Noen psykopater kan bli bedre: Schema Therapy

Noen psykopater kan bli bedre mener David Bernstein, UM professor av Forensic Psychotherapy

http://www.efp.nl/sites/default/files/webmasters/pres_sessie_6_david_bernstein.pdf

http://schematherapymidwest.com/node/)
Pasted from an article from webpage (i will recapitate it later- just need in case
http://webmagazine.maastrichtuniversity.nl/index.php/research/mind/item/355-some-psychopaths-can-be-treated

“SOME PSYCHOPATHS CAN BE TREATED”

Although the claims are preliminary, the first results of his research on patients involuntarily committed for psychiatric treatment (TBS patients) are promising. David Bernstein, professor of Forensic Psychotherapy, may have found a treatment for even the worst cases of psychopathy: schema therapy. “The social benefits could be enormous”, he says.

New research by David Bernstein, who was recently appointed UM professor of Forensic Psychotherapy, challenges this theory. Bernstein is currently leading a large-scale study of over 100 TBS patients in seven TBS clinics. The preliminary results are promising. In their first group of patients, the team observed a faster decrease in the risk of recidivism. Crucially, this risk decreased the fastest in the group considered the most psychopathic – the very group often deemed untreatable. Bernstein stresses caution in interpreting the results, as they are not statistically significant and no fixed pattern has yet been established. “But if these results are confirmed for the entire research population, we will have found the first effective treatment for psychopaths.” This would be a real breakthrough for the field of psychopathy.

Vulnerable state

The treatment is called schema therapy, an integrated form of psychotherapy specially designed to treat personality disorders and ‘treatment-resistant’ patients. What makes this method unique is that it focuses not on unchangeable character traits, but on the patient’s emotional state. It uses a package of special treatment techniques, ‘limited reparenting’ being the most important of these. In establishing a relationship with the patient, the therapist assumes a parenting role. “Psychopaths are often antisocial and emotionally detached. They don’t trust anyone and refuse to cooperate”, Bernstein explains. “To gain their trust, the therapist adopts a caring and compassionate role.” The goal is to break through this emotional detachment and draw patients into a more vulnerable position, making them ‘softer’.

The next step is to teach patients how to discuss their emotions. This is done using the language of ‘schema modes’. A schema mode is an emotional state (intimidating, aggressive, manipulative) that can take over a patient temporarily and play an important role in violent behaviour. “Our hypothesis is that behind these extreme emotional schemas lies a more vulnerable side. That’s the key to accessing strong emotions. Many patients were abused or mistreated as children. The goal is to help heal these earlier wounds.” Further, the patient’s capacity for self-reflection is increased, and they learn to better control their frustrations and impulsive behaviours. “In short, schema therapy strives to transform a patient’s personality by changing their schema modes.”

David Bernstein (55) is professor of Forensic Psychotherapy, an endowed chair sponsored by Maastricht University and the forensic psychiatric centre De Rooyse Wissel. He received his PhD in Clinical Psychology from New York University in 1990 and moved to Maastricht University in 2004. He serves as chair of the Forensic Psychology Section in the Department of Clinical Psychological Science. His main research areas are personality disorders, psychological trauma and forensic issues. Bernstein is an internationally renowned expert in the field of schema therapy, an integrated therapy for personality disorders.