What treatment for psychopaths?

Medical validation:
October 21, 2022

Can psychopaths be cured? The answer is yes, but it is extremely difficult. Because these are the first to evade treatment. The management therefore involves very targeted therapies over the long term. As for prevention, the problem is to detect the signs of disorders in childhood and adolescence. Overview.

Preventing and treating psychopathies is now possible, provided that we give ourselves the means to do so.

Difficult prevention

Difficult to prevent psychopathies. First, because we know very little about the origin of this disorder. The rare studies seem to emphasize a strong genetic component, influenced by experience and the environment. But it must be emphasized that the psychopathy reveals itself in adulthood, and that it is often difficult to identify it in childhood (Read our article Where do psychopaths come from? ). Nevertheless, the June 2006 report of the High Authority for Health on the subject recommends screening children for problems known to be associated with psychopathy in adulthood. We speak in particular of the famous conduct disorders (admittedly very controversial) or attention deficit hyperactivity disorder for instance. But a possible recognition of the problems would require training of the supervising staff and effective care of the children. But today, child psychiatry consultations require months of waiting…

Screening not possible

If it is therefore difficult at present to set up prevention and early detection, what solution is offered to the adults concerned? In theory, there is a possible and effective treatment. The problem with psychopathies is that we cannot consider a classic therapeutic approach. Indeed, the people concerned generally do not respect the rules, so they do not follow their treatment or the recommendations of doctors. It requires what specialists call “containing” care, that is to say a very supervised procedure, with a coordinated approach from all stakeholders and above all continuity over time.


It seems that in the case of psychopathic disorders, the choice of psychotherapies is quite limited. Indeed, psychoanalysis does not appear to be effective in reducing symptoms. But it can be useful to the psychopath to understand his life course and his disorder. According to the experts audited by the High Authority for Health on the subject in June 2006, the approaches that can bring benefits in terms of symptom reduction are behavioral and cognitive therapies and psychodynamic therapies. As far as medications go, there are no specific drug treatments for psychopathy. On the other hand, treatments can be offered to calm people’s suffering. In all cases, this care therefore requires resources and significant investment from health, social and judicial professionals. At a time when the mental health plan is slipping, one wonders if this support will not remain a wishful thinking.

Spontaneous recovery?

It is necessary to underline a particularity of psychopathy: these psychopathic personalities disappear from statistics and consultations after quarantine. For specialists, this phenomenon can have several explanations. First, unfortunately, we must not overlook the high death rate, whether it be suicide, risk-taking that will cause accidents, etc.

Not to mention the possible incarcerations for crimes or misdemeanors, without the detainees being identified as psychopaths, or even sometimes of the commitment under the flags (the famous foreign legion…) which would make it possible to structure themselves! But psychiatrists believe that apart from these events, there may indeed be an “integrative turn” between 30 and 40 years. It is in fact a question of an abandonment of the character traits of opposition, and of the other traits marking psychopathy.

But of course, this disappearance does not mean that they should not be taken care of beforehand.

What treatment for psychopaths?