Netflix's House of Cards may be the best show on TV. The series is loaded with lies, deceit, secrets, murder and sex to be sure, but to me the most fascinating aspect is the depiction of the two main characters, Frank Underwood and his beautiful and equally power-hungry wife, Claire. Frank and Claire are textbook cases of pathological narcissists functioning at the highest level.

It takes a special, power-driven, morally corrupt individual to do what Frank Underwood does. The word sociopath jumps to mind, but is Frank really a sociopath, or just a man with an unquenchable thirst for power? Let’s bring out the DSM criteria and analyze:

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:
 
• Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. No surprise here. Frank Underwood is constantly scheming to get what he wants, laws and ethics be dammed. Murder is simply a tool to get rid of a problem. One of the most shocking scenes is when he secretly meets a nervous Zoe in the subway. When she least expects it, Underwood pushes her into the path of an oncoming train, showing no hesitation and no regret, even though they had a physical, intimate relationship. Check.

• Deceitfulness, as indicated by repeated lying, use of aliases or conning others for personal profit or pleasure. It's difficult to keep track of all the lies Underwood weaves, though he lies so well you're almost convinced he believes his own lies. Lies to cause a huge rift between the billionaire Raymond Tusk and the president; lies regarding Claire's abortion due to her alleged rape by a top-ranking general, and lies to cover up Claire's affair with the photographer. Francis Underwood deceitful? Check.
 
• Impulsivity or failure to plan ahead. Francis Underwood does not fit here. He is rarely impulsive. Rather he is planning, plotting, scheming and calculating—doing whatever it takes to get on top and stay there. His top-notch, prestigious education has served him well in this regard. We can place a big X here.

• Irritability and aggressiveness, as indicated by repeated physical fights or assaults. For the most part, Frank Underwood does not get his own hands dirty and will usually get others to do the dirty work. When necessary, however, he will do whatever it takes without hesitation and without regret, like killing Zoe. Underwood, however, has a willing partner in crime that will do his bidding. Loyal to a fault, the cold-blooded Doug Stamper is kicked to the curb by President Underwood, yet even here he still proves his loyalty and value. Underwood approved of Stamper using Rachel to seduce the alcoholic Peter Russo who Underwood later kills. Check.

• Reckless disregard for safety of self or others. The entire series of House of Cards is based on Frank Underwood's total disregard of others. Not self, mind you, but others. Take, for instance, when he looks into the camera and tells us coldly of Michael Kern (Underwood's Secretary of the Treasury): "I almost pity him. He didn't choose to be put on my platter. When I carve him up and toss him to the dogs, only then will he confront that brutal, inescapable truth."

In the art gallery to Zoe Barnes, he says very matter-of-fact, "I just love this painting, don't you? We're in the same boat now, Zoe. Take care not to tip it over. I can only save one of us from drowning." Underwood is void of a moral compass of this we are certain.
 
Underwood exhibits a disregard for anyone who is not out to do his bidding, as illustrated by one of his many threats, "Love of family. Most politicians are permanently chained to that slogan, family values. But when you cozy up to hookers and I find out, I will make that hypocrisy hurt." His threats are ruthless, not mere words and are aimed and ready to be carried out, no matter the casualties. The world revolves around the narcissistic Francis Underwood, as his thoughts prove episode after episode. This includes inanimate objects as well: "You see, Freddy believes that if a fridge falls off a minivan, you better swerve out of its way. I believe the fridge's job is to swerve out of mine." Check.

• Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. Francis Underwood is consistently thinking, plotting, working. We have no knowledge of any lack of keeping up with financial obligations. However, his top priority and goal is to become President of the United States. When he was Vice-President we saw him plot, scheme and sabotage at every turn to topple the President from his position. Does this serve his position's responsibilities? Perhaps not, but he is a tireless worker and schemer which eventually led to him becoming President. Even if it's evil and conniving, he's consistently working and plotting. Place an X here.
 
• Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated or stolen from another. Frank Underwood is looking out for Frank Underwood, no matter what it takes. "You don't want to work anywhere you're not willing to get fired from, Zoe. Treading water is the same as drowning, for people like you and me." Underwood seems indifferent to anything that doesn't benefit himself. Garret Walker asked, "Are you letting pride cloud your judgment, Frank?", to which Underwood detestfully replied, "Respectfully, sir, you're allowing fear to cloud yours."

Probably greatest window into Underwood’s soul was illustrated after he murdered Zoe. They had been lovers, but that didn't matter. The murder was business -- nothing personal. He never lost his appetite and he sure didn't lose any sleep. Check.

B. The individual is at least age 18  years. One must be at least 35 years of age to be President. Check.
 
C. There is evidence of conduct disorder with onset before age 15 years. We aren't privy to much of Underwood's childhood but no telling what sort of skeletons he has in his closet. I’m going to assume yes. This behavior has always been present. Check.

 
D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder. There is no evidence of bipolar disorder or psychosis in Frank. Rather he is very charismatic and charming. He can flash an infectious smile and be quite attentive and is always in total control. Check.

Netflix
Source: Netflix

 
Clearly, Francis Underwood not only meets the sociopath criteria, he is the definition of a sociopath or to use the DSM 5 term, antisocial personality disorder.  We tend to only consider the common criminal who spends repeated time in jail to be the classic sociopath, but Underwood -- the elite, rich and powerful politician -- fits the clinical definition even better. Despite the fact that he's charming, gracious, charismatic and has loyal followers, we see he's also cunning, sinister, a pathological liar and eminently dangerous if you get in his way.
 
Justice and virtue be damned. Sociopaths know right from wrong, yet are difficult and dangerous, causing mayhem wherever they go. House of Cards is a fun roller coaster ride that reveals if you can't stand the heat in the kitchen, then GTFO. We have to wait for 2016 before the next season begins, but it should be a thrilling ride. As Underwood said himself, "There can be no false steps now. The higher up the mountain, the more treacherous the path." With Claire walking out on him, the stakes couldn't be higher and I have a prediction that explains that.
 
Throughout the show, Claire is portrayed as having just a bit more of a moral conscience than Frank does. But what if that has all been an act? What if Claire has been playing Frank the whole way and now intends to run for president herself?
 
House of Cards is sinister and engaging, while illustrating a lack of compassion on a whole new level. For sociopath Underwood, life is merely a chess game. He knows how to play it well -- and when charm doesn't bring desired results, other behaviors will -- but without those pesky feelings of guilt or conscious you or I might feel. Frank is extremely dangerous, as well as the most powerful man on the planet. Season 3 should be even more thrilling and ruthless as Frank Underwood perhaps meets his match in Claire.

About the Author

Dr. Dale Archer

Dale Archer, M.D., is a clinical psychiatrist and the author of Better Than Normal: How What Makes You Different Can Make You Exceptional.

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