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Book Review: The Psychopath Test

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.

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71 Comments on "Book Review: The Psychopath Test"

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  1. Hens says:

    TB I saw that movie and loved it ~!! I bet Oxy could kill a goat with her cast iron skillet !~Someone mentioned the movie ‘ Cowboys and Alien’s’ here the other day, well I went to see that yesterday it was a thumbs up for me…~~!!!

  2. Ox Drover says:

    Hens, I can turn people to PILLARS OF SALT with my stare. LOL I learned it at my mummy’s knee….my stare is almost as good as P-son’s, but I have to be MADDER’N A WET HEN to pull it off. It is when I get quiet and “that look” that I’m dangerous. It is when I am yelling that I am NOT dangerous, just when I am quiet—like a cat just before she pounces.

    We used to have a nasty mouthed vet around here and I had him out to look at a cow and he got out of his truck just a cussing. She had a retained placenta and I needed blood drawn on her and needed her cleaned out. He drew the blood but sgtarted to leave and I asked him if he wasn’t going to clean her out and he said “I’m too old to get diseases” you do it. So I LOOKED AT HIM WITH **THAT*** LOOK and he asked me “Well, what do you want?” (He should not have asked a question he didn’t want the answer to) so I said “HOW ABOUT A VET THAT ISN’T AFRAID TO GET HIS HANDS DIRTY, DO YOU KNOW ANY?”

    hE CAME OVER AND SHOOK HIS FINGER IN MY FACE. Bad mistake on his part. I QUIETLY said “get your finger out of my face now!” and I had THE LOOK on my face. Each word was softly said and separated from the other words carefully. He backed off me like I had pulled a rattle snake out of my pocket. So I can be very successfully assertive if I need to be.

    They have those fainting goats in Tennessee (really) which is a breed of goat if you scare it, it faints. So I guess you could get it scared by looking at it.

    I think I’ll just stick to turning people to pillars of salt though. LOL

  3. DUPED NO MORE! says:

    ahahahahaha
    too funny you guys…

    I am going nite nite…
    you all have a good nite and may the Angels light on your pillows until the morning sunshine…

    *Blessings*

    Dupey

  4. Twice Betrayed says:

    Hens: That movie is hilarious!!!!! LOLOLOLOL about your comment on Ox and her skillet!!!!! Too funny!

  5. kim frederick says:

    Hey, TB. How have you been?

  6. Twice Betrayed says:

    kim: Hey, good and bad…with this adrenal fatigue! Had a bad day yesterday-ate some asparagus and it made me too acidic and gave me heartburn and itchy skin. Bleh! Better today! Thanks for asking and saying hello!!!!!

    How have you been? GOOD, I hope! ❤

  7. Twice Betrayed says:

    Ox: I was sick yesterday with my stomach so didn’t read on the book. I read the first chapter this AM and am on the second now. Actually, I found chapter one pretty interesting after all. I guess the ‘mystery’ is: we are all nuts? Or we are not all nuts? AHAHAHAHAHA! I love his warped self revealing writing style. Page 34 [after he had purchased the Psych textbook]where he quickly diagnosed himself with 12 different disorders is absolutely hilarious! *Arithmetic Learning Disorder[he didn't want to do sums as a kid], *Parent-Child Relational Problem [when he didn't want to do his homework as a child], *Caffeine Induced Disorder [drinking coffee], *Malingering Disorder [avoiding work] and most hilarious of all: *Nightmare Disorder [dreams of being pursued and declared a failure] where he said ALL his nightmares involved someone chasing him down the street while yelling, “You are a failure!” AHAHAHAHAHAAAA~Hilarious!

  8. Ox Drover says:

    TB I am so glad you are enjoying that book! I thought it was really great! I’m on another reading binge…with all this hot weather outside there is nothing else to do and I ain’t gonna go outside if it is 115 degrees! LOL

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