Corporate psychopath

From an NPR "review" of Jon Ronson's book "The Psychopath Test" (not really so much about psychopaths, more about psychological tests in general, unfortunately):

"Robert Hare, the eminent Canadian psychologist who invented the psychopath checklist, ... recently announced that you're four times more likely to find a psychopath at the top of the corporate ladder than you are walking around in the janitor's office," journalist Jon Ronson tells Guy Raz, host of weekends on All Things Considered.
***
Picture a psychopath and you might think of Norman Bates. But Ronson says successful businessmen can also score high on the checklist. While researching his book, Ronson visited the Florida home of Al Dunlap — known as "Chainsaw Al" — who as CEO of appliance maker Sunbeam was notorious for his gleeful fondness for firing people and shutting down factories.

"So I turned up at his house, and it was full of sculptures of predatory animals," Ronson says. "And he immediately started to talk about how he believed in the predatory spirit, which was word for word what Bob Hare writes about in the checklist: Look out for their belief in the predatory spirit."

But Dunlap managed to turn the psychopath test on its head, Ronson says.

"He admitted to many, many items on the checklist, but redefined them as leadership positives," he says. "So 'manipulation' was another way of saying 'leadership.' 'Grandiose sense of self worth' — which would have been a hard one for him to deny because he was standing underneath a giant oil painting of himself — was, you know, 'You've got to like yourself if you're going to be a success.'"

I see this rather frequently, accusing sociopaths of trying to twist bad behavior to look like good, flaws to look like superhero traits, and damaged brains to look superior. People who make these accusations must believe that sociopaths are villains by definition, but that's not an entirely consistent or defensible position to take. Neither are some of the other assertions I see most frequently:

• Either we're 4 times more likely to be at the top of the corporate ladder than be the janitor (and so presumably resourceful enough to get those jobs), or we're so impulsive and evil to the point that we are all leeches on productive society.
• Either 1 in 25 people (technically Americans) are sociopaths, so presumably some of them are your normal seeming co-workers or neighbors, or the only people who could properly be classified sociopaths are serial killers, people you would never meet, particularly not writing or commenting on a blog.
• Either we're very talented chameleons who are able to hide in plain sight, or we're so obvious that anyone we date can immediately and successfully diagnose us.

There are many others, of course, but this post is already getting long. I don't mind people believing one thing or the other and broadcasting that belief loudly and frequently, I just ask for a little bit of rationality and consistency in those professed beliefs.

Guest post: The Psychopath Test review

“The Psychopath Test” by Jon Ronson (reviewed by Mindless Pleasures)

“The Psychopath Test” is a non-fiction whirligig of a book from the sometime Guardian journalist/documentary filmmaker and author of “The Men Who Stare at Goats”.

Not unlike the aforementioned book, which was about men who stare at goats, ‘The Psychopath Test’ is about psychopaths and a test that can determine how to identify them. If anything, you couldn’t accuse Ronson of ambiguous or misleading book titles.

Disturbingly however, Ronson’s book claims that psychopaths – or to use the more subtle yet interchangeable terminology – sociopaths – are more prevalent amongst us than we may think, and invariably most of us would have had some experience with them in our lives whether we realised it or not.

Certainly, having read the book and cross-referenced the, ‘now-famous twenty-point [Dr. Bob] Hare PCL-R Checklist’ [Psychopathy Checklist – Revised], I can attest that I have experienced knowing one – and I’m not talking facetiously about an ex-girlfriend either.

But perhaps what is more disconcerting, and possibly the most salient point in the book, is that many of these sociopathic attributes are almost indistinguishable from what characterises a successful business person.

Or to paraphrase the devilishly eldritch line from Bret Easton Ellis’ fictional protagonist Patrick Bateman in “American Psycho” when asked in a crowded restaurant what he does for a living replies glibly, “murders and assassinations” upon which the person evidently mishearing the response acknowledges, “Oh, mergers and acquisitions”.

The prerequisite characteristics to ‘excel’ (for want of a better word) in said activities are apparently not dissimilar.

Of course, the book is not implying that all successful business persons are potential sociopaths. However, the major thesis of “The Psychopath Test” could be distilled down to the premise that the actions and consequences of a minority of these extremely dangerous and formidable individuals affect the lives of the majority. Whether they be calculating serial killers, cold-hearted mercenaries or ruthless captains of industry.

In fact, I would argue that the book provides a significant psychological piece of the puzzle, if not a corner piece, of what is inherently wrong with so much of modern society today. However, incongruous to its serious subject matter “The Psychopath Test” is written in Jon Ronson’s customary witty, dry as gin, self-deprecating style – perhaps for the one reason that if you didn’t laugh, you’d cry.

Unless of course you’re a psychopath, in which case you’re probably emotionally incapable of doing either.

The Psychopath Test

Representing every stereotype about Brits, this is Jon Ronson promoting his upcoming book "The Psychopath Test," which actually doesn't seem to be that much about psychopaths so much as the "madness industry," or at least that is what I gather from Amazon promotional quotes like this: "Jon Ronson's exploration of a potential hoax being played on the world's top neurologists takes him, unexpectedly, into the heart of the madness industry."

Jon, if you're reading this, what hoax are you talking about? I'm getting a weird Charlie Sheen-esque vibe from your video, i.e. not quite sharing the same reality as the rest of us. Is the book any more believable?

(Or maybe I'm just trying to undermine your message because you've come too close to the real truth about "our" perverse manipulation of the madness industry!)

This American Life

I just got around to listening to this This American Life episode on psychopaths:

It's largely more of the same from the NPR articles, but in audio format. More from Jon Ronson about sociopathic CEOs, sociopathic stares, small amygdalas make you "dangerous," and the role that the "predatory spirit" plays in success.

The most entertaining section is the part about Jon Ronson meeting a sociopathic seeming CEO who fired an employee who happened to be bragging about his car thusly: "You may have a fancy sportscar, but I'll tell you what you don't have -- a job." Gasp! Psychopaths can be so straightforward and tactless!!!!!

Spoiler alert, host Ira Glass practically outs himself as a sociopath, but not really, according to the psychologist, because he wasn't malicious enough (is that the hidden PCL-R trait, that only psychologists are privy to?)

It could happen to you

I spoke with a friend who was recently ousted from a job based on fabricated charges. She told me that she finally understood -- for the first time -- a little bit about what it was like to be me. She told me that before this happened to her, she had always just assumed that if anyone left her previous places of employment or were fired, it must have been because there was something bad about the firee that she simply didn't know about that justified the firing. 

It's a commonly held belief (and absolutely self-serving), that if something bad happens to someone, that person must be guilty. It's so common that when an even worse thing happened to a mutual friend of ours, during what became a minor media scandal the precipitated the ouster, her co-workers were quoted as saying things like, "you think you know a person, but I guess everyone is capable of darkness." When this mutual friend was eventually exonerated by her place of employment, the employer gave her a sort of a shrug of his shoulders -- yes she was innocent, but there was no way that they could re-hire her given the salacious nature of the scandal and the delicate nature of the job. Now she has no career.

Even before my own very personal experiences with the media, one of my extended family members was an integral part of a national scandal. Although she was largely kept out of the limelight for being a minor, I was able to see how dodgy even very respectable journalistic outposts were about accurately reporting the facts. There's actually a surprising amount of inferences dot connecting reported as absolute that goes on (probably true of any area of life), and there's an odd sort of hubris and self-assurance that some journalists have that their inferences have to be right, just because that is how the journalist happens to see it. 

So Jon Ronson has his book about public shaming out. I haven't read but excerpts (see here for adapted excerpt re Justine Sacco), but obviously I am a fan of the topic, given its coverage on this blog. I've never been a fan of the empath's capacity and eagerness to form lynch mobs. And I can imagine that Ronson's book may be the least loved and most controversial of his books because there is a significant portion of the population that loves lynch mobs so much that they will defend almost every aspect of them, including the capacity and authority to judge others to the point of deciding who gets to live a normal life or not. 

For instance, in his piece that reads (at least to me) largely as a defense of his own part in the Jonah Lehrer shaming, Slates's Daniel Engber quotes the observation of a theatre professor regarding the reaction that some had in learning that Lehrer was to speak at a Midwestern university: “As soon as it became clear to certain people on the East Coast that Jonah was here, I started to get phone calls from people who had no other wish than to ruin his life.” Can you imagine hating a stranger so much that years later you are still harassing him in anyway you can?

Engber gives some obeisance to the idea that he was less knight in shining armor and more misguided Crusader: 

It seemed to me that Payne might have had a point. Am I part of this East Coast mob of angry journalists, out for nothing less than Lehrer’s blood? Ronson’s book suggests as much. In the coda to his chapters on the scandal, he cites a post of mine in Slate, in which I found signs of plagiarism (among other problems) in Lehrer’s newest book proposal. Could I be, as Ronson hints, a self-appointed fury, cruelly bent on someone else’s destruction? 

He concludes, no. Why? Because even though he has done only a bit of anecdotal fact-finding (sound familiar?), he believes that Lehrer has still not owned up to what Engber imagines is scores of misdeeds. What does he base this belief on? Not much more than the fact that Lehrer's publishers never released their reports on his other books, which naturally indicates that they have something to hide: "Houghton Mifflin never published the results of its investigation, so there’s been no full accounting of the problems in Lehrer’s work. But it’s safe to say the Dylan quotes were just the tipoff for something much worse." Is that really safe to say? In what sense of the word "safe"? Safe to say in the sense that it is convenient to assume without verifying and makes Engber's piece seemingly stronger and more compelling (again, what he accuses Lehrer of having done in making "'mistakes'" that "tend to make his stories more exciting".)

Other misdeeds are that the following sentence appears in Lehrer's work and also appears in another book: "The coaches were confident that the young quarterback wouldn’t make a mistake," along with similar descriptions of what happened during a Super Bowl (probably all descriptions of the Super Bowl would be similar because they're all based on the same underlying facts of what actually happened?).  

So basically we have a menace to society on our hands in the form of Jonah Lehrer. And Engber concludes, unsurprisingly from a pitchfork wielding member of the original mob, that Jonah Lehrer should never get back into society's good graces perhaps until he acknowledges all of the mistakes that Engber thinks are mistakes, or perhaps never because how could we ever trust him again. As Engber notes himself, "there are rules to telling stories," and when we tell ourselves stories of self-justification to excuse the blood that we may have spilt in enacting justice, best to stick to the original script of -- if something bad happened to a person, they must have had it coming somehow. 

Otherwise we'd have to admit, as my friends have unfortunately had to recently, that this sort of life ruining and shaming can truly happen to anyone.

Daily Show

Another psychopath related interview:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Jon Ronson
www.thedailyshow.com
Daily Show Full Episodes Political Humor & Satire Blog The Daily Show on Facebook

Bias and the PCL-R

I might have spoken too soon about Dr. Robert Hare. From this unique and conspiracy theory oriented review of Jon Ronson's "The Psychopath Test," selections from the book:

"Serial killers ruin families." Bob [Hare] shrugged. "Corporate and political and religious psychopaths ruin economies. They ruin societies."

This--Bob was saying--was the straightforward solution to the greatest mystery of all: Why is the world so unfair? Why all that savage economic injustice, those brutal wars, the everyday corporate cruelty? The answer: psychopaths. That part of the brain that doesn't function right. You're standing on an escalator and you watch the people going past on the opposite escalator. If you could climb inside their brains, you would see we aren't all the same. We aren't all good people just trying to do good. Some of us are psychopaths. And psychopaths are to blame for this brutal, misshapen society. They're the jagged rocks thrown into the still pond. (p. 112)

"If some political or business leader had a psychopathically hoodlum childhood, wouldn't it come out in the press and ruin them?" I said.

"They find ways to bury it," Bob replied. "Anyway, Early Behavior Problems don't necessarily mean ending up in Juvenile Hall. It could mean, say, secretly torturing animals." He paused. "But getting access to people like that can be difficult. Prisoners are easy. They like meeting researchers. It breaks up the monotony of their day. But CEOs, politicians ..." Bob looked at me. "It's a really big story," he said. "It's a story that could change forever the way people see the world." (p. 118)
***
[Hare in response to a criticism that he speaks of psychopaths as if they are a different species:] "All the research indicates they're not a different species," said Bob. "There's no evidence that they form a different species" ...

Bob looked evenly at me. "I'm in the clear on this," he said. There was a silence. "My gut feeling, though, deep down, is that maybe they are different," he added. "But we haven't established that yet." (p. 268)

I've always gotten the feeling that he talks the talk of the objective scientist, but when push come to shove he pushes back with what looks inordinately like personal bias, and I'm not the only one that thinks this.

The science of evil

I wanted to write a response to this NY Times review of Simon Baron-Cohen's book "The Science of Evil," but I already expressed most of my outrage about the book and it's theory that a lack of empathy is the root of all evil here. Today, however, there was an interesting response to both Baron-Cohen's book and Jon Ronson's "The Psychopath Test" by Yale professor of Psychology Paul Bloom, again in the NY Times. Under the title "I'm Ok, You're a Psychopath":

For Baron-Cohen, evil is nothing more than “empathy erosion.”
***
Now, one might lack empathy for temporary reasons — you can be enraged or drunk, for instance — but Baron-Cohen is most interested in lack of empathy as an enduring trait.
***
For Baron-Cohen, psychopaths are just one population lacking in empathy. There are also narcissists, who care only about themselves, and borderlines — individuals cursed with impulsivity, an inability to control their anger and an extreme fear of abandonment. Baron-Cohen calls these three groups “Zero-Negative” because there is “nothing positive to recommend them” and they are “unequivocally bad for the sufferer and those around them.” He provides a thoughtful discussion of the usual sad tangle of bad genes and bad environments that lead to the creation of these Zero-Negative individuals.

People with autism and Asperger’s syndrome, Baron-Cohen argues, are also empathy-deficient, though he calls them “Zero-Positive.” They differ from psychopaths and the like because they possess a special gift for systemizing; they can “set aside the temporal dimension in order to see — in stark relief — the eternal repeating patterns in nature.” This capacity, he says, can lead to special abilities in domains like music, science and art. More controversially, he suggests, this systemizing impulse provides an alternative route for the development of a moral code — a strong desire to follow the rules and ensure they are applied fairly. Such individuals can thereby be moral without empathy, “through brute logic alone.”

This is an intriguing proposal, but Baron-Cohen doesn’t fully elaborate on it, much less address certain obvious objections. For one thing, if people with autism can use logic to be good without empathy, why can’t smart psychopaths do the same? And what about the many low-functioning individuals on the autism spectrum who lack special savant gifts and don’t spontaneously create moral codes? On Baron-Cohen’s analysis, they would be Zero-Negative. But this doesn’t seem right. Such individuals might be awkward or insensitive, but they are not actively malicious; they are much more likely to be the targets of cruelty than the perpetrators.

I think there’s a better approach, one that involves breaking empathy into two parts, understanding and feeling, as Baron-Cohen himself does elsewhere in his book. Individuals with autism are unable to understand the mental lives of other people. Psychopaths, by contrast, get into others’ heads just fine; they are seducers, manipulators, con men . . . and often worse. . . . The problem with psychopaths lies in their lack of compassion, their willingness to destroy lives out of self-interest, malice or even boredom.

Bloom goes on to criticize Baron-Cohen's theory by pointing out that everyone can suffer from a lack of empathy due to circumstances or sometimes through choice. Unfortunately Bloom does not then take the final step of questioning whether a lack of empathy should actually be the scientific definition of "evil," as Baron-Cohen advocates, but instead makes a nod to the I-hate-sociopaths camp, quoting: "'Why should we care about psychopaths? They don’t care about us.'" At least people are starting to think twice before drinking the Hare et al. Kool-Aid of fear-mongering.

Recent book media

Some recent media features on the book:

• NY Times Book Review by Jon Ronson
• NPR radio interview
• BBC World Tonight radio interview with Professor Kevin Dutton, author of Wisdom of Psychopaths
• Newsweek/Daily Beast (the comments are hilarious)
• Huffpost Live with Dr. James Fallon and Dr. John Edens (my diagnosing psychologist)
• Publisher's Weekly Review
• ABC Radio Australia
• Tyler Cowen at Marginal Revolution
• Business Insider review
• Scientific American Review
• Slate's Patrick Bateman Review
• Bottom Up Radio interview
• Gluck Radio interview

Psychopath treatment: a success story

This was an interesting email sent to Jon Ronson, author of The Psychopath Test: A Journey Through the Madness Industry, from a diagnosed psychopath who sought treatment (relatively successfully). Here are selections, links are mine and my comments in brackets:

Four years later, with sessions no less frequent than once or twice a week, I came out of therapy unrecognizable from when I went into it. 

Yes thearapy was transformative, though it is possible to overstate its impacts. I will always see the world through different lenses to much of the rest of the world. My emotional reactions are different, my endowments are impressive in some respects, not so in others, much like other people. 

It is also the case that, being ‘normal’ takes a degree of energy and conscious thought that is instinctive for most, but to me is a significant expenditure of energy. I think it analogous to speaking a second language. That is not to say I am being false or obfuscating, merely that I will always expose some eccentric traits. [I also find it to be taxing to interact with people legitimately because it's a very deliberate choice, a performance of sorts rather than a way of interacting that comes naturally to me.] 

So why am I writing all this to you?

Well, from someone who is both psychopathic and treated, there are many fallacies about psychopaths with which I am deeply cynical. Unfortunately psychopaths themselves do themselves no favors, as the label given to them plays into their ego over generously - ‘If we are born that way’ psychopaths reason, ‘then it is not wrong for us to be as we are, indeed we are the pinnacle of the human condition, something other people demonize merely to explain their fitful fears’. [It's so easy to think this way. It's so hard to acknowledge that the world might be a lot more complicated than you think it is, and people (everybody, really) a lot less stupid and a lot more valuable than you think they are. I had to be trained to see the world differently (by Ann, for those that have read the book).]

We are neither the cartoon evil serial killers, nor the ‘its your boss’ CEO’s always chasing profit at the expense of everyone else. While we are both of those things, it is a sad caricature of itself. 

We continue be to characterized that way, by media, by literature, and by ourselves, yet the whole thing is a sham. 

The truth is much, much more complex, and in my view, interesting.

Psychopaths are just people. You are right to say that psychopaths hate weakness, they will attempt to conceal anything that might present as a vulnerability. The test of their self-superiority is their ability to rapidly find weaknesses in others, and to exploit it to its fullest potential.  

But that is not to say that this aspect of a psychopaths world view cannot be modified. These days I see weaknesses and vulnerabilities as simple facts - a facet of the human condition and the frailties and imperfections inheritent in being human. [I've talked about this here.]

At the same time it is true that my feelings and reactions to those around me are different - not necessarily retarded - just different. It is the image of psychopaths as something not quite human, along with espersions as to their natures, that prevent this from being identified. 

So how to explain these ‘different’ feelings?

Well, lets look at what (bright) psychopaths are naturally quite exceptional at… We are good at identifying, very rapidly, extreme traits of those around us which allows us to discern vulnerabilities, frailties, and mental conditions. It also makes psychopaths supreme manipulators, for they can mimick human emotions they do not feel, play on these emotions and extract concessions. 

But what are these traits really? - Stripped of its pejorative adjectives and mean application, it is a highly trained perception, ability to adapt, and a lack of judgment borne of pragmatic and flexible moral reasoning. 

What I’m saying here is that although those traits can very easily (even instinctively) lead to dangerous levels of manipulation, they do not have to. 

These days I enjoy a reputation of being someone of intense understanding and observation with a keen strategic instinct. I know where those traits come from, yet I have made the conscious choice to use them for the betterment of friends, aquaintences, and society. People confide in me extraordinary things because they know, no matter what, I will not be judging them. [I particularly relate with this paragraph.]

I do so because I know I have that choice. After years of therapy I am well equipped to act on it, and my keen perception is now directed equally towards myself. 

Its true that I do not ‘feel’ guilt or remorse, except to the extent that it affects me directly, but I do feel other emotions, which do not have adequate words of description, but nevertheless cause me to derive satisfacton in developing interpersonal relationships, contributing to society, and being gentle as well as assertive. 

Such as statement might tempt you to say ‘well obviously you’re not a real psychopath then’. As if the definition of a psychopath is someone who exploits others for their personal power, satisfaction or gain. 
***
In the end, psychopaths need to be given that very thing everyone believes they lack for others, empathy; a willingness to understand the person, their drives, hopes, strengths and fears, along with knowledge of their own personal sadnesses and sense of inferiority…As it is, such cartoon, unchangeable, inhuman characterizations offers nothing but perpetuation of those stereotypes. 

Serial Killers & Ruthless CEOs exist - Voldemort does not. 

Overall I found his experience to be very similar to my own. He sought help at the beginning of his adulthood because he felt like he didn't have control over some of the things he thought and did. He was led through a paradigm shift by a trusted and wise individual (his therapist, my close friend) who first saw and understood him, then met him halfway and spoke his language rather than preaching at him in the foreign language of emotional morality. I don't think this is an easy process. His process took four years. Mine took about two, but of intense focus. I also know of a handful of people who have even gotten there on their own, though, so it definitely is possible. I actually hope that the book is really helpful that way, in terms of helping undiagnosed sociopaths to recognize themselves and also give them a message of hope. It's possible for sociopaths to train themselves to think and act in different ways. We will never be completely fluent or automatic in our empathy or moral reasoning, but with some accommodation we can be not only fully functioning in society, but successful and contributing members of society. 

Bad but redeemable?

In the NY Times review of the book, Jon Ronson wrote that I simultaneously humanized and demonized myself. Some of my friends and family are a little upset that I didn't focus more on my "good" traits in the book, I think partly because it makes them look a like idiots for choosing to like me. Most people do not focus on their bad traits -- their every bad thought and motivation. Most people carefully craft a persona that they present to the world full of flattering photographs taken from the right angle and lighting and a résumé that shellacs over flaws and imperfections. I didn't want to whitewash myself or the traits of sociopathy. But I was also hoping to not convey that I thought that having the label "sociopath" meant I was all badass and there's nothing anyone can do about things. There actually are a lot of things people can do about it to make my life miserable and it's not too absurd to think that eventually all sociopaths really will be locked up or otherwise isolated from general society. But I was hoping to show that despite having some negative or potentially dangerous characteristics, there is still some hope for everyone, sociopaths and non. Because if someone as unlikeable as me can manage to be work and be loved in my own way, then it suggests there are ways to properly integrate sociopaths into society in pro-social ways.

Along those same lines, from a reader, Sarah:

From what I can tell, you're a clinical douchebag who deserves the Nobel Prize.  This kind of blows my mind, makes me slightly uncomfortable, and also boosts my faith in the survival of the human race.  Congrats.

I've just finished your book, and frankly, I'm not at all certain that "you" actually wrote that book or, if you did, whether any of it is factual or not.  But if it's a scam or fake, it's a great one, and if it's true -- if you actually do exist as an ethical, self-aware sociopath -- you've done all the "normal" and "abnormal" humans on the planet a great service by writing a memoir.

I'm an empath who has a visceral revulsion towards sociopaths, narcissists, and sadists (not that these are the same categories, but there are some similarities.)  I've had my personal run-ins (even been almost "ruined" by one), and I've witnessed well-paid sociopaths royally fucking up our economy and society.  So I wasn't inclined to like or respect you at all when I started reading the book.  

And there are certainly some things you describe that make me want to puke, or beat the shit out of you.  However, this desire to slap you across the face, which waxed and waned as I read, made me realize that even I have sociopathic traits, and that everybody else does, too.  No matter how guilt-ridden, emotional, and attuned to the feelings of other people we empaths are, everyone sometimes wants to exercise their power, take advantage of weakness, or feel in control of their environment.  My desire to hit you emerges solely from a wish to demonstrate that I am tougher, smarter, and more powerful than the Biggest Bitch in the Room.  If that's not a sociopathic impulse, I don't know what is.

So, speaking for the empaths (as I'm sure many have done before me), thanks for drumming up some self-reflection of the type I generally avoid.  I attend to myself carefully in many ways, and am quite aware of various weaknesses.  It's just that I usually frame my weaknesses as a surplus of love and squishiness, rather than a surplus of power-hunger or calculation.

Regarding that Nobel: if even a shit like you turns out to be not so much a shit as a regular human being who happens to function at the far end of a mysterious spectrum, then maybe we all have something pro-peace/pro-social to offer.  I absolutely love the suggestions you make for helping sociopathic kids, and I honestly believe they would not go amiss if applied to any young human who is different in some way.

Thanks, asshole.

Dealing with mental illness

I really enjoyed this interview between schizophrenic and author Eleanor Longden and author of The Psychopath Test: A Journey Through the Madness Industry Jon Ronson, which is worth reading in its entirety. She talks about how the first voice in her head was just narrating what she happened to be doing, and in some ways she found it calming:

[W]hat research suggests is that voice-hearing (and other unusual experiences, including so-called delusional beliefs) are surprisingly common in the general population. This recognition has led to the popularity of 'continuum models' of mental health, which suggests different traits and experiences are all part of human variation – not strictly categorical in terms of "us and them", "sane and insane", "normal and abnormal". However, I do think life events play a vital role in determining who becomes distressed and overwhelmed and who doesn't. This might include experiences of abuse, trauma, inequality, powerlessness and so on, but it can also include the immediate reactions of the people around you. If you don't have people who will accommodate your experiences, support you, and help you make sense of what's happening, then you're probably much more likely to struggle.

And she wasn't supported or accommodated, instead her friend flipped out, followed by her psychiatrist, until she was institutionalized and the voices got much worse.

[My psychiatrist] really made me feel like a walking inventory of symptoms. This forensic-like scrutiny grew to feel very frightening and de-stabilizing, and was basically sending the message that the only relevant thing about me was my deficits. Not my strengths, not my abilities or resources, just my Bad Brain. I was eventually admitted to hospital (voluntarily), and the impact of that was disastrous because it sealed my perception of myself from someone who was confused, unhappy and frightened into someone with an uncontrollable, carnivorous mental illness. Eventually, I was diagnosed with schizophrenia. The voices (which by this time had multiplied and become much more aggressive) were witheringly contemptuous about this: "You can't even SPELL schizophrenia," one of them said, "So what the hell are you going to do about having it?!"

How did she find her way back?

I don't think there was a single, defining turning point, more an accumulation and fusion of positive changes. Primarily, I was very fortunate to have people who never gave up on me – relationships that really honoured my resilience, my worth and humanity, and my capacity to heal. I used to say that these people saved me, but what I now know is that they did something even more important: they empowered me to save myself. My mum, for example, had an unconditional belief that I was going to come back to her and was willing to wait for me for as long as it took. I also met an amazing psychiatrist, who absolutely didn't subscribe to the idea of me as 'schizophrenic' – or any other label for that matter. "Don't tell me what other people have told you about yourself," he would say, "Tell me about you." 

This led her to a period of profound self-acceptance:

For the first time, I had an opportunity to try and see my voices as meaningful – messages and metaphors about emotional problems in my life – and in turn begin to relate to them more peacefully and productively. I began to understand the voices (as well as my other experiences, like self-injury, anxiety, and paranoid beliefs) in a more compassionate way. Not as symptoms, rather as adaptations and survival strategies: sane reactions to insane circumstances. The voices took the place of overwhelming pain and gave words to it – memories of sexual trauma and abuse, rage, shame, loss, guilt and low self-worth. Probably the most important insight was when I realised that the most menacing, aggressive voices actually represented the parts of me that had been hurt the most – and as such, it was these voices that needed to be shown the greatest compassion and care. Which of course ultimately represented learning to show compassion, love, and acceptance towards myself.
***
But primarily it was when I stopped attacking and arguing with them, and began to try and understand them, and relate to them more peacefully. It was about putting an end to the internal civil war I mentioned earlier, because each of them was part of a whole – me! I would thank them for drawing my attention to conflicts I needed to deal with. I remember one very powerful moment, several years down the line, when I said something like, "You represent awful things that have happened to me, and have carried all the memories and emotion because I couldn't bear to acknowledge them myself. All I've done in return is criticize and attack you. It must have been really hard to be so vilified and misunderstood." There was an immensely long pause before one of them finally responded: "Yes. Thank you."

I found myself relating a lot to this last part -- part of learning to deal with any mental issues is a self-acceptance of yourself, your strengths, and your weaknesses. We all have what Carl Jung called the Shadow, parts of our personality that we would rather not acknowledge about ourselves. But in order for us to become whole, self-actualized human beings, we must not only acknowledge these aspects, but embrace them (see The Tools: 5 Tools to Help You Find Courage, Creativity, and Willpower--and Inspire You to Live Life in Forward Motion for some help on how).

Like most people, I used to ignore my shadow +90% of the time and the other part of the time I became the monster I was afraid I truly was. When I finally cared enough to get better, I knew I couldn't keep doing this, flipping back and forth between the projected-ideal-me and the indulging-every-bad-impulse me. The truth was that both those versions of myself were a distortion, and until I could acknowledge and accept the real me, any changes that I made would be superficial and not-lasting. I saw this same transition in the last season of Dexter, where he finally acknowledges that the "dark passenger" he always blamed for his killing impulse was really just a part of him that he had long ago alienated, and later personified as an external entity. People want me to feel shame for who I am, I can tell. But I'm not going to, because it would make me a much worse person (see also Ted Bundy).

Nobody chooses to be who they are. We make choices and we can define ourselves by our choices if we choose, but there will always be people defining us by other things, including things that we didn't ask for and cannot help. We can't do anything about that either. We just do the best we can and that has to be good enough. As Longden said:

I last heard voices yesterday. They were repeating something I'd read on the internet. The comment was: "I'm going to spoil the ending for you. The ending is – everything's going to be great!"