The book opens with a curious incident: scientists and scholars in various parts of Europe receive a book titled Being or Nothingness, which consists of a collection of largely unintelligible aphorisms. One of the scientists gets in touch with Ronson, and he attempts to figure out what’s going on. The answer, he eventually discovers, is that a harmless crazy person is mailing intellectuals copies of this book. There’s no rhyme or reason to it, but the intellectuals want to find both a rhyme and a reason. This investigation leads Ronson to look into the idea of madness and whether it’s legitimate, and the only group that will talk to him about this question is the Church of Scientology, which introduces him to a man named Tony who’s been locked away in a psychiatric hospital for years a la R.P. McMurphy in One Flew Over the Cuckoo’s Nest. The reason he hasn’t been let out is that he’s been diagnosed as a psychopath, a condition considered incurable.
Intrigued, Ronson interviews the creator of the test for diagnosing psychopathy, Bob Hare, and he also learns how to diagnose psychopaths himself. The result is that he starts seeing psychopaths more or less everywhere. He interviews two potential psychopaths—one a CEO responsible for downsizing the Scott Paper company and leaving many people jobless, the other the leader of a paramilitary group responsible for the violent deaths and torture of supporters of Jean Bertrand Aristide in Haiti. He also reflects on conspiracy theorists and the possibility that he is, himself, a psychopath, before examining the DSM-III and DSM-IV, as well as the affect they have had on the over—and misdiagnosis of children with problems like bipolar disorder and autism. Overall, the book raises many questions about the legitimacy of diagnostics, and Ronson does an exemplary job of putting pressure on positions from both sides of the debate.