Jon Ronson’s “The Psychopath Test: A Journey through the Madness Industry” is an extremely interesting book. I listened to an NPR “This American Life” Podcast that inspired me to read this book.
Ronson’s book is not a rigorous academic look into psychopaths, but that might one of the secrets of why it is so enjoyable. He presented the topics in a fascinating way and often covers topics in ways you may expect journalists (which he is) to write about them. He is always looking for the “story” behind a topic, which leads to a half a dozen investigations, which he loosely weaves into a book on the “Madness Industry” (using his words).
Another aspect of the book that is refreshing is that Ron seems to have no agenda or pre-conceived views on the topics he is writing about. He does not hold himself out as an expert, but just someone who is curious on the topic (as I was). As he goes through his investigations you see how he draws his conclusions on a topic but then as he learns more his views change. In this way you are able to see both “sides of the coin” on many of the topics in the book. Also, this storytelling approach really pulls the reader along.
The bonus is that Ronson has an extremely dry British self-effacing humor that runs throughout the book and it was hard not to chuckle at times as he tried to describe his own dysfunctions.
If you want to get a flavor of Ronson and this book, you can watch this 18 minute talk he gave at a “TED” talk about the book [...]
One way to think of this book is an entertaining documentary on the topic, since he tends to meander around the topics and at times seems to have no clear direction. However, it is definitely a fun read and when you are done, you will have an excellent idea of what a psychopath is and is not. You will also gain a sense of some of the issues surrounding applying a label like psychopath to people.
NOTES
With that conclusion I end my review of the book and what follows is some of the more interesting things I noted when reading the book (and topics I plan to read more about):
DSM Guide
The bible for psychiatrists and psychologists is the DSM guide (“The Diagnostic and Statistical Manual of Mental Disorders”). The DSM is the place where experts in the field try to classify all mental disorders. The DSM is an attempt to define a set of consistent labels and terms for disorders and thus give a common and consistent reference point to allow for more accurate communications and documentation. Of course any project to describe and categorize anything as complex as human personalities and disorders is not going to be perfect. Also, any labeling system has some negative unintended consequences and this seems to be the case with the DSM manual as well. The manual was first published as DSM-1 in 1952, but existed under different names going back to 1870.
DSM and Psychopath
This DSM manual does not use the term psychopath, but instead uses the term “personality disorder” (I guess the term psychopath became politically incorrect).
The manual describes a personality disorder as follows:
“This disorder, by enduring antisocial behavior, diminished empathy and remorse, and disinhibited or bold behavior. As an aspect of personality, it represents scores on different dimensions of personality found throughout the population in varying combinations.”
The idea of a psychopath type personality has been around since the early 19th century, but it has only been tightly defined in the last 40 years.
Psychopath Test
Though the DSM’s definition is vague, there is a relatively test to determine if someone is a psychopath that is not in the DSM guide. One of the most popular psychopath testing methods was developed by Bob Hare, who is a professor from Vancouver’s University of British Columbia (the school I graduated from). The test was developed by Hare in the 70s and is often referred to as the Hare Psychopathy Checklist-Revised (PCL-R).
Before 1970 there was a general agreement among criminologists that criminals were the result of an unfortunate environment (how they were brought up or other negative life events). There was a belief that there was no such thing as a person who was just born “bad”. Over the next 20 years Hare’s studies resulted in a change in this status quo belief.
Hare was interested in studying psychopaths, however at the time there was no definitive way to determine who was and was not a psychopath. The idea of a psychopath personality had been around for a long time, but more as a general understanding. He knew as long as there was no definite way to “diagnosis” a person as a psychopath they could not be studied, so he set out to define a method to test a person for the psychopath personality type.
Hare hypothesis was that psychopaths were people who were wired “bad” at birth. The idea was that since these people had defective personalities there would likely be no real cure for them. Consequently he postulated that psychopath criminals would have much higher recidivism rate when being released from prison. Hare did not assume that every criminal who was incarcerated in a high security prison was a psychopath. He accepted that many of the prison population would have been lead to a life of crime by their unfortunate environmental circumstances.
For Hare to test his theory, he knew the first thing he would have to do was come up with a scientific way to classify a person a psychopath (or not). To come up with a test he would have to be able to work with a population where there may be a high concentration of psychopaths. To this end he successfully sought permission to do his studies at a local penitentiary. He was given access to prisoners in the only western Canadian maximum security federal prison: The BC Penitentiary in New Westminster, British Columbia, Canada. This BC Penitentiary, that house up to 750 prisoners, started in 1878 and was finally decommissioned in 1980. I grew up close to this prison so was very familiar its notorious reputation. It had housed many notorious and violent prisoners and was in the news often due to riots and hostage takings. When the prison closed in 1980 they opened the facility to the public for a short period of time before it was torn down and replaced by condos and I still have vivid memories of my tour of the buildings there.
To get subjects for his study Hare asked for volunteers from the inmate population at the prison. He was not sure how many “takers” he would get, but he quickly learned that the prisoners where extremely bored and his offer to study them was a chance for them do something different. Also, one of his first volunteers was a “King Pin” inmate and after he met Hare, he told the general population that this was a good guy and you should all volunteer to be tested by him. From that point on, Hare had no shortage of inmates to study.
The first test Hare performed on his subjects was to connect them to both an ECG monitor an electrical shocking device. He then informed the subject that at the count of 10 he would zap them with a very strong electrical shock. He would then start to count … 1, 2, 3. As was expected many of the prisoners became noticeably anxious as he approached 10 and their ECG strip clearly matched their external reaction of fear. However, the psychopaths registered almost nothing until the point of the actual shock. When the electrical shock was applied all subjects responded in a similar fashion, with a loud yell of pain (since the shock was severe). Sometimes he would then immediately repeat the test with the same subject and of course the non-psychopaths would now be extremely anxious because they knew exactly what was happening. However in this second test, again, the psychopaths would have no measurable reaction before the point of the shock. Hare wrote up these results in an academic paper, but he could find no one to publish his work. The feedback he received from the journals was that their review boards believed he had faked the results. When they reviewed the ECG results they did not think any person could possibly have no reaction before the point of the shock (or in other words the results were not human). Unfortunately for Bob Hare (but maybe a good thing for society) they government banned the use of shock treatments or testing on the prisoner population. This means Hare was back to ground zero on his project to accurately classify psychopaths. This blocked path lead them in the direction of a check list approach that became the Psychopath Test of today.
The Hare check list test uses a scoring system were a test score of 30 or more (out of 40) results in the subject being deemed a psychopath. The test consists of 20 questions and for each question you can score a zero (0) if your answer is “no”; or a one (1) if your answer “maybe”; or a two (2) if our answer is “yes”. Thus the lowest score is zero (if all our answers are no) and the highest score is 40 (if all our answer is yes). To be considered accurate a certified and trained expert must administer the test. The tester must independently verify certain answers (like the juvenile delinquency record). The twenty questions in the Hare test measure for these personality traits:
• glib and superficial charm,
• grandiosity
• need for stimulation
• pathological lying
• cunning and manipulating,
• lack of remorse
• callousness
• poor behavioral controls
• impulsiveness
• irresponsibility
• denial
• parasitic lifestyle
• sexual promiscuity
• early behavior problems
• lack of realistic long-term goals
• failure to accept responsibility for own actions
• many short-term marital relationships
• juvenile delinquency
• revocation of conditional release
• Reckless disregard for safety of self or others
The average “normal” person scores 3 to 6 on the Hare test and an average non-psychopath criminal scores 16 to 22. A non-criminal psychopath average score is 30 to 34 where criminal psychopaths score from 30 to 40 points.
The 20 traits are broken down into two major factors:
Factor # 1 -- Interpersonal, Moods and Feelings factors (example: glibness, grandiose self-worth, pathological lying, manipulative, lack of remorse, lack of empathy and failure to accept responsibility).
Factor # 2 – Lifestyle and Antisocial behavior (poor control, lack of realistic goals, irresponsibly, need for stimulation, impulsivity, poor control, early behavioral problems).
A couple factors that do not fit into #1 and #2 factors are Short-term marital relationships and promiscuous sexual behavior.
Psychopath Recidivism
Once Hare finished his testing he was able to classify the inmate population into psychopath and non-psychopath and started studying statistics from the two groups.
The results of these tests were striking in that the psychopath’s recidivism rate of violent crimes was dramatically higher. When these results were published criminologists and prison systems around the world became very interested in the Hare test. Experts realized that Hare’s test could be used to determine (statistically) which inmates would likely re-offend if released and thus could be a powerful tool for parole boards.
At first Hare did not make the details of his testing method public. Hare was concerned that his test could be used to incorrectly label people. However, after a period of time he was pressured into releasing the full details of the test. Today his check list is used by the majority of prisons systems around the world to classify some of their inmates as psychopaths. In the Ronson book he points out that most people who achieve this label have extreme difficulty in ever being paroled from prison, since no one wants to be the person who sign off on allowing the psychopath to be released. Today, much of the criticism of the Hare test surrounds this same issue of miss-labeling an individual as a psychopath.
In Ronson’s book he investigates a particular prisoner and how he was housed in Broadmoor Hospital for the Criminally Insane in England. This prisoner was trying to be released because he claims he was incorrectly classified as insane or a psychopath. Ronson leads us through the journey of meeting this inmate and his subsequent thinking on this individual.
Oak Ridge – Dr. Elliott Barker
Ronson covers a fascinating experiment by Dr. Elliott Barker who tried to cure psychopaths in the Oak Ridge hospital for the criminally insane (now known as the Mental Health Centre Penetanguishene in the town of Town of Penetanguishene, which is about 100 miles north of Toronto). Dr. Barker believed he could cure psychopaths through therapy sessions that also included the patients taking LSD. He based his belief on what he had learned on a worldwide tour and other treatments he had observed. With this flimsy background he requested and gained permission from the Canadian government to administer his experimental treatments at Oak Ridge. The patients (prisoners) were then put through a bizarre set of “encounter sessions” where he would encourage them to get their anger and feelings out (all while high on LSD). Sometimes these sessions would be done with no clothes on. He also encouraged peer counseling between prisoners. These sessions could go on for days while the subjects were encouraged to confess their innermost feelings and act out any way they wanted. When the study ended there was some optimism that it may have had a positive impact, but follow up studies showed that many of the subjects who were released became repeat offenders with some extremely grizzly and violent crimes. Thus in the end the experiment was a failure and became another plank in the argument that psychopaths cannot be rehabilitated.
Amygdala
Experts believe that the part of the brain that does not work “normally” in a psychopath is the amygdala. The amygdala controls fear and since the psychopaths have less fear, the thinking goes, that they likely have a malfunctioning amygdala.
The amygdala is a small part of the brain that is sometimes described as an olive shaped blob behind your ears. The amygdala inputs information from you body’s sensors (things like temperature, sound or shocking images). Outputs of the amygdala are messages to be sent to other parts of the brain to take action based on the amygdala inputs. For example the first time the amygdala “learns” that feeling a hot temperature is often followed by pain, the second time it receives a message that your body is contact with a very high temperature it can tell another part of your brain “this is really going to hurt so do something quick”. When the other parts of the brain receive this message from the amygdala they can send messages to take specific action to address the inputs, like quickly moving your hand off a hot stove burner. Because fear is one of the easiest human emotions to study, the amygdala is one of the most studied parts of the brain. Fear is tied to human survival and easy to study because of the short period between input and reaction. An example of this was Hare’s electrical shock experiment. You can postpone the reaction to the feeling of hunger by not eating for an hour or you can drive a few more miles after feeling exhausted, but when you lose your balance while on top of a 25 foot ladder, you cannot delay your reaction and live.
The theory is that the psychopath’s amygdala does not correctly translating its input senses to output action signals and thus they are more immune to fear.
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It is an awful lot harder, Tony told me, to convince people you’re sane than it is to convince them you’re crazy.Highlighted by 583 Kindle readers- ‘If people like you, you can manipulate them to do whatever you want them to do!’Highlighted by 441 Kindle readers
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Lady Fancifull
Well written and engaging; could have gone so much further
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My conclusion is: there is no conclusion
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Entertaining survey of a serious topic
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