Working in acute psych for 30 years, I didn’t see this as offering excuse for Spitzer. We all have diminished responsibility for one reason or another, but are ultimately responsible for our actions. If your morality is important to you, then you take added precautions when you enter situations of greater temptation, such as positions of power.
I see the doctor’s explanation as a description of how things happen, rather than why. That power and prestige increase people’s risk of narcissism seems fairly obvious, and offering an environment based rather than brain-chemistry based explanation is merely the same thing from a different perspective.
I have half-seriously called this type of behavior “thinking from the waist down” (I have four grown sons). That there are some neck-up drivers to the behavior doesn’t change things.
