(Mis)diagnosis

Author's note: I'm just having some fun with the DSM - couldn't resist it when Sherlock called himself a sociopath. Now, why would such a brilliant man get his own diagnosis wrong? John Watson wanted to find out, and so did I.

Being a psychologist has its benefits once in a while. - Emma

"You're not a sociopath, Sherlock."

"Mmmm." The detective lifted an eyebrow, looked at Dr. Watson, and then returned to texting on his phone. John was sitting across the room, on the only spare foot of space on the sofa that wasn't covered with organic chemistry texts and foreign language dictionaries.

"So why did you tell Anderson you were?" John asked.

"I had my reasons."

"Well, I may be an idiot just like the rest of them, but I did sit through several courses on psychiatry, you know. And I know enough to know that you wouldn't make the mistake of thinking there's a difference between a psychopath and a sociopath."

Sherlock looked up.

"I'd assumed that you'd slept through those lectures."

"Give me some credit, Sherlock."

"Or else you would have known that your limp was psychosomatic."

"Doctor, heal thyself," John said sarcastically. "Highly original, Sherlock."

"You did say that your injury was to your shoulder, not your leg." Sherlock smiled to himself, bringing the tips of his long fingers together under his chin.

"Yes, I know that." John paused. "Right." He paused again. "But that's the whole point – if it's psychosomatic, it means you're not aware that it's all in your head. Even if you're a doctor."

"Did I ever say you were faking it, John?"

"No. But just because something is psychosomatic doesn't mean it's not real."

John paused, hoping that Sherlock would stop talking about his limp. My imaginary, non-existent limp, he reminded himself. He hadn't used his cane again since he and Sherlock had chased that cab on foot.

"I know I'm not a sociopath," Sherlock said suddenly.

"You do?"

"Of course I do. I'm not an idiot and I can be bothered to get a diagnosis right, when I want to. Especially when it's just a matter of checking off boxes."

"Checking off boxes?"

"Psychiatry must be the most backwards specialty in medicine. There are no bioanalyses you can run, no lab tests to tell you when someone is mad. It's diagnosis by checklist. Get five out of nine symptoms and – fancy that! – you're clinically depressed. Not much challenge in that, is there, John?"

"So you know that it's not even the right diagnosis?"

"Yes, John, I do know that sociopathy is rather out-dated when it comes to psychiatric nomenclature. Psychopathy too, as it turns out. Tell me again – if it hasn't been too long since you were in Bedlam – what's the term you doctors use nowadays?"

"Antisocial personality disorder," John blurted out.

"Anti…social," repeated Sherlock, as if thinking about it. "Against society. Curious. Tell me more."

"Antisocial people – wait, let me see your computer."

"No, it's in use."

"Fine, I'll use my own." John put in a quick search to bring up the Diagnostic and Statistical Manual of Mental Disorders.

"First point: failure to conform to social norms with respect to lawful behaviors, repeatedly performing acts that are grounds for arrest."

"Not applicable," Sherlock said. "I don't follow the rules, but that's only because I am solving crimes. And the police don't arrest me for it, obviously, because I'm on their side."

"And here, the next one is deceitfulness, repeated lying, use of aliases, etc."

"I think the last one of us who used an alias was you John. Pretending to be me, I might add."

"Ha ha, Sherlock. You know that was just Madame Shan's confusion over seeing your credit cards in my wallet. But what about the 'deceitfulness' part? You lied to van Coon's neighbor so that she would let you get into his flat."

"Yes. I suppose that solving crimes, by necessity, requires one to lie. But I don't do it for the fun of it."

"Don't you?" John asked. "Then what was it all about back there, telling Anderson that you were a sociopath, when you know perfectly well that he didn't need to do any more research, because psychopaths and sociopaths—" He was interrupted.

"—Don't really exist?" Sherlock smiled. "Come now, you know as well as I do that they do. A rose by any other name, and all that, John. Besides, you haven't finished diagnosing me with antisocial personality disorder yet."

"Oh, right." John looked at his screen. "It says here….impulsiveness, failure to plan ahead…."

"One never knows what can happen when you're solving a crime. But I do plan ahead. When it suits my purposes. Next item, doctor."

"Irritability and aggressiveness, as indicated by repeated physical fights or assaults."

"Ha! I don't exactly seek out violence, but I can't help it if people want to kill me."

"Well, this was my point, Sherlock. You aren't a sociopath. You don't even have antisocial personality disorder—"

"—Doesn't mean I don't have an antisocial personality, though, right?"

"Well, you put up with me, so I'd say not."

"It would be more correct to say that you put up with me, John. Though I'm glad to have you think that I'm the one who's being accommodating here. Makes it less likely that you'll leave."

"But you're not antisocial, Sherlock," John said, shaking his head. "Not in any sense of the term. You're not trying to destroy society, you're trying to save it."

Sherlock harrumphed. "Really, John? No one's ever told me that one, before. And truth be told, I never considered my motives to be that noble."

"But you're not cruel, either. You don't have that callousness that antisocial types have."

"Oh, damn, John," Sherlock drawled. "I must be losing my touch. Now you're going to tell me that just because I knew what to say to Sarah after she nearly lost her life at the hands of Madame Shan, that now I must have feelings?"

"I can't see that there's much difference between having feelings and acting like you have feelings." John paused a moment. "I mean, at some point, even if you don't want to, if you act like you care for long enough, I believe that you'll really start to care."

"Interesting hypothesis, Doctor Watson. So you're a behaviorist? I should have guessed, with a name like yours. John Watson, indeed."

"What?"

"John B. Watson, American psychologist. Died 1958. Probably the most famous behaviorist, if you don't count Skinner."

"Who?"

"B.F. Skinner. Another behaviorist. American, of course."

"So?"

"Watson and Skinner believed that behaviors are the only thing that can tell us about another person, the only things that give us insight into other people's minds. So, taking their word for it—and yours, too, apparently—if I act like I care, then it means I do care. Right?" Sherlock sighed. "Seems rather simplistic, even for a medical man. Completely overlooks the possibility that I might not be telling the truth."

"But then again, you might be," John said.

"I might," Sherlock replied. "But where's the fun in letting you know, one way or another? If you're really a behaviorist, you'll figure it out eventually."

"Actions speak louder than words, eh?"

"Precisely. If that's your point of view. Now, John, before you look any further at that book and come to the conclusion—erroneous, I should add—that in fact I have obsessive compulsive disorder, or worse, that I'm some kind of autistic savant—could you hand me a pen?"

John chortled, still looking at his computer.

Sherlock raised an eyebrow. "The pen?" he asked again, impatiently.

"I'd forgotten about this one," the doctor said, pointing to the screen.

"Pen," Sherlock insisted. John didn't pay him any attention.

Sherlock stood and came around to look at what John was reading, cinching his silk robe more tightly around his waist.

"Hilarious," he said in a dead pan.

"Yes, I thought so, too," John replied. "Mycroft thought that you had a flair for the dramatic, but if he'd only known you were - "

" - Histrionic," Sherlock finished for him. "I know, I know."

"It all fits!" John said, practically gleeful. "The bespoke suits, the head in the refrigerator, the sulking..."

"I do not sulk."

"Yes, you do." Then, reading: "Overly concerned with his looks, needing to be the center of attention, sensitive to criticism...yup, pretty much sums up Sherlock Holmes."

"John, if you don't close that computer and get me the pen that you're sitting on, I'll kick you so hard that you won't have to worry about an imaginary limp any more."

"Is that a threat, Sherlock?" John asked. "Hmmm, so you are aggressive, after all. I may have to reconsider my diagnosis."

"Close the computer, John."

"Histrionic personality disorder with violent features."

"You're making that up," Sherlock said, crossing his arms over his chest.

"And now you're sulking. Perfectly fine to do so, by the way, if you're histrionic."

"Shut up."

"My pleasure."