The Failure of the Mental Health Industry

What if oncologists refused to treat patients with terminal cancer?  Chalking up the afflicted for dead, imagine that they withhold treatment that could extend the quality of life for those dying as well as for those around the dying.  I would imagine that there would be a great murmur from society, proclaiming such withholding of treatment to not only be unethical but antithetical to the promise of life.  Why then is it acceptable to withhold treatment from those having personality disorders?  This post will focus particularly on the lack of available treatment options for those with Antisocial Personality Disorder (ASPD), but this can extend to other disorders considered taboo or worthy of scorn by society; those such as Narcissistic Personality Disorder and Histrionic Personality Disorder.  “Fluffy” disorders such as Borderline Personality Disorder (BPD) are not meant to be part of this discussion.

That said, consider how Borderline Personality Disorder is approached these days.  In the past three decades, great advances have been made in treating Borderline Personality disorder and enriching the quality of life for those with the disorder as well as those that are affected tangentially by the afflicted.  This would seem to imply that the longstanding belief that all personality disorders are forever is somewhat false.  Disordered behavior only exists so long as those having the disorder have their lives disrupted as a result of the disorder.  With that in mind, recent strides in BPD research imply that disordered behavior can be regulated and lives improved.

Why then do so many therapists and mental health professionals refuse to treat those with ASPD, for instance?  If no work is done to try and help those with ASPD then we are left with a self-fulfilling prophecy: those with ASPD have the condition for life because there are no treatments available to rein in such behavior, and no treatments are available for ASPD because the larger mental health professional body refuses to touch ASPD patients due to assumptions that the condition is for life.  I am not optimistic that this will change beyond a very localized level.  ASPD patients are choked dry by an endless cycle of referrals by professionals that have little problem charging money for conditions they know that they refuse to treat.  That is unethical, yet no one speaks up.  There is no outcry as with the hypothetical example I led this post with.

Yes, with ASPD in particular, there are many unknowns.  It is unknown how those who are imprisoned differ from those that remain out of legal trouble yet still have ASPD.  However, to my knowledge, there are no endeavors to attempt to find such differences.  The two groups are assumed to be equivalent.  There are no curious minds that are willing to rise above the frustration they face with the typical challenges that ASPD patients bring.  Mental health professionals are hellbent on picking low-hanging fruit that has been successfully treated and documented previously.

And thus the self-fulfilling prophecy will come to pass and those (admittedly few, though we have no statistics available on this) wishing to understand and corral their personality disorder and antisocial proclivities will remain left in the wastelands.  It is unfortunate, unethical, and ultimately detrimental to a society that has decided that antisocial behavior is unacceptable.  I’m sure that many of my neurotypical readers will gladly accept such a prophecy; it’s what is best for the prison business and what is easiest to ensure that antisocial individuals will not harm them.  They are as lazy and intellectually stunted as the mental health professionals whose very charge is to help anyone who seeks it, without value-judgement and with a good-faith effort.

Image is licensed under the Creative Commons Attribution-Share Alike 2.5 Generic license.  Use of this image should not imply endorsement by the image author, Brocken Inaglory.

Demonizing the Demon - The Sins of Academia Regarding Psychopathy
Victim Complex


  1. mel says

    Maybe treatment will be available in the future, but for now, once a psychopath is an adult, there is no rehabilitation. No drug or no therapy program has been proven to make any difference. In fact, there is research indicating that therapy makes sociopaths worse.

    There has been a ton of research and brain scans show psychopaths can’t activate the parts of the brain that register emotion.

    Many people wish there was a cure because they happen to love psychopaths and hate the reality that doing so is a waste of time because psychopaths can’t ever reciprocate love and will only manipulate. A relationship with a psychopaths is a waste of time, you will get hurt in the process. This is the really and happens in 100% of all cases.

    Also, I don’t believe that psychopathy is considered a brain disorder like schizophrenia and other mental afflictions because psychopaths know what they are doing and they like it.

    • Jessica Kelly says

      All studies on rehabilitation have been conducted on imprisoned psychopaths and not “successful” psychopaths. There is no reason why therapy should not be available to those who seek to reduce the chaos in their lives. There is a fundamental and unknown difference between the imprisoned and the successful and today’s post actually goes into detail why such needs to be studied.

    • brenali says

      It’s not enjoyment, really. More of an acceptance. A paraplegic has to make the most of their lack of workable limbs, a psychopath makes the most out of their wiring.

      I would like to know where this “100% of all cases” comes from. It may not be the love that you would expect, but there can be an attachment, almost love.

      And regarding therapy making one “worse,” wasn’t the study considering a psychopath becoming a better mimic “worse?” Why does it matter if the music is heard if it is danced to expertly?

      • mel says

        To Jessica and brenali – A “successful” psychopath is a psychopath who has managed to stay out of prison. This distinction does not necessarily mean the psychopath is successful in life and with interpersonal relationships. Un-incarcerated psychopaths are offered therapy all of the time. The primary reason psychopaths get worse after therapy is because they use the information to better manipulate, not to improve. Research states that psychopaths see no need to improve their situation. So, isn’t all of this pointless. The psychopath likes who s/he is. The psychopath is in full control of his/her behavior and could shift how s/he behave, if s/he wanted to. Psychopaths don’t want to. Psychopaths enjoy manipulating and probably even find manipulation essential to deal with their incessant boredom. A normal relationship, without manipulation, would suffocate a psychopath.

        Here’s the rub: Normal people don’t like being manipulated. Normals don’t like being manipulated into believing the psychopath cares, loves, feels empathy etc. when the psychopath can’t and then lies about it. That’s the bottom line. If the psychopath were to be open and honest about their disorder, then a normal might be able to deal with that and even reach some kind of understanding and feel compassion. The “normal” might even decide to stay in a relationship with a psychopath. But… the psychopath would not like that because that would be boring. Psychopaths need to be playing a game. It’s a game where only the psychopath knows the rules and the goal posts are forever shifting. The psychopath always knows what s/he is doing. That’s’ why you can’t pity the psychopath.

        This article is filled with blame and self pity. Research states that’s what psychopaths do to get attention.

        • FNP says

          Contrary to popular belief, the masses do actually like being manipulated. That’s one reason propaganda works so well. A completely open and honest psychopath is like a neurotypical that’s antisocial and narcissistic – it breaks the definition. However, pity is not empathy, and is something that any person can feel for any other. It’s a feeling of “Haha sucker, I’ve got more than you, you pathetic loser”.

          • mel says

            FNP: I know it’s hard for you to comprehend this, but people do not like being manipulated. Just because people are manipulated, doesn’t mean they approve of it. Usually, once a manipulation is discovered people become angered.

            Your implication seems like an attempt to justify psychopathic manipulation as is your definition of pity. A psychopathic view of emotions and behavior is very different from how normal people see and react to things.

            People who feel:“Haha sucker, I’ve got more than you, you pathetic loser,” are people I tend to try to avoid. a manipulative person knows how to twist words, play on emotions and otherwise manage a situation in a sneaky fashion to get what he wants. I just don’t like these folks.

        • says

          Excuse me? Non-incarcerated psychopaths are offered therapy all the time? Where are the numbers on that? Where are the clinicians’ manuals for treatment? That is outright untrue, and what this article is about. There are no resources for those who seek them. (jess, it’s reine, btw)

          • FNP says

            mel thinks that psychopaths would want to be empaths, basically. They literally can’t figure out that empaths are weak people who can’t get along without resorting to irrational behavior.

          • mel says

            FNP – That’s actually not what I think. Normal’s are actually stronger because we can actually live with the truth and figure the likes of you out, so that we can avoid you. Psychopaths’s on the other hand need normal people to manipulate, so you can relieve your incessant boredom. Only to a psychopath are regular emotions considered “irrational behavior” because you don’t have them and therefore you are unable to understand them.

            Nicole – Yes, in the free world psychopaths are offered therapy all the time. They either decline because they find it unnecessary, or they use it to manipulate further. Psychopaths are offered therapy because they burn a lot of bridges and cause a lot of unhappiness everywhere they go. The other half of the relationship will often seek therapy to try to fix the relationship mess, to no avail. Life with a psychopath is a sinking ship because of the lack of integrity that is needed to maintain a healthy relationship.

          • Jessica Kelly says

            Please tell my brethren and their light wallets from the cycle of referral hell that therapy is freely available.

          • FNP says

            Psychopaths are only offered therapy if they’re in prison. Outside of prison, finding a therapist willing to work with you even just to curb the antisocial behavior is next to impossible.

            If it’s so easy for neurotypicals to see who is or isn’t a psychopath, then why are you so afraid of us? You seem to have no clue that there’s a difference between empathy and emotions though. Schizoids are the ones that don’t feel emotions. Psychopaths have a shallow affect, not a flat affect. We definitely feel things, we just don’t base our lives on those feelings.

          • mel says

            I know of many psychopaths who are offered therapy. They all have refused it.

            Normal people are not afraid of psychopaths ( except for the ones who like to kill), but we tend to avoid them once we spot the red flags. We avoid because we dislike manipulation not because we are afraid. Living with people of the lie is a horrible way to live.

          • FNP says

            If normal people aren’t afraid of psychopaths, then why do these “normal” people routinely call for all psychopaths to be rounded up and put in prison camps?

            Neurotypicals fear what they don’t understand. Psychopaths just ask why it’s necessary to waste the effort on fearing something.

      • mel says

        FNP – They go to prison when/if they break the law. If a psychopath does not commit a crime, but is unsavory, then s/he will be avoided.

        Normal people do not call for all psychopaths to be rounded up and put in prison. That’s an exaggeration. We may not like how they behave, but what you are saying is ridiculous.

  2. Anonymous says

    “Research states that psychopaths see no need to improve their situation. So, isn’t all of this pointless.” – yet you see a psychopath here who wnats to improve and is having therapy. actually, more than one.

    • Anonymous says

      And, about successful psychopaths, yes, there are differences in environment and in the fact that psychopaths who are not in prison seek treatment on their own, and the other ones are obligated to have therapy. It may influence the outcome.

      • mel says

        I think it’s wonderful that the author is in therapy and wants to improve. I hope the therapy helps. I wish all psychopaths would apply therapy instead of using it to further manipulate. I wish all psychopaths could be authentic instead of trying to control and con. I think honesty and truth is always the best policy. The truth is certainly freeing.

        • FNP says

          I wish I could have a fleet of private jets. The only difference between my wish and yours is that mine is actually possible.

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