The book presents a searing account 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, draws from his extensive clinical experience working with disadvantaged populations. 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 Manhattan InstituteGoogle Books. Based on his observations of patients, he argues that persistent poverty stems more from destructive behavioral patterns and mindsets than from purely economic factors