Psychopath

I'm up early but will go into more detail about my Brady theory tomorrow

The surgeon thing? Look into utilitarianism. The trolley problem etc...

Huh? Perhaps we have different understandings of "emotional investment". My reference was to another PP stating that surgeons would "just see them as another patient/number" and "how could they possible view them as anything else"

Surely at the heart of the "caring profession" (a job you are in) is actually genuinely caring? Rather than just doing it for money? How can you fake caring?! You either do or don't? That's what empathy is...thinking "if I was in this patients shoes how would I like to be treated? How could I better this patient's experience right now as they sit in a really shitty situation?"

It's beyond sympathy and it's what people who are in caring roles are expected to do...it's part of the core attributes.

It's a scary thought that some delivering the care have no attachment/thought/emotional investment towards those they are giving the care to..but I suppose sadly I've seen the evidence of this in the delivery of some truly awful care.

My ex was one and I’ve taught a few in school.

@Sheog

Because respect for others, empathy, integrity, and responsibility are literally the core values of being a Doctor. It then would come as no surprise that a Doctor has compassion and cares and has empathy for their patients?? It's in their nature.

They see patients (gleaning a history, family set-up, background) at the beginning of a journey (initial consultation for example) and see them through to the end, and along the way (hopefully successfully) remove the carcinoma/fix/repair/reconstruct/improve upon the patients body/wellbeing/life.

This is at the forefront of their minds whilst they operate, I can vouch for this as conversation in the theatre is quite often about how tragic the situation is or what family they have or how this patient has been battling. To say they only see patients as a number is actually disrespectful.

It gives incredible job satisfaction but also absolute heartbreak at unsuccessful cases.

I'm actually a bit baffled how anyone "can't see how they can be emotionally invested"

Can I ask genuinely why you think they aren't?

I speak in relation to the vast majority but I am aware (like in all health care roles) there are the odd few who you might say lack all empathy/are detached etc but even at that who are we, as observers to judge the intentions or emotional connection anyone has?

That is true, but antisocial elements do not necessarily a psychopath make. It’s got to be considered within the context of the bigger picture, and the bigger picture in Brady’s case doesn’t tell a particularly clear story.

The disaffectedness would correlate with schizoid personality as well, and the embarrassment about anything that that he would consider to be a weakness would correspond to narcissistic elements. He was certainly sadistic, and I would agree with the previous poster that sadistic personality disorder is more a fitting diagnosis that psychopathy:

• Sadistic personality disorder is no longer in the DSM, but it's still recognized by personality aficionados.
• The chief component of sadistic personality is taking pleasure in cruel, demeaning, and aggressive behaviors as a means of control.
• It is differentiated from antisocial personality disorder in that, for the sadistic personality, cruelty and aggression is an end unto itself.

SPD is wildly overlooked, and is often conflated with psychopathy despite it being distinct. Of course there’s also the mental illness element of Brady’s psyche as well, which is something he actively tried to conceal. He wasn’t a stupid man, and he was also someone committed to appearing a certain way.

@Sheog I don't know that I can explain it. He just cares. Partly, no doubt because it is his job and if he messes up it looks bad for him but one of the reasons he went into medicine was to make a difference and he wants to help his patients and he cares what happens to them. I think if that's a feeling you don't have then it's very difficult to explain.

@thelinkisdead I'm not suggesting that because I know a surgeon who is invested then all surgeons are, simply that at least some are and probably a large minority or a small majority are to a lesser or greater degree.

*Brand new profession
*makes me shudder a bit now

The tribunal judgement is interesting reading, I followed the case at the time as well. I think he fits many, many of Hare's criteria (grandiosity, glibness and superficial charm, lack of affect, lack of remorse, impulsivity, juvenile delinquency etc) - and certainly was hugely manipulative, would only talk to people high up in the hospital 'hierarchy', would tend to flatter outsiders and writers to get them to do things for him, and so on.

But psychopathy is a spectrum like any PD, there will always be some incongruous elements. One thing I always remember reading is that when he was first being interviewed by police, he showed no reaction to the absolute horrors he was charged with but was very, very embarrassed at being asked to name his parents because his father was unknown. That is something that crops up a few times - being easy to embarrass. Easily embarrassed about his father, his accent, sexuality, etc etc. That is the only really incongruent thing I can bring to mind, though.

I think I spent many years with a psychopath. We dated for 6 months before a work colleague told me he had a fiancé of many years. Everyone knew except me, I looked a total idiot in my aging new profession. I had specifically asked whether he was single. The lying was only trumped by the gaslighting when I found out, one comment being ‘i told you it was on and off’ - no he didn’t and I don’t think his fiancé of many years would have agreed with that description either. Sadly, I was massively under his spell by then. He was incredibly charming and funny and clever and knew just the things to say to reel you in (me, colleagues, friends, all different stuff, total bullshit chameleon). We had a physical chemistry that I have never found again since. He then kept me dangling (I may leave her, I need to choose, I love you and that should be enough). Stupidly I allowed myself to be dangled - a clever independent professional young woman. Eventually he said he’d left her for me, moved out of their shared flat but I then found out from another colleague that fiancé was pregnant and they were still very much together. Just total and utter lies. And a complete lack of care that I was bound to find out. I found out later that there were many others alongside. It was astonishing - I genuinely couldn’t believe that someone could behave like that. With a colleague too! Utter madness.

He had a shit background, negligent needy mum, part of a weird religious cult at one point. I think he could tell I was an emotionally vulnerable person at the time and he made a beeline for me, I think he could sense it. In retrospect I realise he chose me over numerous other pretty colleague prospects precisely because of that. he’s now massively internationally successful/world leading in his field. Still with that poor fiance now wife. Does a really dangerous sport to a high level as a hobby. Still takes drugs and lives a risky life. A thrill seeker with no scruples.

I look back and am so thankful I escaped. But he was definitely a psychopath and it makes or shudder a bit now how utterly reeled in I was by his charming facade. Dangerous person. But it taught me an awful lot about people, relationships and also myself.

Having a family member who is emotionally invested does not make a professional trend; there will be those who are and those who aren’t. I’m invested in my career for myself, and it is the byproduct of me being so that means those I work with are so well cared for. Do not mistake that for any higher emotion than simply the desire to do well at my job, I actually think if more people were like me, we wouldn’t have professions striking; this idea that we do a job for the greater good keeps wages lower than they should be in terms of educational cost/student debt etc

@Remembermynamealways....

Well we are all part of of a big jigsaw are we not and having a surgeon focused. Unemotional. Cold treating me would be very different to me having a cold emotional fil who helped to ruin many wonderful moments of my life

Well, it doesn’t make sense to me how and why anyone would be emotionally invested. Can you ask them why they feel an emotional connection? I’d be quite interested because I like to understand other perspectives.

@Sheog most doctors are emotionally invested to a lesser or greater degree. I have a nephew-in-law who is a cardiologist who is emotionally invested in his work. My niece, his wife, is a psychiatrist, equally invested.

@honeyrain I know that surgery is in the top ten professions with the most psychopaths. Of course, we're not talking about serial killers or the totally maladjusted but decent, intelligent people who lack empathy. My guess would be that those with psychopathic tendencies working in medicine are, I would hope, not suffering from comorbidities that could make them a danger to others. Probably lacking in a really good bedside manner but are damned good at their jobs. Of course, when it comes to consultants who have to talk to me about all that ails me I prefer someone without those tendencies!

This makes perfect sense

@thelinkisdead, I'd take a moral code and comprehensive understanding of human nature over Empathy (capitalised!) any day. It's almost the definition of empathy, isn't it? Theory of mind.

To the poster saying about surgeons being emotionally invested in their patients: I’m not a surgeon but I do work in a ‘caring’ profession and I’m absolutely not emotionally invested. Im very good at my job and I strive for the highest standards, but it isn’t out of empathy or caring; it is out of pride in my work and a desire to be the best. Luckily my goals align perfectly with those of my profession and my appreciation of order and perfection means that I want the best for those I work with. Do not confuse that for caring on a deep emotional level though; I care because I am paid to. I would never act detrimentally to those I work with because it goes against my moral code; there is no empathy there running any deeper than a comprehensive understanding of human nature.

@honeyrain No, I can’t see how they can be emotionally invested in their patients. It’s a task and possibly a challenge, but it’s not about the person themselves who could be anyone.

@MouseMinge

I have observed some Surgeons do display traits of autism which bodes well in the theatre environment...highly intelligent, focused, organisational skills, attention to detail etc. The downsides though are not conducive to effective working relationships with staff or patient interaction (this actually will and does have direct impact on how effective their work is)..for example not understanding others, being blunt/rude, not understanding social cues etc.

Psychopathy in surgeons or any health care professional is completely different and wouldn't be admired nor sought after..in fact it would be down right dangerous...No empathy, callous, lack of remorse, lying. The repercussions would be devastating.

@Sheog Do you actually believe that surgeons aren't emotionally invested in their patients?? Just because what? They cut people open or make a shit load of money by doing it? I think it shows a lack of understanding in just how difficult and demanding physically and emotionally their jobs are. Some of the life and death situations they face on a daily and some of the most gut wrenching conversations they have to have with patients and their families would make you think twice.

Wow, I bet your thesis is fascinating!

I've thought my nephew was a psychopath from a very young age (toddler). He was just "off".

Someone was introduced to him aged about 10 and after said, "I think that kids a psychopath"!

And yes, enjoys hurting animals and a compulsive liar. And definitely believes he is the most important person in the world.

Psychopath doesn't mean killer and I don't see how making unqualified parallels is helpful.

Many people seem to diagnose and see them at every turn but it's not so hard to think of unemotional people... the average politician? They see and cope well with suffering at every turn. Most people couldn't do that.

Brady concealed and obfuscated to an extreme degree. He wasn’t easy to diagnose, and the ‘understanding’ of his mental state evolved through the years. He didn’t actually present as typically psychopathic, and some of the symptoms he manifested were incongruous with psychopathy.

this is interesting reading on the subject:
https://www.judiciary.uk/wp-content/uploads/JCO/Documents/Judgments/ian-brady-mh-tribunal-240114.pdf

I'm interested to hear your thoughts on Brady. He had clinical diagnoses of NPD and ASPD and has always been regarded as a textbook psychopath in terms of most things I've read. Essentially a case of a severe PD that was complicated later by psychosis / schizophreniform symptoms that seemed to emerge because he couldn't cope in prison. I think it is likely he was always psychotic to a degree (MH wrote that he used to talk to trees etc) but not to any level that impaired responsibility. He was both psychopathic and psychotic IMO.

V.interesting thread especially around nature / nature. There was also a thread some years ago that started with the OP experiencing a chilling response to a male who simply walked past her in a supermarket. Another post also referenced someone who experienced the same when entering a prison cell (can't recall the circumstances they were there themselves bit that is irrelevant) where a prison officer was sitting with an inmate. She found out later that the prisoner was Myra Hindley. The thread also referenced the book, gift of fear which amongst other aspects validates "gut feelings" that we rationalise as an aspect of socialisation which doesn't always serve us well to respond to threats to our wellbeing.