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Since its publication in 1991, Bret Easton Ellis’s American Psycho has attracted many disparate and contradictory responses due to its characterization of Patrick Bateman as a monstrous perpetrator and narrator of misogynistic, inhuman, graphic, and detailed violence. This essay examines the diverse responses and their limits and read the text as a brutal realism of capitalist affect. This essay also argues that much of the misunderstanding about the text stems from the attempt to decode the extraodinary but plausible narrator Patrick Bateman in terms of meaning and signification rather than a-signification and intensity. Because the psychotic Bateman embodies Capitalist affect and narrates the entire novel American Psycho requires a different reading—that is, a reading of the narrative as affective engagement including his act of communicating with others by carving letters on their bodies. This specific literary engagement can be called paranoiac realism not only because the narrative form involves a paranoiac narrator but also the form insulates its own textual reality by subsuming the others’ voices as noise.