Dalrymple's key insight in Life at the Bottom is that
long-term poverty is caused not by economics but

by a dysfunctional set of values,
one that is continually reinforced by an elite culture
searching for victims.

This culture persuades those at the bottom that they have no
responsibility for their actions
and are not the molders of their own lives.

Here is a searing account - probably the best yet published -
of life in the underclass and why it persists as it does.

Theodore Dalrymple, a British psychiatrist who treats the poor
in a slum hospital and a prison in England,
has seemingly seen it all.

Yet in listening to and observing his patients, he is
continually astonished by the latest twist of depravity
that exceeds even his own considerable experience.

..by turns hilariously funny, chillingly horrifying, and
all too revealing - sometimes all at once.