"The Psychopath Test" by Jon Ronson

This seems to be the time for challenges to the world of psychiatry among my reading. There was Sybil Exposed last month, and now Ronson's The Psychopath Test. The latter is less clearly focused than the former, but it's a lot more fun. Ronson's new book explores the diagnosis of psychopaths and some of the problems surrounding it. He also interviews and researches some diagnosed and potential psychopaths in hopes of learning more about them. 

Unlike most nonfiction books which have a clear central premise, The Psychopath Test is much more loosely organized. The book begins with Ronson's interest in the somewhat vogue idea that many of our great leaders are psychopaths (or have other personality disorders), and that illness helped them achieve their greatness. Nonetheless, the book doesn't stay on this train of thought, exploring everything from Scientology's anti-psychiatry crusade, to conspiracy theorists, to the creation of the DSM (the APA's diagnostic manual). Reading the book is, at times, like following Ronson's stream of conscious association; everything doesn't always seem relevant (for example, he spends time criticizing the DSM, but "psychopathy" is not even a disorder listed), but it's so interesting that it doesn't matter.

One train of thought that initially sets Ronson off is his skepticism at the legitimacy of some of the APA disorders. This idea ran throughout Sybil Exposed, though Ronson's book stays more neutral than Sybil. I was drawn in because it's something I feel myself, even though I'm married to a psychologist, perhaps because I teach at a public school in which learning disabilities are excessively over-diagnosed for students by parents looking for excuses and rationales for medication rather than the truth. Ronson's not out to "expose" the APA or challenge its work, but his research does raise questions about the manner in which disorders are created and diagnoses made, as well as psychiatry's close relationship with pharmaceutical companies. As Ronson says near the end of the book, "There are obviously a lot of very ill people out there. But there are also people in the middle, getting overlabeled, becoming nothing more than a big splurge of madness in the minds of the people who benefit from it."

Ronson is a personal writer whose use of his own story creates intimacy with the reader. He's comically self-referential (as when he continually reflects about whether he's displaying psychopathic tendencies) and approaches his material much like his reader would.

I don't know if The Psychopath Test would be best for someone researching psychopathy, and it probably annoys some psychiatrists, but I found it fascinating and a lot of fun while also providing some insight into the problems facing the psychiatry field today.