Treatment of Secondary Psychopathy: A Proposed Application of Decompression Treatment

Abstract

Previous research has achieved little success in the pursuit of an effective treatment regime for psychopathy, leaving many researchers skeptical as to whether psychopathy is treatable at all. However, the same researchers often unintentionally adhere to an underlying fallacy, by assuming that psychopathy is a uniform construct. By reducing psychopathy to its primary and secondary variants, it quickly becomes apparent that this distinction is key with respect to treatability. In particular, the two psychopathy variants have three major etiological differences with regards to emotional processing, reward sensitivity, and attachment style factors. Accordingly, a relatively novel corrections/clinical hybrid model titled ‘decompression treatment’ (DT) naturally becomes relevant to the discussion. Designed to be an alternative to conventional corrections placement, DT has exclusively handled the most serious of offenders since its inception, including violent inmates, mentally disordered offenders, and most notably, adolescents manifesting psychopathic traits. The model relies on three core principles: first, is minimizing the amount of potentially harmful stimuli present in the corrections environment; second, is providing a reward system to those who exhibit prosocial behaviour; and third, is building positive relationships between patients and staff. Fittingly, these three principles directly correlate with the lived experiences of secondary, but not necessarily primary, psychopaths. After making a case for the models application in the secondary psychopath population, the discussion concludes with an examination of the strengths and weaknesses of the model. Ultimately, DT lends itself to be a promising treatment option for secondary psychopaths.