Reviewed by Joyce Alexander, RNP (Retired)
I bought The Psychopath Test—A Journey Through the Madness Industry, by John Ronson, based mainly on the title. Jon Ronson is a journalist and author of two previous books that were widely accepted. A movie was made about one of them, The Men Who Stare at Goats, starring George Clooney. The first couple of chapters of this book weren’t all that interesting to me, but before long I was hooked into the story he was writing.
Mr. Ronson looks at the “madness industry” from an outsider’s point of view. He actually took training from Dr. Robert “Bob” Hare in how to use the Psychopathic Check List-Revised to spot a psychopath. Ronson went a few steps further, though, in his learning about commercial psychiatry, and the industry that has grown up around the DSM II-V, defining what is and what is not “madness.”
Dr. Robert Hare, as we know, was the developer of the PCL-R, which is similar to the “cook book” diagnostic manual for psychiatry (DSM), with check lists of symptoms for definite diagnostic criteria to define and “diagnose” what is normal behavior and what is not. There were some interesting discussions documented between Ronson and Dr. Hare about the validity of the PCL-R and where the “cut off score” should be.
Ronson gave the history of the development of the DSM, which has expanded with numerous added “disorders” and “mental illnesses” with each new edition and revision, to where it is now nearly a thousand pages. Though it is intended for mental health professionals, the DSM IV sold many, many more copies, mostly to laypeople, than there are mental health professionals in the world.
Ronson set out to interview and evaluate several people who were “notorious” criminals or well known high-flying and important business leaders and politicians in several countries to see how they fared when compared to the PCL-R. He also was able to visit the inside of the “hospitals” in the UK where diagnosed psychopathic criminals are held, literally “forever,” while they are being “treated” for their psychopathy after their criminal sentences are served out.
Ronson’s faith in the diagnostic ability of the mental health professionals was not strengthened when he studied the famous experiment by Dr. David Rosenhan and several others in the 1970s, who went to several mental hospitals and reported to the physicians there that they “heard voices” in their heads. This was the only abnormal symptom (or lie) that they presented to the professionals. They were admitted to the hospitals, where they never again acted “crazy” or lied to the staff. They behaved entirely normally. It was almost two months before they could “get out” by admitting that they were crazy and needed help. “There was only one way out. They had to agree with the psychiatrists that they were insane and then pretend to get better.”
Rosenhan’s experiment, once published, caused pandemonium in the mental health profession. One hospital challenged him to send in more fakes. Rosehan agreed. The hospital claimed it found 41 fakes the first month. The down side of their sleuthing, though, was that Rosenhan hadn’t sent any fakes to their hospital.
While no branch of medicine is totally objective, (they don’t call it the “practice” of medicine for nothing!) by its very nature, psychiatry is somewhat more subjective (in the eye of the beholder) than physical medicine. Ronson’s book does make the point, though, that putting labels on every behavior imaginable isn’t the answer to improving the practice, and neither is a pill for every disorder.
Psychiatry and pharmacology have both made vast improvements in the lives of many people who are truly mentally ill, but with poor diagnosis and poor medication, some great horrors have also been accomplished as well. Not every bad behavior means a person is psychopathic and not every bouncy kid is ADHD or bi-polar at age three. Ronson does make the point that mental health is a located on a continuum. No one is 100% mentally “healthy,” any more than no one is 100% physically “healthy.”
On the whole, I enjoyed the book, and he makes some great cases and writes in an interesting manner. The only criticism for his writing are the first couple of chapters “The Missing Part of the Puzzle Revealed—”and I’m not quite sure why they were included in this otherwise very interesting book. Maybe somehow I missed his sense of humor, but the rest of the book made up for the start I didn’t get.
I would recommend this book to anyone wanting to learn about abnormal versus normal psychology, and a bit about the “industry” that has grown up around “madness.”
The Psychopath Test on Amazon.com.
BBE ~ I think you have hit the nail on the head with this: “Perhaps subconsciously we felt that by “fixing” them, they would then be happy and connect happiness with us.”
I think you have found the commonality between those of us that have been forever trying to fix others and those who only tried to do it with their spath. The desire to make someone happy.
Louise, the point is not what I did for her or what she did, but that I HAD NO RIGHT TO BE ANGRY WITH HER BECAUSE SHE LET HIM COME BACK INTO HER LIFE….AND BOY WAS I EVER ANGRY WITH HER!
The fact I helped her did NOT give me a “Right” to tell her how to run her life or to be ANGRY with her because she didn’t run it to suit me.
So I am getting to where when I “help” someone I do it as a GIFT not a down payment on a “right” for me to get angry with them if they choose to continue with their bad behavior, or go back to their bad behavior. I will always have compassion and empathy for people who are suffering, even if they brought the suffering on themselves. For example, say a friend who has lung cancer and has been a life time smoker. I still feel compassion for their suffering even though their choices of smoking brought it on themselves….or say someone who had a spending problem or a gambling problem of didn’t manage their money right and went deeply into debt, then lost their house….I feel compassion for them even though they brought it on themselves….but at the same time, if I give them money, then they go buy a new TV instead of food, then I cannot be angry with them because I EXPECTED they would use the money more “wisely.” (In MY view of “wisely”)
I DID expect that young woman would not let her abusive husband back into her life, and when she let him back into her life it made me MAD AS HELL that he was sitting on the couch that I HAULED 800 miles, in the apartment that I got for his wife and kids, but in truth, I had NO RIGHT to be angry with that woman because MY EXPECTATIONS were not fulfilled. She had a legal right to make her own decisions….but at the same time, I needed to take responsibility for myself and let her take responsibility for herself.
Just like the old coot “Grandpa” age 83 that lives down the road from me in utter complete poverty and picked up a meth-ho off the streets who shows up the first of each month when he gets his “check” and stays 2 weeks until it is gone…then she leaves him there til the first of the next month. He isn’t “senile” in the sense that he could be locked up for his own protection, but his JUDGMENT IS POOR, he still knows who the president is and so on, so is not “legally” demented. But his decisions are VERY POOR…It is HIS RESPONSIBILITY to take care of himself and he is not doing a very good job of it and won’t let his daughter help him because she doesn’t approve of his meth-ho girlfriend….but I check up on his from time to time the last two weeks of each month, and a while back I found him with NO ELECTRICITY and 100+ degree heat, NO WATER (no electric=no well=no water) and NO FOOD, and no phone, and 2 flat tires on his truck. Whose responsibility was that? HIS of course. But at the same time, I took him 5 gallons of water, and I fixed a meal and took it down to him. I don’t give him or “loan” him money any more, no matter how he cries, and I no longer give him gasoline.
This old man has been a good neighbor and a good friend for many years, and I hate like hell to see his situation now, but you know even though he is now a “bubble off of plumb” he is still responsible for his and I’m not his “keeper” or responsible for him, but at the same time, I care enough about him to keep an eye on him so he doesn’t end up dying for lack of water in 100+ degree heat by checking on him every few days. Yea, he has grandkids that SHOULD be there for him, but they are worthless and have taken a great deal of what little he had before this, but ultimately, HE is responsible for the shape he is in financially, but I have NO expectations he is going to make better decisions and I don’t get mad at him for “thinking with the small head” instead of the one on his shoulders. What little I do for him is a GIFT without expectations he is going to change, and it doesn’t cost me much either emotionally or financially to stop by his house and see if he has food and water.
With the young woman, the EMOTIONAL cost in me getting angry at her when she let her husband move in with her….THAT cost was more than I am willing to pay again.
BBE and h2h:
Ah ha!! YES! I think that’s it…I think I loved him so much that if I could “fix” him and he would be happy, then I would be his HERO. I so wanted to be his hero. I think he is actually searching for one and I thought I could be it. Plus, I never met someone who was a man, but was yet so much like a lost little boy. He had so many problems. I will never forget the day I saw him at work and I wanted to just grab him and take him away from it all. It was very powerful. But he is no good. He battles demons and makes everyone else unhappy. The OW in triangulation with me told me that he told her that he only disappoints people who love him. And that his kids would be better off without him. But this was over two years ago. I don’t know if he still feels this way and it’s not my place to care or want to know.
Oxy:
Yes, I get that. If we are going to help someone in whatever way, financially, emotionally, whatever, we cannot expect anything in return. We have to do it out of the kindness in our hearts and never expect anything in return. Especially when it comes to money…NEVER expect that back! I don’t give people money, but if I did, it would be a GIFT and not a loan. Actually, last year a friend asked me for $50 until her child support came in. No one ever asks me for money and it was only $50 so I did it. I kept hearing I’ll have it for you in two weeks when I get paid and then two weeks came and went, blah, blah, blah. This went on for a few months and then I finally just told her to accept it as a gift from me and not to worry about…told her she didn’t have to pay me back and I sincerely meant it with no malice in my heart. She was like really?? She was so grateful.
You are a good person for checking on your neighbor. It’s a good lesson for all of us in how we can check on someone and help someone without giving away too much of ourselves or getting hurt or losing money or whatever.
You are the BEST!!
Louise;
Funny, even though online my x-spath always goes by some “XYZboy” or “XYZlad” moniker online, I did not really see him as a lost little boy but this in fact is what he is. But I did see him in some ways as somebody I could protect and nurture. He was just like the little Xmas tree I picked out that he dissed so much. A little rough around the edges and small, but with a little TLC I though it would be a fine little tree.
On the bright side, I am no longer worrying about the lost little boy, rather the $40K I lost in the stock market.
BBE:
Soooo sorry about your loss in the stock market. That stinks!!! I hope you can try to make it back.
Louise;
Right now, trying to make it back is the worst thing I can do as that is how I lost it! I need to get a real job. Even if I was making money at it, it is too stressful given that I have had heart surgery. Also, it is lonely and since the x-spath all I have been is lonely. At least a job keeps me not only occupied, but gives purpose.
I need to remind myself that before my last employer and those sociopaths, I actually liked what I did and made a good living at it. They were a bad experience, but I cannot let it taint everything.
BBE:
I understand. I hope you can find something that you will enjoy doing! Let us know!! And keep stress free. That is what I am trying to do. TRYING is the key word here. It doesn’t always work, but I am doing a better job than I used to do.
Louise;
Thanks. Keeping stress free is Priority #1, along with not getting sucked in by another sociopath…
Louise;
One additional thing to consider regarding the x-spath is something that just stuck me when I logged into my FB account. One of my cousins just posted a picture of her and her family. She lives in Georgia and I have not seen her is several years and in this picture she looks just like the x-spath’s sister. I am floored by the resemblance.
He I met him, a plus was that he could pass the “family test.” He was polite quite, unassuming, did not scream gay and what I did not realize until I saw both pictures of hi online and now my cousin, he looks like part of the family.