Ramsay Bolton’s Personality Disorder Analysis

Subject: Psychiatry
Pages: 4
Words: 1181
Reading time:
5 min


In the contemporary world, many famous movies’ characters are displayed as individuals with a certain type of disorders that enables to master the skill of diagnosing through analyzing them. Once of instances of such persons is Lord Ramsay Bolton, the fictional antagonist from the fantasy drama television series “Game of Thrones,” that is an adaptation of the book “A Song of Ice and Fire,” written by George R. R. Martin (“Game of Thrones,” n.d.).

Known for being a sadistic, psychopathic character, Ramsay Bolton is likely to have antisocial personality disorder combined with sexual sadism. This essay will examine manifestations of pathological behavior for this fictional individual and define a possible diagnosis for him with an appropriate justification based on current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) codes (American Psychiatric Association, 2013). Moreover, a psychological model that best explains the cause of the symptoms and sadistic, antisocial behavior will be provided. In addition, the possible treatment plan with the ways for Ramsay Bolton to manage his disorder’s consequences and its manifestations will be discussed.

Manifestations of Pathological Behavior

It is possible to outline the variety of manifestations of pathological behavior showed by Ramsay throughout the movie. He is known for terrible hunting trips for “two-legged prey” that implies stripping women naked, releasing them into the forest, and chasing with a pack of feral dogs (Vineyard, 2016). If a woman gives him a “good sport,” he names a dog after her, while otherwise, the one who did not satisfy his sadistic needs is fed to dogs skinless (Vineyard, 2016).

The other instance of Ramsay’s psychopathic behavior when he set a loyal servant, Reel, up to die for his crime without showing any signs of grief or guilty (Vineyard, 2016). Moreover, he likes physical torture, as in such a session, in the scene with Theon Greyjoy, he revealed his sadistic personality. His words to the victim, which are “if you think this has a happy ending, you haven’t been paying attention,” prove that he enjoys the process (Persaud, 2019, para. 2). Such behavior, based on excessive cruelty, clearly indicated the presence of a disorder.

Moreover, Ramsay violated the social norms in many other instances of his behavior. He forced his brides to marry him as an act of war, as with his first wife, Lady Donella Hornwood (Vineyard, 2016). Eventually, he intentionally locked her in a tower, and made her starve to death. In addition, Theon was forced by Ramsay to participate in the rape of one of his brides (Vineyard, 2016). It can be concluded that Ramsay has pleasure in harming others even if such behavior is not beneficial for him in a long-term perspective, summarising all the mentioned above evidence.

Possible Diagnosis

Taking into consideration all the manifestations of the sadistic, psychotic behavior of Ramsay Bolton, the following possible diagnosis can be made. Cluster B Personality Disorders, 301.7 (F60.2) Antisocial personality disorder is the most likely to be present. It is possible to support the outlined conclusion with the help of the Diagnosis Criteria. First, here is the unarguable failure to conform to the social norm because of the repeated performing of acts that are ground for arrest even in the fictional world of the Game of Thrones (American Psychiatric Association, 2013, p. 659). Moreover, evidence shows repeated lying to obtain personal profit or pleasure.

As it was claimed previously, Ramsay cannot help torturing and physically humiliating others even if it might result in adverse consequences for him that implies impulsivity and failure to plan ahead. There is a presence of irritability and aggressiveness in his behavior, displayed in any evidence examined above. Disregard the safety of others is also can be tracked in the violence showed by Ramsay. Finally, he does not feel guilty for his actions, which indicates a lack of remorse. Therefore, the is 6 of 7 diagnostic criteria from group A present in the character’s behavior.

Second, Ramsay is over 18 years old, which indicates that he is positive to the diagnostic criteria group B. Third, there is no much information about his childhood and the evidence of conduct disorder with onset before age 15 years (American Psychiatric Association, 2013, p. 659).

However, there is evidence that his mother complains to his father about his behavior (“Game of Thrones,” n.d.). However, taking into consideration his status in society and the family he grew in, manifestations of his tendency to violate social norms at a young age shall have been presented (American Psychiatric Association, 2013, p. 659). From this point of view, criterion C also supports the diagnosis. Finally, there are no signs of Ramsay having schizophrenia or bipolar disorder, which would prevent him from being positive according to criterion D. Therefore, it can be concluded that this fictional character has significantly expressed antisocial personality disorder.

Psychological Model and Possible Treatment Plan

It is possible to build a model that consists of factors that could potentially lead to the examined behavior and antisocial personality disorder. With respect to genetics, Ramsay is a bastard who was conceived in rape, as his father, Roose Bolton, had done this to a miller’s wife after hanging him. Possibly, it is a biological inheritance that makes the character behave as described above and has the disorder, as it is a risk and prognostic factor (American Psychiatric Association, 2013, p. 661).

With respect to the environment, Ramsay grew and lives in, the fictional world of the Game of Thrones is full of violence, with constant exposing of children to the scenes of crime and cruel murdering. With respect to such factors as childhood trauma and verbal abuse, being a bastard implies being unloved and vulnerable to be deprived of inheritance and any rights after a legitimate child is born. Therefore, all the mentioned factors could contribute to the disorder.

A possible treatment plan that might help Ramsay to cope with his sadistic behavior can be outlined. Cognitive behavioral therapy (CBT) can assist in changing patterns of negative thinking to improve social functioning (Haelle, 2020). Simultaneously, psychotherapy with a practitioner can be effective by making Ramsay more sensitive to other people’s feelings and encouraging more socially acceptable behavior (Haelle, 2020). In addition, such medications as antidepressant drug Pamelor (nortriptyline) or antiepileptic drugs for aggression treatment can make it simpler for the individual to manage his disorder (Haelle, 2020).

Finally, it is an absolute necessity for Ramsay to stop participate in described above events and any others that include violence, such as torturing, hunting, raping, and murdering. The summarized effect of all the mentioned interventions may result in successful coping with an antisocial personality disorder.


Ramsay Bolton, the fictional character of the movie “Game of Thrones,” is considered to be a sadistic individual who has the pleasure of breaching social norms and physical violation of others. He can be diagnosed as the one having expressed antisocial personality disorder, according to DSM-5 codes. A sequence of measures, such as CBT psychotherapy, taking of specialized medications, and not exposing himself to violent events can facilitate his condition and eventually make his behavior more socially appropriate.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Web.

Vineyard, C. (2016). All the ways Game of Thrones’ Ramsay Bolton is way worse in the books. Web.

Persaud, C. (2019). 10 dastardly Ramsay Bolton quotes forever burned in our minds. Web.

Haelle, T. (2020). How to treat antisocial personality disorder. Web.

Game of Thrones. (n.d.). Web.