Oh, Don. Don, Don, Don. As the sixth season of Mad Men approaches its final episode this weekend, our antihero is — perhaps more than ever — disappointing us. Nearly every Sunday night we've been left desperately wanting to shake some sense into Mr. Draper (cheating on Megan? really?). Part of the disquiet stirred by watching Don's spiral this season was the growing awareness that we're staring into the face of a man with so much potential, so much wasted ... something. Depth? Passion? Dedication? Something.
Thanks to his ongoing flashbacks of a dark, abusive childhood spent raised in a brothel, it's become increasingly obvious that Don's issues are deeply rooted. (Okay, understatement.) So maybe his being an asshole makes a smidge of sense. It's just Don's way of coping: anesthetize his anxieties with alcohol. Exploit his insane amount of charisma to win clients and lovers. Stifle his gaping loneliness with extramarital sex. Save his hide, at any cost, by lying, lying, and lying some more. Then, just when we think we've figured him out, he turns around and does something decent, reveals a brief flash of human emotion — real tears shed over his failed relationship with Sylvia, risking business with an important client to save her son from Vietnam, one of the few selfless gestures we've ever seen from him.
All this informs the question that's been clawing at the inside of our skulls since the show's 2007 debut: What the hell is wrong with Don Draper? Is he an alcoholic? A sociopath? A sex addict? A narcissist? A mega-dick? All of the above? So we recently asked five Mad Men-loving clinical experts to offer their hypothetical diagnoses of Don, and what they'd do to fix him. See if any of them match your go-to armchair analysis. Then get back to the couch and re-watch Sunday's episode.
The diagnosis: Don has a bit of everything.
Dr. Paul Hokemeyer, senior clinical adviser to Caron Ocean Drive
"You could diagnose Don for days. I'd be surprised if he ever walked into my office, given the issues he presents: antisocial personality disorder, narcissistic personality disorder, and paranoid personality disorder. Antisocial personality disorder is marked by a disregard for the well-being or feelings of others. Sufferers have no concern for the normal state of affairs or complying with the rules. They're very charismatic and good at initiating relationships, but they have no capacity for sustaining relationships over the long haul.
"Narcissistic personality disorder is concerned with power, prestige, vanity, image, and the hedonistic need for lots of sex, alcohol, cigarettes — lots of stuff — to feed an insatiable ego.
"Paranoid personality disorder leads to the incapacity to trust. All of this stems from trauma Don experienced in early childhood — his primary caregivers were hostile and violent. I'd also diagnose him with post-traumatic stress disorder as evidenced by his frequent flashbacks."
The treatment plan: "Treating Don would be a huge challenge because he doesn't trust, and he'd be very resistant. He'd have a problem putting forth effort or time to establish a therapeutic relationship with someone he couldn't manipulate. Having said that, I work with people like him all the time, so my approach would be a combination of educational and experiential. I'd start with educational interventions, engaging in the Socratic method of investigations and exploring his reality from an intellectual standpoint. We'd reveal contradictions: Does he feel he's successful? What does that mean? In what areas of his life? As soon as we established trust and rapport, I'd engage him in equine therapy — working with a horse — which would be powerful for him. It'd be about challenging his notions of power and what that means."
The diagnosis: Basically, a drunk.
Scott Bienenfeld, CEO & medical director of Rebound Brooklyn
"I think Don's an alcoholic, and that's his overarching problem. For some addicts and alcoholics, it's just about straight-up drugs and alcohol, but for him, it's deeper — he's a complicated character with a history of trauma and loss. We learned about his father early on. I don't know if his dad was a drinker, but probably. It's also clear he has issues around adult female role models. But before he could work on any of these other issues, he would need to get clean and sober.
"There's clearly a good guy in there. He's not a malicious, uncaring guy, but he's very defended. And that's alcoholism — when the feelings get even a little bit intense, boom: bottle. Happy, sad, painful, whatever — boom, you drink. There's no way any specialist would get anywhere with him with medication or psychotherapy until he was clean. He's a damaged guy, but he's intelligent. He's a poster child for the myth that if you love your job, have a beautiful wife and an amazing apartment, then you can't be an alcoholic. He represents this era of excessive consumption and a bottomless search for fulfillment."
The treatment plan: "I'd suggest rehab or AA before anything else. The idea that he would be able to stay clean and sober in an environment where there's constant access to alcohol is unlikely. He would also probably need a medically supervised detox. But for Don Draper, the idea of going through life without alcohol would be like ripping a Band-Aid off a third-degree burn. That's how noxious his issues probably feel to him."
The diagnosis: He can't control himself.
Scott Haltzman, M.D., psychiatrist and author of The Secrets of Surviving Infidelity
"Diagnosing fictional people is always impossible, but always entertaining. Is he an alcoholic? Hard to say, but he always seems to have something in his hand with a few ice cubes in it. (The alcohol could contribute to disinhibition, one of the root causes of infidelity). He has symptoms of narcissistic personality disorder and antisocial personality disorder, but he also appears to have an impulse control disorder.
"Impulse control disorder is a rather broad category as psychiatrists often can't figure out whether problems of behavior are compulsive (e.g. a need to do) or impulsive (done without thinking). Things like shoplifting and hair-pulling are sometimes in this category, as is sexual compulsion and compulsive shopping.
"Sometimes it can happen from chronic drug use or brain injury, sometimes people who grow up with ADHD get that way, and sometimes it's because parents never taught their children how to control their tempers. Ultimately, these individuals show poor impulse control and poor frustration tolerance, and often get into trouble as a result. Sometimes they abuse substances to avoid feeling lack of control."
The treatment plan: "Treatment is tricky. There is no proven medical treatment for narcissism or antisocial disorder. If Don had either of these disorders, he might do better with group treatment. I might consider sending him to Dr. Steven Stosny's boot camp, as it may help foster a sense of compassion for other people. Impulse control problems don't have any specific pharmacologic treatment. It's moot, though, since use of alcohol minimizes the effectiveness of any medications, and the character seems like the kind of person who would avoid taking medication."
The diagnosis: He just can't connect.
Joseph Scardapane, Hofstra University psychology professor and assistant provost
"Don has an attachment disorder based on his childhood. His mother died in childbirth, he was brought to his father's home, his father died, and then he was raised in a whor*house. His ability to connect with people is impaired. He never formed attachments consistently in childhood or adolescence, so now in his adult life, he goes from one relationship to another.
"Narcissism comes to mind, too. Even his use of sexuality is a way of covering up his anxiety and fears of abandonment. In some ways he abandons the women he's with before they have time to abandon him. For all his philandering, he doesn't take well to women leaving him. He gets angry, morose, seeks out other women. His early brothel environment was highly sexualized, so he learned to use sex in a way that's soothing, to connect. In a recent episode he said to Betty something like, "Why do people only feel connected when they're having sex?" That said so much about him.
"I'm not big on the "sex addict" term. His activity is very purposeful. It's not like he's having totally indiscriminate sex. He uses sex in a way that helps him connect with people, but it's addictive in that it's never enough. Once he has someone, he doesn't know how to develop a relationship in which he doesn't need outside stimulation to feel fulfilled. Ultimately he's never learned to live with himself."
The treatment plan: "I don't know if he'd be the least bit interested in treatment. I keep wondering whether he's going to crash. I've never seen him as upset as the June 9 episode. With this affair with the neighbor, and with Sally — his defenses are gradually coming down as he's being faced with the consequences of his behavior. He may be moving in a direction where he'd be more open to help. You can see it in his face, his whole affect.
"One of the things I'd try to help him with would be ... not soothing himself with alcohol and sex. He needs to experience the pain in his life and learn from it, not be afraid of it. Mindfulness work, learning meditation techniques, sitting with feelings to learn they're not dangerous and you don't have to act on them ... He's an escapist in a lot of ways."
The diagnosis: A deep-down narcissist who may never change.
Dr. Nicholas Kardaras, Ph.D., LCSW-R; clinical director of The Dunes East Hampton
"Don definitely meets the clinical description of narcissistic personality disorder — grandiosity, lack of empathy, and obsession with one's own power. It's an extreme form of egocentrism. And is he an alcoholic? Obviously heavy drinking was part of the culture of the time, so it's not that atypical, but we start to think someone has an issue if there are negative consequences. It does begin to look like alcohol dependency for Don. Usually alcoholism is a sign of other underlying issues. It's hard to do a lot of growth when you're self-medicating by getting high. He also has identity issues, coming from his background and the false identity he's assumed.
"Personality disorders (like narcissistic, antisocial, and borderline personality disorder) are usually lifelong — they're part of the way you're wired, so they're extremely difficult to treat. We recommend long-term intensive therapy to address those issues. But getting a narcissist to shift ... is no easy trick. At my rehab we have a lot of Don types. An afflicted person can sometimes be helped by having a spiritual shift or crisis. A near-death experience, a nature experience, or an awe-inspiring experience like having a child can help them see, 'I've been a complete asshole my whole life.'"
The treatment plan: "With someone like Don, I'd start him on some volunteer work to get outside himself — say, going to the soup kitchen downtown once a week. That's why 12-step work can be good for the rich and powerful — it's about helping others, getting outside of yourself. I'd also suggest Buddhist meditation."
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