The Psychopath Test, by Jon Ronson

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It all started with a parcel that a researcher at University College London received from an anonymous sender containing a curious expensively-produced book.  The contents of the book were obscure, but surely too much effort had gone into its production for it to be a meaningless prank.  The recipient discovered that others had been sent copies, yet despite a large amount of collaborative effort the meaning remained out of reach.

Eventually Jon Ronson was approached as someone who might be able to solve the mystery.  He did, in an absurdly simple way by checking a database, and then doorstepping the sender.  The oddities of the person responsible for posting out these cryptic books to academics, a Swedish translator, became the starting point for Ronson to ponder the quirks of individuals who fall outside the curve of what is considered normal behaviour.  That in turn led him to delve into what makes a psychopath tick.  That was the idea.  In practice, as a non-academic he takes a scattergun approach to the subject.

As part of his exploration he looks in a sketchy way at the recent history of the treatment of mental illness, beginning with a well-meaning but misguided 1960s counter-culture behavioural approach involving liberal doses of LSD.  He hears about the DSM, The Diagnostic and Statistical Manual of Mental Disorders, which causes him to branch out into a more general examination of mental illness and the industry it supports.  And an industry it is, with its own vested interests that do not always work in the individual’s, or Society’s, best interests.

A lot of the book is to do with misdiagnosis, trying to infer an entire galaxy of characteristics from a few behavioural traits, and often getting it wrong.  The result is a pathologisation of behaviours on the boundary of normal that in another age would merely have been considered eccentric.  Who benefits from the situation?  The drug companies do.  No wonder DSM has grown so huge, allowing profit-hungry pharmaceutical companies to benefit from increased sales.  It does seem curious, given the individualism that the US holds so dear, that its psychiatrists seem ready to brand so many of its citizens abnormal.  The disorders listed in the constantly expanding editions of DSM seem to drift ever-closer to what would once have been considered normal, with the result that it is easy to make fun of some of them.

Others are too serious to make fun of, because of the consequences.  There are huge numbers of children diagnosed as having ADHD, bipolar disorder, autism or Asperger’s.  Once upon a time parents would have been told that the kid would grow out of it – which they mostly did – whereas nowadays they carry a label, and a stigma, for life.  At the same time it lets the parents off the hook; it’s not poor parenting after all, it’s not their fault, it’s a brain imbalance, and they aren’t responsible for that.  No wonder there is such a push-pull emphasis on dosing the kids.  As Ronson’s investigation of the discussions that go into producing DSM indicate, getting consensus between psychiatrists on what should count as a mental disorder is not easy, which makes diagnosis seem more of an art than a science.  Psychiatrists too represent a vested interest as the bigger DSM is, the more it keeps them in work.  At the risk of wanting to make the bloated manual even longer than it is already, perhaps there should be another entry, one called ‘compulsive psychiatric labeling syndrome’ which applies to those who think up entries for DSM.

The heart of Ronson’s book is Bob Hare’s PCL-R Checklist (the Psychopathy Checklist –Revised), a twenty-point scale which can be used to identify psychopaths (and which gives Ronson his title).  Ronson attends one of Hare’s training courses, and spends the rest of the book applying the checklist to people he meets.  The checklist is influential so it would have been useful to have technical information on how it was validated, but that would have changed Ronson’s light tone.  Nor does he look at what peer-reviewed research has been done on it in the quarter of a century it has been in use.

During his investigation Ronson is occasionally assisted by the Scientologists, who have long been running a campaign to discredit psychiatry.  While to his credit he shows the Scientologists’ extreme anti-psychiatry to be as misguided as psychiatry’s own excesses, they will probably be happy with his book, as it shows psychiatric diagnosis to be a rather blunt instrument for assessing degrees of mental illness, and the unhealthy influence of the drug companies.  One wonders who was using who the most here.

Despite the lack of depth, there is one valuable insight that Ronson provides as a psychiatric outsider from his use of the Hare checklist.  Applying the items willy-nilly he eventually starts to think that being a ‘psychopath spotter’ has turned him a little ‘power mad’.  This is not something a psychiatrist would admit to, but it does provide an interesting insight into not only psychiatry but also the strands of psychology that involve making critical decisions about other people: there may be an element of satisfaction in having control over other people’s futures.  It begs the question of how clinical ‘psychopath spotters’ would score on the checklist.

Ronson looks at how television likes people who are on the borderline, different enough to make them interesting, not too different to be scary, and then eggs them on to perform, unbothered if it damages them further.  An interview with an ex-researcher for a reality show elicits the cynical confession that her criterion for choosing guests was whether they were on medication, and if so, what.  If they were not taking anything they were rejected as likely to be dull.  If they were on something strong, say for schizophrenia, they were rejected as too risky.  Those on something like Prozac were considered ideal, and were most likely to make it on to the show.

The best bits in the book are the interviews which illustrate the issues in action.  There is ‘Toto’ Constant, the ex-leader of a Haitian death squad, now in prison for mortgage fraud (well, they got Al Capone for tax evasion).  Then there is Tony, who actually blagged his way into Broadmoor after a GBH conviction and then found he couldn’t get out after being diagnosed a psychopath, finding himself incarcerated for far longer than the prison sentence would have been.  Al Dunlap, CEO of a toaster company, enjoyed firing people gleefully, seemingly caring nothing about the consequences; rather than being in jail he lives in a luxury mansion and surrounds himself with statues of predatory animals and portraits of himself.  And there is David Shayler, the ex-MI5 spook and unsavoury conspiracy theorist now claiming to be the Messiah.

They run the spectrum from Toto, who seems firmly in the psychopath category, cheerfully admitting to wanting to get people to like him so he can manipulate them more easily, to Shayler, who is just a sad man who enjoyed his five minutes of fame and has tried to find increasingly outrageous ways to recapture the public attention he craves, with little success and much ridicule.  Dunlap, whose psychopathy Ronson eventually questions, ironically claims many of the supposedly negative attributes on the Hare checklist to actually be positives which he enthusiastically endorses as applying to himself as part of the go-getting entrepreneurial spirit that he sees embodied in the United States.  One can only conclude that all psychopaths may be nasty, even if they hide it under a veneer of charm, but that doesn’t make all nasty people psychopaths, just flawed individuals.  Tony for Ronson is the most fascinating of his subjects because he is on the borderline. He seems fine, so ordinary, and exemplifies the double bind of attempting to convince your therapists you are sane when the behaviours you exhibit trying to prove it are turned against you as evidence that you are insane.  But is he being manipulative, how far can you trust what he says?

All this makes for a very meandering journey, and that means that the book’s lack of a discernible structure is in danger of puzzling the reader, who wonders where it is going.  The lack of focus is actually signalled in the first sentence, when Ronson says that ‘This is a story about madness’, and then launches into the business with the Swedish translator and his weird project to send mysterious books to random academics who have no idea what the volumes mean (if they have a meaning, which Ronson concludes they don’t).  The Swede may be extremely eccentric, but his is not a story about madness.  That comes later in Ronson’s narrative, but he has already muddied the water by implying that pulling the legs of sundry individuals, albeit in a creepy way, is somehow at one end of a continuum that at the other includes psychopathic serial killers.  He fails to show why sending out the books, which in another context would be considered an art project, is in the book at all, other than to get Ronson thinking about unusual mental states, and it is a somewhat long-winded opening for such a simple hook.

The overall impression is that Ronson is new to the subject of psychopathy, found Hare’s checklist intriguing, and decided there was a book, plus the odd article and broadcast, in it.  There’s little new here, but it is packaged in an enjoyable way, and will doubtless bring the issues to the attention of many who had not thought about them before.  But you really do come away thinking that this is more about Ronson’s personality than it is about that of the psychopath.  It could be said that there is a touch of hypocrisy here because he may decry the ways in which mental illness is used by the entertainment industry as its raw material, but in a way he is guilty of that himself, even if he thinks he is producing a humane, liberal, balanced critique.

I’ve seen Ronson twice now giving talks about the book, and his persona is the same – the bemused wry outsider, talking about his own anxieties as much as about the subject on the card.  It’s a lightweight approach, one that doesn’t really work with mental illness because it isn’t rigorous enough.  There is a sense of strain putting it all together as he expands his target to take in mental illness as an industry, but then much of it seems arbitrary; you feel he is struggling to bring the book up to the required length, because as well as the chapter on Shayler he shoves in a chunk on Paul Britton the criminal profiler who came unstuck over the Rachel Nickell murder by fixating erroneously on Colin Stagg as the prime suspect, and a lengthy detour into the issue of childhood bipolar disorder.

Ronson is very persuasive in getting interviews and accessing places that are normally off-limits to the public.  He gets people talking, but he can’t (or shouldn’t) claim to be an investigative reporter.  Notwithstanding its title, the reader does not learn much about what makes a psychopath tick, other than they are likely to fulfil a number of the criteria on Bob Hare’s checklist, and may have an overactive amygdala.  The overwhelming impression given is that being a psychopath has a biological aetiology.  He doesn’t touch on gender differences – why, if it is brain chemistry, are there not more female psychopaths?  Are they better at hiding it?  In a sexist world do they not have the opportunities to express it?   What is the influence of such factors as race or class or childhood deprivation?  There’s really nothing on social factors, which would need an in-depth analysis.  A clue to the approach is given in the acknowledgements, where Ronson says he left ‘four or five pages’ out of a chapter because they were ‘boring’.  The readers must not be bored, which means they must not be taxed too much.  There is a huge academic literature on mental illness and its (mis)treatment outside of ‘On being sane in insane places’, but you wouldn’t know it from this.

As I was reading The Psychopath Test, I heard a news item about a 1982 proposal, as part of Britain’s Cold War contingency plans, to put psychopaths in charge of the government post-apocalypse.  This was on the grounds that they would be able to make dispassionate (though not compassionate) decisions that would cause those with consciences to display bias because of their degree of empathy, and which would give them sleepless nights.  Fortunately the proposal was swiftly rejected.  The person who came up with the idea obviously hadn’t actually met a psychopath, or never expected to be the object of their decision-making processes.

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