Psychopaths. We can’t seem to get away from them. Set up an Internet search alert for the term and your email will come alive with links. Postings from the U.S. and Europe, where “psychopath” has become a common pejorative, is particularly high, with items that range from “I think I am/my partner is a psychopath” to “psychopaths in government,” to the more recent “psychopaths on Wall Street.”

The popularity of the term has led to imprecision in its application as well as a tendency to apply it to anyone whose behavior we view as selfish or mean-spirited. It’s a term we spit out when we encounter any person who we find to be horrific, cruel, or generally offensive. Much of the popular use of “psychopath” is inaccurate, reflecting a negative view of those thus labeled rather than a formal diagnostic assessment. But the term is so attractive, speaking to our images of the worst of the worst, and allowing us to tag the “bad guys” with it.

In a way, identifying a true psychopath is easy. They represent the extreme form of antisocial behavior: entirely self-serving, completely lacking in empathy, indifferent to the distinction between right and wrong, prone to pathological lying, lacking a sense of responsibility, remorseless, irresponsible, emotionally shallow, devoid of goals, or focus on the future, conning and manipulative, and with a history of criminal behavior. But is everyone who shares some of these characteristics a psychopath? No, and we've written a book, “Almost a Psychopath,” to address the more complex, nuanced, and pervasive problem of people who may not meet all the criteria for a formal diagnosis of psychopathy, but who nevertheless possess many of the symptoms and cause significant injury and pain to those around them as a result.

Almost psychopaths behave and experience the world in many ways like true psychopaths, but they are able to fly under the radar because their symptoms are less intense in both quality and quantity. As a result, they frequently get away with their conning and manipulation, leaving those they leave in their wake scratching their heads and wondering “What was that about?”

In our book, we look at the extreme form of psychopathy, but our focus is on people who exhibit psychopathic traits but would not meet the criteria for a diagnosis of psychopathy. And in the postings that follow this one, we will take you on a tour of behaviors, incidents, and life events that cry out “Psychopath ” but that in fact dwell within that broad expanse between normalcy and psychopathy .

We wrote our book, and we are offering this blog, to help sort out the problematic behaviors we encounter every day. While labeling behaviors and people is attractive and often satisfying, it can lead to an all or nothing approach: a person either is or is not a psychopath. If they aren’t, then we may be encouraged to write off their damaging and malicious behavior to their peculiar personality or even cast it in a positive light, e.g. he’s got what it takes to make it in this dog eat dog business. Our term “almost a psychopath” is intended less as a label than as an umbrella under which we can gather a host of problematic behaviors, from the misguided to the indifferent to the malicious, and (1) acknowledge the damage they cause and (2) explore ways to confront and overcome them.

In the postings that follow this one, we will take you on a tour of behaviors, incidents, and life events that smack of psychopathy. Some of them will depict full-blown psychopaths, but the majority will represent the Almost Effect: significant symptoms, short of a diagnosis, that cause tremendous pain and suffering to the individual and those around him or her. We hope you will join us as we begin our monthly exploration of the Almost Psychopaths in our world.

About the Authors

Ronald Schouten, M.D., J.D.

Ronald Schouten, M.D., J.D., is an associate professor of psychiatry at Harvard Medical School and director of the Law & Psychiatry Service at Massachusetts General Hospital.

Jim Silver

Jim Silver, J.D., is a criminal defense attorney and former prosecutor.

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