Given its goal of forming a genuine emotional connection with the patient, and altering the patient’s core personality traits, ST represents a departure from other cognitive-behavioral treatments for psychopathy that assume that changing psychopathic personality features is impossible due to these patients’ serious emotional deficits (Wong & Hare, 2005).
Bernstein, Arntz, & de Vos (2007) adapted ST for forensic patients with serious personality disorder pathology. They theorized that patients with psychopathy/antisocial personality disorders make prominent use of five overcompensating schema modes that involve maladaptive coping styles:
- Attempts to con and manipulate (“conning and manipulative mode”),
- Self-aggrandizement and devaluation of others (“self-aggrandizer mode”),
- Attempts to bully and intimidate (“bully and attack mode”),
- Focusing of attention to detect a hidden threat or enemy (“paranoid over-controller mode”), and
- Cold, calculated aggression aimed at eliminating a threat or rival (“predator mode”).