“Almost a Psychopath” and Psychopathy

These are people who display a number of the traits that we associate with psychopathy, but in fewer numbers and with less intensity than full-blown psychopaths do. Key factors: conning and manipulative behavior, being glib and superficially charming, pathological lying and a general aggressive sense of self where every action and every behavior is focused on them facilitating and achieving their own needs. Psychiatrist Ron Schouten, MD, JD, on the phenomenon of being “Almost a Psychopath” (WBUR.org)

Schouten and James Silver, JD, are the authors of another “Almost Effect” book out of Harvard, the award-winner Almost a Psychopath. Both have experience as criminal lawyers, and Schouten is also a psychiatrist.

The official book description makes it clear that the “Almosts” are among us: “They are not the deranged criminals or serial killers that might be coined ‘psychopaths’ in the movies or on TV. They are spouses, coworkers, bosses, neighbors, and people in the news who exhibit many of the same behaviors as a full-blown psychopath, but with less intensity and consistency.”

Even true psychopaths often don’t match the media-generated stereotypes and could easily be one’s coworkers. According to one survey conducted in Britain, the professions with the most psychopaths include CEO’s, lawyers, TV/radio personnel, salespersons, surgeons, journalists, police officers, clergy, chefs, and civil servants (PsyBlog).

Whereas about one percent of the population are deemed full-fledged psychopaths, about five to fifteen percent could be Almosts. This means we’re all likely to come into significant contact with at least one individual in this category at some point in our lives.

Boston Magazine has excerpted from Almost a Psychopath five different case studies, including a community member who fakes cancer; an office bully; a physician who sexually abuses kids; a troubled child who becomes a rebellious, substance-abusing, lying teen; and the following example of “the dishonest therapist”:

After George and his wife went through a difficult period in their marriage, George decided to enter psychotherapy. After only a few meetings, the therapist suggested that George’s wife, Ann, come in for a few sessions, and she agreed. After two sessions, the therapist began seeing them as a couple. Initially, there seemed to be some progress; Ann seemed happier at home and she was invested in the therapy. Which made it all the more shocking when one day Ann announced that the marriage was over and she wanted her husband out of the house. Devastated, George called his therapist in a panic, and the therapist agreed to see him that day. The therapist was supportive but told George that ‘sometimes things turn out this way, and it’s probably best for you to move on with your life.’ In short order, the couple divorced. Some months later, George learned that Ann and his therapist (who was still treating George!) were living together.

What if you come to realize you know an Almost Psychopath? Abigail Zuger, MD, New York Times, summarizes the authors’ advice:

If you are a parent, you will almost certainly need to enlist professional help; you may take some long-term comfort from data suggesting that a child may outgrow worrisome behavior, but just waiting it out is unlikely to be a good tactic.

If you are a friend or spouse on the receiving end of an almost-psychopath’s attentions, you should know when to stop negotiations and walk or run away; the same goes for co-workers and employees. As the authors emphasize, almost-psychopaths are ‘far better at doing what they do than we will ever be in detecting and stopping them. And sometimes that requires that you escape a bad situation and allow others to come to their senses in their own time.’

Co-author Schouten speaks below:

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