Pål Grøndahl believes that a lot of what we read and see in movies and on TV about
people with psychopathic personality disorder is misleading.
dislikes media headlines like: ‘Is your boss a psychopath?’, ‘Ten signs that your partner is a psychopath’, or ‘How to spot a
“These types of
headlines can cause victims to feel guilty. They believe they should have recognised the person’s true nature earlier,” Grøndahl says.
But it’s not nearly as easy as the tabloid press makes it out to be, he believes.
Gradually exerts more power
psychopaths have numerous intense and short-lived relationships with others.
“But you can be
with a psychopath for a long time before you suspect anything,” he says.
We meet him at
the Deichman library in Norway’s capital Oslo on the occasion of the launch of his book Psykopatiske
personligheter (Psychopathic personalities).
charming at first – good at figuring out your needs, telling you what you want to hear, and overwhelming you with outward signs of affection.
There is a gradual development in most relationships, which is why controlling actions become normalised, Grøndahl emphasises.
He has a
doctorate in forensic psychiatry, and has been a forensic psychiatric expert for
Grøndahl’s book is based on research and experiences from
his own practice.
Feels like walking on eggshells
controlling and suspicious.
relationship becomes so confining and the room for action so restrictive that
it feels like you’re walking on eggshells. Until you think ‘this is completely crazy, I must ask others if what I am experiencing is normal’,” Grøndahl says.
out of the relationship can be more difficult than outsiders might imagine. The
psychopath’s version is that you are the problem.
sick and weak, and I’ve done everything for you,” is the psychopath’s response.
It can take a
long time before the victim sees through the lies, according to Grøndahl.
Victims have often become extremely isolated and cannot see how unsustainable the
relationship is until they have the benefit of hindsight.
Deceived several times
met many people with psychopathic personality disorder, both patients and
people he has examined forensically.
“I’ve been deceived several times by people who I later realised had distinct psychopathic traits,” he
don’t realise until later that the person you had in your office probably had a
psychopathic personality disorder,” he says.
The pieces fall
into place when he later reflects on the situation.
In his book, Grøndahl provides
several examples of clients with high levels of psychopathic traits that he has
been fooled by.
“It was uncomfortable and strange. Bizarre experiences,” Grøndahl says.
One patient had
ordered a psychiatric opinion, but he never paid for it despite saying he would
– even when the claim was sent to debt collections.
Psychopathy is not a diagnosis. The
term is used today as a psychological concept that was developed around 30
years ago. The term is used outside the two diagnostic systems found in Europe
and the USA.
Psychopathy consists of two
Half of the diagnosis consists
of an affective part, and the rest has to do with behaviour.
Affective dimension: Patients
are arrogant, narcissistic, have an inflated self-image, and little compassion
and understanding for other people’s feelings. They are easily offended when
they don’t get their way.
manipulate and engage in antisocial acts towards others.
In modern psychopathy research,
a checklist called the Psychopathy
Checklist – revised (PCL-r) has been developed. The checklist includes 20 perceived
personality traits that are scored on a 3-point scale used to predict risk of psychopathic
personalities by Pål Grøndahl)
Treating victims of psychopaths
When asked if
he has ever diagnosed someone with the disorder and shared the diagnosis with the
client, Grøndahl needs to think for a while.
“No, I don’t think I ever have. They rarely seek help for this. They are more likely to come in for other reasons, such as struggling with anxiety and depression,” Grøndahl says.
But he has
treated several spouses, partners, and children of psychopaths.
He has seen children
who have been exploited and worked for free in the family business against
empty promises of taking over.
Where do we find the most psychopaths?
estimate that around one per cent of Norway’s population has a psychopathic
personality disorder. That is about 55,000 people.
But where are they
Grøndahl thinks most of them live in a grey area between being seemingly ‘normal’ citizens on the one hand, and exhibiting
border-crossing or criminal behaviour on the other.
By way of
comparison, there are only about 3,000 inmates in Norwegian prisons at any given time.
Only a small
fraction of individuals with psychopathic personality disorder commit serious
crimes like violence or financial embezzlement that result in a criminal
Many in leadership positions and politics
psychopathic personalities are drawn to leadership roles and politics.
“They probably choose
these occupations because they enjoy attention and media coverage. The more
resourceful individuals with psychopathic traits have good speaking
skills and can withstand being in the midst of media storms,” Grøndahl says.
They excel in job interviews and are experts at selling themselves.
“That’s why you
need to be somewhat vigilant. Is the candidate very confident that they are
perfect for the position? If so, it may be wise to take time in making a hiring decision,” he says.
Grøndahl has previously remotely diagnosed Donald Trump as, if not a psychopath, then at least a malignant narcissist (link in Norwegian). Several researchers were certain of this, following the storming of the U.S. Capitol nearly three years ago.
The smart ones go far
Rosenqvist, a retired forensic psychiatrist, believes that a problem with psychopathy research is that it has mostly focused on criminals.
It would be
exciting to do more research on successful psychopaths, Rosenqvist said in an
interview with sciencenorway.no in 2019.
She believes it
is important to acknowledge that high-functioning psychopaths make up part of this
population too. Some may just be very good at not getting caught. They can
become both demagogues and stock speculators.
journalists refer to some people as ‘financial acrobats’, I think it’s a simple
way to refer to psychopaths,” she said.
more likely to engage in financial fraud and commit white-collar
crime than others, Grøndahl confirms.
“Many of those who have started financial pyramid schemes are probably in this group,”
also more often gang leaders in criminal networks.
without saying that you have to be fearless and devoid of empathy when you can order children to commit murders,” he says.
The so-called Kurdish
Fox, the leader of the Foxtrot network in Sweden, is a case in point. But Grøndahl
has admittedly never met him.
The diagnosis should be reinstated
no longer an official diagnosis in Norway.
was removed in 1992 because people did not like the moral judgment inherent in
the term. In the USA, convicted violent offenders and murderers with the diagnosis also received higher sentences than others,” Grøndahl says.
Many people thought
the term was stigmatising, he explains.
Now, Grøndahl advocates for reintroducing the term. Publishing his book is part of his effort to do so.
He believes psychopathic
personality disorder should be recognised as a distinct diagnosis.
“It’s a very
serious personality disorder that we have to take seriously. It’d be like putting a bell on the cat,” Grøndahl says.
are often used in expert assessments.
Therefore, he thinks it should become a diagnosis rather than a stigmatising label.
Is treatment possible?
it is difficult, but not impossible, to treat certain people with psychopathic
He writes extensively about treating psychopathy in his book, but it is not all
do not know as much as they would like about the causes of the disorder.
that genetic vulnerability accounts for up to 50 per cent of the cause of
psychopathic personality disorder.
“The rest is influenced by environmental conditions, such as a difficult upbringing
or perhaps a parent who is a psychopath. It’s hard to distinguish what causes
what,” Grøndahl says.
Maybe preventable at a young age
Grøndahl is more optimistic about interventions for at-risk children.
more malleable, more impressionable. Interventions can have a preventive effect
if they are introduced early in the socialisation process,” he says.
It is possible
to recognise early signs of potential emerging antisocial behaviour.
who appear emotionally cold, who don’t understand that they should
be kind to others, might be prevented from developing into completely antisocial individuals,” he says.
But a lot of
pieces have to come together for this to happen, and the parents would have to
approve the evaluation.
Translated by Ingrid P. Nuse
Grøndahl, P. ‘Psykopatiske
personligheter’ (Psychopathic personalities), Universitetsforlaget, 2023.