Ronson details his attendance at a Scientology banquet at L. Ron Hubbard’s former estate. Ronson sat beside Tony Calder, former Rolling Stones manager. Lady Margaret McNair, who heads the UK’s Citizens Commission on Human Rights, mocked disorders proposed for DSM-V, including Intermittent Explosive Disorder and Internet Addiction. While Ronson found the CCHR dismissive of real suffering, he suspected they had identified a genuine problem: excessive diagnostic labeling.

Ronson traces his revelation at the Scientology banquet to Robert Spitzer, a psychiatrist who spent his career codifying diagnoses. Spitzer’s mother underwent ineffective psychoanalysis throughout his childhood, fueling his distrust of the field. In 1973, psychologist David Rosenhan tested psychiatry’s reliability by having eight sane people feign hearing three simple words and gain admission to mental hospitals. Later, when a hospital challenged him to send more imposters, staff reported identifying 41; Rosenhan revealed he had sent none.

Spitzer took over DSM-III editing in 1974, aiming to minimize subjective judgment with symptom checklists. During chaotic meetings from 1974 to 1980, committees proposed disorder names and criteria while Spitzer typed them into what became a 494-page manual. New categories included PTSD, autism, and bipolar disorder. Psychopathy was replaced with antisocial personality disorder after a dispute between Hare and sociologist Lee Robins.

Ronson’s further research has revealed that field testing suggests that more than half the population could meet criteria for a mental disorder. DSM-III became a bestseller, spurring a pharmaceutical boom as companies developed medications for millions of newly diagnosable patients. Psychiatrist Gary Maier likens aggressive drug representatives to street dealers.

Ronson also spoke to Allen Frances, Spitzer’s successor, who acknowledged that his and Spitzer’s work had inadvertently created false epidemics of autism, ADHD, and childhood bipolar disorder. Adding the milder “Asperger’s” diagnosis sent reported autism rates from one in 2,000 to one in 100. Ronson notes that the childhood bipolar surge proved more harmful. Professor Ian Goodyer and other international experts have insisted the condition does not exist in young children, yet large numbers of American children continue to receive the diagnosis.

Curious to know more about the veracity of the pediatric disorder, Ronson visited Bryna Hebert in Rhode Island, whose son Matt was labeled bipolar at age four after a tantrum over pretzels. The diagnosis came from a unit run by Dr. Joseph Biederman, later accused of promoting drugs made by Johnson & Johnson, which funded his research. Matt and his sister, Jessica, have taken numerous medications for a decade. From child psychiatrist David Shaffer, Ronson learned that these children often have “ADD” or other mental atypicalities but are not bipolar; the misdiagnosis can entail severe lifelong consequences, including medication side effects and psychological burden.

When discussing incorrect diagnoses, Bryna told Ronson about a foster child misdiagnosed as bipolar because their symptoms from sexual abuse matched a checklist. Ronson later asked Spitzer about medicalizing normal behavior, who, after a long silence, conceded that some DSM-III categories may have been mistakes.

Ronson concludes the chapter with the story of four-year-old Rebecca Riley’s death in December 2006. Diagnosed bipolar at age three by Dr. Kayoko Kifuji, a follower of Biederman’s approach, Rebecca was prescribed 10 daily pills. One night, her parents gave her pills to help her calm down and to keep her quiet, only to find Rebecca had died in her sleep. Her death was ruled an overdose, and her parents were convicted of murder. Her mother later said Rebecca was probably just hyperactive.

Ronson returns his attention to Being or Nothingness and the story of Tony at Broadmoor. More than a year after first encountering the mysterious Being or Nothingness book, Ronson received an excited call from Tony, who invited him to a release tribunal at Broadmoor’s DSPD unit and asked to be identified by his real name. At The Paddock Centre, Ronson observed the high-security facility housing hundreds of psychopaths, including Robert Napper and Peter Sutcliffe. He met Professor Anthony Maden, Tony’s chief clinician, who seemed in good spirits despite the day’s unusual activity and engaged Ronson in conversation about Tony’s case.

When Ronson suggested Tony’s desire to be named reflected the Hare Checklist trait Grandiose Sense of Self-Worth, Maden agreed. Before the tribunal, a magistrate asked if Ronson was a Scientologist; he clarified that while the CCHR helped him access Broadmoor, he was not a member. Brian from the CCHR arrived to support Tony, who appeared on crutches, joking that guards had beaten him before admitting he broke his leg playing football.

The tribunal lasted only minutes and ordered Tony’s release from Broadmoor, either to a medium-secure facility or directly to the community within three months. Tony gave Ronson psychiatric reports detailing a traumatic childhood defined by his mother’s abuse and addiction to alcohol, and an unstable home life.

In a further conversation between Ronson and Maden, Maden criticized Hare’s tendency to discuss psychopaths as if they were a separate species, noting Tony had both psychopathic traits and endearing qualities. He emphasized that the PCL-R is imprecise, as very different people can score identically. Tony’s future, Maden said, was in his own hands.

Months later, Tony called Ronson from Bethlem Royal Hospital, complaining he had gone from the frying pan into the fire and was surrounded by more dangerous inmates than at Broadmoor. When Ronson mentioned meeting Emmanuel “Toto” Constant, a Haitian death squad leader who said that making people like you is purely manipulative, Tony was genuinely shocked, saying he had never thought that way; Ronson reflects that Tony lacks a core psychopathic trait. In January 2011, Tony was released from Bethlem.

Ronson details his final meeting with Hare at Heathrow, during which Ronson reported Maden’s criticism of Hare’s work. Hare defended his language as clinical shorthand, comparing psychopath to hypertensive, and attributes such criticism to left-leaning academics uncomfortable with labels. He conceded that his gut feeling was that psychopaths might be fundamentally different than other typical individuals, though this remains unproven. Reflecting on his evolving regard for Hare’s work, Ronson admits becoming power mad as a psychopath-spotter.

Weeks after his meeting with Hare, Ronson received a package from Sweden: a copy of Being or Nothingness from Petter Nordlund, the book’s creator whom Ronson had previously tracked down. A few days earlier, Nordlund had sent an email to Ronson warning that something would arrive in the post and that after the next day, he (Nordlund) would no longer communicate. During this brief window of question-asking opportunity, Nordlund explained the book’s structure—21 printed pages and 21 blank pages, to represent being or nothingness. Ronson emailed an apology for having dismissed Nordlund as merely eccentric, now seeing how obsessions can produce interesting work. Inside the book he found a handwritten card wishing him good luck.