Psychopathy and the Medical Profession

IMG_9598Psychopathy is present in all professions. In The Wisdom of Psychopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success, Kevin Dutton provides a side-by-side list of professions with the highest (CEO tops the list) and lowest (care-aid) percentage of psychopaths.   Interestingly surgeons come in at #5 among the professions with the highest percentage of psychopathy while doctors  (in general) are listed among the lowest.

Although by no means a scientific study, Psycopaths, by their very nature, seek power and it would make sense that a psychopath among us might pick surgery over pediatrics or pathology as they are drawn to power, prestige, and control. Be this as it may the incidence of psycopathy or psychopathic traits in doctors of any specialty is low. Statistics indicate that no more than 1% of men in general exhibit psychopathic traits. In Women these characteristics are far less.

Due to irresponsible behavior and a tendency to ignore or violate social conventions and rules,  psychopaths frequently find themselves engaged in conduct involving the criminal justice system or involved in other disciplinary action. Juvenile delinquency, arrests, school suspensions and misconduct related issues are barriers that preclude professional careers for many and, with around 15% of the prison population estimated to be psychopathic, incarceration and recidivism are common final pathways. Because of this tendency it would be highly unlikely for most sociopaths to follow a standard professional career pathway involving academic rigor and normal professional and societal expectations,  because impulsive irresponsible actions commonly blocks it. This would predict a probably much lower prevalence of psycopathy in physicians compared to the general population.

That being said, such self imposed removal from a potential  career is the sole product of getting caught for misconduct and being held accountable for it.   Psychopaths possess several traits that make this difficult.    With a talent for “reading people” and identifying their weak spots and vulnerabilities they are able to get people to see what they want them to see.  Psychopaths often exude charm, confidence and charisma.  They can lie effortlessly and are very convincing..

The natural history of psychopathy involves risky behavior and the ability to get away with it or out of it. The consequences of this depend on if and when it occurs. It is entirely conceivable that some may live their entire lives undetected. With a need for stimulation and a proneness to boredom the psychopath is particularly prone to drug abuse and addiction and twice as likely as the general population to be diagnosed.

 Psycopathy involves a path of risky behavior as well as the potential for being held accountable for it. At any age the behavior that brings they psychopath to the attention of the criminal justice system is often drug or alcohol related. The natural history of the average psychopath reveals an overrepresentation in prison with a 15x greater risk in general. Any statistics on psycopathy in a population is based on psychometric evaluations retrospectively in specific populations. Being arrested or getting caught for something does not reveal the pathology or the correlation. You have to look for it.

And nothing is known of subpopulations of psychopaths and the impact of intelligence, education, profession and other factors and how they relate to outcomes and consequences over time. Egocentricity and a sense of entitlement drives they do not adapt to the environment but try to make the environment adapt to them. Without empathy and lacking remorse the goal is always self-serving and a question of what they can get out of it.

 Many judges, as an alternative to incarceration, have been requiring people arrested for drug and alcohol related offenses to attend AA meetings and provide proof of participation. As misguided as this is on other levels it is also dangerous. Given a choice between incarceration and attending AA the majority of any population, including those with psychopathic traits, would choose the latter. And as in any situation they would use it to see what they could get out of it. Masters of manipulation and impression management in a room full of potential victims. The reports of rape and theft coming out is no surprise. It is in all likelihood much worse.

And in reality psychopaths exist in every profession, including medicine.

What is the natural history and final common pathway of M.D. psychopaths?  Where do these shape-shifters end up?

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In his book Without Conscience, Dr. Robert Hare notes “If we can’t spot them, we are doomed to be their victims, both as individuals and as a society. ” Dr. Clive Boddy in Corporate Psychopaths observes that unethical leaders create unethical followers, which in turn create unethical companies and society suffers as a result.” And if you look at the FSPHP branch of the ASAM that is exactly what you will find.  less than 1/% of the population are psychopaths but they represent more that 10% of those in prisons.  What is the natural history of the physician psychopath? You do the math.

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http://psychopathyinfo.wordpress.com/2012/03/22/characteristics-of-corporate-psychopaths-and-their-corporations/

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31 thoughts on “Psychopathy and the Medical Profession

    • I am a surgeon. Acts such as abuse of any fellow human being are so foreign to me, that they become inconceivable. There is no “power” in what I do. I treat disease and patient problems with surgical skills; nothing more and nothing less. This is what I was trained to do in my chosen profession. My faculty mentor in residency labeled me an “empath” (practically unknown in medicine let alone surgery) because I connect with others on a very deep level; reading energies from words and feelings. Yes, I am often labeled as a “different kind” of surgeon; nice, respectful and grateful for the privilege of being able to see the wonder of humanity and dignity in all humans as I treat their disease with my surgical skills. My residents and fellows thrive under my teaching (very proud of them as they appreciate good instruction) without abuse on my part.

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  1. It takes 2 to tango. Most ‘victims’ of psychos are guilty of wishful thinking. And thank god for psychos because who in their right mind could cut people open and put them back together. Not me. I couldn’t handle the responsibility or face the family if there was something i could have done different. I have great respect for surgeons.

    As for addiction, it is simply a lie. Psychos are great at lying. So it makes perfect sense. Go to AA and manipulate the depressives.

    Nice blog. Gonna thumb through it.

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  2. I am currently reading a lot about “corporate psychopathy” and sociopathy and it is unfortunately the empathic among us who often fall victim to these predators. My estimate is that about 30-40% of the current FSPHP are bona fide sociopaths. It is a perfect funnel for them and they are heading towards a Nash equilibrium of psychopathy by both removing those with conscience and blocking all facets of accountability and exposure. It may take two to Tango but this is not a dance–It’s careers, livelihoods, families and lives.

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    • You are dead on about empaths falling victims to predatory sociopaths and psychopaths. I am an empath and have struggled with falling prey to these kinds of people my entire life. It is why I opted to study Psychology. I needed to better equip myself with the tools to identify them, and deal with them. I have had FAR too many encounters in life with far too many narcissists, sociopaths, and people with Borderline Personality Disorder. They are almost magnetically drawn to me and then they suck the life right out of me.

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  3. What is the relationship between sociopathy and psychopathy?

    The Sociopath Next Door (Martha Stout) has been really valuable to me. One of the points Stout makes, and that I struggled with in my own case, was that empathic people have trouble believing that any human being can manifest sociopathic behavior, to the degree that when the pattern becomes apparent, the empath doubts their own sanity.

    From life experience, the differences of sociopathic expression in men and women are also interesting. Women tend to generate conflict around them and then plead victimization. They provide justification for sociopathic men to come in and lay people low. The strongest method that I have found for dealing with sociopathic behavior is to attack the pattern of triangulation: immediately discount any statements that suggest others are out to hurt you, unless they are accompanied by an offer to bring everybody together to see if the differences can be worked out.

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    • I read Stout’s book also.It WAS an eye opener. It also helped to explain a lot of dynamics in my divorce. … I just couldn’t understand how someone could behave as the did (with utterly no remorse or conscience, all the while putting out a false picture of themselves to others. Now I can.

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  4. The Physician Health Program model needs to be examined from the corporate psychopathy perspective. One of the two doctors who wrote the model guidelines for the system for the Federation of State Medical Boards subsequently surrendered his license for long-term sexual misconduct with a patient and many of those involved are felons–even some double felons. Just as many incarcerated sociopaths play the “I’ve found God” card in attempting to get released, the majority of these doctors claimed they had been saves by A.A. and got their licenses back because they promised to go into addiction medicine and help others like them. It is a perfect funnel for sociopathy. They grew in numbers, organized, removed themselves from accountability and oversight,are now in charge and we are paying the price. Their research is all propaganda. They introduced junk science as forensic testing using a loophole to avoid FDA approval and set up the biggest scam of the century under the radar.Look at my post “three-shells and a pea” as it shows how they have it set up.

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  5. Indeed a fascinating problem that I also spend a lot of time pondering. It is bothersome that little is known and that we seem to be having definitional issues. Wikipedia, for one (which we know, of course, is the universal source of truth) presents different statistics – 4% general population and 50% prison inmate population. The DSM uses different terms like “antisocial personality disorder”. It also lists “narcissistic personality disorder” one of the characteristics of which is a “lack of empathy”.

    Any thought experiment about potentially testing of psychopathy ends up walking a dangerous line between predicting the weather and starting a witch hunt. All the while, the evolutionary perspective suggests that, since these individuals are around, they must possess some useful traits! It’s a very nasty dilemma. Thanks for discussing it – enjoyed your post!

    Liked by 1 person

  6. Indeed a fascinating problem that I also spend a lot of time pondering. It is bothersome that little is known and that we seem to be having definitional issues. Wikipedia, for one (which we know, of course, is the universal source of truth) presents different statistics – 4% general population and 50% prison inmate population. The DSM uses different terms like “antisocial personality disorder”. It also lists “narcissistic personality disorder” one of the characteristics of which is a “lack of empathy”.

    Any thought experiment about potentially testing of psychopathy ends up walking a dangerous line between predicting the weather and starting a witch hunt. All the while, the evolutionary perspective suggests that, since these individuals are around, they must possess some useful traits! It’s a very nasty dilemma. Thanks for discussing it – enjoyed your post!

    Liked by 1 person

  7. It is interesting to note that I have been in contact with many psychologists in a social group (not Facebook) and it seems that a very large percent of them are “psychologically damaged” from childhood. Many undoubtedly are “silent” psychopaths. I ran some experiments during my doctoral dissertation era and found that about 2% of the society among the volunteers we dealt with (several hundreds) were psychopaths based on their financial decision-making in economic games. Even the extra hormone oxytocin we had them sniff that makes people more trusting and generous did not change that 2%. So psychopath lack receptors to oxytocin, the social hormone, to the point that they cannot be changed or improved upon. It is not an “illness” or “disease” but a genetic predisposition.

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    • This is exactly the kind of blunt, simplistic model responsible for your profession’s short, bloody history, which grew up with imperialism, functioning as its lackey. It’s exactly why the CIA and NSA looked to psychologists to find its torturers, and why the APA continues its failure to come to terms with that moral crisis.
      Don’t construct one more boogeyman in my name, nor present your graduate student experiments as Science’s Stamp of Approval. Never feel free to appropriate words like “psycho” and toss them about as if they have meaning. People gave their lives in the struggle for Constitutional protection of their brains – as most broadly construed.
      You have no right to even say that any human being has a genetic incapacity to be human. But to say it in the form of a “medical ‘ diagnosis! That’s a crime. Collect your $200 and go directly to your next grant-writing conference,

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  8. Interesting and suggests:
    1. Don’t know but suspect a very high percentage of psychopaths among prominent politicians.
    2. Perhaps the count was higher among doctors back when they did their own surgery and before they evolved from professionals into bureaucrats?
    3. I suppose that the degree of psychopathy is a variable, as with other personality types. If so, the lesser degrees might provide some advantages to both the possessor and society. And of course, the opposite would be true too. Our species seems designed to provide a spectrum of a multiplicity of types, discarding the extremes in one way or another and utilizing the less extreme toward again, varying degrees of productivity, at various times. As it seems to me …

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  9. Yes the analogies between regulatory medicine and the current political climate are striking. Unlike politics, however, where there are at least some constraints (i.e. the anti-science concrete thinkers at least had to be voted in to gain power) the medical profession is unconstrained. Those who rose to power were not voted in but “volunteered” and gained an uninvited seat at the table of power. And the state Physician Health Programs were the perfect funnel for sociopaths to re-invent themselves.

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  10. I went to a class at the VA Hospital for Mental Health issues. One day someone asked what those buttons on the wall were. There were two in each room. The answer, “In case someone goes postal.” So I wonder, they put us under pressure, half-suspecting we are crazy and they talk up stigmas???? Interesting. Befuddled in America.

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  11. In my experience, I’ve found that there are large numbers of psychopaths (PPD) and “almost a psychopath” (AAP) in the mental health field (MHF), which isn’t surprising to me because these MHF PPDs and AAPs want to prey on their patients’/clients’ weakened emotional state (a large number of sexual impropriety accusations and convictions occur against the MHF providers when compared with other healthcare providers). MHF PPDs and AAPs, I sense, go into the MHF not only to better understand themselves, but so that they can hide their tracks better. In other words, these PPDs-AAPs know they’re nuts or misfits; and they go into the MHF to better understand themselves and be with the other nuts and freaks who are more tolerant of their deviant behavior and where the PPDs-AAPs can “hide their tracks” better.

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  12. […] It is a system of institutional injustice that is killing physicians by driving them to hopelessness, helplessness, and despair. The general medical community needs to awaken to the reality of the danger to expose and dismantle it at the State level.  And many of the doctors caught in this maw do not even have an addiction or substance abuse issue –equivalent to the 12-year old girl in referred to Straight for sniffing a magic marker.  On the other hand many of those in charge of the administration of these programs have engaged in egregious even horrific misconduct and have a history of manipulating the system. […]

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    • Thank you Claire Marie- I appreciate all of the comments. We need to get decent people in power/-the current regime is rotten to the core. We need to identify the top- down corruption and remove them with zero tolerance. Unfortunately they’ve been left alone to proliferate like feral cats

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  13. From my own unfortunate experience with the medical profession, I can say without question that, as an institution, the medical field is sociopathic. If you are harmed (even badly, like me), they will not own their own mistakes and abuses let alone apologize like any five yr. old would. How ironic that in some cases the healing professionals are the most dangerous.

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  14. […] It is a system of institutional injustice that is killing physicians by driving them to hopelessness, helplessness, and despair. The general medical community needs to awaken to the reality of the danger to expose and dismantle it at the State level.  And many of the doctors caught in this maw do not even have an addiction or substance abuse issue –equivalent to the 12-year old girl in referred to Straight for sniffing a magic marker.  On the other hand many of those in charge of the administration of these programs have engaged in egregious even horrific misconduct and have a history of manipulating the system. […]

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