Doctor REACTS to House MD | Psychiatrist Analyzes Psychopathic Patient | Dr Elliott

#doctorreacts #drelliott #house #psychiatrist
Check out my reaction to Bojack Horseman: • DOCTOR REACTS TO BOJAC...
It's a Sin reviews: • DOCTOR REACTS TO IT'S ...
This Doctor REACTS video is looking at a classic episode of House MD. House has been admitted to a psychiatric hospital to address his Vicodin dependency and of course, this uncovers some much deeper issues. This is a two parter so I'm dividing this into two videos. Over the two, we'll learn about a variety of mental illnesses, about some medications like SSRIs, and some principles of psychotherapy.
If there's any that you find that you want me to have a look then leave links in the comments or DM me on instagram. Some of these are absolutely brilliant!
SUBSCRIBE for new videos every Sat and every Wed: / @doctorelliottcarthy
Connect with me on socials:
Twitter: @elcarthy
Instagram: @dr.elliott.carthy

[@m3grim]

I've always seen House as less of a medical drama and more of a detective one: a question needing a solution, broad answers to start, more clues added bit by bit, narrowing the focus until a clearer answer reveals itself. Not great medicine, but still great tv imo. 😊💕

[@annadownya]

This is accurate as the show is based around the setup of House being a medical Sherlock Holmes. In fact there are multiple Sherlock Holmes references hidden throughout the show!!

[@m3grim]

@@annadownya Oh for sure! I more meant that like, to me, the medicine is less important than the narrative. Concessions are made to medical accuracy to allow the story to function, and that's fine imo. 👌

[@generichuman2044]

That's why House is one of the greatest shows ever made imo. It is a medical drama but it's not the usual emergency room with constant romance drama. It's more of a detective show with incredible acting and well written characters

[@kyihsin2917]

@@annadownya Starting with his name House (house = home, plural homes, sounds like Holmes) and his buddy Wilson (slightly altered from Watson)

[@Ninad3204]

Guess his address?.... 221B Baker Street

[@OceanLily]

All doctors with YT channels are on a mission to ruin House for us because med school ruined it for them!😂

[@macmcleod1188]

I'm liking the guy who races House for the diagnosis based on the clues in the show. He is doing every episode of house in order- not just hitting the most popular episodes.

[@LuminarySol]

@@macmcleod1188 Who's this? Sounds fun

[@macmcleod1188]

@@LuminarySol Dr Sermed Mezher . He really deep dives into the clues as the show progresses too. So it's very informative.

[@elderwash]

kzbin.info/www/bejne/d4G3hKCZlttqerM

[@laurencewinch-furness9450]

I was at uni with a guy who I'm pretty sure had a personality disorder (probably histrionic). He thought he could qualify as a cardiologist because he watched House!

[@SomeoneBeginingWithI]

to be fair to House "he's the last doctor you'd ever want treating you" is exactly what his job is. You only get to see House if all the other doctors have failed. You'd really really rather not need him.

[@tyrant-den884]

Pretty sure you are intentionally misinterpreting him. There is a big difference between "when no one else can get it" And "You and all your loved ones will be traumatized and then you will die"

[@104thironmike4]

Yeah, no. House is the doctor you never want to see in real life, because real life does not have such things like plot or plot knowledge armor, if you like. Most things that House diagnoses are just flat out wrong, as seen in this case, aka made up. IRL specialists of a certain skill and expertise will suffice.

[@nooneofconsequence1251]

yeah.. I recognize that this show is ridiculous fantasy and nobody like House actually does or could exist in real life... but the premise of the show is that he is always treating patients that are extremely unusual and hard to diagnose or highly resistant to traditional treatments. And... as I have some experience being one of those patients... I can attest to the fact that normal doctors are almost always at a complete loss when they encounter something or someone who is not typical. And I kind of wish someone like House did exist because I've wasted decades of my life on doctors that behaved better without producing any useful results... but... yeah... the show is ridiculous fantasy.

[@allisoncastle]

Oh the cope 😂

[@Eutropios]

He literally addresses this at 17:53. You not understanding this indicates that you didn't bother watching the video.

[@segaiuolo]

(On a speed date) House: "I'm a diagnostician" Woman: "..." House: "I find out what's wrong with people and I fix it" Woman "don't all doctors do that?" House:"... YYEAH, BUT THEY CAN'T DANCE LIKE I CAN..."

[@SaraMorgan-ym6ue]

wait House can dance🤣

[@doctorposting]

she’s right though. it’s annoying when he acts like that’s a specialty. that’s literally what every doctor does🤣

[@segaiuolo]

@@SaraMorgan-ym6ue ... like no other 😁

[@SylviusTheMad]

As my Dad used to say, "Just because I'm paranoid, that doesn't mean they're not out to get me."

[@jakepullman4914]

Did they get him?

[@SylviusTheMad]

@@jakepullman4914 They did not.

[@MintyFreshCupcakes]

Its insane how easily you can get "alterned mental status" in the ER. Last time I was in the ER i was delirious and unable to hold conversations but its because i was in PAIN and about to go into kidney failure. Infections can make someone not act like themselves

[@SaraMorgan-ym6ue]

your a person that does bad things🤣

[@doctorposting]

not sure what your point is. altered mental status is a symptom. so yea, if you have an infection it could cause altered mental status…

[@bertone122]

Almost every sicknes make people act like not themself 🙂, dogs, cats and other animals aswell

[@Antony_Oscar]

Ever since I read a post that talked about how so many chronically ill patients would kill for someone like Dr. House to find out what's wrong with them, I've watched the show very differently. Most of these patients have already gone through a lot of doctors and for sure some of them have been told they're lying or faking it. The post talked about how people are always saying stuff like, "In real life House would get sued so badly", but as I said, a lot of chronically ill people and people with mystery illnesses would kill to meet a doctor who takes them seriously.

[@alicepbg2042]

I mean... it might take awhile for house to take you seriously

[@hollyhayes9640]

Dude, I have a mystery illness that I didn't know about until 2018, and I spent almost that whole time (28 years) being told by doctors that I was faking it for attention/too stressed out/just anxious/hysterical. It got so bad eventually that I got frustrated and ended up figuring out what was wrong with me myself, because no one listened to me for almost 3 decades. I have Hashimoto's Thyroiditis.

[@tyrant-den884]

This is how fake spiritual "doctors" like Jon of God get cults.

[@briancrawford8751]

@@hollyhayes9640 They never test for Hashimoto's antibodies. Did they do it when you asked?

[@missolympiabinewski]

It's amazing how often they start treating something without testing for it first. "No time" is sometimes thrown out as an excuse. A patient crashing is more dramatic than sitting around reading a blood test though.

[@angryshot]

actually this isn't unusual at all. a huge number of conditions (even common ones) are, from a testing perspective, either extremely dangerous, hard to perform or expensive (or all 3, actually those 3 things are completely related, so 1 thing i guess) to test for and even if you do the test it isn't going to give you perfect or even near perfect specificity and sensitivity. when i say testing, i am referring to tests that require complex processes, doctors use simple "tests" all the time, take Bartomier-Michelson's sign for appendicitis. It's complicated, hence the next point. the conceit of the show is that they only take cases that have already been through "the system" so all the "normal" read "statistically relevant" and "simple" or "cheap" tests for likely conditions have been done and have failed. so they get to skip all the "normal" responses. It's highly unlikely any doctor or medical system would ever do anything like they do in this show even though it actually might work (and I believe several of the medical plots are in fact based on real world cases that were extraordinarily unlikely but were diagnosed none the less). Medical insurance and institutional cowardice because of iatrogenic outcomes make House stand out as strange, but not impossible.

[@grabble7605]

How exactly is 'Dramatic fiction includes drama.' an amazing thing?

[@holysecret2]

@@angryshot I like to view him as a mad scientist people turn to when every regular method has failed

[@Eutropios]

​@@angryshotHe literally addresses this at 17:53. You not understanding this indicates that you didn't bother watching the video.

[@labrador_dali]

House MD s6e21 "Baggage" pls I'm gonna keep bugging you about this lmao good episode for you to do because a good amount of it is spent on House's therapy session with Doctor Nolan

[@TonyHavenMusic]

“Hi Elliot, I’m Paul, I’m a diagnostician” Elliot “you don’t exist” Paul - many years of psychotherapy to come

[@TonyHavenMusic]

“Not very treatable” House “hold my Vicodin”

[@marktallentire3464]

House as a real doctor: Worst ever, will kill thousands House as a tv doctor: Awesome 😂

[@sabnock31]

He can't kill thousands even if every patient he treat is going to end up dead. House get's at max one patient a week.

[@craftyluna6381]

Oooooo this is really making me want to see your take on Amos from The Expanse. I don't know if his character is supposed to be a psychopath, but he doesn't seem to have emotions the same way other people do, and he doesn't intrinsically understand right from wrong, but his way of dealing with it is to identify someone he thinks is a good person, and try to act in a way they would approve. It's like he outsources his morality. It would be quite the undertaking to watch the whole show (though you should, it's amazing) but there are some compilations out there that might work.

[@Doodle_1019]

Since House is a Sherlock adaptation, they treat it less like a medical drama, but applying a Sherlock-like method for discovering the diagnosis. House sees everything like a puzzle; a mystery to be solved.

[@tyrant-den884]

That doesn't suddenly mean the methodology is good. He would be a bad detective too.

[@Doodle_1019]

@@tyrant-den884 Oh, definitely not. They just have taken a different approach from the standard.

[@Uhlbelk]

In america we use the term "altered mental status" in medicine to refer to someone being at a different level of cognition than their normal. If I have to send someone to the hospital, and the only clear symptoms are they are lethargic and non-responsive to questions, and appear to be in pain they are unable to communicate, instead of trying to cram all the specific abnormal results into a single line explanation as why they are being sent to the emergency room, we use the term "altered mental status".

[@SomeoneBeginingWithI]

If the person is lathargic, wouldn't "lathargic" be more useful as a one-word descriptor?

[@anduncan15]

Right, but the point is this can cover many things.

[@Eutropios]

He literally addressed in this video (if you even bothered watching) and explains as to why this is harmful.

[@Uhlbelk]

@@Eutropios If you spent the time and effort to tease out the "altered mental status" then you wouldn't need to send them to the ER, or consult a specialist. If you had a 5 paragraph description of everything possibly wrong with a patients mental status, you are wasting time and duplicating effort. Every doctor is trained in school to essentially do every specialty short of the technical procedural work. But I, (and everyone else) don't want the clinic doctor or the ER doctor detailing that cranial nerve IX has a mild left sided weakness. They want quick recognition that this patient is having neurological symptoms in their head that should prompt a stat head CT. Now if the psychiatrist evaluated a patient and stated they had a mental health problem, yes, that would be completely useless, but if it is written by the ER triage nurse it communicates many important medical ideas.

[@katiekehoe724]

Your video made me have kind of a revelation with psychopathy. In general when you talk about it, you only think of it in extremes. Physical violence, ponzi schemes, and torture. But it's not like that in everyday life. Like how there are people with autism who don't speak, can't physically look people in the eye, and need multiple sensory items. (Sorry I have autism and this is how it compared to me, obvs no connection between them). Those are who are like the "poster child" of the condition. But I have like level 1, wasn't diagnosed until 27 because I was able to pass "well enough." I could have gone my whole life without the diagnosis and would have if I hadn't looked into it. My only reason to look into it, though, was because I was noticing the deficits. I don't have a lot of friends, I sometimes can't look people in the eye, I can't carry a conversation well if it doesn't interest me, and my thinking is pretty concrete. These were things that were halting me from engaging in society at the level you expect even "awkward" people to. Nerds, outcasts, punks, LGBT they still manage to find their culture and friends even though "socially" they are seen as other. So my condition puts me at a disadvantage with society in general, why it's classified as a disability. When I started to think about "psychopathy can't be cured" it put in on the same level as my autism in my brain as it can't be cured either. This is just how I am, I can learn to deal with it and try to participate in society as best I can. The same is true for psychopaths, but while my condition worsens my interactions with people, theirs probably makes it better. I mean there is a reason you see so many politicians, lawyers, financial people with psychopathic traits. It is part of what makes them successful. They don't have the same hangups that would make decisions harder. They know what is best for them or the people they need and they take that option every time. So in a sense, and at least in our society as we've made it today (I live in US, so grain of salt) , they actually have an advantage. Their condition can help elevate them in society and I don't know if that says good things or bad things about how our society is set up. Like the only reason people with disabilities are seen as "less than" is because we can't participate in society like we are supposed to. But a person who uses a wheelchair wouldn't be disabled in a society that catered to wheelchair users. Psychopaths have a leg up in society because for the most part they are the ones in positions to make those changes and are convicted in their own self interests. Sorry this was a tangent! But it got my brain firing and I wanted to comment to share this. I want to give the book a read and see what points they make about it. I wish we'd be able to put more time into psychopathy research for things like this. Not necessarily to cure psychopathy, but to understand the human condition better. Like what would the world be if we all had to go to therapy lol

[@aimeem]

That makes a lot of sense. I read that a lot of surgeons tend to have psychopathic traits because it makes their jobs easier

[@lkf8799]

Super interesting comment. Thanks for sharing your thoughts.

[@briancrawford8751]

@@aimeem True. I've also found out from a doctor I know that it's not uncommon for surgeons to retrain in psychiatry.

[@mab9060]

I actually have low empathy (it sometimes happens to people on the autism spectrum), so I'm glad you point out it's a continuum, not a black-and-white thing. Just because I could do something bad to a person and not feel bad doesn't mean I enjoy hurting people or want to hurt people. I'm too scared of the potential consequences of criminal behaviour to ever try it. And diminished empathy actually makes manipulating people way harder, because it's impossible to tell what people want or understand how they might behave in a certain situation. Also, does anyone else think it's strange that promiscuity is on the checklist? I don't see how liking one-night stands is somehow antisocial, and conversely, an asexual person with ASPD might fly under the radar because of that question.

[@diegovasquez840]

ASPD is a combination of a couple of different personality traits, and in the classical sense people with ASPD are extremely impulsive, often acting without regard for others or their own personal safety. Psychopathy is strongly related with this impulsivity, but ASPD and psychopathy (and lack of empathy) are not generally synonymous. The terminology likely needs to be updated.

[@xzonia1]

@@diegovasquez840 Huh, I've never heard of autistic people as being prone to impulsiveness. I'm autistic but didn't know it growing up (found out a few years ago by taking an online test used by professionals and scored really high). The first time I heard about psychopathy I thought maybe that's what's wrong with me (but I do actually care about others and don't want to hurt anyone for that reason). I'm a very thoughtful, cautious person though. I'm also what they used to call "high functioning" so I don't fit all the classic traits of autism. Like the OP, I'm asexual too, so yeah I also find the promiscuity question a weird one to include. I'm genuinely clueless how to manipulate people and that's like watching a magic trick to me when I see others do it (my older brother is brilliant at manipulation on others; not remotely autistic, which might be why his ploys don't work on me).

[@diegovasquez840]

@@xzonia1 “impulsive” references two different phenomena in the context of ASPD vs ADHD/Autism. People with ADHD/Autism (the comorbidity rate is something insane like 80%) refers more to inattentiveness and difficulty with social controls. The impulsivity of ASPD is much different - they cannot stop impulses even if they know it is morally wrong, while those with Autism or ADHD will never do something they find immoral. Manipulation is exclusive to personality disorders and is not a consideration with autism, which is a developmental disorder more than anything. People with autism usually have great difficulty in understanding social cues or manipulation (as you yourself have attested to), but this is second nature to someone with ASPD. They use and manipulate others constantly, and will do brazenly illegal things without a second thought. They may have moral objections, but this is overridden by a complete lack of impulse control.

[@diegovasquez840]

Also empathy is a manifold construct. When we refer to lack of empathy in autism we refer specifically to cognitive empathy (which is the ability to understand the intentions of others), and evidence is already casting doubt on this viewpoint. With ASPD, we are referring to emotional empathy. This is not always impaired in people with ASPD, some may genuinely love animals or close partners, they just have no impulse control and do things that make it seem like they lack empathy. True lack of emotional empathy belongs more in the domain of sadism and machiavellianism.

[@xzonia1]

@@diegovasquez840 Ah okay, thanks! Yeah, my niece has ADHD + Autism. I must have whatever is the opposite of ADHD because I can focus intensely for hours on something / fixate to a high degree on a task. Sometimes I'll blink and hours will have passed without me noticing because I was so focused on what I was doing. I've heard others refer to this as being "in the flow" of their work, but I think in my case it's something else, but I've never heard of a condition that is attention centered (rather than deficient). Yeah, I'd never do something I found to be immoral for any reason. You're very right about that! So strange how these behaviors are defined by conditions we have rather than just being a part of our personalities. X) Thanks for your replies! :)

[@nftbandit9645]

I think the thing that justified House and his antics was the fact that he was people’s last hope. If you got to the point where house was treating you, you’re shit out of options.

[@Eutropios]

He literally addresses this at 17:53. Good try though!

[@youleeahnah]

Loved this ❤🥰. I enjoy your analysis and the humanity behind all your ideas, like acknowledging the human bias and our limitations to understand our own minds, let alone others' ... I wonder if it's really possible to feel real empathy for what another person is feeling when you yourself cannot ever feel or experience what the other person is going through.. for example male doctors attending to women specific health (pregnancy, pcos, etc). I really think bias and misunderstnading empathy play a role in the limited research/ interest to improve the healthcare/ treatment of those we don't understand.

[@macmcleod1188]

The thing to keep in mind is that many House episodes are based on rare but real cases. An ordinary doctor might see one or two of these cases in a career. But by the conceit of the show, these rare cases funneled to house's team. And then they choose the most interesting of those rare cases. In the first season, it's established that other doctors have usually eliminated all the normal, common causes for their symptoms. They stopped spending 60 seconds of the show to reestablish this every episode in the 2nd season.

[@104thironmike4]

Uh, no, that is not true. They are losely based on real conditions and deseases, yes, but not one by one cases, and the correlation is often mixed up or flat out wrong and exaggerated ("truth serum + MRI" lol), or like shown in this video, straight out made up. They are not based on rare but real cases lol. They are fake.

[@Eutropios]

He literally addresses this at 17:53. Try again!

[@macmcleod1188]

@@Eutropios no I didn't do the courtesy of listening to that and his response clearly ignores the fact that all the normal methods of treating the problem have been found to be an effective. So it's going to be simpler just to mute you.

[@factbeaglesarebest]

While being a diagnostician is not medically recognized as a field, it actually is something doctors can specialize in… it’s not your job title but rather an aspect of your job you excel in. Basically some drs can get really good at diagnosing illnesses, especially mystifying ones. So sure it’s not a field of study, but it certainly is an area where doctors can focus and get good at. Your primary may not be able to diagnose a rare disease, or even something quite focused, which is why you go to specialists; psyche, ortho, ENT, etc… There are doctors who are really good with diagnosing (they don’t get involved with treatment usually), but basically yeah. Their strength is in differential diagnosis, evaluation, and they help people get the help they need.

[@cobbsta88]

The cut to Doctor Cox "you're wrong" rant, you are a man of culture hahaha

[@petergivenbless900]

The question around crying is interesting, I assumed it was well understood so I was surprised to hear that it isn't! I wonder if the shared physical aspects that appear in other responses, such as eye watering with irritation (and sneezing) and convulsive breathing in laughter, might paint a picture of how crying functions (a combination of a kind of emotional allergic trigger and gasp surprise reflex)? As to "why do people enjoy watching antisocial behaviours?", perhaps it's kind of like "outsourcing" your shadow?

[@beqaafrasidze1245]

hhey, loved the video as always...Haven't watched you in a while...I'll be honest...don't love the music that is playing in the background while you speak, I dunno if others told you that. But , hhey, you're the youtuber so what do I know. Much love❤️

[@wordlife94]

House may be the last doctor that you’d want to have as a patient, but he’s also the last doctor that most of the patients see. Most of them have already been to several doctors before getting to him

[@roseeame]

love this!!! i wonder if you'd ever look at an episode of criminal minds?? i'd love to see your analysis

[@MichaelJung-o6w]

There is a TED talk, where a doctor x-rayed people diagnosed with mental illness, and a significant percentage showed scarring of the brain tissue, indicating physical trauma at some point, which could point to different treatments, in addition to current treatments. Also, I read of a theory, where most mental illnesses present in adolescents, and the theory is, the RNA acting as ✂ become very active in early adolescents and possibly in some people, cut away too much brain tissue, resulting in mental issues of various kind. I can only wish for definitive answers sometime in the future.

[@killingjoker797]

Watching House and searching medical relevance constantly is like watching Interstellar but on purpose choosing to focus on how that one planet next to the black hole is impossible.

[@finlandguy]

This channel is just awesome! I regularily rewatch your old House reactions!

[@toferj7441]

I think that somewhere in the first season (first few episodes?) they explain that the "department of diagnostic medicine" isn't really a thing and that Cutty created it specifically for House to give him something constructive to do.

[@lafkalaf6374]

Very interesting analysis, & I learned things about psychopathy thanks to you 👍 I'd love your intake on the episode with the schizophrenic mom and her son ("The Socratic Method" in Season 1). I think it's the most interesting House MD episode when it comes to mental health

[@nephilim6032]

The show isn't a medical drama. It's Sherlock Holmes.

[@Stefanka11]

While House isn't accurate when it comes to medicine, it's a fantastic show for philosophical discussions on morality and ethics. I just found your channel recently, oddly enough while looking for something completely different - but i'm glad i stumbled here and ended up binging several of your reaction series videos. I'll definitely be back.

[@alistaircaradec2180]

Oh God, the Wilson's disease one! My mum's an ophthalmologist, and I distinctly remember her going "You what?" when she says they ruled it out based on the absence of rings xD

[@Zer0ThePlagueDoc]

I always find it most entertaining watching diff doctors react to House MD, and they each have a different outlook on him as a doctor. This and Scrubs.

[@XCHADHIGGINSX]

Your American accent is so hilarious and accurate 😂

[@kadda1212]

I find the topic of antisocial personality disorder and psychopathy interesting. I am wondering how one can help someone get through life who has that, especially children who display antisocial behavior and are often very agressive.

[@seanodonnell429]

We are fascinated by people who do bad things because we are fascinated by the unknown. We have a biological imperative to explore unknown territory and try to understand/master it. The drive for exploration and creation is what gives our lives meaning as thinking/rational beings.

[@kjgfdsa3577]

PLEASE more House! I'd love to see you do the episodes "No Reason" and "Baggage"

[@IceMetalPunk]

"Diagnostic medicine doesn't exist." Well, neither does "consulting detective" 😏

[@johnobrien2055]

I mean there's the old adage, just because you're paranoid doesn't mean someone isn't out to get you.

[@Grand_Master_Skywalker]

After all the backstabbing I’ve been through in friend groups, my career across 3 companies, and my family, I’ve learned someone is always out to get you.

[@Haldurson]

I don't know if he was a psychopath, but I have some suspicions. My mom's much younger sister lived with severe schizophrenia, and she'd been in and out of hospitals her whole life. Later in life, she was living with my grandmother. My grandmother was taking care of my aunt in Florida (I doubt she was well-equipped to do that) and my grandmother had a stroke. Meanwhile, my aunt let the family know that she had gotten married. So my brother and I went down to visit the both of them. The fiance claimed to be a geologist (I had studied Geophysics, and I don't think that was a coincidence). He took my brother and I out to a restaurant, where he bragged that he was going to buy that restaurant. He also bought my brother and I clothing at a nearby department store. There were red flags that should have been going off in my mind, especially when my aunt gave me a confused look when I congratulated her on her wedding. After I went home, my aunt and the supposed husband disappeared totally, as did all my grandmother's savings (while she was in the hospital, too sick to take care of finances). The police said that he was a con man, and that they could not find either of them. My aunt, so far as I can tell, was being manipulated. They never actually had gotten married. My mom even hired a private investigator to try to track either of them down. They were never found. Because of how young my aunt was, I still have memories of her before she was diagnosed. I treasured a metal toy yellow submarine that she had brought back to me when she had been traveling to England. I strongly suspect that this guy took advantage of my aunt because of her mental illness.

[@Suthek]

"He's the last doctor you'd want treating you." To be fair, if he focuses on the cases nobody else can solve, more often than not he actually *is* the last doctor treating you.

[@TechTehScience]

House, to be fair, is a detective drama with a veneer of medicine. It's mentioned that he heads the only 'diagnostics department' in the country. Which to say: yes, it's not something that exists IRL, it's a department that only exists within the hospital House works at. The cases he receives are cases that other doctors have been incapable to solve and he finds interesting, so by that logic, if other doctors using typical methods are incapable of figuring a problem out, then House and his team with their unorthodox methods attempt to. Continuing from that, their whole method of naming off ideas is guesses based on symptoms, test results, and what they figure other doctors wouldn't have already checked or treated for. By the time a case reaches House, a history has already been done along with plenty of clinical examinations and investigations by other doctors who failed. So it's not just so much them naming off hunches so much as a hypothesis to see if the rest of the team has a better one or reasonings for why that one doesn't make sense and this is because by that point hypothesis is all they've got. The point of them being quick to treat is because House's medical ideology is that treatment can itself serve as a test by observing how the situation might change. So a hypothesis might be wrong, its treatment may not have helped, but it may give them more to go on. I guess the argument for House and his team being good doctors would fit into the category of patients with terminal illnesses being granted the chance of using medication that is being trial'd. A lot of people would rather take the shot than just die.

[@R.96108]

Very informative. Love your videos. 👍🌷

[@IntolerantMaster]

Loving the video as always but that background piano music is a bit loud and distracting however. Kinda overpowering your voice.

[@cicciofrizzo6663]

I would have loved to hear your thoughts about the ending of this episode, where she does change and decides to leave her husband, but regardless of that, great video, I love hearing people talk about House and this was incredibly interesting and informative

[@transrightspanda]

i was misdiagnosed as schizophrenic for a whole year. after a sui attempt in october i saw the crisis team and they referred me to the local mental health team who then diagnosed me as emotionally unstable personality disorder

[@RanabirDan]

Borderline personality disorder?

[@uekernas]

Love the Dr Glaucomflecken homage!

[@berf9445]

I enjoyed that. My psychiatrist has me diagnosed with "cluster b personality traits", but I don't know if that includes anything from antisocial personality disorder. We've never gone over it, and I've never asked. I don't lack empathy. I think it's an odd "diagnosis". Do you ever diagnose that broadly?

[@Shadow-zf5uc]

Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.

[@hbq76]

There's a lot of overlap between personality disorder constructs, epecially in the cluster B PDs, which are generally characterised by impulsivity, mood lability, and difficulties with relationships and self-image. In the ICD, they don't even use specific PDs any more; it's just 'personality disorder.'

[@GivenFailure]

You should probably ask for clarification, I'm not an expert but that doesn't sound like a diagnosis at all to me. That is odd without giving more information about what they mean, cluster B is categorical rather than descriptive. So for example someone with cluster B traits maybe could have very low empathy, but someone else with cluster B traits could have extremely high empathy leading to emotional instability. It's more about the domain of the traits rather than their specifics or direction

[@briancrawford8751]

That diagnosis was usually added to bipolar disorder on a different axis when they had five axis diagnoses. Biplolar II with Cluster B is a pretty common combo, whether it's true or not.

[@berf9445]

@@briancrawford8751 That's interesting I have bipolar 1 so I guess that makes sense now! Thank you.

[@user-bx3rg7yb1d]

I've got video idea. The TV show supernatural, episode sam interrupted obviously just the parts with the shrinks don't show the monster parts. Buts it's interesting to see what you think of mental conditions involved in a world where monsters are real and how the doctors respond.

[@eyallev]

I think in that ep', it's hinted that she is "evil" after all (or I could be wrong, I also remember an ep' ending with the patient crying in the end, might be that one; or could be both, she figured out how to fake crying).

[@lexwithbub]

I think there was also an ep with a psychopathic kid, and that one turned out like that.

[@eyallev]

@@lexwithbub oh yes, the chess player

[@Harrison_J_T]

As you said fMRI is used for research, not diagnosis. But also studied have shown that certain differences in the brain structure of apparent psychopaths are also seen in those with autism - researchers don't really understand why and definitely recognise autistic people are not psychopaths. But then theres not much understanding of ASD or wgat causes it in general in medicine (though some interesting studues atound this are currently happening) So, while the scenario of Thirteen performing an fMRI is unrealistic, she also is jumping straight to psychopathy when the patient may actually just be autistic. I know thats not the case in this episode but if someone were to go off brsin structure like this its a possibility

[@macmcleod1188]

I think it's not just the MRI. Thirteen was already suspicious. And the patient wasn't acting autistic. We didn't sit through the 30 minutes of questions and observe the patient's reactions. Thirteen did. She's our eyes and ears.

[@jansenart0]

"Just because you're paranoid, don't mean they're not after you."

[@ninino86]

Would love you to do a proper video on psychopathy vs sociopathy. There is so much misinformation out there. Im not even sure anymore if I/we should use those terms anymore.

[@michaelmay5453]

You can absolutely get that from an fMRI scan, in fact there is no better way to do it (the second best being an EEG) and this is a correct diagnosis. Empathy IS more complicated but you'd see a lot more neural activity in someone who was not a sociopath. What we see in this fMRI is a conscious response, a trained response using language without further considerations of the implication of the question. What you'd normally see is a complex response of almost all parts of the brain because this is a question that should trigger instinctual and considered responses, specifically in the basal ganglia and pre frontal cortex but ESPECIALLY in the frontal cortex. On the other hand, this is what you'd see in a sociopath, not a psychopath (who still experiences the full range of neural response and either ignores it or simply elaborates on it to get to a point of the most beneficial for the self response) so perhaps I should have listened instead of writing a response.

[@estellesstories7467]

Thank you for discussing psychopathy as a trait construct on a continuum. This is so often not addressed accurately.

[@estellesstories7467]

You’re likely well aware of the triarchic model of psychopathy in non-criminal populations. Would love to hear your take on the work by Abigail Marsh and colleagues’ org PsychopathyIs.

[@lone_wolf106]

I’ve always wondered if I could beat the police and commit a perfect crime, but I am too empathetic, as well as lazy, to actually try.

[@DerakosZrux]

I actually became more interested in this when I discovered a few series about people with these diagnoses (can't remember which one specifically) that were living normal lives and were really just a little quirky.

[@fannybett9167]

Do you remember now? That show sounds interesting

[@Miss_Lexisaurus]

Do you think some of the love for House is because he's a doctor who is absolutely determined to figure stuff out where many people, especially with more complex or rare issues, deal with doctors who would rather blame the patient or just can't be bothered and avoid running tests - so the idea of having a doctor go to such lengths to figure out what's wrong is almost aspirational?

[@redblue8977]

someone needs to suggest season 5 episode 20 really quick, its perfect for this channel plus addresses house's coping mechanisms

[@Nightraven26]

4:34 in the hospital where I work doctors cannot access patients’ psychiatric medical history in the electronic database. You have to call psychiatrists and ask them to access the database for you and tell you why the patient was hospitalized to see if it’s relevant to the current problem. I’m guessing it’s to protect patient privacy, but it’s seriously annoying that mental health is considered so much different than physical health, and as a doctor you’re not supposed to share any information about a patient, anyway. Also, I’m guessing there’s still a stigma about mental health among medical professionals, as sometimes when you have a psychiatric patient going for surgery, you’re going to have physical diagnoses written in the anesthesiology exam (like DM typus 2, st.post. CVI), but when it comes to psychiatric diagnoses, many doctors will not write them down in Latin, but instead write ICD codes like F23, F31, etc., and then you have to google what the code is to know how to approach that patient. Not to mention if somebody has, for example, anxiety, depression, and organic delusional (schizophrenia-like) disorder, many non-psychiatry doctors (in my experience) will avoid talking about mental health problems and just say “the patient has a couple of F-diagnoses” (referring to the ICD-10)

[@MeredithBKassnerHypnotherapy]

In the field here in the US, we use AMS and we quantify it further. We also try and figure out why they have AMS and treat it if we can. 🚑

[@genegray9895]

Psychopathy has an identity as a disorder outside of ASPD. ASPD is always a behavioral disorder, but psychopathy can have subclinical manifestations and is diagnosable with a brain scan. It's caused by congenital lesions in the left medial temporal lobe, orbitofrontal cortices, and prefrontal cortices. It's an X linked recessive trait so it's more common in XY people than XX people, though the genetics are more complicated than I'm going to get into. The subclinical presentation is comparable to autism but also very distinct from autism, lacking the overt markers like stimming but maintaining underlying traits like lack of empathy and social dysfunction. Subclinical psychopaths also have problems with learning and impulsivity.

[@skyofthelivingdead]

So basically, a fictional show from the aughts is a fictional show from the aughts.

[@BlanBonco]

I get worried about projection then i end up going in destructive circles but i know my blindspot and it's oddly not about it. Variables are so annoying

[@gobbelhuhn3830]

Hello DrEliott, is stumbled across your channel in the past weeks and was really intrigued by sour analysis on various depictions of mental illness in tv shows. Annd of your opionions on related topics as well. But your fascination with schizophrenia leads me to a question. I was diagnosed with this illness at 22 (now im 30) and even though my actual therapist doens't seem convinced by it, becauss i lack a lot of the post-episodic symptoms in thought an behavioue, becase of the intensity and the resistence to treatment of my delusion i experienced in the followong months i wholeheartedly agree with the diagnosis. I was at a psychiatric hospital etc. An because at that time i was a creative writing student, i was determined to write down, how i experienced this crazy episode and wanted to shed some light on the process, how a critical mind can give in to the delusion of a world conspiracy of therapists and other institutions, who bei means of treatment and aimed confrontation and catharis wanted to create the savior of mankind. Yes, it went that deep and i wrote like 30p pages, before i realised, that it sabotaged my therapy and return to reality to concentrate on this delusional thoughts. However the idea of bringing it down to a novel never went away. Especially because i observed that for a lot of people, who experienced something like that, it is hard to document the process. Becauss of the immense stress and so the collection of the crazy worldperceptio theyve build stays superficial even in psychatric treatment, atleast in my case. Life went on, and other things became important but sometimes i srill have the thougt that a really detailed inside view on the weeklong downward spiral thats leads you further and further away from the reality could be of interest for studying schizophrenic episodes. Do uou think there is a value to a 800 + pages long deep dive in psychotic perception to the scientific world? Or am i again overestimating the possible value of such a recollection? Thank you for your content and positive impact on views on mental health. (And sorry for bad english, i am from Germany)

[@thesaltnation5570]

Idk i think house is my favorite doctor show not only because of how he thinks but also the fact that it has sub storys not relating to health at all more about relationships and friendships i love it!

[@camilogonzalez5576]

My takeaway is that I'm binging House again

[@Paradox-es3bl]

I think we have a different definition of violence. Blackmail? Violent? No. Hostile? Sure. Harmful? I'd imagine so. Not violent.

[@Pyrotechnic558]

Loved the video as always. I would suggest not adding the background music when you’re talking though. It’s distracting and I don’t think it adds much.

[@terenzo50]

I wonder if you've ever seen Smiley's People (1982), the followup miniseries to Tinker, Tailor, Soldier, Spy (1979) both starring Alec Guinness. There was a presentation of a character suffering from schizophrenia housed in a Swiss clinic run by nuns that I thought was rather good. The actress was Tusse Silberg. She was very much like one of the two schizophrenic patients I had known personally.

[@justarlo898]

ohh that made me think, i'd love to see your take on sameen shaw in person of interest. She has a self-diagnosed (and unspecified) Axis II Personality Disorder. if you're not familiar with the show itself, i think season 3 episode 5 "Razgovor" gives some insight on her character and how she proccesses emotions :)

[@faelyn.]

Just a question, do you specialize in schizophrenia? I have C-PTSD and my psychologist told me that my hallucinations and delusions are just symptoms of that, but they occur even when I am not having a flashback or dissociating from memories, and the delusions I have are seemingly unrelated from my trauma. I've been admitted for episodes of psychosis before, and I was just wondering if you may have an opinion on this, because I might want to get a second opinion just to make sure if I do have it, I could get tested and catch it early, since many people in my family have also been diagnosed with schizophrenia and schizoaffective disorder. Thank you!

[@tiffanytartt5690]

I’m an EKG tech and work in the ICU strictly. I see at least 4-6 patients in a week with SVT or A. Fib/Flutter. They’re both very very common lol.

[@spaceexplorer29]

This is such a good analysis, always been curious about this subject. The scarf was distracting me the entire video though 😅

[@holysecret2]

On this warm day I was starting to sweat just looking at it 😄

[@AndreJNick]

I know you don't like House but I've always wanted to hear your opinion on S3 Ep12. I think that one could be really interesting

[@danevanaarde7301]

One thing that i hate is when they mix up psychopaths and sociopaths in medical dramas as well as police dramas.

[@grabble7605]

I'd love to sit and watch this video, Elliott, but first I gotta go wash the dishes 'cause I have OCD.

[@urgoslav5107]

This makes me interested in what your opinions on the psychology of the main character's brain from the game, Disco Elysium, and his 20+ internal brain voices he consults.

[@kermstyson]

Suggestion for another episode: Family Guy - Send In Stewie, Please from Season 16 where Stewie goes to an English therapist!! Lots of good things to talk about! :)

[@matthewkilner]

Is your lens dirty or is it a weird upscale or something?

[@theghostofuchiha1496]

This man wouldn't be able to save his life if told to shut up for 15 seconds. It's like man is on a mission to speak every 7 seconds..

[@alextaylor3939]

I'd love to see you react to an episode of The Great, it's a comedy about Catherine the Great overthrowing her husband and becoming empress. I suggest season 2 episode 3, which explores isolation, sleeplessness, trauma, and grief... the entire time watching the episode I was thinking "I wonder what Dr Elliot would say about this"

[@shackielackie]

Very interesting topic!

[@Harrison_J_T]

I have heard what was previously called sociopathy as now being known as antisocial personality disorder but ive akso heard sociopathy and psycopathy are different things. Is it that antisocial personality disorders is something that csn present in many different ways and therefore encompasses psychopathic and sociopathic traits or is it just out understanding of these traits gtieing and therefore terminology and meaning changing?

[@toferj7441]

I had NO IDEA that we knew so little about crying.

[@MARYWTHER]

Lol this video is so liberating. Something I really never liked about House (and really is kinda traumatizing when watching the show) is how they treat their patients like guinea pigs. Oh it's maybe that, let's drill into that person's brain to check our theory. Oh it's maybe that, let's pump their bone marrow. Oh let's inject them with some medicine that could be fatal if we're wrong but oh well if we don't do it they're gonna die anyway. 🤷 And then it ends up being the patient having cut their nails too short and it being some kind of infection or whatever. Something *so benine* and yet the patient spent the episode having 3 seizures and having 4 cardiac arrests, bleeding blue blood and having their skin turn yellow and all. So the drilling to the brain, the organ failures, the blood infections etc, all end up being unnecessary. I swear I watched several House episodes and every time I was like "the way I'd SUE this hospital if they gave me that kind of treatment"... because that's what they deserve. There's an episode where House VOLUNTARLY kills a baby to verify his theory... HUH??! There's an episode where they put a nun through all kinds of crazy things to the point of destroying her liver! But it ends up being her birth control having messed up and her being allergic to copper... My dude, you didn't ASK about her literal birth control before almost killing her?! You didn't CHECK if it was allergies?! Especially since her first symptoms appeared when she was handing COPPER dishes and all?! I would SUE you until you go to jail, my dude! Like I get it, House is a version of Sherlock Holmes... but the people with whom Sherlock Holmes was dealing were mostly dead. House is supposed to save lives yknow...

[@CandygramMongo]

At 12:55 what does dr elliott say as the name of the phenomenon that makes us get the creeps around psychopaths? He mumbles something like « encounter transference » but I can’t make it out. Ive been looking for info on this for a while

[@bc5653]

"it's counter - transference"

[@CandygramMongo]

@@bc5653 Thanks much.

[@birdiekay686]

Can anti-social risk factors be increased by something that happens in utero? Like if the mother takes certain drugs while pregnant?

[@jlchips]

Hi, you say you read comments, but is there a place I can contact you more directly? I have a topic to bring up that is very important.

[@firestorm165]

Friendly reminder that empathy does not equal sympathy. Example you can have empathy for a friend that's complaining that they've lost their license, whether you have sympathy for them once you've found out they lost it because they got caught driving with a BAC 5 times the legal limit is another story

[@dernwine]

"The show that makes everyone want to go to Med School and as soon as you're there you realise what a terrible doctor he is." Ah the Indiana Jones syndrome, I know it well.

[@janleslielvaas3211]

Big house fan, i have some reaction suggestions, Melvin udall from the movie As good as it gets, Hector and Ricky from the movie Hunt for the wilderpeople, the final suggestion is Charlie Baileygate from the movie Me,myself and irene, could be fun.

[@retinapeg1846]

I had to pause the video to check if I was hallucinating the music omg I just switched from oxycodone to a fentanyl patch I thought I was overdosing.

[@linasaurus3254]

What do you think of the psychology of Dr. House himself?

[@Genin99]

He reacted to the story arc about House in a mental institution.

[@jfwalken]

A couple of points, 1) the creators of House base a lot of the episodes on obscure case studies of things that actually happened. So as unbelievable as the cases are, at least in the earlier seasons, they likely happened, they have to update the procedures and what not and its why doctors frequently claim "that's outdated" probably because it was from a case study from the 70's. But it makes me laugh at doctors poo pooing case studies as nonsense. 2) the in universe reason why house doesnt do histories. Is typically the patient has already been to a list of doctors for the same cause. So he presumes that whatever he would ask has already been asked and wasnt helpful or their lying about something and wouldn't tell him anyway.

[@annystasia]

Oh, I've read that Psychopathy is inherited, while Sociopathy is something that you get, was that wrong? I do know that these are not official diagnoses, APD is, but I thought that's how mental health professionals distinguish them

[@seanodonnell429]

Uh, no we should not broaden the definition of violence to include blackmail, harassment, and coercive control. The words we use have specific objective meanings for a reason. It’s so we can communicate with each other. If we just arbitrarily change the meaning of words to include more unrelated things, then we can no longer communicate with each other. Let’s say you are with a friend on a horse farm, and he points in the direction of the horses and says “Look at the dogs!” You are looking in that direction but see no dogs. You’re confused. You say “I don’t see any dogs. I just see horses.” Your friend says “Oh, I expanded my definition of dog to include horses.” Wouldn’t you confused and annoyed by this? Who is your friend to think he can just arbitrarily change the definition of a word for himself that everybody uses?

[@DianeCooperTW]

Hope you do more episodes of House, the way he dismisses and loathes psychology and psychiatry when those are the two things tha can fix him is really infuriating