One if the most common questions which gets asked about psychopaths is whether they can ever be cured or changed. Is there ever any hope of a psychopath stopping their destructive behaviour and changing? Have researchers found any way to bring them to some kind of understanding of normal human feelings like empathy and compassion?
The short answer is no.
Studies of psychopaths have effectively revealed them to be completely incurable and unresponsive to treatment. In fact efforts to treat them often make them worse and more deceptive.
It appears that psychopaths are the “bad apples” of humanity who are wilfully evil and destructive beings. Any efforts to try and bring them out of these behaviour patterns only appear to make them ever more determined to continue them. Let’s look at the issue in more detail.
Psychopaths Do Not Respond Well to Treatment
In technical terms, the prognosis for psychopathy is very poor. That is to say, those who have been subjected to (attempted) treatment in controlled environments such as psychotherapy appear to show no improvement in their behaviour. They remain every bit as dishonest, deceptive and manipulative as they always have been.
All the research we could find into psychopathy from experts in the subject, testing psychopaths usually from the criminal justice system, basically comes to this conclusion. They appear completely unresponsive to any kind of treatment and most especially extremely unresponsive to any kind of negative reinforcement (punishment). Punishment or threats of punishment do nothing to deter the psychopath from behaving as they do.
There is some evidence that positive reinforcement can help to manage psychopaths in controlled settings. In other words, giving rewards for good behaviour instead of punishments for bad behaviour has been shown to improve the behaviour of psychopaths or at least stop bad behaviour. But this is merely managing psychopathy and not curing it. The underlying malignancy remains.
Similarly it has also been observed that putting psychopaths through therapy in an attempt to treat them can often make them worse. It merely allows them to pick up psycho-jargon from the therapist that they are then able to mirror back to others to give off a superficial air of emotional intelligence and literacy. In other words, it makes them even more adept at deceiving people. It is as if any attempt to try and change them only makes them more determined to be the way they are.
The identification of psychopaths in a clinical environment has been formalised into an official “Psychopathy Checklist”, devised by renowned expert Robert Hare, which ticks off well known psychopathic character traits such as deceptiveness, superficial charm, lack of empathy or conscience, impulsiveness and so on. The more traits they score for the higher their total score; over a certain point they are normally diagnosed as a psychopath (see here where we cover this checklist in detail, including examples)
Psychopaths in clinical environments are assessed and diagnosed against a certain checklist of well known characteristic traits, such as lack of empathy, deceptiveness, superficial charm, ruthlessness etc. These traits do not leave them and they are completely unresponsive to treatment.
Psychopaths Appear Incurable (Nature Versus Nurture)
This brings into mind obvious questions around nature or nurture. Are psychopaths born or made? Does psychopathy have a genetic basis, where some people are born with certain traits and cannot help it, or does a person’s upbringing and environment play a part in making a person psychopathic or sociopathic?
There are studies which appear to show that psychopaths do indeed have defects in the structure of their brain which make processing emotion difficult or impossible. Research has shown that the uncinate fasciculus, the amygdala and the prefrontal cortex in particular do not connect and function in the same way they do with normal humans. Processing of emotion and impulse and aggression control are impaired as a result.
Similarly there are those that argue that upbringing and environment also play a role in the development of psychopathy and other personality disorders. It is difficult to argue how our environment, particularly in our early years, cannot somehow play a role in the person we grow up to be as an adult.
A warm, empathic, caring environment during childhood will tend to produce an adult of the same general disposition, secure and confident of their place in the world and quite capable of connecting with and caring for others.
Conversely, a harsh, uncaring, unloving environment during childhood, where the parents are constantly demeaning, belittling and dominating their child cannot fail to have some negative consequences on the development of the child and the adult they later become in life. In extreme cases this may produce someone who is so closed off they are incapable of connecting with and caring for others, which is when they enter the realm of psychopathy.
The fact that childhood has an impact on personality cannot now be reasonably disputed; the entire profession of psychotherapy is largely an effort to undo and repair much of the damage that is done to people by poor upbringing and parenting and the effect it has on them later in life in their relationships with others and how they function in the world.
So which is it then? Are psychopaths born with genetic brain defects which unavoidably make them the way they are or are there specific factors in their early environment and their relationships with their caregivers which make them prone to psychopathic behaviours and traits later in life? Researchers are still undecided on the topic and no definitive answer has yet been found to this question.
A reasonable conclusion to come to for now though is that it is probably a case of both nature and nurture in most cases of psychopathy. In other words, there may be a genetic disposition to it in terms of brain structure in some, and then a bad environment early in life fully brings out this dormant trait and turns it into full blown malevolent psychopathy.
To repeat the phrase one speaker used in his presentation on psychopathy:
Genetics sets psychopathy up (loads the gun) and then a bad environment pulls the trigger.
Psychopathy is increasingly thought by experts to be genetically influenced, with certain people born with brain defects which prevent emotional processing, empathy and impulse control
This view is further supported by another interesting account given by Stefan Verstappen is his equally excellent interview on psychopathy, where he details a physicist who submitted himself to testing and indeed found himself to have all the brain defects that would indicate psychopathy. See the 46 minute mark where they discuss this.
He presented these findings to his family, who admitted that he does struggle to make certain connections and doesn’t “get” certain things, but otherwise was a perfectly loving and caring father who did not manipulate or scheme over others. He had the genetic markers for psychopathy but not the evil, malevolent, scheming behaviour patterns that the worst ones do.
He attributed this to an extremely loving, caring childhood from good, understanding parents which meant the psychopathy gun may have been loaded in terms of his genetics, but the trigger wasn’t pulled because his childhood was peaceful and contented.
So there is a lot to be said for the nature-nurture explanations acting in tandem to produce psychopathy and not an either/or framework where we must pick one or the other. Wherever it comes from though, psychopathy can be identified by observing a series of now well known behaviour patterns over a period of time in someone, and this is the crucial thing to remember when spotting and defending against these predators.
Where their disorder comes is in a sense irrelevant in this regard; it is about recognizing and getting away from them as quickly as possible whenever we find ourselves caught in their midst.
A Possible Complication to the “Incurable” Hypothesis
We should also mention a possible complication to this “incurable” hypothesis, in that the sample of which this conclusion is formed is arguably skewed towards the most extreme psychopaths and therefore provides a distorted view on whether the condition is treatable and curable or not.
We say this because the only real psychopaths that are available for testing in a controlled environment are those which have been apprehended for horrendous crimes and sent through the criminal justice system.
In other words, some of the worst, most sadistic serial killers, rapists and so on. Experts such as Robert Hare have spent a lifetime working with such psychopathic types and they indeed confirm a relentless tendency to lie, manipulate and scheme.
These are the only psychopaths available for testing because they got caught committing crimes we have laws for. Most psychopaths do not fit this mould and are at large in the general population, with a tendency more towards psychological rather than physical violence towards others.
They have learnt to curb their violent impulses and move them underground to more insidious, concealed forms of abuse such as mind games, “gas-lighting” and other forms of emotional abuse. These actually form the bulk of psychopaths who manage to blend in with society. The most extreme violent psychopaths who end up in custody are only a small subset of all psychopaths. See our article on whether psychopaths are always violent.
We may therefore be basing our conclusions on whether psychopaths are curable on a biased sample of the most extreme violent psychopaths who have indeed projected their blame and rage onto the world to such an extent that they are irreversibly psychopathic and too far gone. There is likely no way back for some once they go past a certain point in murdering or committing other horrendous crimes.
However we must also point on that the diagnosis of psychopathy does not tend to be with an “on/off” criteria where a person either has it or not. Rather psychopathy tends to run on a spectrum or continuum whereby people who score highly for certain psychopathic traits tend to be regarded as more psychopathic than people who score lower. If they pass a certain threshold on the psychopathy checklist, then they tend to be clinically diagnosed as a psychopath.
The Role of Free Will & Choice in Character Change
The issue is also further confused when we bring free will and choice into the equation. Arguing that some psychopaths are genetically born to be the way they are leaves no room for free will and moral choice to enter the equation. It also does not account for anecdotal evidence like we mentioned above about people who may be genetically predisposed to psychopathy but do not act in an evil manipulative way in the world.
In this sense psychopathy and evil can be seen to emanate fundamentally from a series of choices a person makes, regardless of any genetic traits they already possess. This is the view of psychiatrist M Scott Peck for example based on his interactions with evil people over his career.
His excellent book People of the Lie is recommended reading for anyone studying psychopathy and evil in general. Click the link to check the price on Amazon.
Genetics may make a person more or less predisposed to psychopathy, but in the end all people still have free will to act in a certain way in the world and psychopaths are using this free will in a destructive malevolent way rather than a peaceful and harmonious way. This is a choice we all have regardless of our genetic disposition from the free will perspective.
Do Not Wait For a Psychopath to Change
However we raise these caveats only to balance the picture somewhat and come at the issue from a deeper philosophical angle as well as one based purely on the research on the topic. All this research shows psychopaths to be utterly incurable and untreatable.
We merely argue that a psychopath is still responsible for all their behaviour towards others and cannot get off the hook by blaming genetics or childhood for their actions. Free will has to come into the picture if people are to be held responsible for evil they commit towards others.
Anyone who has dealt with a psychopath in the real world knows full well that the vast, vast majority of them do not stop their behaviour and show no signs of remorse, regret or change. In fact we are yet to see any anecdotal account of a psychopath actually changing. If anyone does have such an account please feel free to contact us or post in the comments as the exception is always as interesting as the rule.
Victims of psychopaths also know the horrendous, long lasting psychological damage they can cause in the lives of others with their constant mind games, manipulation and other forms of covert abuse. The psychopath is never moved to stop this behaviour as they have no empathy for the consequences of their actions on others.
Nothing is off limits in terms of what they will do or how far they will go to destroy another person psychologically. In fact their behaviour most often gets progressively worse over time as they continue to erode the boundaries of their target.
This is characteristic of relationships with psychopaths; see our article on increasingly outrageous behaviour as characteristic of these people. Victims must realize that the psychopath will not stop; they will just keep going as they lack the fail-safe of empathy to place on limit on their actions towards others.
See also Jackson Mackenzie’s book Psychopath Free, for a detailed breakdown of all the forms of emotional abuse they routinely commit. His new book Whole Again goes into ways to heal from the long term damage this kind of abuse causes. Click to check the price on Amazon.
Therefore the question of whether a psychopath can change or be cured is from one perspective a moot one. The damage they cause to others is well documented so the most important question is not how to cure them but how to spot them and get away from them. This needs to be the number one priority for someone caught up with a psychopath.
We do not advise anyone to waste time or energy wondering whether they can somehow cure or change the psychopath, or get them to stop their behaviour. All these efforts are futile and will just bind you further to the psychopath.
Rather our advice and the advice of all experts and writers in this field is to escape and evade and get away from the psychopath as quickly as possibly. Cutting off all contact is the only way to break any connection to the psychopath and the earlier you can spot a psychopath and do this the better before they cause too much damage.
It is also crucially important to arm oneself with resources to help spot and avoid a psychopath before they enter your life, as this is far preferable to having to spend years and often thousands of dollars on therapy to recover after a psychopath has already wreaked havoc in your life and left to move on to another target.
See our Resources section for books and video which will arm you will all the knowledge you need to do this.