A CASE OF Sadistic Personality Disorder
By: THEODORE MILLON
et al.
Notes:
(1) Numbers mark aspects of the case most consistent with DSM
criteria as follow, and
do not necessarily indicate that the
case “meets” diagnostic criteria in this respect.
(2) Patient's name has been changed in respect to
confidentiality, and names mentioned are not of a real existent person.
Case of Chuck
Chuck
is a middle-level supervisor for a debt-collection agency. He is good at what he does, and he enjoys
his work. He is here because of a bad
evaluation, one Chuck believes was rigged by his own supervisor to prevent
Chuck from taking his job, a feat in which Chuck feels confident in succeeding. The evaluation
claims that Chuck is too
hard on his subordinates, specifically, that he disciplines them publicly, and does so deliberately to humiliate them. (2)
With
great zeal, Chuck pronounces himself a fair supervisor, but emphasizes that no
one is going to slack off on his watch. He expects a full day from everyone, with no chatter,
no down time, no small talk, no coming in late,
and no excuses for not getting assigned work done.
(3) “I don’t work with problem employees.
I pressure them until they work, and if they
don’t have the good sense to quit, then I find reason
to fire them!” he says, smirking. (6) “Not everyone can do this kind of work,” Chuck says, almost glowing, “but it’s made for
me. I love making people do their job, but I get
the biggest rush from collecting debt. I collect more debt than anyone.” (4) Though his job is usually
done on the phone, he confided that has in fact “paid visits” to customers who are not sufficiently respectful of his
efforts. (6)
Chuck
was born in South Boston to a fiercely religious Italian family, the fifth of
six children. He notes proudly that his family “had no goddamn idea what to do with me.” His
four sisters are described as “virgins that should be in a nunnery.” His only
brother has always been actively involved with
the church, and considered joining the seminary,
but decided to teach instead. “I had no such ambitions,”
Chuck states, “and the family always looked down on me.” He notes sarcastically that “there was so damn much saintliness
in our family that God must have decided to throw in a devil, me, to test their faith.” He smiles at that idea, and goes on
to describe himself as a “tough little fucker” who was first a problem in
school, then a problem because he was never in school,
then a juvenile delinquent with a talent for fighting. “My smart mouth got
me in a lot of trouble when I was young. That’s the
reason I’m so damn good at my job.” He still
studies weapons, and collects books on war.
(8)
Chuck’s
relationship with his family is distant. He has never married but boasts about
the several girlfriends he “services.” His life seems centered on his work, where
manipulative aggressiveness is not only
approved, but rewarded. Chuck sees himself as an “enforcer of the law” and is
somehow righteously empowered by this egotistical
interpretation. Chuck described one case with great satisfaction where he so
completely intimidated a debtor that she fled completely
across the country. (6) “Sometimes, I
tell them we can put a lien on their home and
take it away, even though there’s no such thing,”
he boasts. “Then I keep calling them back and count down the days.” He does not perceive his behavior to be a problem. (5)
DSM-III-R Criteria
A. A pervasive pattern of cruel, demeaning, and aggressive behavior, beginning by early adulthood, as indicated by the repeated occurrence of at least four of the following:(1) has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some non-interpersonal goal, such as striking someone in order to rob him or her)
(2) humiliates or demeans people in the presence of others
(3) has treated or disciplined someone under his or her control unusually harshly, e.g., a child, student, prisoner, or patient
(4) is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals)
(5) has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal)
(6) gets other people to do what he or she wants by frightening them (through intimidation or even terror)
(7) restricts the autonomy of people with whom he or she has a close relationship, e.g., will not let spouse leave the house unaccompanied or permit teen-age daughter to attend social functions
(8) is fascinated by violence, weapons, martial arts, injury, or torture
B. The behavior in A has not been directed toward only one person (e.g., spouse, one child) and has not been solely for the purpose of sexual arousal (as in Sexual Sadism).
References
(1) Personality Disorders in Modern Life, second edition,
2000, 2004 by John Wiley & Sons, Inc.
(2)Diagnostic and Statistical Manual of Mental Disorders, Third
Edition Revised.
Copyright 1987 American Psychiatric Association.
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