The underlying disorders of what is commonly referred to as psychopathy are indeed detectable. I also find it comforting that they are in fact disorders and that being evil in this fashion is not an attribute of an otherwise high-functioning mind. Psychopaths can be high-functioning in some areas, but a short interaction with them almost always makes it clear that there is something is.wrong.
Cat burning was also a form of entertainment once. Defining something as fun or entertainment is a matter of politics as much as anything else. The same goes for friendliness. I fear that once we pinpoint it, it’ll be outdated.
Everybody who is known to be a psychopath is a bad psychopath, by definition; a skilled psychopath is one who will not let people figure out that he’s a psychopath.
Of course, this means that the existence of sufficiently skilled psychopath is, in everyday practice, unprovable and unfalsifiable (at least to the degree that we cannot tell the difference between a good actor and someone genuinely feeling empathy; I suppose you might figure out something by measuring people’s brain activity while they watch a torture scene).
I suppose you might figure out something by measuring people’s brain activity while they watch a torture scene
Even then it is far from definitive. Experienced doctors, for example, lose a lot the ability to feel certain kinds of physical empathy—their brains will look closer to a good actor’s brain than that of a naive individual exposed to the same stimulus. That’s just practical adaptation and good for patient and practitioner alike.
Considering the number of horror stories I’ve heard about doctors who just don’t pay attention, I’m not sure you’re right that doctors acting their empathy is good for patients.
Cite? I’m curious about where and when that study was done.
Thanks for your reply, but I think I’m going to push for some community norms for sourcing information from studies, ranging from read the whole thing carefully to heard about it from someone.
You don’t have enough information to arrive at that level of certainty. He was not, for example, a general practitioner and I was not a client of his. I was actually working with him in medical education at the time. Come to think of it, bizarrely enough and by pure happenstance that does put the subject into the realm of his specialist knowledge.
I don’t present that as a reason to be persuaded—I actually think not taking official status, particularly medicine related official status, seriously is a good thing. It is just a reply to your presumption.
While I don’t expect you to take my (or his) word for anything I also wouldn’t expect you to need to. This is exactly the finding I would expect based off general knowledge of human behavior. When people are constantly exposed to stimulus that is emotionally laden they will tend to become desensitized to it. There are whole schools of cognitive therapy based on this fact. If someone has taken on the role of a torturer then their emotional response to witnessing torture will be drastically altered. Either it will undergo extinction or the individual will be crippled with PTSD. This can be expected to apply even more when they fully identify with their role due to, for example, the hazing processes involved in joining military and paramilitary organisations.
Part of what seemed iffy was the claim that it was good for both the patients and the practitioner, when it was correlated (from what you said) with experience, with no mention of quality of care.
When someone says their source is “a doctor”, what are the odds that it’s a researcher specializing in that particular area? Especially when the information is something which could as easily be a fluffy popular report as something clearly related to a specialty?
Also, I had a prior from Bernard Siegal which is also intuitively plausible—that doctors who are emotionally numb around their patients are more likely to burn out. This was likely to have been based on anecdote, but not a crazy hypothesis.
I believe you have a sign error in your last paragraph. Doctors who do not emotionally numb themselves are the ones considered at risk to burn out. I have a friend from one of my T groups who is a physician at M. D. Anderson Cancer Center and she is now working in intensive care where the people are really messed up and people die all the time. She believes genuine loving care for her patients is her duty and makes her a better physician; she was trained be emotionally numb and she felt like it was an epiphany for herself to rebel against this after a couple of years in her current assignment.
I have not asked her if her attitude is obvious to her supervisors. My guess is that it probably is not; I do not think she is secretive about it (although she probably does not go around evangelizing to the other doctors much) but I would think that the other doctors are too preoccupied to observe it.
In the book Consciousness and Healing Larry Dossey M.D. also explicitly discusses behavioral norms of professional physicians being to minimize emotional involvement and he has arguments that this is a bad practice. (That book is not an example of good rational thinking from cover to cover.)
Part of what seemed iffy was the claim that it was good for both the patients and the practitioner, when it was correlated (from what you said) with experience, with no mention of quality of care.
Desensitization to powerful negative emotional reactions is not the same thing as not caring and not building a personal relationship.
Most of our default emotional reactions when we are in close contact with others who have physical or emotional injuries aren’t exactly optimal for the purpose of providing assistance. Particularly when what the doctor needs to do will cause more pain.
I’ll add that at particularly high levels of competence it makes very little difference whether you are a psychopath who has mastered the deception of others or a hypocrite (normal person) who has mastered deception of yourself.
The underlying disorders of what is commonly referred to as psychopathy are indeed detectable. I also find it comforting that they are in fact disorders and that being evil in this fashion is not an attribute of an otherwise high-functioning mind. Psychopaths can be high-functioning in some areas, but a short interaction with them almost always makes it clear that there is something is.wrong.
Homosexuality was also a disorder once. Defining something as a sickness or disorder is a matter of politics as much as anything else.
Cat burning was also a form of entertainment once. Defining something as fun or entertainment is a matter of politics as much as anything else. The same goes for friendliness. I fear that once we pinpoint it, it’ll be outdated.
What do you mean by psychopathy?
At least one sort of no-empathy person is unusually good at manipulating most people.
Everybody who is known to be a psychopath is a bad psychopath, by definition; a skilled psychopath is one who will not let people figure out that he’s a psychopath.
Of course, this means that the existence of sufficiently skilled psychopath is, in everyday practice, unprovable and unfalsifiable (at least to the degree that we cannot tell the difference between a good actor and someone genuinely feeling empathy; I suppose you might figure out something by measuring people’s brain activity while they watch a torture scene).
Even then it is far from definitive. Experienced doctors, for example, lose a lot the ability to feel certain kinds of physical empathy—their brains will look closer to a good actor’s brain than that of a naive individual exposed to the same stimulus. That’s just practical adaptation and good for patient and practitioner alike.
Considering the number of horror stories I’ve heard about doctors who just don’t pay attention, I’m not sure you’re right that doctors acting their empathy is good for patients.
Cite? I’m curious about where and when that study was done.
Don’t know. Never saw it first hand—I heard it from a doctor.
Thanks for your reply, but I think I’m going to push for some community norms for sourcing information from studies, ranging from read the whole thing carefully to heard about it from someone.
Only on lesswrong—we look down our noses at people who take the word of medical specialists.
That doctor almost certainly wasn’t speaking out of his specialist knowledge.
You don’t have enough information to arrive at that level of certainty. He was not, for example, a general practitioner and I was not a client of his. I was actually working with him in medical education at the time. Come to think of it, bizarrely enough and by pure happenstance that does put the subject into the realm of his specialist knowledge.
I don’t present that as a reason to be persuaded—I actually think not taking official status, particularly medicine related official status, seriously is a good thing. It is just a reply to your presumption.
While I don’t expect you to take my (or his) word for anything I also wouldn’t expect you to need to. This is exactly the finding I would expect based off general knowledge of human behavior. When people are constantly exposed to stimulus that is emotionally laden they will tend to become desensitized to it. There are whole schools of cognitive therapy based on this fact. If someone has taken on the role of a torturer then their emotional response to witnessing torture will be drastically altered. Either it will undergo extinction or the individual will be crippled with PTSD. This can be expected to apply even more when they fully identify with their role due to, for example, the hazing processes involved in joining military and paramilitary organisations.
Part of what seemed iffy was the claim that it was good for both the patients and the practitioner, when it was correlated (from what you said) with experience, with no mention of quality of care.
When someone says their source is “a doctor”, what are the odds that it’s a researcher specializing in that particular area? Especially when the information is something which could as easily be a fluffy popular report as something clearly related to a specialty?
Also, I had a prior from Bernard Siegal which is also intuitively plausible—that doctors who are emotionally numb around their patients are more likely to burn out. This was likely to have been based on anecdote, but not a crazy hypothesis.
I believe you have a sign error in your last paragraph. Doctors who do not emotionally numb themselves are the ones considered at risk to burn out. I have a friend from one of my T groups who is a physician at M. D. Anderson Cancer Center and she is now working in intensive care where the people are really messed up and people die all the time. She believes genuine loving care for her patients is her duty and makes her a better physician; she was trained be emotionally numb and she felt like it was an epiphany for herself to rebel against this after a couple of years in her current assignment.
I have not asked her if her attitude is obvious to her supervisors. My guess is that it probably is not; I do not think she is secretive about it (although she probably does not go around evangelizing to the other doctors much) but I would think that the other doctors are too preoccupied to observe it.
In the book Consciousness and Healing Larry Dossey M.D. also explicitly discusses behavioral norms of professional physicians being to minimize emotional involvement and he has arguments that this is a bad practice. (That book is not an example of good rational thinking from cover to cover.)
Desensitization to powerful negative emotional reactions is not the same thing as not caring and not building a personal relationship.
Most of our default emotional reactions when we are in close contact with others who have physical or emotional injuries aren’t exactly optimal for the purpose of providing assistance. Particularly when what the doctor needs to do will cause more pain.
I’ll add that at particularly high levels of competence it makes very little difference whether you are a psychopath who has mastered the deception of others or a hypocrite (normal person) who has mastered deception of yourself.