House, M.D.: 6x12 "Remorse" - Discussion and Spoilers

[sidious618]

This one was really good and that patient was sure a piece of work.

 

[T'Baio]

I forgot to point out the other night that I was a little disappointed they labelled the POTW a "psychopath" for the whole episode, without once referring to any other disorder. I get that it's TV and "psychopath" is easier to understand for the majority of laymen TV watchers, but it's not like House (the show) ever shies away from using real, technically complicated medical jargon.

Psychopath is often used colloquially in situations like this POTW, but technically what she displayed was sociopathy, or more technically, an antisocial personality disorder. She was more of a sociopath than a psychopath, I think. She did have a small display of violence, if she did indeed poison that guy, but I still think she fits more with sociopathy.

 

[Christopher]

But isn't "psychopath = violent killer" itself a media myth? Medically speaking, psychopathy is defined as a personality disorder characterized by the lack of empathy and conscience. Quoth Wikipedia:

Psychopaths are glib and superficially charming, and many psychopaths are excellent mimics of normal human emotion; some psychopaths can blend in, undetected, in a variety of surroundings, including corporate environments. There is neither a cure nor any effective treatment for psychopathy; there are no medications or other techniques which can instill empathy, and psychopaths who undergo traditional talk therapy only become more adept at manipulating others. The consensus among researchers is that psychopathy stems from a specific neurological disorder which is biological in origin and present from birth. It is estimated that one percent of the general population are psychopaths.

One percent -- that's tens of millions of people in the US alone. Clearly most of them can't be serial killers and supervillains or the whole world would be in chaos (well... more than it is already). Real psychopaths are generally just people who are only out for themselves and don't give a damn about others. Which probably encompasses a large percentage of successful businesspeople, athletes, celebrities, and politicians.

David T. Lykken proposes psychopathy and sociopathy are two distinct kinds of antisocial personality disorder. He believes psychopaths are born with temperamental differences such as impulsivity, cortical underarousal, and fearlessness that lead them to risk-seeking behavior and an inability to internalize social norms. On the other hand, he claims sociopaths have relatively normal temperaments; their personality disorder being more an effect of negative sociological factors like parental neglect, delinquent peers, poverty, and extremely low or extremely high intelligence. Both personality disorders are the result of an interaction between genetic predispositions and environmental factors, but psychopathy leans towards the hereditary whereas sociopathy tends towards the environmental.

So I'd say the characters were using the term accurately while they believed her personality disorder was innate. As it ultimately turned out, her antisocial tendencies were the result of an illness in adolescence, which by the definition above would make her a sociopath rather than a psychopath. But the way psychopathy was defined in this episode was a lot more accurate than the way it usually is in the media.

 

[T'Baio]

While there are doctors who have ascribed a diagnostic and definitional label on psychopathy, it generally isn't considered a medical diagnosis by use of the DSM.

When I mentioned violence, I didn't mean people labelled psychopaths are all serial killers, but when used colloquially, which professionally psychopath usually is, it's generally because violence is involved.

I think in a professional environment, they would probably stick to the DSM-IV. Ic ould be wrong.