The Psychopath Test by John Ronson explores the shortcomings of psychiatry and the elements of human error in diagnoses.
Contents
Bullet Summary
- There are a lot of grey areas between sane and insane
- Diagnoses often contain a (sizable) portion of the human personal opinion
- We have too many mental disorders on record (347): not everything is a dangerous symptom that needs to be medicated
Full Summary
It’s difficult to summarize The Psychopath Test because it’s the story of author’s own research into psychopathy.
But it does not reach any conclusions or make any points based on research or on an overview of the literature.
But here are my main takeaways:
Psychiatrists Often Got it Wrong
Before the Hare Psychopathy Checklist labeling someone a psychopath or not was fully up to the medical personnel.
And they would often got it wrong.
Hospitals for example admitted for treatment as psychopaths several healthy individuals who only wanted to prove that the system couldn’t really tell people apart.
When the experiment was revealed, the psychiatric world was shocked.
One hospital then said to send more healthy people posing for psychopaths and they would recognize them.
They indeed recognized more than 40.
The problem was, no healthy individuals were purposefully sent.
That’s what the the Hare checklist wanted to provide: a standardized way of assessing patients that would eliminate (or reduce) human judgement.
Turns out, it might have not really done it:
Psychopathy Diagnosis Is Very Personal
The author reviews a few “grey area” cases and shows the limitation of the Hare’s checklist. The Hare Psychopathy Checklist is the instrument psychologists and psychiatrists use to assess and “label” people as psychopaths or not.
It turns out, a checklist might not be such a great tool and is very prone to human judgment. And human mistakes.
There is A Psychiatric Label For Everything!
The author makes the point that we used too many drugs. Sometimes for people who have issues that might not necessarily be the symptoms of a psychiatric issues.
But, he says, the DSM has so many entries that almost any behavior could be labeled as a mental illness.
Psychopath Corporates
Jon Ronson also goes into corporate and psychopathy. If I remember correctly at one point the book either claims or suggest that “the higher you go, the more psychopaths you meet”.
The author interviews one of the most ruthless CEO corporate America has ever seen, Albert Dunlap.
I didn’t think that was a good example at all though, since Dunlap ended up in a big crash and burn. So if everyone psychopath were like Dunlap, they’d soon exterminate themselves.
The Psychopath Test Criticism
The book has been criticized for its lack of scientific rigor and for the sensationalism it seeks to create.
The title by itself “a journey through the madness industry” is sensationalist. “Madness”? “Industry”?
Most of all, I invite you to read Bob Hare’s reply here. It’s an instructive -and even entertaining- read.
That being said, I have to add my own critique to the critique: Hare complaining that his checklist is “copyrighted material” is freaking ridiculous.
If he is about spreading knowledge, he should share that stuff for free.
Real Life Applications
Watch Out For Diagnoses. And Self Diagnoses
Diagnoses, often, are nothing but a personal opinion which leverages experience, research and maybe a checklist. But they still keep that personal opinion in the mix.
Watch out especially for your own self-diagnoses, as they tend to be particularly poor.
CONS
There Is Grey… But Sometimes There Is Black and White
The author quotes the book The Sociopath Next Door. However, the messages from these two books are very different.
The Sociopath Next Door makes the point that it’s sociopaths who want you to believe that everyone can do anything. And blurring the lines of “good” and “evil” only serves the sociopaths.
I side with Martha Stout here: There are evil people. And good and evil doesn’t overlap nearly as frequently as romanticized novels would want you to believe (also read “Do Good and Evil Overlap“).
Disjointed
The Psychopath Test might has well have been called “A Random Walk in Psychopathy”.
If felt random to me, without a single threat that would unify the different parts and chapter.
No Single Message
At the end of the day, if someone were to ask me “what’s this book about”, it would take me a long winded answer which would say a lot while at the same time saying little.
I don’t think that’s a good thing because books like this usually leave me with little takeaways.
Sensationalist, Unscientific Categorization of Psychopath
As Ronson interviews a famous financial operator, he tries to score him on the Hare checklist. But he does so in a light and shallow way.
PROS
Raises Some Good Questions
The Psychopath Test raises some very good and important questions. Such as:
- How much can we really trust mental diagnoses
- How do we ensure we don’t make grave mistakes (ie.: keeping non dangerous people locked and setting dangerous ones free)
Review
I didn’t really get the point The Psychopath Test was trying to make.
I listened to the audiobook and I failed to understand the author’s point and to take away much from the book.
At the end of the book, I didn’t feel I ad learned too much of either sociopathy, psychopathy or mental illnesses in general.
Except, maybe, that labeling is difficult and possibly prone to lots of mistakes.
That, by itself, can be a major takeaway though.
I think indeed the author was trying to somewhat discredit the psychiatric profession, but he falls short in exactly admitting it.
That is what I missed from this book: a clearer stance from the author. Even if his stance ended with a “I’m not sure”, he should have been clearer about it in my opinion.
Overall, all in all, I would say this:
If you want to understand psychopathy, this book is not for you.
If you want to read a more journalistic, captivating book on psychopathy and the issues around the mental illness, then go for it.
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