E-book Edition

Crime and Disorders
of the Mind

True Cases by Forensic Psychologists and Psychiatrists

Endorsements

“The workings of a criminally disordered mind has always been a fascinating subject for experts and lay persons alike. What causes someone such as Clifford Olsen to become probably the most evil serial murderer in Canadian history? How do trials play out for these individuals? Does our prison system simply throw away the key after they are incarcerated or is it worthwhile to attempt to rehabilitate such persons? Canadian and international psychiatrists and psychologists answer interestingly such questions in Shrunk, through their writings of true cases.”

—Earl Levy QC, Barrister, Toronto, Ontario

“This highly readable and fascinating book provides unique and personal insights into all-too-real instances in which unbridled mental disorder resulted in tragedy and loss, and wreaked havoc in the lives of perpetrators, victims, and their families. The book provides a glimpse into the often-hidden, troubled, and dark side of human behaviour. The compelling accounts of crimes committed by mentally ill offenders are told by experienced and highly respected psychologists and psychiatrists on the front-lines of the highest-profile mental disorder cases. Shrunk’s authentic portrayal of what mental illness is really like, and what it can do to people, sets it apart from any other book of crime stories.”

—Dr. Hy Bloom, LLB, MD, FRCPC
Consultant in Forensic Psychiatry, Psilex/Workplace.Calm

“Scholarly inquiries into discrimination in Canadian society tend to concentrate on race and ethnicity, with occasional reference to physical disability. This traditionally narrow focus eclipses the legacy of systemic discrimination experienced by persons with mental disabilities, particularly those accused of a crime. Skewed public perceptions and social prejudices about mentally ill offenders have resulted. In turn, justice for such offenders is at risk. The practical experiences of the contributors to Shrunk: Crime and Disorders of the Mind, told in an easy-to-read format, go a long distance to correct those perceptions and mitigate those prejudices, particularly for the average citizen. This book should be on everyone’s must-read list.”

—John Rosen, Rosen Naster Barristers, Toronto, Ontario

“Experiencing an enduring mental illness is a profound personal struggle that I would not wish on anyone! Shrunk: Crime and Disorders of the Mind promotes awareness, knowledge, and understanding of the complexities in diagnosing, treating, and supporting the recovery of those living with a mental illness who come in conflict with the justice system. Shrunk contains true and painful stories of lives tormented by mental illness and criminalization, their victims, and the families who suffer alongside them. And yet, this volume offers the hope that therapeutic jurisprudence works and that recovery is possible in living beyond the limitations of mental illness with meaning and purpose. But it takes the support of a caring community. A caring community that is informed and knowledgeable. Shrunk takes the reader behind the scenes of disordered minds, disabling mental health systems, and despairing families and victims by dispelling myths and misunderstandings. For many this will be a distressful and uncomfortable read, but for every reader an illuminating and elucidating one.”

—Chris Summerville
CEO, Schizophrenia Society of Canada, Winnipeg, Manitoba

“The psychological and psychiatric forensic experts I encountered over decades of criminal law practice, both as Crown prosecutor and defence counsel, whether consulted by myself or by opposing counsel, were invariably highly qualified, experienced, principled and objective. Shrunk: Crime and Disorders of the Mind describes the diligence and commitment of these forensic experts who intervene before and at trial on the issue of fitness to stand trial, possibly providing evidence that the accused is not criminally responsible. It was gratifying to work in many cases with such exemplary professionalism.”

­—C.D. Evans QC, Barrister, Calgary, Alberta

Other books by the Editors

By J. Thomas Dalby

Williams, R. & Dalby, J. T., (Eds.) 1989. Depression in Schizophrenics.
New York: Plenum Publishing Corporation.

Dalby, J. T. (Ed.) 1997. Mental Disease in History:
A Selection of Translated Readings. New York: Peter Lang Publisher.

Dalby, J. T. 1997. Applications of Psychology in the Law Practice: A Guide to Relevant Issues, Practices and Theories. Chicago, Illinois: American Bar Association.

Nesca, M. & Dalby, J. T. 2013. Forensic Interviewing in Criminal Court Matters:
A Guide for Clinicians, Springfield, Illinois: Charles C. Thomas Publisher.

White, J., Day, A., Hackett, L. & Dalby, J.T. 2015. Writing Reports for Court:
An International Guide for Psychologists who work in the Criminal Jurisdiction. Sydney, Australia: Australian Academic Press.

Lorene Shyba, Series Editor, True Cases Books

The Durvile True Cases Series

Tough Crimes: True Cases by Top Criminal Lawyers (2014)

Shrunk: Crime and Disorders of the Mind
True Cases by Forensic Psychologists and Psychiatrists (2016)

More Tough Crimes: True Cases by Judges and Criminal Lawyers (2017)

Women in Criminal Justice: True Cases By and About
Canadian Women and the Law (2018)

Florence Kinrade: Lizzie Borden of the North (2019)

Ross Mackay, Saga of a Brilliant Criminal Lawyer (2020)

Go Ahead and Shoot Me! And Other True Cases
About Ordinary Criminals (2020)

After the Force: True Cases by Law Enforcement Officers (2021)

Crime and Disorders
of the Mind

True Cases by Forensic Psychologists and Psychiatrists

edited by
Lorene Shyba MFA PhD and J. Thomas Dalby PhD RPsych ABN

with a foreword by
Lisa Ramshaw MD DPhil FRCPC

RPsych ABN

with a foreword by
Lisa Ramshaw MD DPhil FRCPC

Durvile Publications Ltd.
Calgary, Alberta, Canada
www.durvile.com

E-book copyright © 2020 Durvile Publications Ltd.

National Library of Canada Cataloguing in Publications Data

Shyba, Lorene and Dalby, J. Thomas
Shrunk: Crime and Disorders of the Mind

Issued in print and electronic formats

ISBN 978-0-9947352-3-2 (epub),

1. True Crime —collections | 2. Canadian Psychology
3. Canadian Psychiatry | 4. Canadian Law
5. Canadian Essays—21st Century

Durvile Publications would like to acknowledge the financial support of the
Government of Canada through Canadian Heritage Canada Book Fund and the
Government of Alberta, Alberta Media Fund.

Book Two in the ‘True Cases’ Series.

Cover Illustration by Melanie Cook, Book and cover design by Lorene Shyba

All rights reserved. No part of this publication may be produced, stored in a retrieval
system or transmitted in any form or by any means without prior written consent.
Contact Durvile Publications Ltd. for details.

The statements, views, and opinions contained in this publication are
solely those of the individual authors and contributors and not of the publisher and the editors.
No one involved in this publication is attempting to render legal or medical advice. Neither the publisher nor the editors can be held responsible for errors, accuracy, or currency of content; for the results of any action taken on the basis of the information in the book; or consequences arising from the use of information contained herein.

Dedication

To my dear family and friends, some of whom drift into
mental disorder moments but I love you anyway.

—Lorene Shyba

To my wife, Sue, and an amazing and talented group of women who happen to be my daughters.

—J. Thomas Dalby

Dr. Lisa Ramshaw,
Foreword

Lisa Ramshaw MD DPhil FRCPC is the Forensic Psychiatry Subspecialty Program Director and an Assistant Professor at the University of Toronto. She is a staff psychiatrist in the Forensic Service at the Centre for Addiction and Mental Health in Toronto and has been a consultant psychiatrist in Nunavut for more than ten years. Her clinical practice includes assessments of criminal responsibility, fitness to stand trial, risk of violence and sexual violence, and assessments and care of individuals under the jurisdiction of the Ontario Review Board. She is also a member of the Ontario Review Board.

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Everything can be taken from a man but one thing: the last of the human freedom—to choose one’s attitude in any given set of circumstances, to choose one’s own way.—Victor Frankl, Man’s Search for Meaning (1946)

As Shakespeare wrote, “There is nothing either good or bad, but thinking makes it so.” These are words my mother shared at the right moment when I was an undergraduate at McGill University in Montreal. These insightful words from Hamlet allowed me to see the world a little differently. The ideas conjured by these words also happen to be fundamental to forensic psychiatry and psychology, a world where mental disorders and the law intersect.

A few years ago, a Toronto man ran over a police officer with a snowplow, killing him. The day before the jury began to consider its verdict, Rob Ford, the infamous then-Mayor of Toronto, called in to a local radio show to complain about the ‘not criminally responsible on account of a mental disorder’ (NCR) defence. Ford talked about how it hurt to see the guy go scot-free and asserted that if you killed someone and acted mentally disturbed, chances of freedom were pretty much assured. After the man was found NCR, and was to be sent to a forensic psychiatric hospital instead of to prison, the hockey commentator Don Cherry echoed Ford’s thoughts, posting on Twitter that “it seems if you kill someone and act mentally disturbed then you can be let free.” But people with psychotic disorders do not ‘act’ mentally disturbed; they are mentally disturbed. John Kastner, who produced and directed the documentaries of tragic crimes and forgiveness NCR: Not Criminally Responsible (2013), and Out of Mind Out of Sight (2014), put it well by asking, “Do we punish anybody else for an illness? A truck driver has a heart attack and kills ten people. Is he a criminal?”

In addition, mentally ill offenders certainly don’t get off ‘scot-free’. In Canada, those found NCR are detained in forensic hospitals —usually for many years, and somes more than thirty years—to protect the public and for rehabilitation.

Forensic psychiatry and psychology are extraordinary fields. Until recently, our professional work has been largely hidden from the public except for sensationalist and negative portrayals. Beyond the intrigue, those who we assess and treat are often shunned based not only on their admittedly destructive behaviour, but due to bias and stigma. The harm they cause makes the public angry; false stories are dreamed up about offenders’ behaviour because better stories are not available to help explain. Imagination fills in the gaps in understanding. At times, interpretations can be debilitating. The person behind the label of ‘accused’ or ‘mentally disordered offender’ often becomes their disordered behaviour in the eyes of the world—as in Hamlet, the “thinking makes it so.” Curiously, some of our non-forensic colleagues also find what we do mystifying and somehow wrong. We all see what we know, not what we don’t know … yet.

In my fifteen years in forensic psychiatry, I’ve seen many sides of the profession: in assessments of risk of violence, in assessments of criminal responsibility, and in treatment and risk management. Working in a maximum secure forensic hospital in Penetanguishene, Ontario, I’ve met people who have lived in the hospital for many years after committing extreme offences: psychopaths driven by a need for dominance and instant gratification; serial murderers driven by narcissistic rage and sexual deviance; grievously ill people who had a delusional need to defend themselves from being killed. Working in a minimum secure forensic hospital with those who are transitioning to the community at the Centre for Addiction and Mental Health in Toronto, and in conducting forensic assessments in Ontario and beyond, I have witnessed many more stories—the man who murdered his mother because he thought she had been replaced by an alien who was going to kill his entire family and who is later forgiven by all except himself; the sex offender driven by desires and perceived needs; and the self-described ‘unique’ terrorist who really is like no other and is driven by a religious conviction that in his case became delusional. The varieties and motivations for criminal behaviour are vast. The challenges in our privileged world are like no other.

Strangely, fears that I had from childhood of the ‘dangerous man’ have softened. Over time, I have become less, rather than more, fearful of ‘the accused’. Understanding lessens the mystery. I am more at ease with what is out there and I know that most people are remarkably good. Their stories have expanded my world.

Hearteningly, society is learning to respond with a greater openness and a desire to understand people who suffer from debilitating untreated mental illnesses. Thanks to treatment and compassion, some of these sufferers are making remarkable recoveries. Recent studies have shown that when released after their treatments, mentally disordered offenders are less likely to commit new crimes than inmates released from prison. As the Honourable Mr. Justice Richard D. Schneider notes, crimes in this population are the result of “untreated mental illness rather than deliberate criminality.” Longer incarceration in prison actually results in poorer outcomes for them.

The personal and moving stories collected in this book will draw you in and allow you to look through a small window into the vast field of forensic psychiatry and psychology—into the experiences of those who have shared a part of the world in which they are fortunate to work. It will make you feel. It will allow you to see others and possibilities in a new way.

— Lisa Ramshaw MD DPhil FRCPC, Founder, Forensic Psychiatry, Assistant Professor, University of Toronto

Dr. Lorene Shyba,
Introduction

Jim: Can you remember back that far? I can’t remember what happened yesterday. (He laughs) I can’t. How do you do it?
Plato: Oh, I had to go to a head-shrinker. Boy, he made me remember. —Rebel Without a Cause, (Ray 1955)

As editors of this book we auditioned a great many titles before settling on Shrunk, but how better, we reckoned, to write about the worlds of mental health and the law than to find a word used to describe the act of shrinking heads, or trying to understand the workings of a disordered mind. From the legal side, criminal defence lawyers use this term after meeting clients for the first time and assessing the circumstances of the crime. C.D. Evans QC, for example, recalls from his experience defending accused murderers and violent offenders that “If the crime is bizarre or absurd, it is a wise precaution to get the client’s head shrunk.” In Tough Crimes: True Cases by Top Canadian Criminal Lawyers, the first book in this ‘True Cases’ series, we discovered that lawyers such as John Rosen had similar thoughts when first encountering Paul Bernardo’s disturbed mind, as did Joel Pink QC when un­ravelling the Antigonish Beech Hill murders.

From the mental health side, psychologist Dr. Lawrence Ellerby entices us to enter his Shrunk story about a journey from deviance to rehabilitation by promising to share the “contributions we shrinks can make in this difficult and complex social problem.” And the informed general public, who make up a valued sector of our readership, might be of a mind to help out friends the way Plato, Sal Mineo’s character, did when explaining his new-found clarity of mind to James Dean’s character Jim Stark in Rebel Without a Cause, “Oh, I had to go see a head-shrinker.” After all, who is there among us who hasn’t been touched by mental illness among friends or family.

When we first started working on Shrunk, our idea was to create an anthology that would interface between the legal, the medical, and the behavioural by focussing on cases where judges and juries have called upon mental health experts when faced with the mentally disordered criminally accused. We assembled a list of eminent forensic psychologists and psychiatrists who we thought might be motivated to help build a solution to the problem of understanding mental illness in the criminal justice system. We asked them to consider their own involvement and how being exposed to people with mental health disorders affected them personally. Among our questions were: What were the outcomes in terms of your personal reflections? Was there a case that altered your perspective on humanity?

The original, previously unpublished stories that emerged from our invitations brilliantly illuminate a wide range of topics. These include Personality Disorders in the various Diagnostic and Statistical Manual of Mental Disorders (DSM) clusters, unlawful behaviour due to delusions and psychopathy, the criminal responsibility of accused persons, fitness of accused to stand trial, posttraumatic stress disorder (PTSD), wrongful convictions, and treatment and social consequences. We are in awe of the intense effort shown by our authors to inject their hearts and souls into explaining their experiences.

Our international contributors, Dr. Louise Olivier from South Africa, Dr. Jack White from Australia, and Dr. Sven Å. Christianson from Sweden revealed unique legal situations in their countries, as did Dr. Donald Dutton when describing a remarkable case in the United States. Their stories resonate with interesting terminology and turns of phrase that we edited only gently; in fact, we allowed individual voices to come through from all of our authors, whether Canadian or from countries beyond our borders. Within the editing process, we occasionally nudged writers to identify and focus on the heart of the story but we never had to ply their enthusiasm. Unlike any other book within the genre of True Crime, Shrunk presents the work of forensic professionals who have delved deeply, and with great commitment, into the disturbed human psyche.

‘Forensic.’ The word evokes images of crime scene tape or a cold corpse on the stainless steel autopsy table but its real meaning is much broader and simpler. Forensic is derived from Latin and literally means ‘in the forum’ or in modern terms ‘in the court’. The forum in ancient Rome was the centre of most social debates and although the legal structure of the Romans did not have the same structure as in modern times, it was understood that the forum was where problems were formally and finally settled. When the word is added as a qualifier for psychologists and psychiatrists, it denotes that the focus of the work has a legal purpose. As such, many of the expectations or assumptions that might be made of other medical and behavioural science professionals cannot always be applied to the forensic breed. Forensic experts have, as a primary client, the courts or, indirectly, society even above the needs of the individual or patient being seen. A ‘helping’ role is not always assumed for the individual being examined, and when this is done, it is so that they may not harm other members of our society.

Most ‘patients’ do not come to forensic experts voluntarily but are often mandated to undergo assessments. And while forensic experts consider information that patients provide, this information is not accepted at face value; other data is often sought from multiple sources in due diligence. Very often confidentiality is not offered to patients as forensic experts give opinions in the public forum of the court system, in both written reports and oral testimony. These opinions are often repeated in the popular press, although not always accurately or comprehensively. Thus, in this book our contributors can freely give commentary on their public statements about specific cases, although several of our authors explicitly did obtain consent from the subjects of their chapter as a matter of their professional courtesy. Most of the cases contained in this book identify the individuals at the centre of their story, as they are historically important cases. But when identity did not matter to the narrative, pseudonyms were employed.

Forensic psychologists’ and psychiatrists’ roles in law can be as scientific commentators on mental health issues, evaluators of specific legal questions such as fitness for trial or criminal responsibility, or as advisors on appropriate sentencing/treatment alternatives. With some offenders, court-ordered treatment is necessary and this responsibility also falls to forensic mental health professionals.

Many lay persons confuse psychologists and psychiatrists and in the forensic area there are more similarities than differences. Both professions have the legal authority to diagnose and treat mental disorders and both are involved in almost every component of the legal system. Psychiatrists are firstly physicians undertaking the same training as every other medical doctor and then gaining specialized training with mental disorders. They can prescribe medications if that is deemed appropriate for the care of patients. Psychologists are trained as behavioural scientists with a strong research base and then gain clinical experience in assessing individuals with specialized psychological tests and treating patients using behavioural methods. Coordinated involvement of both professions is common. Allied professionals such as social workers and psychiatric nurses also can play key roles in forensic work.

One of the purposes of Shrunk is to let readers inside the work done by forensic mental health experts. Misunderstandings about ‘insanity’ cases abound among the general public. Legal systems like Canada’s, which are descended from English common law, use precedent as the guiding principle where older established legal judgements guide modern court decisions. For insanity verdicts, a single case from London in 1843 has had continuing world-wide impact in courts. The case of The Queen against Daniel McNaughton for the Wilful Murder of Mr. Drummond1 is arguably the most impactful of any in the history of forensic psychology and psychiatry (although these two professions did not formally exist at that time). A delusional man, Daniel McNaughton, shot the Secretary of the Prime Minister of England in the back in broad daylight in central London. The ensuing legal battle ended with a jury finding McNaughton not guilty by reason of insanity.

The public was outraged and the press indicated that all one had to do to escape justice was to feign madness. Young Queen Victoria, who had already survived several assassination attempts by ‘mad’ men, suggested to her Prime Minister that guidance from the House of Lords was needed. This body in turn asked the twelve judges of Queen’s Bench to craft rules to be used in later insanity cases. The McNaughton rules survive to this day in little-changed form and pronounce that a person labouring under a mental disease that impairs their ability to distinguish right from wrong cannot be held legally responsible for their act—although this often meant long tenures in mental hospitals.

Finally, while forensic experts can offer the courts expert ‘opinions’ they are just that—views which may or may not be used by the trier of fact (the judge or jury) in reaching legal judgements. Not every opinion offered turns for the benefit of the accused. Forensic experts also make it clear in the work that explanations of behaviour are never to be automatically converted to legal ‘excuses’.

As seen in the various biographies of our contributors, they are an august group—leaders in their professions and most have multiple roles as clinicians, educators, and researchers. Many of our authors examined patients linked to the ultimate crime of homicide, but in everyday practice, psychologists and psychiatrists see patients charged with everything from shoplifting to exhibitionism to hit and run driving offences. While most of these stories have adults as the central character, adolescents also receive scrutiny and interventions.

There are many writing styles, as well as themes, represented in the book; from the academic, as reflected by the work of Porter & Dilley, and Cooper & Kanipayor with their comprehensive references and footnotes, to the flights of metaphor and creative non-fiction in the work of Dr. David Dawson and criminal defence lawyer William Trudell. In whatever style told, sober as well as enlightened thoughts and reprimands are exposed­. We feel that however one decides to read the book, starting front to back for legendary tales of criminal evil, back to front for glimpses of optimism, or inside out to begin with stories of our day, Shrunk is worthy of a close read.

— Lorene Shyba MFA, PhD, Editor (with Dr. J. Thomas Dalby)

PART ONE

Legacy Cases

Until we have the courage to recognize cruelty for what it is—whether its victim is human or animal—we cannot expect things to be much better in this world. —Rachel Carson