This book is part of The Almost Effect series, a group of books written by Harvard Medical School faculty and other professionals “who offer guidance on common behavioral and physical problems falling in the spectrum between normal health and a full-blown medical condition.” The books are intended to help the lay public recognize “under the radar” conditions and find resources to do something about them. The authors of Almost a Psychopath are Ronald Schouten, a physician-attorney, and James Silver, an attorney, who have extensive experience in the forensic arena, including assessment and treatment of psychopathy. Not surprisingly, the book begins with a chapter titled “What is a Psychopath,” which focuses on diagnostic criteria from DSM-5. The authors describe the conventional thinking about psychopathic characteristics (lack of empathy, extreme egocentricity, self-serving behavior, insensitivity to punishment), recent brain imaging findings, an historical perspective on the seminal work of American psychiatrist Hervey Cleckley, and the gold standard of assessment, Robert Hare’s Psychopathy CheckList (PCL). They then examine the distinction between true psychopathy and the “almost psychopath,” based principally on “the intensity or frequency of the inappropriate behavior and emotional dysfunction.” The authors rely heavily on case examples to illustrate actual psychopathy and sub-clinical symptom presentation, although most readers will be challenged to sort out the differences. Later chapters in the book differentiate psychopathy from other psychiatric conditions such as psychosis, major depression, and antisocial personality disorder. The authors cautiously advise various steps to take should you identify yourself as an almost psychopath, or if you have to interact with one at home and on the job. Also, there are two very instructive chapters dealing with possible psychopathic traits in children and the not so uncommon phenomenon of almost psychopaths in the business world (“psychopaths are attracted to power and money the way sharks are attracted to chum”). I suspect that anyone interested in learning about psychopathy will get their money’s worth by reading this book. It can also be of benefit in understanding the behavior of co-workers and family members that act callously, cannot empathize, deceive, and manipulate. So, as a clever self-help book, this one has something to offer, most notably because it is informed by recognized research and contemporary practices.

© 2014 James K. Luiselli

James K. Luiselli, Ed.D., ABPP, BCBA-D  is a psychologist affiliated with May Institute and a private-practice clinician. Among his publications are 11 books and more than 300 book chapters and journal articles. He reviews books for The New England Psychologist.