Tuesday, January 02, 2007

Blows My Mind

I'm beginning to see why there's resistence to the idea that narcissists and psychopaths aren't just good people from bad homes who can be talked into being nice if you give them a puppy, a musical instrument, and a little group therapy. There are a lot of sociologists, psychologists, mental healthcare workers and social workers heavilly invested in the staus quo. People who don't want to admit they're wrong. People who don't want to admit they've been conned. People who don't want to admit that they're doing more harm than good.

Dr. Grant Harris, Director of Research at Ontario's psychiatric hospital writes:

As you probably know, there was a special therapeutic community for mentally disordered offenders from the mid-1960's until 1978. The program was unique and many worldwide experts were impressed with its methods for psychopaths.

On the other hand, when we measured the results with a follow-up study, we found something different. The program seemed to make the psychopaths more dangerous rather than less. Psychopaths behaved much worse in the program but were just as likely to be made program leaders and get recommended for release. Experts’ impressions and the measurement of results gave exactly opposite conclusions.

New research by Michael Seto and Howard Barbaree adds to these data. They did a follow-up study of an up-to-date therapy for sex offenders in a Canadian prison. They compared psychopaths to other offenders and studied therapists’ ratings of how well the offenders had progressed in treatment. Clinicians’ ratings of progress were inversely related to recidivism -- offenders the clinicians rated as having done well were more likely to commit serious new offenses. And this was especially true among the psychopaths. Clincians’ impressions and measurement of outcome gave exactly opposite conclusions.

As he points out here in a more recent article, there is actually evidence that treatment makes psychopaths more likely to re-offend upon release!

Our follow-up research showed, however, that the program reduced recidivism among patients who were not psychopaths, but increased the violent recidivism of psychopaths (compared to prison). We think this research teaches some valuable lessons: Clinicians cannot assume that their efforts are beneficial; it is possible to do harm. This fact has been demonstrated elsewhere — some well-intentioned services actually increase the likelihood of crime.

The only way to know whether services are effective is to evaluate outcomes. Our research showed that psychopaths actually behaved more poorly in the program (compared to the other patients), but were as likely, or even more likely, to be trusted by the clinical staff.

He also points out that almost all data is gathered from the subjective impressions of staff evaluators instead of scientifically through objective measurements. Here again, we have psychology forgetting to be a science, folks!

Right, to find out how good a job these folks are doing, ask THEM to evaluate it, duh.

Nooooo, THEY won't get conned by somebody who says he suddenly found Jesus.

THAT is indefensible. I can hardly believe it. How is this establishment getting away with this? I smell goody-two-shoes social engineering by people who won't admit they're wrong no matter how many psychos get let free to prove them wrong by laughing out the door to kill and rape again. Is this establishment that held in lockstep by what's politically correct that nobody dares blow the whistle?

See more information here.
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At 9:54 PM, Anonymous Anonymous said...

This doesn't surprise me as no matter how it is touted, psychology and psychiatry are still largely soft science at best and mostly guesswork in reality.

Actually, I think they have the same problem that I have and that is accepting that there are people who are truly and fully completely evil who can't be redeemed because they like being evil. I can't comprehend it but I do know that evil truly does exist and it is impossible to change a human heart from the outside that desire for change can only come from within. Someone who views themselves as superior to all others of their own kind will never desire to change.

Do I think these people are ill? Yes, exceedinly ill and they should be placed where they will receive some sort of treatment but they should never be released back into society once they have been apprehended for a crime.


At 1:49 PM, Anonymous gh said...

Makes sense, actually. The ones who are rated by clinicians as showing great progress may in many, many cases simply be the ones who have learned how to more effectively polish their angel image.

I won't discount the possibility that therapy can promote healing if someone really wants to change -- but I think it can also just give them a better idea of what they need to do to appear as if they have already changed. And that makes them dangerous!

At 3:52 PM, Blogger Kathy said...

Yes, that they get fooled makes sense. In fact, you can hardly blame them for that.

But I am astounded that these programs don't have to undergo any scientific assessment. Like why don't they have to measure recidivism rates to see whether they're doing any good or not? Why do they go by clinicans impressions instead of hard facts like how many fights the patient has gotten into?

I remember reading that this is something different about Hare's research. When a pscho told him that he loves his family, Hare checked to see if he'd had any contact with them. Never did. So Hare doesn't conclude that psychopaths love their families. he concludes that they lie about it. Are they also lying then when they claim to have found Jesus? Apparantly most clinicians just take these pathological liars at their word. There is no excuse for that. They should be ashamed.

In the linked articles the claim is made that treatment does make them more dangerous. I've heard that it's partly for the reason you state - because it gives them more and better practice at faking it. But also, treatement focuses on raising their self esteem. It's easy to see how that can backfire. If it doesn't raise the self esteem of the damaged little child inside, but increases the egomania of the monster that ate him, treatment will make the psychopath worse, not better. It's irresponsible to be carrying on such treatment for decades, recommending the release of these people, without collecting the necessary statistics to see if the treatment is safe and effective. Only in psychiatry would such shoddy practices occur.

At 8:01 PM, Anonymous gh said...

Great point about the danger of raising their self-esteem! What a Catch-22 for the therapist -- you want to heal the injured self-esteem of the patient, but doing so makes them likely to injure the self-esteem of the non-patient. It almost seems like the "cure" would be to break them down entirely, so all that remains is the original, wounded child, and then from that broken-most point, give them the tools to heal and deal in a new, healthy way. But, of course, if you were to sugest that approach with a narcissist, s/he'd ditch the therapy in a heartbeat -- understandably, as who would ever want to deal with feeling that broken?

At 10:12 PM, Blogger Kathy said...

"It almost seems like the "cure" would be to break them down entirely, so all that remains is the original, wounded child, and then from that broken-most point, give them the tools to heal and deal in a new, healthy way."

I read somewhere that this is exactly what some experts suggest but that few if any therapists try it for the reason you state. Also, I suspect they fear risking suicide during that 'breaking down' phase. It is a Catch-22.


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