Almost a Psychopath

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Ronald Schouten and James Silver have come across plenty of psychopaths in their careers. Schouten, after all, is a former attorney who these days practices forensic psychiatry and teaches at Harvard Medical School, while Silver is a one-time federal prosecutor who’s now a criminal defense attorney in Boston. But what the two men have encountered even more often are borderline cases — not really psychopaths, not really normal. And these kinds of people can be particularly dangerous because, as Schouten and Silver write in their new book, Almost a Psychopath, they can be so hard to spot.

So who are these almost psychopaths, anyway? Compared with the full-fledged variety, they’re “capable of living more easily among the general population and maintaining relationships, with less frequent harm to those with whom they are involved,” Schouten and Silver write. “The almost psychopath uses others for personal gain but is careful not to irretrievably push those people away. And if he or she does overstep, the almost psychopath effortlessly generates a string of excuses, apologies, and promises in an effort to preserve the relationship and future opportunities for personal satisfaction.”

Scary, right? Well, don’t worry. We’ve got everything you need to protect yourself. Ahead, we excerpt five case studies from Schouten and Silver’s book, documenting a range of almost-psychopathic behaviors. We also talk to the authors about how to avoid becoming a victim, and what you can do if the almost psychopath you’re dealing with happens to be a loved one. Oh, and if you’re worried that you might be an almost psychopath yourself — relax. The fact that the prospect concerns you at all is a sign that you’re not.

Read more:

Help! I Have an Almost Psychopath an My Life

Recognizing an Almost Psychopath is the first step. The next is getting help.

Ten Signs You’re Dealing with an Almost Psychopath

How to spot the Almost Psychopaths among us.

CASE STUDY #1

The Troubled Child
Sammy was not really a “bad” child, at least not at first. But his parents did find him challenging, even in infancy. When angry — and it didn’t take much — he would thrash around, bang his head against the floor, and attempt to bite his parents. Two babysitters quit because they could not tolerate his rages. ­Sammy’s pediatrician explained that children are born with ­different temperaments, that they lie along a continuum, and that Sammy would likely grow out of the more problematic behaviors. And as he got older there were extended periods when Sammy seemed perfectly happy, content to sit with his parents and listen to a story. Sammy’s dad was comforted by the thought that his own older brother had been like Sammy and had turned out okay. Perhaps the pediatrician was right.

Sammy’s behavior did change. While he was never particularly cuddly, by age four he had learned that his chances of getting what he wanted increased if he crawled into his parents’ laps or wrapped his arms around their necks. They were so happy to see some semblance of warmth and attachment that they quickly gave into his requests. After all, shouldn’t they reinforce that behavior? Sammy was a quick learner, but it wasn’t clear who was training whom.

Preschool was no picnic for Sammy or for his classmates. Once he decided he wanted a toy, he would grab it. The child who resisted was met with a tug or a slap or, in some instances, a bite. By the time Sammy was in first grade, a school psychologist was called in to assess him. When he met with the­ ­psychologist, Sammy was ­pleasant and ­cooperative, ­playing the ­assessment games like an average six-year-old; however, he got bored easily. The psychologist detected a fair amount of aggression in his storytelling and play with action figures. Testing revealed an above-average IQ but with indications of attention and concentration problems.

The psychologist assured Sammy’s parents that he was quite bright but may have attention deficit hyperactivity disorder (ADHD) as well as some social learning skills deficits. She suggested that they talk with their pediatrician about medication to help him focus and recommended a therapeutic playgroup. The idea of giving a stimulant (the standard medication for ADHD) to a child who was already irritable did not make sense to them. And when they spoke to their pediatrician, she supported them in taking a go-slow approach, suggesting that they try the playgroup first.

The playgroup was helpful. Sammy learned new social skills and found that he would get rewarded for taking turns and letting others have their way. His attention and hyperactivity did not improve, and he continued to have discipline problems at school. But Sammy was smart, and his grades were more than good enough to get him promoted on schedule.

Soon enough, it was time to start high school. Sammy — Sam as he insisted they start calling him — began having more trouble with his studies, and the pediatrician reluctantly suggested that Sam try a stimulant medication to address his ADHD. It helped Sam focus a bit more in his classes and when he did his homework, but he hated taking it. And even if it helped, there were other distractions: girls, parties, and, eventually, experimenting with alcohol and drugs.

In his sophomore year, Sam’s parents took him to see another psychologist. Sam denied using alcohol or drugs. He complained about his parents, and they agreed to try to be “less controlling” and more open-minded if he would agree to behave better at home and in school. The psychologist recommended group therapy with other adolescents, but Sam refused to go. Feeling powerless to force him to attend, Sam’s parents went along with his refusal.

Sam shaped up his behavior a bit at home, his grades improved slightly, and his parents gave him more leeway. He took advantage of this and stayed out later at night with his friends, drinking, smoking pot, and engaging in generally obnoxious behavior. Sam broke his curfew with increasing frequency, making up all sorts of excuses about why he was late. He was more argumentative at home and in school, almost coming to blows with a teacher on one occasion. His suspension from school for that incident was followed by another for throwing a cinderblock out a third-floor window onto a teacher’s car. That was followed by a call from school that Sam had been caught selling his ADHD medication to other students. Now the police were involved, and Sam had been expelled.

A family services evaluation revealed that Sam had taken his ADHD medication only occasionally, saving up the pills to sell to students who used them to get high. Sam spent the money he made to buy other drugs at times, but mostly alcohol. Sam got probation from the court, was assigned a family services officer, and was to begin studying for his general equivalency diploma. These were the most severe consequences he had ever experienced for his behavior, and for once, Sam seemed truly shaken. His parents set a strict curfew, denying him access to the car or taking away his cell phone for any infraction. Sam looked for a job, and eventually decided to join the army. No longer taking medication, and drug and alcohol free, Sam responded well to the discipline and structure of military service, where he found some others who were similar to him. Sam stuck with it and, like his uncle, did okay.

CASE STUDY #2

The Vile Physician
Dr. Harrison was an esteemed pediatric specialist who received referrals from all of the general pediatricians in town. A clinical faculty member at one of the city’s medical schools, he was respected as a teacher and researcher.

Over time, however, troubling rumors began to surface that Dr. Harrison’s examinations of his young patients were not quite what they were supposed to be. Operating under the old maxim that “where there’s smoke, there’s usually fire,” a concerned schoolteacher reported the gossip to the state medical board. Once he was officially under investigation, Dr. Harrison gave up his medical license and retired. Several years later, after his premature death, the first of what became a long series of former patients came forth and reported what had happened: for years Dr. Harrison had been conducting unnecessary physical examinations and sexually abusing these children. He did all of this under the guise of ?a research study, getting consent for multiple examinations of the children. The furthest thought from the minds of parents — or colleagues — was that this beloved physician, who appeared to be completely devoted to bettering the lives of the young, was actually abusing both children and his position of trust. Dr. Harrison was, in short, brilliant — in a conning and manipulative manner. He deceived the parents, the hospital, and his colleagues, all in order to satisfy his sexual desires.

CASE STUDY #3

The Office Bully
Greta was a star. Since early childhood, she rarely failed at anything. Extremely bright, talented in multiple fields, athletic, and attractive, she was always the center of attention growing up. And when she wasn’t, she did whatever was necessary to change that. When she was young, that could include manipulating adults, telling tales about other children, and sometimes outright lying. Everyone in the community knew little Greta — it was hard to ignore such a talent — but very few could say that they liked her.

Some children grow up but really don’t change. Greta was one of those. She was enthusiastically courted by and then admitted to a top college where she charmed the professors and alienated her classmates. In graduate school, where she earned both an advanced science degree and an MBA, it was more of the same. At one point in her science graduate school career, the laboratory notebook of one of her classmates (who happened to be Greta’s top competitor for academic honors) went missing. One classmate quietly warned Greta that she was a suspect; not long after, the notebook was found on a shelf in the supply room.

In business school, Greta again wowed the professors. She was articulate and persuasive, both when she responded to questions in class and when she presented group projects — which she invariably insisted on doing. Greta’s expert social skills prevented her from claiming sole responsibility for all of the group’s ideas, but she definitely represented that she was involved in the creation of all the ideas presented, even those that had not been hers. At graduation, she received a special award for leadership in the classroom. ­Classmates who knew her well were dismayed.

After business school, Greta got a job with a top consulting firm. She “managed up” very well — winning over the senior partners of the firm, or at least the males, with her charm and intelligence. As friendly as she was with the male partners, she was far more distant from the female partners, as if she viewed them as competitors. She treated support staff terribly, making unreasonable demands. She got along a bit better with peers, at least until she felt the need to “throw them under the bus.”

Clients were often enamored of Greta, but the honeymoon didn’t last long. On one trip to visit a client, she complained about the food in the company cafeteria and the midrange hotel they arranged, insisting that they send out for meals and move her to a more expensive hotel. All of this, of course, went on the client’s bill. When Stephan, the chief financial officer of the client company, saw all the additional charges from Greta’s demands, he called Maria, the managing partner at Greta’s firm, and gave her an ultimatum: if you ever send Greta back here again, we’ll find new consultants.

By this point, Maria was not surprised; this was just one in a series of complaints she had received about Greta over several months. Maria had planned to discuss these issues during Greta’s performance review the next month but now felt she could not wait.

When Greta was summoned to Maria’s office, she arrived a few minutes late. Greta smiled and apologized, saying that she had been on the phone with Stephan to talk about the next steps in the project. Maria was astounded; she knew Greta was lying because she had just hung up the phone with Stephan. Maria decided to confront Greta with her obvious untruth. Greta didn’t miss a beat, apologizing for the confusion and explaining that she meant to say Pete, a client with whom she had just started to work and still had a good relationship. Maria wasn’t sure what to believe now.

Maria asked Greta if she knew why she had asked her to come in for the meeting. Looking at her directly — almost through her — and with her trademark smile, Greta said she knew it was time for her performance review, and she assumed that Maria was calling her in to give her a raise and a promotion. “No, not quite,” Maria answered. “I just have to tell you that, while your technical skills are excellent, your people skills are so poor that no one — colleagues or clients — wants to work with you.” She ran through a list of complaints and problems. Greta’s smile never wavered. When Maria finished, Greta responded by saying that she appreciated the feedback and looked forward to her raise and promotion. Then she stood up, gave Maria a big smile, and left the office.

It was no surprise (or disappointment) to Maria when Greta left the firm shortly thereafter, when a headhunter sought her out for a competing consulting firm. Nor was she surprised when she learned of Greta’s lawsuit against the firm, claiming that she had had to quit because of the hostile work environment, discrimination, and harassment of all types.