Dr. Kasia Uzieblo is an Associate Professor of Criminological and Forensic Psychology at the Department of Criminology of the Free University of Brussels (Vrije Universiteit Brussel) in Brussels, Belgium, and Senior Researcher at the Research Department of the Forensic Care Specialists (Utrecht, the Netherlands). Her teaching, trainings, and research focus on sexual/family violence and forensic (psychological) assessment (e.g., risk assessment). Her psychopathy research primarily focuses on the use and the psychometric properties of psychopathy measures, and on the impact of psychopathy on interpersonal relationships. She has also published the Dutch book “Psychopaths, who are they? Misconceptions and fallacies about psychopathy.” She is also the Secretary of the Society for the Scientific Study of Psychopathy (until May, 2024). For access to her publications, please visit her Researchgate profile.
During this interview, she discusses, among other things:
- The challenges of identifying psychopathic traits in people from the general population;
- Her clinical insights into and scientific findings on the manifestation of psychopathy within partner relationships;
- The challenges for intimate partners and for therapists when faced with someone with psychopathic traits.
- How did you get involved in psychopathy research?
I stumbled into this research field by chance. In the final year of my master’s studies in Clinical Psychology, I had the opportunity to develop a doctoral research project. My then supervisor, Bruno Verschuere, pitched psychopathy as a potential research topic. I had long been fascinated by questions like what makes certain individuals capable of gruesome, violent behaviors, and why do some people exhibit less empathy than others? Unfortunately, the master’s program barely touched upon the underlying mechanisms of violent behavior. A doctoral project on psychopathy seemed like a unique opportunity to delve into such a topic, and I eagerly seized the chance.
The more I immersed myself in the subject of psychopathy, the more captivated I became by this personality construct, and the more I wanted to learn about it. It continues to fascinate me, as I’ve been conducting research on psychopathy for almost 20 years now. However, my focus has shifted somewhat over the years. Initially, my research centered on emotional processing in individuals with higher levels of psychopathic traits. However, as time passed, I have started concentrating on the measurement of psychopathy and on the impact that psychopathic individuals have on their interpersonal relationships (such as on their intimate partners).
- If you were going to measure psychopathic traits in a community sample, how would you do this?
That’s a question that occupies us in the preparations for every study within the general population. We consistently opt for self-report instruments, primarily for pragmatic reasons (such as no access to collateral information).
Initially, I mainly worked with the Psychopathy Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005) and the Levenson Self-Report Psychopathy Scale (LSRP; Levenson et al., 1995). However, over time, we transitioned to the Self-Report Psychopathy Scale (SRP 4; Paulhus et al., 2017) because we wanted to measure the psychopathy construct as conceptualized in the Psychopathy Checklist-Revised (PCL-R; Hare, 2003). Each instrument starts from its own conceptualization of psychopathy, and, as a researcher and clinician, it’s crucial to carefully consider which conceptualization you want to see translated into the instrument.
I also assess clients/patients in various settings, including the forensic psychiatric center, the Van der Hoeven clinic (Utrecht, Netherlands), where I am employed. There, we exclusively use the PCL-R (the Psychopathy Checklist-Revised), but, for inquiries from outpatient centers, we often must resort to self-report instruments because administering the PCL-R is practically unfeasible. In such cases, our choice is limited to the PPI-R, as, for now, it is the only instrument with Dutch norms. However, we are in the process of developing Belgian/Dutch norms for the SRP 4, and, hopefully, we can offer this manual to our colleague clinicians soon.
Self-report instruments for measuring psychopathy perform quite well in validation research. However, in practice, you grapple with limitations of these instruments, such as response bias, especially when using them with offenders or forensic clients. These individuals typically have little self-insight, their self-awareness is heavily biased, and/or they may attempt to manipulate their responses on the questionnaire.
We have not yet found a good solution for these issues in practice, which is why we are very reluctant to make important decisions based on the results of a self-report instrument alone.
- How do individuals with psychopathic traits function within intimate relationships?
Generally, not very well. From practice, we have learned that these individuals engage in relationships, and sometimes even long-term ones. However, we often observe that these individuals cause a considerable amount of harm within these relationships. Our research supports this finding.
In our studies, we primarily focus on the impact of psychopathic traits in the male partner on his female partner. We find that psychopathy in the male partner is related to reduced psychosocial and sexual well-being in the woman, decreased relationship quality, and an increased level of conflicts within the relationship. However, we notice that the impact of these psychopathic traits in the male partner is not the same in every relationship. In one of our recent articles, for example, we see that, when partners manage to resolve conflicts in a non-violent manner, this negative impact is less pronounced. Hence, the impact involves a complex dynamic between personality traits and interpersonal behaviors of both partners.
More research is certainly needed to better understand this dynamic. Many questions remain unanswered, such as: what if the female partner has psychopathic traits: Do we observe similar dynamics? Or do psychopathic traits manifest themselves in a (somewhat) different way? Furthermore, reality is often complex. Rarely are there only psychopathic traits at play; these traits are often accompanied by other problematic personality traits such as borderline traits. In research, we generally focus only on psychopathy, but, if we do that, we isolate this construct in a somewhat artificial manner.
Working with forensic clients has also provided me with many insights into interpersonal dynamics. Some of our clients, for instance, can fall head over heels in love with a woman; this infatuation dominates their entire world at that moment. However, this love often turns out to be superficial and relatively short-lived, leading to neglectful behavior, violent behavior, deception, and/or ending the relationship. The realization that they are ‘different’ in this aspect seems to frustrate some clients with psychopathy. One patient, for example, expressed that he understands he is different from others and that he will never be able to experience real depth in his relationships, leading to moments of loneliness.
In clinical work, we are also confronted with the other side, that of the intimate partner. We witness the psychological and sometimes physical suffering, concerns about the impact of the partner with psychopathy on the children, and often a long-lasting but often futile hope that they will one day be able to change their partner’s personality. Various men also share similar stories about their partners whom they suspect of having psychopathic traits. However, they seem to encounter more barriers (including disbelief from the environment) to sharing their stories publicly.
- What is the likelihood that an individual with psychopathic traits will respond to couples therapy?
It’s hard to say. To my knowledge, there hasn’t been any research conducted on the effectiveness of couples therapy, specifically in altering the interpersonal behavior of individuals with a higher degree of psychopathy. In clinical practice, colleagues do encounter such profiles occasionally within couples therapy. Generally, they observe that these individuals are not necessarily motivated themselves to work on their relationship but rather feel pressured to participate, influencing the course of such therapy. Others may use therapy as a platform to assert themselves or to talk about themselves.
From a clinical standpoint, I am currently not very optimistic about the effectiveness of such therapy, especially when one does not work concurrently intensively with the individual in question on an individual basis. Research teaches us that such a combination of individual and systemic treatment has some positive effects on youth with psychopathic traits. We also see increasing evidence that certain individual therapies (e.g., cognitive-behavioural therapy) that follow the Risk-Need-Responsivity principles manage to decrease the risk of violent recidivism in individuals with high levels of psychopathic traits who have committed (primarily sexual) offences. But the question remains whether individual therapy and other approaches including the (family/relational) context can lead to comparable effects in adults with high levels of psychopathy, including in non-forensic clients.
As a scientist, I see it as an exciting avenue to explore. However, as a clinician, I often observe a problem emerging; there is a lack of knowledge about psychopathy among clinicians providing couples therapy. Consequently, therapists may not always perceive how these personality traits manifest in relational dynamics and the potential impact they can have on the therapeutic relationship and the therapy itself. This increases the likelihood that the therapist will be manipulated, deceived, and lied to. Therapists frequently approach me after, for example, a lecture, to share their stories. Many indicate that it’s only after the lecture that they realize some of their clients exhibited striking similarities to a psychopathic personality profile and that they now understand how these clients managed to manipulate them.
- Considering research is generally ahead of application in the field, what is one improvement in the field of psychopathy that you hope to see take place over the next five to ten years?
Within this specific framework, I believe it’s crucial for the clinical fields that deal with the individual (individual therapy) and those that approach the system (such as intimate relationships) to come closer together.
Research clearly demonstrates that we shouldn’t view the person or personality in isolation from the relational context, and likewise, we shouldn’t detach the relational context from the individuals within it. However, it’s still quite common to treat both fields as separate areas of expertise that can exist independently. There are separate conferences, training sessions, journals, and more. Personally, I find this approach highly regrettable because there’s so much we can learn from each other.
Even within the forensic field, I often observe a strong focus on either the relational context or the individual who engaged in criminal behavior. Yet, these two aspects are almost inseparable if we want to better understand the development of problematic behavior, adequately assess the risk of recurrence, and engage in effective risk management.
However, I’m not just advocating for such a synergy in clinical work; we also need to bring together these various fields of expertise more frequently in scientific research. From experience, I know that research with a focus on both personality traits and relational behavior can be complex and highly challenging. Still, in my opinion, only by tackling such challenges can we gain a better understanding of the dynamics that unfold in everyday life.
- What would you want victims or survivors to know about your research?
It is important to reassure them that what they feel and experience is normal and not imagined. While research on psychopathy within partner relationships is relatively new, existing studies reach similar findings. They demonstrate that psychopathy is present in the general population and that the manifestation of these personality traits has diverse detrimental effects on relationships, well-being, sexuality, and more. In this sense, our research and that of colleagues acknowledges their experiences and suffering – an essential validation, especially considering their often-well-founded fear of not being believed or recognized in their distress.
Moreover, our research indicates that how both partners interact can somewhat mitigate the impact of psychopathic traits. However, it’s crucial to emphasize that these research findings do not imply that victims should stay longer with their abusive partners out of a sense of responsibility or the belief that they can change them.
Recently, a colleague at a conference raised a pertinent question: whether our advice to (at least temporarily) leave such partners contradicts the idea that abusive partners deserve a second chance. It’s a thought-provoking question. Partners, including those with psychopathy, can indeed get a second or third chance, provided they take responsibility for working on themselves. In line with this, it’s essential for clinical settings and policies to invest more in the treatment of these individuals. In Belgium, I notice a growing awareness among professionals that change in individuals with higher levels of psychopathy is possible. However, especially in outpatient settings, they often encounter a lack of expertise, tools, and opportunities to effectively work with individuals exhibiting psychopathic personality traits. Professionals must not lose sight of the well-being and protection of potential victims and do their best to safeguard them. In my view, the prevention of violent behavior and the protection of victims do not necessarily exclude each other, but there is still a tendency to think in terms of either-or.
Furthermore, I hope that researchers focusing on psychopathy will be more attentive to the stories of victims. Victims’ insights are essential for gaining a deeper understanding of interpersonal dynamics, developing more effective interventions, and finding better ways to help those adversely impacted.
I often get the response that the results of our studies are not groundbreaking, that we already know all this. But if we already know all this, why do we still struggle with both preventing relapse into violent behavior and protecting (future) victims? We still have much work to do, both in clinical practice and in research.
