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The Challenge of Self-Diagnosis Among Psychopaths

All self-diagnosis is challenging, but psychopathy presents unique pitfalls.

Key points

  • A psychopath rarely self-identifies as a psychopath.
  • With psychotherapy patients must first recognize that they have a problem and desire to help themselves.
  • Most individuals with psychopathic traits are not bothered by them.
Laurentin Robu/Pexels
Source: Laurentin Robu/Pexels

The psychopath is an excellent actor who primes his audience to listen, often getting them to believe incredible lies. According to psychoanalyst Ben Karpman, the psychopath’s “acting” … “is a conscious method for exploiting other people, for influencing them to do what he wants.”1 The glorification and minimization of psychopathy through books, articles, forums, and other media mislead. Determining if someone is a psychopath is not some parlor game involving online quizzes or tests.2,3

Psychopathy belies self-diagnosis

As psychopathy expert Paul Babiak has stated, “The psychopath is the most dangerous of all personality disorders.”4 Robert Hare, who developed the most vetted tool for predicting psychopathy, The Psychopathy Checklist-Revised ("PCL-R"), notes it is “a complex tool for professional use only.” He explicitly states, “Do not use the PCL-R to diagnose yourself or others.”5

Psychopaths see nothing wrong with themselves and usually do not identify as psychopaths

Psychopaths see nothing wrong with themselves. As Benjamin Karpman succinctly states, “The psychopath who has no insight, sees nothing wrong with himself but only with others.”6 A psychopath would simply not self-identify as a psychopath.

A short quote from serial murderer Ted Bundy, who many have considered a textbook psychopath, is particularly telling: “As far as his own life was going, Ted wrote that there was nothing happening to him that reincarnation wouldn’t improve on. He didn’t think about it; he viewed his world from the position of a spectator, a captive audience.”7

Self-diagnosis should be viewed dubiously

For those self-proclaimed psychopaths who believe they can self-diagnose or simply be diagnosed based on their own MRI brain scans, beware. Kent Kiehl, a professor at the University of New Mexico and a world-leading expert in using fMRI to link brain abnormalities to possible manifestations of psychopathic behaviors, disagrees. He has noted, "fMRI has not been shown to predict psychopathy on an individual level with a high level of classification.”8

Why is it so difficult to help a psychopath?

Psychotherapy works on the principle that patients must first recognize that they have a problem and desire to help themselves if therapy is to be successful. Hare, in his book Without Conscience, writes, “Psychopaths don’t feel they have psychological or emotional problems, and they see no reason to change their behavior to conform to societal standards with which they do not agree.”9

Karpman’s conclusions are especially poignant: "When we come to psychopathy, we are confronted with the most striking situation in the entire field of psychiatry ... its etiology has … remained undiscovered and has defied all our efforts to discover it. The hope for psychogenesis is as yet merely a pious wish. Treatment is nil … its course is life-long, seemingly from birth to death.”10

A diagnosis of psychopathy is a serious diagnosis. It is wrong to minimize this most dangerous of all personality disorders. Be suspicious of the motives of those who seek to promote themselves as self-diagnosed “good” or “reformed” psychopaths.


1. Karpman, B. (1961). "The structure of neurosis: with special differentials between neurosis, psychosis ... psychopathy, and criminality." Archives of Criminal Psychodynamics, 4, 634.

2. Summers, Greg. (2022). "Psychopath Spectrum Test: Are You Psycho?"

3. Quizoto. (2023). " How Psycho are You?"

4. Babiak, Paul. (2012). "Psychopathy: An Important Forensic Concept for the 21st Century." FBI Law Enforcement Bulletin. U.S. Department of Justice. 2.

5. Hare, Robert D. (1990). Without Conscience: The Disturbing World of the Psychopaths Among Us. New York: The Guilford Press. 34.

6.. Karpman. 627.

7.. Rule, Ann. (2000). The Stranger Beside Me ... Ted Bundy: The Classic Case of Serial Murder. New York, NY: W.W. Norton & Company. 303.

8. Kiehl, Kent. E-mail to Winifred Rule. April 9, 2024.

9. Hare. 195.

10. Karpman. 643.

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