Alright so my interpretation is a little different and I can’t get into it without full spoilers.

But basically: >! I interpret it as though Patrick Bateman is in hell. The first line of the book is “Abandon all hope ye who enter here” which is a reference to Dante’s Divine Comedy, wherein that inscription is written above the gates of hell.

As the book goes on Patrick Bateman’s mental state deteriorates further and further. He struggles to maintain his facade while losing his sanity, he begins to question his version of events, and towards the end of the book he seems to accept his entrapment.

He’s doomed to a life on Wall Street. A job where he does nothing, a wife he doesn’t even really like, “friends” that he can’t stand, endless posturing and narcissistic grandstanding.

All of this culminates in the final line of the book: “This is not an exit.” Which is a reference to the play by Sartre: No exit. Which is about 3 people who can’t stand each other forced to sit in a tiny room together for the rest of eternity, meaning that: “Hell is other people”

Many readers interpret this as purely metaphorical, meant to illustrate that a life on Wall Street is like hell. I however like to think of it literally. I think Patrick Bateman is actually in hell. I think he’s doomed to an eternity of comparing business suits with people he hates.

So in terms of was it real or was it all in his head. It was real in that it’s his divine punishment for a life is sin.! <