BALTIMORE -- Many defenses have been used to explain why a particular court defendant was not guilty by reason of insanity (NGRI), but some insanity defenses are more inventive than others, several speakers said here at the annual meeting of the American Academy of Psychiatry and the Law.
Typically, said Meghan Musselman, MD, a forensic psychiatrist in Cleveland, insanity defenses are built around a few types of recognized psychiatric illness -- "either a psychotic disorder, an affective disorder, or a cognitive disorder."
But attorneys have mounted defenses on a variety of others, including conditions not defined in the , she said.
One such defense involves parasomnia, or sleepwalking. Sleepwalking patients have eyes directed up and outward in a vacant expression. "They appear to be awake ... [but] if you speak with them, they tend not to respond," she said. Sleepwalkers have no sensory perceptions -- no sense of smell, taste, or -- importantly -- of pain. Once they are awakened, they have no memory of incidents that occurred while they were sleepwalking, and they have a period of confusion if they're awoken during the episode.
One of the more famous sleepwalking cases was that in 1988 of Kenneth Parks, a Canadian man who killed his mother-in-law and tried to kill his father-in-law. Parks, who was married, had developed a gambling disorder and lost his job. One night, Parks fell asleep while watching TV, and then -- all in his sleep -- drove for 14 hours to his in-laws' house, got a tire iron, went into the house and strangled his father-in-law, who survived, and beat his mother-in-law to death with the tire iron. Parks then drove to a police station and said, "I think I killed someone," Musselman explained.
People were surprised by the case because until then, "Parks had a great relationship with his in-laws; people were baffled," she said. One factor in Parks's favor was that when he arrived at the police station, he had a large gash in his hand, but -- as is typical of a person who is sleepwalking -- he felt no pain from it, she added. The jury agreed with the defense's argument that the crime was committed while Parks was sleepwalking and was therefore out of his control; he was acquitted.
The Role of Cults
Holding odd or extreme group beliefs that may motivate behavior is another form of an insanity defense that people have tried, said Brian Holoyda, MD, MPH, a forensic psychiatrist in Sacramento, California. Examples of extremist religious and cult beliefs include , which believe that common law has been replaced by Admiralty Law that has enslaved everyone, and those who believe in UFOs. Some isolated indigenous tribes also may hold unusual beliefs, such as one that believes ancestral gods can be appeased by amputating one's fingers, he said.
Cults are similar to religion in that they have a consensus belief system and dogma that adherents are expected to believe in and follow; however, cults differ in that they have charismatic leaders -- such as Charles Manson or Jim Jones -- who typically report they've received a message from a deity that must be spread to their followers, Holoyda said.
Cult beliefs "may appear odd, atypical, bizarre, but does it mean they're delusional or a psychosis?" he asked. One article published in 2006 posits that cults represent a "mass" shared psychotic disorder, "but I'd offer concerns about that perspective," said Holoyda. "If we assume cult members are all psychotic, it will affect the 'competency to stand trial' argument." Two famous 1985 murder cases involving a father/son duo, Michael and Dennis Ryan, tried to use cult beliefs to bolster a NGRI defense, but , Holoyda said; however, the son appealed based on a misdirection given to the jury and was eventually released, he added.
"Battered Woman Syndrome"
"Battered woman syndrome" is another type of insanity defense that has been used with varying degrees of success, said Phillip Resnick, MD, a forensic psychiatrist at Case Western Reserve University in Cleveland. The phrase was first coined by Lenore Walker, PsyD, who interviewed 100 women in women's shelters and defined the syndrome based on the results of those interviews: a cycle of building tension followed by a battering incident and then loving contrition on the part of the batterer, and this cycle must occur at least twice, Resnick said.
However, Walker's idea of the syndrome was not universally accepted. Resnick noted that prominent legal scholar Alan Dershowitz, JD, of Harvard University was particularly critical of the idea, even writing a book entitled The Abuse Excuse -- And Other Cop-Outs, Sob Stories, and Evasions of Responsibility. Dershowitz argued that the justice system is already biased toward women, since acquittal rates for wives accused of killing their husbands are 13%, compared with 1.4% for husbands accused of killing their wives. "We should not be seduced by the jargon of experts, particularly 'experts' who are really advocates for a particular political position," he said.
One of the elements Walker included in battered woman syndrome was "learned helplessness" -- the idea that the woman has little ability to escape or affect what's going on, and to stop the battering. Resnick said, however, that "if we look at battered woman syndrome, that really does not follow, because all the women Walker interviewed had escaped to a shelter, proving they had the ability to get away from the situation." The syndrome also suggested that these women had poor self-esteem, "but when [survey] instruments were used, people who escaped the situation or those who killed their husbands described themselves as stronger or more independent than other people perceived themselves to be."
One red flag in these types of cases is strangling, he added; women are seven times more likely to be killed if their husband has previously strangled them. One part of the prosecutor's job is to show that the woman is actually battered. Often there are no police reports or hospitalizations because "women who are battered often are ashamed of themselves and may not talk about it with their friends; they might also use scarves and makeup to cover bruises. There is often one confidant who can testify or who noticed the woman wearing scarves," said Resnick.
Perhaps the most famous successful insanity defense related to domestic violence was that of Lorena Bobbitt, who was accused in 1993 of malicious wounding after she cut off her husband John Bobbitt's penis with a carving knife (the penis was retrieved and successfully reattached). Lorena Bobbitt pleaded NGRI, with her attorneys arguing that her husband sexually, physically, and emotionally abused her during their marriage, because she was suffering from clinical depression and a possible bout of post traumatic stress disorder due to the abuse. The jury sided with her, finding her temporarily insane and acquitting her of the malicious wounding charge.
Resnick called the verdict an example of "jury nullification" -- that is, the jury didn't follow the law because it was overly sympathetic to the defendant. "I think they believed Mrs. Bobbitt was severely abused, and didn't want her to do a long period [in jail]," he said.