Sunday, May 30, 2010

Noah Rubinstein - Empathy for Sociopaths?

Interesting article from Good Therapy - it has generally been assumed that sociopaths are incapable of empathy. When I was in school in the first time, back in the 1980s and early 1990s, it was pretty much accepted wisdom that sociopaths had failed to make any attachment bond, and if this was not corrected by age six or so, it was permanent.

The author is suggesting that sociopaths deserve empathy - and I agree with this view. All human beings deserve empathy and compassion no matter what they may have done. This is basic Buddhist teaching - and good therapy.

On the other hand, Richard Schwartz does not believe in sociopathy as a diagnosis (this was said during his workshop at the Psychotherapy Networker Conference in 2009). He sees all forms of mental illness as parts, but that somewhere in the background there is always a Self:
The Self has leadership and healing qualities -- perspective, confidence, compassion, and acceptance -- crucial to our highest, most harmonious functioning. Even the most severely abused, symptomatic clients have this healthy and healing Self, although many have very little access to it initially. The goal of IFS therapy is to differentiate this Self from the parts, thereby freeing its resources for healing by helping parts out of their extreme roles and guiding them into harmonious collaboration.
From this perspective, the sociopathic part is NOT the self, and therefore, it should be possible to "unburden" that part and get some elements of the Self to step forward, making the sociopath more human. I don't how well this works, but Schwartz has worked successfully with sex offenders, which is another tough population.

I'm not sure where Dan Siegel's interpersonal neurobiology comes down on this topic, but it would be interesting to hear his opinions on sociopaths, attachment, and healing.

In my opinion, the moment we give up on a human being's capacity to be "human," we have lost a portion of our own humanity.

Empathy for Sociopaths?

May 28th, 2010

By Noah Rubinstein, LMFT, Executive Director GoodTherapy.org

There is no debate about the fact that sociopathy is a real condition which interferes with or precludes the capacity for empathy and remorse. However, there is debate about how sociopathy should be viewed, and I take a unique and unpopular position.

The etiology of sociopathy is an important area of research that by no means has produced a final verdict on the cause of this condition. The collective research on sociopathy suggests that there are a number of possible interrelated causes for the condition including cultural, environmental, and genetic factors. As far as I know, there is no research to warrant the conclusion that all sociopaths are born with the condition, nor is there conclusive evidence that all sociopaths are the result of their environment, such as lack of emotional attachment.

Whatever the general etiology and prognosis are for the condition of sociopathy, it should not preclude therapists and other mental health professionals from treating such folks with dignity. This declaration may seem shocking at first, but there is a sensible argument for treating sociopaths with dignity. Regardless of whether sociopathy is caused by genetic factors, environmental factors, or some combination, sociopaths should not be viewed as responsible for their sociopathy because the sociopathic condition is not one that is chosen, it is one that is given, whether by genetic inheritance or life experience.

I’m not suggesting that some sociopaths do not make or intend evil action, nor am I arguing that sociopaths should not be held responsible for their actions. From a cursory review of the 20th century alone- and some of its leading figures- it’s clear that sociopaths are quite capable of evil. Because sociopathy is a condition affecting 1 in 100 men and 1 in 300 women, most of us have interacted with a sociopath and many have been hurt, abused, or taken advantage of as a result. I very much understand the kind of destruction and pain some sociopaths can cause as well as the fear, anger, pain, and the inability to forgive which many victims of sociopaths are faced with. I say “some” because not all sociopaths are the violent psychopathic killers that the media portrays them to be.

Additionally, it’s important to mention that even though sociopaths do not feel empathy, they do have a cognitive understanding of what is deemed right and wrong by the culture that they exist in. Of course we can imagine how a lack of empathy can debilitate a person, leaving one to make decisions based simply on consequences or self-serving implications. But it is still reasonable to expect sociopaths, or any member of society no matter how unrealistic it might seem, to have cognitive knowledge of right from wrong, to agree to the golden rule even for self-serving purposes, and to control their impulses.

Again, I’m not in denial of the danger that some sociopaths present. Nonetheless, I recommend that regardless of the danger sociopaths collectively pose to society, it would be in everyone’s best interest to develop empathy for sociopaths and to consider doing what we can to help heal the condition of sociopathy.

Why have empathy for sociopaths?

Again, nobody chooses sociopathy. One’s genetic and environmental inheritance as well as the family and culture one is born into predisposes and shapes each of us beyond our control. What a horrible misfortune to inherit sociopathy.

Sociopaths miss out on the most uplifting experiences of being human: love, empathy, and emotional connection. (Of course, this view is only held by those of us who actually know what love feels like).

Many sociopaths make contributions to society through medicine, military service, and many other fields of service.

And there is hope, no? Currently, the odds of an adult without empathy ever developing the capacity to emotionally attach and feel remorse, regardless of the cause of their sociopathy, is probably quite low. Nonetheless, I believe that it’s better to stay open to the possibility that some sociopaths could have the capacity to develop attachment, remorse, guilt, and empathy. The latest research from the field of interpersonal neurobiology demonstrates that the adult brain can develop new neural connections and can even grow new neurons: a finding that offers tremendous hope. If we can envision future technologies developed through neuroscience and interpersonal neurobiology and imagine how they could contribute to the understanding and treatment of sociopathy, I believe that there certainly is hope. What if the etiology and variations of sociopathy could be differentiated from each other and understood? What if sociopathy could be treated effectively? If sociopathy was a treatable condition, something we could reverse or heal, the amount of collective harm passed around from human-to-human and nation-to-nation could be greatly reduced. With an effective medical treatment for sociopathy millions of children with sociopathic parents might have a chance to develop a healthy attachment and a large number of people with sociopathy produced as a result of their childhood experiences could be prevented.

Of course, this will never happen if sociopaths are seen as invaluable, inferior, and are treated as the lepers of society. The irony is that many of us who fear sociopaths or have been hurt by them inadvertently “steal one from their playbook” by reciprocating and viewing sociopaths without empathy. I encourage you to join me in the hope that someday pro-social groups will join together to contribute the financial resources needed to improve the treatment of sociopathy and, however grandiose, the course of human cultural evolution in turn.

©Copyright 2010 by Noah Rubinstein, LMFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be posted as a comment to this blog entry.


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