Posted on: June 24, 2008 5:41 pm

Introduction to the Sanity Defense

Okay, here's another one of those posts that is written for people curious about a forensic psychology topic that often makes the news, but that people don't know all that much about.  In addition, I'd be happy to answer any questions about the topic, since many people find "not guilty by reason of insanity pretty interesting," and yet the people in the news (or in TV, movies, etc.) usually do a horrible job portraying the issue.

Generally speaking, in order to consider that an individual is guilty of committing a crime, there must be proof of two elements: 1) the individual engaged in unlawful conduct (actus reus); and 2) the individual did so with unlawful intent (mens rea). The degree, or amount, of intent is usually included in the description of the offense. For example, there are differing levels of intent necessary for the commission of involuntary manslaughter versus first degree murder.

The second prong noted above (mens rea) presumes that people act with free will (now, I know this is a debate that has raged forever, and will likely be never be settled, but from a legal standpoint this larger debate doesn’t matter). The law does recognize, however, that while most of us choose our own behavior, and are therefore responsible for it, some individuals are incapacitated due to mental illness to the extent that their free will is impaired.

Broadly speaking, the first type of mental illness that can be considered to potentially impair free will would be mental illnesses that impair cognitive functioning. This would be the sort of mental illness that impairs an individual’s ability to make rational, informed decisions based on a reasonable understanding of the world. For example, an individual with an IQ of 45 would almost certainly be considered cognitively impaired to the point where mens rea would not be assumed. That is, due to severe cognitive limitations, that individual would not be considered able to grasp the world in such a manner that unlawful intent would be ascribed to him or her. A non-mental health way of looking at this would be how we would address a crime committed by a five-year old. We simply don’t hold a five-year old to the same standards as an adult, because their capacity to understand the world and reality is significantly limited.

In another post, I’ll address the second aspect of a limitation on free will.  In addition, I will post an analysis of this issue with respect to Josef Fritzl, the Austrian guy who kept his daughter locked in his basement for 20 years...

Category: General
Tags: Psychology
Posted on: April 6, 2008 12:07 pm

Book Review - "Proust was a Neuroscientist"

Credit where due: I first heard about this book over at MindHacks, and their review (as well as short interview!) suggested this book would be an interesting read. However, I never wrote the title down (as I usually try to do with books I might be interested in reading), and it fell off my radar. However, I was perusing the books in the “New Non-Fiction” section of my library, and there it was! Now, after having read the first chapter, I consider myself very fortuitous.

Proust was a Neuroscientist is described as an examination of how artists working in various media (poets, novelists, painters, etc.) were able to discover an essential truth about the human mind that science has only recently been able to confirm. In a more general way, the book discusses how both art and science are paths to knowledge, and how reducing everything to data points can cost us valuable insights and information. It would also appear (though I have not read the whole book yet), that the author (Jonah Lehrer) endorses the idea that both Art and Science have something important to offer, and knowledge is best served when both are utilized. A somewhat similar idea was posited in the book The Dancing Wu-Li Masters, but with more of an emphasis on the idea that science (and in particular, Physics) has been moving away from a reductionist model, and now thrives on a more creative, artistic vision.

Thus far, I’ve only completed the first chapter, but I found it both well-written and engaging. The subject matter in question was Walt Whitman, and the physicality of emotions. The chapter lays out the history of scientific thought regarding the origin and location of feeling in the human body, and noted that during the time of Walt Whitman (the latter half of the 19th century), the general consensus was that the body was simply a vessel for the brain. The brain was the locale for all that made us human: thoughts, feelings, even the Soul. According to Lehrer, Whitman defied this thinking by writing poetry suggesting it is his body that encapsulates his emotions, his soul, his very being:

O my body! I dare not desert the likes of you in other men

and women, nor the likes of the parts of you,

I believe the likes of you are to stand or fall with the likes

of the soul, (and that they are the soul,)

I believe the likes of you shall stand or fall with my

Poems, and that you are my poems.

- From “I Sing the Body Electric,” of “Enfans d’Adam,” also printed on pg. 10 of Proust was a Neuroscientist

The chapter goes on to discuss Whitman’s background, including the profound impact his medical work during the Civil War had on his perceptions of the body. There is a review of his association and friendship with Silas Weir Mitchell, a doctor during the Civil War who was the first physician to seriously examine the phenomenon of the “phantom limb” (a term used to describe an amputee’s sensation of “feeling” the limb that has been removed). The chapter also discusses the work of William James and his thinking about psychology (as well as his and Whitman’s shared love of the works of Emerson). Finally, there is a discussion about how modern neuroscience is confirming what Whitman wrote of long ago - feelings begin in the flesh.

The chapter specifically cites the work of the neuroscientist Antonio Damasio, and his work regarding the process he has called “the body loop.” Basically, it works like this: We seeing something threatening, the brain triggers a wave of physical changes in order to respond, our body prepares for action, and then our cortex interprets these physical changes (by connecting them to the original stimulus). The science behind this is fascinating, but you’ll have to read the book for more.

The chapter makes some interesting points, including the idea that feelings are important, and should not be ignored for the sake of “rational thought.” I agree with this, to a point. As a therapist, I will always encourage my clients to pay attention to feelings, as they are, in fact, a source of information. However, I also point out that feelings, when too intense, tend to lead to poor choices. This may be due to a variety of reasons, which is beyond the scope of this post. However, I will tell my anger management clients, “This is Anger Management, not Anger Elimination. Anger is fine, anger can be important, and can be useful. It is what you do with it, when it is appropriate, that matters.” Don’t ignore it, but don’t indulge it - listen to it, and work with it.

What was nice about this chapter was both how much I learned about the cast of characters and the theories/ideas behind them, but also how much it prompted me to think about the subject at hand. I can’t ask for more from a book. As I read the other chapters, I may post (smaller) summaries or the main ideas. However, if the rest of the book was as good as this chapter, I say you should just go out and read it yourself.

BTW, if you are interested in psychology, check out my other web page at : http://postcards-from-the-id.typepa

Category: General
Tags: Books, Psychology
Posted on: April 4, 2008 6:48 pm

Movies and Mental Health - "Once Were Warriors"

One of the non-psychology topics I want to post about more frequently is movies. Of course, I would like to do more straight-up reviews of both good movies (as well as fun, if not-so-good ones, such as my other post on "Good-Bad Movies"), but I also want to make at least some of the movie talk relevant to the topic at hand - psychology. Therefore, I will make the occasional post about movies from a psychology perspective. This can mean different things at different times, depending on the movie. For example, I may post about a movie that portrays a psychological problem or intervention accurately and effectively; or, I may post because a movie may provide an individual who is experiencing a certain difficulty some ideas to consider. I may also post about a movie because it is motivating or illuminating in some way. This in no way is meant to replace an opinion about the movie’s effectiveness as a whole - in fact, if I think a movie stinks, I may not post about it from a psychology perspective, except perhaps to warn you!

So, I believe I will start with the 1994 New Zealand film "Once Were Warriors." This is a truly memorable film, well-acted and extremely effective at demonstrating how substance abuse and domestic violence can negatively impact a family in so many ways. This is a film often assigned to individuals in treatment for domestic violence and anger management classes to watch and discuss, due to its ability to demonstrate the ongoing impact of the violence (which perpetrators are often blind to). Of course, the impact of excessive alcohol use on aggression is also effectively demonstrated, and the movie does not offer any easy answers. At times this can be a difficult movie to sit through, and I also acknowledge that it takes a few minutes to adjust to the New Zealand accents, but I thought I would start with this film because it is relatively unknown, is very well-done, and the relationship of the movie to psychology is obvious. The film provides a number of excellent topics to discuss, whether in some form of a treatment format, or just with the person you watched it with. Do not, however, watch it if you are in the mood for a "feel good" movie - it ain’t that. Watch it when you are in a good position to be able to watch a movie that can be hard to watch, especially if you have a history of experiencing violence in your past.

Category: General
Posted on: March 26, 2008 2:43 pm

Some Basic Information About Depression

Depression is one of the more common mental health issues that afflict people, and it’s occurrence is on the rise. The World Health Organization already cites depression as the fourth most significant cause of suffering and disability worldwide (behind heart disease, cancer, and traffic accidents), and by 2020, it is projected to escalate to the number two position. Also noted by the WHO is that most people who need help for depression do not receive it (due to a number of factors). In America, 23 million Americans suffer from depression at any given time; it is the most common mood disorder in the United States. The average age of onset is the mid-20's, but this average has been trending downwards. In fact, adolescents are the fastest growing age groups of sufferers of depression. Only about 25% of people with depression in the United States receive treatment for it. About twice as many women as men are diagnosed with depression, and depression is 1.5 to 3 times more common among first degree biological relatives.

The best way to conceptualize depression is as a biopsychosocial phenomenon. That is, depression has a biological, psychological, and social component. The biological component consists of an individual’s genes and biochemistry, as well as diseases and substance use/abuse (one can end up with depression as a stand-alone diagnosis as a result of a medical condition, as well as from certain types of substance use - even if the substance abuse is subsequently discontinued). The psychological component of depression consists of cognitive distortions, certain attribution styles, previous history and experiences (and resultant "lessons learned" from those experiences). Lastly, the social elements of depression include social disturbances, social distress, and cultural influences. Taken together, it is important to view depression as a complex syndrome, with many facets, rather than with a single explanation.

Depression can exist as a stand-alone disorder, but is often co-exists with other disorders (remember, it is more common to have more than one mental health issue, rather than just one). Disorders that are frequently comorbid with depression include anxiety disorders (in fact, anxiety is often a precursor to depression), substance abuse problems (especially alcoholism), anorexia/bulimia, personality disorders, and medical conditions. The presence of one or more disorders in addition to depression must be factored into a treatment plan, and it makes treatment more complex.

Anxiety, in particular, is strongly associated with depression. Approximately 60-70% of people with Major Depressive Disorder also suffer from an anxiety disorder, in this order: social phobia, simple phobia, PTSD, generalized anxiety disorder, and agoraphobia. Intuitively, this makes sense. If one is worried all the time (or experiencing or symptoms of anxiety), that interferes with your life, which gets depressing. If one is chronically depressed, things don’t get done, which creates anxiety. They go hand-in-hand. If someone has anxiety first (that is, anxiety is the primary disorder), the risk for secondary depression onset is 2-4 times greater than for people without an anxiety disorder. The relevant issues are the number of anxiety symptoms/disorders present, the presence of avoidance behavior, and the degree of psychosocial impairment - the more these are present, the greater the likelihood of onset of depression.

In one of my next posts on this subject, I will continue to chronicle the overlap between depression and anxiety. The good news - therapy for both is similar, and improvement in one area often leads to improvement in the other.

Category: General
Tags: Psychology
Posted on: March 25, 2008 10:46 pm

Ugly Guys Unite - We Have a Chance!!!

But, we have to make up for our ugliness somehow.  Okay,  I'm exaggerating (a little).  Here is a review of some research that suggests, contrary to previous research, women seek all desirable traits in a male partners, but that expectations are tempered by their own desirability.  That is, a woman who is extremely desirable (to men) will seek men that meet all criteria, but that as you lower the woman's desirability, she is willing to prioritize, and sacrifice certain traits in order to secure a partner with the most important traits (to her).  The article lists the desired traits in men as the following:

The researchers identified four categories of characteristics women seek in a partner:

* good genes, reflected in desirable physical traits,  (translation: strong, handsome)

* resources,

* the desire to have children and good parenting skills, and

* loyalty and devotion.

Men, in contrast, are less complicated.  The researchers state that the, ahem, "traits" males seek in partners did not vary among men based on their desirability.  That is, Danny Devito and Brad Pitt have the exact same expectations of who they prefer as a partner.  Now I wonder, what could those "traits" be?  I'm sure people everywhere are shocked by this last bit of information...

On the other hand, this explains how other ugly guys (as well as myself) managed to "marry up,"  i.e. marry people who appearance-wise are in another league - we compensate!


Category: General
Tags: Psychology
Posted on: March 24, 2008 12:12 pm

Competency To Stand Trial - An Introduction (#1)

Very often when I tell people I’m a forensic psychologist, the response is a lot of questions. People know just enough to be interested in forensic psychology, but not enough to truly understand what it is we do. Portrayals of psychologist on television and in movies usually don’t help. In fact, it seems that even some very basic responsibilities of a forensic psychologist are often misunderstood. In addition, there are different types of forensic psychologists, who do different types of work - child custody evaluators, civil law, criminal law, law enforcement screenings, etc. This will be a brief post on one of the more routine evaluations a criminal forensic psychologist performs - the competency evaluation.

A competency evaluation is a pre-trial evaluation ordered by a judge in order to determine if a defendant is competent to stand trial. This is a legal question, not a psychological one, and ultimately the decision regarding whether a defendant id competent or not rests with a judge. However, it is generally a psychologist or psychiatrist who conducts the evaluation, in order to provide the judge with the information necessary to make an informed decision.

The question of a defendant’s competency can be raised by any relevant party in a case - the defendant (through his attorney), the defense attorney (with or without the approval of the defendant, in certain specific instances), the prosecution, or the judge. Once the issue of competency is raised (and there is any reasonable evidence to suggest competency might be an issue), a judge will, more often than not, allow for an evaluation. This is to ensure that an individual is able to effectively participate in their trial, as well as to eliminate the competency issue as grounds for appeal.

One common point of confusion for the lay person is the difference between a sanity evaluation and a competency evaluation. Sanity evaluations are what the public more often hears about in the media, and have included many well-known cases. These evaluations have to do a defendant’s state of ind at the time of the offense, and they are different type of evaluation altogether. A competency evaluation has to do with a defendant’s current level of functioning - how they are doing right now, as the trial is proceeding.

The modern standard for a defendant to be considered competent to stand trial comes from a 1960 Supreme Court decision, Dusky vs. U.S., which defines the threshold for competency as:

1) A sufficient present ability to consult with his/her attorney with a reasonable degree of understanding

2) A rational as well as factual understanding of the proceedings against him/her

In addition, the federal legal system, as well as most states, have added to this definition a requirement that any deficiencies in either of the two areas above must be due to a severe "mental disease or defect," or some similar wording.

In layman’s terms, the issue of competency looks like this. A defendant may be having problems either working with his attorney, or understanding the proceedings against him. A relevant party in the court picks up on this, and the judge issues an order for a competency hearing. A psychiatrist or psychologist evaluates the defendant, and provides the judge with a report that includes information on whether the defendant is currently suffering from a "severe mental disease or defect," and whether or not that defect, if present, is interfering with the defendant’s ability to understand the court proceedings, or work with their attorney.

I will next cover other areas of competency, such as the types of mental health issues that rise to the level of "severe mental disease or defect," and what happens when someone if found to be either competent or incompetent. In addition, if you are a psychologist or a student, and would like to learn more about competency to stand trial, I can think of no better book to recommend than the one profiled to the right, entitled Competency to Stand Trial Evaluations: A Manual for Practice, by Thomas Grisso.

If you are interested in more stuff about psychology and pop culture, please check out my other blog at:


Category: General
Tags: Psychology
Posted on: March 23, 2008 9:36 am

Winner's Never Punish...

...and Punishers Never Win!  Just kidding.  However, the study linked to below examined simulated, cooperative/competitive game play and found that individuals who engage in punishment, including retaliatory punishments, tend not to succeed when alternatives such as cooperation are available. 


The article notes:

<blockquote dir="ltr">

"The result: There is a strong negative correlation between individual payoff and the use of costly punishment. The five top-ranked players never used costly punishment, while players who earned the lowest payoffs tended to punish most often. Winners used a tit-for-tat like strategy while losers used costly punishment. Furthermore, costly punishment did not increase the average payoff of the group."


The article also notes: "Our finding has a very positive message: In an extremely competitive setting, the winners are those who resist the temptation to escalate conflicts, while the losers punish and perish," concludes Nowak."

I've observed this in therapy as well.  It seems many individuals feel a strong urge to retaliate, to escalate with others, when confronted by family or work conflicts.  Often it is very emotional based, and the other individual or individuals involved don't sound like the healthiest people on the planet.  A therapy session may address this issue by simply starting off with an inquiry by me: "Okay, and how does doing that (whatever it is they want to do to get back at the person) help you?" or some variation.  The client will often pause for a second, and then respond (even angrier, perceiving a lack of understanding or empathy), "Well, they did this and I can't just..."  My response will be something along the lines of, "Okay, but that's not what I asked.  I asked, 'How does doing that help you?'"  Then we get into the age-old discussion of allowing others to control us versus taking control of ourselves.  But man, is the sense of punishment (as well as justification for righting the perceived wrong) strong in people.  It can take a long time to crack through that desire and get to helping a person act in their own self-interest.  From personal observation, as well as experiences providing therapy, I think this article is, in general, dead on, and a good rule of thumb to follow - don't get into pissing contests with people, it's lose-lose.  Don't allow yourself to be walked all over, of course, but don't administer "personal justice."  Simply respond when necessary, but don't retaliate.  You are giving others control over you if you do. 

If you are interested in psychlogy, music, movies, art, and otherscientific and/or cultural topics, check out my other blog:


Category: General
Tags: Psychology
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