Are psychopaths trendy? Does saying “I have psychopathic tendencies” pass the dinner table test? Is this merely the latest debilitating condition to be reimagined as a fascinating quirk, à la “I’m a little bit OCD”?

If so, popular non-fiction might be to blame. In 2011, Jon Ronson’s The Psychopath Test introduced millions of readers to a checklist, devised by psychologist Robert Hare, that scores people on a range of psychopathic traits. A year later, Kevin Dutton’s The Wisdom of Psychopaths advanced the idea that we all sit somewhere on a psychopathic spectrum, and that aspects of psychopathy can be harnessed for good. ME Thomas used an alternative term to describe her superficial charm and lack of empathy in Confessions of a Sociopath. Hare’s own own book, Snakes in Suits, written with psychologist Paul Babiak, examines the success of the psychopath in corporate settings.

We love reading about psychopaths, then. But can we even agree on what they are?

The marks of the psychopath

For psychiatrist Hervey M Cleckley, there wasn’t a great deal to argue about. His 1941 book, The Mask of Sanity, describes 15 patients who shared certain unmistakeable features: the marks of the psychopath. “Many of these cases have been classified consistently as psychopaths by not one but a number of expert observers, usually by several staffs of psychiatrists, and nearly always with unanimity.”

In other words, you know them when you see them. They are the manipulators, the tricksters, the charming but emotionally disconnected men like Max, who will convince a jury that he’s crazy to avoid prison, only to persuade all the psychiatrists that he’s sane a few months later in order to escape from a locked ward. They are the strangely placid women like Roberta, who will write sweetly innocent letters back to her doctors saying how much progress she’s made while while her parents continue to report runaway kleptomania.

Hermann Göring, Nazi war criminal.

Cleckley is quick to point out that these people are not mentally ill. They shouldn’t even be in asylums, he says. “Despite the plain etymologic inference of a sick mind or of mental sickness, this term is ordinarily used to indicate those who are considered free from psychosis and even from psychoneurosis [anxiety and mood disorders].” How do they end up there, then? Because society hasn’t worked out how to deal with them – whether they’re mad or bad or who knows what. This is a problem, because they are trouble: “Their behaviour causes great distress in every community.”

More than 70 years later, psychiatrists still broadly agree that psychopathy isn’t a mental illness, but a “personality disorder” – a way of relating to the world and others that resists treatment and does not absolve someone of responsibility for their actions. And the puzzle of what to do with them hasn’t been worked out either. A psychiatrist is still usually roped in to identify what is called “antisocial personality disorder” in the latest diagnostic textbooks. This diagnosis is made on the basis of, among other things, “a lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another; frequent use of subterfuge to influence or control others; use of seduction, charm, glibness; thoughtless initiation of activities to counter boredom”. Many of the same attributes turn up on the Hare checklist.

Does this sound like someone you’ve met? It should do, as estimates of the prevalence of psychopathy tend to hover around the 1% mark. That’s 10 psychopaths in every 1,000-person strong organisation (though, not being very good at holding down jobs, there are likely to fewer of them among the stably employed). Even so, 1% is common enough for most people to encounter a handful in the course of a lifetime. But you want to know whether you’re a psychopath. You could start by getting someone to take your pulse.

Where do psychopaths come from?

If you’re not an athlete, and your heart rate is lower than average, you may be interested to discover that bradycardia, as it’s known, is more strongly correlated with psychopathy than smoking is with lung cancer. That doesn’t mean everyone with a slow heart rate is a psychopath, but a very high percentage of psychopaths have slow heart rates. Why on earth would that be the case?



It turns out that there are a number of physiological traits strongly linked to psychopathy, including tell-tale patterns of activation in the brain and autonomic nervous system. One theory is that psychopaths inherit a set of genes that make it harder to experience fear or excitement. It simply takes more for them to feel stimulated. What seems like a thrill for a psychopath is, for the average person, taking things way too far.



Jane Toppan, nurse and serial killer.

In his 2013 book, The Anatomy of Violence, Adrian Raine, who has been studying the physiological correlates of psychopathy for 40 years, tells the story of cheerful Massachusetts nurse “Jolly” Jane Toppan. Trusted by her patients and with easy access to powerful drugs, she managed to kill 31 people between 1895 and 1901. Found not guilty by reason of insanity, Toppan ended her years in an asylum at the ripe old age of 81.

“One of her greatest excitements in life was to watch life itself slowly sucked out of the patients she cared for. She would first inject them with an overdose of morphine. She would then sit patiently with them, gazing into their eyes almost like a lover, observing the moment when their pupils contracted and their breath shortened.” She wanted to witness the very moment of death, which, she later said, gave her a moment of “voluptuous delight”. And yet, she recounted:

When I try to picture it, I say to myself, ‘I have poisoned Minnie Gibbs, my dear friend, I have poisoned Mrs Gordon, I have poisoned Mr and Mrs Davis.’ This does not convey anything to me, and when I try to sense the condition of the children and all the consequences, I cannot realize what an awful thing it is.

Raine believes this is because parts of her brain linked to the experience of emotion and “moral sense” – the amygdala and the pre-frontal cortex – were impaired. There’s no record of her having been injured or suffering from a disease that could account for this. Does that mean she was born a psychopath?

As ever, nature and nurture both play a part. There are certainly genetic differences that can predispose someone to psychopathy. They may even bestow an evolutionary advantage. “If you went through life exploiting, taking advantage, as long as you kept on the move, you could certainly have lots of children,” says psychologist Beth Visser, assistant professor at Lakehead University in Canada. “You wouldn’t support them, enough of them would make it. So this aggressive, cheating strategy could work.” She points out, however, that it would only be effective if less deceitful temperaments were the norm. If we were all psychopaths, there’d be no one to take advantage of.

As a result of this ‘carrying’ of psychopathic genes in the general population, there are some people born with “quite strong tendencies” who are at especially high risk. According to Visser, “they need more exceptional parenting and the right circumstances to become good people”. Get things wrong, and you end up with Jolly Jane.

Samuel Juni, professor of applied psychology at New York University, places even greater emphasis on early environment. For him, the wellspring of psychopathy is hurt. “It usually comes about because of having been extremely disappointed or traumatised … in childhood.” If the developing child is placed in a position where emotions are painful, threatening or overwhelming, one defence is to “block them totally and become more or less like a computer, or a robot, that just pursues their own particular interests regardless of feelings. Both their own feelings and anybody else’s.” But what about nurse Toppan, and her desperate attempts to feel something – anything? Attempts that led her to murder, again and again. “Running away and trying to get in touch are psychologically not contradictory unfortunately. When you’re running part of you is running from something that you would very much like to be in touch with but you can’t.”

Help, I’m a psychopath!

Not every psychopath becomes a serial killer. Not every psychopath goes to jail. You may have waited in line with one for the bus today, or been served by one at a restaurant. To borrow the subtitle of another Robert Hare book, these are the “psychopaths among us”. They can lead productive lives. As Juni says: “It’s possible to have people who have no feelings, have no concern for others, but are quite practical, saying, ‘look I want to have a job, I want to have a family because it suits me’. But that same person,” he cautions, “I wouldn’t trust them.”

James Fallon might be one of those people. A research neuroscientist, he is now more famous for having accidentally discovered that his own brain bore all the hallmarks of psychopathy. He tells me the story: academic colleagues would send him brain scans of murderers hoping to learn more about a pattern of activation many of them seemed to share. Fallon, a specialist in brain anatomy, helped to interpret them. But one day, after having scans of his own family’s brains made as controls for a separate study into Alzheimer’s disease, he got a surprise.

One of the eight in the pile was very abnormal and looked just like these killers I’d been looking at … And so I told [my assistants] that the technicians must have got these scans mixed up with the pile of murderers and to go back and check it. And they checked it twice, two of them, and they came back and said no, it’s somebody in your family. So I had to break the code, you know, the blind code. And when I peeled it back, it was my name, and I was like ‘Ah, ok’.

A shock, but not to everyone. “I went back and I mentioned it to my wife. ‘You know, one of the PET scans they just did on our family looks just like a psychopath, and it was me’ and she said, ‘It doesn’t surprise me’.”

James Fallon, neuroscientists and ‘pro-social’ psychopath.

So how does Fallon’s psychopathy manifest, if not through cruelty or criminality? “I’m always on the make … I’m always trying to get people to buy into my little world. Even if for five minutes or an hour.” Does that involve inventing stuff? “I don’t have to lie or use violence to get what I want. [I’m] upper middle class, always had enough money and sex, dates … I grew up, I was good looking and athletic and very popular.” All the same, “I have … this intense, non-stop manipulation of people, and it’s something that I have to fight actively.”



Does he feel emotions? “I can be moved by certain things.” When was the last time he cried? “Well do you know, when my father died – I didn’t cry, but I had this intense welling up of sort of connection. He and I were close, I have been close to my parents and much admired them and did a lot of things with them. You know I was hyperventilating and it was … it wasn’t sadness, it was another emotion, it was quite unique, I don’t know how to describe it.”



Fallon regards himself as a “pro-social psychopath” – someone who inherited most of the high-risk genes for psychopathy, but “hasn’t been triggered” and lives a productive life. And there is indeed evidence that psychopathic traits can be of benefit – they’ve been linked in some studies to creative prowess, for example.

The concept doesn’t meet with universal acceptance, however. “I think that would be kind of a remarkable combination,” says Visser. “Because in general there’s this aspect of impulsivity and really short-term thinking where I’m picturing this person maybe trying that out and then just throwing it all away for short-term gain.” Juni is more direct. “They’re not pro-social. They are keen on picking up what it is that people are feeling or not and then using it practically but not empathically.”

“There have been quite a few ‘expert’ psychopaths who understand other people, who were really quite perceptive about what others’ feelings were,” he continues. “They use that understanding to hurt them, not help them – and really caused a lot of trouble because of that. Goering, for example.”

So am I a psychopath?

Since you’ve got this far, well, the truth is probably not. Psychopaths don’t examine their consciences, and they rarely seek treatment. “We find not one in one hundred … spontaneously goes to his physician,” observes Cleckley. Visser says: “It’s the people around them who have had their hearts broken or their money stolen or whatever who are going for help.

“If it’s bothering you, you’re probably fine.”



You’re fine. But what about the person sitting next to you: could they be wearing the mask of sanity? Ask if you can check their pulse – but do it very, very nicely.

