An Exclusive Authorlink Interview With Novelist Keith Ablow
Author of Psychopath (St. Martin's Press)

By Doris Booth

August/September 2003

PSYCHOPATH by Keith Ablow

PSYCHOPATH by Keith Ablow

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PSYCHOPATH, Dr. Keith Ablow's fourth thriller in the popular Frank Clevenger series, was released in July 2003 by St. Martin's Press. Here, the author discusses how he originated the idea for the series, how he found a publisher, and how he finds time to write while juggling a busy career as a forensic psychiatrist. He also provides a glimpse inside the minds of real killers with whom he works, and reveals some of his own personal thoughts about evil.


"I wanted to create a killer as gifted as my hero . . ." —Ablow


AUTHORLINK: How did you conceive the idea for Psychopath?

ABLOW: I wanted to create a killer as gifted as my hero at entering people's minds. Frank Clevenger, a forensic psychiatrist, and the Highway Killer share the same profession. Dr. Jonah Wrens is a psychiatrist who desperately longs to free himself from mental illness. I wanted to create a character who wouldn't be easily dismissed as purely evil. Wrens, though a gifted healer, struggles against the particular joy he derives from killing.

Early in my career, I served as medical director of a Boston psychiatric facility. I used to hire locum tenens (temporary) psychiatrists for short periods of time. These doctors are licensed in up to 50 states and fill in wherever shortages occur. I thought of them as unusual people—highly trained, very smart, and completely rootless. They go anywhere in the country on a moment's notice. The idea for Jonah emerged from that experience. He's a traveling psychiatrist for hire.

It's potentially a bad situation. In fact, a psychiatrist friend of mine, Paul Mendelsohn, was killed by locum tenens anestheologist Jonathan Kappler, who was mentally ill, had practiced in 50 different facilities, and had never met my friend. Kappler ran him down and killed him on a jogging path. What happened to Paul provided some of the inspiration for this novel.


"A forensic psychiatrist gets involved in anything that interfaces with psychiatry and the law." —Ablow


AUTHORLINK: This is not your first novel. What else have you written? How did you begin?

ABLOW: Before beginning the Clevenger series, I had written nonfiction, including the true crime story, WITHOUT MERCY, about Jonathan Kappler. That fueled my interest in portraying destructiveness in a fictional context to explain mental illness. The first novel in the series, DENIAL, introduced Clevenger as a brilliant but deeply troubled, forensic psychiatrist. (By the way, I have just finished producing and co-writing the pilot EXPERT WITNESS for CBS, which revolves around three forensic psychiatrists working in a group practice. The show stars Matthew Modine as Dr. Matt McBride.)

AUTHORLINK: What, specifically, does a forensic psychiatrist do?

ABLOW: A forensic psychiatrist gets involved in anything at the interface with psychiatry and the law. We treat violent people. We testify in court as to whether a person is insane or sane. We evaluate parents to determine whether mental illness makes it impossible for them to continue parenting. We determine competency; whether a person has the mental capacity to handle his or her affairs. The forensic psychiatrist is called upon anytime a legal moment coincides with a question of mental health.


"The writing profession chose me. I didn't choose it." —Ablow


AUTHORLINK: What made you decide to become a writer?

ABLOW: The writing profession chose me. I didn't choose it. I grew up in a pretty town. My parents were nice people. When I was in the fourth grade, the English teacher called my parents in for a consultation.

"Keith's writing is good, but it's very dark," the teacher said. "Is anyone at home dying?"

No one was. My parents were mortified. They urged me to write about happier things. And, I did for about 20 years.

I began writing fiction when I was in medical school in the late 1980s. Since that time, I always had the beginning of an unpublished novel stuck away in a drawer. But I don't think I knew the proper structure for fiction.

One day I complained to my psychoanalyst that one thing bothering me a great deal was that I had received dozens of rejection letters for my novels.

"Well, maybe you don't know how to write a novel," the doctor gently suggested.

That's when I decided to study how to write.

AUTHROLINK: How did you make your first sale in fiction?

ABLOW: I had had some success in writing nonfiction, but the novel-writing journey was less rewarding. I had written twelve pages of the novel, DENIAL, and stuck it away in the drawer, as usual. One day, I was looking for additional booksellers to stock WITHOUT MERCY and thought that a woman I had met, named Pat Hass, was from a family who owned a chain of bookstores. I was wrong about that. In fact, she was an editor at Knopf/Pantheon (Random House). I had misfiled her card under booksellers, when, in fact, she was an editor. Not realizing my mistake, I called her.

"Well, I'm not a bookseller, I'm an editor," she advised. "What are you working on now, or are you just taking a break?"

"I'm working on a novel," I explained. "But I have written only twelve pages."

"Fax me the pages you have finished," she said.

The next day I got a call from Dan Frank, editor in chief at Pantheon. "I'd like you to come to New York and talk about a contract," he said.

I was stunned. For years I had tried to sell my fictional works.

"We'd be happy to buy your work," Dan said. "But we'd have to have two books, not one."

"No problem," I responded. In 1997 I signed a two-book deal with Pantheon. They published the first two books in the series, DENIAL and PROJECTION. Then I switched to St. Martin's Press for the last two, COMPULSION and PSYCHOPATH. I've just signed a contract for books five and six with St. Martin's as well, through my agent, Beth Vesel, of the Beth Vesel Literary Agency in New York.

It seems that things began happening for me when I stopped wanting success so desperately to happen—when I just stepped back and said "I'll just work on something for myself, without thinking about whether it will sell." That's when DENIAL came about.

It also came about after I went out and bought the late Gary Provost's books about novel writing. Then I called and asked him to read my work, and tell me why I wasn't selling. It was a tremendous learning experience for me. He filled my manuscript pages with notes.

AUTHORLINK: What was your biggest flaw in the beginning?

ABLOW: I was so interested in the internal world of the characters that I sacrificed the story at many points. I was unaware of a number of structural rules, especially how to maintain conflict and pacing. Provost also told me to write about the things I knew best. Empathy, justice, and evil were subjects that came naturally to me.

AUTHORLINK: Do you think people have both good and evil inside?

ABLOW: We are all born with the capacity for empathy. It is the quality that insulates us from evil. Sure, this trait has a neurological—a genetic—basis. But it can be beaten out of you; abused out of you. Once you lose your empathy, you lose your restraint toward others. In talking to killers, I find they get a paradoxical enjoyment out of watching situations that horrify other people. They are so removed from their own pain that the pain of others is pleasurable. These people weren't born evil. They were born with a good nervous system or a bad one which influences the way they deal with stress. The necessary ingredient for someone to become a murderer is for that person to have been spiritually murdered himself. The vast majority of us are restrained by what it would be like to lose someone we love. In a killer, that empathy is absent. Everything in your life experience matters—whether you're tall or short, whether you had asthma, whether your teacher told you you were a good kid or a bad one, whether you had even one source that enabled you to build your self-esteem. Whether you're born with a genetically vulnerable brain or not is a matter of luck. But even the worst genetics in the world would not birth a murderer if that person had good parents and a positive life experience.

The question is, whether any light gets let into the human equation. The soul looks for a place to get a foothold in things that are good. At a certain point, if there is not enough to sustain people they shut down. They no longer experience their own pain, and they become numb. Neurologically, they shut down. When they cannot feel their own suffering, they no longer care about the suffering of others.

I once asked a patient, a Peeping Tom, what he would do if the woman he watched fell down and injured herself.

"I would laugh," he answered.


"Because she's stupid."

To him, she was not human because nobody had ever extended him that status. People are exquisite creatures. They have an amazing capacity to feel the pain of others, but the feeling is really fragile. When people become destructive, it is not a random act of nature dishing out lousy genes. We have more power than that.

When a person is depressed or obsessed, we recognize that they're sick. Only when they are without empathy do we call them truly "evil." Yet, this still remains a sickness—an illness to the extreme.


"I am always writing in my mind, no matter what other venues I am addressing." —Ablow


AUTHORLINK: You still practice psychiatry and frequently testify in state and federal court cases involving violence. You even have an intensive counseling practice where you meet with people for unlimited amounts of time—up to three months. When, pray tell, do you find time to write?

ABLOW: I write everyday, for varying amounts of time. I don't recommend this method as ideal. But I'm good with intrusions. I can be writing and get a call from an attorney, then twenty minutes later go back to the story without a problem. I think it's some sort of inclusive mental state. The common thread is story telling. I am always trying to make sense of one story or another in whatever venue I'm addressing.

"Let me tell you about this crime," a lawyer will say, or, "I need to understand this about my life," a patient will say. So, story lines are an integral part of everything I do. It's just a matter of whether I'm applying that skill in a courtroom, my office, or in a novel.

AUTHORLINK: How long does it take you to write a novel?

ABLOW: About eight months or so, part-time.


"Ask yourself , 'What can I offer that people want?' " —Ablow


AUTHORLINK: What advice can you offer for new writers trying to break into publishing?

ABLOW: I suggest a new writer spend $69 for the Audio Novel Workshop available at 800 642-2494. This program laid out the structure of a novel for me. It helped me get into the mind-set where I could put myself in the reader's place. J.D. Salinger once said to ask yourself what you would most like to read in the world, and then write it yourself.

Be self-critical. Ask yourself, "What can I offer that people want?"

And don't rush. In the beginning, I was so motivated to become a novelist that I rushed right past the very tools I needed to do the job. I thought one was either born with talent or not. I felt I was, and that the editors who had rejected my work must be missing my talent. But I had more to learn.

Writing is partly an acquired talent, just like basketball. You still have to learn the rules and practice a lot. I wouldn't want to treat my patients based on my innate intellectual capacity for psychiatry. I had to have a lot of training.

It is a good thing to say, "I am going to be a writer, and I'm going to do what it takes to learn how." It's self-confirming. It takes away the delusional aspects of your self-concept. Sometimes jumping into a task without having the necessary tools is a way of avoiding reality—avoiding the long, laborious process.

When you sign up for a writer's conference or buy a book about writing, you're declaring you are going to be a writer, more so than if you simply pick up a pen to write. The greatest incarnation of intention is to say, "I am going to be a writer, and I am going to acquire all the necessary tools to get me there."

—Doris Booth