BOOK REVIEW: The Psychopath Test (redux)

Back in May and June, the media blitz for The Psychopath Test, by Jon Ronson, was in full swing. I finally got around to reading the book.

Ronson is a British journalist who apparently specializes in writing about nut cases. He wrote The Men Who Stare at Goats, which was made into a movie starring George Clooney and Jeff Bridges. He has a BBC radio show that, according to the New York Times book review, is considered comedy. But he’s famous, and people like him. I guess I wish that he’d used his clout and notoriety to do some good with this book.

Its full title is The Psychopath Test—A journey through the madness industry. The title is accurate. The book is essentially a history of how the disorder was identified and how the study and treatment of psychopathy evolved, with the stories of a few psychopaths included, most of them killers.

Ronson makes the most important point of the book almost in passing. He describes several meeting with Bob Hare, the respected psychopathy researcher who created “the psychopath test” that gives the book its title (the Psychopathy Checklist-Revised, or PCL-R). Ronson includes a scene in which he is in the U.K., driving Hare to the airport.

Hare says that he wishes he hadn’t spent all his time studying psychopaths in prison—he should have also studied them at the stock exchanges. (I’ve heard Hare make similar statements.) Ronson writes:

“But surely stock-market psychopaths can’t be as bad as serial-killer psychopaths,” I said.

“Serial killers ruin families.” Bob shrugged. “Corporate and political and religious psychopaths ruin economies. They ruin societies.”

This—Bob was saying—was the straightforward solution to the greatest mystery of all: Why is the world so unfair? Why all that savage economic injustice, those brutal wars, the everyday corporate cruelty? The answer: psychopaths ”¦ We aren’t all good people just trying to do good. Some of us are psychopaths. And psychopaths are to blame for this brutal, misshapen society. They’re the jagged rocks thrown into the still pond.

I thoroughly believe that psychopaths are responsible for most of the human-caused pain in society. Ronson actually came out and said it. But unfortunately, he didn’t continue to make the case. After the statement on page 112 of the book, he never returned to the thought.

One other part of the book was enlightening. Ronson spends a few pages discussing the evolution of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM), now in its fourth edition, with the fifth edition underway. On page 239, he explains why the mental health field has not agreed on what to call this disorder—psychopathy, sociopathy, antisocial personality disorder, whatever. He writes what he learned from Robert Spitzer, a psychiatrist who became editor of the third edition of the DSM:

I’d always wondered why there had been no mention of psychopaths in the DSM. It turned out, Spitzer told me, that there had indeed been a backstage schism—between Bob Hare and a sociologist named Lee Robins. She believed clinicians couldn’t reliably measure personality traits like empathy. She proposed dropping them from the DSM checklist and going only for overt symptoms. Bob vehemently disagreed, but the DSM committee sided with Lee Robins, and Psychopathy was abandoned for Antisocial Personality Disorder.

So there it is—the beginning of the dispute about naming the disorder and how to diagnose it, which has only kept the general public confused.

You might be entertained by this book—Ronson’s writing style is engaging, and the historical background is interesting. But if you’ve had a close encounter with your very own psychopath, you aren’t going to learn anything to help in your recovery.

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(((thanks Oxy.))) i am a bit of a shambles. so will need time to get to calm cool. am doing it quite well with dad (yay me), but the nurses, oy!

there is an outbreak of e. difficile in the hospital. i became the queen of sanitizer in 2 seconds flat. will wear gloves the next time too (but will have to pinch some of theirs as they don’t have latex in the hospital anymore.)

she comes and she goes in terms of knowing me. doesn’t help that i have a mask on. usually she would be very cuddly – but she is experiencing touch as pain and a physical violation.

man, i lived with her for 3 years – don’t know that i recognized how traumatized i was by her dementia – but i sure feel it after a few hours with her in the last 24. have set up a nuerofeedback session for tomorrow.

Ox Drover


I understand for sure. The C. Diff is bad but very common as well as surfaces contaminated with MRSA so HAND WASHING and GLOVES. Don’t let anyone touch her until AFTER they have washed their hands in front of you. The sanitizer is fair, but washing is BETTER. Also watch that they don’t put a stethascope on her without cleaning it off first, that is one of the nastiest things to pass infections around. ALSO the phone in the room is filthy! And the curtains are filled with spores and bacteria so if they are pulled, pull them gently so not to fan them around the room.

Watch the IVs don’t infiltrate as her veins will be very fragile, also may need to use a tourniquet very loosely to start one so the veins don’t blow. I usually used finger pressure on a vein in very elderly people.

They aren’t allowed to “tie down” demented patients like we used to in the old days so it is a problem keeping them in bed. The alarms under them are worthless, and also bed rails are actually dangerous so they can’t put up all 4 rails at once without a specific order to do so AND continual watching of her. So they may actually move her out by the nurses station in the hall way so they can watch her better.

Also, you might when her medical condition stabilizes ask for a geri psych consult and have her moved to a geri psych unit where they can come up with a medication that will help calm her if nothing else so that she is A) not unhappy and B) not a physical danger to herself.

After working in a geri psych unit for a couple of years I gained some respect for what they do with demented patients in getting them where they are calm and happy….they may live in the past but at least it is a pleasant past that they enjoy, so I don’t see dementia as a bad thing when it masks the unpleasant reality of the current situation of poor health and losses of people and things the person loved.

I remember one patient who only had one leg and two teeth and she was curled up in the fetal position. It took 6 people to change a diaper on her, one to hold each limb or portion of one, one to hold her head to keep her from biting and one to change the diaper. It took 6 weeks, but at the end of that time, she was happy, pleasant, and scooting around in her wheel chair with her one leg, singing and talking about life in the cotton fields with pleasure, feeding herself and totally “out to lunch” but happily so and was cooperative with caregivers and family. So at that time she was returned to the nursing home where she had been unmanageable previously and unhappy there. The fact that she didn’t miss her husband any more (I guess she thought he was just out of the room and not dead) or her kids that had predeceased her, or that she only had one leg and was nearly blind…

The early stage of dementia like my neighbor “grandpa” has that leaves him legally sane but unable to make wise judgments or to catch that he is being manipulated are much harder for family to endure and for the patient’s safety.

So just keep in mind that your voice if not your touch can sooth her, but that when you must leave and go home to get some REST YOURSELF she won’t remember the time that you were gone as TIME is not “real” in the state she is in (in terms of our reality of the passing of time).

I know this whole thing is a stressful event, and the situation at the hospital is adding to that stress….but TAKE CARE OF YOU TOO….that’s important! (((Hugs)))) and good thoughts coming your way.

It’s past my bedtime here already…darn being in a different time zone from you all!!!

I’m going to turn in for the night.

One/Joy, I’ll send some positive energy your way. Too bad we are all separated by cyberspace, otherwise I’d pop in to visit and bring you some chocolate overkill brownies or something. I know you’re in a hospital and in a very stressful situation, but don’t forget to take a few minutes alone to find your center of gravity. If we all have things in common in here, I think one of them is being so selfless at times that we completely ignore our own needs. Make sure that you pull away from time to time and look after yourself. Maybe set an alarm clock on your phone to go off twice per day which says, “One/Joy time.” During this stressful situation, you’ll have to force yourself to focus completely on yourself to regroup, so maybe it would help.

Good night all!!!


sweet dreams panther 🙂


onestep-in cases of C Difficile-don’t wash with hand sanitizer, use soap and water only. The waterless alcohol stuff doesn’t work on it.

BTW, I got called for the second interview at my first choice hospital and I am going on Friday afternoon. Oxy is right about all the nurses getting worked like slaves, but hopefully I will be joining their ranks again real soon. It’s sad but you do have to watch everything that people do with your mom.


Oxy, thanks for the advice re the hospital. I realize one of the problems is that she is in the ER and not on the geri unit. They would be handling this differently. she has had geri pysch evals in the past – but they should send someone down to do that now. so I will see what I can do.


Lizzy – Alright; that’s great! Towanda girl!!

And thanks for the info re c difficile. she went in their with an infection and hopefully she won’t die in there of another.


Panther – am at home working. distracted for sure, but working regardless. don’t want to go back there tonight, so will call and see how she is doing, and how long she is expected to be in for.

and i’d so take the brownies and the visit!

i am being less selfless (double neg, but oh well. 😉 ) than ever.


One-it’s bad that you have to worry about that, but you do. Infections that you can get while in the hospital are danger. Hopefully though now it is getting more serious for them, since hospital borne infections are no longer being covered by insurance/medicare for treatment. They will have to educate their staff and get them on the right page, otherwise they will be eating the cost of the treatment for infections that patients are given by hospital staff.

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