Can you teach empathy to antisocials?

Find out as we probe the dark triad of narcissism, antisocial, and Machiavellianism in the Epstein story.

Welcome to the Carlisat Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Agen, the editor-in-chief of the

Carlott Psychiatry Report. And I'm Kelly Newsom, a psychiatric NPR, and a dedicated reader of

every issue. At 1030 at night, on August 9th, 2019, Jeffrey Epstein was locked into his prison cell for the last time.

The two guards dutifully recorded their safety checks every half hour throughout that night,

but the record, they later admitted, was falsified.

No one saw Epstein until eight hours later, when he was found dead at 6.30 in the morning. The official cause

was suicide by hanging, but in the days that followed, 42% of Americans believed he was murdered.

And that number is growing. In 2025, only 16% except the official story and 50% believe he was murdered.

Take any detail from the case, and you can spin it both ways.

Did the guards fail to monitor him because of corruption?

Or was that just the usual slacking off in a prison known for low morale, staffing shortages,

and mandatory overtime? A few weeks before his death, the guards found a semi-conscious Epstein

in what they ruled was a suicide attempt. But Epstein tells a different story. He said his cellmate

was trying to kill him. Some say Epstein was depressed and contemplating death.

Others say he was optimistic and expecting a pardon. And some say he was too narcissistic to take his own life.

We don't know how Epstein died, but we can dispel that last myth. Narcissistic personality disorder raises the risk of suicide.

The APA practice guidelines rank it among the major risk factors for suicide,

listing extreme narcissistic vulnerability alongside past suicide attempts,

substance use disorders, loss of executive function, and extreme

...