The Psychopath Test

The PCL-R Checklist is psychopathy's gold standard. Canadian psychologist Bob Hare spent decades distilling psychopathic behavior into twenty traits — from Glibness/Superficial Charm and Grandiose Sense of Self-Worth to Lack of Remorse and Criminal Versatility. Each is scored zero, one, or two. Score thirty or above out of forty, and you're classified a psychopath. The checklist is used by parole boards, justice departments, and psychiatric hospitals worldwide, including the DSPD units where patients like Tony are held indefinitely.

Hare refined the list at a 1975 conference where eighty-five experts pooled observations about psychopaths' verbal tics, sentence constructions, and behavioral patterns. The checklist's power is enormous: a high score can effectively mean lifelong detention. Critics worry it gives trained checklist-administrators too much subjective power over people's fates.

The Oak Ridge experiment was radical idealism. In the late 1960s, Canadian psychiatrist Elliott Barker created the Total Encounter Capsule — a small green room where criminal psychopaths stripped naked and spent eleven-day stretches on LSD, confessing their darkest feelings while Barker watched through a one-way mirror. On camera, tough prisoners seemed to transform, tenderly praising each other. Some even asked parole boards to delay their release so they could finish therapy.

Then the recidivism data arrived. Normally, 60 percent of released psychopaths reoffend. Of Barker's graduates: 80 percent. One abducted and raped an eleven-year-old boy. Multiple-child-killer Peter Woodcock, after years of empathy training, used his first three-hour pass to murder a fellow patient with a hatchet. He later admitted the program taught him to "manipulate better and keep the more outrageous feelings under wraps."

Al Dunlap was Exhibit A. The former Sunbeam CEO — whose Florida mansion overflowed with stone predator sculptures — cheerfully recast Bob Hare's psychopathy items when Ronson read them aloud. Superficial Charm? "Totally charming!" Manipulative? "I think you could describe that as leadership." Impulsivity? "Quick Analysis." Lack of remorse? Frees you to "move forward and achieve more great things." A crime-scene photo? "I intellectualize it."

Wall Street rewarded the behavior. When Dunlap was named Sunbeam CEO, the stock jumped from $12.50 to $18.63 — the largest single-day gain in NYSE history. When he announced firing half of 12,000 employees, it surged to $28. Goldman Sachs issued bullish research reports. Towns like Shubuta, Mississippi became ghost towns. Hare's own study found corporate professionals were four to five times more likely than the general population to score as psychopaths.

This is the book's central thesis. Ronson discovers that journalists, TV producers, psychologists, and pharmaceutical companies all share a strange incentive: to identify, amplify, and monetize particular kinds of madness. TV guest booker Charlotte Scott checked potential guests' medication lists to find people who were "just mad enough" — Prozac was perfect, schizophrenia was a no-no. Reality shows like Wife Swap and Extreme Makeover mined families for their most dramatic dysfunction, sometimes with lethal consequences.

David Shayler's arc maps the formula perfectly. The former MI5 whistleblower's descent — from 7/7 conspiracy theorist to hologram believer to declaring himself the Messiah — shows that media interest tracks a narrow band of madness. Too boring gets ignored, too outlandish gets abandoned. Only the "right sort" of madness earns airtime, leaving the truly ill either exploited or discarded.

Robert Spitzer revolutionized psychiatry — for better and worse. Inspired by the 1973 Rosenhan experiment (in which eight sane people were admitted to mental hospitals simply by claiming to hear a voice say "thud" and couldn't get released for an average of nineteen days), Spitzer set out to replace subjective psychoanalysis with objective checklists. Over six chaotic years at Columbia University, he and his team hammered out hundreds of new disorders on an old typewriter. DSM-I had been 65 pages. DSM-III came in at 494. DSM-IV would reach 886.

The consequences were seismic. Field-testing revealed over 50 percent of Americans qualified for a mental disorder. Drug companies suddenly had hundreds of new conditions to medicate. Spitzer was delighted — until he wasn't. Asked if some categories described normal behavior, he fell silent for three minutes before admitting: "Some of it may be."

Rebecca Riley died from her prescription. In 2006, the four-year-old Boston girl was found dead after her parents overdosed her on antipsychotic drugs prescribed for childhood bipolar disorder — none approved for children. She'd been diagnosed at age three by a follower of Dr. Joseph Biederman, the Harvard psychiatrist who claimed bipolar disorder could start "from the moment the child opens his eyes." Biederman's unit later faced conflict-of-interest scrutiny for receiving Johnson & Johnson funding.

DSM's own former editor called it a false epidemic. Allen Frances, who edited DSM-IV, told Ronson his manual had "inadvertently contributed to three ongoing false epidemics": autism, attention deficit, and childhood bipolar. Autism diagnoses went from fewer than one in two thousand children to more than one in one hundred. Children who were difficult or moody were being labeled with a lifelong genetic condition — and drugged accordingly.

Ronson's honesty about his own corruption is the book's sharpest turn. After completing Bob Hare's three-day course, he found himself mentally scoring everyone — labeling a restaurant critic a psychopath for killing a baboon, diagnosing mutual friends over dinner. His wife learned the PCL-R Checklist and joined in. Filmmaker Adam Curtis confronted him: "You're like a medieval monk stitching together a tapestry of people's craziness."

The pattern extended beyond Ronson. Criminal profiler Paul Britton orchestrated an elaborate honey trap against Colin Stagg, an innocent man, by stitching together his most deviant-seeming qualities into a false portrait of a killer. While the real murderer walked free and killed again, Britton remained unable to see what he'd done wrong. The power to label madness — whether via checklist, profile, or editorial instinct — tempts everyone who holds it toward excess.

Ronson ends where he began — with strangeness as a feature, not a bug. Petter Nordlund, the Swedish psychiatrist whose obsessive, cryptic book baffled academics worldwide, was dismissed as a crackpot. But his eccentricity created community, intellectual debate, economic activity, and an international mystery. His final message to Ronson was two words: "Good Luck." Ronson's overanxious brain — the one that made him shriek involuntarily on planes and panic that his wife was dead when she didn't answer the phone — was the same engine that propelled him through this entire investigation.

The book's uncomfortable conclusion: society simultaneously pathologizes and exploits unusual minds. We drug difficult children, detain ambiguous cases indefinitely, and entertain ourselves by watching troubled people on television — all while insisting everyone should be normal. Perhaps, Ronson suggests, our unhappiness, anxieties, and compulsions are precisely what lead us to do rather interesting things.