The psychiatric beach read: Anti-Social Personality Disorder in commercial fiction

October 15, 2016

Written by Susan Karpasitis

Psychopathy in literature is by no means a modern phenomenon. We only have to glance across a bookshelf of ‘classic’ works to be confronted by Shakespeare’s Richard III, Vanity Fair’s Becky Sharp, Dostoevsky’s Stavrogin and Stevenson’s’ Hyde, and their glorified psychopathic personalities. However, what has changed in post millennial literature and contemporary psychiatry is the way we categorise and empathise with these characters. Writers in the field of the medical humanities posit that perhaps we have been misguided in our approach; that perhaps these characters and the many more besides, are actually suffering from a personality disorder known as Anti-Social Personality Disorder (APD).


Photo courtesy of David Pacey. June 15th 2013.

The classification of personality disorders in the The Diagnostic and Statistical Manual of Mental Disorders (DSMV), the American Psychiatric Association’s “bible” of mental disorders, would seem to support this. So should we in fact be viewing characters as sufferers rather than perpetrators? Should we be seeking to review how we think about anti-social personalities in Literature? The answer from literary trauma theorists seems to be a resounding yes. Psychopathy and sociopathy (another confusing and largely outdated term) are not necessarily the same diagnosis as APD. The APD guidelines are much broader than those for Psychopathic Personality Disorder. Therefore, whilst those that we may label psychopaths may fit into the diagnostic criteria for APD, not all of those with APD are necessarily psychopaths. In fact, Kiel and Buckholtz in their 2010 paper suggest that as few as one in five sufferers of APD would meet the criteria for psychopathy (1).

The texts that I would like to consider then are Gone Girl by Gillian Flynn and The Jack Reacher series by Lee Child (I use text to refer to the whole series rather than individual novels for reasons that will hopefully become clear later). I have chosen these two texts because of their commercial popularity. Gone Girl after its release in 2012 catapulted to the top of the New York Times bestsellers list and remained in that position for 20 weeks selling over 7 million copies in 28 countries (2). With the release of the adapted screenplay in 2014, it became the second highest grossing book of the year selling just under another million copies (e-books and print combined) (3). There have been more than 8,000 independent reviews (EBSCO Host, MLA and Google Scholar searches combined) and that is of course besides the immeasurable informal coffee room and cocktails discussions of the novel and film adaptation.

The Jack Reacher series is one of the most successful commercial series of books this century. According to Forbes magazine (March 2014), Lee Child’s Jack Reacher series was named The Strongest Brand in publishing (4). Child’s media page states that “the Jack Reacher series by Lee Child is a billion dollar brand published in 42 languages and 97 territories. With well over 100 million books sold, the series has commanded over a billion dollars in global sales. Personal, the 19th Jack Reacher thriller, was number one on the best-sellers lists simultaneously in all English language countries and sold more copies than any other hardcover, of any type, for the year 2014 in the UK.” (5)

As to why I haven’t focused on one of the 19 book series. There are two answers to that – firstly, all of the books (dare I say it) are basically the same in that they replicate the same narrative structure and vary only in their settings and minor plot points (I never said this was ‘good’ literature). Secondly, I chose the whole series because of this repetition and pattern. I would argue that the familiarity and predictability of the novels play a huge part in our understanding of APD. For those of you who may have bypassed either of these two commercial beasts, let me give you a quick rundown.

Outline of Gone Girl: Amy Dunne, the muse for a series of children’s books called Amazing Amy is married to Nick. Amy engineers her own disappearance and apparent murder in order to frame her husband as punishment for perceived failings and infidelity. She constructs a false journal implicating Nick in her disappearance and citing issues of domestic violence. Amy goes into hiding whilst an America wide search is initiated, in which she is portrayed as a wronged abused spouse, and Nick becomes a figure of public hate. Amy’s plan fails when her constructed ‘on the run’ identity is challenged by a couple in the motel she is hiding in, who steal her money. She turns to an ex-boyfriend for aid, before violently murdering him in bed, constructing a fabricated rape and kidnapping story involving the ex-boyfriend. She is subsequently welcomed back as America’s sweetheart. All charges against Nick are dropped although he is left with new insight into his wife’s lack of emotional empathy and callousness. He stays with Amy for the sake of their unborn child.

Outline of the Reacher series: Jack Reacher is an ex-military cop who has turned his back on the structured life of the American Army to become a drifter. With no possessions besides a plastic toothbrush he wanders through the states trying to connect with the American identity that eluded him as an army child growing up on foreign military bases. Inevitably he becomes embroiled in mysteries and unsolved crimes in each of the towns and cities he inhabits. Using his superior physical strength and mental acumen he solves crimes and problems that the police seem unable to fathom. The end of each novel ends with Reacher breaking any emotional attachments he may have developed during the story and detachedly moving on randomly to his next scenario.

It is clear from analysis of both texts that the protagonists exhibit characteristics that align with current understandings of personality disorders (in general). To diagnose a personality disorder, according to DSMV, the following criteria must be met:

1.Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning.

Both characters exhibit obvious signs of intimacy impairment. Dunne demonstrates an inability to empathize with her husband which leads to her framing him for her murder. Reacher’s stated inability to maintain intimate relationships is represented through his lack of possessions:

“To fill a small bag means selecting, and choosing, and evaluating. There’s no logical end to that process. Pretty soon I would have a big bag, and then two or three. A month later I’d be like the rest of you.” ― Lee Child, 61 Hours

The criteria also states that:

2. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.

3. The impairments in personality functioning and the individual‟s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.

Both characters are contrasted against the social norm of the respective fictional worlds that they inhabit, and their behavior is shown to be consistent across situations (point 2 in the criteria) and yet inconsistent with effective functioning in that world.

In Gone Girl, Dunne purposely pits herself against the social norm as she sees it in her rant about the constructed identities of women.

I used to see men – friends, coworkers, strangers – giddy over these awful pretender women, and I’d want to sit these men down and calmly say: You are not dating a woman, you are dating a woman who has watched too many movies written by socially awkward men who’d like to believe that this kind of woman exists and might kiss them.”

Whilst there is merit in her challenge of female constructs, it is Dunne’s self- positioning of being ‘outside’ of this categorisation of ‘pretender women’ that contrasts her against the social norm, as she sees it.

Similarly, Reacher constructs himself in direct opposition to what he considers to be the ‘civilized’ world:

“Enough, a person might say, if that person lived in the civilized world, the world of movies and television and fair play and decent restraint. But Reacher didn’t live there. He lived in a world where you don’t start fights but you sure as hell finish them, and you don’t lose them either.” ― Lee Child, Worth Dying For

In addition to meeting the criteria for a personality disorder, subjects must also demonstrate the specific traits associated with APD. These include: Goal setting based on personal gratification; absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior. This goal setting behavior is evidenced in Gone Girl by the meticulous planning of her own abduction, and subsequent manipulation of the authorities. Reacher lacks this element of self-direction but certainly conforms to the criteria for ego centrism. (Again this is a confusing area for diagnosticians as the traits of APD can be easily confused by those of Narcissistic Personality Disorder).

Furthermore, according to DSMV, there must be:

4. Impairments in interpersonal functioning (a or b):

a) Empathy: Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another.

b) Intimacy: Incapacity for mutually intimate relationships, as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others.

Impairments in interpersonal intimacy functioning are quite clearly demonstrated in Gone Girl. One example is Dunne’s inability to empathize with pregnant women (a cultural given that she later exploits for her own purposes).

“Americans like what is easy, and it’s easy to like pregnant women – they’re like ducklings or bunnies or dogs. Still, it baffles me that these self-righteous, self-enthralled waddlers get such special treatment. As if it’s so hard to spread your legs and let a man ejaculate between them.” ― Gillian Flynn, Gone Girl

Meanwhile lack of remorse is a trademark of the Reacher series, usually represented through his objectification of others:

“He picked up the wrench and broke the guy’s wrist with it, one, and then the other wrist, two, and turned back and did the same to the guy who had held the hammer, three, four. The two men were somebody’s weapons, consciously deployed, and no soldier left an enemy’s abandoned ordnance on the field in working order.

The doctor’s wife was watching from the cabin door, all kinds of terror in her face.

“What?” Reacher asked her.” ― Lee Child, Worth Dying For

Finally, the subject must demonstrate traits from Subsection b which include manipulativeness, deceitfulness, callousness, hostility, irresponsibility, impulsivity and risk taking.

Indeed, Subsection b serves almost as a review of both texts; there are numerous examples demonstrating that the required behaviors for a diagnosis of APD are present in the characterization of both protagonists. However, what is more important than the presence of these features is the positioning of the reader in relation to these representations.

Gone Girl’s Amy is by no means a simplistic representation based on feature spotting the diagnostic criteria of the DSMV. In fact, though she exhibits many traits of Anti-Social Personality Disorder (APD), her exact diagnosis has become the debating ground of a reasonable amount of psychiatric literature. There are those who argue she also displays signs of Borderline Personality Disorder, Bipolar Disorder, and Dissociative Identity Disorder. Therefore, the characterisation of Amy is important in that it has opened up debate as to the measurability of symptomatology and the problematic overlap between various diagnostic labels in the DSM. The contemporary reader is armed with a basic understanding of psychopathic traits, and Amy’s inability to fit nicely into pre-existing ideas of ‘psychopathy’ lead the reader to at the least discuss these anomalies, and potentially even to research her symptoms and the wider category of APD. In doing so, they will find further anomalies and confusions. So whilst the representation of APD in this case is problematic, it is also symptomatic of a society that, armed with available information (or at least the mechanism to access it), can and want to discover more about medical diagnostic criteria of personality disorders. This places Gone Girl as an intersectional text that deliberately encourages a questioning of borders between fiction and psychiatric medicine. In short, the reader becomes analyst (itself not an unproblematic concept) and this is evidenced by the wealth of online discussion and reviews in psychological journals accessed by the public.

The Jack Reacher series is also important in its positioning of the reader. Though Reacher is never explicitly acknowledged as having APD, the symptomology is unmistakable, and becomes more embedded as the series progresses. But again what is more interesting than Reacher’s personality disorder is Child’s ability to make the reader empathise with the disorder without explicitly stating it. APD is one of the harder disorders to empathise with; Reacher is made more likeable by his moral code which states that only those deserving of violence will suffer it. “No, I’m a man with a rule. People leave me alone, I leave them alone. If they don’t, I don’t.” ― Lee Child, Nothing to Lose

This ego centric behavior, as outlined previously, is a feature of APD and yet, as the series progresses, the reader is lulled into accepting and even willing his violent behavior to continue. Child himself stated in a recent interview that Reacher will never change and each novel falls into the same predictable patterns of narcissistic injury, violence, disengagement from social norms and finally the breaking of all previous attempts at interpersonal empathy and intimacy. The repetition of this pattern, though perhaps more concerned with brand-marketing from Child’s perspective, effectively mirrors the unbreakable patterns and mindset exhibited by those with APD. As the DSMV states, “the impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations”.

Just as the reader becomes comfortable with, and expectant of, the extreme gratuitous violence and self-congratulatory excuses for violence, so to the Anti -Social Personality becomes settled with and turns to such displays as a pathological part of his/her condition. We become complicit in Reacher’s anti-social behavior and our complicity propels Reacher in terms of fictional development and in terms of real life commercial success. Guardian critic Rick Gekoski summarises this well stating: “I have established a simple rule for ranking the books: the more people he kills (and the badder they are), the better I like it, and him.” (6) Gekoski also admits that acknowledging ‘liking’ Reacher novels in literary circles is almost akin to sharing a dirty secret. We like him despite (or is it because of?) his implied disorder and we question our own moral judgment as readers for this empathy. As a result, we are less likely as readers to overtly label him with a disorder because of our complicity and the desire for extreme violence and narcissism that the character evokes.

Therefore, there are two reader approaches to the APD characters in both texts. The reader as analyst, a stance encouraged by Gone Girl – which generates out of text responses to personality disorders and actively encourages research of medical conditions. And the reader as complicit, as encouraged by the Reacher series. The reader becomes empathically drawn to patterns of thought associated with APD and feels comforted by extreme violence which would be considered unacceptable in the real world. There are of course consequences to these representations. First is the issue of violence. In both representations, APD, whether explicitly stated or implicitly implied, is associated with extreme violence. The equation of mental illness (7) with violence is problematic albeit widespread misconception. People with mental illnesses are actually much less likely to engage in violent acts than traditional representations would have us believe. As both characters clearly display abnormal levels of violence and the characteristics of APD, it becomes too tempting for the reader not to make a connection between the two.

On the other hand, there is a positive element for the public’s passion for what I will loosely term the ‘psychiatric beach read’. The amount of attention Gone Girl received has inevitably led to more discussion of mental illness both in and out of academic circles. Whether this discussion is aimed at correcting misrepresentations or endorsing them, these conversations are an important starting point for serious discussion of one of the last taboos of modern society. This in turn raises the age old question of whether literature has a social responsibility when it comes to representing mental illness.  Of course I cannot begin to answer that question. But going back to the two texts under discussion, we could perhaps ask which is a more helpful representation in line with deconstructing stigma and creating conversations around mental illness?

Is it Gone Girl with its explicit, yet inaccurate/ overly complex portrayal of numerous and overlapping disorders? Its real world outcome was a buzz of social media and literary discussion of mental illness. Or is it perhaps the Reacher series? The reader over the series of books is drawn into the world of APD and given insight into the psychological and emotional history of the character in a depth that can only be achieved through a sustained series of interconnecting novels. Does this emotional empathy offer more in terms of understanding, a more complete picture perhaps, than direct external analysis?

The popularity of this genre of fiction shows no signs of abating. As the innovative work on trauma studies has shown us, we as readers are drawn to psychological trauma and are interested in the origins of that trauma whether it be a psychic event or personality disorder that brings with it, in fictional terms, the possibility of explaining trauma. I would love to end on a definitive note, stating that popular fiction owes it to the medical community, to the sufferers of personality disorders and to the general public to represent mental illness in a way that is not glamourised, is factually accurate and responsible. However, such a portrayal would show everyday people experiencing long periods of wellness and being non-violent. That would not generate $1 billion in sales like the Reacher franchise or sell close to 8 million copies as Gone Girl did. In turn we wouldn’t have the discussions that we are having now that generate the potential for the dispelling of stigma and myth. And so the paradox continues.


  1. Kiehl, KA., and Buckholtz, JW. 2010. Inside the mind of a psychopath. Scientific American Mind, September/October: 22-29.
  7. There is still some debate as to whether personality disorders can be considered as mental illnesses however current research in the filed as well as the nimh guidelines suggest that they do fall into that category. For further information see: R. E. KENDELL,The British Journal of Psychiatry Feb 2002, 180 (2) 110-115; DOI: 10.1192/bjp.180.2.110


Susan Karpasitis is an English Literature lecturer at Trinity College. Her research interests include representations of madness in literature, the medical humanities and literary trauma theory.


One Response to “The psychiatric beach read: Anti-Social Personality Disorder in commercial fiction”

  1. […] volume continues with The psychiatric beach read: Anti-Social Personality Disorder in commercial fiction by Susan Karpasitis and Fetishism in Cinderella and the Impotence of Prince Charming by Cara […]

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