Dealing with Psychopaths

Discusses the enneagram and Paill Spectrum as major factors in causing bad behaviour. There are genetic factors as well as environmental factors causing problem people to exist.

 

Kinkajou : Dealing with Psychopaths
Erasmus : Firstly, we are going to talk about the description of a psychopath (or a sociopath), and then we going to talk about how these people come about.
The term psychopath is not an official mental health diagnosis. It is just a commonly used term to describe extreme behaviour. But what sort of extreme behaviour is typified by a psychopath? Psychopaths don’t come with a label attached. They can be charming and persuasive.

 

 

Kinkajou : So, give us some definitions.

Dr Xxxxx : The term psychopath has a commonly accepted usage to describe someone who is callous, unemotional and morally depraved.

Psychopaths are generally described as having an extreme lack of empathy., being manipulative and exploitative, (egocentric) and/or behaving in an impulsive and risky manner, having a lack of remorse for their actions, and often having criminal tendencies. They may lack conscience or guilt and refuse to accept responsibility for their actions. Strangely though – people may also describe them as charming, (at least superficially).

Criminal

 

Other Common symptoms of psychopathic behaviours include:
Puffed-Up Self-Esteem, Deceitfulness and Shallow Emotions.
The more official medical term for unusual and problematic behaviour is “sociopath”.

However often the term psychopath and sociopath are used synonymously and interchangeably by many people. Sociopath is the common usage term for the medical diagnosis: Antisocial Personality Disorder, (APD).

Kinkajou : So if you’re going to accept the existence of psychopaths and sociopaths, how do you tell the difference?
Erasmus : Since there is  was no accepted medical definition of the two terms, I will talk about the common usage accepted definition of the two terms- psychopath and sociopath.
The general difference is simply one of degree. Both may exhibit the same types of behaviour. Psychopaths are worse than sociopaths.

It’s possible to exhibit psychopathic traits without being an actual psychopath. People with psychopathic traits don’t necessarily engage in psychopathic behaviour. Only individuals with psychopathic traits who also exhibit antisocial behaviour are considered to be psychopaths.

One study found that about 29% of the general population exhibit one or more psychopathic traits, but only 0.6% are likely to fit the definition of a psychopath.
The Gender distribution tends to be skewed towards males, with 3 to 5 times more likelihood of being diagnosed with ASPD than females, with 6% men and 2% women within the general population. There appears to be a strong heritable component.

Prevalence decreases with age, suggesting that patients can learn over time to change their maladaptive behaviour.

 

Dr Xxxxx : If you understand Paill, you are likely to realise where most of this behaviour has its genesis. Paill causes brain injury. But it will affect different personalities differently. So a sociopath is likely someone with specific personality traits exacerbated by specific Paill brain injuries.

Goo : So let’s get back to : What is the accepted medical definition then of antisocial personality disorder?

Antisocial personality Disorder

Dr Xxxxx : Symptoms & Criteria for Antisocial Personality Disorder

According to the DSM-5, there are four diagnostic criteria,
A. Disregard for and violation of others’ rights since age 15, as indicated by one of the seven sub features:
Failure to obey laws and norms by engaging in behaviour which results in criminal arrest, or would warrant criminal arrest
Lying, deception, and manipulation, for profit or self-amusement,
Impulsive behaviour
Irritability and aggression, manifested as frequently assaults others, or engages in fighting
Blatantly disregards safety of self and others,
A pattern of irresponsibility and
Lack of remorse for actions (American Psychiatric Association, 2013)

The other diagnostic Criterion are:
B. The person is at least age 18,
C. Conduct disorder was present by history before age 15
D. and the antisocial behaviour does not occur in the context of schizophrenia or bipolar disorder
Dr Xxxxx : Differential diagnosis

Narcissistic personality disorder
These patients are exploitative and lacking in empathy or compassion, but they tend not to be aggressive and deceitful as occurs in antisocial personality disorder.

Borderline personality disorder
Patients are similarly manipulative but do so to be nurtured rather than to get what they want (e.g., money, power)

Substance use disorder
Impulsivity and irresponsibility due to substance influence must be ruled out before diagnosing ASPD. ASPD can still be diagnosed if substance use is co-occurring.

Drug Implements : Substance Use Disorder

Conduct disorder: Conduct disorder has a similar pervasive pattern of violating social norms and laws, but conduct disorder must be present before age 15.

Dr Xxxxx : Other Conditions:
Impulse control disorder
Attention-Deficit/Hyperactivity Disorder (ADD or ADHD).

 

 

 

Erasmus : What are the Key identifying characteristics, in your opinion?
Dr Xxxxx : Stories change:
It is hard to catch them out, but if you do a new story appears. You will often have trouble believing your own memories. If you suspect you are dealing with a sociopath or a psychopath, it is a good idea to write things down in the diary. So once the story changes, it is easier for you to remember “exactly” what has been said before.
Dr Xxxxx : Loyalty to themselves.

Psychopaths and Sociopaths lack Loyalty

Dr Xxxxx : Visible gain: in terms of power/control over people, getting money from people, getting sex from people, obtaining good regard/good opinions from people.
Dr Xxxxx : Creating isolation: it is fairly obvious that if you control information flow, you can control what another person believes and thinks and that you gain power over the other person. If you are the only one that the other person can turn to, you are in the driver’s seat.
Dr Xxxxx : Telling everyone what they want to know, as they want to know it.
Dr Xxxxx :   Accomplices: Manipulators manipulate everybody. Why stop manipulating one person when you can control the actions and opinions of many.
Dr Xxxxx : Strange ideas.
Dr Xxxxx : Concrete thinking: the inability to think about other factors in the situation. They see one problem and one answer.
Dr Xxxxx : Predatory behaviour: obtaining money or sex or power from people.

 

 

Dr Axxxx : Many of these conditions relate to either personality or frontal lobe brain damage caused by Paill Spectrum.
Erasmus : Enneagram “eights” are always the biggest and the best. They want to be the top of the heap. They desire the adulation and worship of lesser people. They desire control.
Erasmus : Enneagram “ones” are perfectionists and desire to live in a perfect world where everything fits within their model of perfection. The classical example is the “one” husband who forces his wife/ family to fit into his model of perfection. Everything in its place, everything clean and everything exactly as the person wishes it to be.
Erasmus : Enneagram self- pres are people with minimal social attachment and minimal feelings of empathy to others. They care about survival in themselves. Feelings can seem quite unreal to them.
Goo : In the above personality types, it is only when the behaviour becomes extreme that it is abnormal. People can look at the above personalities and judge them to have sociopathic/psychopathic traits. But the reality is this type of behaviour is simply very normal for these personality Enneagram types.
Dr Axxxx :Paill Spectrum from the early stages causes varying levels of frontal lobe brain damage. An extreme example I heard early in my career was:
Dr Xxxxx : There was a man in a caravan park who  was becoming very annoyed at the noisy bats in the trees near him. He decided that it would be a good idea to shoot the bats to get rid of them. He then realised that if he did this, the caravan park owner would be very upset at him. So he decided that it would be good idea to shoot caravan park owner instead.

He had a good think about this but could not quite see what the problem with this was. So he rang the police to talk to them and to tell them what he was doing and to ask for some advice. They told him don’t do anything – just wait for us to come and talk to you in person. So he put the gun away and waited patiently for the police to turn up. As soon as they turned up they arrested him – as a dangerous “psychopath”.

The reality here is what you can see is frontal lobe brain damage. He cannot see the bigger picture making his choices “unreasonable”. He cannot see other options for behaviour in the circumstances he faces. This is known as concrete thinking. Most of us would probably recognise it better if we described as “narrow minded” thinking. These people also tend to be impulsive, angry, irritable and may have strange ideas. All very basic Paill Spectrum symptoms.

 

 

Erasmus : So if you’re talking about genetics as being the basis of psychopathic and sociopathic behaviour, you are actual talking about many different parts to the same equation. Personality is obviously based on genetics. See our enkcharms.com or ennegenes.com sites.
Dr Xxxxx : Paill Spectrum has significant underlying genetics as well. But what you inherit is the tendency to poor nutrition compromising your immune system and helping infection to cause damage. The most important and common factor underlying susceptibility to Paill Spectrum is simply wheat allergy. This is associated mainly with three HLA DQ genes – obviously genetic.

The official version about genetics in psychopath’s and sociopaths:
Various studies in the past have shown differing estimations of heritability, ranging from 38% to 69%. Environmental factors that correlate to the development of antisocial personality disorder include adverse childhood experiences (both physical and sexual abuse, as well as neglect) along with childhood psychopathology  such as ODD or ADHD.

The reference here to trauma is very important. Children who have undergone physical or sexual abuse are likely to come from families with Paill Spectrum susceptible genetics (hence the bad behaviour of people around them). ODD and ADHD are child symptoms of Paill Spectrum. So what you have actually said is that an adult who is a psychopath or a sociopath – with probable injuries from the Paill Spectrum organism – is also likely to have symptoms of the Paill Spectrum infection in childhood – namely ODD and ADHD.

Goo : When you say it like that, it’s disturbing how un-insightful these observations are. People with symptoms of a chronic disease early in life ,  later in life may also have symptoms of the same disease .

Dr Xxxxx : There are some other genes which may have some contribution to some of these behaviours as well.
Research has focused on establishing the exact gene contributing to ASPD, and much evidence is pointing toward the 2p12 region of chromosome 2 and variation within AVPR1A. There is also evidence of variation in the oxytocin receptor gene (OXTR) contributing to the broad ranges of behaviour elicited in antisocial personality .

Dr Axxxx :Substance abuse has been found to show a significant correlation to the diagnosis of antisocial personality disorder, while education and intelligence displays a negative correlation, with a higher prevalence of ASPD amongst those with lower IQs and reading levels.

IV Substance Using

Erasmus : Now here it gets profound. People who have a drug problem (substance abuse problems) generally have poor nutrition which accelerates the Paill Spectrum infection. So it’s not surprising that the level of brain damage is increased – with symptoms. And if you have more education and intelligence – you’re less likely to show antisocial personality disorder simply because you have a head start in life. So it takes longer to reach a point where that is enough brain damage to cause symptoms.

Kinkajou : Moral of the story:
Erasmus : You can’t change your personality. All personalities have their own problems – their own path to heaven all hell. There is really no such thing as a bad personality.
Yes I would agree many of my friends are Enneagram “eights”. When you understand the personality, you can get along with them very well.
Poor nutrition causes immune dysfunction accelerating Paill Spectrum infection. Bad luck. But it is the human condition.

Kinkajou : So let’s go through some of the characteristics of a sociopath to look at how these behavioural quirks may arise. Let’s talk about some of the types of people who fall into the category of antisocial personality disorder and the likely root cause of their behaviour.

Dr Xxxxx : Self-Functioning Characteristics
Self-functioning characteristics are those that reflect what a person is like and how that person views his or her actions or goals. “ In order to be diagnosed with APD, you must exhibit all of the following characteristics:
Attaining self-esteem from power, personal gain, or pleasure
>> ? Enneagram eight

Egocentricity or self-centeredness
>> ? Enneagram self pres

Setting goals based on personal gratification with little regard to law or ethics
>> ? Paill Spectrum frontal lobe brain damage

 

Dr Xxxxx : Interpersonal Characteristics
Interpersonal characteristics are those that describe how a person interacts with others in general. You must also exhibit these traits to be diagnosed with APD:
A lack of empathy for other people's suffering or hurt or when confronted with the hurt or anger of people they have manipulated

>> ? Enneagram self pres or ? Paill Spectrum frontal lobe brain damage

 

 

The inability to have a truly mutually emotionally intimate relationship because of the instinct to control (by dominance or intimidation), coerce, or deceive
? Enneagram self pres or ? Paill Spectrum frontal lobe brain damage

Dr Xxxxx : Behavioural Characteristics
Behavioural characteristics complete the clinical diagnosis by describing the route a person will take to either control, coerce, or deceive, such as:
A strong tendency to disregard commitments, promises, and agreements, including financial ones
>> ? Poor memory (related to Paill Spectrum brain injury)

Difficulty in making plans, preferring to believe you're able to nimbly navigate problems as they appear
>> ? Poor memory (related to Paill Spectrum brain injury) and possibly some involvement in deeper brain areas related to sequence organisation.

 

 

It is not uncommon for someone with APD to be in repeated fights or assaults.
>> Typical anger and irritability arising from Paill Spectrum.

Lying as a means to gain social entry or advantage, such as proclaiming yourself a decorated war hero when you have never served.
>> ? Enneagram “three” or Enneagram “ eight”

Making decisions on the spur of the moment with little regard to consequence if an immediate goal is to be achieved.
> > typical Paill Spectrum lobe brain damage

Persistent anger or irritability, even over small things, as well as mean, spiteful behaviour
>> typical Paill Spectrum frontal lobe brain damage

Reacting with callousness, aggression, remorselessness, or even sadism when confronted by the fallout of your actions
>> (any/many of the above)

Risk taking, becoming easily bored, and an ability to ignore personal boundaries and justify even the most outrageous of actions
>> ? Paill Spectrum effects of poor memory

The emotional manipulation of others—for example, pretending to be interested in someone simply to achieve a goal
>> (any/many of the above)

 

Kinkajou :

Signs of a Psychopath

Dr Xxxxx : Psychopathic traits may emerge during childhood and grow worse with age. The following are some of the most common signs of a psychopath.

Dr Xxxxx : Superficial Charm
Psychopaths are often likable on the surface. They’re usually good conversationalists and share stories that make them look good. Psychopaths may be funny and charismatic as well.
Goo : Most people try to be nice and likeable. That is the human way.

 

Dr Xxxxx : Need for Stimulation
A psychopath loves excitement. They like to have constant action in their lives, and they frequently want to live in the "fast lane."
>> ? Paill Spectrum frontal lobe brain damage
>> ? Enneagram “Seven”

Quite often, a psychopath's need for stimulation involves breaking rules. They may enjoy the thrill of getting away with something, or they might even like the fact that they could "get caught" at any moment. Consequently, psychopaths often struggle to stay engaged in dull or repetitive tasks, and they may be intolerant of routines.
>> ? Paill Spectrum frontal lobe brain damage: typical poor memory and poor concentration, possibly with involvement of deeper areas of the brain with loss of sequencing ability and sequence memory.

Dr Xxxxx : Pathological Lying
Psychopaths tell lies to look good and get out of trouble. They also tell lies to cover up their previous lies. So, they have difficulty keeping their stories straight sometimes as they forget what they’ve said. If challenged by anyone, a psychopath will simply change their story again or rework the facts to fit the situation.
>> ? Enneagram “eight” or “three” or “two” or “six”.

Dr Xxxxx : Grandiose Sense of Self-Worth
A psychopath has an inflated view of themselves. They see themselves as important and entitled. Psychopaths often feel justified to live according to their own rules, and they think that the laws don’t apply to them.
>> ? Enneagram “eight”
Dr Xxxxx : Manipulative
Psychopaths are really good at getting other people to do what they want. They may play on a person’s guilt while lying to get someone else to do their work for them.
>> ? Enneagram “two” or “three” or “nine”.

Dr Xxxxx : Lack of Remorse
A psychopath doesn’t care how their behaviour affects other people. They may forget about something that hurts someone, or they may insist that others are overreacting when their feelings are hurt. Ultimately, psychopaths don’t experience guilt for causing people pain. In fact, they often rationalize their behaviour and blame other people.

>> ? Paill Spectrum frontal lobe brain damage: typical poor memory and poor concentration

Dr Xxxxx : Shallow Affect
Psychopaths don’t show many emotions—at least not genuine ones. They may appear cold and unemotional much of the time. But when it serves them well, a psychopath might exhibit a dramatic display of feelings. These are usually short-lived and quite shallow.
For example, a psychopath may show anger if they can intimidate someone, or they might show sadness to manipulate someone. But they don’t really experience these emotions.
>> Very typical of ? Enneagram self pres

Dr Xxxxx : Lack of Empathy
Psychopaths struggle to understand how someone else might feel afraid, sad, or anxious. It just doesn’t make sense to them as they’re not able to read people. A psychopath is completely indifferent to people who are suffering—even when it’s a close friend or family member.
>> Very typical of ? Enneagram self pres

Dr Xxxxx : Parasitic Lifestyle
Psychopaths may have sob stories about why they can’t earn money, or they might often report being victimized by others. Then they take advantage of the kindness of others by depending on them financially. A psychopath uses people to get whatever they can with no regard for how the other person may feel.
>> ? Enneagram “Seven”

Poor Behavioural Controls
Psychopaths struggle to follow rules, laws, and policies much of the time. Even if they set out to follow the rules, a psychopath usually doesn’t stick to them for long.
>> Very typical Paill Spectrum frontal lobe brain damage

Promiscuous Sexual Behaviour
Since they don’t care about the people around them, a psychopath is likely to cheat on their partners. They may engage in unprotected sex with strangers, or they may use sex as a way to get what they want. Sex is not an emotional or loving act for a psychopath.
>> Very typical Paill Spectrum frontal lobe bone damage.

Dr Xxxxx : Early Behavioural Problems
Most psychopaths exhibit behavioural problems at an early age. They may cheat, skip school, vandalize property, misuse substances, or become violent. A psychopath's misbehaviours tend to escalate over time and are more serious than their peer’s misbehaviours.
>> Very typical behavioural disorders especially in children, due to Paill spectrum brain damage.

Dr Xxxxx : Lack of Realistic, Long-Term Goals
A psychopath’s goal might be to become rich or famous. But quite often, they have little idea about how to make these things happen. Instead, they insist that somehow, they’ll get what they want without putting in the effort to get there.
Goo : I’ll bet this is just simply evidence of brain damage and concrete thinking due to frontal lobe brain damage from Paill spectrum.
Kinkajou : Adolf Hitler was like this. He wanted to be an artist but did not do the work to make the achievement. He missed out on being enrolled at the Art Academy.

Dr Xxxxx : Impulsivity
Psychopaths respond to things according to the way they feel. They don’t spend time thinking about the potential risks and benefits of their choices. Instead, a psychopath wants immediate gratification. So, they may quit a job, end a relationship, move to a new city, or buy a new car on a whim.
Goo : I’ll bet this is just simply evidence of brain damage and costly thinking due to frontal lobe brain damage from Paill spectrum.

Dr Xxxxx : Irresponsibility
Promises don’t mean anything to a psychopath. Whether they promise to repay a loan or sign a contract, they aren’t trustworthy. They may shrug off child support payments, get deeply in debt, or forget about obligations and commitments.
A psychopath doesn’t accept responsibility for the problems in their lives. They see their issues as always being someone else’s fault. Psychopaths frequently play the role of the victim and enjoy sharing stories about how others have taken advantage of them.
Goo : I’ll bet this is just simply evidence of brain damage and concrete thinking due to frontal lobe brain damage from Paill spectrum. They just don’t understand the consequences of their actions.

 

Dr Xxxxx : Many Marital Relationships
Psychopaths may get married because it serves them well. For example, they may want to spend a partner’s income or share their debt with someone else. But their behaviour often leads to frequent divorces as a psychopath's partner will eventually see them in a more accurate light.

Homelessness common
in end stage antisocial personalities: Paill

Goo : I’ll bet this is just simply evidence of brain damage and costly thinking due to frontal lobe brain damage from Paill spectrum.

Dr Xxxxx : Criminal Versatility

Psychopaths tend to view rules as suggestions—and they usually see laws as restrictions that hold them back. Their criminal behaviours can be quite varied. Driving infractions, financial violations, and acts of violence are just a few examples of the array of crimes a psychopath might commit.
Of course, not all psychopaths become incarcerated. Some may operate under shady businesses or engage in unethical practices that don’t lead to an arrest.

Getting Raided

Goo : I’ll bet this is just simply evidence of brain damage and costly thinking due to frontal lobe brain damage from Paill spectrum.

Dr Xxxxx : Revocation of Conditional Release
Most psychopaths don’t adhere to the rules of conditional release when they are released from prison. They may think they won’t get caught again, or they find ways to excuse their behaviour. A psychopath might even blame "getting caught" on other people.
Goo : I’ll bet this is just simply evidence of brain damage and costly thinking due to frontal lobe brain damage from Paill spectrum.

 

 

Kinkajou : But hang on. How do you explain the psychopath who just picks up a gun and starts shooting people. I think it quite likely that none of the descriptions above may apply to many of these people.
Erasmus : Quite true. I think these people are best explained by Paill Spectrum. One of the common features of Paill Spectrum is the short-circuiting of memory strands. Intense inappropriate ideas and beliefs develop. For example, “I am fat” when you weigh 35 kg. For example, “I do not belong in this man’s/woman’s body”.
Dr Xxxxx : But weird and intense ideas belong in the schizophrenia family.
When you have a lot of weird intense ideas and your cognition structure and memory structure is significantly damaged, you can call this condition schizophrenia. If the damage only affects a single or two memory strands, these people do not have schizophrenia. They cannot be diagnosed as having schizophrenia. They do not meet the diagnostic definition of schizophrenia. Yet they have exactly the same issue schizophrenics do. They hold intense and inappropriate ideas and beliefs.

 

Kinkajou : Weren’t you telling me about one of your patients who shacked up with a young schizophrenic girl?
Dr Xxxxx : Yes the man in question was about 70 years old and he had set up co-habitation with a young 16-year-old girl who had a drug problem and schizophrenia. The arrangement gave her food and protection and stopped other people taking advantage of her. For the older man, the carrot was the sex arising from the relationship.

Unfortunately, every so often, perhaps while he was watching TV, thoughts would enter the young girl’s head. The thoughts would say “kill”. He would suddenly find himself in the space of several seconds, fighting for his life.

I told him, “You must be crazy to keep this sort of relationship going. A few seconds of inattention and you could end up with a knife in you. You could end up dead. Is the sex really worth it?” I won’t tell you the reply – but I will tell you that it is a “man” replying.

This young girl is developing an intense inappropriate idea or belief in the context of her schizophrenia. But you do not need to develop schizophrenia to develop such beliefs. So consequently, any psychopaths who take up a shooting spree are likely motivated by an intense and appropriate belief – but are not schizophrenic.
Erasmus : Paill Spectrum does this very readily.
Dr Axxxx : And as we have stated before, the cure is good nutrition and education. A friend of mine working in the prison system in New South Wales (Australia) has described their latest program for the prisoners. It is the provision of nonviolent “family” movies and content to prisoners through a notepad within the prison. They can watch whatever they want – but the only choices are pleasant movies which do not teach violence, do not teach aberrant behaviour, which do teach “normal and pleasant human interaction”. And this is exactly what you need to do to repair Paill Spectrum brain damage.

Dr Xxxxx : Classical symptoms Paill Spectrum include sweaty hands. Unfortunately, it is a very common symptom. People with minor damage affects can have significant sweating as can people with major damage affects. So, it is not very quantitatively correlatable with degree of impairment.

I would imagine it would be very easy to do a memory test which reflects quantitative impairment. We do it with children and dyslexia easily enough.

Dr Axxxx : True you need to remember – in Paill Spectrum the damage can vary in quantity but also in the regions of the brain that are affected. And damage can change over time, especially in response to nutritional changes. Someone who is an affected child, can make a good progressive recovery in cognition over time but still bear the scars of dyslexia. So, assessments could well be complex as well.

Dr Xxxxx : Complications
Many individuals diagnosed with antisocial personality disorder remain a burden to their families, co-workers, and closely associated peers, such as neighbours, despite becoming less troublesome with age.

Most of those who improve with age, still cannot re-claim their lost prospects:  in areas such as education, domestication, and employment.
Those patients who did show remission were more likely to have better social supports with spousal or family ties existing.

Help required : But How?

 

 

Kinkajou : Is There a Psychopath Test?
Dr Xxxxx : While there may be plenty of free "psychopath tests" floating around on the internet, two that are used most often are the Psychopathy Checklist-Revised (PCL-R) and the Psychopathic Personality Inventory (PPL).

Psychopathy Checklist-Revised (PCL-R): The PCL-R is a 20-item inventory that assesses whether an individual exhibits certain traits and behaviours that could indicate psychopathy. It’s intended to be completed with a semi-structured interview and a review of available records, such as police reports or medical information. This psychopath test is often used to predict the likelihood that a criminal may re-offend, as well as their capacity for rehabilitation.

Psychopathic Personality Inventory (PPL): This test is used to assess psychopathic traits in non-criminal populations. It may still be used with incarcerated individuals, but is more often applied to other populations, such as university students.

Substance use often ends in Death

 

 

 

Treatment

Dr Xxxxx : Personality cannot be cured.
APD has no cure or first-line recommended treatment. Instead, therapeutic strategies often focus on problematic behaviour, coping skills, and co-morbidities such as substance use disorders.

Typical approaches include:
Talk therapy (individual and group)
Cognitive behavioural therapy (CBT)
Mentalization-based therapy (MBT)
Democratic therapeutic community (DTC)5
Impulsive lifestyle counseling6
Medications (antidepressants, antipsychotics, mood stabilizers)

 

Dr Xxxxx : Paill Spectrum is very amenable to medical therapy including nutritional therapy and antibiotics.