The conflict triangle - victim, villain and hero

Beyond the Conflict Triangle: Reframing Victim, Villain, and Hero Dynamics in Residency

In the world of conflict resolution, one powerful concept that helps explain why so many interpersonal tensions feel stuck or repetitive is the Drama Triangle—a model developed by Stephen Karpman. While originally rooted in psychotherapy, its relevance to medical training is uncanny. Recognizing this triangle can be a game changer for how we handle tough interactions in residency.

The Conflict Triangle: Victim, Villain, and Hero

At the heart of the Drama Triangle are three roles people unconsciously adopt in high-stress or emotionally charged situations:

• Victim: The person who feels powerless, mistreated, or overwhelmed. This role often says, “Why is this happening to me?” The Victim is not necessarily someone who is victimized, but rather someone who sees themselves as having no agency or options.

• Villain (also known as the Persecutor): The one blamed for the problem. The Villain is controlling, unfair, or overly critical. In this role, someone is cast as “the bad guy”—whether or not that’s true.

• Hero (or Rescuer): The fixer. The person who jumps in to save the day, often without being asked. They may seem helpful, but this role can inadvertently reinforce dependency and avoid real solutions.

What makes the Drama Triangle tricky is that roles shift constantly. A Hero can quickly become a Villain if their help isn’t appreciated. A Victim may lash out and become a Villain. It’s a cycle—reactive, emotional, and unproductive.

So What? Why This Matters in Residency

Medical residency is an intense, high-pressure environment. In such settings, the Drama Triangle can appear in all sorts of ways:

• A junior resident feels overburdened (Victim), sees their attending as uncaring or unreasonable (Villain), and turns to a co-resident to bail them out (Hero).

• An attending rescues a resident by shielding them from feedback (Hero), but then becomes frustrated when performance doesn’t improve—and shifts into the Villain role.

• A chief resident mediating a scheduling conflict gets caught in the middle, moving from Hero to Victim to Villain depending on who they’re talking to.

Once you're inside the triangle, conflict tends to spiral or repeat—because no one is operating from a place of clarity or accountability.

Moving Beyond the Triangle

Breaking free means shifting from drama roles into more constructive stances:

• Victim → Creator: Instead of focusing on what's being done to you, shift to what you can do next. This doesn’t mean denying difficulty—but it means reclaiming your agency.

• Villain → Challenger: Instead of criticizing or blaming, you can challenge with curiosity and respect. Challengers can hold high standards without being harsh.

• Hero → Coach: Instead of solving others’ problems for them, coaches support others in finding their own solutions. It’s still compassionate—but more empowering and sustainable.

Final Thoughts

Conflict isn’t inherently bad—it’s just a signal that something needs attention. But how we show up in conflict determines whether it becomes destructive drama or a path to growth.

Recognizing the Conflict Triangle gives us language to reflect, reset, and re-engage from a place of awareness. And in the emotionally charged world of medical residency, that can make the difference between burnout and resilience, division and connection.