I don't have any knowledge regarding the proficiency part, but I can say, drop the bastard as soon as you notice you have him.
But if you want to be safe at all times, keep your Madness down. Buy / Craft a Teddybear, and sleep for 8 hours so when you login after that, 1 madness level will have gone down. Alternatively you can get an affluence set that is +200 ( Maybe slightly more, mine is 225 ) to enter the Hookah Den. Smoking the Hookah will reduce your Madness by 1.
Here is a post you should read very carefully and keep in mind at all times:
viewtopic.php?f=2&t=13907