“Crazy, Not Insane” – We’re mad [MOVIE REVIEW]
(from left) Dr. Dorothy Otnow Lewis and Dr. Jonathan Pincus examining Nollie Martin. Photo courtesy of HBO.
“Crazy, Not Insane,” another thought-provoking documentary from Alex Gibney (“Agents of Chaos,” “Out for Blood”), is being released by HBO and HBO Max. Gibney has focused his sights on Dr. Dorothy Otnow Lewis, a psychiatrist who has devoted her life’s work to the provocative question of why some people kill.
Why, under similar circumstances, do some kill and others do not. Is there something in the brain or in the environment or a combination of the two? Is this a nature versus nurture question? But more importantly, she raises the issue of how we treat the killers.
Dr. Lewis began her career working with children, including many in juvenile detention. In the course of treatment she interviewed the children, parents, caregivers, and teachers extensively and found one thread that often ran through the backgrounds of the juvenile offenders—abuse, both physical, sexual, and mental, sometimes horrifyingly extreme. This insight into the juvenile criminal mind led her to explore the backgrounds of adult violent offenders. Teaming with Jonathan Pincus, a Yale neurologist, they noted brain abnormalities in the x-rays from many of the criminals she studied.
More controversial, however, was her discovery of multiple personality disorders, or clinically speaking, dissociative identity disorder (DID) in some of her most famous cases. She has endured a great deal of criticism for using this diagnosis on some of the murderers she has been called on to observe and work with. Recognized as a legitimate psychiatric diagnosis in 1994, DID is often demeaned and ridiculed in court.
Working with Arthur Shawcross, a serial killer about to enter the penalty phase of his trial, she uncovered a horrific history of childhood abuse, brain scan evidence of visible injury, and multiple alters. Lewis, called by the defense in the penalty part of his trial, was vilified and ridiculed for her diagnosis, despite the additional evidence of brain injury. Dr. Park Dietz, a forensic psychiatrist especially popular with prosecuting attorneys, dismissed the very idea of DID as a viable diagnosis. Even after more than 25 years, the courts are skeptical.
Lewis learned a great deal from the Shawcross debacle. She was undermined by the defense that hired her; her findings of abuse and neurological damage were ignored; and her diagnosis and videoed sessions of Shawcross revealing his alters was literally laughed out of court. She, herself, made numerous missteps in her approach to the testimony. Despite her efforts and documentation, he was sentenced to be executed.
Forensic psychiatrist Dr. Dorothy Otnow Lewis on the stand during the Arthur Shawcross trial, being questioned by Shawcross’s lawyer, Thomas Cocuzzi (1990). Photo courtesy of HBO.
Lewis’s experience on the Shawcross case hardened her resolve. She did not retreat from the DID diagnosis when she found it. She continued to videotape her interviews and bolstered her belief that the combination of early physical and mental abuse combined with neurological abnormalities were viable mitigating factors that should be considered in court.
“Our law works on a notion of competence and a notion of insanity, both of which don’t make sense psychiatrically,” Lewis explains, adding, “You are competent to be executed if you know what you’ve been found guilty of and if you know what it is to be executed. That is a pretty low bar.”
As Richard Burr, a defense attorney with the Southern Prisoners’ Defense Committee, explains, “English Common Law in the Middle Ages stated that if someone had become mad, the madness itself was enough punishment. This English Common Law was brought over with the pilgrims but at some point that notion got lost.” Our justice system is not set up for rehabilitation. It is more biblical in the sense that punishment is based more on retribution and revenge. Lewis’s goal is to understand and make others understand about the sometimes unstoppable path to killing that occurred long before the act that brought that person to trial.
Lewis was not alone on this path. Although not noted in the documentary, in 2013 Adrian Raine, a neurocriminologist, produced a summary of his life’s work in The Anatomy of Violence: The Biological Roots of Crime that serves as a confirmation of Lewis’s and Pincus’s early work. Raine had spent his early career interviewing and studying prison inmates. He conducted controlled studies on the effects of malnutrition, parental abandonment (both physical and psychological), head injury and various physical indices that are repeatedly found in recidivist criminals. His work has shown that a combination of bio-social factors, all with roots in various anatomical sections of the brain that control emotion, impulsivity, and aggression may indicate an almost irreversible propensity to criminal behavior. He has often been called on to testify in the trials of murderers who were discovered to have brains showing the effects of early head injury.
Whether or not Gibney set out to create an anti-death penalty film, it is clear from the cases studied that true justice was not served in executing the profiled killers. As is pointed out, we redefine the word “adult” when it suits the punishment. The mentally challenged are dispatched despite proof of a known handicapping condition. Documented mental illnesses such as schizophrenia are routinely ignored when it comes to trial. There is very little effective oversight to prevent or stop cases of horrendous child abuse and yet when there is a perfect storm of early physical, sexual, and mental abuse, coupled with head trauma, whether accidental or deliberate, and psychiatric illness the courts are all too often willing to look the other way.
Lewis has devoted her life to interviewing the criminally insane, a term the courts seem no longer to use or believe. The bar for insanity is too high to jump. The need for punishment will override it on almost all occasions. This is not to say that some murders and murderers are horrific beyond comprehension. Many are. Lewis was the last person to interview Ted Bundy, as incomprehensible a murderer as ever lived. But maybe there are some things that we will never understand.
We have an incalculable desire for retribution. If executions were public exhibitions, they would, no doubt, be sold out events. Gibney even interviews Sam Jones, an electrician by trade, who travels throughout the country as a freelance executioner in those states still using the electric chair. Proud of his job and expressing no regrets, his hobby is painting, always creating art after he has presided over an execution. Displaying his various post-execution canvasses to Gibney, they are quite disturbing.
Lewis continues her work and has helped shape defense strategies in death penalty cases and changed the way that attorneys have looked at their clients. Perhaps someday there will be a recognition that Crazy is Insane.
There should be more Dorothy Lewises in the world. And there should be more Alex Gibneys to document them.
Launching on HBO and HBO Max on Wednesday, November 18.