True crime TV shows, podcasts, and books love to explore the minds of serial killers. To perform such heinous acts a person must be “insane,” “crazy,” and “mentally unstable.” Over time, the “schizophrenic serial killer” became the monster behind many of these crimes. But is it true?

Where did the stereotype of serial killers having schizophrenia come from? When was schizophrenia first considered to be a violent mental illness? What’s the truth to the myth of the schizophrenic serial killer?

In this episode of Inside Schizophrenia, host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard track down when schizophrenia first became associated with violence and how the myth grew.

They are joined by guest Dr. Ann Wolbert Burgess, a pioneer in the assessment and treatment of victims of trauma and abuse who helped shape the FBI’s behavioral analysis methods in her prolific study of the criminal mind.

Warning: this episode of Inside Schizophrenia contains graphic content and offensive language about people with schizophrenia that some may find upsetting.

Professor Ann Wolbert Burgess, Doctor of Nursing, APRN

Ann Wolbert Burgess, D.N.Sc., APRN, FAAN, is an internationally recognized pioneer in the assessment and treatment of victims of trauma and abuse, and author of A Killer by Design: Murderers, Mindhunters, and My Quest to Decipher the Criminal Mind. She has received numerous honors including the Sigma Theta Tau International Audrey Hepburn Award, the American Nurses’ Association Hildegard Peplau Award, and the Sigma Theta Tau International Episteme Laureate Award. Her courtroom testimony has been described as “groundbreaking,” and she has been called a “nursing pathfinder.”

Her research with victims began when she co-founded, with Boston College sociologist Lynda Lytle Holmstrom, one of the first hospital-based crisis counseling programs at Boston City Hospital. She then worked with FBI Academy special agents to study serial offenders, and the links between child abuse, juvenile delinquency, and subsequent perpetration. Her work with Boston College nursing colleague Carol Hartman led to the study of very young victims and the impact of trauma on their growth and development, their families and communities. Her work continues in the study of elder abuse in nursing homes, cyberstalking, and internet sex crimes. She teaches courses in Victimology, Forensic Science, Forensic Mental Health, Case Studies in Forensics and Forensic Science Lab.

Rachel Star Withers

Rachel Star Withers creates videos documenting her schizophrenia, ways to manage and let others like her know they are not alone and can still live an amazing life. She has written Lil Broken Star: Understanding Schizophrenia for Kids and a tool for schizophrenics, To See in the Dark: Hallucination and Delusion Journal. Fun Fact: She has wrestled alligators.

To learn more about Rachel, please visit her website, RachelStarLive.comm.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To learn more about Gabe, please visit his website,

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Warning: this episode of Inside Schizophrenia contains graphic content and offensive language about people with schizophrenia that some may find upsetting.

Announcer: You’re listening to Inside Schizophrenia. Hosted by Rachel Star Withers, an advocate who lives openly with Schizophrenia. We’re talking to experts about all aspects of life with this condition. Welcome to the show!

Rachel Star Withers: A common stereotype is the schizophrenic serial killer, and we are not here on this show to feed that stereotype, but to dissect it, because something that you’ll learn with us today is that it comes from a very specific point in time. Our goal with this episode is to give you talking points to dispel the myth of the schizophrenic serial killer. Where did the stereotype of serial killers having schizophrenia even come from? When was schizophrenia first considered to be a violent mental illness? What’s the truth to the stereotype of the schizophrenic serial killer? We’ll be answering these questions today on Inside Schizophrenia, a Healthline podcast. I’m Rachel Star Withers, your host here with my great co-host, Gabe Howard. Joining us later in the episode is a pioneer in the assessment and treatment of victims of trauma and abuse who helped shape the FBI’s behavioral analysis methods in her study of the criminal mind, Dr. Ann Wolbert Burgess.

Gabe Howard: I’m super excited about her interview because of her mostly fictional portrayal on the Netflix series Mindhunter. But they sort of did a dramatized version of the work that she and other FBI profilers and analysts did during that time. And it was just incredibly fascinating. She’s written so many books, so she’s an excellent person to talk to about this phenomenon. But to get us started, that’s a little later in the episode, I want to say that I believed I believed that people with schizophrenia were dangerous. Before I was diagnosed with bipolar disorder, before I met people living with schizophrenia, before I became a mental health advocate, I believed all this as well. So, I want to make sure that any of our listeners who are listening know we’re not trying to be mean or say, how could you be so stigmatizing? I did it, too. I believed that people with mental illness were dangerous. I believed all the stereotypes as well. So, I really do have this understanding of how easy it is to follow the stereotype, to believe the myth, and to accidentally start stigmatizing a group of people because, well, really, our society is just kind of set up to perpetuate this. Did you fall into that as well, or did you always know that there was just a lot of hokum involved in these stereotypes and rumors and beliefs?

Rachel Star Withers: The stereotype of the schizophrenic serial killer. I mean, that’s one that’s haunted my whole life. I’ve had people ask me flat out asked me, have you ever killed anyone? Like, well, I don’t think I’d be walking around hanging out with you if I had. But it’s just that’s something that’s ingrained in people. And even for me, I always have felt that it doesn’t matter how much I say, oh, people with schizophrenia are more likely to be the victim of a crime than the perpetrator. That doesn’t take away these infamous serial killers, right? Who had schizophrenia. I assume this all came from a few serial killers, which, yes, had schizophrenia, and that might not have been the case. Pre-1960s, schizophrenia was not seen as a violent disorder. In fact, a 1927 textbook of psychiatry said people prone to schizophrenia are sensitive persons who maintain a childlike facial expression far apart from the usual age, an expression of vagueness, dreaminess. This patient is quiet, serious and shy in school or college. He may never take part in rough gangs. He is a genuine love of nature and is often found alone in the woods and fields. He may be extravagantly enraptured by a beautiful sunset. Oh, my goodness. I have never been described so beautifully.

Gabe Howard: And that is such a far cry from beware, will kill you.

Rachel Star Withers: Yes. I mean, this sounds like I’m going to find these schizophrenics lost in the woods, enjoying the sunsets.

Gabe Howard: I really do get this idea of like running through a field and spinning

Rachel Star Withers: Yes. Yes.

Gabe Howard: Sort of like sound of music, right? Like that. That is. That is what pops into my head as you are reading this.

Rachel Star Withers: Right.

Gabe Howard: Of course, I was born in the 70s, so I never lived during a time where people living with schizophrenia were ever thought of in this manner.

Rachel Star Withers: No.

Gabe Howard: I was born in 1976. So. So yeah, I always got the violent version. Which begs the question where did the violent version come from then?

Rachel Star Withers: Up until the 1960s, schizophrenia patients were pretty much seen to be non-threatening, harmless to society, even. The crimes they committed were like vagrancy, small crimes like that. And, if you recall, Gabe, back in our episode, The Evolution of Schizophrenia Treatments, we actually talked about the eugenics and sterilization movements. They weren’t trying to sterilize the people with schizophrenia because they were dangerous. They were doing it because they thought they were inferior. Danger was not part of it. Something happened very big to make us go from these dream-like child wonderments that are inferior to everybody else to being these homicidal killers.

Gabe Howard: And really to drive this point home. In 1952, the very first edition of the Diagnostic and Statistical Manual, the DSM, which is used to diagnose and is currently on revision five, defines schizophrenia as a psychological reaction characterized by emotional disharmony, unpredictable disturbances and stream of thought and regressive behavior. They were considered non-threatening and harmless. And again, something massive changed. Rachel.

Rachel Star Withers: It started in the 1960s. What else was going on in our country during that time? The civil rights and suddenly psychiatric journals and research articles describe patients whose illness was marked by criminality and aggression. The next part that I’m about to quote, just so we’re clear, I am quoting from these different research articles. They describe black people with schizophrenia as aggressive and violent, hostility and delusional beliefs that their civil rights were being compromised or violated. Growing up as a Negro in America may produce distortions or impairments in the capacity to participate in surrounding culture, which will facilitate the development of schizophrenic types of behavior. There are factors in the Negro culture that predispose them to more severe schizophrenic illness. Suddenly, they needed a reason why black people were dangerous and schizophrenia just kind of felt like, hey, we have these mentally ill people. How can we change schizophrenia to become dangerous? And these are research articles. This is what’s being researched at that time. It even went to the point that two New York psychiatrists came up with a new disorder called protest psychosis, where the black liberation movement has literally caused delusions, hallucinations and violent projections in black men. With all of this, society latched on. They didn’t latch on before when we were when we were forest children, but they latched on to this whole schizophrenic killer. The Federal Bureau of Investigation put out its most wanted list and leading papers and described many of them as gun-toting, schizophrenic killers on the loose. The Chicago Tribune advised readers to remain clear of an armed and dangerous Negro mental patient who was extremely dangerous and mentally unbalanced schizophrenic escapee from a mental institution who had a lengthy criminal record and a history of violent assaults. I mean, that that just sounds like a movie synopsis right there. And a dangerous, escaped mental patient, unbalanced schizophrenic. Like doesn’t that just that reads like a synopsis for a horror movie?

Gabe Howard: It sounds like fiction because it is. And I think about just general stigma that most people understand. And this is that on steroids. African-Americans in the 1960s had a real reason to protest. They had a real concern. They in several areas, they weren’t allowed to vote. There was the whole separate but equal movement. Sincerely, I don’t think anybody within the sound of our voice needs us to recite everything that went wrong in the 1960s when it came to race relations. But this is one that doesn’t get talked about a lot. Rather than address their concerns, we just painted them as mentally deficient.

Rachel Star Withers: And this isn’t just a few like newspaper articles that we’re talking about. The government’s file on Malcolm X actually listed him as a psychopathic personality, inadequate with sexual perversion. They updated it a year later. Subject has asocial personality with paranoid trends pre-psychotic, paranoid schizophrenia. Gabe, what in the world is pre psychotic paranoid schizophrenia?

Gabe Howard: I sincerely have no idea. As I was listening to you talk, I was like, wow.

Rachel Star Withers: One of the hallmarks of schizophrenia is hallucinations and delusions. So, a pre-psychotic version of this. So that wouldn’t be schizophrenia.

Gabe Howard: You’re getting ready to have this. Rachel, sincerely, on a practical basis, that could only be diagnosed in reverse, if that makes sense, right? So, after you have the hallucination, you could decide that the period of time before that would be the pre. Right. I don’t see how you could diagnose it in the moment. You’re getting ready to have a hallucination. You’re getting ready to have a symptom. And of course, remember, this isn’t a doctor who evaluated Malcolm X or who was working with Malcolm X. This isn’t friends and family members. This is literally just a bunch of people watching him at work and deciding this was happening. It’s armchair psychology. It’s irresponsible. It’s terrible. It is terrible. And it is I want to be clear, offensive on every level.

Rachel Star Withers: Absolutely. And what I really want to stress, though, is this is the government. So that’s how deep now that this myth, this stereotype has begun to sink, that the government is calling out these different civil rights leaders to discredit them and pretty much making up diagnoses. Now you’re probably thinking, well, Rachel, okay, that that makes sense with the civil rights. That’s where the violence came from? What about the serial killer part? Well, there used to be something called simple type schizophrenia. And it appeared in the first two editions of the DSM, the Diagnostic and Statistical Manual. And this is how it read. A psychosis characterized chiefly by a slow and insidious reduction of external attachments and interests, and by apathy and indifference leading to impoverished interpersonal relations, mental deterioration and adjustment on a lower level of functioning. This is back when there were different types. And again, this type, simple type schizophrenia only shows up in the first two editions of the DSM. However, a lot of people latched on to it and that kind of became the go to diagnosis for what do we call these serial killers? Because clearly someone who would murder multiple people, who would chop them up, who would do bad things, has to be crazy, has to have a disorder. This one sounds really good. Simple schizophrenia is what they stuck to it. And to be very clear, because I know some people are going to be like, well, Rachel, that was before they knew about personality disorders. No, it wasn’t. No, it was not. It was almost as if we were trying to find the worst sounding thing possible. A world-renowned criminal profiler wrote, the simple schizophrenic never went out of his way to do anything. His method of defensive action was to kill. The simple schizophrenic will always kill first. And then, because he’s curious, he’ll look it over. A simple schizophrenic may kill a woman, but under no circumstances will he ever rape her until she is dead. That is really an intense line there, Gabe.

Gabe Howard: It sounds like conjecture. As I hear it, my bullshit detector goes off like I don’t I don’t think that’s provable as the conclusion and as an emphatic conclusion that these researchers are making out.

Rachel Star Withers: And that’s where everything falls apart because it’s not a psychiatric researcher. These aren’t some type of tests that are being done with a group of people. This is a, again, world renowned criminal profiler saying this. And if you’re the leading one in your field, obviously you’re correct. Right? And it’s scary to think this is what the leading person in that field is saying because it’s very incorrect on multiple levels and it very much stigmatizes and creates a stereotype of the schizophrenic killer.

Gabe Howard: Remember that came out decades ago. And yet the stereotype and the myth that it created still persists to this very day.

Rachel Star Withers: And it’s not just schizophrenia that’s being twisted around. Another word that we’re quite used to is psychopath. Our version nowadays of psychopathy is usually associated with antisocial personality disorder. But to be very clear, psychopath is not a diagnosis. It is not listed in the Diagnostic and Statistical Manual. That’s what makes it dangerous, because most of us in the world assume it is real. And because there’s no exact definition or diagnostic criteria, it can kind of be used however you want, even into mixing other diagnoses. One article I found from Psychology Today, and this is 2014, so not that long ago, federal agents believed one serial killer to have a co-morbid condition schizopathy, a mix of psychopathy and simple schizophrenia. Gabe, that is not real. That

Gabe Howard: That that is not a thing at all.

Rachel Star Withers: That’s not a real thing.

Gabe Howard: It sounds really good, right?

Rachel Star Withers: It does.

Gabe Howard: Like it sounds super scary.

Rachel Star Withers: I mean, co-morbid condition.

Gabe Howard: Wow.

Rachel Star Withers: Yes.

Gabe Howard: And this was reported in a well-respected psychology magazine and website. This is not some fringe Reddit thread with a bunch of Internet trolls making stuff up. This is in a well-respected publication.

Rachel Star Withers: What bothered me most of all, Gabe, was that the article just ends. At no point do they ever even have like a little notation saying this is not a real disorder that they’re talking about. They don’t even correct the fact that simple schizophrenia is no longer a diagnosis. That to me is just wildly irresponsible because whoever was writing the article, I’m like, you knew this. If you work for Psychology Today, I would assume you know the basics of mental disorders. But no attempt is made to correct that interpretation of what that serial killer may or may not have had. It’s completely just a made up, assumed thing.

Gabe Howard: And Rachel, I want to reiterate something that we said at the beginning of the podcast. This is how come when people believe this about me and about my friends like you, I’m not immediately offended because what are they supposed to think? They have heard this from professionals in the field, from respected publications, from leading, you know, doctors, researchers, profiles, criminologists, etc. It’s not some fringe thing that they believe that, you know, popped up on the dark recesses of the Internet Facebook group with a bunch of, you know, haters who also believe that the earth is flat and other conspiracy theories. This is mainstream news coming out of trusted publications and trusted institutions, people who on this very show, we have recommended that you respect and trust. So, again, I really do understand why people believe this. I would actually be more shocked if people didn’t believe it.

Rachel Star Withers: I read a lot of true crime books and different kind of just investigative books. I love it. That’s just one of the things I enjoy doing, Gabe. And every single one on my shelf, I actually have it marked every time schizophrenia comes up. And you would be shocked how many little notations you’ll see in all of my different books. And it made me wonder, okay, maybe they’re going by a different definition of schizophrenia than the Diagnostic and Statistical Manual. So, we’re going to talk about what’s happening here. There are different types of psychology. There’s clinical psychology, and that’s focusing on diagnosing and treating mental disorders. There’s investigative psychology which attempts to describe the actions of offenders and develop an understanding of crime. Criminal psychology, which studies behaviors, motives and the thought processes of criminals. And there’s forensic psychology, which uses psychological principles in the legal field, like assessing a defendant’s mental state and offender rehabilitation. Now, all of these study human behavior, but in completely different ways.

Rachel Star Withers: And it also comes in how they work with people. So clinical psychologists, that’s who most of us are connected with, Gabe. Those are who’s diagnosed us, who’s talked with us. They work directly with clients. Investigative and criminal ones, work with law enforcement agencies. They may not ever talk to the client. They’re kind of looking for many times hypothetical people who did this crime. Let’s make up an idea of who this person is, who we need to go after. And then the forensic psychologists, they’re usually working with the lawyers, the courts, law enforcement and other criminal justice entities. They may or may not ever talk to the person. That’s where things get really kind of squirrely because you have some of these professionals who never actually talk to the person that they’re diagnosing. We do want to point out that, yes, some serial killers have been diagnosed with schizophrenia.

Gabe Howard: That is true, Rachel. And it is important to be honest about that. We’re not saying that 100% of people with schizophrenia are nonviolent, but it’s also important to understand that mothers, fathers, religious figures, coaches, school teachers. I really think that you would be hard pressed to find an occupation or gender or race that did not commit a very violent crime. And yet people do not make that association.

Rachel Star Withers: And when you look at different serial killers, the vast majority that we’ve had here in the United States have been white males. And yet we’re not saying, well, we can’t trust white males because they’re going to all be serial killers. And that percentage is way bigger than how many have been diagnosed with schizophrenia. But yeah, I do want to talk about the fact that some have been diagnosed. First, keep in mind that usually when this happens, it’s when they’re attempting an insanity plea. I can never really trust someone that once you’re caught, suddenly you’re crazy. That seems very odd to me. And I know that has to be very difficult for the courts when that situation comes up. The other issue is that the person may have died when police attempted to capture them and now, they’re being diagnosed after the fact. David Berkowitz, the Son of Sam who claimed a dog commanded him to kill, later admitted to prolific criminal profiler, FBI agent John Douglas, none of that was true. And he’s been known like he’s one of the top ones of, oh, Son of Sam was a schizophrenic.

Rachel Star Withers: And yet he later came out as being like, I might have made that up, you know? And again, he said that after he had been caught. Jeffrey Dahmer, Ted Bundy, John Wayne Gacy, Charles Manson, all of those had personality disorders. Two that definitely did have schizophrenia, Ed Gein, who I always want to point out, had a very traumatic, isolated childhood into adulthood with a very controlling mother. Now, everyone with a controlling mother doesn’t become serial killers. But understand there were multiple things going on there. Another is Richard Chase. He was diagnosed a paranoid schizophrenic and had spent time in a mental hospital. What’s always left out of his story is the fact that his mother weaned him off his medication. And that was when he went on a killing spree. Those two points are always left out. It’s just the assumption of, well, they had schizophrenia. That’s why they did this. And you’re like, no, there was actually a point. Something caused this. In addition to having schizophrenia, their thoughts might have already been distorted, but there was something else that happened.

Gabe Howard: We have to consider the idea that even if you live with schizophrenia, that’s not necessarily the driver of all of your actions. For example, our very own Rachel Star Withers is a stuntwoman. She likes to set herself on fire. She likes to do all of these high-level stunts. It’s not because she has schizophrenia, it’s because she is good at it. And this is an interest of hers and something that she explores in a safe, controlled environment. But even as it’s Rachel, I say, you know, there just is something about hearing that a woman lives with schizophrenia and likes to set herself on fire. That conjures up ideas. It conjures up these ideas that something is going wrong. But in Rachel’s case, those are absolutely false beliefs. They are conjured in the believer’s own mind and there’s no truth to them. We have to apply that same standard when we think about violence and schizophrenia. Did schizophrenia drive the violence or was the violence driven by something else? Or of course, the third option that nobody ever talks about, where’s the co-morbidity? Where’s the intermingling? We’re not saying that schizophrenia played zero role, but is it being given too much of the credit for what ultimately happened?

Sponsor Break

Rachel Star Withers: And we’re back discussing the stereotype of the schizophrenic serial killer. The idea that to commit heinous crimes, a person must be demented, insane, crazy was a common thought process in the 60s and 70s and the FBI brought in Dr. Ann Wolbert Burgess to help shape what became the FBI’s famous Behavioral Analysis Unit. The criminal profilers or mind hunters. And they began to change the way the criminal mind was seen.

Gabe Howard: I have been looking forward to hearing this interview all episode. Let’s go ahead and play it right now.

Rachel Star Withers: Today, I’m talking with Dr. Ann Wolbert Burgess, who is absolutely incredible. She is a professor. She’s a doctor of nursing, an advanced practice registered nurse. And what most people find interesting is that she worked with the FBI and she’s one of the people behind criminal profiling. Thank you so much for joining us.

Ann Wolbert Burgess: Happy to be here.

Rachel Star Withers: Now there’s a million things we could ask you about. Because the show is about schizophrenia, that’s what we’re going to focus on. So

Ann Wolbert Burgess: Sure.

Rachel Star Withers: For our audience out there, who isn’t familiar with you, you were one of the pioneers in crisis counseling and rape trauma and victimology. Correct?

Ann Wolbert Burgess: That’s correct, yes.

Rachel Star Withers: What brought you to that? What made you think this is what I want to study? Because that was not a popular thing in the 70s.

Ann Wolbert Burgess: Well, right. And I didn’t pick it. I happened to be at Boston College and it was my first teaching position and one of the sociologist professors had also just started. Her name was Lynda Lytle Holmstrom. And she was a staunch feminist. And she knew that there was going to be a problem coming along the line with rape. And when I heard what she had found out about these consciousness raising groups and so forth and where women were being raped, I said, well, that might be important from my standpoint as a psychiatric nurse and counseling. So essentially, we started a research program at Boston City Hospital seeing anyone coming in with a complaint of rape. Now, how I got into the offender piece, of course, was that the FBI was at that time tasked with having to train their investigators and agents in the whole issue of rape because it was just coming on the front burner of law enforcement at that time.

Rachel Star Withers: And what had you discovered about the motivation to rape?

Ann Wolbert Burgess: Well, that’s why I was interested in studying the offender, because after listening for over a year with victims, talking about what the experience of being raped was like, I wanted to know what was motivating the offender. And it all had to do with power and dominance rather than sexuality. And that was a major turning point to being able to try to educate people that rape was not even though it happened in a sexual context, it was not really a sex crime. And even they even changed the title of their course at the FBI academy. From sex crimes to interpersonal violence, which, of course, is essentially what any type of assault is from a motive standpoint.

Rachel Star Withers: When you first started working with the FBI, what was the general assumption about why serial killers, serial rapists commit these horrible acts?

Ann Wolbert Burgess: Well, the reason they were studying it is because they didn’t know what was happening. And that was a study or actually the first video that came out was called No Apparent Motive. That people were women were getting murdered and they couldn’t find any necessarily motive. And because we had studied rape and had talked with offenders of rapists, that became the area of how can you call it a sexual homicide when there’s no traditional signs? In other words, that the victim did not have any evidence, if you will, of sexual assault.

Rachel Star Withers: When you’re looking at this, and I think even today, but especially back then, there was the stereotype of, well, crazy people. Only

Ann Wolbert Burgess: Right.

Rachel Star Withers: A crazy person would go after and hack someone up. Only a crazy person would rape a woman and kill her. Talk about that kind of thought process. How did you help change that?

Ann Wolbert Burgess: Well, we never found the crazy person

Rachel Star Withers: [Laughter]

Ann Wolbert Burgess: For one thing, that they weren’t crazy. What we got into that might have been seen as, quote, crazy, as we looked at the crime scene, the because that’s all you have when you go to a homicide, right, is you have a victim. It’s a crime scene. And so, the crime scene could either be classified as organized or disorganized. Now, the organized crime scenes were done by psychopaths, usually very antisocial personality, if you want to get into a diagnostic category. But the disorganized was a and in some ways, and sometimes Bob Ressler would use the term to imply that maybe the person was he would say crazy, but meaning mental, have some type of mental illness or mental disorder. But that that didn’t hold up, that there were multiple kinds of homicides that would start out very organized, meaning it was well planned for the organized offenders. We realized they had been thinking about it, planning it. It’s under the kind of the term of a fantasy that really started in childhood but had nothing to do with a mental disorder, however, and the commission of the crime, something could go wrong. For example, someone could walk in or the victim could get away or that and then the crime scene would become very disorganized.

Ann Wolbert Burgess: But it wasn’t because of the offender’s mental state, but it was because something went wrong in the carrying out of his fantasy of murder. However, there probably were a few that had a genuine disorder, if you want to call it that, of a DSM diagnosis. And I’m thinking of someone like Richard Chase, who was the notorious. What’d they call him? He was a Dracula. He had a delusional system that felt he was losing blood and that he would find birds when he was hospitalized in a mental hospital and he would drink their blood because he thought he was losing blood. So, he had to replace his blood. Now, that clearly is a delusion. That clearly could be put into a category of mental illness. But we just didn’t find, as you said, the crazy people that were going around raping and murdering. We didn’t find that they were mentally ill. They certainly had a personality disorder, if you want to call that. I’m not sure you could call that a mental disorder, but we just didn’t find them to be very crazy in quotes. Is that disappointing?

Rachel Star Withers: I mean, for me, no. For most people, yes.

Ann Wolbert Burgess: [Laughter]

Rachel Star Withers: As someone with a serious mental disorder, no, I want that to be the case. But as someone who likes horror movies, that’s a downer.

Ann Wolbert Burgess: Yeah. Well, yeah. Of course, but certainly for someone with a schizophrenia now, someone like Ed Kemper, I think was classified as a schizophrenic, but he’s still alive and still being talked to. And he certainly was very well-organized and planned his murders very carefully. That was way back in the I don’t know, maybe the 70s when he was at Atascadero, which is a hospital, he went to a hospital rather than a jail or a prison. But he had killed he had shot his grandparents, first went to the hospital. They found him so personable, I guess you could say. Good antisocial personality, of course. And he was let out at age 21 against some psychiatrists’ advice. But he went on to murder coeds and eventually killed his mother and her best friend. He had this kind of interest in killing two people at one time. So now you have sure. You go on the records and he will have a schizophrenic diagnosis. But there was no evidence, certainly in his in his murders. Now, he did have the extremes, but his reason for trying to get rid of fingerprints was so he wouldn’t be identified rather than, oh, that’s just a crazy thing to cut off somebody’s fingers. Do you get the difference?

Rachel Star Withers: Yes. Yes. If anything, it’s a smart thing.

Ann Wolbert Burgess: Well, yeah. And that’s what he would do. And so, they would of course find these armless or handless. I think he also would decapitate them so they couldn’t identify the body for some reason. But, um, and that could be called, oh, this got to be a crazy person running around. I’m sure at the time there were probably headlines like that, but not if you want to look at it strictly from a psychiatric standpoint. No, he wasn’t. He didn’t have any mental illness at that time. He had a very well-designed fantasy that we were able to trace back to very early origin, but had nothing to do with mental illness.

Rachel Star Withers: One thing we hear a lot now is that, okay, it’s a psychopath or a sociopath or a personality disorder. How do you feel about all that, do you think? Like, yes, it’s a psychopath. So, we write them off. Can you fix the psychopath? What do you think?

Ann Wolbert Burgess: Can’t fix a psychopath. No,

Rachel Star Withers: Okay.

Ann Wolbert Burgess: But I do believe in the psychopathic diagnostic. Because there are antisocial people. They do not conform. You know, you’re not. People are not supposed to kill other people. Right? Unless you’re a soldier or you’ve been in some formal way. But they and they have no remorse. They literally have no remorse. So those are the types that I don’t think you can rehabilitate. We looked at patterns of behavior rather than using psychiatric language, because I remember John Douglas, the reason he wanted us, me down there is he said, I can’t go around looking for someone that’s got an Oedipus complex. You know, and he was right, you know, you don’t. But he says, I can sure find someone that’s anti-social or, you know, does bad things or things like that. So, they didn’t want to and we didn’t use any psychiatric language, that I remember. We used behavioral. We looked at behavior.

Rachel Star Withers: Do you think that is connected with mental illness? Psychopathy? Antisocial behavior?

Ann Wolbert Burgess: No, I wouldn’t call it a mental illness. And they don’t in the DSM, they just call it a personality disorder. And I guess we all are some type. I mean, we all grow up somehow and have different traits. But, I do not consider it a mental illness. No, but I do consider it an important label, if you want to call it that, or classification as it does give you direction for what you may or may not be able to do from a treatment standpoint.

Rachel Star Withers: Very interesting. Do you think that schizophrenia in any way predicts violence?

Ann Wolbert Burgess: No, I don’t think the research has shown that either, that people have always been looking for it. Researchers have tried to find some connection between violence and mental illness, or especially schizophrenia, which would be because it’s within the thought disorder type of category. But they did not find a link at all between violence and schizophrenia, mental illness.

Rachel Star Withers: Do you think that any of the serial killers started making up that they were insane after they had been caught?

Ann Wolbert Burgess: I think they do try that. Yes, I think that they do. They will try anything, especially if they’re a psychopath. They’re trying to get away with it. Sure. And that’s why it takes really good experts to be able to do the interview and to cut through that.

Rachel Star Withers: From all of your experience, your knowledge, what do you think could help the situation? Is there anything that, like the normal person can do?

Ann Wolbert Burgess: Well, I think the important thing is that you look at the warning signs. What are the red flags? Get them before they act out. You’ve got a lot of juveniles that are starting to do some really unusual kinds of things. Where are they getting the ideas? We have to educate our teachers and our people that work with have people working with them about the red flags and when should you be concerned? The social media is a big thing. We should be picking up a lot of clues there. We’re looking at cases now that are called incels and they are on social media. And I know there are thousands of them. So, you’ve got to be very, very careful. But there are some that commit horrific acts. And when do you tell someone and who do you tell? There needs to be at any institution, there needs to be a team so that no one person is making a decision. But you’ve got a team effort looking at could this person be have is this a prelude to being violent? You’ve got to present prevent that.

Rachel Star Withers: Is there another realm that you haven’t gotten into that you’re interested in looking in? As far as victimology? Crimes?

Ann Wolbert Burgess: Oh, yeah. We’re looking at see, we looked at behavior was important, but now we’re trying to get into the actual the thought process. And some of these we’re looking at actually murderers’ manifestos. What do they write before they kill? And can we pick up anything there? Because that’s a lot of what’s on social media. And these postings, right? So when should you be concerned about a posting? That’s the next step.

Rachel Star Withers: Do you think because of the internet, you know it used to be a manifesto was only found, you know, like with the bomber afterwards. Do you think you could find the manifestos ahead of time before the person.

Ann Wolbert Burgess: Oh yeah. They’re there. Oh, they’re there. Yeah. And we have to we’re going to compare the ones with murder, with the ones that write a manifesto but don’t. All of that’s on the Web, which makes it easier for a researcher.

Rachel Star Withers: Yes, indeed.

Ann Wolbert Burgess: [Laughter]

Rachel Star Withers: I loved your book. It’s “A Killer by Design: Murderers, Mindhunters, and My Quest to Decipher the Criminal Mind.” Incredible book.

Ann Wolbert Burgess: Mhm.

Rachel Star Withers: Do you have any other projects coming up you want to share with us?

Ann Wolbert Burgess: Yes, we have a second book coming up, and that’s where I’m going to be talking about other cases that I myself testified on, the Menendez case. That’s a big one in the news right now. Very interesting about more information that’s come out on that case and the Bill Cosby case, the Larry Nassar. These are all cases that I’ve had a chance to interview the victim and we’ll be telling it from the victim’s standpoint.

Rachel Star Withers: Well, thank you very much. This has been enlightening and wonderful speaking with you. Thank you for doing this.

Ann Wolbert Burgess: You’re very welcome. Take care.

Gabe Howard: Rachel that is incredible and I am super jealous that you were able to talk to her. You know, her book, “A Killer by Design: Murderers, Mindhunters, and My Quest to Decipher the Criminal Mind” is, of course, it’s out now. It’s been out for a while. It’s an incredible book. I highly recommend it. I learned a lot from this interview. What are your takeaways?

Rachel Star Withers: We’ve been talking this entire time about the stereotype that came up out of the 60s and 70s. And to think, here you have police officers and whatnot, and they’re investigating these horrendous crimes. And it’s easy to think, yeah, an escaped mental patient clearly did them. You know, for someone to do this horrible, disgusting, depraved act, they must be insane. And it’s easy to find insane people. Right?

Gabe Howard: Sure, it sounds believable.

Rachel Star Withers: Because escaped mental patients probably aren’t in hiding for that long. They’re probably pretty easy to catch, you would think.

Gabe Howard: You would think.

Rachel Star Withers: And yet so many serial killers aren’t. And that is what Dr. Anne Burgess really brought to the table of pointing out the fact that, no, you’re not looking for this crazy escaped mental patient because you would have already found them. You’re looking for someone you would never expect. You’re looking for someone normal. You’re looking for somebody you would probably trust. And that’s, I think, the key and what takes the spotlight off of schizophrenia. Schizophrenia is scary, but it doesn’t affect many people. The idea that anyone around you could be the killer is very scary. I think it’s way more scary than a person, a schizophrenic stereotype, delusion who’s covered in blood, drooling in the corner, you know, chewing on a severed hand. The idea that it could be a teacher, somebody in your family, That’s terrifying. And that is a thought people don’t like. They much rather have the myth of this schizophrenic monster running around.

Gabe Howard: It’s comforting lies versus uncomfortable truths. And the reality is, is as you said, Rachel, it can be anyone. As a member of society, as a person who lives in a neighborhood, as a person who travels and has friends, I wish it was so easy to spot violence that you just need to look at their medical records. Wouldn’t that be fantastic? We could eliminate violence in this country if it were that simple. The reality is, if you think about it for more than just a couple of seconds is it’s not that simple. Otherwise, everybody would be caught. There would be no violence. We could predict the violence and save crime before it happened. This is not a dystopian novel. This is this is not this thing where the police can sit down and run a profile on everybody and decide who is going to be violent and who’s not. The best predictor of future violence is past violence. And that’s where it stops. Everything else is just a comforting lie that we tell ourselves so that we can feel safer. But it’s not true.

Rachel Star Withers: And if you remember back to the world-renowned criminal profiler and his very disturbing definition of how a simple schizophrenic would kill. He mentioned a simple schizophrenic will always kill first because he’s so curious. He’s going to look it over. He may kill a woman, but under no circumstances ever rape her until she is dead. That is the monster. That is the schizophrenic running around, chewing on a severed hand, covered in blood, mumbling to themselves in the corner. Right? That that is exactly what he’s described there. That is not somebody who eludes justice for very long. It’s probably going to be easy to track them down. They probably left a trail of blood. And those people, those situations usually aren’t serial killers because you can catch them pretty quickly. It’s the people you don’t expect. And that’s just something to remember. And the reason that the diagnosis of schizophrenia, it carries so much stigma and stereotypes with it that learning what’s fact and what’s fiction can help us all change the narrative. Thank you so much for listening to this episode of Inside Schizophrenia, a Healthline Media podcast. Please like share, subscribe and rate our podcast and we’ll see you next time here on Inside Schizophrenia.

Announcer: You’ve been listening to Inside Schizophrenia, a podcast from Psych Central and Healthline Media. Previous episodes can be found at or on your favorite podcast player. Your host, Rachel Star Withers, can be found online at Co-host Gabe Howard can be found online at Thank you and we’ll see you next time.