The difference between a person with APD and everyone else

I apologize if this post is a bit rambling. I am basically writing about some things I've been thinking about recently and I'm curious to hear what other people think. I'm going to focus mostly on psychopaths but I suppose much of this could be applied to sociopaths and APD in general, too.

We've been told that psychopath lacks a conscience, lacks a sense of guilt, and a sense of remorse. But these are all very complicated emotions. We know it isn't true that a psychopath lacks all emotions. Certainly they can feel anger, can have a sense of happiness, and they share the same basic human desires that everyone else does to varying degrees. In a way you can argue that everyone is driven by those desires and the higher level emotions are artificial. The law-abiding psychopath is law-abiding because he sees the potential negative consequences, whether they be legal or otherwise, of his actions. The "normal" is law-abiding for those and more reasons. Namely, he has a inner-concept of right and wrong which is driven by his ability to empathize. But where does this empathy come from? It comes from the guilt he feels when he hurts another person because he is able to put himself in that person's place and feel the feelings they would. Anybody can do that, even psychopaths, though. Most psychopaths tend to be intelligent, and so they know their actions could hurt other people but they don't care. They can see the emotions in other people but they don't feel them themselves. A violent psychopath is unable to empathize with the fear and pain that his victim feels. Perhaps that is because he doesn't ever feel fear and pain himself. And that might be somewhat true -- many psychopaths experience fear as nothing more than an adrenaline rush. It is perhaps a positive emotion similar to one a normal would get riding a roller coaster. They are never really truly terrified to the extent that the possibility of that feeling recurring causes them to modify their behavior. I'm going to suggest that is possibly a characteristic of a psychopath -- a numbed, or under-developed sense of fear.

I think about how a normal reacts when he is faced with a disturbing situation. For example, let's say he witnesses a violent car accident. He will be a bit shaken. He might have nightmares, disturbing thoughts that persist. He might not be quite himself, but eventually he will get over it and forget. Why was he disturbed? I think it is out of fear. It is because he imagines himself in that situation. He imagines himself getting hit by that car. He imagines himself as one of the family members of the person injured and he thinks about how he would feel and he is scared. He thinks about the pain those people suffered and inevitable end of his own life. He wishes it never happened because if everyone is safe and happy, he is safe and happy too.

Guilt and fear have more in common that one might think. A sense of guilt can come from a inner belief in a higher-being, that one day someone will judge you for your behavior. Or it could come from a belief that your actions will be found out by your peers and you will be punished. Or perhaps a belief in karma, that one day something bad will happen to you. But even if a normal claims to believe in none of these things, he has a sense of guilt, which I believe stems from these very causes I listed whether he claims he believes them or not. The fear of being judged is overwhelming for a normal, whether it is from a higher-being or from another person. Perhaps it is the psychopath's inflated ego and self-esteem that prevent them from ever feeling judged and thus ever feeling guilty.

Even if the psychopath does not empathize with the emotions of others because he can not feel those emotions himself, one would think it is still in his best interest to obey the rules of society with regards to lying, cheating, stealing, manipulating, etc. Sure enough, there are many very successful psychopaths who do exactly that and only resort to manipulation when the benefits significantly outweigh the risks. But normals, even if they share the same desires as psychopaths, don't behave that way. Rather than ask the psychopath "why", perhaps we should ask the normal "why not". On the conscious side of things, some people are driven to be "good" from the same desires the psychopath has. The normal exhibits good behavior because he wants to be well-liked. He wants to be popular. He wants to be respected by his family and peers. But the normal person will still behave that way when no one is looking. The psychopath will not. The normal is able to see how good behavior contributes to a smoothly functioning society. They are able to see that if everyone lied and cheated and stole our society would collapse. But psychopaths are not anarchists. They must know this too. There has got to be something more the normal has that makes them follow through with these beliefs.

Again, I believe some of it comes from fear, and some of it comes from a innate desire to conform because we evolved that way and our society depends on it. The normal is able to see into the future of their lives and those around them and recognize what behavior is going to give them the most satisfaction. Perhaps the psychopath is unable to see this. Perhaps they are fundamentally short-sighted. Perhaps they are just unable to piece together the subtleties of human interaction and emotion and see that greater happiness will result from good behavior. This all must happen at subconscious level. I haven't really been able to come to a specific conclusion, but I wonder if the psychopath suffers from a kind of mental disability that prevents him from being able to make those kinds of logical conclusions with regard to morality at a very young age. Or maybe a psychopath would argue the normals are the illogical ones because it is difficult to logically argue the necessity for a moral conscience on an individual basis.

As of now there appears to be no treatment for someone with a psychopathic disorder. It seems to occur in all types of people without regard to their socioeconomic status, family upbringing or anything else. The psychopath also believes that he does not have a disorder at all. He will never know what he is missing and therefore doesn't want to be like everyone else. Can the normal person understand the psychopath, though? I believe he can because everyone has some natural damper on their emotions. It is necessary to survive. One example might be the recent events in Haiti. For many who don't live there and have no connection to the country it is a very "sad" situation. But for all the horror that occurred there, how many people do you think cried about it? For how many people did it really effect their lives? And for those who say they care, and claim to be upset, was it because they really were or because they want to feel like they are good people? They know consciously how horrible it was, and maybe they are slightly effected internally, but they are able to keep a fairly significant amount of emotional detachment because it really doesn't effect them personally. I contend that the psychopath is the same way. The only difference is the psychopath is that way even about situation who one would normally consider to be much closer to them. The feelings of family members and of friends are so far removed from their own lives, their own happiness, that they only react in as much as it personally effects them. To a normal, this is horrifying, and yet we brush off disturbing situations all the time.

interesting read.

i rather like your theory connecting guilt and fear. however, i would caveat the causal implication with the observation that, while i DO occasionally feel fear, it does not result in a sense of guilt and vice-versa: my lack of guilt does not alleviate my fears.

what i like about your theory however, is not the blanket statement, rather it is the (briefly) stated idea encompassed by the line "fear of JUDGEMENT". that is most certainly one fear i lack. i may fear incarceration, but it is not the JUDGEMENT that i fear- but the physical limitations thereby imposed upon me.

it does seem that those who are "successful" have the understanding of repercussion. punishment if caught. however, that seems to me an indicator of the extent of the "disorder" more than anything. i do not fear ostracization, i do not fear a "bad reputation" or unkind words (no matter how angrily the epithets may be hurled), i do not, in short, fear JUDGEMENT. i am too pretty for jail though. that is where i draw the line. as an aside- by "drawing the line" i mean to say that i will weigh the cost vs benefits, and double check my plans carefully. in most cases at any rate. if htere is one thing i will admit to, it's an impulsive streak. sometimes when the opportunity presents itself, one must act. that is where we get into "severity". there are (quite obviously) those who have no fear of incarceration either. making it seem to be an indicator of sorts- that is, what one is afraid of, and to what lengths one will go to alleviate or avoid said fear.

another question is that of "compulsion". are there "urges" that one must satisfy? speaking for myself: i do not have many of those, and mine are primarily sexual in nature. i am no sadist- just as i feel no guilt upon the revelation that another is hurting, neither do i feel elation at the pain. i remain neutral in that regard.

all emotion is somewhat dulled in me though. at least as i understand the word "emotion". i do not feel compelled to act or refrain from acting based on emotion. i do not often have "outbursts", and when i do- they're bloody well deserved. the thing that most confuses me is how people can use "emotion" to justify behavior. "sorry, i was 'upset'", "not my fault- i was really angry". i am never so emotional as to have that sort of drive. now sometimes i just "want" something. but i've been told that what i am feeling when i "want" something is not an emotion. as for the so-called "higher emotions"? hmmm... to be honest, i'm not sure what exactly is classified as "higher" or "lower" in that regard.

i wonder what (if any) role "natural" inhibitions play in this balance between judgement, emotion, and action. i for one am something of an extrovert. not for the sake of being noticed, rather as a result of the fact that i see nothing inherently wrong with the things i do. i want a mohawk? i shave my head into a mohawk. i want to screw my wife on the back of a city bus? i do so. i've been ticketed for everything from reckless endangerment in a motor vehicle to public urination. the two rank equally in my estimation of "wrong". i would go so far as to say that "inhibitions" spring from the "fear of judgement" issue as well.

which came first... the chicken or the egg? does guilt spring from a fear of judgement? or does fear of judgement arise from the guilt complex? interesting thoughts.

again, good read. keep it up.

antisthenes wrote:interesting read.

i rather like your theory connecting guilt and fear. however, i would caveat the causal implication with the observation that, while i DO occasionally feel fear, it does not result in a sense of guilt and vice-versa: my lack of guilt does not alleviate my fears.

what i like about your theory however, is not the blanket statement, rather it is the (briefly) stated idea encompassed by the line "fear of JUDGEMENT". that is most certainly one fear i lack. i may fear incarceration, but it is not the JUDGEMENT that i fear- but the physical limitations thereby imposed upon me.

it does seem that those who are "successful" have the understanding of repercussion. punishment if caught. however, that seems to me an indicator of the extent of the "disorder" more than anything. i do not fear ostracization, i do not fear a "bad reputation" or unkind words (no matter how angrily the epithets may be hurled), i do not, in short, fear JUDGEMENT. i am too pretty for jail though. that is where i draw the line. as an aside- by "drawing the line" i mean to say that i will weigh the cost vs benefits, and double check my plans carefully. in most cases at any rate. if htere is one thing i will admit to, it's an impulsive streak. sometimes when the opportunity presents itself, one must act. that is where we get into "severity". there are (quite obviously) those who have no fear of incarceration either. making it seem to be an indicator of sorts- that is, what one is afraid of, and to what lengths one will go to alleviate or avoid said fear.

another question is that of "compulsion". are there "urges" that one must satisfy? speaking for myself: i do not have many of those, and mine are primarily sexual in nature. i am no sadist- just as i feel no guilt upon the revelation that another is hurting, neither do i feel elation at the pain. i remain neutral in that regard.

Thanks. I agree and I think you understand the point I was trying to make.

antisthenes wrote:all emotion is somewhat dulled in me though. at least as i understand the word "emotion". i do not feel compelled to act or refrain from acting based on emotion. i do not often have "outbursts", and when i do- they're bloody well deserved. the thing that most confuses me is how people can use "emotion" to justify behavior. "sorry, i was 'upset'", "not my fault- i was really angry". i am never so emotional as to have that sort of drive. now sometimes i just "want" something. but i've been told that what i am feeling when i "want" something is not an emotion. as for the so-called "higher emotions"? hmmm... to be honest, i'm not sure what exactly is classified as "higher" or "lower" in that regard.

I understand what you are saying but I'm not sure it's true for all people with antisocial personality disorder. For example, there are plenty of stories of psychopaths doing things in fits of rage. The rage probably gave them the extra energy to go through with something they had no moral inhibitions about doing in the first place but such actions were not worth their time or risk when in a calmer state of mind. As a person who does his best to temper his emotions, I find acting out of emotion and doing or saying things one wouldn't normally do to be a fault. Yes, this includes "love" too. My feeling is that it is ok to be in love, but decisions regarding another person, such as whether you marry that person, must be made also taking into account more practical mindset.

I would agree that "want" or desire is not an emotion and there are definitely different degrees and types of emotions. To argue about exactly what they are is mostly a semantic point and not terribly interesting to me. But it's possible that you really understand what I mean by higher emotions because you don't have them? To me, there is a huger difference between a "lower" emotion like fear or anger and a "higher" emotion like love (for another person) or sadness (when losing another person).

antisthenes wrote:i wonder what (if any) role "natural" inhibitions play in this balance between judgement, emotion, and action. i for one am something of an extrovert. not for the sake of being noticed, rather as a result of the fact that i see nothing inherently wrong with the things i do. i want a mohawk? i shave my head into a mohawk. i want to screw my wife on the back of a city bus? i do so. i've been ticketed for everything from reckless endangerment in a motor vehicle to public urination. the two rank equally in my estimation of "wrong". i would go so far as to say that "inhibitions" spring from the "fear of judgement" issue as well.

which came first... the chicken or the egg? does guilt spring from a fear of judgement? or does fear of judgement arise from the guilt complex? interesting thoughts.

again, good read. keep it up.

I tend to do what I want to and I'm the kind of person who always finds himself fighting against the norm. What ultimately holds me back though, is a desire of a sense of approval from my peers (might be reduced when compared to others, but it's still there). So yes, it stems from a fear of judgment for me.

I think it is very difficult to answer the chicken or the egg question you postulate because I think in most people, that lies at the subconscious level. People who have a conscience don't actively feel it most of the time yet it controls their lives. It lies somewhere underneath and presents itself as an unsettled feeling that directs you away from actions you feel are immoral. That person might not even be able to answer why they feel such an action is wrong. Why is stealing wrong? Because it hurts another person. Why is hurting another person wrong? Because I can empathize with them and it hurts me. Why does it hurt you? I don't know, I just want everyone to be happy, leave me alone! lol.

So it's a rather difficult question. My initial thought was that the fear of judgment was what caused a conscience and guilt to arise in a person. But it is also possible that we judge people who perform actions we know that would make us feel guilty and so the rules of society and religion all came about as a way of coercing others to get them to follow our internal system of morals.

after some thought on the matter, i believe i have some ideas on the hierarchy of fear (as it were).

it seems to me that the fundamental foundation is the "guilt complex". i believe this is the basis for everything in society.

next comes "fear of judgement"- the reason being, without guilt there is no fear of judgement. the only power judgement has is to activate and play off of the guilt complex. one individual judges another in order to coerce them, via the guilt reaction, into behaving a certain way.

after that come the "inhibitions"... the things one is incapable of doing, because the fear of judgement is so keyed into the guilt complex, that it produces subconscious action or inaction.

this "hierarchy" explains why i am prone to behave in ways which are deemed "socially unacceptable". i have to make a conscious decision to behave in a manner i have LEARNED will avert difficulties. as for your assertion that a psychopath would find this irritating- oh god yes. i get so thoroughly annoyed with frightened little sheeple, following the herd out of nothing more than fear of.. what? fear of another person being "hurt"? i don't think so. i think it is fear of discomfort. fear of judgement. fear of the unknown even.

about the hundred dollar bill- i'd be a hundred dollars richer, any and every day of the week. that is a "slap on the wrist" infringement at worst. no jail time even if i do screw up royally enough to get myself caught.

fear i can understand though. while it annoys me when it manifests in certain ways... that is generally because i see it as the result of some ephemeral emotion, or social conditioning- neither of which do i have any respect for.

as to "higher vs lower" emotions: i believe i am beginning to understand your delineation there. i do not feel, nor do i understand "love" as i have heard it described. nor do i feel any intrinsic desire to affiliate with one individual over another, or to abdicate power in (or over) a relationship based on it. that is one of the "ephemeral" emotions i refer to occasionally. i definitely feel anger- but it is always a justified anger based on logical expectations. i am not entirely sure about "rage", however. i DO have something of a short fuse (or so i have been told) but i do not lose control- i do what i meant to do. hmm i'll leave that tack for now, and take it up in the other post.

good post and theory. I especially agree with the last part, that psychopaths are not disturbed as normals with the bad things that can happen to people close to them or to themselves. Since it's far away from his hapiness or gratifications.
Normal people would be terrified by it, but for the psychopath it is as far away as the events in Haiti.
Well maybe it's because i feel just like that, when bad things happen close to me or to people close to me, it feels very far away.
But i know other people would be horrified by those things.

antisthenes wrote:after some thought on the matter, i believe i have some ideas on the hierarchy of fear (as it were).

it seems to me that the fundamental foundation is the "guilt complex". i believe this is the basis for everything in society.

next comes "fear of judgement"- the reason being, without guilt there is no fear of judgement. the only power judgement has is to activate and play off of the guilt complex. one individual judges another in order to coerce them, via the guilt reaction, into behaving a certain way.

after that come the "inhibitions"... the things one is incapable of doing, because the fear of judgement is so keyed into the guilt complex, that it produces subconscious action or inaction.

This makes sense, although I can't resolve my own conscious fears with my behavior. I can not provide a logical explanation as to why I wouldn't commit what would be an immoral act (according to my own morality) even if I knew know one would ever find out. Perhaps it is because I am not an atheist (agnostic perhaps) and therefore perhaps I am always going to be afraid that if there is a higher-power then ultimately I will be judged by him. But I know 100% atheists who wold behave the same way I do. It seems like the fear of judgment can be understood logically, the guilt complex is deeper and there for it can't be understood as easily. There is no question they are interrelated and form the basis to ones inhibitions.

antisthenes wrote:this "hierarchy" explains why i am prone to behave in ways which are deemed "socially unacceptable". i have to make a conscious decision to behave in a manner i have LEARNED will avert difficulties. as for your assertion that a psychopath would find this irritating- oh god yes. i get so thoroughly annoyed with frightened little sheeple, following the herd out of nothing more than fear of.. what? fear of another person being "hurt"? i don't think so. i think it is fear of discomfort. fear of judgement. fear of the unknown even.

It becomes pretty difficult to discuss morality when you throw "don't hurt other people" out of the picture since that seems to form the basis of most systems of morality. I've never been one to shy away from a difficult discussion though.

I'm guessing a psychopath doesn't have a sense of "fairness" or maybe not even a sense of "give and take"? In any kind of relationship with another person I tend to feel like I should be treated similarly to how I treat that person whether it be a simple transaction with an acquaintance or helping out a friend. I'm able to expand that feeling to society as a whole. I don't tale of advantage of it and I expect it not to do the same to me. While I may not feel any particular emotion towards humanity as a whole, I recognize the value of a human life in the sense that if it had no value, well that would mean my life had no value and I have no desire to return to the middle ages where people where tortured and murdered on a whim. For me it's kind of like voting, if you chose not to participate in the system, how can you expect the system to do right by you?

antisthenes wrote:about the hundred dollar bill- i'd be a hundred dollars richer, any and every day of the week. that is a "slap on the wrist" infringement at worst. no jail time even if i do screw up royally enough to get myself caught.

While I wouldn't behave that way, I know my roommate definitely would. He isn't a sociopath but he does have those tendencies. I know, for example, that he would have a much easier time stealing from a store or from a random purse in a public place but he wouldn't steal from a friend or someone he knows. And the greater the pain it would cause the other person the less likely he is going to steal. So he has some kind of conscience, he just rationalizes it away somehow and would have no problem taking the money.

antisthenes wrote:fear i can understand though. while it annoys me when it manifests in certain ways... that is generally because i see it as the result of some ephemeral emotion, or social conditioning- neither of which do i have any respect for.

I'm not sure much of it is social conditioning. It's generally felt that psychopaths are born, not made. That would mean that either they are born resistant to social conditioning or they lack some kind of inborn sense of guilt that others have. I tend to believe it's the latter but I guess I can't really make a good argument either way. Out of curiosity, what do you respect? I imagine you'd only be able to respect what directly benefits you or is it possible for you to respect other people?

antisthenes wrote:as to "higher vs lower" emotions: i believe i am beginning to understand your delineation there. i do not feel, nor do i understand "love" as i have heard it described. nor do i feel any intrinsic desire to affiliate with one individual over another, or to abdicate power in (or over) a relationship based on it. that is one of the "ephemeral" emotions i refer to occasionally. i definitely feel anger- but it is always a justified anger based on logical expectations. i am not entirely sure about "rage", however. i DO have something of a short fuse (or so i have been told) but i do not lose control- i do what i meant to do. hmm i'll leave that tack for now, and take it up in the other post.

I think there are tons of people who have no idea what love is or have never felt it and I think most of them don't have antisocial personality disorder (there can be many reasons why they are unable to feel that emotion). Consequently, love isn't a very interesting emotion to discuss. Perhaps you were abused as a child and you are angry and hateful towards the world. Maybe you had a perfect upbringing but you have ASPD. It's not too interesting. There are too many variables. The lack of a conscience is more interesting because there are a lot of "bad people" out there who still have a conscience. It still may be possible to connect with the abused child and bring out his "human" side. It isn't possible with a psychopath because that side doesn't exist.

I've never felt a relationship I was in had anything to do with power. If it did, it was not a healthy relationship and I got out of it as quickly as I could. I suppose if you lack the ability to connect with another person, it would only be about power. It would only be about what you could get out of the other person and the behavior associated with someone being in love would only get in the way of that.

gio wrote:I think there are tons of people who have no idea what love is or have never felt it and I think most of them don't have antisocial personality disorder (there can be many reasons why they are unable to feel that emotion). Consequently, love isn't a very interesting emotion to discuss. Perhaps you were abused as a child and you are angry and hateful towards the world. Maybe you had a perfect upbringing but you have ASPD. It's not too interesting. There are too many variables. The lack of a conscience is more interesting because there are a lot of "bad people" out there who still have a conscience. It still may be possible to connect with the abused child and bring out his "human" side. It isn't possible with a psychopath because that side doesn't exist.

So you mean with this last sentence, that a psychopath is actually someone who lacks a personality, a character, a will, a soul or whatever you would call it?

Gio, you're attempting to explain somthing that has an explanation. The reason psychopaths can't feel guilt, or fear, or remorse is because they are essentially defective. If you ask them questions that require emotion to answer while viewing their brain in an MRI scan, the part of the brain that controls emotion does not light up. People are either born with this defect, or they can come across due to serious head trauma. Anything and everything else, including people who are "made" into psychopaths (cue dexter) thats not technically psychopathy, that would be catagorized under ASPD because it's purely a personality disorder, not biological.

Some of your theories are good, and can be very easily applied to ASPD, but psychopath is very plain and dry. Not much room for expansion.

Just somthing one of my study patients did one time that your writing reminded me of was this concept of having the abused child hidden away inside. I've seen psychopaths put on hour long shows of them "regreting" everything, etc, etc somthing to the point where you almost want to believe them, because if they're good, they're hitting every single "G-spot" as i call it, of the guilt-complex. But, none of it is true. A psychopath cannot be "Cured". Think of Bi-polar disorder, or autism. Those are both defects in the brain as well, and along with psychopathy, none of them can truely be cured.

The presense of ASPD/sociopathy (Some people even think of them as different disorders, including one of my profs) make DXing a real psychopath extreamly hard, as they will almost always claim ASPD (Because that can be cured) when backed into an unescapable corner. They go to the psych ward, endure it, pretend to get better, and in 6 months they're back out doing what ever landed them there in the first place.


To the "Psychopath" present in this thread, Anti if you will... you perplex me. Never have i seen a psychopath willing to explain why they do what they do. It usually takes hours of proding just to make them drop their masks of ignorance, and even then it's just mind games. If you manage to last through their mind games (which essentially requires you to temporarly become a psychopath) even then, they'll just clamp up. Mind you, the majority of the psychopaths i talk to are facing serious criminal charges, and would be considered the "low functioning" psychopath i suppose. If you're deluding yourself into some false sense of security because you're behind a computer screen... i suppose that would make sense, but even so... you don't fit. Are you sure you're a psychopath?

you clearly don't understand psychopaths. we like the way we are, and would be perfectly willing to discuss it, we just realize that it's probably one of the worst things we can do for our futures.
also your sample of psychopaths is one of the worst - psychopaths in general have higher IQ than the general population (well documented) and it's mainly the stupid ones that end up as failures, which leaves you a very non representative group. Most psychopaths that are intelligent (I know a few, they're more common than you'd think and as a psychopath myself it's pretty easy to tell, there's all the little cues that "normal" people don't get) have had a lot of time to think through why they have to fake nearly everything about themselves and why other people act so differently from themselves. It's something that I (at least) find very interesting and would love to discuss with people if I didn't realize that it would immediately alienate the majority of people around me. However, I (and the other few psychopaths I know) am exactly the kind of person who would never admit to anything in person but would be glad to discuss it behind the anonymity of the internet and a proxy server.

Whatchasay wrote:Gio, you're attempting to explain somthing that has an explanation. The reason psychopaths can't feel guilt, or fear, or remorse is because they are essentially defective. If you ask them questions that require emotion to answer while viewing their brain in an MRI scan, the part of the brain that controls emotion does not light up. People are either born with this defect, or they can come across due to serious head trauma. Anything and everything else, including people who are "made" into psychopaths (cue dexter) thats not technically psychopathy, that would be catagorized under ASPD because it's purely a personality disorder, not biological.

Some of your theories are good, and can be very easily applied to ASPD, but psychopath is very plain and dry. Not much room for expansion.

Just somthing one of my study patients did one time that your writing reminded me of was this concept of having the abused child hidden away inside. I've seen psychopaths put on hour long shows of them "regreting" everything, etc, etc somthing to the point where you almost want to believe them, because if they're good, they're hitting every single "G-spot" as i call it, of the guilt-complex. But, none of it is true. A psychopath cannot be "Cured". Think of Bi-polar disorder, or autism. Those are both defects in the brain as well, and along with psychopathy, none of them can truely be cured.

The presense of ASPD/sociopathy (Some people even think of them as different disorders, including one of my profs) make DXing a real psychopath extreamly hard, as they will almost always claim ASPD (Because that can be cured) when backed into an unescapable corner. They go to the psych ward, endure it, pretend to get better, and in 6 months they're back out doing what ever landed them there in the first place.

Whatchasay, gio, have you heard about a treatment called TMS (transcranial magnetic stimulation). There is currently research being done by a Dutch professor, that may be able to find a treatment for psychopaths. It's stimulation of specific parts of the brain by electromagnetic current. It may be able to activate fear in the brain. It's already being applied by clinics (in USA and Canada) for treating major depression, and it might also be able to help people with schizofrenia.

They claim to be able to achieve permanent (though small) changes in the brain and/or behaviour of psychopaths using treatment with TMS.

Summary of the research:
http://www.umcutrecht.nl/subsite/Rudolf_Magnus_Institute/Staff/Staff_T_-_V/van_Ojen_RL.htm

Related articles:
http://blue.regence.com/trgmedpol/mentalHealth/mh17.html

http://igitur-archive.library.uu.nl/dissertations/2004-0106-113451/full.pdf

For Dutch readers:
http://www.volkskrant.nl/archief_gratis/article975878.ece/Magneten_voor_het_gevoel