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Please don’t control your temper

Cognitive behavioural approaches to psychopathy


12 / 1994

The aims of this paper are to :

1- Promote the use of the cognitive-behavioural approach in the treatment of anger problems. The cognitive-behavioural model is used by clinical psychologists and emphasises the importance of investigating how a patient behaves in certain situations and what they are thinking about at that time.

2- Show that the patient presented in this paper was treatable despite being diagnosed as "psychopathic".

3- Show that the best way to treat the patients anger problem was to encourage him to be more angry and to express this anger regularly rather than to hold his anger inside until it became unmanageable and his anger exploded.

4- Show that the patient was anxious about becoming angry and thus avoided anger provoking situations but that this was not a good method to use and that he should be desensitised to these situations.

5- Show that when working whit Deaf clients a more visual treatment method must be used, including drawings, videos and role plays.

6- Propose that complicated cases such as this would best be treated by a Deaf Clinical Psychologist but that since this does no exist in England at the moment a hearing Clinical Psychologist should supervise a Deaf Counsellor in the work so that the patient has access to the best qualified person and the most linguistically/culturally appropriate professionals.

The writer’s point of view is this one :

1- This treatment method was successful.

2- The use of the diagnostic label "psychopath" should be used with great caution with Deaf people as the person may have a learnt behaviour problem which is treatable rather than a personality disorder which is not. It is vital to have a thorough knowledge of the patient’s history which may be difficult if the patient has limited language or the interviewer has limited signing skills.

3- The choice to use two therapists, one hearing and qualified, one Deaf and less qualified was successful and is recommended.

- Although this treatment required the commitment of four hours of professional time every week for twelve months this was more cost efficient than holding some in prison or special hospital.

Key words

psychological assistance, psychology, citizen responsibility, social exclusion, right to difference, minority group, communication, basic needs, apprenticeship, right to health, ethics, legislation, social insertion, mental health, bilingualism

, Europe, United Kingdom, London


This paper shows in details how a cognitive-behavioural therapy is going on in the mental health and deafness frame. Some considerations about the term of "psychopathy" are developed.


GESTES Groupe d’Etude Spécialisé "Thérapies et Surdités"a organisé à Paris en décembre 1994 le troisième congrès international de l’ESMHD European Society for Mental Health and Deafness. Une publication des actes suivra ultérieurement.

Fiche rédigée d’après l’intervention de Sally AUSTEN, Clinical Psychologist, et de Herbert KLEIN, Deaf Counsellor, Pathfinder Mental Health NHS Trust National Deaf Services, Old Church 146A Bedford Hill, London SW12 9HW, UNITED KINGDOM; Tel: 0181 675 2100, Minicom : 0181 675 2200, Fax: 0181 675 2266, Videophone: 0181 675 9707


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GESTES (Groupe d’Etudes Spécialisé Thérapies et Surdité) - 8 rue Michel Peter, 75013 Paris, FRANCE. Tel/Fax 00(331)43 31 25 00 - France - gestes (@)

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