Book – “Almost A Psychopath”

Hazelden just released a new book in their “Almost” series, Almost A Psychopath:  Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy?

If you’ve been wanting to confirm your hunch about a relative you’ve always thought was “diagnosable,” or even arm-chair diagnosed him as “a psychopath,” then this book might be a tool to assist in that conviction.  While the book is also for people who are concerned that they themselves might be on the spectrum of psychopathic behavior, my guess is that most people who buy this book will be doing so to justify their hunches about other people.  If they, however, accidentally identify with descriptions in this book, well–that will be a fortunate (depending on your view) accident. And those kinds of accidents happens all the time.

Although I figured that reading this book would result in a lot of, “Ha! That’s so my stepmother…aunt…cousin!” moments, the truth is that despite the exciting book title, the authors are careful to not cross the line into “everyone” is a psychopath zone.  So, rather than come away with a list of suspects I knew, instead I came away with a better understanding of what a psychopath is as well as other mental conditions that can look like psychopathy but aren’t.  (We’re all jumping to “psychopath” as a catch-all for thoughtless people because it’s a hot armchair diagnosis right now–replacing Autistic as the popular diagnosis for quiet children who talked “late” or focused intently on objects not people, which had replaced ADD as the popular adult diagnosis for any sort of hyperactivity mixed with lack of concentration– etc.)

Almost a Psychopath…or Something Else?

The authors point out that often times certain medical conditions may be in play — and which ones should be considered as possibly masquerading as psychopathy or conceal an alternate condition, such as:

Major depression
Bipolar disorder
Borderline personality disorder
Histrionic personality disorder
Anxiety disorder
Substance abuse
Brain injury
Asperger’s Syndrome
Narcissistic personality disorder

The book’s Part 1 focuses on explaining the traits of an almost psychopath as well as similar mental illnesses. It also offers some encouraging words to readers who may be identifying the psychopathic person in their life and going, “Oh, God, how could I have been so stupid as to not SEE this?!” They make the point that psychopaths are so darn charming, and normal, that they seem in fact to be the epitome of both normal and charming, putting the actual normal, charming human beings to shame.  It’s normal to take a psychopath for what they present themselves to be–because we are open-minded, kind-hearted, and assume the best, so that is to say we’re nice, not to blame, but also…perfect prey.

The key, the authors write, is to not repeat the mistake.

True Psychopaths have 3 Traits

…(1) profound lack of empathy for the feelings of others, (2) a willingness to engage in immoral and antisocial behavior for short-term gains, and (3) extreme egocentricity.

(I don’t know about you, but for me, serial killer comes to mind.)

Almost a Psychopath

One case example describes James (an almost psychopath) who is described as behaving differently with his wife after they married, and whose wife was baffled by his deception, hostility, and aggressive justifications about questionable behavior.  They write, as part of their summary:

By definition, almost psychopaths share some of the characteristics of true psychopaths.  Almost psychopaths, like James, can be narcissistic and grandiose, seeing themselves as superior to other people and not bound by the society’s rules and customs.  They can be manipulative, comfortable with lying, and quite capable of justifying their actions, often blaming others for their behavior…

Some patience is required when navigating this book; almost psychopathy is a gray area!

The chapters in Part 1 are:

Setting the Stage
What is a Psychopath?
The Almost Psychopath
Could it be Something Else?

Part 2 digs into the practical bits — what one can do with regard to interactions with the “almost psychopaths” in their lives.  The authors provide examples of people who are manipulative and lack empathy but who are not psychopathic because they do not display the grandiosity that must go with the profile to qualify.  This is important for anyone who is struggling to understand their own tendency to behave callously, or that of someone else, and has great fear that being a psychopath is what’s at stake  — it may very well not be.

The authors provide several different sketches of “almost psychopaths,” who display some of the criteria for being true psychopaths in various combinations — so, for example, some who display two, but not all three, of the above traits, or having some of the above traits in various strengths and rates of frequency.

It helps to have someone, or a particular situation, in mind while reading this second part, to make the information feel practical and relevant.

The chapters in Part 2 are:

Living with an Almost Psychopath
Recognizing Almost Psychopathic Traits in Children
Working with an Almost Psychopath
Confronting Child Abuse by Almost Psychopaths
Adults as Victims:  Confronting Almost Psychopaths in the Helping Professions
Sick or Slick?  Malingering and Manipulation of Illness
What to Do When You Find Yourself in Almost Psychopath Territory

I have two criticisms of this book. One is that while the use of research was definitely interesting, as presented, it made getting into a reading flow difficult.  I would have preferred that the authors had summarized the results in the context of their own writing, their own words, and utilized end notes for any back-up.  The second is that in trying to be all-inclusive or to perhaps showcase the wide scope of almost psychopathy, there was a chapter on almost psychopathic children, and that felt distracting and ill-fitting for this book, a bit outside the core scope. I would have loved for the authors to, instead, have expanded the chapter on Living with an Almost Psychopath, as I believe that is what most of the customers of this book will be seeking solace and advice about.

Full disclosure: the publisher sent me an advance copy of this book. I would recommend it to people who are seriously questioning their ability to connect with others and feel empathy, as well as to get insight from the medical profession into friends/family who may potentially be psychopaths (as opposed to just damn impossible to deal with — or, both).

Book Info:

Almost A Psychopath: Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy?
by Ronald Schouten, MD, JD and James Silver, JD
(c) 2012 Hazelden $14.95

Most of this review also appears on

I also reviewed the first title published in this series, Almost Alcoholic.


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