The Measure of Madness:. Katherine Ramsland
not easy to answer when a defendant is mentally ill or suffers from brain damage. If a man obeys the voice of God instructing him to attack his mother, for example, is he really guilty and responsible for committing this crime? And should he be imprisoned or sent to a psychiatric hospital? These are the moral dilemmas I face every day in my work with mentally ill defendants. I hope these stories convey to you the excitement and challenges of my work as a forensic psychologist as I enter each defendant’s world to measure the madness.
Sometimes, when I am retained to evaluate a defendant, there is no question about whether he or she is guilty of the crime. In all of the cases in the first part of this book, the defendants had already confessed and my job was to assess their mental state at the time of the crime.
It is the burden of the defense to prove that a defendant was insane or lacked criminal responsibility for his or her conduct. In other words, it must be proved that “at the time of such conduct, as a result of mental disease or defect, he lacked substantial capacity to know or appreciate either: (1) the nature and consequences of such conduct; or (2) that such conduct was wrong.”1
The general public inaccurately believes that the insanity defense is widely used and is frequently successful. In actuality, this is not the case. The insanity defense is only raised in approximately one percent of cases and successful in approximately 20 percent of these cases.2
If a defendant is judged to be insane, he or she is legally not guilty of the offense. Typically, the individual is then sent to a forensic psychiatric hospital. By law, he would remain there until the presiding judge rules he is no longer dangerously mentally ill. At that point he would be transferred to a state psychiatric hospital and, if his condition continued to improve, after a period of time (usually measured in years), he could be released to the community.
The first part of The Measure of Madness deals with fourteen cases in which the legal question was the defendants’ states of mind at the time they committed their crimes. Mr. Paulson confessed to killing his wife, but claimed he loved her. Mr. Abrams was also charged with the murder of his wife, but he insisted that he had no memory of it. In one chapter I discuss my work with Daniel Rakowitz who became headline news after his arrest for the killing of his roommate. It was rumored that he cooked her remains. Mr. Bailey was one of the most heartbreaking cases. He was only 22 years old when he aimed his gun at a group of police officers in an apparent “suicide by cop.” In one chapter I review the cases of four bizarre and psychotic defendants who were charged with the murder or attempted murder of strangers. One claimed the victims were aliens and another insisted he was an undercover agent and the victim had “come back from the dead.”
Yet another chapter in this part details the cases of two young women who raised a different psychiatric defense. Both claimed to be suffering from Battered Woman’s Syndrome and raised the defense of extreme emotional disturbance. One was nine months pregnant when she stabbed her sleeping husband and then slit her own wrists. The other told me she was hearing voices at the time she killed her husband.
The defense for both these women hinged upon whether they acted “under the influence of extreme emotional disturbance for which there was a reasonable explanation or excuse, the reasonableness of which is to be determined from the viewpoint of a person in the defendant’s situation under the circumstances as the defendant believed them to be.”3
If these women were found to have acted under extreme emotional disturbance, they would still be convicted of a crime, but the degree of the crime would be lessened. Instead of being convicted of murder, the women would be convicted of manslaughter. In one of these cases I was hired by the defense attorney, in the other, by the prosecution. In both cases I needed to put myself in the position of these women to understand what drove them to kill.
Chapter 1
THE WIDOWER WALKS AWAY
Her body landed on the sidewalk. Did she jump or was she pushed? None of those crowded around could be sure. The police identified her as a resident of the apartment building. Minutes later, a man exited the building and began to stroll nonchalantly down the block. The neighbors identified him as the victim’s husband, Mr. Paulson. The police asked him to take them up to his apartment. Signs of his futile attempts to clean up the apartment were more than enough to raise their suspicions. Within a few hours he confessed—he had strangled his wife, then thrown her body out the window to fake a suicide.
Mr. Paulson’s attorney quickly realized that all the evidence pointed toward his client’s guilt but that the act itself made no sense. How could Mr. Paulson kill his wife when he professed to love her? His client could not adequately explain his motive. All he said was that there had been an “argument.”
Typically, when one spouse kills the other, there is a long history of severe marital difficulties, and substance abuse, or mental illness, or both. But Mr. Paulson had no history of emotional problems. He had never been arrested or behaved violently. Everyone involved in the case was confused.
It was necessary to bring in experts to search for psychiatric issues that could be raised as a defense to save Mr. Paulson from spending the rest of his life behind bars. His attorney called Dr. Daniel Schwartz who had years of experience as an expert witness. Dr. Schwartz, the director of Forensic Psychiatric Services at Kings County Hospital, was well known for his work on numerous high profile cases, including the Son of Sam, the Amityville Horror killer, and John Chapman, the man who shot John Lennon.
I was a newly licensed clinical psychologist and excited to be working on a forensic inpatient psychiatric unit. I had only been there a year when Dr. Schwartz asked for my help on this high profile case. I was surprised to learn that Dr. Schwartz had been unable to uncover any evidence of mental illness in Mr. Paulson.
“Cheryl, I examined him,” Dr. Schwartz said, “I felt I was missing something. I don’t know what was wrong with him.”
“What do you mean?” I asked.
“He wasn’t a violent man,” Dr. Schwartz replied. “And the police knew it. When they took him to the precinct for questioning, they didn’t handcuff him. In all my years in this field, I’ve never seen the police do that. They always handcuff suspects.”
Dr. Schwartz asked me to administer some psychological tests. He was puzzled by the defendant’s flat emotional state and hoped that the tests would help explain his uncharacteristic homicidal rage. Dr. Schwartz also asked me to conduct a neuropsychological evaluation of Mr. Paulson’s perceptual motor skills, language functioning, problem solving, and complex reasoning abilities. There were much more experienced psychologists working on the forensic unit, but I was the only one trained to administer these specialized tests of brain function.
Before leaving for my appointment with Mr. Paulson, I asked for advice from a senior level neuropsychologist, Lucille Horn, Ph.D. We sat in her office and I told her what I knew about the case.
“And here’s the strangest part,” I said. “Dr. Schwartz told me the defendant had a ‘neurological event’ about forty years ago, but was never diagnosed with anything. He was hospitalized twice after he suddenly developed speech difficulties and weakness on the right side of his body. The symptoms resolved after a few months and he never relapsed.”
As we talked, I began packing, doing my best to take only those tests I would need. The tests were heavy and I was taking the subway.
“Well, you have to take the Purdue Pegboard,” Dr. Horn said, gesturing at the large wooden board.1
“That?” I stared at it in dismay. It was 3-feet by 2-feet, easily the bulkiest of the tests in the room. But looking at her face, I knew better than to ignore her suggestion. She was the expert; I had to bring it. The Purdue Pegboard measures fine motor coordination and speed, and could reveal whether or not Mr. Paulson still suffered from brain dysfunction.
An hour later I arrived at my office. Usually the defendants I interview are incarcerated and too poor to make bail. I interview them in the forensic hospital, court holding areas, or at Riker’s Island jail. I was meeting Mr. Paulson in my outpatient