |
![]() Gus1234U, pegasus
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#23
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((((((((((((MICHAH)))))))))))
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![]() Michah
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#24
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Sorry, deleted this post....saved it for another time......it seemed too way off course of the thread.
Michah Last edited by Michah; Dec 29, 2010 at 10:10 PM. Reason: Irrelevant post |
#25
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Ahhhh Michah....I understand that lol....I will insert my private message sent to you earlier lest some wander with assumptions in their heads.
Michah .....Um ....this feels odd saying...but your posts make me cry.I find myself feeling a deep empathy and respect.I don't generally cry.I don't understand why your words sink so deep.I think the mention of wolves grabbed my attention....of course because arctic wolves and everything about them resonates in the core of my soul.But from the point where you said...."I mentally created a platform for us to talk on....'....I could barely see thru the tears.I don't really cry.Anyway...I don't even know why I'm telling you this.And I am trembling ...lol...grrrr...WO.olf does not like to feel.Keep posting beloved Michah ![]() I read:that you 'cry at the beauty of nature'....this is a bit of me...occurs alot.And then.....she mentions the 'Dark'....ahhh......which somewhere is within us all. ............I can relate to the conversation between yourself and your "Dark"............~W~ |
![]() Michah
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