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Attachment and psychopathy in forensic patients

Anne Van den Berg (De Rooyse Wissel, Forensic Psychiatric Hospital, Venray, The Netherlands)
Karel Oei (Institute of Criminal Law and Victimology, Department of Forensic Psychiatry, Tilburg University, The Netherlands)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 3 November 2009

470

Abstract

Effective treatment of patients with severe psychopathy is very difficult to achieve. This conclusion may be drawn from an extensive examination into the usage of the term ‘psychopathy’ in scientific research literature, in theoretical development from various psychological schools of thought, in the practice of therapy and in assessment. The central issue for the authors of this article is the inability of severely psychopathic patients to commit to the patient‐therapist relationship. Attachment theory and mentalisation‐based treatment are used here to define the cause and nature of this inability, which is incurred in very early childhood. These two models can aid in the development of more dynamic definitions of psychopathy, better suited to dynamic therapy formats.The ways in which psychopathy is defined partly account for a number of problems encountered in the practice of therapy. The authors assume that the treatment of psychopathy should be interactional and should match patients' individual levels of psychological development and mentalisation; highly psychopathic patients often perceive others as objects, ie. as part of the context, not as subjects, ie. autonomous personalities.The authors propose to conduct further research in order to verify the validity of their hypothesis. They also put forward a number of suggestions for therapy formats with a view to establishing effective working relationships with psychopathic patients.

Keywords

Citation

Van den Berg, A. and Oei, K. (2009), "Attachment and psychopathy in forensic patients", Mental Health Review Journal, Vol. 14 No. 3, pp. 40-51. https://doi.org/10.1108/13619322200900020

Publisher

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Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

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