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Good morning, Dr. Malzberg.
Good morning. How are you doing? Oh, not too bad. I saw a social media post just this morning, actually, that I thought could be one of those plots for, they talk about modern day Seinfeld. Someone, a woman was posting that she got, as they call it, the ick, in quotes, because her boyfriend was using cheats on an online multiplayer game.
I feel like the ick definitely is valid. Yeah, the ick is definitely a word that came later, but would definitely have been in Seinfeld if it happened now.
Yeah. Yeah. I think it would be George that would be cheating online and he would meet a girl because he was ranking very high and he would have to be hiding it or something like that. That's my imagination.
I think that's a decent theory.
So that leads us to our topic today.
I'm very excited. Today we're talking about the psychology, the psychopathology of Seinfeld.
Yeah. Now it's a little pop culture fluff, but what I'm hoping for is that it's also going to be educational because in my mind, this is going to give people a little bit of an idea of the DSM-5 alternative model for personality disorders, which we've talked about on other episodes. But if you're listening and you're not a regular listener, not listening for educational purposes, I'm a general and forensic psychiatrist.
I work with a variety of cases, but many about criminal state of mind at the time of defense and insanity defense. But I'm mostly clinical. And Dr. Malesberg?
I don't have much to add. I'm a general clinical psychiatrist.
He's selling himself short. Great educator and media man when it comes to a variety of activities surrounding psychiatry online.
Oh, that's too kind. All right, let's get into it.
Now, you had some complaints, I think, about other videos on this topic, right?
Yeah, when I see other videos talk about Seinfeld and even a lot of other media, I hate when they force characters into diagnoses that aren't quite a good fit. I don't like when people shove and fit axis one disorders. And I think this is actually probably representative of what's occurring in psychiatry now. When these things could probably be much, much better explained through personality. And we don't need to pathologize.
Yeah, maybe.
Well, I think you're absolutely right that this is a reflection of the modern diagnostic landscape in that people don't really understand medical diagnosis of mental health. And they think if there's any kind of problem, there has to be a diagnosis. And if there has to be a diagnosis, it has to be the ones I'm thinking about. You'd be shocked how many people are not aware of the basic science and theory behind personality.
They kind of think it's this last resort diagnosis that only very particular people have when, as we talked about, everybody on earth has a personality and you've had a personality basically since you were born, even if it wasn't fully formed. And the personality changes over time too, not as much as we'd like maybe, but it does change.
Absolutely. And I actually get this in my personal life. There'll be like a popular Netflix documentary and I'll get a text from a friend like, what's wrong with this person? What's their diagnosis? Well, actually, they'll text me what's their diagnosis. And it's hard because it doesn't quite, the diagnosis doesn't capture what's actually going on. Like if I say, oh, it's antisocial personality disorder, that's not any, it doesn't add information.
And a formulation to me is much deeper and richer and actually gives you an idea of what's going on with a person or In this case, a character.
Exactly. Two people of the same DSM diagnosis will have radically different behaviors and lives. And I don't know if people understand that diagnosis is not destiny. So let's get into it. Do you think anyone in the core cast of Seinfeld has an actual diagnosis?
You know, before we jump into this, there's a concept I want to describe that's going to be relevant to this answer. Now, there's a concept of what's called flanderization. So what this concept is, is when a television show has a character and the seasons Sorry, what? I didn't watch it regularly enough to know throughout the seasons. I just watched it. That's shocking.
That's shocking, Dr. Malzberg. But go on.
So my understanding of Flanders is he was just a mild-mannered, nice religious guy. And then as the seasons progressed, he became this Bible-thumping, extreme character of religion. I think Cartman is the best example of this. In the early seasons, he's a naughty little boy, but within the realm of normal. And then in the later seasons, he is the absolute...
Yeah, he's a diagnosable psychopath by the midpoint of the seasons.
Complete lunatic, like evil. And so that's what you see is you see this one personality trait. Essentially what happens is the writers start leaning on that small personality trait and then it Why am I bringing this up? Because the early seasons of Seinfeld, if you actually watch, the characters are so normal. It almost seems like a documentary of just normal people living their lives with quirky events happening.
And then by the later seasons, You see these extreme characters. George becomes a caricature of who he was. There, you know, Kramer becomes quirky and quirky and quirkier. George gets angrier and angry and angrier. So I bring this up because early seasons definitely know Axis One. And when we say Axis One, we're referring to non-personality
and non-intellectual disability diagnoses.
Yeah. The only possibility is I think you could, if you wanted to push it in, get George's generalized anxiety disorder. Again, that's not really telling us information, though.
Yeah. Well, I mean, that's really more because the generalized anxiety disorder diagnosis is so loose in its criteria that almost anyone can fit into it. It's really a problem with the DSM rather than an issue with George, the character.
Yeah. Do you think of any axis one diagnosis for the main characters? Now, Crazy Joe Devola, definitely axis one, but of the main characters?
Yeah, not for the main characters. I agree. No actual diagnosis, you know, formal medical level diagnosis for the main characters. Crazy Joe Devola, as the name suggests, something is going on there. I can't tell you the specific diagnosis, but, you know, we clearly see that he He has a level of stability when he's on medications, and then when his psychiatrist goes on vacation unethically with his own patient, Elaine, you know, a romantic tryst, Davola basically decompensates.
And so you can see there, there's more than personality probably going on with Joe Davola, unless he was using substances.
Yeah, I feel like there's definitely some sort of psychotic thing going on. So you're saying no major axis one for our main characters?
That's right. We are in agreement on that. No axis one for the main cast anyway.
All right. So then let's go. Let's dive into it. Let's talk about personality, our formulations of the characters. Let's start with the big one. So, George.
Well, George is an interesting guy. You say, for example, that they flanderize over the course of the series, and that's definitely true. But with George, you also see already some signs of weirdness in the very early seasons, partially based on real-life Larry David, who I believe walked off of the workplace at SNL as a writer, or was it Fridays? I don't know. Some kind of writing job he had.
He walked out. And then he did go back the next week, I think, as if nothing had happened and played it off as a joke. And I think George tries to do that. But I believe with the same boss, at one point he also tries to poison him. Okay, so in a way, that's actually probably worse than a lot of the stuff that he does later in the seasons.
So, you know, George is pretty complex. I don't think that you can say that he has a single defined DSM personality type. He's got a lot of different maladaptive traits. And, you know, as we mentioned, even if he meets criteria for generalized anxiety disorder, technically, I would say that his anxiety problems are better explained by his maladaptive personality. He's got impaired personality functioning.
I think there is a particular thing that he fits into. And I think we could talk about how it's very rare that one person is just one thing. I think he's best defined by vulnerable narcissism. I guess I can give a little bit So when I think of narcissism in terms of like clinical sense, we're thinking of the need for self-validation and the acknowledgement of your abilities.
And there's a big focus on how people view you rather than who you are internally as an individual. Now, the way we think about narcissism is it's a defense against a really low self-esteem internally. So people who don't think highly of themselves develop this false sense of self that they think is superior. And this develops, the development in terms of why this happens is you're not loved for who you are.
So we do see this with George's mother. George's mother shows him very little affection. The things that she cares about is how he's doing, who he's with. I have a few examples that I'll get into that show up a little bit more. But so it's not being loved for who you are as a person and then developing a belief that you need to be false in some way to be loved.
And oftentimes we see that an individual's normal naughty qualities are rejected by the parent and the child needs to be something that internally they're not. In relationships, what we see with narcissists, especially the type that George is, they're hypercritical. They're always trying to improve their partner. They idealize them and that's the closest thing they get to actually feeling strong affections for people. So why do they do this?
They don't have a concept of being loved for who they are. So they can't love someone for simply who they are. And so they rely on idealization, which inevitably is going to collapse. And then it leads to the hypercriticalness. So I'll stop there. I have a bunch of examples to build my case and that kind of show more of that. But any thoughts in regards to that?
Well, what I would say is that I think many psychiatrists would agree with you. I think a lot of them would want to call George this vulnerable narcissism subtype. My criticism of that is that I think a lot of people reach for the vulnerable narcissism without adequate evidence, that they assume that that's the subtype just because you have somebody who is A, male, and B, male. For me, I need more than that.
I need more because to me, borderline is clearly there for George in terms The general borderline personality organization, not the borderline personality disorder as defined by the DSM. But I'm not seeing the hallmarks of narcissism. And the hallmark for me is some identity. He needs some stable, protective identity, positive or negative, And I'm not seeing it. And on top of that, there's not much grandiosity. The feelings of entitlement, I would say, are run in the mill for someone with borderline condition.
There's not much attention seeking, for example. He doesn't, in my opinion, interact with other people in a way where he kind of induces them to support his identity or his perceptions. There's a little bit of it. I'm not saying it's not there at all. But I think that it's better described as a little bit of the traits and mostly borderline stuff.
I hear what you're saying. I'm going to build the cases for the traits that do fit. The first is he's definitely hypersensitive to not being liked, to being seen a particular way. One thing when I was reviewing the show, how many famous actresses that play small roles? Jennifer Coolidge is Jerry's girlfriend. Now, George has this beautiful girlfriend that he actually loses because he's so obsessed with whether or not Jerry's girlfriend likes him.
And he becomes completely preoccupied that Jerry's girlfriend, he's like, I was nice. I was kind. What is it that she didn't see in me? When Jerry admits to George that he's right, that she doesn't actually like him, you can see the seeding rage. He gets completely pissed off. He becomes completely pathetic. He starts tearing up. He's alternating between screaming and being devastated. And... He tries to completely overcompensate by being what he thinks is the perfect guy.
He brings down her bags to the airport. Very incel-like behavior where the other person can obviously pick up that beneath this is a seething, raging individual. He says the quote at the end. I think that the George's girlfriend is like, you don't need to be liked by everyone. And he's like, no, everyone has to like me. I must be liked. And he chooses to break up with his girlfriend in order.
He basically sabotages his whole life because one person doesn't see him the way he wants.
Another example. I mean, obviously there's TV, but let me explain why I don't see that as pathological narcissism as a hallmark of it anyway. I still see that as nonspecific. And if anything, his behavior in that situation shows that his level of pathology is not quite as severe. As poor of a prognosis as true narcissism. He's still perceiving other people there. He is able to acknowledge that someone doesn't like him and he changes himself and his behaviors in order to make that happen.
I think that's quite rare for a truly narcissistic person. The truly narcissistic person will simply adapt their worldview of the other person in a quasi-psychotic fashion to fit what their worldview is. Whether this person hates me because I'm hated by everyone and I'm ever the victim, or that this person is just too stupid to recognize how great I am. And I'm just going to cast him aside like chaff from the wheat.
That's, I think, what a pathological narcissist would do in a situation like that. George really, in that episode, just has more of a borderline fixation. He becomes very fixated on this person, and that becomes very desperate for him because of the level of anxiousness he feels in being rejected. And don't get me wrong, there's rage when it comes to rejection and devaluation in narcissism, but it's also there in borderline.
So to me, it's just a reflection of the same level type of pathology, but not exactly to the narcissistic level.
Now, I can think of examples where he reconstructs his worldview when confronted with reality. I'm thinking of the fire episode. So there's a fire in the house at some kid's birthday party. He knocks over the women and children. He's the first one out the door. It turns out I think it was like a fire alarm. When he gets confronted that he was a total coward, I think he says like, I was being a leader.
I was showing them the way out. You need the person to go first. I think that is a slight example of his ability to reconstruct reality to fit his ideal image of who he is.
Yeah. He probably didn't really believe it there. He was trying to save face in public, and if you cornered him somewhere in a therapist's office and you had him replay that moment, he would not actually think that he was a hero. He's got too much self-loathing for it. So he has the capacity, in my mind, of both self-loathing and self-fooling and aggrandization sometimes. He's got both, and he kind of bounces between the two too much, too chaotically, in my mind, for him to be truly narcissistic.
And I do think that, especially in this sitcom,
truly narcissistic pathology is too
boring. Just too boring and too annoying to be on TV. People don't like that kind of person unless they have some problems of their own that conform to it, generally speaking. The true narcissist is a pretty boring entertainer.
And I think this kind of gets to the heart of the issue is that labels can... Someone can have pathology and not perfectly fit a label. And then you kind of need to go more into formulation and particular traits. I think we do see... This is very, to me, a little characteristic of narcissism. We see a lot of false self-performance. The marine biologist episode, Art Vandele, he very easily adapts particular identities, but he doesn't have one consistent over a long period of time.
Yeah, exactly. He has a very poor sense of self and relies on other people to kind of give him an idea of who he is and what he's supposed to do. A good example of that is his engagement to Susan. So him and Jerry make a pact that they're going to grow up and become adults. And he enacts that pact by getting engaged to Susan. And then once Jerry abandons the pact, his entire confidence in the entire relationship just completely falls apart.
He doesn't have an idea of internal motivations in terms of love, affection. He relies on Jerry's, this very loose pact for such a major life decision. Mm-hmm.
Yeah, I agree. I think we both have a sense of who he is and where his pathology is personality-wise, but we just kind of disagree on the ultimate label. In the DSM-5 alternative model for personality disorder system, I would rate That his identity functioning is at least at a moderate level of impairment. His self-direction is again, at least at a moderate level of impairment. His empathy is moderate to severe.
We really see some problems in terms of his ability to empathize with people and to feel and understand that he's hurt other people. The human fun. Functioning is probably just severe, at best moderate. He is really not doing well in his intimacy, but that's a pattern that we see across the series. And in terms of his personality traits, negative personality traits, he's got a ton of anxiousness, lots of emotional lability, lots of submissiveness.
You can really see that a lot. Yet a lot of hostility, usually passive. He has perseveration, depressivity, and lots of suspiciousness. I think that's something we haven't mentioned enough just yet. He's got kind of a lot of paranoia when it comes. I mean, he, I think, describes himself as paranoid at one point. There's also detachment, you know, withdrawal, intimacy, avoidance, antedonia, depressivity, and some antagonism too, you know, not an insignificant amount with manipulativeness, deceitfulness, and callousness.
But he's very inhibited. He's not disinhibited, which is where you would say he definitely does not have some kind of ADHD problem.
Can you expand on that a little bit more when you say inhibited?
What do you mean? Say inhibited, you say? Yeah. When you said inhibited, what do you mean? Yeah, he's not impulsive. He can become impulsive when he's very emotional or distraught, but usually when he's at a level of ordinary emotional affect for him, Amount of affect, amount of emotional intensity. He is almost too calculating. He thinks too much. He's weighing and deliberating too much, right? That's why he has that kind of change in his...
Life performance, I think, when he does the opposite, you know, in the episode, the opposite. What is he doing there? Well, he has some kind of conclusion and he decides to act against his internal ruminations and his inhibitions. That's why the opposite works for him.
Yeah, when we were texting, I made the joke. It's very funny. He deduced, so DBT, which is gold standard behavioral treatment for borderline personality disorder, opposite action is one of the skills. It's very funny that he deduced one of the core DBT skills on his own, opposite action, which is when you feel a strong emotion that's very destructive, you do the opposite of what he tells you.
George benefits greatly from doing the opposite of what his instincts tell him and then starts thriving in life. One thing I think is worth talking about, I know we're not going into the minor characters, but I think it's worth talking about George's parents. His mother is, I mean, I'm going to continue on with my formulation of narcissism. She puts him down at all times. She, George Steinbrenner gives her a call.
I think he thinks he died. I forget the exact things. And he's like, you know, George was a great guy. And George's mom responds like, are you sure you're talking about George? And then George's dad starts yelling to him about the Yankees and the midst of his son potentially being dead. A great example. So George gets famous for his hands and his hands become he becomes a hand model.
And this is the one time that we see his mom become this loving, doting mother. You know, she they're on the couch and he's like, Georgie, I always knew you had great hands. And she's subservient to him. She's getting him his stuff. He acts incredibly entitled. I think he gets up and he's like, I can't handle the stress. It's not good for the epidermis. It's the only time that she shows like maternal instincts for him.
Another thing I mentioned, one of the things that formulates narcissism is a parent not being able to handle just normal bad behavior or normal problems in a human being. She catches George masturbating. And she falls and goes to the hospital. And then when he goes, she's like, I want you to see a psychiatrist. She can't handle just his normal, like this normal human function that's not a big deal becomes this explosive, incredibly traumatic thing.
Well, you know, we got to account for cultural and generational differences there. I think you're not being a culturally aware psychiatrist there when you say that. But, you know, you've got some solid points.
And then George's dad, Ben Stiller's dad, I think, Festivus, where you audit your grievances. Holidays are supposed to be a time that you're reflecting on how grateful you are. And he makes it so you go around and you tell everyone. And how much they disappointed you. They talk about, you know, he just gets humiliated every year. I think he said, like, every year George would end up crying.
The feats of strength. I think the test was you had to pin you had to pin George's dad. Highly humiliating. No regard for who George is as a person.
Well, you know, that's a tradition or a ritual that I think depends on the cultural understanding of it, right? If everyone's having fun and playing along as if it is real rather than that it is real, then, you know, there's no problem with All right. Let's go on to Jerry. Yep. Well, Jerry, I think as many fans may even complain as well, is quite a bit more boring.
You know, he's a more boring character. He is in comedy parlance, the straight man of the group, right? So naturally, I think he's I would say that he is basically in the normal range of his personality functioning, even if he does have clearly some maladaptive personality traits that are a little bit more excessive than most people. His identity, his self-direction, You know, it's pretty much unimpaired, right?
He knows who he is. He's a stand-up comic. He's doing well in that job. He knows what he likes and what he doesn't like, and he's pretty clear about it. His empathy is a little bit of callousness, okay? Yeah, you know, all the cast has that. But apart from that, he seems to be more capable of accurately perceiving, thinking, and feeling about what other people are thinking and feeling, you know, regardless of whether they're his significant others or not.
But he's callous, so no more than moderate impairment, and he's probably just mild when it comes to his empathy impairment. Intimacy, also a weak area for him. I would say maybe arguably at a moderate level of impairment, kind of like Elaine, about the same. They're a little similar there. But still, that does not qualify him for a diagnosable personality disorder. For the actual primary trait problems that he has, maybe a little intimacy avoidance.
Sure, he has a lot of girlfriends, he's sexually interested, and he seems to enjoy the sex, obviously, but is he really emotionally intimate? Possibly, again, a sign of intimacy problems. He is a little deceitful as well, you know, and does things that are lightly antisocial, like drugging somebody in order to play with their toys. That was a dark moment in Seinfeld. And he's a little grandiose in the way he interacts He overacts with other people.
But his worst personality trait, like the others, is the callousness. And he's got rigid perfectionism as well. You might say he has an anochastic personality. He has a certain way he wants to do things. And then he thinks it's the right way. That's probably why a lot of people will call Jerry obsessive compulsive. But that's obsessive compulsive personality. There's really no evidence of obsessions or compulsions from OCD throughout the series.
Ian, what I want to talk about is you mentioned the obsessive compulsive. To me, that fits Jerry the most. So I think I'll talk about what that actually means and then where Jerry fits in. So now, again, when we talk about right now, the DSM just has personality. We all have a personality. We all have a personality style. And everyone is severely. So I'm going to describe the obsessive compulsive style.
Someone who's obsessive compulsive, on the surface, They're very conscientious, meticulous, regimented, very cerebral. Now, the core defense is that they have little access to their emotional lives. So these are people who are much more comfortable in the realm of thought, ideas, rather than getting to their feelings. So what's going on unconsciously is that they're defending against strong, intense feelings by staying in their head and staying cerebrally.
At least from what you see, Jerry rarely has intense emotions on screen, right? Outside of some small areas of stress.
And so there's actually two examples I can really think of that. First, his worldview, which is if something bad happens, something good is going to replace it. And if something good happens, something bad is going to replace it. This worldview helps to formulate there's no need for emotions. If everything always balances out and everything's always okay, it's an example of the worldview fitting the personality, which we see a lot.
People are attracted to particular types of worldviews based on how they see the life. And his idea that everything always balances out makes it so that if someone steals money from him, he doesn't get angry. If he gets a new job, he doesn't get excited. It actually is like a flattener for him. The second one is... They're talking about getting angry. And George laughs like, Jerry, you don't get angry.
And he's like, what do you mean I don't get angry? He's like, yeah, you just do that high inflection voice. And then Kramer comes in and steals a banana or something. And he does that inflection voice. And Kramer just looks at him and starts laughing and then leaves the room. He has no access or ability to have anger in a productive sense. Now, talking about the core conflict of someone with obsessive compulsive style.
So the core conflict is between obedience and defiance. So obedience, which is like obeying the rules, deference to authority. Someone like this is experienced as humiliation submission and can lead to rage and anger at someone putting rules on top of them. And defiance leads to guilt and fear of punishment. So that's going with another person's preference makes them feel like they don't exist. So the core conflict is...
The conscientiousness and the rigidness and the orderliness derives from a fear of authority and punishment. And we see the rage kind of leak out in critical ways of thinking about things, in minor oppositionality, in regards to little pockets of messiness. And intellectualized- Yeah, so intellectualization and emotional constriction allow you to keep this conflict out of your awareness. And we see this with Jerry's, Jerry uses humor as a positive coping skill.
It's a very, it's a way that he's able to leak If you listen to his comedy, it's really rage and anger against societal rules and very meticulously bashing the silliness of these rules. But it's very funny. He uses his style of categorization and very adept being able to see very clearly into these different rules. And he rages against them through comedy.
Yeah. When you talk about the fear of punishment and fear of defiance issue, it makes me think of the Cable Boy episode where Kramer talks him into getting illegal cable so he All this anxiety and even, I believe, a nightmare, fantasy nightmare about being executed basically by authority for stealing some cables. So we definitely see evidence for this kind of a personality trend throughout the series.
Even knowing that he wrote the show, I think he probably has some unconscious fear of a library book he didn't check in from 30 years ago. An FBI agent is going to come to his door and say,
You're getting dangerously into trying to analyze Jerry Seinfeld, the person, which I don't think we have basis for. It's a fictional work. Talking about things like the stand-up, which I believe he just writes. But certainly the character they portrays, I think it's right there.
Yeah. And then, you know, other features that really fit with Jerry. He's obviously overly concerned with cleanliness, order. There's that toothbrush episode. I think I forget the his girlfriend uses his toothbrush. He struggles with mess. All things that are consistent with the obsessive compulsive personality style.
Are there any other claims other than OCD for Jerry that you've run into that you feel like are spurious from other clinicians or commenters?
Other claims of Jerry. I'm not sure I can think of any ones in terms of diagnoses. Is there anything that you've seen?
I'm just kind of wondering if people have ever claimed to him to have autistic traits, which I would disagree with strongly. Because, for example, you can often see that he's got like five different types of cereal. Just sitting next to each other in his kitchen. That's a background thing that you can see. You can also see that he's really into Superman, which some people might consider a constrained interest.
But I would not say that those things are outside the realm of normal variation. So I wouldn't attribute that to anything in particular.
Any other psychological insights or things that you fit with Jerry?
I'm sorry, he's just kind of a boring character to me. I like the character. I think he makes the show work, but yeah, I don't have much else to say. I think we should move on to a more interesting character, perhaps the second most interesting, if not the first most interesting, depending on your taste, Kramer. Kramer, what do you think about Kramer?
I want to hear you go first. I actually forgot there is technically a potential Axis 1 in Kramer. And it's not going to be what you expect. This is more of a deep cut than it is something you've seen. After you give me your formulation, tell me if you can think of what his axis one is.
Yeah. I don't know how many people have concluded this about Kramer, but to me, Kramer is clearly antisocial personality. He may even be antisocial personality disorder. It's possible. I don't have to do more analysis to confirm that. But the reason why I think people don't think of this is because he's a subtype of antisocial that is basically non-aggressive. And I think a lot of people think that you need the aggression and the physical violation of people's rights to be antisocial.
But I disagree with that. I think that there can be non-aggressive antisocial. I think that we actually have all the DSM-IV model antisocial personality disorder criteria except evidence of conduct disorder before the age of 15. But that's not because we've looked at his childhood and we know it's absent. Don't expect that for a character like Kramer, if they did some kind of a spin-off where they followed him as a kid, he'd be getting to all kinds of illegal activities.
He just simply doesn't have the cruelty and aggression. So not a true dyed-in-the-wool type psychopath, But just a lot of psychopathic traits. Let's go over the evidence. He has a pervasive pattern of disregarding and violating the rights of Jerry. Look at how he treats the boundaries, belongings, just coming in and out of the property and taking whatever he wants, saying that he'll pay back, but of course he does not.
We also actually have evidence of Kramer committing actual crimes, misdemeanors and felonies throughout the series. He breaks into someone's apartment to recover a statue. He vandalizes a laundromat washing machine for revenge using cement. He encourages Jerry to urinate in a parking garage and does stuff himself. He organizes cockfights at one point. I think he steals a mail truck with Newman at one point in order to do the bottle deposit.
And there's also that time where he basically has severe, dangerous neglect of safety with Darren when they drop the bubble full of oil out onto a busy street. And there's more than that, I'm pretty sure.
I'm going to... So I'm going to build what I think is, I'm going to steal man your argument. And then there's something that just intrinsically I don't agree with regards to the antisocial part. So now to steal man your part, looking at the hair psychopathy checklist, you can break it up into two different factors. And then actually you can break it up into like four different factors.
If you break it up into two different factors, you can see one part exists in the lifestyle and antisocial psychopathy type things. And the second part is living a parasitic lifestyle.
And when I when I look at how I'm hearing both, but go on
when I look at the facets on the checklist for the parrot for lifestyle. So need of stimulation, proneness to boredom. That fits pretty well with with Kramer. Parasitic lifestyle, which is is the running joke of the show. Kramer.
Yes, like his defining character trait.
And when Jerry starts saying... I forget the exact... He takes something of Jerry's that Jerry finally cracks. And Kramer's like, it's been holding me back. Living through your lifestyle has made it so I haven't lived my own. So he is absolutely parasitic. Lack of realistic long-term goals. Absolutely. Impulsivity and irresponsibility. He really does fit all of those. Now, the part... That makes me feel like there isn't, there's a difference between antisocial and psychopathy, but he does, he lacks the sadism, and we do see evidence of genuine empathy from Kramer, undoubtedly.
Oh, do we? Let's go over that.
Even in the cockfighting episode, I think, I forget, it's Little Jerry. He eventually develops a real affection for Little Jerry. And the best... Remember when the toe gets cut off? I don't get the sense that he did this out of a sense of being a hero or how he was going to be perceived. He fought like hell to get that toe back to the hospital. He fights a guy off on the bus.
He does engage in some pro-social behaviors. I don't see a power struggle with Kramer. I don't think he gets away with things because it's fun and he can. There is that element of psychopathy of the need to get over and everything being a power position. I don't see that in Kramer.
So we're saying the same thing. Remember, and this is why I think so many people missed the antisocial diagnosis where it is valid. The antisocial personality disorder diagnosis is not psychopathy. It's purposefully encompassing both low grade tendency to break rules, basically. And the parasitic lifestyle and the actual psychopaths, right? And keep in mind, even an actual psychopath has the capacity for what seems to be affection. But if you look closely, it's not the same kind of affection that you have in a regular person.
I mean, every psychopath basically loves their mother, as long as their mother was not overtly abusive, in my experience. But what's this love? Is this love a true understanding, a mental model I think that's Kramer's level of affection towards people and animals like little Jerry. It's not because he has some kind of a strong moral core where he has deliberated and felt about other people's reactions. It's because it seems to be easy and doable and pleasurable in the moment that he does it.
He gets the idea. He thinks he can do it and he does it. So again, you know, we don't need to call him a psychopath. That's why I said he's not a psychopath, but I think he clearly meets adult antisocial. Let's go over the DSM criteria. He's definitely got failure to conform to social norms with respect to lawful behaviors, right? Lots of illegal behavior. We've got the impulsivity and failure to plan ahead.
Definitely reckless disregard of safety of self and others. Forget the Pratt Falls. We've got, again, the Darren situation among others. He has got the consistent irresponsibility. He doesn't sustain consistent work behavior. He probably doesn't honor his financial obligations. He's deceitful as E. Pennypacker in a variety of different schemes. And it's not clear if he has lack of remorse. He's rather cowardly. He's not very aggressive. But DSM criteria is not very stringent for antisocial.
You really only need three of the subcriteria. And again, all he's missing is that conduct disorder before the age of 15.
Well done. I think you... You made a strong argument. Now, with some time to reflect, were you able to think of the axis one?
I'm not sure what you're thinking of. You're going to have to tell me.
So the axis one that I have is gambling disorder is classified as a non-substance related addictive disorder.
Hmm. Hmm. It's definitely possible. You know, I. Oh, yes. Uh. He has a moment of like relapse into gambling disorder.
That's right. That's right. So George, they're sitting at the table and George asks if he wants to bet on a photo that looks like Sugar Ray. And then Kramer comes in. He goes, what do you want? 200, 300, 400, 500. And then Jerry's like, Jerry's like, come on, you've had this under control for three years. It's a lock, Jerry. Jerry, it's a lock.
So you're absolutely right. Yeah.
Hold on. So then that's not the end of the episode. So then I think he goes to pick up someone from the airport and he's sitting next to this guy with his big cowboy hat. And the guy's like, I think Houston's going to come in before Ithaca. And then they start gambling on which plane's going to land. And then he says, so Kramer blows all of his money.
And he's like, all right, Mr. Kramer, you're in the whole $3,000. He's like, all right, let me call back my bank. And he calls Newman.
Right. Newman is his bank. Look at that financial irresponsibility.
So I think that's the only axis one. I think that's more of a fun thing.
No, you're absolutely right. The episode shows you that it's a longstanding problem. It's not just isolates the one episode. You see the clear behaviors. And I do think it is diagnosable, even if you could call it a manifestation or a common comorbidity, something that comes along a lot with the antisocial personality. That's Kramer, and I think it also helps that he is charming. We're charmed by him, I think, generally speaking.
Some people are going to find them disgusted or annoyed by him. That's normal, too, when we look at antisocial personality. But he's going to be charming to a lot of people. And objectively, he is charming to a lot of people in the show as well. So to me, clearly, antisocial personality disorder. Actually, I would make that diagnosis for Kramer in terms of personality.
And what I like about it is I think it also shows like the bi-directionality. It's not like axis one and axis two are like these islands of like gambling disorder is this little pathology that exists in this part of the brain and that it's isolated from the rest of the personality. We see that they're directly related. Like his impulsiveness, his irresponsibility, it's all tied up in, you mentioned it's part of his personality and it's tied up in the axis one gambling disorder.
Mm-hmm. Mm-hmm. Now, finally, Elaine. Apologies for saving her for the last. I actually love this character, but I saved her for last because my opinion is she actually is pretty healthy, generally speaking. You know, no axis one diagnosis that I can think of. She certainly has maladaptive personality traits and some personality dysfunction. But my conclusion, and there is some basis within the writing structure for these characters within Elaine is basically a higher functioning George.
She's George, but she has less severity of almost all of the various problems that George has. Her identity functioning is pretty good. Aside from a short stint as a personal assistant, her job and her work identity is basically in the writing and editing area throughout the show, as far as I can remember. She doesn't really see a lot of impairment for self-direction. You know, she's always in a job or looking for a job.
She has some impairment in empathy, but it's pretty mild and within the realm of normal. She mostly doesn't empathize for people Intimacy is probably her greatest weak point in terms of her personality. You could arguably rate it at moderate intimacy. I'll quote from the DSM here, predominantly based on meeting self-regulatory and self-esteem needs, cooperates predominantly for personal gain. I would say that describes her fairly accurately. And of course, her relationships are pretty short and dramatic as well.
She does also have some personality traits overall that are maladaptive, meaningfully recognizable. You know, hostility, some deceitfulness, and definitely callousness, as you can see in everybody in the main cast. But overall, probably the most functional person other than Jerry and seems more normal than Jerry to me, actually, in terms of the personality traits.
Absolutely agree. I like the higher functioning George conceptualization. And they have that when things start going right for George, Elaine starts falling apart. Now, one interesting thing that I when I was doing a little bit of looking up things on here, her IQ is like 151. So while I agree, she's got a lot more her identity is much more stable than the other characters aside from Jerry.
She does have relatively sustained ability for jobs. She's somewhat underperforming, given her intelligence. There's a YouTube video that the breakdown on Elaine is that the Yeah. Yeah.
Yeah. Well, it's an interesting thing that 151 IQ detail, right? You could ask yourself, is that really something that you can see across Elaine's character in the show? Or is that just kind of a random detail that they put in that doesn't truly get proven or integrated into the overall character's behavior? If we're going to take that as true, that her IQ is 151, I would say this.
IQ has diminishing returns, you know? If you're above a certain IQ and you don't have a particular drive or interest in a highly intellectual area and to apply it in a regimented fashion that makes you marketable or employable, You're not going to necessarily see very high achievement. So I don't see Elaine as needing any negative influences to end up with her job set because your intellectual functioning is not the same as what your preferences are in life and what your habits are.
And it seems to me that Elaine's habits are more to go for something that doesn't require a whole lot of effort, right? This is not someone with a lot of ambition. She likes recognition. She would like a promotion if it's there, but then she doesn't want to do the work. Let's take that... Episode where she's got that coworker of the hearing aid, you know, and the guy with the hearing aid seems to be pretending that you can't hear certain assignments that are being put towards him.
So then Elaine gets dumped on and has to do his assignments instead. There are a lot of different ways people might react to that situation, you know, and the way Elaine reacts is to basically be passive, take the work, sieve, and not really do much on top of that, right? That's one way of reacting to that. Another person might take it on as a challenge and also use it as a way to take a lot of credit and try to advance themselves actively in the organization, right?
Another person might complain and raise hell basically with the other person and the boss and do that either in an adaptive way or a maladaptive way. My point is basically that Elaine doesn't necessarily strive. She doesn't have enough of that narcissism. She likes to be recognized. She likes to be fancy, to have grace. But does she put in the work? She doesn't. So I think it's perfectly in line with what we see.
I'm happy that we're wrapping up on that. I think that's a great example of how people's personality and how they perceive their world has such a huge influence in how things are going in their lives and even their symptoms. A lot of people don't And that there are other ways to interact with the different things that occur in our lives. And the point of therapy, I always think of the ultimate goal of therapy is to expand our degrees of freedom and to be able to see our automatic reactions to things.
Yeah, and you know, whether you're a patient or a clinician,
If you only conceptualize yourself under one constrained medical diagnosis, it's not going to give you much information to work with. It doesn't give you much information to work with in terms of giving treatment recommendations and doesn't give you much information to work with in terms of taking them and making changes in your life. It's only complex formulation, really getting deeply into why people do what they do.
In my opinion, that gets people something actionable and lets you really weigh and deliberate. Should I change myself or not? So if you're not familiar as a clinician, I recommend again, read the alternative model for personality disorders in the DSM because it does capture a little bit more of personality styles and traits and that there's a wide range of personality functioning all the way from basically unimpaired to severe impairment.
That's a better system than the traditional DSM model. And then if you're a patient, you should think about yourself as more than a medical diagnosis. A medical diagnosis is just one way to recognize one constrained problem in your life where there's lots of things feeding into that problem and coming out of that problem in a very complex way that you can't capture through diagnosis.
Absolutely. And the way that societal trends have been going, people are identifying more and more with Axis-1 disorders, and they're attributing more and more of who they are and their personality to Axis-1 disorders. I have friends who, a friend who texted me, my girlfriend couldn't go, she's depressed. And I remember I was at a party with other people and my friend's friend was like, oh, I wanted to go to this other party, but I have ADHD and I can't code switch, so I'm going to stay at this party.
So much danger in over-interpreting things as Axis 1. And when you start thinking in terms of personality, you have more control. You have more ability to change your surroundings. And ultimately, you can live a more fulfilling life. And I hope that this episode showed that if you just think of George as anxiety, and anxiety describes everything that he does... He's stuck in that and he'll never be able to change.
But if you'll get him on max SSRI, maybe a little Lyrica, and then not too much will be different, except you'll worry a little less. He would end up on Symbalt.
Another fun episode would be what psychiatric treatment and psychological treatment would these people end up with today?
I could definitely tell you what most community psychs or clinicians would probably reflexively throw at them with their chief complaints. I hope this was I'm just on one of my endless rewatches right now. The infinite loop of rewatches. That's right. That's right. All right. Well, until next time.
All right.