The DSM doesn’t allow shrinks to diagnose an underage patient with “psychopathy.” Actually, the DSM doesn’t allow the diagnosis of “psychopathy” to people of any age. Yet, they allow kids to be diagnosed as “callous-unemotional.” So what are these kids when they grow up? Psychopaths or the DSM-preferred ASPD? Of course, there is one place where people can still be tested and diagnosed with psychopathy and that is in the penal justice system.
Robert Hare tried to keep the American Psychiatric Association from replacing “psychopathy” with “ASPD.” Perhaps the disconnect stems from the degree to which present-day psychology is dominated by behaviorists. Behaviorists famously deny the reality of such a subjective entity as a consciousness. Perhaps we do have a consciousness (DUH!) but it can’t be seen or examined “objectively” so we might as well act as if it doesn’t exist. This evokes the question of whether a psychologist is really a scientist or a philosopher. Philosophy doesn’t get much respect from scientists who claim they deal in reality and philosophers only deal in some fuzzy sort of wool gathering. Interestingly enough, behaviorism is more concerned with how to make someone behave a certain way than in understanding what makes him tick. Dr. Jordon Smoller of Harvard Medical School, said, “Researchers who were influential in developing the modern DSM argued that the diagnosis should be based mainly on observable patterns of behavior rather than psychological constructs. And so, ASPD emphasizes aggressive behavior, rule-breaking, and criminal acts. Not surprisingly, 80–90 percent of inmates in maximum security prisons meet criteria for ASPD, though only 15–20 percent qualify as psychopaths.
Illimitable Men wrote, “Consciousness remains an enigma to science, and for as long as this remains true, philosophy will remain hegemon of all things metaphysical and thereby spiritual in nature. This is precisely why philosophy exists, for it has repeatedly endured as a form of top-down investigation into the metaphysical substrate of reality for millennia, filling a vacuum of human need that religion embodies, but does not explain.”
Consciousness is something everyone experiences and knows intuitively that it is real for goodness sake. That people calling themselves “scientists” deny it only indicates that they are limiting the scope of their field to the point where it has less relevance to human lives. Only that which can be treated as an object is worthy of scientific examination. Psychiatry is properly a field in biological medicine so it can encompass both the physical and the behavioral aspects of psychopathy. Yet it is the American Psychiatric Association that created the DSM.
While psychiatrists remain firmly routed in the limiting and unproductive channel of behaviorism, it is the neuroscientists who have really moved forward in exploring this possibility. Of course, they are examining the physical and are, thereby making the study of the mind even more objective. In The Guardian, Chris Chambers wrote, “Psychopathy is of course a very real disorder and a lot more complex than portrayed on film. For many years, the gold standard for diagnosing psychopathy has been various forms of behavioural assessment. But now, Californian neuroscientist James Fallon claims he can diagnose psychopathy from a brain scan.” Neuroscientists have identified characteristic scans for various conditions including schizophrenia and bipolar disorder.
However, this field is still in it’s infancy. A diagnosis of psychopathy based on brain scans alone is not accepted as yet. “The flaw with this argument — as Fallon himself must know — is that there is no one-to-one mapping between activity in a given brain region and complex abilities such as empathy. There is no empathy region and there is no psychopath switch. If you think of the brain as a toolkit, these parts of the brain aren’t like hammers or screwdrivers that perform only one task.” I believe they are on the right track however. Of course, there’s another possibility no scientists seem to have considered. What if “psychiatric conditions” other than psychosis can be assessed outside of the narrow field of science. Lay people instinctively act on that assumption. How many newspaper articles have called a public figure a “psychopath” or a “narcissist?” How many people on Facebook have done the same?
Both psychiatry/psychology recognizes that children’s personalities can change before the kid becomes an adult. The brain is known to undergo significant changes as we grow up, even in one’s teens. Professionals who treat kids whose behavior indicates a likelihood of psychopathy in adults work to develop interventions while the kid is still a kid in order to prevent that from happening.
There has been a lot written about callous unemotional kids lately. Most articles acknowledge what psychologist, Michael Stone, said in the documentary, Psychopath Night that “psychopathy is like diamonds — it’s forever.” These kids, despite what the profession insists, are psychopaths. They can’t be “cured” but they can be steered in a pro-social direction mainly by means of positive reinforcement. Psychopaths aren’t deterred much by threat of punishment but are very receptive to rewards. Another viewpoint has been argued in the case of Beth Thomas. A treatment called Rebirthing, nicknamed “tough love,” is supposed to have turned this very “callous unemotional” little girl into a healthy adult free of ASPD or Psychopathy. I have severe doubts about this and explore them in my blog post, Tough Love Success? The writers believed she was cured of psychopathy. I neither support that psychopathy can be “cured” nor the methods promoted.
Mendota Juvenile Treatment Center in Wisconsin has had more success in achieving happy outcomes than many (or any) others. They seem to accept the idea that psychopathy already exists in teens but can be guided in a positive direction. Author and former NPR religion correspondent Barbara Bradley Hagerty wrote, “They will never feel empathy, they will never feel guilt or remorse,” she said. “But if they can train them that, ‘Gee, my life will be better if I play by the rules,’ then they hope that these kids will turn out better.”
- Mendota Juvenile Treatment Center. Wisconsin Department of Health Services
- When Your Child Is a Psychopath. The Atlantic
- Mendota Juvenile Treatment Center Shows Progress in Treating Child Psychopaths. Wisconsin Public Radio
- San Marcos Treatment Center. Home page
- Psychopathy vs. Antisocial Personality Disorder. Elements of Behavioral Health
- Tough Love “Success” Story? Cluster B by yours truly
- 6 Scary Realities of Working With Actual Psychopaths. Reblogged as Neuroscience and Psychopathy in Cluster B.
- Attachment Therapy. Child Abuse by Another Name?