June 19, 2012 -- Chances are you might know someone who is almost a psychopath. The coworker who throws you under the bus. The friend who constantly takes advantage of you. A politician on TV or even some beloved fictional characters. (Think Scarlett O'Hara or J.R. Ewing.)
When people are chronically callous, unreliable and manipulative, they can wreak havoc on those around them, making them what a new book calls an almost-psychopath.
"These are people who are pervasive chronic liars, about things big and small," said Dr. Ronald Schouten, director of law and psychiatry services at Massachusetts General Hospital in Boston. "They will lie almost reflexively and also engage in very predatory, planned lying. They really enjoy pulling a fast one on other people, and they don't feel bad about doing it."
In their book, "Almost a Psychopath," Schouten and James Silver, a criminal defense attorney and former federal prosecutor, frame psychopathy in the concept of the "almost effect." The idea suggests that mental health problems can exist even if someone doesn't meet the by-the-book definition of a condition, much like people can be pre-diabetic or pre-hypertensive.
Telling lies at times or being occasionally unfeeling is part of the normal range of human behavior. But for almost-psychopaths, these behaviors are the rule, not the exception.
Only about 1 percent of the population are true psychopaths, people who ignore most of society's social and legal mores to meet their own needs, unbound by feelings of guilt or empathy. Perhaps not surprisingly, true psychopaths are well-represented in prisons.
But a larger number of people are almost-psychopaths, operating in the shades of gray between normalcy and true psychopathy. Their behavior is not extreme enough to land them in jail, but they can cause enormous harm to those around them, Silver said.
"We see these people as sliding under the radar in some respects, because they probably won't be incarcerated or identified in a clinical setting, but they're out there causing lots of problems," Silver said.
Far from being on the wrong side of the law, almost-psychopaths might be wildly successful, charming and well-liked, as long as you don't wind up on the wrong side of them. Ken Lanning, a retired member of the FBI's Behavioral Science Unit, calls such people "pillar of the community psychopaths," the politician, doctor or business executive who lies and manipulates others for their own gain.
"If you're trying to run a business or you're in politics, if you're the boss, being a psychopath can really be a positive thing. You can lie, cheat, steal to get what you want," Lanning said.
Psychiatrists agree that even people who don't meet the clinical definition of psychopathy can still be destructive in personal relationships. But diagnosing them might not be necessarily useful.
"In our efforts to understand people, it's very easy to label them, and that doesn't contribute to our understanding of the complexity of human relationships," said Dr. Carol Bernstein, past president of the American Psychiatric Association.
Dr. Igor Galynker, director of the Family Center for Bipolar Disorder at Beth Israel Medical Center in New York, noted that almost-psychopathic tendencies can come in handy for a large number of people in certain situations. A soldier on the battlefield or a corporation's CEO wouldn't do very well if they are unable to make decisions that might harm others. But knowing how to deal with people who do this all the time is important.
"You just need to be aware when you meet these people that they will do what is best for them but not necessarily what's best for you," he said.
The authors said their intention is not to attach labels or psychological diagnoses, but to help people who might be struggling with a difficult, hurtful person in their lives.
Author Silver said, "You're not going to be able to change an almost-psychopath. But the idea is to keep track of their behavior, so that it informs you on how you want to interact with or disengage with these people."
Lanning, formerly of the FBI, said being able to recognize almost-psychopaths will help you protect yourself.
"If you don't understand these psychopathic types," he said, "you'll be easily conned by them."