The idea that evil acts can only be committed by evil persons seems to me to be illogical, a medieval, primitive, prescientific delusion. Yet it forms the bedrock of our legal system, and is why our prisons are full of the mentally ill. It is also uncritically held by the media. For example, the front page headline in yesterday's London Evening Standard reads "40 cyclists killed -- 4 drivers jailed". Something evil has happened, therefore this must be the lorry drivers' fault. Is anyone willing to defend this popular belief, this inexorable deduction?
What a wonderful question! It could relate to early Judaic and Christian belief systems where unwanted emotions, thoughts, acts, events were understood to be the result of evil spirits, either sent by a displeased deity or invited by pact with the devil or sin. And that begs the question, where do the ideas of sin and evil come from? It also seems a way of othering people who do things that violate the moral code and distancing them from oneself, a sort of defense against the thought that one could do the same thing oneself. This is all conjecture of course, but what an interesting question. Shall look forward to the rest of this thread.
Assuming the worst of strangers is common practice. It probably goes back to the days that our ancestors hunted each other for food. People instinctively consider each evil a trap set by a dangerous predator.
The legal system is not based on the belief that people who do evil things are evil. In the case of the killed cyclists, there are various degrees of murder and manslaughter to account for the lorry drivers' intentions.
"The legal system is not based on the belief that people who do evil things are evil. In the case of the killed cyclists, there are various degrees of murder and manslaughter to account for the lorry drivers' intentions"
Yes, in theory you are correct, but in practice the default position of the media is that the drivers must have had evil intent. The subheading from the ES front page reads "Motorists 'let off with lenient sentences'"
The legal system seems more based on the idea of retributive justice, an eye for an eye, than the idea that evil people do evil things. Seems to have religious underpinnings as well. Which would make sense, given the historical role of the church in governing the state. But in practice, it is administered by people, people who from all appearances do tend to hold the belief that evil acts are done by evil individuals.
A huge question with many layers, let's look at a few of them:
1. "The idea that evil acts can only be committed by evil persons seems to me to be illogical, a medieval, primitive, prescientific delusion."
This is tautological, indeed that is often the level of debate in contemporary criminal justice public discourse. The act defines the person. If we see the act as evil, we then label the person as evil. The act is a signifier. We make a moral judgement about it. I am not sure this is medieval, or primitive; it is too contemporary for that. It is wrong, illogical, but not a delusion.
2. "Yet it forms the bedrock of our legal system, and is why our prisons are full of the mentally ill."
Two parts to this. It was not the bedrock of our criminal justice system. Traditionally the criminal justice system was little interested in the person: it was the act that was punished. Proportional to its severity and perceived harm. Just deserts. And once you had served your time, you could re-enter the community with the full rights of citizenship.
Now, the index act is taken as a flag to give the collective awareness there is a dangerous person in our midst, and if deemed of high risk we can take this opportunity to immobilise this person through detention. The removal of tolerance from society, deliberate exaggeration of risk and creation of moral panics has resulted in the increased use of incarceration in many countries.
Or as Banksy observed in the reverse "You are an acceptable level of threat and if you were not you would know about it."
People with mental illness, now more free to live in the community post deinstitutionalisation, have been free to be swept up by these policies of increased incarceration also. Prisons have always contained more of the people on the margins of society: people with mental illness are but one example.
3. "It is also uncritically held by the media. For example, the front page headline in yesterday's London Evening Standard reads "40 cyclists killed -- 4 drivers jailed". Something evil has happened, therefore this must be the lorry drivers' fault. Is anyone willing to defend this popular belief, this inexorable deduction?"
I don't think it is that the media are uncritical. It is a deliberate policy, not a failure of criticism. It is a simple form of populist politics that wants the world made simple. Them and Us. The Axis of Evil. The Evil Amongst Us. All simplistic reassuring reductionisms that shore up the readership or the voting base, project blame for our woes on to others, and dehumanises them. Societally, we fail to see what we loose when we reduce ourselves to these distortions or reality.
Is the answer supposed to discuss a particular legal system or any legal system?
"Prisons have always contained more of the people on the margins of society: people with mental illness are but one example."
I do not think mentally ill people are usually on the margins of society, nor that this in any case explains the large excess of the mentally ill in prison. I think it is for this reason (as Alexander notes):
"The act defines the person. If we see the act as evil, we then label the person as evil. The act is a signifier. We make a moral judgement about it."
Take the case of the Yorkshire Ripper. Despite numerous psychiatrists stating he had paranoid schizophrenia, the jury ignored this. The High Court judge who recently ruled on his case (see below), clearly reasoned thus -- gross evil deeds were done, no other explanation exists (schizophrenia evidently being a moral weakness, a defect of will or character, and totally irrelevant), so the YR was simply a very evil person.
"This was a campaign of murder which terrorised the population of a large part of Yorkshire for several years. The only explanation for it, on the jury's verdict, was anger, hatred and obsession. Apart from a terrorist outrage, it is difficult to conceive of circumstances in which one man could account for so many victims."
"Is the answer supposed to discuss a particular legal system or any legal system?"
The question was based on my observations from the outside of the UK legal system, but I do not suppose it is much different elsewhere. For example, in the USA it is considered acceptable to execute schizophrenics if they have committed a sufficiently evil deed.
'Is the answer supposed to discuss a particular legal system or any legal system?'
Stephanie, I am unsure if your question is aimed at my response. I write form my mix of experience, primarily in the NZ/Canadian systems with knowledge of the UK and Australian approaches. Whilst I have read a lot about the US and talked with colleagues there a great deal, I have never worked there. So great have been the US polices of mass incarceration over the last 30 years I am reticent to extrapolate from a country that still widely uses the death penalty and imprisons around 720/100,000 of its citizens, to the UK and Commonwealth countries with an approach to criminal justice that eschewed capital punishment and imprison 110-180/100,000. These seem different worlds.
The legal system is not based on the default position of the media in practice. The legal system can ignore mental illness for reasons that have nothing to do with what news papers have printed. 'Being based on' means more than 'occasionally agreeing with'.
I don't think that popular belief is that evii is only done by evil people. Most people agree with Hannah Arendt about the banality of evil. Ordinary people - all of us - commit acts of evil when the circumstances are right.
"I don't think that popular belief is that evii is only done by evil people."
I would have thought it was pretty obvious that JD (see below), who came from a respectable family, has a serious psychiatric illness. Yet no mention was even made of this possibility, let alone a considered argument as to why this could not be the case. It was enough to label her an "evil 31-year-old", which was highlighted in red on the Mirror website in case we didn't get the message. Or is the message really this -- Some mentally ill persons are evil because of the illness?
"Twisted serial killer Joanna Dennehy chuckled in court today and claimed she was “not sorry” for stabbing three men to death.
The evil 31-year-old gave a sinister grin when prosecutors described the five stab wounds suffered by one of her victims...She then broke into outright laughter after it was revealed a photo had been taken of his body lying on a bed. And the tattooed killer beamed as Peter Wright QC told how the corpse of victim...was stuffed into a bin.
As she stood in the dock, Dennehy interrupted the prosecutor to deny that Mr Lee’s murder was sexually motivated.
http://www.mirror.co.uk/news/uk-news/serial-killer-joanna-dennehy-laughs-3146590#ixzz2uoMIEuhU "
There are no evil people just people who do evil acts. It is indeed medieval to think in terms of monsters and hobgoblins or individuals motivated soley by evil. Some of the most evil acts in human history were carried out by bureaucrats and office boys, people who led basically normal family lives when they were not presiding over mass murder.
It is also a myth that those who are mentally ill cannot be concomitantly evil. mental illness removes the normal powers of reason only by degree. It is paradoxically discriminatory and stigmatising to say that a person cannot decide for themselves to do bad things just because they suffer from a mental illness.
There are many mentally ill people in the penal system and in most cases it is an appalling failure of the system. There are however some mentally ill people in the penal system who deserve to be there. There never was a case of 'bad or mad', it is very possible to be both.
"It is paradoxically discriminatory and stigmatising to say that a person cannot decide for themselves to do bad things just because they suffer from a mental illness."
This is generally true. I believe that there are always cases of extreme, rare outliers. I think to say that there are no evil people is
"It is paradoxically discriminatory and stigmatising to say that a person cannot decide for themselves to do bad things just because they suffer from a mental illness."
Schizophrenics commit more than their fair share of murders, many quite brutal and "evil". Either the illness is playing a role in this, or it is not. If not, then we cannot complain, as indeed we do not, when some countries still execute schizophrenics without a second thought. The general view seems to be that they should pull themselves together, and ignore the delusions, hallucinations and thought disorders than can lead to murder. If we accept that the illness plays a role, then why do we imprison them for life? (Another underlying assumption is that schizophrenia is incurable). The crucial determining question is surely "Would they have committed the offence(s) if they had not had schizophrenia? I cannot believe that the Yorkshire Ripper, for one, would have done so.
If a mentally ill person can always decide for themselves on an appropriate course of conduct, why do we still use compulsory Sections?
People are a complex mixture of good an evil and both states are perceptions of behaviour rather than absolutes. Mother Teresa was lauded as a good person in believed to be a living saint yet she condoned many activities that would be considered bad, even if not absolutely evil. Jimmy Savile was a hideous predatory paedophile but raised millions for charity, should he be classed as an evil person or should it be some of his acts that are evil.
The pharmaceutical industry commits hideous breaches of medical ethics and criminal acts on a level that would be regarded as recidivist. At the same time their donations of drugs to developing countries and research into treatments and cures saves millions of lives. Are they good or evil, on which set of criteria should we judge them?
It is not true that schizophrenics commit more than their fair share of murders, the last time I checked the statistics for each person killed by a mentally ill person 10 are killed by corporate manslaughter, 20 by non mentally ill patients, 25 by passive smoking and 125 by infections acquired during medical treatment in hospital* so it is the corporations and normal people that commit more than their fair share of 'murders' Mentally ill people are of course incapable of committing murder either by the M'Naughten rules or diminished responsibility, only those capable of forming the mens rea can commit murder.
The reason we have compulsory section orders is because the mentally ill need to be 'contained'. This dates back in legal terms to at least 1394 with de prerogativa regis which gave the king jurisdiction over the property of idiots and culminated in a modern sense as early as 1800 in Hadfield's case, where the expression was first used "for his own sake and the sake of society at large" the precursor to the section 2 and 3 justification.
* Evidence submitted to the Joint Committee on the Draft Mental Health Bill (RCP 2004) 31-4
"It is not true that schizophrenics commit more than their fair share of murders"
See here for just one corroborative study:
Acta Psychiatr Scand. 2011 Sep;124(3):226-33.
Schizophrenia disorders, substance abuse and prior offending in a sequential series of 435 homicides.
Bennett DJ1, Ogloff JR, Mullen PE, Thomas SD, Wallace C, Short T.
OBJECTIVE:
To examine the relationship between committing homicide, the presence of schizophrenia, substance misuse and past criminality.
METHOD:
The study employed a data linkage design, using contacts recorded on two statewide databases, one of which recorded public mental health services contacts and the second of which recorded contacts with the police. The estimated rates of schizophrenia disorders, substance abuse and criminal convictions found among a population of 435 homicide offenders were contrasted with estimated rates in two composite comparison samples.
RESULTS:
Of the 435 offenders, 38 (8.7%) had been diagnosed with a schizophrenia disorder, which was RR 13.11 (95% CI 9.14-18.80) times more likely than a comparison sample. Rates of known substance abuse between homicide offenders with and without schizophrenia and community-dwelling residents with schizophrenia did not differ significantly. However, these rates were higher than those found in the general community. A similar pattern emerged for comparisons regarding offending histories between these same groups.
CONCLUSION:
The association between homicidal violence and having a schizophrenia disorder cannot be explained away simply on the basis of either comorbid substance abuse or prior criminal offending.
"The reason we have compulsory section orders is because the mentally ill need to be 'contained'."
So everyone who signs or colludes with a Section is a stooge of an oppressive State, conspiring to deprive people of their liberty? Could it not be that some professionals think that it is in the interest of the ill persons themselves to have their illness treated?
"Mentally ill people are of course incapable of committing murder either by the M'Naughten rules or diminished responsibility, only those capable of forming the mens rea can commit murder."
I don't understand this. Are you saying that schizophrenics
1. Lose the ability to understand the law, ie that society disapproves of homicide.
2. Cannot form a proper intention. In a review I did of old UK homicides, true murder, ie where it was clearly intended and premeditated, was far commoner amongst the mentally ill than among murderers in general.
3. Are not being convicted of murder. I seem to read about such cases in the UK at least once a month.
"If a mentally ill person can always decide for themselves on an appropriate course of conduct, why do we still use compulsory Sections?"
I don't think that a mentally ill person can always decide for themselves on an appropriate course of conduct. When a person is psychotic by definition they are out of touch with reality.
"This is generally true. I believe that there are always cases of extreme, rare outliers. I think to say that there are no evil people is misguided."
I need to explain this comment. I am not just talking about schizophrenics, but all people, and so less schizophrenics will fall into this group if they even fall into it at all.
The original question was: "What is the origin of the popular belief that evil deeds are done by evil people?" I think I must express my definition of evil. I believe that a person that is conscious of and willfully malicious without provocation or reason is evil, he/she may not be considered mentally ill. Some under this definition would define an individual, who is also a sociopath, that commits a heinous crime an evil person. Do all sociopaths commit heinous crimes? Some would define a person who is manipulative, for example feigning to be of good intent, yet committing heinous acts and not considered mentally ill because of outward appearance an evil person. Many would not even consider this person as being evil because they would be unconscious of the malintent cloaked in niceties. I do believe that there are people who are so compartmentalized in their thinking that they become dulled to their actions yet at some level are aware of them. These persons may be mentally ill or not by definition. it is possible that the lack of impulse control or conversely high level of control could be treated with therapy and medication but if one does not see this as a benefit then I suppose if he/she is causing deliberate conscious harm then i define that as being evil, and not just an evil deed but when a way of life an evil person. The person can show moments of clarity when genuine empathy is felt, however transient, but may continue to hurt others knowing that he/she is being cruel, gaining such great satisfaction from the unjust act that he/she cannot justify foregoing the pleasure of carrying it out. I do not consider this type of behavior something that is simply a person doing an evil deed and not really defined as being an evil person, the latter being the more general rule, I consider this behavior in a person as being an evil person. I do believe that evil persons exist at the extreme end of the spectrum, and in infinitesimal small number(s) spread over centuries. Most persons probably do evil deeds but are not inherently evil. There are those on the other hand who are so self conscious and sensitive that believe themselves to be evil but are the kindest on earth (at the other far extreme).
"It is not true that schizophrenics commit more than their fair share of murders, the last time I checked the statistics for each person killed by a mentally ill person 10 are killed by corporate manslaughter, 20 by non mentally ill patients"
When I do the numbers there are approximately 300 million persons in the US. Approximately 1% or 3 million are schizophrenics. Approximately 75% of persons in the US do not have (NIH mental health) do not have an identifiable mental illness. So 225 million are not considered mentally ill. So when the math is said and done 0.3 % of schizophrenics commit murder, and 0.26 % of non-mentally persons commit murder.
I can't do the calculation based on the information that I have at this time, or my brain is not letting me. I have more urgent things to do. I do not know how many murders are committed by mentally ill persons who are not schizophrenic. however if 1% of the population commits one murder for every 20 that 75% of the population then I would have to say intuitively that the 1 % kills more than those in the 75 % on a percentage basis.
Margaret
I was trying to make a simple point. As I walk down the street at night I am comforted that I am much less likely to be attacked by a 'schizophrenic' than a member of the non-diagnosed, non-drugged society in which I live.
On another more interesting, if equally disturbing point 'medical accidents' (love that euphemism) kill more people than murderers and RTA's combined.
Anthony
I would love to see that study demonstrating that 'schizophrenics' are predisposed to murder.
On the other points the law states that murder is a specific intent crime and that mens rea cannot be formulated by the mentally ill and children under 10 years old. Now quite obviously an 8 year old can intend to kill an intended victim and might even state that immediately prior to the attack. However the 8 year old is Doli Incapax and incapable of criminal intent under the law.
The insane similarly, by defect of reason cannot commit murder. The definition refers to a defect of reason arising out of a disease of the mind. This is a legal question for the judge, not a medical one.
"I would love to see that study demonstrating that 'schizophrenics' are predisposed to murder."
It is not just one study, in fact there are so many that reviews are needed, eg:
PLoS Med. 2009 Aug;6(8):e1000120.
Schizophrenia and violence: systematic review and meta-analysis.
Fazel S1, Gulati G, Linsell L, Geddes JR, Grann M.
BACKGROUND:
Although expert opinion has asserted that there is an increased risk of violence in individuals with schizophrenia and other psychoses, there is substantial heterogeneity between studies reporting risk of violence, and uncertainty over the causes of this heterogeneity. We undertook a systematic review of studies that report on associations between violence and schizophrenia and other psychoses. In addition, we conducted a systematic review of investigations that reported on risk of homicide in individuals with schizophrenia and other psychoses.
METHODS AND FINDINGS:
Bibliographic databases and reference lists were searched from 1970 to February 2009 for studies that reported on risks of interpersonal violence and/or violent criminality in individuals with schizophrenia and other psychoses compared with general population samples. These data were meta-analysed and odds ratios (ORs) were pooled using random-effects models. Ten demographic and clinical variables were extracted from each study to test for any observed heterogeneity in the risk estimates. We identified 20 individual studies reporting data from 18,423 individuals with schizophrenia and other psychoses. In men, ORs for the comparison of violence in those with schizophrenia and other psychoses with those without mental disorders varied from 1 to 7 with substantial heterogeneity (I(2) = 86%). In women, ORs ranged from 4 to 29 with substantial heterogeneity (I(2) = 85%). The effect of comorbid substance abuse was marked with the random-effects ORs of 2.1 (95% confidence interval [CI] 1.7-2.7) without comorbidity, and an OR of 8.9 (95% CI 5.4-14.7) with comorbidity (p
The biggest confounder in all of those distinguished studies is the rather 'broad' diagnostic criteria applying to the cluster of mental disorders branded as schizophrenia. The reality is there is no way of accurately determining what 'non schizophrenic psychosis' is or for determining the massive confounding effect of the so-called co-morbid disorders. In others words the studies are little more than guesswork. Random effect models are not quantitative and neither are meta-anayses.
The risk of psychotic patients killing is well established in cases studies but it is a not a predictor and it is highly inaccurate and unscientific to talk in such terms. I take note that the studies are riddled with the usual 'riders'
A final note is that the homicides here are presented in pure statistical terms and take no account of the circumstances in which these killings occurred. Since people with histories of psychoses tend to gravitate downwards in society and frequently end up among criminals, drug addicts and other violence high risk groups it is inaccurate to compare the homicide incidence with a so-called normal population.
There are of course similar studies that indicate that blacks and hispanics are associated with violent offending, thankfully they are now totally discredited.
Barry, I have performed a number of studies addressing exactly this question. As have many others. It is reasonably clear that:
1. Psychotic illness increases the risk of homicide by 4-10 fold, depending on the base rate of homicide in the population [see Schanda H
Psychiatry reforms and illegal behaviour of the severely mentally ill.
Lancet 365:367, 367-9]..
2. In general, it is the presence of active psychosis that increases this risk, not a life time diagnosis [see the first episode presenters, the early work of Taylor and others, the formative or qualitative work many of us have done; the recent release work of Coid and others]].
3. General violence [less severe, more minor violence], as opposed to homicidal violence has a different predictor set [see the CATIE data] and comorbidities become more prominent here [substance misuse, personality disorder, unstable social environments].
And work in clinical forensic psychiatry. As Paul Mullen and others have long observed, the individual pathways to violence via relapse of delusions, hallucinations and disturbed and frightened affect is very obvious, but often obscured in large scale studies of mixed populations.
" Since people with histories of psychoses tend to gravitate downwards in society and frequently end up among criminals, drug addicts and other violence high risk groups it is inaccurate to compare the homicide incidence with a so-called normal population."
Could you cite this assertion?
"I was trying to make a simple point. As I walk down the street at night I am comforted that I am much less likely to be attacked by a 'schizophrenic' than a member of the non-diagnosed, non-drugged society in which I live.
'On another more interesting, if equally disturbing point 'medical accidents' (love that euphemism) kill more people than murderers and RTA's combined.'
But not based on the number of deaths or murders caused by each category, a person from what category is more likely to actually act violently and murder someone?
Obviously there are less schizophrenics experiencing psychosis than than members of the non-diagnosed, non-drugged society in which you live, so it may be more likely that you would happen to be attacked by one of those persons.
Margaret:
RE: "When I do the numbers there are approximately 300 million persons in the US. Approximately 1% or 3 million are schizophrenics. Approximately 75% of persons in the US do not have (NIH mental health) do not have an identifiable mental illness. So 225 million are not considered mentally ill. So when the math is said and done 0.3 % of schizophrenics commit murder, and 0.26 % of non-mentally persons commit murder."
What you are seeking is Population Attributable Risk. In New Zealand in NZ for the 1970-2000 time period, based on our 2004-5 data, we constructed the following table [assumptions: NZ averaged 3 million adults over this time period; lifetime prevalence of psychotic illness approximately 1%]:
Outcome
Homicide Not Homicide Total Percent
Exposed
Psychotic illness 65 29935 30000 0.22%
No psychotic illness 779 2996340 2970000 0.026%
Total 844 2999156 3000000
Percentage of all homicides associated with psychotic illness: 7.7%
Relative risk = 8.46
Population Attributable risk [that is the contribution to all homicide in the ppn associated with psychotic illness] = 6.94%
These number s are approximate and largely illustrative, but typical of the world literature. Other studies have looked at this in systematic reviews. See also Steven Segal's Paper in the the 2011 Social Psychiatry and Psychiatr Epi [10.1007/s00127-011-0450-0] for a thorough US look.
Shall we return to the question for a moment as we seem to have digressed somewhat.
What is the origin of the popular belief that evil deeds are done by evil people?
Why are we conflating 'evil' with schizophrenia?
Can I ask for clarification here? Are those posting risk evaluations on schizophrenics suggesting that schizophrenics are 'evil people'? Does the 'diagnosis' schizophrenia suggest dangerous? Should we lock 'em and through away the key?
The tabloid press likes this simple moral panic approach especially when headlines can scream "Killed By Paranoid Schizophrenic" Mentally ill people suffer enough stigmatisation so perhaps we should not too loudly congratulate studies that stigmatise them further. Mentally ill people are statistically more likely to be victims of violence too!
'What you are seeking is Population Attributable Risk.'
Alexander,
Thank you for the edification with your illustrative example. I greatly appreciate it.
Margaret McHenney
Barry,
'Can I ask for clarification here? Are those posting risk evaluations on schizophrenics suggesting that schizophrenics are 'evil people'?
I can only speak for myself and my definition of evil. My view of evil is that someone willfully, consciously and maliciously commits something wrongful against a person without any discernible provocation. For me it doesn't have to be murder, it just means the person is not empathic or self reflective. Obviously not all schizophrenics commit murder, and I doubt that when a schizophrenic commits that act in the manner that I suggested as being evil that the numerical figure is any higher a percentage per person in the "schizophrenic" 1 %, than that of the general "non-mentally ill" population (76% according to NIMH). I think that the reason that I keep harping on your statements is because you don't back them up with data. So, while I appreciate your contributions to the conversation, I feel frustrated and a bit miffed when an assertion is made with comments not backed by concrete evidence.
'Does the 'diagnosis' schizophrenia suggest dangerous?'
Not generally in my opinion or in my experience. In fact in my experience not at all.
'Should we lock 'em and through away the key?'
I don't think so. Do we lock up all persons because there is some minute percentage of a population that commits heinous crimes.? In a Swedish study, "http://www.sciencedaily.com/releases/2013/12/131206111644.htm",: 'Of the 2.5 million individuals included in the study, 4 percent were convicted of at least one violent crime, 93,642 individuals in total. Of these convicted at least once, 26 percent were re-convicted three or more times, thus resulting in 1 percent of the population (23,342 individuals) accounting for 63 percent of all violent crime convictions during the study period.'
"Our results show that 4 percent of those who have three or more violent crime convictions have psychotic disorders, such as schizophrenia and bipolar disorder. Psychotic disorders are twice as common among repeat offenders as in the general population, but despite this fact they constitute a very small proportion of the repeat offenders,"
I think that it would be more constructive to diagnose and treat persons who are unfortunate or fortunate, depending on your viewpoint, enough to experience psychosis, in order to avoid repeat violent offenses however miniscule a proportion of psychotic incidents those may consist of. I also think that it would be more constructive simply because being psychotic opens a person up to stigmatization and might not be a very pleasant experience considering how misunderstood mentally ill persons are by general population some of whom earn their keep as attendants in psych. wards. By treat I mean with medication and therapy if possible.
'Mentally ill people suffer enough stigmatisation so perhaps we should not too loudly congratulate studies that stigmatise them further. Mentally ill people are statistically more likely to be victims of violence too!"
I am not congratulating "studies that stigmatise them further." I am pointing out that some of your claims are misleading. I am that last person on earth who would be interested in further stigmatizing mentally ill persons, or anyone for that matter. I have been victimized at one point or another in my life and would not wish it on anyone.
Barry:
'Can I ask for clarification here? Are those posting risk evaluations on schizophrenics suggesting that schizophrenics are 'evil people'?
I agree broadly with Margaret's response. Clinically I have never seen a person with schizophrenia who I would call evil. Most people with schizophrenia who commit violent acts out of delusional paranoid or grandiose beliefs or hallucinations believe that they are doing the morally or necessary correct thing. Subjectively they are moral persons, it is simply that their ability to apprehend the world is disordered. Treat the illness and they are good and moral persons once again. Their actions may appear horrific, however.
I very rarely have seen non-mentally ill offenders who make me uncomfortable in a manner that suggests a different, brutal, wanton or callous motivation that sits very uncomfortably. It raises the sense of an extreme form of interpersonal destructiveness or harmfulness that has us reaching for a lexicon: that of moral attribution and the term evil emerges in this context.
Two issues here: explanation and condemnation. As a psychiatrist, I have a role doing the former. I have no place doing the latter. That is for courts and wider society. As a member of wider society, I may develop my own moral/ethico/philosophical reaction to certain people and certain acts, may choose to invoke the concept of evil. But I don't think there is much science to it. In that regard, the original question is almost tautological.
'Does the 'diagnosis' schizophrenia suggest dangerous?'
No. the diagnosis is not dangerous, only certain symptoms, at certain times, and certain people with the diagnosis. To apply it broadly is stigmatizing and scientifically inaccurate.
'Should we lock 'em and through away the key?'
Only if we want to thoroughly misunderstand the illness, recovery and adopt an approach that is discriminatory, vindictive and punitive.
'Mentally ill people suffer enough stigmatisation so perhaps we should not too loudly congratulate studies that stigmatise them further. Mentally ill people are statistically more likely to be victims of violence too!"
The science is the science. We need to own it and understand it. As an author of some of this work I don't seek congratulations. But I do think there are things we can take from the literature to try and reduce such violence associated with psychosis. Sit with families with a young family member who is psychotic and threatening to them. Prevention is a rather good idea.
"Can I ask for clarification here? Are those posting risk evaluations on schizophrenics suggesting that schizophrenics are 'evil people'?"
I am strongly contending that the media, public and much of the judicial system do not care if an offender is schizophrenic or not. So, if an evil deed has been done, the offender is therefore labelled evil, conflating evil with mental illness.
"Does the 'diagnosis' schizophrenia suggest dangerous?"
Here it is the professionals and mental health charities who are in denial about the increased risk of violence for the mentally ill to themselves or others.
Here is a contribution to the topic from a leader in Medical Times 1850;22:146 titled Non-punishment under the plea of Insanity:
The "plea of insanity", as it is now familiarly called, or in other words, that new-fangled mode of philosophising which releases a man from the responsibility of his social offences, however light or however grave they may be, is, we are happy to observe, not likely to be legitimatised in our judicial courts. The judges of the land appear determined to protect the interests of society by weighing facts in the scales of Justice, rather than shadowy psychological speculations; and jurymen, while they listen with becoming gravity to the mystifications of scientific jargon, evince a praiseworthy pertinacity in adhering to the instinctive principles of common sense. The mad plea, however, we are aware, was beginning to to make some progress among us...In the days of the good old Newgate Calendar... judges were presumed to, and in reality did, "look quite through the deeds of men"; they weighed the nature and the consequences of evil actions, and never dreamed of investigating the anatomy and pathology of the culprit's wits; but now-a-days the psychological sun has risen above the moral horizon...
Whilst the mad plea has since made more progress amongst the medical and legal professions,I think this article elegantly epitomises the current views of the public and of the popular press in particular, at least in the UK.
My favourite contemporaneous commentary on the pleas of insanity came in the progenitor of what is now the Murdoch press, The Times, in 1843, after the House of Lords established the McNaughten Rules for the pleas of insanity . Under the title of 'On a Late Acquittal', they editorialized with the following doggerel:
Ye people of England, exalt and be glad,
For ye are now at the will of the merciless mad,
Why say yea that but three authorities reign,
Crown, Commons and Lords? You the insane.
They’re a privileged class whom no statute controls
And their murderous charter exists in their souls.
Do they wish to spill blood, they have only play
A few pranks, get a asylum’d a month and a day,
The hie to escape from the mad doctors keys
And to pistol or stab whomsoever they please.
Not sure how much has changed. The same anxieties, the same distortions. And the same dynamics that we must try and address as a forensic mental health community.
I am amazed that people think I am conflating evil with mental illness, nothing could be further from the truth. Idiots in the media like to draw comparisons and make uneducated links between mental illness and 'evil'.
If we are to consider the concept of 'evil' we need some kind of definition. Hannah Arendt's is perhaps the most poignant. It is a form of banality. We live in an evil society where a tiny few are obscenely rich while others go without the basic necessities of life. We live in an evil world where power crazed sociopaths cause misery to millions in the name of politics, religion and corporate excesses.
It is absurdity indeed to blame a the poor unfortunates stricken with mental illness while singing the praises of politicians, celebrities, bankers and ruthless corporate chiefs who cause vast suffering to so many. We can accept that we may never achieve egalitarianism if full and that some will be luckier than others but we can never expel evil from humanity while one of its major motivations is greed and personal gain.
While children die from treatable diseases, while people have no clean water to drink and while the rich get richer at the expense of the many we are all evil. Evil deeds are indeed done by evil people but it is the omissions that are most evil, not the deeds
"While children die from treatable diseases, while people have no clean water to drink and while the rich get richer at the expense of the many we are all evil. Evil deeds are indeed done by evil people but it is the omissions that are most evil, not the deeds"
I agree with this statement Barry. but one can only help a person when he or she is primed to receive the suggestions. Sometimes it is better to lead by example and to influence persons who's trust has been gained. That is why I volunteer, give to charities and assist others who are struggling, when I feel it is appropriate and helpful. When you have solved your some of your own problems and feel stable enough to benefit others, it is time to be generous.
I am not an expert in this field. I have much life experience dealing with helping mentally ill persons with some amount of success. I have benefited from many persons' input. I tailor this information that i have so painfully gained and bring into play knowledge concerning others' circumstances by passing it on in a way that it is applicable, but only if I intuit that they are prepared to assimilate it in a beneficial way.
I am deeply disturbed by the conflation of evil with mental illness here. I have met plenty of evil people in my personal and professional life. Most of them were not 'ill', just downright nasty pieces of work. I have met many mentally ill people also because of my line of work. The vast majority were not evil, although mental illness does not automatically preclude an individual from being also a nasty person.
Evil is a manifestation of selfishness and such it is usually banal. Greed is evil, neglect is evil, cheating is evil. The origins of these behaviours is sadly human nature, there are no demons, no spells or sorcery, just part of the human psyche itself.
Evil Vs. Evil actions comes first to mind here. Can a person be inherently evil within and commit no actions to show the evil inside?, I would say Yes. I find that many persons do not commit what society views as evil acts outwardly on any daily basis however when they do strike out, there evil is no less damaging. The Narcissist who has greed and lust for another on their wedding day is an act of an evil person, man or woman. It does not use murder or brutality however it is evil none the less. To take advantage of another for profit is not illegal within marriage however it is evil. Evil also has many levels. Mental illness however must play a role in the cause of such evil and why it is more deeply rooted in some over others. It is difficult for me to believe that this is human nature. Something must trigger this outward expression of evil just as there is a reason why that person holds dear to the evil within and often repeats the cycle.. Perception is also a main contributor. Do we perceive sadness for the 40 cyclist killed or anger for the four motorist that may have caused this to occur? Either way society seems to look for and seek out the worst of the news first. The headlines of 'death' are surely read prior to the headlines of 'wife plans to bilk spouse out of millions on wedding day'. This is my opinion of human nature.
On the opposing, what comes of the human who has no ability to conjure such evil selfish thoughts to even act upon? Is this the metal illness variable? This is of great interest to me as a continuing student of psychology.
Mental illness plays no part in evil. Evil is a moral construct not a pathology and what may be determined as evil today was perfectly acceptable at other times. Romans and Greeks did not consider themselves 'evil' because they kept slaves and we cannot judge them by 21st century morals.
The concept of mens rea must come into any discussion of evil. It is not for instance necessarily evil to kill another human being. This can be done in self defence or by accident. It is not the act of killing that is judged morally but the state of mind at the time of the act.
The law and psychiatry both consider those mentally ill incapable of mens rea. It is used to justify the detention and enforced treatrmnent of the mentally ill and the lack of mens rea is a defence in criminal law. Indeed in crimes of specific intent the absence of mens rea negatives the crime.
It is flawed thinking and a logical error to conflate mental illness, i.e. a malfunction in thought processes with the construction of a guilty mind. The mentally ill have enough to worry about without being considered 'evil'. In any case anyone thinking this needs to check the statistics. We are many times more likely to suffer violence from those who are not mentally ill. Maybe evil is part of normality!
I would question the actions of a person who is a pathological malignant narcissist, Are there actions evil in today's moral judgments? Is their behavior criminal or evil or is it just culpable in relation to their state of mind. I agree that mens rea is the legal indicator. When we are only able to dissect in retrospect the actions of an individual four decades later per se to show that there actions caused harm and continue to cause harm to others. However this individual I speak of is not at all fictitious and they even work with children who have been removed from there custodians care for many reasons. I feel that this choice to 'counsel' our youth is an act of evil by todays standards. Does this make it acceptable? Should I just view this as an individual who has slipped past 'the system' due to their high academic abilities?
I agree with many of Barry Turners remarks here. Again as continuing a student of psychology I wish to better understand and recognize the differences. I would have accepted evil as the answer however after many nights of continued research. I find that mens rea is not fool proof and Evil may still exist. I do agree that many mentally ill people are being punished and even put to death for crimes that they were unable to comprehend what is right or wrong at the time of the crime. still others are allowing there criminal mind to guide them as well as there education in psychology to harm others who are already victims. I do hope to find a clear answer to this and many other questions. It is not as black and white as I had previously thought.
Mentally ill persons are no more likely to have inherent evil than the general population. Perhaps some diagnoses are more likely to magnify an evil kernel than others. Mental illness can be exacerbated by living during formative years in a mentally ill infused environment, but that does not necessarily produce persons that would intentionally harm others. Some individuals are more likely to consider harming oneself. Is harming oneself evil? I find myself having evil thoughts only occasionally since I have turned 54. Before that I simply felt injured by intentional insensitive actions of inherently mean persons.
"It is not the act of killing that is judged morally but the state of mind at the time of the act.The law and psychiatry both consider those mentally ill incapable of mens rea. It is used to justify the detention and enforced treatrmnent of the mentally ill and the lack of mens rea is a defence in criminal law. Indeed in crimes of specific intent the absence of mens rea negatives the crime."
In which case, why does the US legal system and the public think it is perfectly acceptable to execute schizophrenics?
"Mental illness plays no part in evil."
We could probably agree to this on this site, but this has no influence on public opinion. Every few weeks in the UK media there is yet another case of a horrific "evil" murder by someone with obvious schizophrenia, yet there is little if any realization or acceptance of the notion the person only committed the crime because they were mentally ill.
" In any case anyone thinking this needs to check the statistics. We are many times more likely to suffer violence from those who are not mentally ill."
In absolute terms, this is correct, but relatively speaking, those with schizophrenia are far more likely than non-schizophrenics to commit murder. Denial of this uncomfortable fact does not help patients, society or researchers.
"I do agree that many mentally ill people are being punished and even put to death for crimes that they were unable to comprehend what is right or wrong at the time of the crime."
Many know perfectly well that what they are doing is wrong or illegal, but this does not mean to say they can alter their conduct. For example, they may be suffering from delusions or command hallucinations, and lack insight. The mentally ill cannot simply be expected to "pull themselves together".
Anthony
I think the press among others may be over extending the use of the term 'schizophrenic', let alone "obvious schizophrenic". That term has no scientific basis and encompasses a huge range of behavioural, perceptional and cognitive dysfunctions.
By far the majority of murders are carried out by people who are not mentally ill so capacity for murder is in no way related to any generic condition described as schizophrenia. The vast majority of 'schizophrenics' like the vast majority of 'sane' people do not have any propensity towards violence or murder.
There is no direct link between the imperfect 'diagnosis' of schizophrenia and propensity towards violence and it is simplistic in the extreme to use numerical/statistical correlates. Many schizophrenics become victims of violence, many live in marginalised deprived circumstances where crime and violence are most common. It is not denial to refute these simplistic correlates, of course schizophrenics commit murder but so do policemen and teachers, are we to draw conclusions about that?
Why the US criminal justice system executes people is similarly a complex question but some of the reason is that many of the the US population want retribution. The politicians therefore give it to them to get their vote.
Describing the mentally ill as a dangerous population, apart from being morally wrong is counter productive. Driving them into a downward spiral and into the lower margins of society only makes it more likely that they will commit and become victims of crime.
Having spent 30+ years working with the mentally ill I know only too well that they cannot "pull themselves together", for that matter neither can most of the 'sane'
"There is no direct link between the imperfect 'diagnosis' of schizophrenia and propensity towards violence and it is simplistic in the extreme to use numerical/statistical correlates."
See below for one study. There are many other similar reviews in the literature, so it is irresponsible to deny this strong link.
*****************************************************************************
Encephale. 2009 Dec;35(6):521-30. doi: 10.1016/j.encep.2008.10.009.
[Risk of homicide and major mental disorders: a critical review].
[Article in French]
Richard-Devantoy S1, Olie JP, Gourevitch R.
Abstract
INTRODUCTION:
Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. It is also generally thought that schizophrenia predisposes subjects to homicidal behaviour.
OBJECTIVE:
The aim of the present paper was to estimate the rate of mental disorder in people convicted of homicide and to examine the relationship between definitions. We investigated the links between homicide and major mental disorders.
METHODS:
This paper reviews studies on the epidemiology of homicide committed by mentally disordered people, taken from recent international academic literature. The studies included were identified as part of a wider systematic review of the epidemiology of offending combined with mental disorder. The main databases searched were Medline. A comprehensive search was made for studies published since 1990.
RESULTS:
There is an association of homicide with mental disorder, most particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. However, it is not clear why some patients behave violently and others do not. Studies of people convicted of homicide have used different definitions of mental disorder. According to the definition of Hodgins, only 15% of murderers have a major mental disorder (schizophrenia, paranoia, melancholia). Mental disorder increases the risk of homicidal violence by two-fold in men and six-fold in women. Schizophrenia increases the risk of violence by six to 10-fold in men and eight to 10-fold in women. Schizophrenia without alcoholism increased the odds ratio more than seven-fold; schizophrenia with coexisting alcoholism more than 17-fold in men. We wish to emphasize that all patients with schizophrenia should not be considered to be violent, although there are minor subgroups of schizophrenic patients in whom the risk of violence may be remarkably high. According to studies, we estimated that this increase in risk could be associated with a paranoid form of schizophrenia and coexisting substance abuse. The prevalence of schizophrenia in the homicide offenders is around 6%. Despite this, the prevalence of personality disorder or of alcohol abuse/dependence is higher: 10% to 38% respectively. The disorders with the most substantially higher odds ratios were alcohol abuse/dependence and antisocial personality disorder. Antisocial personality disorder increases the risk over 10-fold in men and over 50-fold in women. Affective disorders, anxiety disorders, dysthymia and mental retardation do not elevate the risk. Hence, according to the DMS-IV, 30 to 70% of murderers have a mental disorder of grade I or a personality disorder of grade II. However, many studies have suffered from methodological weaknesses notably since obtaining comprehensive study groups of homicide offenders has been difficult.
CONCLUSIONS:
There is an association of homicide with mental disorder, particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence...
"It is not denial to refute these simplistic correlates, of course schizophrenics commit murder but so do policemen and teachers, are we to draw conclusions about that?"
If it were true that police and teachers were far more likely than the general population to commit murder, which I doubt, I would certainly want to draw policy conclusions.
"I think the press among others may be over extending the use of the term 'schizophrenic', let alone "obvious schizophrenic".
On the contrary, I think the press underextend the term schizophrenia, and if they can avoid mentioning the mental illness of a criminal, they will. When has there been, for example, any article in the popular press explaining why the Yorkshire Ripper has been in Broadmoor Hospital for many years?
The article mentioned above conflates several dysfunctional states of mind into one and is therefore poorly constructed as an hypothesis. It does serve however to indicate how poor quality research can evade the alleged quality control of peer review.
I take particular note of the conclusion drawn from DMS IV (sic) that 30 to 70% (an astonishingly imprecise figure) of murderers are graded into mental disorders and personality disorders. No serious researcher in psychiatry would make such a ridiculous statement. Those terms are of course frequently conflated in the press and in other poorly constructed research but they are quite distinct and presenting them as one 'cause' of murder introduces insurmountable confounders in any serious mental health research.
Incidentally there is no 'epidemiology' of homicide. That kind of language indicates immediately a failure to understand both the epidemiology of mental illness and its aetiology and is rather more representative of journalistic and sensationalist language than scientific.
Personality disordered offenders are not insane. It is virtually impossible to identify potential killers in this grouping and personality disorder is nothing to do with schizophrenia. Personality disordered offenders do not suffer from hallucinations, thought disorder or cognitive dysfunction and many of them occupy positions of importance.
Presumably the 'policy conclusion' of this paper was that the mentally ill should be incarcerated because some of them pose a risk to society. Since many non-mentally disturbed people also pose such a risk how would we devise a method for incarcerating them too?
The reason the Yorkshire Ripper's insanity is not mentioned in the press frequently is because it is not a story. Only if there was talk of him being released or allowed out on day trips would this be of interest to the press. While he is in Broadmoor he can be forgotten, just like countless non-violent people would be if we returned to the 19th century asylum model.
The care in the community programme has not been a failure by any stretch of the imagination. Mentally ill people have benefitted greatly from it and the drugs that can control their illness. Yes there have been some tragedies caused in the main by localised failings in the care system and voraciously snapped up by the media but to suggest that it could ever have be perfect is as absurd as the flawed methodology used in that 'research'.
There is a high incidence of violence and murder in the lower stratas of society and the underclass are highly prone to violence. Perhaps the desperation that poverty and frustration brings might be something to do with it. Maybe we should lock all of them up too!
"The reason the Yorkshire Ripper's insanity is not mentioned in the press frequently is because it is not a story."
No mention was made that the YR also had schizophrenia in the recent story on the Mirror website below, which could hardly be more relevant:
"Yorkshire Ripper copycat wanted to kill more prostitutes than his hero Peter Sutcliffe
Dec 05, 2014 16:56
By Jeremy Armstrong
Court hears that schizophrenic David Parsons hired a prostitute to come back to his flat and then he tried to kill her with a hammer"
Anthony
Could you clear something up for me?
Referring to your question and the direction of this thread are you arguing that schizophrenia is a form of evil?
"Having spent 30+ years working with the mentally ill I know only too well that they cannot "pull themselves together", for that matter neither can most of the 'sane'"
In my opinion the mentally ill who have the means and the desire to "pull themselves together" are more successful at this endeavor than some persons who are considered "sane". They can avail themselves to both appropriate counseling and the wide array of beneficial psychiatric drugs under the right circumstances (that is under the supervision of gifted counselors and psychiatrists), while "sane" persons may not acknowledge, or even realize that they have a problem---it is their position or opinion that "other persons have the problem". It is clear to me that some "sane" persons are obtusely insensitive or possibly even sadistic and drive some susceptible persons to a state of mental illness. Some mentally ill persons are driven to insanity by "sane" persons in the current state of affairs!
This exchange is now far removed from the original question. If the question is now are people who suffer a psychotic illness at higher risk of violent behavior than other people in the community, then the epidemiology is crystal clear: yes. And some of the work for this has been cited above.
And no, this is not simply a statistical association. The mechanism for this relationship are reasonably well understood [arising from co-morbidity, social circumstances and acute symptoms of illness: all contribute, which has made the literature a bit confused as one of these areas may at times be emphasized over others]. And any one of us who works in forensic mental health rehabilitation knows [as I have for 25 years] that 85% of the people we are helping recover have a psychotic illness and have been violent.
But:
1. this has nothing to do with evil, the original question;
2. this is not a justification for public fear or rejection. The increased risk is treatable with good mental health services, support and social inclusion. It is not a justification for re-institutionalization.
Attached is a recent blog of mine that tries to summarize this in a simple way for public messaging/education [ http://camhblog.com/2014/12/10/understanding-mental-illness-and-violence/ ]. This is a crucially important issue for two major reasons. Get the understandings wrong and we can increase stigma. Deny that the relationship between violence and mental illness exists and we risk being seen as negligent in the eyes of the public who know full well that psychosis increases violence risk, even if the public totally misjudge the magnitude of that association.
In my view, polarizing this discussion into: there is no increased risk of violence or there is a huge and frightening risk, damages recovery messages and the goals of social inclusion for people with psychotic illness [that I have also fought for for 25 years!!]. We must be clear we know there is an increased risk, that we understand where it comes from and we can work hard to reduce the risk, so that the public need not fear people with psychosis.
And I don't think this discussion should continue under this heading, but perhaps another question can be posed.
Alexander
I totally agree. We must not equate mental illness with evil, to do so is counter productive and likely to increase violence in sufferers rather than alleviate it. Stigmatising people as evil has no positive outcome. No one is denying the association of mental illness and violence, it is an everyday occurrence on acute admission wards. Frightened people do lash out and much of the violence perpetrated by the mentally ill is in states of fear rather than states of 'evil'.
Incidentally people with heart problems and diabetes have been known to pose a risk of causing violent deaths to the public at large, especially when they are behind a steering wheel.
Is driving while knowing you have a heart disease evil perhaps?
"And I don't think this discussion should continue under this heading, but perhaps another question can be posed. "
As a serial offender, my justification for going off piste is that I assume RG has some reputation for scientific integrity, so that I think any controversial or contentious statement should be challenged wherever it occurs. These RG discussions can be accessed by search engines, and I suspect can be as easily found by key words in them as by finding the questions themselves.
"In my view, polarizing this discussion into: there is no increased risk of violence or there is a huge and frightening risk, damages recovery messages and the goals of social inclusion for people with psychotic illness [that I have also fought for for 25 years!!]. We must be clear we know there is an increased risk, that we understand where it comes from and we can work hard to reduce the risk, so that the public need not fear people with psychosis. "
I couldn't agree more. However, this battle was lost long ago in the British Press, and not just in the tabloids. For example, the lead story in one redtop a few years ago was about someone who had committing a horrific crime and was being given some non-punitive activity at Broadmoor Hospital. The message was: This person is inherently evil and must be punished indefinitely. I was the only person who complained to the Press Complaints Commission about this. Any mental health professional who publicly challenges this conflation of mental illness and evil really would be mad.
Very many psychiatrists do challenge the conflation of mental illness with evil and violence. The Critical Psychiatry Network is an expanding group of practicing and academic psychiatrists who all challenge the ridiculous orthodoxy and the imbecile opinions of the press.
www.criticalpsychiatry.co.uk
"Referring to your question and the direction of this thread are you arguing that schizophrenia is a form of evil?"
There is no simple answer to this question, as evil is such a slippery word. To dissect the different usages:
I regard schizophrenia as a medical illness like diabetes, though of uncertain cause. Hence it is unjust and ridiculous to treat schizophrenics as criminals, or to label them as evil, since it is often only because of their illness that they can become violent. This seems to be a minority opinion in society. I do not hear protests when schizophrenics are executed in the USA. I suspect the public do not formulate this as a problem, and mental health personnel would be committing professional suicide if they spoke out and protested.
I have just been reading the new (2014) book Naming Jack the Ripper by Russell Edwards, which coincidentally contains highly relevant information:
- There is good contemporary and recent DNA evidence identifying the killer as Aaron Kosminski
- "It is probable that Kosminski was schizophrenic...The symptoms mentioned in the report by Dr Houchin are typical of schizophrenia". That now makes 3 schizophrenic Rippers (see my recent post).
- "Many notorious killers have been diagnosed with schizophrenia or have shown behaviour that strongly suggests they have it." He names David Berkowitz, Ed Gein, Peter Sutcliffe, Mark Chapman, Richard Chase. Chase was sentenced to death in the gas chamber despite a diagnosis of paranoid schizophrenia two years before his first murder.
Despite all this, Edwards, who is studying for a MA in Psychotherapy and Counselling, states:
"The violence of schizophrenics is something that has been the focus of media attention in modern times, even though schizophrenics are statistically no more violent then the general population".
For once, it seems the media are more in touch with reality than university psychology teachers.
""The violence of schizophrenics is something that has been the focus of media attention in modern times, even though schizophrenics are statistically no more violent then the general population".
For once, it seems the media are more in touch with reality than university psychology teachers."
Hear Hear
Gordon,
As an expert in capital murder cases on mitigation of punishment, I am amazed by the role played by issues of moral character in attributions of moral culpability. This concern has been examined by a number of experimental social psychologists. Their research has demonstrated that people often dismiss actions of bravery or virtue enacted by individuals with a history of character flaws or bad character. The notion that bad character will determine bad acts is a common bias in judging human actions and is considered one of the primary reasons why character is not admissible in the guilt phase of criminal cases in the U.S. and other legal systems. People have an inherent bias against out of moral character calls for leniency for good acts committed by bad people, but not for out of character defenses for supposedly good people. A book that you might find interesting is by Desteno and Valdesolo(2011) titled Out of Character: Surprising truths about the liar, cheat, sinner (and Saint) lurking in all of us. I confronted this and other character issues in relation to attributions of culpability in my own book on death penalty mitigation published by Oxford University Press in a chapter titled: Assessing culpability: the role of background and character. There are different mind sets about issues of moral character that are also responded to in very different ways by different moral tribes.
"character is not admissible in the guilt phase of criminal cases in the U.S. and other legal systems."
As a non-expert in murder cases, my impression is that the first thing the jury does is make a binary overall assessment of defendants, are they good or bad characters, and this largely influences their verdict. This is done on superficial and quite unreliable features like their demeanour and appearance. Once labelled bad, then biasses like those Jose mentioned come into play.
I put this question up because I was concerned at how the mentally ill were dealt with by the legal system. It seem that the vileness of the deed is such a powerful drive that it totally overrides and negates any mental illness the perpetrator has. Bad deed = bad person. Society should be setting an example to murderers by acting more rationally than they did, something it is signally failing to do.
Thanks for the book recommendation, Jose. However, judging by its title, it does not look as if it will have a lot to say about mental illness.
I attach an article I wrote for the New Scientist on the concept of mad or bad?
And a powerpoint presentation I gave at Amsterdam University Law School on behaviour and criminality.
Gordon,
Sorry, I though you were just interested in evil deeds not crimes committed by persons with mental illness.
http://www.healthline.com/health-news/childhood-violence-and-adult-brain-structure-011513
Above is a link for the article that I am citing published January 15, 2013 for those interested in reading the full article. The results of research by Swiss think-tank EPFL were released January 15, 2013 in Translational Psychiatry: Original Article
Translational Psychiatry (2013) 3, e216; doi:10.1038/tp.2012.144 Published online 15 January 2013 titled:
Peripuberty stress leads to abnormal aggression, altered amygdala and orbitofrontal reactivity and increased prefrontal MAOA gene expression
• Being exposed to violence can impact a person’s behavior especially impulse control and violent tendencies.
• There is some evidence found by researchers that psychological trauma during childhood physically changes the makeup of a child’s brain, most importantly the part of the brain involved in decision-making.
• James Keim, director of the Oppositional & Conduct Disorder Clinic at the Institute for the Advancement of Psychotherapy in San Francisco argues that a child exposed to violence won’t necessarily grow up to be violent.
• Exposure to violence triggers changes in specific areas of the brain. According to Professor Carmen Sandi, head of the EPFL’s Laboratory of Behavioral Genetics, the research alluded to in this article “…shows that people exposed to trauma in childhood don’t only suffer psychologically, but their brain also gets altered. This adds an additional dimension to the consequences of abuse, and obviously has scientific, therapeutic and social implications.”
• The most significant change (bolstered by series of experiments done in rats) researchers found was to the orbitofrontal cortex, the lower front portion of the brain behind the eyeballs.
• The orbitofrontal cortex is believed to be responsible for signaling other parts of the brain about reward or punishment offered in given situation. This signaling can allow the mind to adapt to achieve rewards and to avoid punishment (as happens when children learn not to touch a hot stove). This area of the brain is also associated with addiction, learning social cues, and the ability to make good decisions based on potential outcomes.
• “In a challenging social situation, the orbitofrontal cortex of a healthy individual is activated in order to inhibit aggressive impulses and to maintain normal interactions,” Sandi said.
• Researchers discovered how adolescent violence translates into aggression in adulthood by experimenting on rats. Some rats were exposed to violence during youth, and researchers tracked their behavior as they grew.
• The brains of adult rats with aggressive tendencies were studied. The findings showed that those male rats had little activity in the orbitofrontal cortex, which reduced the rats’ ability to control their negative impulses. This also had an effect on the amygdala, another part of the brain responsible for emotional responses.
• Basically, the rats exposed to abuse did not have the proper hierarchical control, or reaction in their brains to keep them from over-reacting when they encountered something they perceived as a threat.
• In the past researchers who have studied the brains of violent human individuals, such as murderers and mobsters, have observed the same limited response from the orbitofrontal lobe and a corresponding lack of impulse control.
• MAOA and the ‘Warrior Gene’: The EPFL also paid close attention to a gene, MAOA, which is associated with aggressive, antisocial behavior. Certain genetic variants can predispose a person to an aggressive attitude, and researchers have noticed that psychological stress triggers changes in how this gene is expressed.
• Essentially, trauma changed how the rats’ genes performed permanently. When given antidepressant medication, the effect was reversed and aggressiveness decreased.
• Frequently in scientific research, the term violence is used synonymously with impulsiveness. Impulsive behavior can be triggered by a chaotic, violent, environment, as well as when violence from an adult cannot be anticipated.
• Children raised in chaotic, unpredictably violent environments learn to navigate the instability of home and find themselves bored when seated in a classroom because there aren’t enough stimuli. These individuals have trained themselves to function in a perpetual danger-zone.
• In the face of stress, a surge of adrenaline in the body heightens visual memory but tones down hearing. So when a child exposed to violence is in a stressful situation or feels threatened, his body blocks out what others are trying to tell him.
• According to James Keim, adrenaline inhibits pro-social skills, and young minds trained to kill in a war setting could easily change their brains in the same way as the EPFL rats exposed to violence at a young age. “They are neurologically tuned to perform best in that kind of environment…”
• Unlearning learned behavior: The largest impact is made when a child learns to self-regulate his or her “extreme adrenaline responses” (organized sports are a good example of an outlet and opportunity to self-regulate) and when mentors teach non-violence as a social norm.
Of course there are individuals who exhibit violent tendencies and were never exposed to violent environments, for example children adopted into quiet innocuous environments. These individuals’ actions can be explained by any number of events: developmental anomalies of the brain. Genetic variants of MAOA related to a predisposition to violent behavior. Physical trauma such as experienced in concussions, and other events that could leads to changes in the anatomy of the brain, or presumably gene expression relating to volatile reactivity to the environment.
Of course not all persons exposed to violent upbringing express the brain changes through violent measures. It is obviously a more complex process than that. Some exposed to these environments appear to escape unscathed, while others do not exhibit the violent components, but only the lack of impulse control.
This week's awful event in France indicate that there is a propensity in humans to commit evil deeds for the flimsiest of excuses. There is no suggestion that the violent criminals responsible for the mass murder at Charlie Hebdo and in the later sieges were 'mentally ill'. They were simply adherents to a hideously distorted aberrant version of religion. It may very well be that they were of a narcissistic and dangerous personality disorder, a common personality failing in grandstanding murderers but that is not a mental illness.
Evil is a word to describe extreme forms of aberrant behaviour that are outside the norms of decency and obviously includes violence and the infliction of harm for self gratification. The self centred, self obsessed attitudes of those who believe they should be martyrs is an example of such evil.
"This week's awful event in France indicate that there is a propensity in humans to commit evil deeds for the flimsiest of excuses"
These events which led to the death of about 17 people had very clear and objective causes, cartoons offensive to many Moslems, and the death and destruction visited on the Middle East by Western Governments. Note: this is an explanation, not a justification. On the other hand, thousands have been directly and indirectly killed on the basis of a demonstrable untruth, the presence of weapons of mass destruction in Iraq. If not an outright lie, it was gross carelessness in not checking this out critically. I do not think our leaders were evil, just woefully or indeed deliberately ignorant of basic psychological mechanisms and cognitive biasses.
"They were simply adherents to a hideously distorted aberrant version of religion."
They simply took literally some passages in the Holy Books, something all religions have done or are even still doing. You do not have to be a narcissist, psychopath, or have a mental illness or personality disorder, or indeed to be evil, to do this.
"Evil is a word to describe extreme forms of aberrant behaviour that are outside the norms of decency and obviously includes violence and the infliction of harm for self gratification. The self centred, self obsessed attitudes of those who believe they should be martyrs is an example of such evil."
This apposition of the two sentences is just the reason I put up this RG question. Whether or not Barry intended there to be any logical connection or link, many will see one there, internalising the idea that the entity of evil detaches itself from the deed, floats away and attaches itself to the doer.
"The self centred, self obsessed attitudes of those who believe they should be martyrs is an example of such evil."
This surely characterises all martyrs, and is the main reason they let themselves be killed. The Catholic Church makes these people saints, eg Joan of Arc.
It is difficult to see Joan of Arc as evil although many of her 'sponsors' certainly were. The revised view of her today is of course not so much the leader of the Dauphin's army and more as its mascot.
It is also not quite accurate to say she was burned for witchcraft, she was actually burned for denying her femininity by wearing men's clothes repeatedly.
Most martyrs were megalomaniacs of one sort or other. Judging by poor old Joan's childhood tribulations she may very well have been suffering from mental illness.
"Judging by poor old Joan's childhood tribulations she may very well have been suffering from mental illness."
Her problems started when she had unilateral auditory hallucinations. Despite intense pressure and bullying, she refused to accept these as evidence of illness. I am very impressed with her clarity of thought, and think it very unlikely she had a mental illness.
Incidentally, there is no plausible brain origin or explanation for unilateral AHs. Actually, I think they originate in the ear, which easily explains their unilaterality. Joan also had episodes of dizziness and sickness, so likely had Meniere's disease or such like.
"Judging by poor old Joan's childhood tribulations she may very well have been suffering from mental illness."
Mental illness is not exclusive to a childhood filled with tribulations, and childhood tribulations do not necessarily lead to mental illness, although science points to children with a genetic predisposition to become mentally ill when the stressors experienced in childhood exceed the physiological setpoint determined by their genetic makeup. Trials and tribulations can trigger physiological events leading to mental illness in those who are predisposed.
" I am very impressed with her clarity of thought, and think it very unlikely she had a mental illness."
I find this comment very bigoted. I am acquainted with numerous "mentally ill" persons who have extreme clarity of thought during much of their conscious moments. Bipolar and schizoaffective persons on medication and not stressed to an extreme are an example as well as persons on medication struggling with depression
Why is it that every time mental illness is mentioned it triggers value judgments or indignation?
If Joan of Arc was about today she would without doubt be labelled schizophrenic as she exhibits loads of the DSM criteria* (notice I do not say symptoms, schizophrenia is a classification not a diagnosis) Hearing voices from God, especially where the person attempted to act out the instructions would get them 'sectioned' in just about all of the jurisdictions that I have professional experience of.
It is correct that mental illness is not confined to a childhood filled with tribulations but I have encountered very very very many patients where that was the case. I am not excluding those who were lucky to have an idyllic childhood, simply pointing out a common factor in the development of mental illness.
"It is correct that mental illness is not confined to a childhood filled with tribulations but I have encountered very very very many patients where that was the case."
Is having a "terrible" childhood a reality or a perception? I have an aunt who looks at her childhood as being very good while her sister feels that the situation was intolerable. I wasn't there, but I know both women and they simply have different temperaments and different expectations. My father had much misfortune and painful encounters throughout his life, but he was genuinely grateful for his experiences and was an eternal optimist.
We are getting off track, but I just had to express that commentary.
The recent Sniper trial illustrates the conflation of mad and bad:
Life for bad-not-mad killer who shot American Sniper London Metro Feb 26th, 2015 p 31.
The jury here quickly concluded that Routh was bad, not mad, despite his obvious diagnosis of schizophrenia. They were infuenced by the prosecution argument that if he was insane, he would not have fled, and Routh said he had shot deliberately, thinking his victims were going to kill him. Could someone please explain to the US public that psychosis is compatible with organised planned activity and actions, and that delusions can lead to homicide? Even the prosecution was too embarassed to request the death penalty in this case. though plenty of other schizophrenics have been executed in similar cases.
Here is the sort of case that makes me think we are back in the Dark Ages. Whether James Holmes is legally insane or not is hardly the point, what is crystal clear is that he was/is psychotic and that was why he killed those people. Any legal system that does not realise this is more insane and more culpable than any killer.
Here is a typical comment after a recent news report on the Batman Killer that explicitly conflates mental illness and evil:
"Sick and tired of the defense using mental illness as an excuse for murder! Of course these people are damaged all the more reason to permanently remove them ! It is not revenge it is ridding our population of evil and making people pay for their evil deeds!"
If Holmes ever decides to complete his Neuroscience PhD, will there be anything on the syllabus relevant to his case? Or are neuroscientists too scared to put their heads up above the parapet? Is anyone on RG prepared to give moral and scientific support to the one [sic] juror who thought it wrong to execute a psychotic person?
When mental illness causes a crime, then the issue of moral character is irrelevant for mental health and criminal justice policy because the mental illness negates their criminal responsibility. That is, if one accepts the values associated with the need to treat rather than punish persons who lack the capacity to know right from wrong because of their mental disease or defect. However, some states have eliminated the insanity defense (Idaho, Kansas, Utah, and Montana). In addition, Michigan established an alternative defense, guilty, but mentally ill. This law allows for a recognition of circumstances when a mentally ill person has an "evil mind" that is translated into an evil act, but is mentally ill and in need of treatment.
Arizona, on the other hand, tries to address this problem with a guilty except insane defense which is clearly oxymoronic to many legal scholars. Nonetheless, it works for circumstances in which a person who is insane will receive the same sentence as a sane person for the offense that they committed, but they are treated in a hospital for the length of the commitment for their presumptive sentence because they are also insane. If they are not insane, then they are sentenced to prison. However, after the completion of this sentence, the treatment staff with oversight of GEI patients have no jurisdiction over the case. A few such individuals have committed serious offenses after completing their presumptive sentence and were without treatment because they did not meet criteria for civil commitment when they were no longer under the jurisdiction of the Psychiatric Security Review Board. This points to the complexity of the relationship between crime and mental disorder and the competing social constructions of how to respond to persons with mental illness who commit crimes: values of treatment versus values of punishment, as well as approaches attempting to balance the two competing sets of values. Are these incommensurable modes of discourse or competing value systems that are embedded in cases like the James Holmes case?
Accordingly, I disagree with Gordon's comment about the irrelevance of insanity in the James Holmes case because we have not found a way to determine guilt in ways that can ignore the legal tradition's current focus on identifying the elements of a guilty mind in establishing a person's guilt. The legal culture still adopts notions of free will and arguments by legal scholars like Stephen Morse continue to resonate with other compatibilist who challenge hard determinist approaches to incompatibilism in criminal law.
Having a terrible childhood is usually a reality. Being beaten, neglected and sexually abused is usually thought of as really bad rather than a perception of bad. Suffering repeated trauma causes mental illness, suffering even one trauma that is bad enough can cause it.
Anecdotal stories about the perceptions of one's aunt or her sister's perceptions of the quality of childhood is hardly evidence of anything except the aesthetics of two individuals
There is a huge conglomeration of evidence that demonstrates the link between childhood trauma and psychosis, it is not absolutely determined but then again neither are the 'chemical imbalance theories'.
Operant conditioning theory alone provides us with an explanation why people do violent and anti-social acts. People subjected to violent and callous behaviour 'learn' to be violent and callous.
Some people are prone to react to PTSD more than others but trauma is a major factor in psychiatric illness. It cannot be sidelined or ignored in favour of the pharmaceutical industry's marketing propaganda based on 'chemical imbalances'
See American Journal Of Psychiatry Article (July 2015) attached:
Barry,
You are correct that trauma can trigger psychosis. The case that triggered the Guilty but Insane legislation in Arizona involved a temporary case of insanity. The person when restored to reasons was released after 6 months. This led to the unfortunate circumstance of a law that eliminated the insanity defense as it previously existed to insure that persons with temporary insanity would need to serve at least the presumptive term for their illness even if found insane.
Most psychotic responses to trauma would quality under Brief Psychotic Disorder in the DSM-5 (formerly Brief Reactive Psychosis). Trauma can also be a precipitant to the onset of Schizophrenia, but it is not generally considered a cause of this serious and persistent condition. It is, however, a major contributing factor to many mood, and anxiety disorders.
Criminal responsibility remains a big issue in the legal culture, but not in the science community that adheres to much more of a deterministic frame of reference. However, the problems with the Durham test or product test continues to separate the legal community from the scientific community. Scientists recognize the limits on choice rooted in a person's background, but the law is less receptive. It still assumes that decisions that are free reflect on a person's moral character. Until this assumptions is challenged by compelling evidence by the scientific community, this assumption about an evil mind guiding evil or guilty actions will remain a component of our law, as will discussions about circumstances when criminal responsibility can be negated or mitigated by reason of mental illness.
In sum, I am saying that the fundamental assumption that our actions reflect our moral character is the residual assumption from western philosophy that continues to influence our notions of evil behavior initially raised by Anthony. The insanity defense was the strategy employed by the law to recognize causal factors that negate this assumption about human agency and responsibility.
Here is a perfect example of the conflation of evil with psychosis:
More from the Sun website Dec 1,2015
"He's evil, not insane: Ripper set to move to 'Monster Mansion' after 31 years at Broadmoor
EXCLUSIVE: Killer loses cushy life in hospital and fears move to high-security jail in Wakefield
EXCLUSIVE by ROBIN PERRIE and MICHAEL HAMILTON...
PETER Sutcliffe fears he will be moved from cushy Broadmoor to Wakefield Prison — the high-security jail dubbed “monsters mansion” after its notorious inmates.
Doctors have ruled Yorkshire Ripper Sutcliffe’s treatment at the secure hospital has ended, 31 years after he was admitted as a paranoid schizophrenic....
“Category A prisons are a pit of black despair and hopelessness. I’ll spend the rest of my days there.”...
“The nurses discuss things with you at Broadmoor, they’re friendly and patient. But in prison all they do is bung you your tablets and expect you to get on with it. All my letters and phone calls would disappear as well.”
Sutcliffe has become so depressed at the thought of prison he is now on suicide watch, with Broadmoor staff checking him every 15 minutes....
Doctors now believe his mental health is fine. Sutcliffe himself told psychiatrists he no longer hears the voices that urged him to kill — although he recently claimed he was hearing them again."
“While nothing is easier than to denounce the evil doer, nothing is more difficult than to understand him”
F. Dostoevsky, The Possessed
I am not sure the point you are making, Anthony. He was convicted of his crimes [found responsible, not evil: evil is a moral judgement others are making. That he was responsible for the offences was the legal outcome]. He appears to have become psychotic at some point, and needed hospital care. He may have had a contribution of illness to the original offences, of that I do not know. But now the hospital has decided he no longer needs hospital care and his illness can be managed in a prison, with out patient type mental health follow up [as all prison inmates receive]. Decisions of this sort are made on a daily basis.
The question as to whether he should have been found responsible for the offences or found NGRI was resolved a long time ago, and is not revisited in this decision. This isn't conflation, just media hyperbole because of the high public profile of he and his offences.
"I am not sure the point you are making, Anthony"
The conflation refers to the implication that evil and mental illness are similar, and need no disaggregating. The Sun article headline started "He's evil, not insane". The Sun has very clever lawyers who would no doubt say that as his schizophrenia is in remission, he is not currently insane. What , of course, it wants to not too subtly infer is that he was never mentally ill when he committed his horrific murders. Indeed, the accompanying bilious Sun editorial said that PS only says he hears voices when it suits him, in other words, he was malingering. If anyone knows a better explanation for the Ripper murders, other than the one given by PS that he was obeying divine voices, then we need to hear it. I cannot understand how the media can get away with labelling schizophrenics evil. Are there no mental health professionals or charities that are concerned about this stigmatization of the mentally ill?
The Sun newspaper is written for dumbasses who get some prurient entertainment from gloating over punishments. They also are constantly fed by nincompoop stories about 'cushy prisons' and the easy cosy life in secure psychiatric hospitals.
The journalists who write these stories are as dumb as their readership and perhaps if they spent a couple of weeks in one of these 'holiday camps' as they like to call them they might learn something.
I have in my time been both a mental health professional and a criminal defence lawyer which has given me a wonderful insight into mental hospitals, secure units and 'bang up prisons' I have worked with 'schizophrenics', a ridiculous term if ever there was one and psychopaths for many years. Stigmatising the mentally ill is an appalling brutish way to treat the most vulnerable in our societies and anyone who does this should be vilified.
It is not however any help to suggest that simply because Sutcliffe might have been hearing voices that his crimes are any less evil. He is an evil manipulative psychopath and deserves to be behind bars for good.
"It is not however any help to suggest that simply because Sutcliffe might have been hearing voices that his crimes are any less evil. He is an evil manipulative psychopath and deserves to be behind bars for good"
The crimes he committed are evil per se. The mental state of the killer is irrelevant to this.
Given that genes and physiological abnormalities are involved in psychopathy, I think it is inappropriate to label psychopaths evil. We are back with the concept of Original Sin. I would have thought it was obviously wrong to label schizophrenics evil, but clearly I am in a minority here since our prisons are full of people who would not have been there had they not through no fault of their own inherited some schizophrenia genes.
Having met a number of violent psychopaths I have concluded they are evil. They are not mentally ill, they are not deluded, they do not hear voices and they are not 'genetically' psychopaths.
Our prisons are indeed full of mentally ill people and many of them have the absurd label of schizophrenic. That is not in any way related to psychopathy. While there is no conclusive evidence of a 'schizophrenia' gene its is true that their disability is no fault of their own and that they do not have the mens rea to commit crimes.
Sutcliffe was devious enough to try to conceal his guilt and his weapons while he believed he would get away with it. When it was obvious he would not he elected for the insanity defence. Manipulative, lacking in empathy, unable to accept responsibility, a pathological liar and certainly dangerous deprivation of liberty for his whole life is the most humane way of treating him and protecting everyone else.
In any case the 31 years he has served so far have done him the world of good.
"Sutcliffe was devious enough to try to conceal his guilt and his weapons while he believed he would get away with it. When it was obvious he would not he elected for the insanity defence"
So what you are saying is that basically PS was lying when he said he heard voices, and that was why he was trying to clear the streets of prostitutes. And the defence and prosecution psychiatrists who unanimously agreed at his trial that PS was schizophrenic were naive incompetents.
We will never know for a fact whether the shrinks were naive or incompetent although those two traits are often found in that profession.
Nevertheless we can all be happy that Sutcliffe has been locked up for decades and that the incarceration has been very beneficial to him. Another three or four decades should see him fit for release.
Even given the very brief details below, this case illustrates the general way deluded people are dealt with by the law. The obvious message is that mentally ill people who have no insight into their delusions and act on them should nevertheless pull themselves together to make themselves gain or feign insight so they now have sufficient judgement to show remorse, otherwise they will end up in prison whenever they fall foul of the law as many psychotics do. A very similar version of this story appeared in the written Metro May 4th, with the exception that it started "A warped woman who.."
"A woman who was sexually obsessed with pop twins Jedward has been jailed for just two years after having sex with two 14-year-old boys...
The 39-year-old made a move on two boys after inviting them to her home in Dundonald, South Ayrshire, to get drunk and watch films about 2½ years ago.
Her solicitor Ian Gillies expressed concerns about her mental health and told Ayr sheriff court she ‘needs supervision at the higher end of the scale’...
However, the sheriff, John Montgomery, said he had to jail her as she had shown no remorse."
Read more: http://metro.co.uk/2016/05/04/jedward-obsessed-woman-who-had-sex-with-two-14-year-old-boys-is-jailed-for-just-two-years-5857890/#ixzz49l3dSTVo
Here is a prime example of the conflation, or even equation, of evil with mental illness from an unlikely source. Obama made no mention of mental illness, but James Ruben said on BBC Today program this morning the perpetrator was "obviously mentally ill".
"Read the President's full remarks:
Today, as Americans, we grieve the brutal murder -- a horrific massacre -- of dozens of innocent people. We pray for their families, who are grasping for answers with broken hearts. We stand with the people of Orlando, who have endured a terrible attack on their city. Although it’s still early in the investigation, we know enough to say that this was an act of terror and an act of hate...What is clear is that he was a person filled with hatred."
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