Insanity Defense

I followed with horror the news from Norway when the bomb exploded outside government buildings, and then, the shooting rampage on a campground island. Now more information about Anders Breivik is emerging. Since he is in solitary confinement with only access to his lawyer, the information is filtered through the desires of the lawyer. This lawyer's paramount desire is that his client is deemed insane. He wants us to think that the way the man sees the world is distorted to a large degree, and from what I've read, it is. Anders Breivik is narcissistic and incapable of remorse or empathy. However, his behavior and crime was carefully planned over as much as nine years and other parties than his lawyer says that this cold calculation does not meet the criteria of someone who is psychotic. What fueled the crime, - hatred for a minority and self promotion, - or deluded state, an impulsive state, where the man is so out of touch with reality that he can't be held accountable for his actions?

It is my experience that sane minds distort reality. I have relatives who think that fossilized dinosaur bones were put in the earth by God to be a mystery to mankind, since the world is only so many thousands of years old as according to the Christian Bible. The dinosaurs could not have lived hundreds of millions of years ago because the earth wasn't around then. Actually, I don't know how old the scientists say the earth is or exactly how old the dinosaurs are, but I trust their scholarship. I trust that humans evolved from animals and were not planted in the Garden of Eden. But, like my fundamentalist Christian relatives, I don't completely trust scientists.

One of the worlds premier thinkers, Stephen Hawking, recently called the belief in life after death a "fairy tale" and he finds no science to back it up. Since I believe in life after death, having only some rumors and religious assurances (as well as the near to my heart case of my husband who believes some of his dreams take place in heaven) - having in short the flight of fancy of human brains to back me - I believe in the afterlife. I know I could be mistaken. But psychotic? Insane? For believing in heaven? No. At the worst I am mistaken.

So clear, rational thought is not so easy to attain as some would hope for. Deciding for yourself what is real and what is not real, with all the experts and voices of the world clamoring for attention, is a process. Picking your beliefs often depends on childhood experience, your parents, who in the news persuades you the best, and what your natural inclinations are open to. You were born with character and personality, little nuggets of self that wish to express themselves, and they do by influencing what you eventually believe or disbelieve.

I would purpose this further test case of the Norway man some are calling insane. If Anders Breivik were put on anti-psychotics I think that none of his view points, or outrageous claims would change. He would not view his actions with remorse and horror, he would not change his political views that his nation is being ruined by the immigration of Muslims, and he would still believe, that the best people to give him a psychiatric evaluation are the Japanese since they have, according to Breivik, the best understanding of honor. Put him on anti-psychotics and he would still insist that he be seen in court wearing a uniform of the Knights of Templar, and he would still refuse to have his mugshot taken. His cruel and absurd world view runs deeper than psychosis. Anti-psychotic medication does not have an impact whether or not I believe in heaven, whether or not I believe in dinosaurs, and whether or not I have a sense of what is good and decent and humane.

Gabby Giffords appeared recently in Congress to vote on the important debt limit legislation. It has been nearly seven months since she was shot in the head. Jared Loughner who shot her and killed others in his attack has been declared mentally incompetent to stand trail. The court has had some back and forth with the mental health facility Loughner is incarcerated in. Apparently he was medicated against his will, and while the prosecution believes that if he were medicated he would be fit to stand trial, a judge recently ruled that he cannot be medicated against his will. In one news article I saw that Loughner had been diagnosed as schizophrenic, and after reading his behavior in the courtroom (making meaningless remarks out of turn, rocking back and forth in his chair) I believe the diagnosis. This is a case where I believe that scientists. If they say he is schizophrenic this is a true diagnosis and he isn't merely being canny and imitating crazy.

I almost feel that the prosecution by demanding that he be forcibly medicated is hoping that the drugs can force sanity and Loughner will know regret. He will see reality. The victims will have some sense of closure that the criminal sees what he has done. If Loughner is psychotic, and incompetent, the implication is that he cannot comprehend right from wrong and he is at the mercy of random impulses. I wonder, does he know the difference between alive and dead? Can he name himself a killer? In psychosis, any belief is possible, and beliefs can change like the wind.

I've been psychotic. When you are psychotic one of the things you believe are lies. I know now that I'm not the Anti-Christ, I know I'm not descended from Buddha, I know that my eyes don't shoot laser beams that kill people, I know that I won't turn invisible, I know that all the nuclear weapons in the world will never be turned and target the moon. But when I was psychotic and believed these things I believed them with a deep conviction that would sometimes bring me to tears.

I think that the worst fear of the prosecution who is trying to medicate Loughner is that any punishment won't touch him. He's beyond the opinion of a jury, because mankind is no longer his peer. If you sentence him to death, he won't know why he is being killed. If he is really sick, you can put him in a jail and he won't even know that he is in a jail. I've met a woman in a hospital on a locked psychiatric ward who was trying to figure out where she was. Was she in a restaurant? Where is the elevator she asked me? And she thought she knew me. I was on a bus with her going to KMart to buy towels. She had just been brought in and wasn't medicated. A schizophrenic friend I have can't even remember her hospitalization before she was medicated. She was so psychotic the function of memory was denatured.

Since Loughner was medicated, and then rejected being medicated, it must have been unpleasant. I think that as a criminal he no longer has the right to rule over what is pleasant and unpleasant. But if I vote that he should be forcibly medicated because he has committed a crime, this opens a door for others to be forcibly medicated as well. As it stands you can forcibly incarcerate in a psychiatric hospital a person if he is a danger to himself or others, at least this is the rule in Connecticut. Incarcerate is different from medicate. And I know that doctors will lie to get a patient they think severly mentally ill incarerated. When I was hospitalized once the reason the doctors gave me for my being there was that I couldn't feed myself. This was a lie, I was perfectly able to find food, fix food. But they wanted me in the hospital and since I didn't meet the criteria of being a danger to myself or others they invented a false situation. Imagine the doctors pushing medication on a homeless person; is the homeless person a danger to themselves from being frozen to death? This is an easy argument. Most patients when they are told that they must take medication as a condition for release from a hospital take medication because they want their freedom. I took medication in part for this reason, but in part because my mind wasn't working properly and I knew it. The side effects from the medication were so horrible that I can't believe I stayed with the hospital's program. However upon being released from the hospital, it took me about six months before I realized that I had the freedom not to take the medication if I didn't want to. And I went off of it. I passionately believe in this freedom as a freedom along with a woman's right to choose abortion, freedom of speech and freedom of religion. How your mind works is your own business. Criminals should be locked up, and if convicted and freed, perhaps get mandatory medication injections. I was given the luxury to choose whether or not I wanted medication, and when I had horrible side effects, I bore these side effects of my own free will. It took seven hospitalizations before I took anti-psychotics at a level which would prevent further hospitalizations. I had to learn. But I was never forced. And life as an unmendicated schizophrenic taught me much about my illness and the necessity for medication. I didn't want to go into crisis after crisis - crisis is painful. The individual naturally wants the least painful existence.

I have a schizophrenic friend who upon hospitalization was forcibly injected with anti-psychotic medication and her memory of the event is on par with remembering a rape. She takes medication now-a-days, but it is of her own free will. Incidentally, she has three children and during the pregnancy was drug free. Most people can endure being schizophrenic and unmedicated, however, it is very uncomfortable.

As a person who participates in peer support meetings at a hospital, I've met newly diagnosed people who have just started taking medication. Almost all complain bitterly about their side effects. It is rare for people to take a psychiatric drug and have no side effects. I think that after a while you forget what it was like not to have the side effects, but this processes of acceptance sometimes takes years. I'm not being theatrical when I say that what I see in peer support, is people who suffer because they are taking medication. The reason they continue the medication (although some press their medication provider for change, or simply cut medication doses unsupervised) is that they have a memory of enduring a far worse fate at the hand of their mental illness unchecked. The medication makes life easier, even if they have to endure ringing in their ears, shaking hands, trouble waking in the morning, or in general, feeling the haze of alteration in thought, being doped.

For me I have not yet found the perfect medication. And I suspect it doesn't exist, because my illness, mostly negative symptoms, is not well controlled by medication. My illness is stronger than what medication can cure, and I can never be like the majority of the population in terms of what stress I can handle.

But getting back to the insanity defense. I have no problem with locking up an dangerous schizophrenic for life. Especially if they are not on medication. Schizophrenia itself will torment the criminally insane quite well. I think in Norway Anders Breivik will not be found insane, or at least, he will not be found to be schizophrenic. But I don't know. The important point is that he is removed from the general population and his will is limited. The comforts of life are limited as punishment. I suspect he is sane enough that he will go to jail and not a psychiatric hospital. Killers, despite how difficult it is for gentler people to understand, can be sane and rational. Point is they have no regard for the sanctity of human life. Emotionally they are horribly flawed, and they don't seem sane. But then I think about soldiers who kill the enemy. You don't call a soldier crazy or emotionally flawed for doing their job. People can learn to shut off their empathy, they can be made into killing machines, and the people who train soldiers know how to manipulate the mind very well. My husband takes great pride in how dangerous American soldiers are.

I hope Jared Loughner is committed to a psychiatric hospital. I know that hospitals for the criminally insane are cold, hard places and pretty much indistinguishable from jail. As penalty for his crime, I hope Jared Loughner is never released. There has to be accountability and restitution made to the victims, and I'm afraid that there is a little bit of an eye for an eye and a tooth for a tooth savagery in me. Good, innocent people are dead, and their loved ones suffer by their loss.

Loughner will know a crumb of peace if he ever consents to being medicated.

Unmedicated Loughner is as much of a monster as Breivik.

But I think the two are two different types of monsters.