Many psychoanalytic clinicians and researchers experienced in working with severe personality disorders have concluded that patients with a diagnosis of antisocial personality disorder are not treatable with psychodynamic psychotherapy (Gabbard 2005; Kernberg 1984; Kernberg et al. 2008). This pessimism is based on the seeming impossibility of engaging with patients whose pervasive deception and emotional detachment forecloses any possibility of entering into a viable therapeutic relationship, while the focus of therapy is constantly being diverted from exploration of the patient's mind into managing his risky antisocial behaviors. Although there is a lack of systematic controlled empirical evidence to indicate that psychodynamic treatments are effective in these individuals, recent research into the psychopathic patient's abnormal cognitive deficits and emotional responses (Patrick 2006) and awareness that antisocial personality disorder is a disorder of attachment (Meloy 2002) are stimulating a renewed interest in psychodynamic approaches
