4.1 Can serial killers be treated?

Society must protect itself from serial killers and psychopaths, and prison is of course a preferred option. The question is then whether these people shall be punished, and that’s it, or whether to attempt to rehabilitate these people using some form of psychotherapy. In this respect, the problem is that therapy requires a form of empathy from the analyst, and it is not always easy to establish empathy face to face with a cold-blooded killer.

4.1.1 Summary – Treating serial killers

The second part has been aimed at examining the possibilities for successful treatment of serial killers. This part was introduced by the actual legal consequences there are for serial killers, to highlight how serial killers are handled. In Norway and Denmark, “forvaring” can be given, in which the time in prison can last from 12 years to lifetime in Denmark and Norway, and that it seems likely to be lifetime or death penalty in the US. Treatment does not appear to be especially significant in any of these circumstances.

The absence of any considerations of whether serial killers ought to be treated was influencing the following discussions. These were reflections concerning serial killers ability to freely choose their actions and whether they are to be termed evil or ill. These reflections were aimed at illuminate the adequacy of the legal responsibility that serial killers hold. The conclusion of this was, that it seems like serial killers are in a position to appropriately be designated as having a rather severe form for mental disorder, which does suggest that they rather ought to be characterized as “mad” instead of “bad”. This due to the fact that their behavior seem to characterize as a mental disorder (psychopathy or antisocial PD), which also seem to deviate to a large degree, from what is to be considered normality. Due to this, they seem to have some restraints attached to their ability to freely choose their behavior, in that it is anchored in their psychopathologic nature. This does seem to indicate that the legal responsibility of serial killers should be reconsidered and possibly be down-graded.

However, as it can not be denied that serial killers need to be prevented from continue their actions, the alternative to prison was evaluated. By looking at the challenges and potential pitfalls with treatment, the discussion continued in the direction of a suggestion to how treatment, in the terms of self psychology, could take form. Empathy and the use of this in the selfobject transferences in the therapeutic setting, is the key element. This is suggested as an aspect that indicates that self psychology is a favorable theory in treatment of serial killers. This is due to the hypothesis that empathic selfobjects is what has been lacking in the life of individuals with narcissistic injuries, and such that letting this be played out in a therapeutic setting, will strengthen and make fragments in self develop into a more coherent self. Again, to be able to do this, it is crucial that serial killers are truly understood. Elsewhere, relating to them in a constructive way will be threatened. The difficulties with being empathic and other countertransferences are hypothesized as being the main reasons why prognoses for treating criminal psychopaths in general, are rather poor, and it is hypothesized in this, that using empathy, like that of Kohut, both to understand and treat serial killers, is likely to give results in a positive direction.

4.1.2 Future directions in treatment of serial killers

As mental illnesses can be understood as exaggerated forms of phenomenon in the psychic life (Jaspers, 1997, p. 577), it is to be highlighted that the understanding and the suggestion of a treatment aspects is not necessarily restricted to serial killers, but also to other patients that might not have the same degree of “exaggeration” in their psychic life. This way, the therapeutic suggestions might also work very well, with patients with less degree of narcissistic and antisocial conditions.

However, it is to be stated that, as has earlier been mentioned, taking other therapeutic strategies in addition to self psychology, within an integrative strategy, might be valuable. This is, as there might be some incomplete aspects with the traditional self psychological theory, as other theories can fill in. It is possible that the newer self psychological theories that have integrated other perspectives, and are withholding the traditional focus on empathy and selfobject transferences in therapy, will be relevant strategies in therapy. But, it is also a suggestion that other theoretical perspectives might benefit from integrating aspects from self psychology, especially the sustaining of empathy. And such it is suggested that therapists will have the ability to treat serial killers without a pure self psychological entrance angle.

Whether or not therapists in the field of criminal psychopaths, or potentially serial killers, are capable of using the suggested strategies remains to be seen.