The psychotherapy of psychopathic disorder

Abstract

The Mental Health Act 1983 definition of psychopathic disorder includes the concept of ‘a persistent disorder or disability of mind’. If this is taken to mean a wide variety of further definable mental disorders, then it is a potentially useful vehicle for ensuring treatment for many distressed, difficult and dangerous people, who would otherwise fall through the net because they are not ‘mentally ill’. The psychopathological features of people with behaviour problems, as they emerge during therapy, fall into at least six broad categories which, although not mutually exclusive, have, in the author's experience, a useful bearing on ‘treatability’ and prognosis. Each of these personality types is described in turn, together with an indication of its implications for treatment.