Hitler Multiaxial Psychological Profile - Research Paper Example

? The multiaxial assessment carried out by this study on the psychological profile of Hitler has diagnosed Hitler with a set of mental and personality disorders. The major mental disorder that has been found out in him is paranoid type schizophrenia combined with personality change caused by exposure to mustard gas that he had as soldier in the First World War. Hitler also had had paranoid personality disorder. The environmental factors that contributed to his psychological morbidity have been identified as father abuse and spoiling by mother. He has been diagnosed as having “minimal psychological symptomatology but significant impairment in functioning” as per the global assessment of functioning score (American Psychiatric Association, 2000, p.33). In view of this diagnosis, it has been concluded that continued medication combined with psychotherapy for a prolonged period is the only way possible to bring such a person at least partially to premorbid conditions. Hitler's Multiaxial Psychological Profile • Introduction of the person Hitler is a person who needs only the mention of his name to be identified worldwide, but needs more than what is available in our academic knowledge to be understood as an individual. Hitler’s character has been an intriguing phenomenon for psychologists who have studied the complexities of his behavior that prompted the genocide of Jews and the Second World War. It can be generally stated that Hitler was a cruel man, a dictator, still a crowd puller at least in Germany of his period. He might also be considered as a social evil, if examined from the criteria of humanism and human rights. First person accounts of personal encounters with this man have depicted him as “unremarkable and unlovely” (Welch, 1998, p.2). It has also been said that while “the pathology (of Hitler) alarmed some Germans (in the period of his making), for most, it added to his appeal” (Victor, 2000, p.6). • Background of the person and presenting information In 1919, when Hitler became a member of the Nazi Party, “he was a homeless, lost person-a dreamer trying to hang on to his tenuous identity as a soldier for a country of which he was not even a citizen” (Victor, 2000, p.6). A native of Austria, Hitler had a troublesome childhood with constant failings in schools and eventually he became a drop out (Victor, 2000, p.6). After his mother’s death (with whom he had a very strong bonding) and after failing to get admission to an art school, Hitler had totally avoided contact with his family members and friends (Victor, 2000, p.6-7). The time was also getting ripe for the rise of a figure like Hitler as Germany was going through a stage of “political instability”, economic crisis, sudden changes in the society (fading aristocracy and an impoverished middle class), “fear of communism”, and also disillusionment with the leadership (Victor, 2000, p.6). Hitler infused a sense of nostalgia for the past legacies and a romantic kind of nationalism in the minds of the people by manipulating this social context (Victor, 2000, p.6-7). Though Hitler has been judged as a man of “insecurity and personal weakness” by historians like John Lukacs, contrasting these psychological readings, he rose to the pedestal of a national hero, moreover a dictator (qtd. in Victor, 2000, p.7). Becoming the ruler of Germany, Hitler carried out extermination programs of Jews who he thought were evil and responsible for all failures of Germany, thereby killing millions of Jews in concentration camps and gas chambers. And this is the context in which it has to be found out what was the mental profile of this man that prompted him to commit such inhumane acts. • Data collection methods (testing, interviews, observation, etc.) As no direct interviewing can be carried out while examining the psychological profiles of historical figures, what a researcher has to depend on for data collection in this kind of research are previously done studies and also interviews with the authors of such studies. This is applicable for the given situation as well. This study will conduct email interviews with five living historians who have studied the psychological profile of Hitler and published more than one book or article on the same. All the response sheets relevant to the multi-axial analysis will be e-mailed to these five persons and their replies collected. • Five-axis diagnosis This study envisages conducting a multi-axial diagnosis of Hitler’s psychological profile. A multi-axial diagnosis is “an assessment on several axes, each of which refers to a different domain of information that may help the clinician plan treatment and predict outcome” (American Psychiatric Association, 2000, p.27). The five axes explored in such an analysis are: Axis I Clinical Disorders Other Conditions That May Be a Focus of Clinical Attention Axis II Personality Disorders Mental Retardation Axis III General Medication Conditions Axis IV Psychological and Environmental Problems Axis V Global Assessment of Functioning (American Psychiatric Association, 2000, p.27). The usefulness of this method of psychological assessment has been that it gives a comprehensive picture of the psychological profile of the assessed person “that might be overlooked if the focus were on assessing a single presenting problem” (American Psychiatric Association, 2000, p.27). This method is highly systematic as well, which enhances its validity (American Psychiatric Association, 2000, p.27). Under Axis I, the analyst has to report “all the various disorders or conditions in the Classification except for the Personality Disorders and Mental Retardation” (American Psychiatric Association, 2000, p.27). The conditions are listed in the order of their gravity and include all mental problems like, schizophrenia, cognitive disorders, anxiety disorders, eating disorders, sleep disorders etc. (American Psychiatric Association, 2000, p.28). Under Axis II, personality disorders like paranoid personality disorder, antisocial personality disorder, narcissistic personality disorder etc. and mental retardation have to be coded (American Psychiatric Association, 2000, p.29). While listing and coding conditions under Axis III, medical conditions outside mental disorder categories “but relevant to the understanding or management of the individual’s mental disorder” are included (American Psychiatric Association, 2000, p.28). These may include, infectious and parasitic diseases, or any other general medical conditions, or even “injury and poisoning” (American Psychiatric Association, 2000, p.30). Under Axis IV, “psychological and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders” have to be included (American Psychiatric Association, 2000, p.31). These can be factors like an event in the life of the person, any kind of stress, psychopathology of the person etc. (American Psychiatric Association, 2000, p.31). And these conditions are further classified into groups for the sake of convenience like “problems with primary support group”, which is problems with family members, “educational problems”, “problems related to the social environment” like problem with a peer, “housing problems”, etc. (American Psychiatric Association, 2000, p.31). Under Axis V, which is named, global assessment of functioning, “clinician’s judgment of the individual’s overall level of functioning” is included (American Psychiatric Association, 2000, p.32). This is done by way of “Global Assessment of Functioning (GAS) Scale” (American Psychiatric Association, 2000, p.32). This scale consists of “10 ranges of functioning” (American Psychiatric Association, 2000, p.32). If any one of the Axis I and II disorders is absent, it has to be coded as V71.09. (American Psychiatric Association, 2000, p.28). If Axis III disorder is absent, it is noted down by writing, ‘Axis III: None’ (American Psychiatric Association, 2000, p.30). While doing this multi-axial analysis, the coding system for this study, was based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). The results of the multi-axial assessment that was conducted are given below: Hitler – DSM multiaxial diagnosis Axis I – 295.30 Schizophrenia, Paranoid Type 310.1 Personality Change Due to Mustard Gas Exposure, Combined Type Axis II – 301.0 Paranoid Personality Disorder Axis III – 987 Toxic Effect of Mustard Gas Axis IV – Problems with Primary Support Group – Father abuse, Mother spoiled him Axis V – 31 GAF The score 295.30 on Axis I indicates paranoid type schizophrenia. The symptoms of this disorder include “excess or distortion of normal functions” and also “a diminution or loss of normal functions” (American Psychiatric Association, 2000, p.299). The code 310.1 stands for personality change caused by the trauma of mustard gas exposure. The score, 310-1 on Axis II represents paranoid personality disorder. People having paranoid personality disorder are found to “persistently bear grudges and are unwilling to forgive the insults, injuries or slights that they think they have received” (American Psychiatric Association, 2000, p.691). The score, 987 on Axis III represents again the toxic effect of the mustard gas. As shown by the assessment on the Axis IV, Hitler has been found to have been mentally and physically abused by his father and also spoiled and unnecessarily pampered by his mother. These are supported by the studies done previously as well. On Axis V, the score is 31 which represents the global assessment of functioning made by the researcher. This score indicates an individual “with minimal psychological symptomatology but significant impairment in functioning” (American Psychiatric Association, 2000, p.33). The other psychological features of a person belonging to a GAF score of 31 are: Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure or irrelevant) OR major impairment in several areas, such as work, or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school (American Psychiatric Association, 2000, p.34). Here, it can be seen that many of these characteristics match with the childhood and adult biographical information on Adolph Hitler. • Related psychosocial and family issues At a personal level, Hitler has been found to have some psychological reasons for his anti-Semitism. Fr example, some historians (Victor, 2000; Fest, 2002) have pointed out that Hitler attributed his strained relationship with his father (who, according to some reports, was an illegitimate son of a Jew), to his father being evil, of a mixed race (Victor, 2000, p.18). This notion of Hitler might have been enhanced by the ill treatment he had to endure at the hands of his father. On the other hand, his mother pampered Hitler and she provided him with money throughout the youthful years of her son as he wandered without taking up any job (Fest, 2002, p.21). The life of Hitler as a youth was characterized by sustaining on others’ charity, “unable to study or work, unable to sustain an intimate relationship, and beset by inhibitions, conflicts, and imaginary diseases” (Victor, 2000, p.7). From this description, it is more than clear that Hitler was mostly incapable of establishing normal relationships with other people, and this applies to his family as well. Regarding Hitler’s sexuality, there have been contradicting reports but the major psychosocial implication of his sexuality has been that he tried to control other people’s sexuality. In order to establish a perceived pure and superior race, Hitler “established restrictions on intercourse among adults and over thirty restrictions on marriage, while urging unmarried adolescents to get pregnant” (Victor, 2000, p.8). He also launched a “breeding program that included kidnapping women” (Victor, 2000, p.8). Under yet another experimentation project, many people whom he thought incapable of producing healthy and intelligent children of pure race were sterilized (Victor, 2000, p.8). Hitler is also been supposed to have feminine character by analysts and it has been observed that his attractiveness to German masses of that period arose from a “feminine quasi-erotic appeal” (Kershaw, 2001, p.33). • Related career and vocational issues Hitler could not complete his academic studies in a normal way and he became a school drop out (Fest, 2002, p.18). Hitler himself had attributed this failure to the sense of defiance that he felt towards his father (qtd. in Fest, 2002, p.19). Hitler had a talent for drawing and sketching but after declaring that he was going to dedicate his complete attention to painting, he dropped out of that vocation also (Fest, 2002, p.21). He also could not procure admission as an art student to the Vienna Academy (Fest, 2002, p.28). Young Hitler had been found to be incapable of “systematic work” and always searching for “new occupations, new stimuli, new goals” (Fest, 2002, p.21). He never could stick on in one particular profession or pursue a single career goal. When he tried to join Austrian army, his application was rejected owing to his poor health condition (Fest, 2002, p.62). But later he was taken into the German army during World One and was awarded the “Germany’s highest award for bravery - the Iron Cross” (Fest, 2002, p.68). But in every vocation, Hitler was not much liked by his colleagues and he was considered as a difficult personality (Victor, 2000, p.69). October 1918, was a crucial period in the life of Hitler as he was “blinded by a (mustard) gas attack” in the war (Coolidge, Davis and Segal, 2007, p.2). Coolidge, Davis and Segal, (2007) have inferred from their findings that Hitler was suffering from post-trauma mental “repercussions of mustard gas exposure” (p.13). It was while he was admitted in a hospital after the gas exposure that Germany was defeated in the war. And it was after he came back from the war that he entered politics and rose to the leadership of Nazi Party and Germany. • Proposed treatment and intervention options Coolidge, Davis and Segal (2007) had also studied the psychological profile of Hitler and have concluded that he had paranoid type schizophrenia (p.12). Also he had been diagnosed with antisocial, narcissistic, paranoid, sadistic and borderline personality disorders (Coolidge, Davis and Segal, 2007, p.13). The findings of the present study are in agreement with this previous study as well. As “complete remission…is probably not common in” schizophrenia, the positive symptoms that could help a prognosis have been identified (American Psychiatric Association, 2000, p.309). These factors are: Good premorbid adjustment, acute onset, later age at onset, absence of anosognosia (poor insight), being female, precipitating events, associated mood disturbance, treatment with antipsychotic medication soon after the onset of the illness, consistent medication compliance (i.e., early and consistent treatment predicts better response to later treatment with antipsychotic medication), brief duration of active-phase symptoms, good interepisode functioning, minimal residual symptoms, absence of structural brain abnormalities, normal neurological functioning, a family history of Mood Disorder, and no family history of Schizophrenia (American Psychiatric Association, 2000, p.309). In the case of Hitler, if a hypothetical treatment plan has to be prepared, all these factors have to be singularly considered and decided upon. The present study has revealed some information regarding some of these factors only. In such a situation, further study has to be conducted before deciding upon a final treatment plan. Regarding the personality disorders that have been mentioned above, as found in Hitler, the treatment option is “an average of 520 hours of” psychotherapy (Sartorius and WHO, 1993, p.237). Psychodynamic group therapy has been found to be the most effective method under this (Sartorius and WHO, 1993, p.273). • Continuing assessment and proposed follow-up Regarding a person with the above-said psychological profile, continuing assessment and follow up is very crucial. In the case of Hitler, such a concept can be applied only hypothetically. Continued medication and psychotherapy for a prolonged period is the only way possible to bring a person at least partially to the premorbid conditions. The multi-axial assessment has also to be repeated in fixed intervals. • Potential legal and ethical issues There is a set of potential legal and ethical issues involved with the treatment of such a person. In the case of Hitler, even if it is assumed that it was possible to make a multi-axial assessment on his psychological profile when he was alive, an ethical and legal problem is bound to arise. Hitler being a leader of a political party and a hero of his times, at least in Germany, it would have been legally impossible to get his approval and cooperation for carrying out the assessment and not to mention to commence a treatment. The ethical issue involved might be that when an individual and the majority of people who know that individual, consider that individual as normal (not having any psychological problem), there could not be any scope for a diagnosis and treatment ethically. References American Psychiatric Association, (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR, American Psychiatric Association Task Force on DSM IV, Arlington: American Psychiatric Pub. Coolidge, Davis and Segal, (2007) Understanding mad men: a DSM IV assessment of Adolf Hitler, Individual Differences Research, Vol.10, No.10, pp.1-16. Fest, Joachim.C. (2002) Hitler, Boston: Houghton Mifflin Harcourt. Kershaw, Ian (2001) The "Hitler myth": image and reality in the Third Reich, Oxford: Oxford University Press. Sartorius, N. and World Health Organization (1993) Treatment of mental disorders: a review of effectiveness, Arlington: American Psychiatric Pub. Victor, George, (2000) Hitler: the pathology of evil, New York: Brassaey’s. Welch, David, (1998) Hitler, London: Taylor & Francis. Read More