What is an “almost psychopath”? — A case study

If women can be psychopaths, then they can certainly be almost psychopaths. Consider this: growing up, did you know any girls who might be considered bullies, girls who made your life miserable in school and who seemed to lack empathy? The idea of “mean girls” has caught on in popular culture, perhaps because, sadly, it strikes a chord for many of us. The New York Times bestseller Queen Bees and Wannabees by Rosalind Wiseman and the American teen comedy-drama inspired by it, Mean Girls, reflect a fascination with how high school social cliques operate and affect teenage girls. Certainly the subject resonates with many people, and surely part of the reason is that most of us know female almost psychopaths.

What might one of these mean girls look like as an adult? For an example, take the case of Christiana. Her mood swings, angry outbursts, constant lying, and manipulation of classmates, co-workers, family members, and friends—as long as they lasted as friends—would easily earn her a diagnosis of borderline personality disorder. As an adolescent, Christiana was one of the “cool kids.” She bullied classmates and ran with a clique that was straight out of a mean girls script. Beginning in high school, she had multiple failed relationships and an employment history marked by firings for insubordination or her quitting because her co-workers and bosses were “stupid.”

Christiana was unmarried and twenty-one when she gave birth to her daughter, Angelica, and she soon found that being a mother cramped her lifestyle. The child’s father lived with her for a time, but she ultimately threw him out when she discovered that he had slept with another woman—even though Christiana herself was involved with another man.

Christiana’s sister and parents adored Angelica, and Christiana took full advantage of their attachment to the girl. Christiana often dropped Angelica off at her parents’ or sister’s house and asked them to mind the child for a few hours. She would then stay out drinking with her friends until early in the morning. When she returned, she would lie, saying her car had broken down or she had fallen asleep or a friend needed help. She might even claim that she had told them she would be staying out so late. When confronted about these lies, Christiana would fly into a rage, verbally (and on a few occasions, physically) assaulting her family. Several times she decided to punish her parents and sister by refusing to let them see Angelica, telling them they would never see the child again if they didn’t apologize for their alleged wrong. These relatives always gave in to Christiana’s demands,  partly to calm her down but mostly because they recognized that Angelica’s visits were the most normal, stable days of the child’s life. Despite all this support, Christiana frequently told acquaintances stories about her “abusive” parents and “mean” sister.

Statistically, the overwhelming majority of people diagnosed with psychopathy are men, and the opposite is true for borderline personality disorder—most are women. Therefore, it’s not surprising that most mental health professionals reviewing this case would likely conclude that Christiana has borderline personality disorder. In some ways, she is a classic borderline. But if she were a he—Christian instead of Christiana—those same professionals would instead most likely be thinking psychopath and not borderline.