How to Treat Antisocial Personality Disorder

Antisocial personality disorder is a mental health condition marked by an ongoing pattern of involvement in behaviors that exploit or manipulate other people, or significantly violate their rights. People with this condition are sometimes referred to as sociopaths or psychopaths. While doctors can only officially diagnose its presence in adults, signs frequently begin to appear at a much earlier age. Experts in the field acknowledge the difficulty of finding truly effective treatment for antisocial personality disorder. However, non-medication-based therapy may help in some cases.

Antisocial Personality Disorder Essentials

Antisocial personality disorder belongs to a group of mental health conditions known as Cluster B personality disorders. All conditions in this category produce unpredictable or excessively dramatic thoughts and/or actions. Specific traits of a serious antisocial personality may include:

• Lack of concern for other people’s emotions, wants or needs
• Ongoing stealing, lying and/or manipulation of others
• A tendency toward aggression and/or overt violence
• Frequent lawbreaking
• Frequent displays of arrogance or anger
• Involvement in substance use/abuse
• Lack of regard for personal safety or the safety of others, and
• An absence of remorse or guilt for harmful or risky behavior

Doctors diagnose the condition when at least one of these problems appears in a person over the age of 17 who:

• Had the symptoms of a childhood mental health condition called conduct disorder by age 14, and
• Does not suffer from bipolar disorder or schizophrenia

No one under the age of 18 receives an official diagnosis for any type of personality disorder, even when symptoms of that disorder are present.

Treatment Challenges

Most people affected by antisocial personality disorder never receive treatment of any kind. This is true largely because, unlike individuals with certain other mental health problems, individuals with serious antisocial personality traits don’t usually report their condition to others or seek help. In fact, most people who receive treatment for antisocial personality disorder are ordered into a doctor’s care after entering the criminal justice system.

Cognitive Behavioral Therapy

As a rule, medication is not used in treatment for antisocial personality disorder. Instead, doctors rely on non-medication-based psychotherapy. Treatment usually involves either classic “talk” psychotherapy or cognitive behavioral therapy (CBT). CBT produces its positive effects by helping you understand the triggers that lead you to act in harmful ways, and also by helping you to develop new behaviors that don’t lead to harm. Some forms of this therapy provide you with rewards as encouragement to improve your healthy coping skills. Relatively few studies have specifically looked at the benefits that CBT has on people affected by antisocial personality disorder. However, several studies indicate that this form of therapy can do such things as:

• Decrease an antisocial person’s involvement in substance use
• Increase positive feelings toward others, and
• Improve the ability to function socially

Talk Therapy

Talk therapy is the classic model of psychotherapy. It gets its name because it helps patients talk through their problems and come to important personal realizations. Some people with antisocial personality disorder benefit from talk therapy, especially when that therapy focuses on specific issues instead of taking a more general approach. However, severely affected individuals may experience little or no improvement. This is true mainly because talk therapy relies heavily on participants’ genuine belief that they bear at least some responsibility for their own problems. Extremely antisocial people may simply lack the ability or desire to take this kind of responsibility.

Schema Therapy

Researchers are now beginning to explore the usefulness of a CBT offshoot called schema therapy as an antisocial personality disorder treatment. This therapy, specifically designed to help people who fail to respond positively to traditional CBT techniques, is based on the belief that antisocial behaviors stem from poor childhood coping skills. Use of schema therapy may help people with antisocial personality disorder decrease their violent tendencies and engage more fully in their treatment.

Resources

U.S. National Library of Medicine – MedlinePlus: Antisocial Personality Disorder https://medlineplus.gov/ency/article/000921.htm Mayo Clinic: Antisocial Personality Disorder – Treatment http://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/diagnosis-treatment/treatment/txc-20198986 Psychiatric Clinics of North America: The Effectiveness of Cognitive Behavioral Therapy for Personality Disorders                                      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138327/ National Institute for Health and Care Excellence: Antisocial Personality Disorder – Prevention and Management                                                         https://www.nice.org.uk/guidance/cg77/chapter/1-Guidance The Society for the Advancement of Psychotherapy: Psychotherapy for Individuals with Psychopathy/Antisocial Personality Disorder http://societyforpsychotherapy.org/psychotherapy-for-individuals-with-psychopathy-antisocial-personality-disorder/