"Most psychopaths live in a grey area between being seemingly 'normal' citizens and exhibiting boundary-crossing behaviour," psychologist Pål Grøndahl says. He believes they are not as easily identifiable as some media suggest.

There are tens of thousands of psychopaths in Norway – but they are hard to spot

They have an inflated self-image and little empathy. They manipulate and defraud others. There are tens of thousands of them in Norway. But they can be difficult to detect, Pål Grøndahl writes in his new book on psychopathy.

Psychologist 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.

He strongly dislikes media headlines like: 'Is your boss a psychopath?', ‘Ten signs that your partner is a psychopath’, or ‘How to spot a psychopath’.

“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

Many 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).

Psychopaths are 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 several years.

Grøndahl’s book is based on research and experiences from his own practice.

Feels like walking on eggshells

Psychopaths are controlling and suspicious.

“Eventually, the 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. 

But breaking out of the relationship can be more difficult than outsiders might imagine. The psychopath's version is that you are the problem.

"You’re 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

Grøndahl has 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 says.

“You often 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 parts:

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.

Behaviour: They 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 behaviour.

(Source: 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?

Researchers 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 all?

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 case.

Many in leadership positions and politics

People with 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

Randi 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.

“When journalists refer to some people as ‘financial acrobats’, I think it’s a simple way to refer to psychopaths,” she said.

Gang leaders

Psychopaths are 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,” he says.

Psychopaths are also more often gang leaders in criminal networks.

“It goes 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

Psychopathy is no longer an official diagnosis in Norway.

“The diagnosis 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.

Psychopathy checklists are often used in expert assessments.

Therefore, he thinks it should become a diagnosis rather than a stigmatising label.

Is treatment possible?

Grøndahl says it is difficult, but not impossible, to treat certain people with psychopathic personality disorder.

He writes extensively about treating psychopathy in his book, but it is not all uplifting reading.

Genetic vulnerability

Researchers still do not know as much as they would like about the causes of the disorder.

They estimate 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. 

“Children are 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.

“Children 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

Read the Norwegian version of this article at forskning.no


Grøndahl, P. 'Psykopatiske personligheter' (Psychopathic personalities), Universitetsforlaget, 2023.


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