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Good Psychology: Racter from Shadowrun: Hong Kong

So the Shrink loves videogames. I was recently playing Shadowrun: Hong Kong (check it out here!) when I came across the following dialogue from Racter, one of the companion characters.

[Image: A portrait of a white-haired man in black smoking, accompanied by the text: “Racter: Absolutely. I was diagnosed as a primary psychopath at the age of eight.”]

Me, upon reading this:

[Gif: Loki arching his eyebrows, sighing, then shaking his head unimpressed and disappointed.]

[Image: “Well... ‘diagnosed’ is probably not the correct word. There is no formal diagnosis of ‘psychopath’ in the DSM. But all the markers were there.

I displayed a complete lack of empathy on the Davis Interpersonal Reactivity Index, and I scored a perfect 40 on the PCL-R. A blood test showed that I had inherited a damaged gene that has been linked with aggressive behavior, and the activity level in my ventromedial prefrontal cortex is vanishingly low.”]

[Gif of a sudden pan in on Andy from Parks and Rec, looking extremely shocked and very happy]

Guys, gals, and nonbinary pals, I have never before seen a piece of media properly talk about psychopathy. It’s to the point where I actively discourage people from trying to use it in their work, because I’ve never seen it well handled.

But holy shit. The writers of this game did their fucking research.

And guess what? Racter is not a bloodthirsty Hollywood-style “psychopath” who’d stab you as soon as look at you.

Some direct quotes:

“Before I turned to the shadows, I considered myself a ‘prosocial’ psychopath. That is to say, I had the markers for psychopathy, and I expressed some of the expected behaviors. But I never killed anyone... at least, not until it became a job requirement.

Now, I’m not so sure. I will admit that there is a certain thrill to our profession... it’s quite liberating, being paid to hunt and kill other men. But I only indulge in these appetites when I’m on the job, and I never bring my work home with me.”

“People with my condition... my *advantage*... are not incapable of bonding with others. The only difference is that we do so on a cerebral level, rather than an emotional one.

I enjoy our association, and I recognize the advantage in our being allies. I like talking to you. What better reason for us to be friends?”

The writers managed to avoid the near-omnipresent media stereotypes when writing his character. Hats fucking off.

Note - There is more than a little Freudian psych that heavily plays into part of his character. But you know what? It’s actually not too badly handled, and even with my hatred of Freudian psych, the Shrink is willing to give them a pass for this one.

Also note - I was looking through one of the Shadowrun RPG rulebooks and found they had dedicated ~40 pages to operationalizing mental illness for use in a tabletop RPG. It was glorious.

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So, here is my follow-up question on your help with the PSTD: the world the character lives in is an alternate version of the late 19th and early to mid 20th centuries. I know that psychology was in its infancy as a discipline then, so I am wondering if he could get therapy for it then. For plot reasons, my MC is himself interested in forensic psychology (and psychoanalysis- yes, I know...), so I am also wondering whether he'd be able to recognise that there is something wrong with him himself?T

The Shrink was able to clarify that this story takes place in 1920′s Munich and Vienna, which is definitely an interesting time period in the history of psychology! Freudian psychoanalysis was in full swing at that point, and those cities were definitely hotspots for the newly developing field of psychotherapy. So it’s very possible to have your character seeing one of those early therapists.

PTSD as a diagnosis was not recognized until 1978, when it was included in the DSM-III, so you won’t be able to use that term. However, there were certain things back in that era that could be seen as proto-PTSD diagnoses.

These include:

Soldier’s heart / Irritable heart / Da Costa’s syndrome (1862) - It’s unclear, but it’s possible that this was used as an attempt to explain why soldiers returning from the American civil war weren’t the same. However, it was thought to be a physiological heart condition, not a mental disorder.

Railway spine (1867) - specifically referring to the symptoms that passengers in railway accidents developed. However, this diagnosis was controversial, with many thinking it was a result of neurological damage, others saying it was just another form of hysteria.

Shell shock (1915) - this term only arose in WWI, and was thought to be a result of brain damage suffered as reaction to artillery shells going off nearby. It took some time for people to realize that there was a psychological, not physical, component.

All of these were thought to be medical conditions, not mental illnesses - so keep that in mind when writing how your character ends up in treatment. Your character was likely referred to a psychoanalyst after medical doctors could find nothing ‘wrong’ with them.

Whether or not your character could get into “forensic psychology” depends on how you define the term - it’s a pretty broad subject. There were some scattered studies related to legal settings (eye witness testimony, development of the polygraph) in the time frame you’re talking about, but generally psychologists were not taken seriously by the American court system until the 1960s (I’m not sure about other countries).

As for recognizing there’s something wrong with themselves…that’s up to your character. Honestly, it’s pretty likely that they’d realize something is wrong with themselves, but your character may or may not realize that it’s related to their trauma.

http://www.pbs.org/wgbh/pages/frontline/shows/heart/themes/shellshock.html

https://www.ptsd.va.gov/public/ptsd-overview/basics/history-of-ptsd-vets.asp

http://criminal-justice.iresearchnet.com/forensic-psychology/history-of-forensic-psychology/

http://criminal-justice.iresearchnet.com/forensic-psychology/history-of-forensic-psychology/us-developments/

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Actually, on the Oedipus complex thing, it is still studied and used in France, at least in the universities I studied in. And while everybody (except for a few Old People) agrees that Freud is full of shit and that his theories are less scientific than worms in glasses, we tend to think... meh, maybe he was onto something. And a few case studies show that some children may suffer from learning difficulties if they don't "go through the stages". So... period piece or romance in France ? :)

If you’re talking about the psychodynamic school or the Neo-Freudians, sure. There are some adaptions / repurposing of Freud’s theories that do make sense.

The thing with case studies is that…they’re case studies of a single person. Nowadays, we don’t do research like that. We use randomized clinical trials to objectively determine if a kind of therapy is effective.

I will concede that Freudian therapy has been found to be more effective than no therapy at all. But would you rather have treatment that has been found to work for 100 people, or treatment that has been proven to work in 100,000 people? And guess what? The second treatment is much less time intensive (once a week for a few weeks/months vs. 2-3 times a week for at least two years) and cheaper.

It’s like having horses in the military. Yes, they were once an integral part of warfare. There are still some horses in the American military today. But now that we have so many better, more efficient alternatives to horses, it doesn’t make sense to use them anymore.

I did mention in my post to only use it if you’re writing a period piece. If it’s still actually used in France, by all means, go for it. Just know that it’s a laughingstock everywhere else, and using it in a modern setting promotes the misconception held by many people that all therapy is Freudian.

PS: I love the phrase “less scientific than worms in glasses.“

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Hi there! Another note about Freud: as far as I know, his theories are still used in latin America too. I'm from Chile and the freudian (and post-freudian) school is pretty strong :/. I had a teacher that talked about Freud's work as if it were the bible or sth, it was kinda disturbing. The shrink is right, tho: not all therapy is freudian and there are much better options. For example, here in Chile, cognitive constructivism is widely practiced.

Good to know! That’s actually very interesting. I definitely come into this blog from an Americentric perspective; around here cognitive behavioral therapy is the big thing nowadays.

Thanks for sharing more of the international perspective!

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My character is a forensic pathologist, she originally specialized in general surgery. However after she finished her residency and all that jazz, her hands developed a tremor that couldn't be explained as a neurological problem. The thing is she doesn't have the same tremor issue when working with the dead, what I've put in her backstory is it's from anxiety due to several patient deaths, (that were 100% NOT her fault). (1/2)

(2/2) The only problem I have with that is that she’s not overly anxious as a person, in fact that goes against some of her established traits, is there anything else that could explain the tremor developing from something psychological, other than anxiety? Thanks so much, and sorry about the length!

Yep. Conversion disorder with the abnormal movement specifier is exactly what you’re looking for.

I don’t have much in my archives about it aside from an early (and not quite as good) demystifying post on it (see here). As such, I’ve decided to go more in depth with it here.

Some things to note about conversion disorder that aren’t covered in the criteria or are specifically relevant to your character:

It often, but not always, begins after experiencing a psychological stressor (such as, for instance, several patient deaths).

Typically, the character only experiences one neurological symptom at a time.

Conversion tremors are typically irregular (coming and going rather than being constant), and usually disappear when the character is distracted.

One of my sources (see here) even stated that conversion symptoms can reduce a character’s level of anxiety - which sounds very consistent with your character!

There are a couple of different theories why conversion disorder develops. The two I’ve seen described the most are:

Psychodynamic - conversion symptoms develop because they’re symbolic of a psychological conflict being experienced by the character. This theory is very, very old, and was in fact was developed by Freud. And I think y’all know my opinions on Freud at this point.

Learned - the symptoms develop because the character has learned that they gain something (pity, support, etc.) when they express them. They’re not doing it on purpose - it has become a reflexive response.

The psychodynamic theory seems to better explain your character’s symptoms - the psychological conflict seems to be a fear of causing more patient deaths, thus she’s developed the tremor because of her fear. That’s why it goes away when she’s working with dead bodies.

http://emedicine.medscape.com/article/805361-overview?pa=fdPTDcCC03iYrwKYKWFL4m2wtXqzHFEwvcRDkzpYgrWC4imaPwfMXMcakatfOHSkNSWm9PrtbPBjeObGr0x5kV%2FDMAtBBAsM6eN9kpLn%2Fas%3D

https://rarediseases.org/rare-diseases/conversion-disorder/

https://www.brown.edu/Courses/BI_278/Other/Clerkship/Didactics/Readings/Conversion%20Disorder.pdf

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2,000 Followers and Special Announcement!

Y’all, Holy. Shit. 2,000 followers??? :O

Thank you so much, Shrinky-dinks, for coming to my blog and listening to me talk about stuff. I’m sure you’ve heard this all before, but I wanna say it again - I would never have gotten this far without y’all. <3

So to celebrate, I’ve got someone for y’all to meet!

Say hello to Brainy!