We concur that the plight of the evildoer is a quite severe and dark existence, but the doctor goes too far in assuming their suffering from the uncertainty of their existence and its limitations is responding to the voice of their conscience when that may well be attenuated to a severe degree or cut off entirely. What they truly must contend with is their isolation because their world shrinks to consist only of their ego. As they are loveless, they cannot love and care for and feel good about themselves, let alone anyone else, yet they still have survival instincts and they have an ego, and it is only in rewarding the ego in some way that they can experience something positive happening. But the ego is a very limited part of the self and, being self-serving, cannot be fully nurturing and rewarding in the sense of what most people need, which is the comfort of shared relationships, having a friend or two, a life partner to share deep love with, and a companion who can be counted on to care about them and help them, and even at times be self-sacrificing when there is a need for something extra.
Evil people cannot fill such roles, nor will they attract normal people who can serve them in a meaningful way, because love is not a useful currency for them, so a normal person will feel frustrated being around them because their love will not be felt. All the evil person wants is adulation, being serviced in a slave-like fashion, so rather than take a lover, they seek a servant, a minion who they can control and whose attentions they will find flattering and further empowering to their ego, that they are indeed special, as they believe, and anyone they can attract to do their bidding reinforces that self-image. But it is ultimately hollow because it is shallow and only a semblance of a normal human relationship. In actuality, evil people are missing the very things that define "humanness," and are more like the shell of a human being, and on some level they suffer because they are living an existence with little value, in a state of limitation and lack.
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