I encounter disagreeable people constantly. The clerk who treats a simple question as an imposition. The driver leaning on his horn before the light has changed. The woman who shoulders past on a narrow pavement without a word. I extend each of them the same courtesy: I assume they are having a bad day. It costs me nothing and is often true. I will never see them again, so I will never know. A stranger presents no pattern. What I have stopped extending is that charity to people I have known for twenty and thirty years — the ones whose unpleasantness is not a bad Tuesday but a settled disposition. They were like this at thirty. They are like this at sixty. They will die like this.

These are not criminals. They break no laws and will never see the inside of a courtroom. They damage the people around them, steadily and without justification, and decline to account for any of it. They do not thank anyone. They do not apologize. The conversation is always returned to them. The grievance is always fresh and always someone else’s fault. A normal person who behaves badly feels the friction of it afterward and makes some gesture of repair; that friction is what we mean by conscience. In these people the friction is simply absent, and its absence is not a phase. It is the architecture.

We used to have a word for them. My grandparents’ generation called them assholes, and the word did useful work, because it was a moral judgment rather than a medical one. Today the same person arrives pre-excused. He has a cluster B personality disorder. He is somewhere on the spectrum. Her hormones are off. She is carrying unprocessed trauma, and if the trauma cannot be located, we infer it from the behavior and call the inference a diagnosis. Allen Frances, who chaired the task force that produced the DSM-IV, spent his retirement warning that his profession was converting millions of ordinary people into mental patients. The psychologist Nick Haslam gave the mechanism a name — concept creep — after documenting how abuse, addiction, bullying, trauma, prejudice, and mental disorder had each expanded to cover progressively milder things. His warning was that this pathologizes everyday experience and breeds a virtuous but impotent victimhood.

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