In psychoanalytic thought, the radical analyst Wilhelm Reich is recognized as having laid the foundations for the clinical study of (pathological) character structures—or, in the more recent terminology, “personality disorders.” Since the publication of Reich’s pioneering Character Analysis (1933), psychodynamic (Freudian) psychologists have sought increasing clarification and consensus regarding the clinical reality of such personality syndromes—such as borderline, antisocial (sociopathic), and narcissistic. This evolving typology, which is periodically revised, has been based on extensive clinical case-histories. In this brief article, I am merely extrapolating from the standard psychiatric handbook, the diagnostic manual of the American Psychiatric Association (known as the DSM; using the 4th edition, 1994).
In order to be diagnosed as sociopathic, the individual must exhibit at least three of the following: “failure to conform to social norms with respect to lawful behaviors… deceitfulness, as indicated by repeated lying… impulsivity or failure to plan ahead… irritability and aggressiveness… reckless disregard for the safety of self or others… consistent irresponsibility… [and] lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.” This diagnostic category, which has a high co-morbidity with alcoholism, is only applied to cases where some evidence exists of childhood delinquency (such as bullying, torturing animals, etc.).1
Moving on to the DSM’s criteria for narcissistic disorder, at least five of the following must apply to justify the diagnosis: “a grandiose sense of self-importance… fantasies of unlimited success, power… believes that he or she is ‘special’ and unique… has a sense of entitlement… is interpersonally exploitative… lacks empathy… is often envious of others… [and] shows arrogant, haughty behaviors or attitudes.” “Many highly successful individuals,” the DSM concludes (with unintended irony), “display personality traits that might be considered narcissistic.”2
In his definitive chapter on “Personality Disorders” in The Harvard Guide to Psychiatry, John G. Gunderson noted that the narcissistic syndrome “overlaps considerably with the interpersonal style of anti-social personality—so much so that narcissistic individuals are sometimes considered ‘white-collar’ psychopaths.” As to this sociopathic personality, he further states that the more “flagrant” behaviors may diminish after age 45, but that “the related issues of callousness and exploitativeness may persist. The distinction from narcissistic personality disorder is then unclear.3
It is thus plausible to consider “narcissism” and “sociopathy” as really two poles on a continuum of overlapping traits (and indeed, the newly-revised DSM has moved in this direction). Extrapolating from Gunderson’s clinical observations, I am suggesting that “sociopathic narcissism” is a characteristically political syndrome, disproportionately manifested in successful U.S. politicians, who both attain and wield power without the normative constraints we expect of “good citizens.”
Assessing the conduct and policies of recent presidents, I would tentatively place Bill Clinton closer to the “narcissistic,” and Bush closer to the “sociopathic,” poles of the continuum. As for the two major candidates for president in 2012…?
- As a child, George W. Bush was said to enjoy blowing up frogs with firecrackers, and his later pastimes included “branding” fraternity pledges with a red-hot coat hanger. In adulthood he admittedly has had a “problem” with drinking. [↩]
- American Psychiatric Association, Diagnostic and Statistical Manual (4th edition, 1994); pps. 98-99, 705-706, 716-717. [↩]
- John G. Gunderson, M.D. “Personality Disorders.” In: The Harvard Guide to Psychiatry (3rd edition, 1999), Ed. A. Nicholi, M.D. Harvard University Press; pps. Cited 317-318. [↩]