Have you ever looked at a copy of the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the ‘DSM‘)? It’s a reference book published by the American Psychiatric Association, and it is used by clinicians for diagnosing mental illness. Each ‘disorder’ is described using a number of diagnostic criteria, risk factors, cultural and gender considerations, differential diagnoses and so on. It makes for very compelling reading, as Jon Ronson discovered in his exploration of psychopathy, The Psychopath Test.
I was much crazier than I’d imagined. Maybe it was a bad idea to read DSM4 when you’re not a trained professional…
Yes, even on a good day, I could browse through the DSM and slot myself into a whole bunch of disorders (today for instance, sluggish cognitive tempo disorder, otherwise known as lack of motivation).
Ronson presents a number of case studies alongside an understanding of ‘psychopathy’ from a social, historical and clinical perspective. Notably, psychopathy is not listed in the DSM as a stand-alone disorder (rather, people who are referred to as psychopaths are generally diagnosed with disorders such as antisocial personality disorder and narcissist personality disorder).
Much of the book is devoted to Ronson’s observations about the Psychopathy Check List, a diagnostic tool developed by criminal psychologist, Dr. Robert Hare. Ronson humorously applies the Check List to journalists (he recognises traits such as the need for stimulation; being cunning and manipulative; being charming, in himself), to demonstrate that like the DSM, the Check List is seductive in its simplicity. But applied out of context or inappropriately, the Check List could have disastrous consequences, leaving a person labelled for life.
I was underwhelmed by the case studies, with the exception of that of ‘Tony’. Tony ‘acted insane’ to get a lighter jail sentence for a crime he had committed. He drew inspiration from various movies featuring psychopaths and as intended, was sentenced to a high security British psychiatric institution rather than a jail. The plan back-fired spectacularly – Tony either had to prove his sanity (difficult to do); be considered ‘untreatable’; or take the middle road, which is to be treated, declared ‘cured’ and then released. This took many, many more years than if Tony had gone to jail.
…what would I do if I had to prove I was sane? I’d like to think that just being my normal essentially sane self would be enough but I’d probably behave in such an overly polite, helpful and competent manner, I’d come across like a mad butler with panic in his eyes.
Ronson’s intention may have been to show that one person’s ‘normal’ is the next person’s ‘crazy’, however, he joins dots that can’t be joined (for example, the parts about increasing numbers of children being diagnosed as bipolar is really interesting but inclusion in this book implies a link between bipolar and psychopathy – an unconsidered conclusion might therefore be that with increasing bipolar diagnoses in children, we’ll have more psychopaths wandering around in the future. Huh. That’s crazy.).
3/5 Some chapters were better than others.