Francis “Frank” J. Underwood From Netflix’s House of Cards: A Textbook Case of Antisocial Personality Disorder

I always like to take the opportunity to explain misunderstood psychiatric concepts or diagnoses, and to clarify when a psychiatric term is used incorrectly or prone to misinterpretation.  In today’s blog, I aim to do both of these things.

 

First, I’ll use the character of Frank Underwood as a “case study” to illustrate the misunderstood psychiatric diagnosis of Antisocial Personality Disorder.

 

houseofcards-660x374

Kevin Spacey in House of Cards, Image: Netflix

While enjoying the second season of House of Cards, I could not help but notice how Kevin Spacey’s character, Frank Underwood, meets a textbook definition of Antisocial Personality Disorder (ASPD).  Inspired by Spacey’s tremendous performance, I thought I would venture forth and use this example of a central character in a drama to illustrate this misunderstood and, often, underestimated psychiatric disorder.

Individuals with antisocial personality disorder (or sociopaths) are difficult and dangerous; they deny, lie, and contribute to all manner of mayhem in our communities and societies. They know full well what is going on around them and know the difference between right and wrong (and hence are fully responsible for their own behaviors) yet are simply unconcerned about such moral dilemmas.

Below is the “textbook” definition of ASPD interspersed with examples from the life of Frank Underwood, which perfectly illustrate the elements of this disorder.

 

SPOILER ALERT: For those of you who have not been on a streaming binge and watched all of Season 2 yet, consider yourself warned.


Antisocial Personality Disorder 301.7 (From the DSM V): 

A) A pervasive pattern of disregard for and violation of the rights of others,  occurring since age 15 years, as indicated by three (or more) of the following

1) Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.

 

Image: Netflix

Image: Netflix

Murder. Not once, but at least two times (that we know of).  He swiftly pushed Zoe Barnes into the path of an oncoming metro train. Let’s not forget this was a woman with whom he had had a physical relationship with and a (sort of) emotional intimacy.  No doubt, this personal history contributed to Barnes’ poor judgment and her letting down her guard; she suspected he was a murderer but still underestimated what he was truly capable of. Frank leveraged her miscalculation to his favor.

In addition to murder, let’s not forget the unlawful behaviors carried out, on his orders, by those who work for him – e.g. vanquishing the remaining reporters who tried to expose him for what he truly is.

 

2)  Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure

 

Image: Netflix

Image: Netflix

Honestly, I found it hard to keep track of the web of lies Frank wove during Season 2. What was notable was the sincerity with which he told many of these lies, almost as though in the moment he believed them himself. He repeatedly lied so he could drive a wedge in the previously tight relationship between the Billionaire, Raymond Tusk, and the President – a wedge he created, on purpose (and at much cost and hassle to the American tax payer!) to further his own goal of becoming President. 

 Then there was the web of lies told to cover the fact that his wife Claire’s (played by Robin Wright) abortion had nothing to do with her alleged rape by General McGinnis, but more to do with the inconvenience of Underwood’s political campaign timings.

A final example is the strategic drama he created (along with Claire) to cover her affair with Galloway.  Again, there was no inkling of any remorse or feelings that they should be held accountable for their actions.  Instead there was only a rigid entitlement:  How dare anyone get in the way of me becoming president?

 

3)  Impulsivity or failure to plan ahead

 

Underwood has a degree of impulse control.  In fact, his ability to plot, scheme, and plan has served him well with regards to his political posturing and career.  This is not the case for many with ASPD.  Those without means, education, or status can be dangerously impulsive, and this behavior often leaves them in jail, prison, or dead.

 

4)  Irritability and aggressiveness, as indicated by repeated physical fights or assaults

Image: Netflix

Image: Netflix

 

See point #3.  He is aggressive and violent but has probably learnt, over time, to become more measured in his actions.  Repeated irritable outbursts and acts of physical aggression are not compatible with life in political office.

 

5)  Reckless disregard for safety of self or others

 

 See point #1.

 

6)  Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations

 

 Did Frank Underwood honor any of his obligations or duties associated with being the Vice President of the United States of America?  Did he use his powers to be of service to the American people or to his country?  No.  His days and nights appeared to be utterly consumed with one goal…to become president of the United States.  At any cost.

 

7)  Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated or stolen from another.

 

Image: Netflix

Image: Netflix

This was best illustrated in his reaction to the murder of  Zoe Barnes.  It was business as usual.  Not a hair out of place, no loss of appetite or sleep.  No remorse, no guilt or angst. She was getting in his way as he tried to forge a path to the presidency, so he got rid of her and never thought about it again. Her murder was no more of an incident than flicking lint from his jacket lapel.  In fact, he was so cool after the event that it makes me wonder about his psychopathic tendencies, but that would be a whole other blog for another day.

 

B) Individual is at least 18 years old

 

C) There is evidence of conduct disorder with onset before age 15 years

 

Who knows what skeletons lie in the Frank Underwood closet?

 

D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

 

One final point that is not done justice in the brief description above (more details can be found here) – those with ASPD are able to be utterly charismatic, charming, and almost bewitching. This characteristic is one Spacey has down to a tee in his performance.

Image Credit: Melinda Sue Gordon

Image Credit: Melinda Sue Gordon

When Frank wants something or needs to manipulate someone, he is able to “switch on” the charm in an instant.  He conveys to others that he cares deeply about them by flashing an infectious smile and being gracious and attentive.

And, as season 2 showed, there were many who fell prey to his deceit…not least of all the President of the free world.  Perhaps nowhere is his charisma more evident that in the perverse loyalty of those in his inner circle; all turn a blind eye to what he is capable of and appear to be utterly captivated by his personality and presence.

 

My second point: The term “antisocial” is used incorrectly or prone to misinterpretation. 

 

The seriousness of ASPD leads me to my next point – the confusing usage of the term “antisocial.” Antisocial is often used in lay language to indicate someone who is shy and unwilling or unable to associate in a normal or friendly way with other people. While this is a legitimate definition of the word, I have never been a fan of how this one word can be used in such opposing ways. I would advocate that we reserve this word for individuals with personality disorders associated with the features described above. People who are described as “antisocial” because they are shy are (typically) not dangerous.  This is in sharp contrast to the definition of antisocial widely used in mental health terminology. In this context antisocial goes hand in hand with being “antisociety” and is a disorder associated with much more sinister and outright dangerous and reckless behavior.

 

At this point, many of you might be saying, well who cares about these individuals?  They are just evil, so why bother to make a psychiatric case about them?  Just lock them up and throw away the key!

 

But the situation is vastly more complicated than that.

 

ASPD is common.  For the reasons outlined above (their lies, deception, and charm) sociopaths are not always easy to detect, yet ASPD is associated with huge costs to our society that extend well beyond the individual who has the disorder. We have to stay curious about ASPD – about how the disorder develops, how to detect it, how to manage it – as our societies pay for its consequences on many levels, economically, socially, and emotionally.

And when someone with ASPD ends up in a position of unparalleled power? Well, who knows what the consequences could be.

 

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16 Responses to Francis “Frank” J. Underwood From Netflix’s House of Cards: A Textbook Case of Antisocial Personality Disorder

  1. n00ser says:

    I appreciate your second point and your attempt to reclaim the term antisocial. The introvert in me especially appreciates it. However, I think using Frank Underwood as a “textbook” case only worsens the problem of misunderstanding the diagnosis.”Sociopaths” are only a small minority of the people who meet criteria for ASPD, and most commonly also overlap between ASPD and Narcissistic Personality Disorder (NPD), for which he also clearly meets criteria. Not all people who meet criteria for ASPD are even close to sociopaths. The most common underlying trait for antisocial behavior is not lack of empathy, but impulsivity. Frank doesn’t have “a degree” of impulse control, he has superhuman impulse control and devises and executes complex manipulations across months and even years. Neither is he “reckless,” meaning acting without consideration of consequence. On the contrary, he is acutely aware of cause and effect, and able to carefully plan because of this awareness. Suffice it to say, Frank is far from a textbook case of ASPD; he is the exception to the rule.

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    • Shaili Jain, MD says:

      I agree Frank has “superhuman impulse control” when it comes to his political posturing but the murders (x2) are a example his lack of control over his primal impulse and, hence, his “recklessness,”

      He has people who can kill on his order; by engaging in the antisocial acts himself he risks loses everything he is striving for….he can’t help himself and in that moment he acts without consideration of consequence.

      My guess is that the 20 year old Frank was horribly impulsive and reckless but, over the decades, he has honed it, “burnt out” a little if you will….

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      • n00ser says:

        Hey, thanks for the reply. I see that we are using different definitions of “impulse,” which may be the source of our disagreement. It seems to me that what you mean by the “primal impulse” is an unconscious drive, i.e. something akin to the “Id.” I could of course be mistaken, but I believe “impulsivity,” as referred to by the DSM, is to be understood as acting without thinking, rather than heeding an unconscious, primal impulse. As per the DSM, the criterion is met when a person does things, “on the spur of the moment, without forethought and without consideration for the consequences to self or others.” This is quite uncharacteristic of Frank. In addition to it being a criterion, it is the most prevalent trait associated with the diagnosis (ADHD is a primary risk factor for development of ASPD). I would have to see a pattern of being unable to control immediate impulses in order to consider this criterion met. Perhaps he was more impulsive in his youth, but if he does not meet the criterion now then it does not matter for current diagnosis. I wouldn’t expect it to attenuate so much anyway; we’re talking about a personality disorder here.

        Perhaps I am picking nits. The reason I bring this up is not because Frank doesn’t meet criteria for other ASPD items (e.g. deceitfulness), but because Frank is an exception to the “textbook” (meaning typical) definition of ASPD, and as such perpetuates the myth that ASPD is equivalent to sociopathy. He is clearly a sociopath. However, to my understanding his behavior is not typical of an ASPD diagnosis. Thus, using Frank as a textbook example perpetuates the myth that ASPD = sociopathy; this is my only beef with your excellent post. It seems I am making an issue out of something small, but I am concerned with larger implications of misconceptions about diagnoses and potential stigma, something we must always be vigilant against.

        I appreciate your reply. You certainly pushed a button and got my mind fired up.

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        • Shaili Jain, MD says:

          Thanks so much for your thoughtful comment! I appreciate your perspective!

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  2. hey man !!! you completely ruined my admiration for FRANK .

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  3. Pingback: Reporte Ciencia UANL » Francis “Frank” J. Underwood From Netflix’s House of Cards: A Textbook Case of Antisocial Personality Disorder

  4. Pingback: An examination of House of Cards’ Frank Underwood, “a textbook case of antisocial personality disorder” | Scope Blog

  5. Maria says:

    Please write Claire Underwood psychological portrait. She’s extremely more complex than Francis and, unlike him, capable of proving guilt, something that has to do maybe where the show is heading plot wise, as Claire is based on Lady Macbeth. Robin Wright played her with subtle perfection, she does a lot with gestures, stares, body language.

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    • Shaili Jain, MD says:

      thanks for your comment. Watch out for an upcoming follow up post on Claire’s diagnosis!

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  6. Pingback: Examining House of Cards’ Frank Underwood, “a textbook case of antisocial personality disorder” | iLoveMyBrain

  7. Rusty says:

    Thank you for this interesting article. I’m curious about Frank’s ability to love. He professes love (although possibly platonic) for Claire, and seems to sometimes have loyalty or affection for others such as Freddy (the BBQ restaurant owner) and his chief of staff. But is a sociopath truly capable of these feelings? If not, how can we explain Frank’s “softer side.”

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    • Shaili Jain, MD says:

      Thanks for your comment. I think you are spot on when you say he “professes” love. Frank “loves” those whom he views as an extension of himself, i.e. those who represent a narcissitic extension of himself. The levels of loyalty he demands is oppressive e.g. gets his chief of staff to do all sorts of illegal activities on his behalf. Did you see how he revelled in pitching Doug stamper against the new guy on his staff? Not a very nice way to treat your inner circle? My guess is the minute people don’t do what he asks of them he stops “loving” them and drops them in an instant. The story with Freddie was touching but again fleeting, I doubt his thoughts re: Freddie would linger on…

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      • Rusty says:

        Thanks for you reply. I agree it seems like he only treats people well as long as they’re useful to him. I thought it was interesting that he initially was angry at Claire when she foiled his plans for the Clean Water Act, but seemed to listen and back off when she complained they hadn’t been in sync for the past six months. It was almost a wake up call that he needed to realize how important it is to continue to have her as an ally, for the moment anyway.

        On the question of impulsiveness raised by Nooser, I’m curious about the need to only meet three of the criteria to be considered a sociopath. Perhaps he doesn’t meet that criteria, but enough of the others to still be considered a sociopath?

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  8. coacervate says:

    I’m fascinated by this analysis. I am not up to your level of knowledge but one thought came to me that may be of interest. It was clear to me that Francis, like Hitler, thought he was doing right. They both saw their ends justifying the means. So in that sense does he really know right from wrong? and to really push the envelope…Frank was the one “wronged” by a weak and potentially disasterous administration. What weight do a couple of little lives have against the potential good that a strong benevolent despotic character brings to the presidency? What will happen now that Frank has won? Is it similar to our fate had Hitler won?

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    • Shaili Jain, MD says:

      Thanks for your comment.
      Hmmm, I think I would beg to differ…I think he does know right from wrong he just does not care and he gets so much pleasure from doing wrong he cannot resist. He derailed the government and subverted government policy, he could not get over the personal insult to his ego that the president overlooked him for the post he decided so he made it into a personal vendetta, putting it before country and doing his job as he should.

      I have yet to see any clear ideology come from Frank…who (other than himself) is he doing all this for? What is all the point? I don’t sense any bigger vision or “higher purpose” other than his own insatiable need for power.

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