Real-Life Monsters Real-Life Monsters

Real-Life Monsters Real-Life Monsters

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Real-Life Monsters Real-Life Monsters A Psychological Examination of the Serial Murderer

Stephen J. Giannangelo

Copyright 2012 by Stephen J. Giannangelo

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher.

Library of Congress Cataloging-in-Publication Data

Giannangelo, Stephen J. Real-life monsters : a psychological examination of the serial murderer / Stephen J. Giannangelo. p. ; cm. Includes bibliographical references and index. ISBN 978-0-313-39784-4 (hardcopy : alk. paper) — ISBN 978-0-313-39785-1 (eISBN) I. Title. [DNLM: 1. Homicide—psychology. 2. Criminal Psychology. WM 605] 616.89—dc23 2012014963

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For Mom and Dad – together again together always And for Kathy thank you for finding me

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Preface ix

Acknowledgments xiii


1. Introduction: An Identification of the Offender 3

2. Clinical Diagnoses and Serial Killer Traits 13

3. Biology and Its Effect on Violent Behavior 33

4. Environment, Background, and Personality 43


5. Theoretical Discussion and Methodology 63

6. Case Studies 71

Case 1: Andrei Chikatilo 72

Case 2: Arthur Shawcross 77

Case 3: Jeffrey Dahmer 82

Case 4: Edmund Kemper 86

viii Contents

Case 5: Anthony Sowell 91

Case 6: Aileen Wuornos 96

Case 7: Dennis Rader 100

Case 8: Rodney Alcala 104

7. Reflecting on Case Studies 109

8. Theoretical Analysis and Development 121

9. A Conversation with a Monster? 129

10. Conclusion 143

Appendix A: Case Briefs 159

Appendix B: Glossary/Explanation of Terms 169

References 173

Index 185


In the early 1960s, as a child growing up in New England, I spent a great amount of time with a riveted focus on the subject of movie monsters. Plastic models, magazines, and the latest horror flick ruled the day for this child. I even managed to convince my slightly skeptical mother to allow me to go to bed early on Saturday evenings, so she could wake me up in time to watch the weekly monster movie shown at midnight. Concerned relatives counseled my mom, thinking that maybe I could turn out, well, odd. Maybe they were right.

Still, for some reason, I never was all that affected by the horrors of the cinema. While interesting, I never did buy into the terror of Frankenstein’s Monster, The Wolf Man, or the Creature from the Black Lagoon . They were interesting, but not real. Later movies came closer: The Exorcist, The Omen — these monsters looked a little more like they could be hiding under my bed—but not really. I believe this is what sparked my interest in human psy- chopathology and extreme abnormal psychology. I wanted to know what real monsters were capable of.

For it’s the people who walk among us that strike fear into our hearts. Not the seven-foot tall hulk with bolts in his neck, sewn together with leftover parts from the graveyard—it’s the normal-looking scrawny kid who works at the chocolate factory, brings people home, and desperately clings to the idea they might not leave this time. And then eats them. It’s not the half-man, half-wolf that howls at the full moon and scours the night for victims—it’s the chubby ex-shoe salesman turned contractor, the part-time performing clown, who lures a parade of young, unsuspecting victims to his home. And then buries them in his crawl space.

These are the monsters of real life. This is what real nightmares are made of. In a 1993 New York Times interview, prolific true-crime author Jack Olsen


x Preface

we took a field trip to Holmesburg Prison, and I’m 19 years old and we get inside and I see all these guys who look just like me. I thought that criminals looked different. And this is what I attribute my interest in crime to.

I start every book with the idea that I want to explain how this seven or eight pounds of protoplasm went from his mommy’s arms to become a serial rapist or serial killer. This is my drive and my compulsion. I think a crime book that doesn’t do this is pure pornography.

I had the honor of discussing such issues with Mr. Olsen in 1997. He told me how much he liked my original book about serial murder and said it “was one of the clearer voices” on the subject and taught him plenty. This is high praise from an author I respected immensely. I’d hoped to have Mr. Olsen pen a foreword for this project, but sadly we lost him in 2002. He will be missed. I did need, however, to restate his position about curiosity based on that “seven or eight pounds of protoplasm.” I share this compulsion.

This book is a continuation—a 2012 perspective on an idea I developed in my first book, The Psychopathology of Serial Murder: A Theory of Violence. It seems the concept stands today, with over a decade’s worth of additional information and feedback. In addition, the perspective of this book, unlike those that cover the general subject of serial murderers, is to look specifically at the psychological underpinnings of these monsters that walk among us. The behaviors of these creatures are actually consistent enough to identify, and the goal is to pin down a developmental process that creates them.

The suggestion and presentation of an original theory is, at best, optimistic and ambitious. To attempt to explain a phenomenon such as the psychopa- thology of the serial killer could easily be described as overwhelming. How- ever, that is the intent of this book, as it was 15 years ago.

The reader must be aware that this book will by no means insinuate an explanation that could be carved in stone. The theory must be considered a starting point, a conclusion based on a limited amount of available knowl- edge; something to be reexamined and rethought with the passage of time and accumulation of information. Thus, this book continues that process.

The intent is to observe the available information regarding the serial killer, to dissect and apply the consistencies, and to develop a model of pathology. Observed will be clinical viewpoints, existing theory, socio-environmental in- fluences, and actual case histories. All these factors and more are critical to this analysis and will contribute to the thinking about this subject.

The serial murderer is examined in the context of the fourth edition, text revi- sion Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV-TR ), the reference published by the American Psychiatric Association. This is not to say that this book speaks only to those in the arena of psychology; quite the contrary. The book encompasses the disciplines of sociology, history, biology, psychology, and law enforcement, to name a few, and attempts to reach anyone interested in the development and the impact of this particular offender on our society.

Preface xi

This book is organized as a review of current clinical perspectives that could be applied to the psyche of the serial killer (Chapter 2); a review of the idea behind biological bases for violence, criminal behavior, and serial mur- der (Chapter 3); a discussion of sociological observations and environmental factors in the killers’ backgrounds (Chapter 4); a discussion of the synthesis of a preliminary theoretical model of pathology (Chapter 5); the analyses of eight case studies in the context of prior assumptions (Chapters 6 and 7); a resulting analysis of an etiological theory (Chapter 8); a fascinating, frank conversation I had with a confessed serial killer sentenced to death row and his insights (Chapter 9), and a conclusion (Chapter 10) with observations and suggestions. Future research is also considered.

The reader should note that references to various serial killers and related nonserial cases will appear throughout the text. For those unfamiliar with a particular case, a brief synopsis of each offender appears in alphabetical order in the Case Briefs of Appendix A. Therefore, each individual will not be foot- noted; they are easily referred to in the appendix.

The reader should also note that terms in this book are by no means uni- versal. Various writers have very specific usages for concept terms such as dissociative and deviance, which very well may not agree with others’ usage. Several forms of media use certain terms in a completely generic manner, to the point of losing their intended distinctions. For example, many newspapers and other media continue to use the term mass murderer in reference to serial killers, whereas those who study these individuals clearly do not find the terms interchangeable.

Therefore, the reader should direct his or her attention to the Glossary in Appendix B to clarify the use and intention of many of the terms used in this book. They are specifically used within the context of this book’s perspective and do not intend to insinuate a universal acceptance of their use.

The reader of this new volume should also be aware that while there are many new and current references, there are a number of older citations of studies and research done many years ago. Some are essential to the historical context and the discussion at hand; many were produced around the same time frame a certain offender was found out and prosecuted; others are classic references that remain important and relevant. I would actually call them es- sential, when discussing a narrowly viewed and examined subject such as the serial murderer and theories of violence and criminology. The reader should be assured that this work, while retaining much of the classic contributions of the genre, has clearly been reexamined in light of new study, theory, and science.

Clearly, theory about serial killer development will continue to rage. Argu- ments of guilt and innocence will continue, as in the cases of Wayne Williams, Albert DeSalvo, and Lucy de Berk. Over the years, long-established kill totals evolve as they have with the 2011 victim analysis of John Wayne Gacy. Even the identities of some killers, as famous as the Zodiac Killer and Jack the Rip- per, are unknown. “Nobody will ever know—I am as mystified now as I was

xii Preface

then,” said officers in the Ripper case, according to Honeycombe (2009). I’ve been lucky enough to view the Black Museum at Scotland Yard, and while some I spoke to were reasonably sure of their belief of Jack’s identity, others still did not agree. I just hope this book can aid the readers in making their own informed opinions about these debates and many more.

Maybe we can yet capture the real-life monsters they can’t quite convert to the movie screen.


The production of a new book is impossible without a host of great friends and respected people who offer input, guidance, and support.

To my friend Cathy Clevenger, my resident attachment disorder expert and long-time professional dealing with the most high-risk young offenders, a great amount of thanks for years of teaching knowledge, expertise and shared experiences, and a fine contribution to this project.

Michael Wilt and Valentina Tursini both contributed greatly to the final stage of making this new book possible. Michael for his help at the beginning and Valentina’s professional and tireless efforts in dealing with both my fuzzy proposal and endless questions throughout. And of course Beth Ptalis for tak- ing us to the finish line.

Kate Vernor, for suggestions and references on the research side. Professor Scott Culhane of the University of Wyoming and Commander

Ron Freeman of Duquesne University, for unselfishly offering some terrific research material, and Ron: thanks for the fine quote.

Great thanks to Jessica Senn, who graciously offered her expertise on the line art and figures.

I really should acknowledge Rick, who provided personal insight and an honesty about some difficult issues that must be recognized. These things are rarely discussed in this way.

I still must continue to acknowledge the assistance of those who made contributions to my previous book, without which this work would be impossible. Great thanks still go out to: Karen Kirkendall, Joel Adkins, Ron Ettinger, Karen Klainsek, Judy Rodden, Kim Egger, Dale Lael, Mike Giannangelo, Keith Hanson, Danielle Waller, Bob Craner, Ken Daugh- erty, Irene Kelly-Pasley, and my friend, mentor, and colleague, Dr. Steven Egger.

xiv Acknowledgments

And a massive, heartfelt thanks to my amazing wife Kathy Giannangelo, who not only provided unwavering support when I truly thought I’d never get to take a fresh look at this project, but also took on some difficult proof- reading and provided additional creative input. This is not to mention her essential IT skills and technical expertise that saved me endless hours of kick- ing computers and developing further alternate forms of linguistic profanity.

Part I Part I

The Development of a Serial Murderer

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Introduction: An Identifi cation of the Offender


We continue to be haunted with the fear that people will remem- ber this killer, even glorify him, for the slaughter of our children.

—Families of victims of Danny Rolling

As I peered through the thick glass separating us, I caught a glimpse of my own reflection. I had a look of rapt attention, as if I could not wait to see what happened next. For a moment I was aware of the sad, grey prison walls enveloping us and the stark bleakness of the surround- ings. I glanced down and noticed I was literally on the edge of my seat, anticipating what he was about to say, in what direction he might go. My seat was quite a bit different than the stool he sat on, with hardware for shackles attached.

He explained to me why he killed so many women in a short pe- riod of time. He quickly agreed he’d do it again if given the chance. He debated whether he should really be considered a psychopath. As he spoke, I couldn’t help but think there was nothing about him that would make me consider him a threat if we were on the outside. He tried to understand what would take him from an adventurous young man to what people regarded as a monster.

I’m still trying to understand.

4 Real-Life Monsters

Serial murder. Rarely a day goes by without a fleeting reference to this expres- sion. It’s heard on television, in movies, in newspapers, and in everyday con- versation. More average Americans know who Jeffrey Dahmer is than Jonas Salk. Everybody’s heard of serial killers.

“We fear evil, but we are fascinated by it. We reject the ‘Other’ as different and dangerous because it’s unknown, yet we are thrilled by contemplating sexual excess and violations of moral codes by those who are not our kind” (Zimbardo, 2007, pp. 4–5).

But who are they? What makes a handsome, normal-appearing young law student murder dozens of women? Why does a mild-mannered chocolate fac- tory worker kill, dismember, and cannibalize individuals he found attractive, who came home with him on particular nights? What makes a serial killer kill? More important, what makes him or her in the first place?

The subject of serial murder has been the focus of an inordinate amount of attention, research, debate, and often exploitation in recent years. The sensationalism and emotional response the subject evokes make it an easy target for articles, movies, true crime books, yellow journalism, TV tabloids, and other money-making paraphernalia ranging from comic books to trading cards. However, sifting through this avalanche of sensationalism does yield a lining of true research and scientific study that might suggest answers to just who the serial killer is, and why.

SOME DEFINITIONS OF SERIAL MURDER The first difficult question is, who exactly is a serial killer? The Federal Bu-

reau of Investigation (FBI) has one definition; various theorists have others. Is it just someone who kills more than one person? A hit man? Is a merce- nary a serial killer? What about an abortion doctor? The more the question is asked, the more answers there seem to be.

Credit for the term “serial killer” is given by Ramsland (2005b) to Richard Hughes in his 1950 book, The Complete Detective . Robert Ressler, a long- time FBI profiler, is often credited with common usage of the term, after hearing the term series in use in England regarding a pattern of crime. He also felt this was comparable to serial adventures in the movie industry (Vronsky, 2004). Different writers and theorists have also quoted other examples of the use of the term in the 1960s and 1970s, while even more have claimed the credit themselves.

Many definitions of serial murder are established by specific parameters, such as victimology, geographic location, and killer–victim relationships. Some feel serial killers must reveal a certain pattern or their victims must rep- resent deeply rooted symbolism. Other theories include sex and dominance.

The FBI states their definition of serial murder, taken from Title 28, Sec- tion 540B of the U.S. Code, describes the killing of a series of three victims or more, “having common characteristics such as to suggest the reasonable pos- sibility that the crimes were committed by the same offender or offenders.”

Introduction: An Identifi cation of the Offender 5

According to Brantley and Kosky (2005), the agency makes no reference to “underlying motivation” and the definition is “intentionally broad” in order “to encompass the full array of serial killers” (p. 28).

In 2011, the FBI’s Behavioral Analysis Unit (BAU) published the results of a 2005 symposium held in San Antonio, Texas, comprised of 135 scholars, government crime experts, and veteran homicide detectives. This group con- cluded that serial murder should be defined by the “unlawful murder of two or more victims by the same offender in separate events.” This clearly broad defi- nition was intentionally designed out of concern that serial murders were being underestimated (Hargrove, 2011). However, this definition would incorrectly include gang killings, murder for hire, and spree killers, to name a few.

Very specific parameters cause some researchers to eliminate some of- fenders from a grouping of serial killers based on, possibly, a technicality. Colin Wilson, referring to G. J. Schaefer, stated, “technically speaking, based solely on his convictions, Schaefer could not be labeled a serial killer” because Schaefer had only been convicted of two killings (Schaefer & London, 1997, p. 1). Wilson apparently rigidly adheres to a three-victim minimum standard. It would be difficult to limit those studied as serial killers based on an arbitrary number of kills actually resulting in conviction.

Holmes and DeBurger (1988) listed distinctions they found within a pat- tern of serial murder. They included almost always a male killer and a female victim; a victim the same race as the killer; a killer whose age is between 25 and 35; no geographic variation in sites; victims of similar status; and a stranger-to-stranger relationship between killer and victim (p. 24). Inasmuch as these variables appeared consistent in their small (44) sample, most of these distinctions are arguable in light of various case histories. For example, while male killer or female victim roles are common, many cases include homo- sexual male killers and victims. A reasonable modification of this assump- tion could be male killers and eligible sexual partner victims. The common assumption that killers and victims are usually of the same race can also be disputed. While the general criminological principles state “murderers and victims look remarkably alike” and “murders tend to be overwhelmingly in- traracial” (Goode, 2008, p. 153), this seems to be more of a reflection of another conventional wisdom, that the likelihood of murder rises along with the level of intimacy between people. However, serial murder is more often a stranger-to-stranger crime, and too many of the cases tend to have unique features, which causes conflicts in painting with too broad a brush.

Eric Hickey, author of Serial Murderers and Their Victims (1991, p. 8), feels a serial killer must be defined in the most general of terms, so as not to eliminate offenders by speculation rather than through verifiable evidence. His definition includes “any offenders who kill over time.” Hickey’s assertion seems plausible for the most part, except that his all-inclusive population is not usable for purposes of this book. Hickey’s demographic approach and breakdown are dissimilar from this book in that there are specific offenders excluded from this consideration, by design. Hickey correctly notes that some

6 Real-Life Monsters

serial killer traits can be eliminated from the definition due to “speculation” rather “than verifiable evidence given the current state of serial murder re- search” (1997, p. 12). The direction of this book is to consider a psychologi- cal theory originally formulated by personal speculation, and then to evaluate its merit in the context of verified evidence.

Steven Egger’s (1990, p. 4) definition of a serial killer states:

a serial murder occurs when one or more individuals (males, in most known cases) commit a second or subsequent murder; is relation- shipless; is at a different time and has no apparent connection to the initial murder; and is usually committed in a different geographical loca- tion. Further, the motive is not for material gain and is believed to be for the murderer’s desire to have power over the victims.

Egger’s definition also includes a specific consideration of the victims, of- fering that they may have a symbolic value and insinuating that they are se- lected often for their perceived vulnerability. He further defines this in his 2002 book, The Killers Among Us , where he explains victims typically “in- clude vagrants, the homeless, prostitutes, migrant workers, homosexuals, missing children, single women, elderly women, college students and hospital patients” (p. 5). The assumptions regarding the serial murderer definition in this book will more closely resemble Egger’s than any other, differing mainly in reduced consideration of victim status and concentration on the killer’s personality, internal motivators, and development. While a certain vulnerable victim is a clear and favorite serial killer target, the sexual interest target is also a substantial one.

The focus here will be on what would appear to be the essence of the phenomenon of this particular criminal. The definition of a serial murderer, which parameters this book will be operating under, will therefore be narrow; much more narrow than most studies of the subject. There will be an attempt to identify a very specific psychological dynamic in theory. Mass murderers and spree killers, for example, are not included, as they appear to involve an entirely different set of psychodynamics.

AREN’T THEY ALL MASS MURDERERS? This is a critical part of this book. It’s routine for the newspapers to refer

to serial killers, spree killers, and mass murderers all in interchangeable terms. However, the focus of this book is to correctly and definitely identify the psychological makeup of the serial killer. Why should we care? That will be discussed in the Conclusion.

The fact is there are very different sets of dynamics at work in each type of offender. While a mass murderer in general language is a person who kills a group of people, in more specific terms he or she is the offender who purpose- fully kills a large group at a single event. George Hennard, who in 1991 drove

Introduction: An Identifi cation of the Offender 7

a truck into a Luby’s restaurant in Killeen, Texas, and then executed as many people as possible with a handgun, is a very different psychological case than a calculated cold-blooded predator like Anthony Sowell. The prototypical mass-murdering school shooters or workplace massacres or a violent rampage by a jilted spouse, such as that of Robert Stewart who shot eight elderly nurs- ing home residents in North Carolina in 2009, bear no resemblance in their very public acts as compared to a long-term patient predator who kills many carefully selected victims over time. A spree killer such as Andrew Cunanan leaving a trail of seemingly random victims behind represents an entirely dif- ferent mind-set than the young photography targets of Rodney Alcala.

Eliminated are murderers of a serial nature who have any financial or other tangible motivation that might render incidental the killing aspect of the crime. Also eliminated from the study is the cult-obsessed type, as the true serial killer—or at least the type this analysis tries to identify—may be drawn to cult activities, but not necessarily. The serial murderer kills because he or she wants to, not because he or she is mindlessly led by a cult. This targeted personality may carry out killings in a serial manner owing to an association with a cult, but not because he or she is merely guided or even controlled by that influence. The specific psychological phenomenon to be identified here is a development of internal factors, owing someone to habitually kill for the implicit thrill, satisfaction, or satiation of the act; or as Herman Mudgett put it: for the “pleasure of killing my fellow beings” (Editors of Time-Life Books, 1992, p. 95). The ultimate control of another human being and the accompanying catharsis are the psychological hallmarks of the individuals to be discussed.

The reader must understand that the focus of this book is to try to identify and characterize the individual who kills for the joy of killing. Unlike Hickey’s broader population, this book will consider a smaller, more focused sample set of data, defined by greater consideration of preliminary information. The examination will be of a group of offenders whose need and motivations to kill appear unencumbered by extraneous variables, such as money or outside influence.

THE PROBLEM OF ESTIMATING NUMBERS The actual prevalence of this type of offender is difficult to pinpoint. His-

torical estimates have ranged from 6,000+ victims a year (McKay, 1985), to 4,000 a year (Lindsey, 1984), to 3,500 to 5,000 a year (Holmes & DeBurger, 1988). Kenna Kiger noted that active offenders have been estimated as low as 30 to as high as 500, depending on the source of research (Egger, 1990, p. 37). Egger later referenced a disagreement between the FBI and the CNN, who reduced the former’s estimate of serial killers between 1977 and 1992 from 331 to 175 after eliminating duplications. An FBI agent quoted in the CNN report guessed at “25, 35, or 40” active at a time, whereas another guessed probably 50–100 (Egger, 2002, p. 68). These figures represent activity in the

8 Real-Life Monsters

United States, as cross-cultural research is extremely limited. There is little agreement, and very little in the way of reliable accuracy in numbers, other than the fact that these killers exist and continue to thrive in our society. Even the aforementioned Texas symposium published in 2011 didn’t attempt to rigidly place a number beyond the fact that serial murder is relatively rare in the grand scheme of murder and that there is a consensus that many suc- cessful killers have gone undetected (Hargrove, 2011). The FBI stated that approximately 2 percent of homicides reported to Violent Criminal Appre- hension Program (ViCAP), on file with the bureau in Quantico, Virginia, are attributed to serial murder. Retired FBI profiler Mark Safarik guessed there were up to two dozen serial killers operating now.

A 2010 USA Today report stated, “during the past four decades, at least 459 people may have died at the hands of highway serial killers, FBI statistics show.” Suspects included as many as 200 long-haul truck drivers, with at least 10 suspects believed to be involved in 30 or more murders. However, the report went on to state it was very difficult to pin down actual serial killings as opposed to other types of crime, including drug trade. Figuring out how old a particular crime is also is challenging. Many victims included prostitutes, a favorite disposable target of serial killers. A highway rest stop would seem to be an ideal spot for serial killers to operate, with prostitutes engaging in high-risk activity and the highway offering an easy-access escape route. Infor- mation continues to be fed to the FBI Highway Serial Killings database, but sorting out the results remains unclear. Still, an agent who oversaw the FBI effort for three years stated, “We seem to have one a week that comes in. . . . They’re out there” (Morrison, 2010, pp. 1, 2A).

In 2011, long-haul trucker John Boyer pleaded guilty to the murder of a woman in North Carolina and confessed, without a hint of remorse, to the killings of women in Tennessee and South Carolina, and was suspected in more (Collins & Dalesio, 2011). Investigators were taken aback by the unbri- dled hatred for women by the man who lived with his mother near Augusta, Georgia. One investigator was greeted in an interview with Boyer by, “What bitch are you here about?”

The media have called attention to the activities of law enforcement agen- cies in apprehending the perpetrators of these sensational crimes. As well, the direct relationship between the media and serial killers is clear. Gibson (2006) concludes that in all cases of serial killing the “interrelationships between se- rial killers, law enforcement, the media and the public are complex,” media coverage influences the killers as well as the investigation, and “serial killers and serial murder cases influence the media” (p. xvii).

Undeniably, these issues are of critical importance and relevance. However, the direction and perspective of this book is psychological, putting forth a blueprint of the development and motivation of the serial killer. Discussed here are some of the current theories commonly applied to this phenomenon. These theories are then combined with admitted intuition and speculative

Introduction: An Identifi cation of the Offender 9

insight to develop and consider a theoretical model of the psychopathology of the serial killer.

VICTIMOLOGY Another key element is, when trying to identify a serial murderer, that

there must be a presence of a certain link to the victims. Victims of a mass murder generally have no connection other than being in the same place (the wrong place) at the same time, such as the victims at Columbine, Richard Speck, Luby’s, or Virginia Tech. A serial murderer, the type that this book attempts to identify as a psychological personality type, generally has a rhyme or reason to his or her victim choice—whether it’s physical, pretty young girls with hair parted in the middle for Bundy, or a general sexual target as with Gacy or Dahmer, or disposable sexual surrogates as with Shawcross, or simply a person engaging in a high-risk personal lifestyle who is an easy target that might not be missed (victims referred to as the “less dead” by Steven Egger), victims of killers like Dahmer, Shawcross, and Anthony Sowell. Generally, a thread that ties the victim pool together can be realized when identifying a serial murderer. Some may be carefully stalked, while others could be simply unlucky, found in the wrong place at the worst possible moment, as in the cases of the Zodiac Killer, Gary Ridgway, and David Berkowitz. Victimology, along with psychological state, is usually how a serial murderer is separated from a mass murderer or a spree killer, and is a critical point within the profile assembled of a particular offender.

DO WE KNOW WHAT WE THINK WE KNOW? Finally, the study of serial murder continues to humble even the most ex-

perienced researcher. I was told by Dr. Steven Egger, as renowned an expert on the subject as there is, that the more one studies this subject, the more comes the realization of how little one knows (personal communication, 1993). Competing theory and additional knowledge continue to confound and blur a topic we would all hope could be much more clear.

In 2003, I clipped an article in the London Guardian about Lucy de Berk, an accused serial killer nurse from the Netherlands (Osborn, 2003). The case was interesting because not only did she appear to kill at least seven patients in an angel of mercy fashion (and as well was suspected in many more), she fit into many serial killer profiles, both in gender and in behavior. Stories of her “compulsions” from her diary fit neatly into commonly held psychological ideas regarding this type of offender’s profile. The FBI published an article in the Law Enforcement Bulletin (Brantley & Kosky, 2005) in 2005, analyzing de Berk’s case in terms of motivation, behavior, and characteristics. In the context of serial murder in general, Lucy’s crimes were viewed as not atypical, especially within the realm of “heath-care worker serial murderers.”

10 Real-Life Monsters

Lucy de Berk’s patients at the hospital in the Hague seemed to unexpect- edly die. Suddenly. A hospital review determined that not only had 8 patients under her care died, but 19 elderly patients had died while under her care in a previous facility. Another died at home after a visit from Lucy. She was ar- rested for the murder of 13 patients in 2001.

In 2002, the District Attorney’s office and the Hague Police Department presented the case to the FBI’s BAU at the National Center for the Analysis of Violent Crime. An on-site review resulted in the eventual expert testimony of BAU personnel regarding the motivation, behavior, and psychological characteristics of serial murderers (Brantley & Kosky, 2005). It was noted that female serial murderers kill those in close proximity, including those within custodial care as in the cases of health care serial murderers. Issues including power, recognition, excitement as well as a reduction of stress and tension were discussed as reasons for health care workers, primarily female, to kill.

In Lucy de Berk’s case, she repeatedly wrote in her diary about giving in to her compulsions. She wrestled with confusion over her lack of feelings or compassion. She strove to understand her self-described “sociopathic person- ality” (Brantley & Kosky, 2005). She stated, “I don’t even know why I am doing it. . . . I will take this secret with me to the grave. . . . Still, I hope I am helping people by this” (Osborn, 2003, p. 13).

The FBI reported de Berk had established a close relationship in the case of every victim and had been seen in the vicinity of them before their deaths. Oddly, Lucy reported deterioration in the patients, which contradicted other nurses’ observations. She had been accused of stealing drugs that happened to be the same ones the victims had been taking. Intoxication of specific drugs was noted in the deaths of at least two little girls.

Lucy was convicted of four counts of first-degree murder for the injection deaths of three babies and an elderly woman and three counts of attempted murder as well as perjury, falsifying a high school diploma, and theft of several books from the prison library. She received life imprisonment. On appeal, she was convicted of seven counts of murder and four counts of attempted murder.

However, after serving six years of a life sentence, de Berk was not only cleared, released, and exonerated of the crimes, she received a personal apol- ogy by the country’s attorney general Harm Brouwer, and a financial set- tlement was discussed (“Court Clears,” 2010). It was determined during a subsequent retrial that much of the evidence, highly speculative statistics of probability, was faulty and other circumstantial evidence invalid.

An assertion by a statistician that the odds of her being present during each suspicious death were 1 in 342 million was debunked. A witness who testified about hearing incriminating statements recanted. Deaths previously ruled suspicious were now deemed not to have signs of being unnatural. The damning words found in de Berk’s diary regarding her compulsions were later explained away as her desire to use Tarot cards, or according to de Berk’s daughter were “pure fiction” written for a novel.

Introduction: An Identifi cation of the Offender 11

Were there serial murders committed in those hospitals in the Netherlands? It is simply impossible to conclude. It is also impossible to ascertain the in- volvement of anyone at that scene at this point in time. Still, the de Berk case is an example that facts and analysis of both concluded cases and theoretical concepts accepted for years may or may not be accurate, and may continue to evolve.

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Clinical Diagnoses and Serial Killer Traits


I actually think I may be possessed with demons, I was dropped on my head as a kid.

—Dennis Rader/BTK

CLINICAL PHENOMENA AND THE SERIAL KILLER Many syndromes and clusters of personality traits as recognized by the psycho- logical community are noted in the literature regarding serial killers. The fol- lowing labels and diagnoses are often assigned to these offenders at some point in their contact with psychologists or psychiatrists, both before and after their crimes. Also, many law enforcement agencies, in studying this type of offender, point to the following characteristics and clinical phenomena in an effort to un- derstand the thought and behavior patterns driving these offenders’ behaviors.

THE ANTISOCIAL PERSONALITY Often, serial killers are described as psychopaths or sociopaths, or in more

widely accepted terminology, as having dissocial or antisocial personality dis- order (APD). According to the Diagnostic and Statistical Manual, Fourth Edition Text Revision ( DSM-IV-TR ) (American Psychiatric Association [APA], 2000, p. 706), the criteria for this disorder includes:

A. Pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 as indicated by at least three of the following:

14 Real-Life Monsters

1. Failure to conform to social norms with respect to lawful behav- ior as indicated by repeatedly performing acts that are grounds for arrest.

2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profi t or pleasure.

3. Impulsivity or failure to plan ahead. 4. Irritability and aggressiveness, as indicated by repeated physicals

fi ghts or assaults. 5. Reckless disregard for the safety of self or others. 6. Consistent irresponsibility, as indicated by repeated failure to

sustain consistent work behavior or honor fi nancial obligations. 7. Lack of remorse, as indicated by indifference to or rationalizing

having hurt, mistreated, or stolen from another. B. Individual is at least 18 years of age. C. Evidence of conduct disorder onset before age 15. D. The occurrence of the behavior is not exclusively during the course

of schizophrenia or a manic episode.

These criteria are particularly relevant to the serial killer, as many such offenders share childhoods colored with demonstrations of behavior con- sistent with criteria for conduct disorder, such as using weapons, physical cruelty to people and animals, forced sexual activity, and fire setting ( APA, 2000 pp. 98–99). Key elements shared by the sociopath or the antisocial per- sonality, and the serial killer are a failure to conform to social norms regarding lawful behavior, physical aggressiveness, impulsivity, lack of regard for the truth, manipulativeness, and most important, lack of remorse or empathy. Remorse is reported by some serial killers after commission of some crimes, but never to the point of their changing their behavior or seeking help, such as Dodd, Nilsen, Dahmer, Bundy, and others.

Causal factors for an antisocial personality include a possible biological pre- disposition (Andreasen, 1984), childhood trauma (shared by the vast major- ity of serial killers), possible neurological factors in the control of impulsivity regarding serotonin levels in the brain, and heredity. The DSM-IV-TR states that APD is more common among the first-degree biological relatives of those with the disorder than among the general population. Adoption studies indicate that both genetic and environmental factors contribute to the risk (APA, 2000, p. 704).

Those diagnosed with antisocial personalities also share deep-seated doubts regarding their own adequacy (Havens, personal communication, 1993). Most antisocial personalities are men, again reflecting serial killer demographics.

It should be noted, however, that it is not enough to simply describe the serial killer as an antisocial personality. The vast majority of the current prison population shares this diagnosis, as well as many average citizens (Politicians? Car salesmen?) who are not incarcerated. Actually, most of us at some time or

Clinical Diagnoses and Serial Killer Traits 15

another could look over the DSM-IV-TR’s criteria and recognize a few quali- ties close to home. This clustering of traits is helpful, however, as it adds to an overall profile and suggests possible consistencies and etiologies, but the criteria should not be overrated.

THE PSYCHOPATHIC PERSONALITY Antisocial, sociopath, and psychopath are not interchangeable terms, as

often commonly used. Psychopath is a far more severe psychological condi- tion in terms of symptoms and treatment. According to Blair, Mitchell, and Blair while 80 percent of U.S. inmates reach diagnostic criteria for APD, only 15–25 percent meet the criteria for psychopathy as established by Hare (Blair et al., 2005, p. 19). Psychopaths and sociopaths are not separately listed in the DSM-IV-TR, nor are they found in the World Health Orga- nization’s ICD-10 classification. Psychopathy was a term used in earlier versions of the DSM but gradually fell under the label of antisocial and is considered basically a synonym of antisocial, describing a subject with a lack of empathy and attachment to others while exhibiting manipulative behavior.

The ICD-10 classification of dissocial identity disorder may be meant to mirror the APD listing, but it does mention a little more in the way of behav- ior, namely that the behavior is not “readily modifiable by adverse experience, including punishment” and a “low threshold for discharge of aggression, including violence,” both characteristics sounding closer to a psychopathic personality. Personality traits listed include amoral, antisocial, asocial, psycho- pathic, and sociopathic (World Health Organization, 2008, p. 345).

This book, however, strongly supports the position that the psychopaths (and sociopaths) are markedly more severe offenders than antisocials, as es- tablished by research on their behaviors. Reportedly the DSM-V, currently under development, will re-examine the character issues that separate them from mere antisocials.

The psychopathic offender appears to be predisposed for predatory vio- lence and is the classic serial killer personality. Indeed, this type of personal- ity was the subject of J. Reid Meloy’s book, The Psychopathic Mind: Origins, Dynamics, & Treatment (1988).

The psychopath, according to Meloy, is a personality incorporating both aggressive narcissism and extended chronic antisocial behavior over time. The personal history of psychopaths shows a trail of used, injured, and hurt people as these individuals tarnish their object world in a continuous effort to build their own fragile sense of self. Robert Hare (1993) noted that psycho- paths “have little aptitude for experiencing the emotional responses—fear and anxiety—that are the mainsprings of conscience” (p. 76).

In identifying the psychopath, the revised Hare Psychopathy Checklist (PCL-R :2nd ed.) (Hare, 2003) measures such traits, most if not all of which are found in the serial killer personality:

16 Real-Life Monsters

1. glibness and superfi cial charm 2. grandiosity 3. continuous need for stimulation 4. pathological lying 5. conning and manipulativeness 6. lack of remorse or guilt 7. shallow affect 8. callous lack of empathy 9. parasitic lifestyle 10. poor behavioral controls 11. promiscuity 12. early behavior problems 13. lack of realistic, long-term goals 14. impulsivity 15. irresponsibility 16. failure to accept responsibility for actions 17. many short-term relationships 18. juvenile delinquency 19. revocation of conditional release 20. criminal versatility

These traits are comparable to those traits found in the antisocial personal- ity, but the checklist goes a step further in identifying internal as well as ex- ternal characteristics. This clustering is similar to ones observed in Cleckley’s classic work Mask of Sanity (1941).

The defining trait of the psychopath has to be considered his or her com- plete lack of empathy, to the point of simply not understanding remorse or the concern for others. He or she may be able to feign remorse and attempt to say the right things, usually through repetition of counseling and time in the system. In 1989, just hours before his execution, Ted Bundy was inter- viewed by Dr. James Dobson in a video shot on Death Row in Florida entitled Fatal Addiction . Much of Bundy’s talk attempted to underline a connection between his development as a killer and an exposure to violent pornography. However, when specifically asked about remorse, his rambling three-and-a- half minute answer sounded like the classic psychopath who was grasping for the words to sound like someone who could convince others of his regret. His words were unconvincingly hollow:

D OBSON : [I]s the remorse . . . there? B UNDY : I know that people will accuse me of being self-serving but

we’re beyond that now, I mean I’m just telling you how I feel . . . but, through God’s help, I’ve been able to come to the point where I’ve, much too late, but better late than never . . . feel the hurt and the pain I’ve been responsible for. Yes, absolutely. In the past few days myself and a number of investigators have been talking about unsolved cases.

Clinical Diagnoses and Serial Killer Traits 17

Bundy went straight from trying to convince the listener he was remorse- ful for his murders to essentially selling his value as someone on death row who could help clear unsolved cases, to discussing violence in the media, people with predisposition like his, kids watching TV at home, and could not help but come across as a person who could not understand the concept of remorse beyond a detached attempt at saying what he thought people might want to hear.

During the penalty phase of his trial, Anthony Sowell took the stand and apologized to his victims’ families, without much explanation. After he was given the death penalty, a juror later stated, “we found it [his statement] to be completely rehearsed, completely condescending, complete lack of remorse.” Another juror reported Sowell winked at her at one point (“Sowell jury: death sentence,” 2011). A surviving victim who saw a headless corpse in Sowell’s house said, “Does he feel shame? Does he feel anything?” (Seewer & Sheeran, 2011).

The psychopath is more frequently and severely violent than the antisocial personality, and the violence continues until it reaches a plateau at age 50 or so, whereas nonviolent activity drops off sooner (Hare, McPherson, & Forth, 1988). The psychopath is generally regarded as untreatable.

A key aspect of the psychopath in regard to serial killers is that the violence tends to be predatory and primarily on a stranger-to-stranger basis. The vio- lence is planned, purposeful, and emotionless. This emotionlessness reflects a detached, fearless, and possibly dissociated state, revealing a lower level of impulses generated by the autonomic nervous system and a lack of anxiety. The psychopath’s general motivation is to control and dominate, and his his- tory reveals no bonds with others.

Sexually, psychopaths continue their grandiose demeanor and are hy- poaroused autonomically, which causes them to be continuously seeking sensation. Their attitude is one of entitlement, not reciprocity. This lack of bonding reflects a lack of emotionality and a diminished capacity for love, where sexual partners are partly objects and are devalued. The psychopath also displays a propensity for sadism (Meloy, 1993). Stanton Samenow once noted that the criminal experiences an “adrenaline rush” by “fantasizing about vio- lence, talking about violence, and behaving violently” (2004, p. 102).

It should be noted that psychopaths tend to “engage in more instrumen- tal, goal-driven homicides,” whereas “non-pychopathic offenders engage in predominantly reactive, spontaneous violence” (Bartol & Bartol, 2008, p. 271). Regardless of the psychopath’s personal goal and lack of empathy, his behavior is planned and purposeful as opposed to emotional and in response to a stimulus.

In 2010, the journal Psychological Science noted a study by University of New Mexico psychologists who observed that psychopaths know the differ- ence between right and wrong, but can fail to weigh the difference when making decisions (Monteleone, 2010). It was observed that the psychopathic inmates studied had demonstrated difficulty in making inferences connecting

18 Real-Life Monsters

negative consequences to risky situations as well as failing to connect required actions or compensations to behaviors an average person would understand, such as putting gas in a car after borrowing it.

Experiments conducted by researchers at the University of Wisconsin-Mad- ison (UW) demonstrated psychopaths behaving in a manner similar to those suffering brain damage, reported in the journal Neuropsychologia (Doherty, 2010). The experiments support the theory that a defect or wiring flaw in a portion of the brain behind the eyes called the ventromedial prefrontal cortex is responsible for psychopathic behavior. This part of the brain has been identified as the origin for emotions like empathy, guilt, and shame. Research involving games played by inmates at the Wisconsin Department of Corrections showed prisoners diagnosed with primary psychopathy who played the games with UW researchers used the same kinds of strategies and made similar decisions to play- ers who had suffered devastating damage, often due to medical conditions such as strokes and tumors, to this portion of their brain. These subjects reportedly had led normal emotional lives until their brains were damaged.

Blair et al. concluded that if an individual’s neurocognitive systems in- volved in the regulation of reactive aggression and emotional learning are impaired at an early age, the individual “will present with the emotional dif- ficulties associated with psychopathy.” Affected areas will include socialization that could result in “elevated levels of instrumental aggression” (Blair et al., 2005, p. 141).

Again, it should also be noted, that the psychopath terminology is com- monly used interchangeably with the possibly more commonly used term sociopath . In the purest of technical considerations, a sociopath is an offender who more likely learned his or her behavior, while the psychopath appears born with the personality. In any case both offenders will look very much alike in the ensuing discussions of this book: marked absence of empathy, manipulative nature, and using other people, an aggressive, predatory pattern of behavior and no regard for consequences.

Both will also display a certain immaturity that seems to go with the psy- chopath or the sociopath, a dimension of the personality seeming to reflect a holding pattern at a particular age of development, which almost explains the narcissistic, selfish, and uncaring perspective. Dr. Betty McMahon described Danny Rolling as “extremely immature . . . there is a great impairment of em- pathy. That is something that tends to come with maturity” (Ryzuk, 1994, p. 388). Rolling said once that “something died” at a very young age and he would always be immature and inadequate (Rolling & London, 1996, p. 9).

BORDERLINE PERSONALITY DISORDER A comparable condition to APD is borderline personality disorder, which

includes a pervasive pattern of instability in interpersonal relationships, self- image, affects, and marked impulsivity. This pattern begins by early adulthood and is present in a variety of contexts, as indicated by the presence of at least five of the following ( APA, 2000, pp. 706–710):

Clinical Diagnoses and Serial Killer Traits 19

1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships charac-

terized by alternating extremes of idealization and devaluation. 3. Identity disturbance; markedly and persistently unstable self-image

or sense of self. 4. Impulsivity in at least two areas that are potentially self-damaging. 5. Recurrent suicidal behavior, gestures, threats, or self-mutilating

behavior. 6. Affective (emotional) instability due to a marked reactivity of mood. 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or diffi culty controlling anger. 9. Transient, stress-related paranoid ideation or severe dissociative


Again, this disorder includes a defective sense of identity and extreme in- stability. The sufferer often views the world and people as “all good” or “all bad” (Baron-Cohen, 2011, p. 55). This description could relate to the large percentage of female serial killers who act as angels of mercy, who attempt to right the world’s wrongs, or who seek revenge and owe the world (or some part of it) a payback. Aileen Wuornos was diagnosed by a prison neuropsy- chologist as meeting all eight of the criteria for borderline personality disorder (Reynolds, 1992).

Although borderline personality disorder is more often (75%) diagnosed in females, it is not exclusively so, as even Jeffrey Dahmer was diagnosed by prison psychiatrists as having features of this disorder (Dvorchak & Holewa, 1991). Arthur Shawcross also exhibited such characteristics, and John Wayne Gacy was described by a forensic psychiatrist, Richard Rappaport, as utiliz- ing borderline personality organization. Rappaport stated that Gacy brought young boys to his home so he could “star in a play scripted by himself,” illus- trating a primitive ego defense common to borderlines: projective identifica- tion (Cahill, 1986, pp. 339–340).

Causal factors in borderline personality disorder include a history of incest or other sexual abuse and a proneness to experience dysphoria, or a general- ized feeling of ill-being, as well as abnormal anxiety, discontent, or physical discomfort, commonly thought to be connected to a problem of the limbic system. Dissociative symptoms may occur during extreme stress. Borderline is approximately five times more common among first-degree biological rela- tives with the disorder than in the general population.

Both APD and borderline personality disorder display gross deviation from normal attachment processes, which results in a disinhibition of violence (Meloy, 1993). The borderline individual will be pathologically attached, whereas at the other end of the spectrum is the antisocial, who is patho- logically detached. Pathological attachment development issues often result in personalities that are criminal, and exhibit traits of the sociopath or the psychopath.

20 Real-Life Monsters

DISSOCIATION Another phenomenon usually considered in the psychology of the serial

murderer is the dissociative state or disorder. Dissociation (Egger, 1990) is the lack of integration of thoughts, feelings, and experiences into the stream of consciousness. In other words, it is a mental separation from the physical place of an individual. Dissociation has been cited as an example of spontane- ous self-hypnosis (Bliss, 1986, p. 166). The phenomenon has been used to describe peoples’ reactions to various traumatic experiences, as well as a pre- cursor to pathologies described in the DSM-IV-TR, such as fugues, amnesias, depersonalization, dissociative identity disorder (formerly multiple personal- ity disorder), and posttraumatic stress disorder (PTSD).

The DSM-IV-TR (2000) describes general dissociative disorders as a dis- ruption in the usually integrated functions of consciousness, memory, iden- tity, or perception (p. 519). Disorders include depersonalization disorder, with criteria such as experiencing a feeling of detachment from, and as if one is an outside observer of, one’s mental processes or body, like one is in a dream. This statement has been made by many serial murderers.

Morton Prince (1975, p. 291) referred to dissociative states as:

a large category of conditions characterized by alteration of the per- sonality. In this category are to be found various types of alteration, some normal and some abnormal, all due to the same processes and mechanisms and therefore fundamentally resembling one another, in that they are all types of depersonalization and repersonalization from the standpoint of the modern conception of the structure of the per- sonality. Specifically, these types are known as sleep, hypnosis, fugues, trance, somnambulisms, multiple personality, etc.

Causality regarding dissociative states includes severe childhood trauma and some evidence of a physical predisposition. Many of those who experi- ence dissociative states are of above-average intelligence, another trait found in many serial killers.

Literature involving serial killers and the possible presence of a dissociative state is extensive:

Jeffrey Dahmer : He couldn’t embrace. He couldn’t touch. His eyes were dead.

(Dvorchak & Holewa, 1991, p. 32)

Ted Bundy : I looked up at Ted and our eyes locked. His face had gone blank, as though he was not there at all.

(Kendall, 1981)

Clinical Diagnoses and Serial Killer Traits 21

Bundy himself stated after a murder he would be coming out of a hor- rible trance or dream.

(Dobson, 1989)

Dayton Leroy Rogers : He seemed to be slipping in and out of a fantasy state [while calling the victim someone else’s name] . . . he was all- consumed by the deep mental state he was in.

(King, 1992, pp. 30, 38)

Wayne Nance : He [the victim] looked him straight in the eye. He saw nothing: no glee, no remorse, just a dead gaze.

(Coston, 1992, p. 313)

Bobby Joe Long : It was like a dream me doing it.

(Norris, 1992, p. 125)

Even beyond the serial killer, violent crime continues reports of what would seem to be dissociative states. An Indiana teenager who strangled his 10-year-old brother told his girlfriend he wanted to be just like a fictional TV serial killer and fantasized about killing people since the eighth grade. Andrew Conley described the murder as “watching the murder from outside himself” (Wilson, 2010). A Jamaican American mass murderer on Long Island, Colin Ferguson shot and killed 6 and wounded 19 more while being described as “he had a blank look on his face” (Ramsland, 2005a). In Kansas City, a woman convicted of killing an expectant mother, cutting the baby from her womb and stealing the child, reported being in a dreamlike state during the murder (Duclos, 2008). In 2011, Levi Aron admitted to killing an eight-year- old and dismembering him. Later, he was described in a psychiatric evaluation as, “his mood is neutral, practically blank” (“Levi Aron,” 2011).

It should be noted that it’s not uncommon for defense attorneys to con- coct insanity defenses centered around offenders who don’t remember com- mitting an offense. Dissociative states should not be confused with psychotic or delusional episodes or hallucinations. Still, many of these reports of disas- sociation are plausible especially in the cases of serial killers and others when the reports are made by witnesses’ observations.

These episodes indicate a certain level of dissociative process, albeit on a minor scale. Usually, the process does not appear as a full-blown dissociative disorder, such as a psychogenic fugue state or multiple personality disorder and does not enter into the psychopathology of the serial killer. These disor- ders have not been documented or confirmed with any frequency (if at all) and are often the basis for an attempt at malingering or are used as the basis for an insanity defense (e.g., Bianchi, Gacy).

22 Real-Life Monsters

Drawing a parallel between a psychopathic personality and the dissociated demeanor of the serial murderer, Meloy (1992) noted that “psychopathy is, among other things, a disorder of profound detachment.” He added, “from this conscienceless, detached psychology emerges a heightened risk of vio- lence, most notably a capacity for predation” (p. xvii).

DOUBLING The discussion of dissociation leads to mention of a recent theory in the

psychology of rationalizing killing, that of doubling. Robert J. Lifton, in The Nazi Doctors (2000, p. 418), refers to doubling as:

the division of the self into two functioning wholes, so that a part-self acts as an entire self. An Auschwitz doctor could, through doubling, not only kill and contribute to killing but organize silently, on behalf of that evil project, an entire self-structure (or self process) encompassing virtually all aspects of his behavior.

This self process could easily be the phenomenon exhibited when a killer appears to be in a different or detached state, watching what is going on rather than being the direct participant, thus removing himself or herself from the feelings and responsibilities of murder. Lifton speaks of the benefits of doubling, including the connection of the two selves. This connection could allow serial killers to put on a mask of sanity when not participating in crimes, as well as to avoid guilt, which might otherwise be utilized in a typical anti- social personality. Finally, the unconscious dimension of doubling takes place largely outside of awareness, allowing an alteration of moral consciousness. The serial killer who attaches critical importance to his or her acts, and is driven by the fantasy and then the act, can incorporate those acts through this unconscious dimension. It is an active psychological process, a means of adaptation to extremity (pp. 418–430). Robert Ressler, veteran profiler for the FBI, has stated “psychopaths . . . are known for their ability to separate the personality who commits the crimes from their more in-control selves” (1992, p. 154). This sounds very much like Lifton’s principles.

James S. Grotstein speaks of the development of a “separate being, living within one that has been preconsciously split off and has an independent ex- istence with independent motivation, separate agenda, etc.” and from which can emanate “evil, sadism, destructiveness or even demoniacal possession” (1979, pp. 36–52). He attributes its development to those elements of the self that have been artificially suppressed and disavowed early in life.

The phenomenon of doubling appears to have been observed even by Freud (1938), who coined the term splitting to identify dissociation in re- lation to repression. This was further specified by Kohut (1971, pp. 176– 177, 183) by conceptualizing vertical, rather than horizontal, splits in the psyche, noting the “side-by-side existence of cohesive personality attitudes

Clinical Diagnoses and Serial Killer Traits 23

with different goal structures, different pleasure aims, different moral and aesthetic values.”

According to Lifton, doubling can include elements considered character- istic of sociopathic impairment, such as a disorder of feelings, pathological avoidance of a sense of guilt, and resort to violence to overcome a masked depression. Murderous behavior may thereby cover a feared disintegration of the self, a concept that appears so critical and so damaged in the view of a serial killer.

NARCISSISTIC PERSONALITY DISORDER The DSM-IV-TR describes the narcissistic personality as that having a per-

vasive pattern of grandiosity (in fantasy or behavior), with need for admira- tion and a lack of empathy. The pattern begins by early adulthood, and is present in a variety of contexts, as indicated by at least five of the following (2000, pp. 714–717):

1. Has a grandiose sense of self-importance. 2. Is preoccupied with fantasies of unlimited success, power, brilliance,

beauty, or ideal love. 3. Believes that he or she is special and unique and can only be under-

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