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Ethics and the Difficult Patient
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17. The Psychodynamic Diagnostic Manual’s P Axis- Personality Disorders- Considers the Following Factors: Temperamental, Thematic, Affective, Cognitive, and Defense patterns
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31. “ Dr. Robert Gordon, a clinical psychologist from the area and a renowned expert on the MMPI-2 personality assessment, said that Ben showed only normal signs of anxiety, nothing extreme, and, in fact, the test supported a diagnosis of a psychopathic personality. That meant Ben could probably deceive others with skill and would not be hindered by guilt or remorse. Rosen quotes Gordon as stating, "There are no signs he felt residual anxieties at the time of the crimes.” TruCrime Library By Katherine Ramsland and with Trista Dashner
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34. Causes: Psychodynamic - childhood When parents are cold, uncaring, and dangerous this leads to poor attachment, empathy and trust. Introjects don’t lead to the development of a healthy super-ego (capacity for remorse or moral reasoning), mentalization of objects is remains primitive. There may be bizarre gaps in moral reasoning, "superego lacunae" or holes in their conscience. Think of Tony Soprano having affairs and killing for money, and then very moralistic towards his wife and children.
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45. MacDonald triad: Children with a longer-than-usual period of bedwetting, cruelty to animals, and pyromania. These three traits are now included under conduct disorder. A child who shows signs of antisocial personality disorder may be diagnosed as having either conduct disorder or oppositional defiant disorder. Markers in Childhood
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52. Fargo (1996) a car salesman has hired two men to kidnap his wife for a ransom of $1 million that he hopes to get from his rich father in-law. The husband hires two men, an aggressive psychopath and a passive/parasitic psychopath working together. What was meant to be a simple kidnapping for money turns into multiples murders when the aggressive type explodes in violence.
53. Fargo- The police officer questions the husband car salesman (also a passive/parasitic psychopath)
54. House of Games (1987) - In House of Games, a handsome con man sucks in a female psychiatrist by making a deal with her. She asked him not to have her patient injured because of his gambling debts. He claims that he will write off her patient’s debts in exchange for informing him about the “tells” of another poker player. He charms her, invades her space, touches her, and asks for a favor in the first few minutes of their meeting.
55. The Sopranos (1999-2007) Tony Soprano’s mother is a cold hostile psychopath. She orders a hit on her own son. Tony is in denial about this, and physically attacks his therapist when she confronts him about his mother’s borderline personality and hostility towards him. Tony would rather displace his aggressive than get in touch with his feelings of sadness. He also turns his longing into an erotic transference to his therapist.
56. Sopranos- Tony testing boundaries, threats, projecting dishonesty, acting out transference instead of using insight
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Editor's Notes
OJ Simpson Amy Fisher, Amy Elizabeth Fisher (born August 21 , 1974 ), dubbed the "Long Island Lolita " by the press, is an American woman convicted of the 1992 shooting of the wife of her lover Joey Buttafuoco , with whom she began an affair as a 16 year-old student at Kennedy High School in Bellmore , New York . Fisher served seven years in prison for assault, first degree. The case drew a great deal of media attention. Since leaving prison in 1999 , Fisher has become a writer . Ted Bundy, Husaine Frank William Abagnale, Jr., Grifters, Lay and Skilling, Jeffery daulmer Jeffrey Lionel Dahmer ( May 21 , 1960 � November 28 , 1994 ) was an American serial killer . Dahmer murdered 17 men and boys between 1978 and 1991, with the majority of the murders occurring between 1989 and 1991. His murders were particularly gruesome, involving rape , necrophilia and cannibalism .
passed bad checks worth about $2.5 million in 26 countries. His life story provided the inspiration for the feature film Catch Me if You Can . Pan American World Airways estimates that between the ages of 16 and 18, Frank Abagnale flew over 1,000,000 miles on over 250 flights and flew to 26 countries, at Pan Am's expense, through deadheading . He was also able to stay at hotels for free during this time. Later, he impersonated a pediatrician in a Georgia hospital under the name "Frank Conners". He chose to do this after nearly being caught by police after leaving a flight in New Orleans . Aware of possible capture, he retired to Georgia for the time being. When filling out an application for an apartment he listed his previous occupation as "doctor" fearing that the owner might check with Pan Am if he had listed "pilot". After becoming friends with a real doctor who lived next door, he became a resident supervisor as a favor for him until they found someone who could take the job. He did not find the job difficult because the supervisor does not do any actual medical work. Abagnale forged a Harvard University law transcript, passed the bar exam of Louisiana and got a job at the office of the state attorney general of Louisiana at the age of nineteen.
Taped conversations are widely available of an Enron trader urging a power plant operator in Las Vegas to 砥 nexpectedly � take his plant off-line that night in order to create a supply crisis the next day. This would allow the electricity brokers to wildly inflate their prices. The next day, Jan. 17, hundreds of thousands of people suffered artificially caused power outages across the state, causing then California governor Gray Davis to declare a state of emergency. Taking plants off-line was just one of countless manipulations that caused the cost of energy to skyrocket in California in 2000 and 2001. In other taped phone calls, Enron traders are heard cynically joking about squeezing the elderly to enrich themselves.By the end of 2000, market manipulation had caused the price of electricity to soar to unbelievable levels. At certain hours, electricity brokers were purchasing a megawatt of electricity 謡 hich cost $45 the previous year 庸 or as much as $1,400. That is a 3,000 percent increase in cost, all of which was passed down to the customer.As the people of California suffered, Enron 痴 stated annual profit tripled. And they were not alone. Other energy brokers saw profit increases of 500 to 800 percent. 前 ff shoring � the debt As Enron reaped enormous new profits in California, the company suffered heavy losses in its speculation businesses. Due to its lavish payouts to executives and shareholders, Enron 様 ike the high-tech and energy sector in general 預 lso took a hit from the economic recession of 2000-2001, which saw sharp drops in the price of oil.By late 1999, Enron 痴 stock was selling for $90 per share. Over the next two years, until declaring bankruptcy in 2001, Enron executives like Lay, Skilling, Andrew Fastow and others oversaw a tangled web of schemes designed to keep the stock price high, despite mounting losses.The Enron executives created fake companies, sometimes in other countries, to buy pieces of Enron 痴 debt, which on paper would be converted into revenue. But the fake companies were all completely under Enron 痴 control.In this way, Enron executives were able to slow, but not stop, the slide in Enron 痴 stock price, and delay the banks, pension funds and other investors from a panicked sell-off of their shares.While Lay and his cohorts continued to declare through 2001 that everything was fine, they sold off their own Enron stock. In e-mails and speeches to company employees, he claimed that he was actually buying more stock. It was later revealed that in 2001, Lay bought $4 million of the stock but sold $24 million. At the beginning of 2001, Enron 痴 stock was selling for $80 per share and Lay was spending a lot of time at the White House. By the end of the year, the company was bankrupt and the stock was selling for only 30 cents.The total monetary loss exceeded $60 billion, sustained primarily by big investors and pension funds, many of them state and city funds.This is what drew the wrath of the capitalist ruling class, and caused Lay and Skilling 痴 convictions. They tricked and defrauded the big investors. The executives were not questioned at all about the California energy crisis, which hurt millions. In fact, the California crisis was made explicitly off-limits in the trial
outlines the [current] knowledge [obtained] from brain-imaging studies / [provides] a brief overview of neuropsychological findings on violent offenders / [argues] that frontal and temporal lobe dysfunction appears to be related to violence / more specifically, a dimension of frontal-to-temporal dysfunction may exist, with violence aligned most closely with frontal dysfunction, and sexual offending aligned with temporal lobe dysfunction--with both sexual and violent offending being characterized by both frontal and temporal dysfunction /// reviews 14 brain-imaging studies using CT, PET [positron emision tomography], RCBF [regional cerebral blood flow], and magnetic resonance imaging (MRI) conducted to date on offender groups Violence, brain imaging, and neuropsychology. Raine, Adrian ; Buchsbaum, Monte S. Stoff, David M. (Ed); Cairns, Robert B. (Ed). Aggression and violence: Genetic, neurobiological, and biosocial perspectives. (pp. 195-217). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers (1996) xvii, 403 pp. Prefrontal dysfunction in murderers lacking psychosocial deficits. Stoddard, Jacqueline ; Raine, Adrian ; Bihrle, Susan ; Buchbaum, Monte Raine, Adrian (Ed); Brennan, Patricia A. (Ed); Farrington, David P. (Ed); Mednick, Sarnoff A. (Ed). Biosocial bases of violence. (pp. 301-304). NATO ASI series: Series A: Life sciences, Vol. 292. New York, NY, US: Plenum Press (1997) ix, 359 pp.
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