buybuydandavis comments on Notes on Psychopathy - Less Wrong

18 Post author: gwern 19 December 2012 04:02AM

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Comment author: buybuydandavis 20 December 2012 02:00:56AM 7 points [-]

Deviant but not necessarily diseased or dysfunctional minds can demonstrate resistance to all treatment and attempts to change their mind

Maybe they need better treatments. Has anyone asked psychopaths - "How would you convince a psychopath like you to stop doing X?" Has anyone let psychopaths try? Aren't they the master manipulators? They even have a readily available model of a psychopath to test out the theory on. How convenient! Sufficiently motivating a psychopath with rewards for changing the mind of another psychopath might be an effective treatment for the first psychopath. Did they try that treatment?

I don't mean to be pissy, but "resistance to all treatments and attempts to change their mind" strikes me as a huge claim. Ruling out the "it's something I didn't think of" theory is one of the worst cognitive biases.

Comment author: betterthanwell 20 December 2012 02:16:29PM *  9 points [-]

Maybe they need better treatments. Has anyone asked psychopaths - "How would you convince a psychopath like you to stop doing X?" Has anyone let psychopaths try? Aren't they the master manipulators? They even have a readily available model of a psychopath to test out the theory on. How convenient! Sufficiently motivating a psychopath with rewards for changing the mind of another psychopath might be an effective treatment for the first psychopath. Did they try that treatment?

Something like it was tried in Canada, in the sixties, with LSD, in a four year experiment where a group of 30 psychopaths were, at least apparently, temporarily reformed through unconventional means.

This strange and unique program was obliquely referenced in the top post:

...operated for over a decade in a maximum security psychiatric hospital and drew worldwide attention for its novelty. The program was described at length by Barker and colleagues…The results of a follow-up conducted an average of 10.5 years after completion of treatment showed that, compared to no program (in most cases, untreated offenders went to prison), treatment was associated with lower violent recidivism for non-psychopaths but higher violent recidivism for psychopaths.

The Insane Criminal as Therapist
E.T. Barker, M. H. Mason, The Canadian Journal of Corrections, Oct. 1968.

Here's an account from a recent pop-psychology book, The Psychopath Test:

In the late 1960s, a young Canadian psychiatrist believed he had the answer. His name was Elliott Barker and he had visited radical therapeutic communities around the world, including nude psychotherapy sessions occurring under the tutelage of an American psychotherapist named Paul Bindrim. Clients, mostly California free-thinkers and movie stars, would sit naked in a circle and dive headlong into a 24-hour emotional and mystical rollercoaster during which participants would scream and yell and sob and confess their innermost fears. Barker worked at a unit for psychopaths inside the Oak Ridge hospital for the criminally insane in Ontario. Although the inmates were undoubtedly insane, they seemed perfectly ordinary. This, Barker deduced, was because they were burying their insanity deep beneath a facade of normality. If the madness could only, somehow, be brought to the surface, maybe it would work itself through and they could be reborn as empathetic human beings.

And so he successfully sought permission from the Canadian government to obtain a large batch of LSD, hand-picked a group of psychopaths, led them into what he named the "total encounter capsule", a small room painted bright green, and asked them to remove their clothes. This was truly to be a radical milestone: the world's first ever marathon nude LSD-fuelled psychotherapy session for criminal psychopaths.

Barker's sessions lasted for epic 11-day stretches. There were no distractions – no television, no clothes, no clocks, no calendars, only a perpetual discussion (at least 100 hours every week) of their feelings. Much like Bindrim's sessions, the psychopaths were encouraged to go to their rawest emotional places by screaming and clawing at the walls and confessing fantasies of forbidden sexual longing for each other, even if they were, in the words of an internal Oak Ridge report of the time, "in a state of arousal while doing so".

...

Barker watched it all from behind a one-way mirror and his early reports were gloomy. The atmosphere inside the capsule was tense. Psychopaths would stare angrily at each other. Days would go by when nobody would exchange a word. But then, as the weeks turned into months, something unexpected began to happen.

The transformation was captured in an incredibly moving film. These tough young prisoners are, before our eyes, changing. They are learning to care for one another inside the capsule.

We see Barker in his office, and the look of delight on his face is quite heartbreaking. His psychopaths have become gentle. Some are even telling their parole boards not to consider them for release until after they've completed their therapy. The authorities are astonished.

Several of the 30 participants of the experiment went on to commit violent homicides some years after release.

An internal memo from the experiment: "LSD in a Coercive Milieu Therapy Program" (E.T Barker)

Intriguing.

Comment author: buybuydandavis 20 December 2012 07:13:41PM *  0 points [-]

Cool.

But in case it wasn't clear, I wasn't proposing that as a guaranteed cure, only as an example of a treatment they may not have tried.

The researchers concluded:

We believe there is no evidence that any treatments yet applied to psychopaths have been shown to be effective in reducing violence or crime.

It's the OP's jump from "nothing we tried works" to "resistance to all treatments don't work" that I objected to.

Comment author: gwern 20 December 2012 07:40:20PM 2 points [-]

I don't see why you would interpret "it's untreatable" as "gasp! how dare he claim that there is no possible treatment and never will be a treatment and they've thought of everything!"

They have demonstrated resistance to all treatment and attempts to change their mind. That is simply the case. And that's when the treatment doesn't backfire...

Comment author: buybuydandavis 20 December 2012 09:34:00PM 0 points [-]

Because I find that people use "can't be treated" not as a cue to search for a treatment, but as a claim that such a search will be fruitless. "Can't be done", not "we don't know how to do it yet".

And again, they haven't "demonstrated resistance to all treatment", they've "demonstrated resistance to a very finite list of treatments".

Comment author: mwengler 20 December 2012 03:11:59PM 2 points [-]

Does it make more sense than asking a depressed person how to treat depression, an anxious person how to treat anxiety, or even a politically conservative person how to convert her to liberalism?

I wouldn't expect particular insight from any of these classes. I would expect to gain insight by talking to them extensively while I was trying various therapies, which I would view as similar to measuring blood sugar levels in people I was trying to treat for diabetes.

Comment author: buybuydandavis 20 December 2012 08:10:22PM 1 point [-]

Are depressed people believed to be master manipulators? Anxious people? Are either of them believed to have no problems with brain function?

I'll give another reason to believe that psychopaths might be better able to help themselves, this time from the summary conclusions:

We believe that the reason for these findings is that psychopaths are fundamentally different from other offenders and that there is nothing “wrong” with them in the manner of a deficit or impairment that therapy can “fix.” Instead, they exhibit an evolutionarily viable life strategy that involves lying, cheating, and manipulating others.

Psychopaths are different in the head. The usual appeals are crafted for the usual heads, by the usual heads.

But I'd refine the summary, noting that while psychopathy may succeed in evolutionary terms, something has not succeeded for their sample of psychopaths because they're in prison, and unlikely to wish to be there.

Has anyone tried to make them better, and more effective psychopaths, psychopaths that wouldn't end up in prison?

I would guess that there are few therapists with a willingness to do that, with the psychological and intellectual capabilities to pull it off. I find the "usual head" quite crazy myself, not very convincing, and likely largely incapable of understanding a paper clip maximizer.

Comment author: gwern 20 December 2012 10:50:44PM 0 points [-]

Has anyone tried to make them better, and more effective psychopaths, psychopaths that wouldn't end up in prison?

Yes, because that sounds like a great idea...

After short-term anger management and social skills training, 24-month reconviction rates for 278 treated and untreated offenders yielded an interaction between psychopathy and treatment outcome similar to that reported by Rice and colleagues (1992). Whereas the program had no demonstrable effect on non-psychopaths, treated offenders who scored high on Factor 1 of the PCL-R had significantly higher rates of recidivism than high-scoring but untreated offenders.

Comment author: buybuydandavis 20 December 2012 11:31:02PM 0 points [-]

I see no indication there that they were trying to make them better and more effective psychopaths, as opposed to less psychopathic.

As part of their treatment, were they told "we're going to make you the best psychopath you can be"? I doubt it. And I doubt the psychopaths perceived that either.

Comment author: gwern 20 December 2012 11:35:19PM 0 points [-]

How are better social skills and better anger management not making them more effective (if indeed they can be trained at all)?

Comment author: buybuydandavis 21 December 2012 12:08:59AM *  0 points [-]

"Better" according to a psychopath? Or better according to the people trying to "fix" the psychopaths?

Comment author: gwern 21 December 2012 12:16:07AM 0 points [-]

They don't want to be in prison either.

Comment author: bogus 20 December 2012 11:10:17PM *  0 points [-]

That's not saying much, though. "Had no demonstrable effect on non-psychopaths" = the program was no good. Aren't "anger management" programs widely stereotyped as useless?

Comment author: gwern 20 December 2012 11:18:13PM 0 points [-]

"Had no demonstrable effect on non-psychopaths" = the program was no good. Aren't "anger management" programs widely stereotyped as useless?

Dunno. But how else are you going to find out whether it works but by trying it? In which case you are morally responsible for the consequences, in this case, the rather bloodless description 'significantly higher rates of recidivism'. (Many Bothans died to bring us this information...)

Comment author: ChristianKl 21 December 2012 12:09:01AM 0 points [-]

How would you convince a psychopath like you to stop doing X?" Has anyone let psychopaths try? Aren't they the master manipulators? They even have a readily available model of a psychopath to test out the theory on. How convenient!

Not every psychopath is in prison. I would expect that some of psychopaths work as psychologists and do treat other psychopaths.

Comment author: buybuydandavis 21 December 2012 01:40:44AM 0 points [-]

They'd probably be good at it if they had the motivation to help people, but I wouldn't expect them to have that motivation. And if they did enter the profession, it would be to fully exploit their patients. How could they resist?

Comment author: ChristianKl 21 December 2012 03:01:05PM 0 points [-]

They'd probably be good at it if they had the motivation to help people, but I wouldn't expect them to have that motivation.

Why? Having empathy with someone else isn't the only reason to be motivated to help someone. Proving to yourself that you are powerful enough to cure the patient is also a reason that motivates you to help.

Comment author: buybuydandavis 21 December 2012 08:50:30PM 0 points [-]

I don't think psychopaths feel the need to prove themselves. I would expect a psychopath to gravitate toward situations where their manipulation of others yielded a direct benefit.

Comment author: ChristianKl 21 December 2012 09:16:46PM 0 points [-]

What does "direct benefit" mean?

Comment author: moridinamael 20 December 2012 04:51:15AM 0 points [-]

This sounds like a wonderful idea for a novel, at least.