Searching for meaning in a book “about” mental illness.

I detect a drift into the mainstream of the idea of personality disorder, and in an attempt to understand why I have been reading some pop books – perhaps the best known being Ronson’s The Psychopath Test.

The book is subtitled “A journey through the madness industry”: it’s never clear what Ronson means by the madness industry but it’s true that the main structuring device is a journey, although it’s from one person to another rather than (unfortunately) from one idea to another.

We start with Ronson meeting a neurologist in a café in London, and an anecdote about an anonymous incoherent book she has received. There are warning signs here about this careless superficial book – the person he’s meeting isn’t a neurologist and even a casual conversation with a few mental health clinicians would have marked his card about how common it is, if you work in that world, to receive unsolicited books and articles from people hoping to interest you in their idiosyncratic view of how things work, and how little such gifts really tell you about either mental illness or mental health services.

It’s difficult to identify a theme in what follows. To start with it seems to be an exploration of psychopathy, which Ronson has been persuaded is routinely diagnosed in clinical and forensic practice on the basis of Hare’s Psychopathy Checklist and as an explanation for which he mentions repeatedly a half-baked idea about amygdala function. So we get a visit to a special hospital, a skimmed review of some aspects of the Oak Ridge scandal, and an interview with a ruthless businessman, but half way through he seems to lose interest in that line of thinking and we get an account of David Shayler’s mental illness, an interview with a guest-booker for (among others) the Jeremy Kyle show, and a drift off into stuff about DSM and the overdiagnosis of bipolar disorder in children in the USA.

All this is sketchily researched. The piece about the Oak Ridge scandal doesn’t mention the Class Action lawsuit started in 2001 against The Ontario Government and Drs. Elliott Barker and Gary Maier for breaching the basic human and civil rights of participants. The account of Shayler’s mental illness has no obvious point in relation to understanding ideas about psychopathy and the egregious picture of Shaler dressed as a woman suggests the main aim is to invite sniggering. In his report of an interview with Hare himself, there’s a recycled anecdote that comes from the introduction to Hare’s 1993 book about psychopathy. The interview with Charlotte Scott (the Jeremy Kyle producer) is mainly a rewarmed version of her earlier mea culpa published in the Guardian.

The people Ronson interviews have a habit of speaking in odd tabloid journalese, issuing stupid one-liners like if you’re worried about being a psychopath then you’re not one. Adam Curtis asks him – what does all this say about our sanity? – one example of recurrent cod philosophy about the difference between sanity and insanity that reminded me of nothing more than Rosenhan’s fraudulent paper On Being Sane in Insane Places.

Reviewers, at least those quoted in the book, apparently find it all hilarious. Will Self says he found himself “laughing like the proverbial loon” for page after page. And this coupled with a comparison one of them makes between Ronson and Louis Theroux provides a clue about what is going on. Ronson tries disarming mentions of his own tendency to anxiety and of the intrusive and disabling nature of mental illness, but in truth this is Barnum and Bailey psychiatry, a parade of grotesques (people and ideas) at which we might laugh or shudder depending upon our disposition. Its appeal is to Hollywood stereotypes – Gordon Gekko meets Michael Corleone – and doesn’t offer anything interesting about the contentious diagnosis of personality disorder (antisocial or otherwise) or sympathetic to the popular understanding of mental illness or the people who try to treat it.

I guess it’s that appeal to the familiar that accounts for the popularity of this grim book – the offer of a reassuring romp through a landscape populated by really odd people who aren’t like us. I didn’t find it remotely funny, just rather unpleasant.