Is Joffrey a psychopath? Why is Ramsay Bolton so mean?

Westeros doesn't seem to have psychologists to answer these questions, but thankfully the real world does.

Dr. Kirk Honda is a licensed marriage and family therapist who hosts a podcast called Psychology in Seattle. On the show, he's "diagnosed" a few "Game of Thrones" villains as if they were patients on his office couch.

Of course, no psychologist or psychiatrist can actually diagnose anyone, real or fictional, without meeting them. But Honda took his best shot anyway.

You can listen to everything Honda had to say about each character in his podcast, available here, but he also agreed to provide Business Insider with a short summary of five characters' diagnoses.

Ramsay Bolton: Sexual sadism disorder, sadistic personality disorder, and anti-social personality disorder/psychopathy

Helen Sloan/HBO

"In my opinion, Ramsay has sexual sadism disorder along with sadistic personality disorder...since he demonstrates marked pleasure and complete lack of remorse from the suffering of others," Honda told Business Insider. (Sadistic Personality Disorder was removed from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders after the 3rd edition, and is no longer considered an official diagnosis.)

Honda dubbed Ramsay the most problematic character in the show, due to his "tremendous pleasure in harming others," even when that sadistic behavior doesn't benefit him in the long run.

"Anti-social or psychopathic [personality disorders]... are both related to sadism and its sub-category, sexual sadism," Honda explained, adding that the two are "slightly different but largely overlapping."

He added that Ramsay's disorders are likely due to "his biological inheritance from Roose Bolton, who also exhibited significant psychopathic behavior, particularly before Ramsay was born, and Ramsay’s difficult childhood."

Listen to the full podcast

Joffrey Baratheon: Conduct Disorder and Sadistic Personality Disorder

Macall B. Polay/courtesy of HBO

Honda believes Joffrey suffers from a specific form of sadistic personality disorder called tyrannical sadism, due to his habit of relishing in "verbally and physically harming and abusing others with his power."

But Honda hesitated to apply too many labels to Joffrey because personality disorders in minors are usually not diagnosed until they become adults and their personalities finish forming. For that reason, Honda diagnosed Joffrey with conduct disorder "because he exhibits a pattern of violating the rights of others."

Honda believes Joffrey's disorder stems from "abuse from his father, distant mother, trauma from parental conflict and violence, looking like a girl and being teased — a detail that's in the books — inbreeding, mother drinking while pregnant, being told he’s better than others, and poor parenting."

Listen to the full podcast

Cersei Lannister: Anti-social Personality Disorder/Psychopathy

HBO

Cersei's diagnosis isn't as straightforward as the others, Honda said, because of her position as a female in a highly patriarchal society. Cersei was marginalized and abused by her father and husband when she was younger, and "is surrounded by a context that values power, specifically royal power, so her psychopathic behavior could be a result of circumstances and culture, rather than personality," he said.

Unlike Joffrey and Ramsay, most of Cersei's anti-social acts are "instrumental in gaining power and could be considered acts of survival, from her perspective."

Honda believes Cersei may also have alcohol dependence issues, though she doesn't seem to experience any ill effects from her heavy drinking (a criterion for the disorder).

"In my opinion, she seems to drink to cope with the stress of her life, which is tremendous. It’s common for people to self-medicate in this way," Honda said.

Listen to the full podcast