A Cure for Psychopathic Criminals?

Dennis Rader mugshot

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Contrary to popular belief, psychopaths are not considered to be mentally ill. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), released by the American Psychiatric Association (APA) in 2013, lists psychopathy under the heading of Antisocial Personality Disorders (ASPD).

According to the APA, psychopathy is a personality disorder that is exhibited by people who employ a combination of charm, manipulation, intimidation, and sometimes violence to control others, in order to satisfy their own selfish desires. It is estimated that approximately 1 percent of the adult male population in the U.S. are psychopaths (1). Men are more likely than women to be psychopaths.

Key traits of the psychopath include:

• A disregard for laws and social mores
• A disregard for the rights of others
• A failure to feel remorse or guilt
• A tendency to display violent behavior

Generally speaking, psychopaths are glib and charming and they use these attributes to manipulate others into trusting and believing in them. Because of their strong interpersonal skills, most psychopaths can present themselves quite favorably on a first impression and many function successfully in society. However, as explained by psychologist Dr. Paul Babiak and his colleagues, a number of the attitudes and behaviors common to psychopaths are distinctly predatory in nature and they tend to view others as either competitive predators or prey (2).

When psychopaths view others as prey, their lack of feeling and bonding to others allows them to have unusual clarity in observing the behavior of their intended victims. Moreover, they do not become encumbered by anxieties and emotions that normal people experience in interpersonal encounters (3).

A detailed examination of psychopathy and its powerful link to serial homicide is presented in a separate article.

Can psychopathy be cured?

According to mental health experts, the short answer to this question is no. Dr. Nigel Blackwood, a leading Forensic Psychiatrist at King’s College London, has stated that adult psychopaths can be treated or managed but not cured (4).

Blackwood explains that psychopaths do not fear the pain of punishment and they are not bothered by social stigmatization. Psychopaths are indifferent to the expectations of society and reject its condemnation of their criminal behavior. According to Blackwood and others, callous and unemotional psychopaths simply do not respond to punishment the way that normal people do. Consequently, adult psychopaths in prison are much harder to reform or rehabilitate than other criminals with milder or no antisocial personality disorders (5).

Because they do not respond in a normal fashion to punishment, reward-based treatment seems to work best with psychopaths. Such strategies have been used effectively to mange psychopaths in institutional settings.

In reward-based treatment, psychopathic prisoners are given small privileges such as watching television, playing games or other perks in exchange for good behavior. For example, reward-based treatment has been utilized effectively with convicted serial killer and psychopath Dennis Rader (known as “Bind, Torture, Kill” or BTK) at the El Dorado Correctional Facility in Kansas.

Rader has been a model prisoner since his incarceration in 2005. Although he remains in solitary confinement twenty-three hours per day, he has received increasing privileges, including foods he likes, in exchange for his good behavior. He has told me in personal correspondence while researching my book that he looks forward to his little rewards. I believe that the obsessive, compulsive nature of many psychopaths such as Rader make a reward-based system particularly effective.

Their behavior remains good or even improves as they become increasingly fixated on their rewards. Despite the practical utility of reward-based treatments, however, the fact remains that there is no known cure for psychopathy. In other words, it can be managed quite effectively but not cured.

I offer many other shocking insights into the minds and actions of psychopathic serial predators such as BTK, with whom I corresponded extensively, in my book “Why We Love Serial Killers: The Curious Appeal of the World's Most Savage Murderers.”

Dr. Scott Bonn is a criminologist, professor, TV analyst and author. Follow him @DocBonn on Twitter and visit his website docbonn.com