Review of Guilty by Reason of Insanity

 

Review of Guilty by Reason of Insanity by Dorothy Otnow

338pg , c1998

This was a very hard book to read. The author does a good job of recounting her interactions with really sick people. She does the usual telling of her history of getting into psychiatry and what changed and how it affected her outlook, etc.  She doesn't give solid dates of this or that but you get the sense this was during the 70's and beyond because she referenced the rise of Sybil and 3 Faces of Eve.  She intertwines her personal growth and life, the persons she interviews, the courts and the state of belief in multiple personality disorder. Although heavily accepted today split personality or DID was disregarded back then and it's adoption was slow in coming. Even the author was skeptical until she came face to face with some one who had alters. 

The author has 4 or 5 case studies that highlight the points and experiences she had with them. The hard part to read was the horrific abuse that the people experienced when they were young that warped them and turned them into killers and abusers themselves. 
The people she interviews all had abnormal brain activity, a history of physical abuse and a history of torture and thus created a killing/torture machine.  
Because many of the case studies are on death row there is a lot of discussion over ' can you justify killing a sick person'  ?  
Her and her partner do a lot of dissecting over brain injuries, TBI, EEG patterns, prefrontal cortex damage etc to make the case that there is neurological damage that is causing ' states' of behavior such as anger management, blackout attacks, etc. 
She does say something that I found hard hitting " ...before we would come to appreciate how much the families of children who murdered have to hide. Only after Jonathan and I had evaluated a group of juveniles condemned to death, after we had tried to talk with their parents, their brothers and sisters, struggled in vain to reconstruct their past, would we understand that many of these families would rather see their children put to death than reveal what had happened between the closed doors of childhood.  What is more, we would find that many of the adolescents themselves prefer death to exposing their abusive parents. " 
 Perhaps her conclusion is brain injury+ abuse + lack of support = killer. 

The author sort of shows her hand when she meets a killer who is not behind bars...A professional jail executioner. The guy had assisted with 20 some executions and the author picks his brain trying to see if he has abuse or similarities with the violent psychos that she interviewed earlier.  While there are some similarities and she tries to make the connection that the same twisted lack of empathy from him is an indication that he would have made a killer outside of the jail. I don't agree with that. The guy she interviewed, although abrasive, sometimes contradictory, and socially uncouth was following legal patterns.  There's no indication he would have broken social codes or the law outside of his job. 

The one thing she doesn't do  or at least I missed it, is compare people with the same kinds of issues who don't turn out to be killers. Does she find anyone that's had abuse and brain damage and is still a decent human being ? 
It does bring up the question - how much of our drives, our decision making, is driven by  the physical constructs of the brain and can we choose anything else?

Overall, an interesting read for those with a interest in the insanity plea, dissociative identity disorder, violent crime and the justice system but really leave a dark outlook on the future of humanity.