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Mental Disorders

by David W. Jones
Routledge, 2015
Review by Maura Pilotti, Ph.D. on Apr 12th 2016

Disordered Personalities and Crime

In Disordered personalities and crime: An analysis of the history of moral insanity, David W. Jones encourages the reader to see diagnostic categories related to the commission of crime through a multiplicity of contextual frameworks. His goal is to convey a key message. Namely, at any given point in time, assessment criteria and their application are the byproducts of societies where assessment practices exist, including not only the norms and views of human nature that define principles and contents, but also the actors that are responsible for development, dissemination, and perpetuation of such practices. The latter include institutional agencies (e.g., the legal and criminal justice system and the health and welfare system), and individual agents (i.e., scholars, practitioners, and members of the general public), all contributing to the fabrication, dissemination, and perpetuation of boundaries between the normal and the dangerously diverse. 

Yet, boundaries are not as clear and settled as they are purported to be. On the contrary, they have a tendency to shift and require reframing and reconceptualization as fresh facts pertinent to criminal acts and related interpretations become public domain and people (including scholars, practitioners, and laypersons) react to the available "information".  The author's artful illustrations of such shifts as time passes is at the core of Disordered personalities and crime: An analysis of the history of moral insanity. Indeed, the book provides a detail-filled chronological overview of the changing characterizations of the "morally insane", "psychopath", or person exhibiting "antisocial personality disorder". At first, each chapter may appear an expedition into a thick jungle of facts, anecdotes, and learned interpretations. Yet, readers will never feel lost or consumed by the jungle because they are in the hands of a capable guide who points them to a path that gradually widens to show the ruins of an abandoned city. As if they were archeologists, readers are given an opportunity not only to appreciate the stones of ancient buildings and the artifacts that surround them, but also to imagine the lives of the long-lost inhabitants. With the exception of the last chapter, which is devoted to contemporary debates of insanity related to criminal actions, each chapter is thus a stunning journey into a lost world of human artifacts woven into an organic narrative which the author's analytical skills and insights magically bring to life. Thus, although other books have attempted to review literature on assessment and treatment of deviance in the criminal domain, Jones's work is a must read for its breadth of coverage and keen critical exploration of known facts and viewpoints. 

Although remarkable in its breadth and depth of coverage, other aspects of the author's book are also reasonable to consider. For instance, what does it help readers to understand? First and foremost, readers receive a wealth of evidence suggesting that labels related to the commission of criminal acts (e.g., morally insane, psychopath, sociopath, and personality disordered) do not explain such acts with any acceptable validity or reliability, but merely describe ostensibly unique clusters of undesirable (e.g., deviant, dysfunctional, dangerous, and capable of producing distress in others) behaviors and cognitions. Of course, cognitions pertain to the realm of a human mind, and, as such, cannot be directly observed. Thus, as inferences, they provide the logical tapestry that is needed to explain the diverse actions expressed by a perpetrator which span from ordinary to unspeakable. In essence, labels are markers for and badges of specific forms of psychopathology that not only are assumed to be conducive to actions considered criminal in the judicial system of a society, but also can justify protective and/or corrective measures (e.g., length and conditions of imprisonment, whether rehabilitation is feasible, etc.) toward label-holders. Notwithstanding use and purported meaning of labels, the sources of cognitions and behaviors that comprise their content remain a matter of speculation with the forces of nature (i.e., heredity) pitted against the impact of nurture in a never-ending battle for predominance.

Second, people's understanding of individuals who have been labeled as morally insane, psychopath, sociopath, or as suffering from antisocial personality disorder, not only is filtered by the assigned label and its meaning, but also shapes our actions towards them and their actions towards us, thereby creating a vicious cycle of mutually reinforcing events. Although the objectivity and validity of psychological diagnoses have been questioned by several notable scholars (see Greenberg, 2013; Frances, 2013; Rosenhan, 1973), the self-fulfilling power of all labels related to mental disorders remains largely unabated. As Rosenhan has noted in On Being Sane in Insane Places (1973), once activated in laypersons and experts alike, mental illness markers are oddly both the ultimate deniers of human diversity (serving as interpretative tools for all occurrences that suit them and as blinders for all that do not), and the ultimate supporters of such diversity (serving as stark reminders of the boundaries between "us" and undesirable and potentially dangerous "others"). These markers are the quintessential stigmas. They are used by members of a society (i.e., laypersons, scholars, and practitioners alike) to define a person who strokes their fears of vulnerability and lack of control over their surroundings, thereby offering an illusory and comforting realization of knowing the unknown. If interiorized by the intended recipient, they can not only become irreversible, self-fulfilling prophecies, but also enter the sphere of conventional "wisdom", thereby preventing unbiased explorations of motives and circumstances of violent acts against others. The latter is a duty that societies and its members have towards victims which can shape suitable guidelines to penalize perpetrators of criminal activities, explore rehabilitation options, and prevent recidivism.

If the diagnosis of psychopathology is recognized by many scholars as a less-than-objective and valid process whose outcomes become powerful, self-fulfilling prophecies and blinders against scientific explorations, what else is to be gathered from reading an archeological analysis of diagnostic categories related to criminal conduct and their use?  To this end, remember that the author's book keenly explores how a variety of definitions of deviance have been used to explain criminal actions across time, illustrating both their weaknesses and their practical usefulness to societies where they have existed. As such, information shared by the author is so thought-provoking that is likely to force readers to engage in a self-examination of the extent to which cognitions and actions in everyday life are qualitatively distinct from those representing psychopathology in criminal cases (e.g., when does one's utter dislike of another person or people lead to murder?). In addition, Jones's work engages readers' critical thinking skills to examine past and existing views of human nature and question their validity and reliability. For instance, are human beings intrinsically good? If so, is evil largely a byproduct of undesirable experiences?  Alternatively, is evil a predisposition in all of humanity that merely needs a little nudge from life experiences to translate into objectionable thoughts, emotions, and observable actions? To what extent and in which circumstances can rehabilitation be considered feasible?  

In sum, Disordered personalities and crime: An analysis of the history of moral insanity can help readers of all persuasions to understand the challenges connected with assessment and understanding of individuals who have committed severe crimes. Notwithstanding the validity and reliability of assessment tools and available explanatory constructs, both tools and constructs have and will continue to shape societies' responses to crime. As such, knowledge of such responses across time along with an accumulation of scientific findings on the sources of human actions can contribute to the development of informed perspectives of severe criminal offences in contemporary societies. The latter can promote societal reactions that not only are commensurate with the seriousness of these violations and the suffering of victims, but also reflect the desire to prevent offenses and, whenever possible, consider the objective feasibility of rehabilitation.  

 

Greenberg, G. (2013). The book of woe: The DSM and the unmaking of psychiatry. New York, NY: Penguin.

Frances, A. (2013). Saving normal – An insider's revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: William Morrow & Harper Collins

Rosenhan, D. L. (1973). On being sane in insane places. Science,179(4070), 250-258.

 

© 2016 Maura Pilotti

 

Maura Pilotti, Ph.D., Ashford University