What if the 'Batman Shooter' is Insane?

Most people with mental illness are not violent, but left untreated mental illness can be a risk factor for aberrant behavior which may include violence.

What If...?

What if alleged shooter James Holmes if found to be insane?

An insanity finding would mean that at the time of the crime, Homes did not appreciate that what he was doing was wrong. This may be hard to fathom for many people but for those suffering from breaks from reality, there is a big difference between the world in their mind and the world the rest of us perceive.

I recently asked a professor of mine from college who is a forensic psychologist and expert on evaluations for competency to stand trial what his take is on Mr. Holmes. My friend outlined several important points.

Holmes was:

  • is/was a very intelligent fellow in his mid-20s (typical age of onset for paranoid schiz) who flunked out of graduate programs,

  • banned from a local shooting range for "bizarre" behavior,

  • reportedly dyed his hair red and told people he was the Joker during the attack,

  • arrested at the scene next to his car and apparently made no attempt to escape,

  • And Holmes appeared in court today looking very dazed and disoriented, like somebody who is struggling to tell fantasy from reality.

    My friend also stated "Unless he has taken a good class in abnormal or forensic psychology - from an experienced legal insanity evaluator - he seems to be showing all the reliable signs."

    A proper clinical evaluation isn't done by reading press reports and observing a few seconds of someone's behavior as presented by the news; my friend knows this and is not offering a forensic evaluation, rather he offered some observations.

    More Than A Defense Strategy

    The first most important thing to note is that if Mr. Holmes is suffering from serious mental illness, the 20 July atrocity just got worse.

    To think that someone might not have had control over his behavior due to the lack of mental health care is a tragedy in and of itself. This is compounded by the lives that were destroyed by the consequence of someone who did not receive mental health care.

    Imagine for a moment that Mr. Holmes one day receives the treatment, which would probably include medication, he needs to see reality as it is. Can you imagine the horror that he would feel knowing that what he did destroyed the lives of so many?

    A psychopath (a subset of people with ASPD) is someone without conscience. Someone suffering from serious mental illness, such as paranoid schizophrenia, is completely different; they have a break from reality. But when under a proper treatment, many if not most afflicted persons, understand compassion and right from wrong. There is no treatment for a psychopath.

    A Pattern Emerges

    After a shooting of this nature happens, most pundits immediately discuss gun control. But if we look at the history of these types of shootings, in these examples, gun control may not be what (or at least all) we should be talking about. The common denominator is mental illness.

    For example, consider:

    • Jared Lee Loughner - the shooter of US Rep Gabby Giffords was found incompetent to stand trial;

  • Charles Whitman - a student at the University of Texas at Austin and a former Marine who killed 14 people and wounded 32 others during a shooting rampage in 1966 (Whitman suffered from a tumor the size of a walnut pressed up against his amygdala);

  • or the Columbine shooters - both of whom suffered from being bullied at school, which may have resulted in PTSD manifesting in violence. Each also was reportedly to suffer from mental health issues;

  • And now allegedly Mr. Holmes, who as my qualified expert friend notes, is exhibiting many 'reliable signs' of mental illness.

    Most people with mental illness are not violent, but left untreated mental illness can be a risk factor for aberrant behavior which may include violence.

    Speaking more broadly, some mental illness may be organic, whereas other mental illness may be acquired. And then clearly, there are those who have a predisposition to mental illness and succumb to a hostile environment.

    Considering the number of shootings that transpire throughout the US on a daily and yearly basis, this recent act is a rare instance and not representative of the norm. Should public policy concerning guns be based on isolated events? Probably not. But we can still learn from these events and address any shortcomings laws may have. But the vast majority of gun crimes in the US are not of this nature.

    From a public health and safety point of view, perhaps mental health and illness is the area of public policy that we too often overlook and maybe a national dialogue on mental health and mental illness is just as and even more important that a national dialogue on gun control.

    Paul Heroux is an Attleboro resident and has a Bachelor's in Psychology and Neuroscience from the University of Southern California, a Master's in Criminology from the University of Pennsylvania, and a Master's in Public Administration from the Harvard School of Government. Paul previously worked for a jail and prison. Paul can be reached at PaulHeroux.MPA@gmail.com.

    This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

    pablo July 27, 2012 at 03:56 PM
    Interesting to note... That the only ones that took any appropriate action before the fact were the so called 'gun nuts'!
    paul July 27, 2012 at 05:05 PM
    If you kill people you do not know for no reason with no motive you are insane. The court will try to prove he's sane because that's the only play they know, but we all know he's crazy.
    Duff White July 27, 2012 at 05:56 PM
    Several issues with the author's argument(s): Holmes was not banned from a local shooting range for bizarre behavior. He emailed a request for an application and the owner phoned Holmes 3x. The owner of the range refers to the voice on the answering machine greeting as "very bass, very deep-sounding" and "bizarre or freakish"- these comments were made about Holmes' voice, not observations of his actions. As a result of the perception determined by the range owner after hearing Holmes' answering machine greeting, he instructed employees not to allow access if he came to the range. This past Academic year, Holmes took a class that "explored the biological origins of psychiatric & neurological disorders"- the author infers taking of such a class could enable Holmes to demonstrate signs of mental defect. Holmes wore "a bulletproof helmet, vest, and leggings; a throat protector; a groin protector; gloves; and a gas mask"- one might argue that he had an idea he might be shot at and took extensive measures to protect himself. (source Wash. Post and NY Times) The appearance of the defendant in court might be more of a gauge of his competency to stand trial and aid in his own defense, not necessarily his mental status at the time of the crime.
    Addled July 27, 2012 at 07:29 PM
    Many people- such as Mr. Holmes- are very good actors that have done their research beforehand. He planned the murders and knew that his actions were wrong. His final plan was to go back to his apartment where the police would go to capture him, but would have the police (or himself) trigger the traps set to kill more people as well as himself. Why kill himself? Because he knew right from wrong and knew he'd go to prison for the rest of his life or receive the death penalty. James Holmes is sane, a good malingerer, and will be found guilty.
    Paul Heroux July 27, 2012 at 07:35 PM
    If you are right, then I hope he never sees the outside of a prison, ever. If you are wrong, I hope you will join me in advocating for education, awareness and compassion for persons suffering from mental illness. They don't ask to be that way and their behaviors can be more than problematic for them; they can destroy lives, families and communities. I suspect that neither one of us are qualified to determine if Mr Holmes is insane or not. Keep an open mind. I will.
    Paul Heroux July 27, 2012 at 07:36 PM
    Thanks, Mr White for your comments, but you're making my point. It seems that Mr Homes is suffering from mental illness of some form. 1) Shooting Range - someone detected that perhaps Mr Holmes is not balanced; it doesn't matter if it was over the phone or visual observation or written. 2) Coursework - Please re-read what I wrote. The point that my expert colleague was making was just that unless Holmes learned well what specifically to fake, he is giving 'reliable signs' of mental illness. 3) Yes, Homes wore armor. He said he was the Joker, a fictional character who would be prepared for combat. Wearing armor doesn't exclude Holmes from being someone suffering from serious mental illness such as paranoid schizophrenia. 4) Holmes may be suffering from schizophrenia. But, to be clear, let me explain the difference between "competency to stand trial" and "insanity". They are not the same, nor are the judged in the same time frame. Insanity is a legal finding whereby the person did not understand that what he was doing was wrong 'at the time of the crime'. Competency to stand trial is an issue concerning the 'time of the trial'. I'm glad you said 'might be a gauge' because an observation of how someone acts over a 10 minute period is is not how a forensic evaluation is done for either insanity or competency to stand trial. If Holmes is found 'insane', another question is 'is he competent to stand trial?' Two different questions. Regards. :)
    Duff White July 27, 2012 at 07:41 PM
    Mr. Heroux: I know who you are but I do not know you so I cannot make a determination as to whether or not I like you. The Child Safety Zone Ordinance passed 11-0, so I was not the only person who disagreed with your position. I understand the difference between insanity and competency. Your original posting referred to the defendant's looking "dazed and disoriented" in court, which was several days after the crime occurred and not a reliable indication of mental status at the time of the shooting. What if after several days of interrogation and a lack of sleep, he was dazed? Might his appearance in court be similar to that which you described? You and your former instructor pointed out that unless he had taken a class, his actions, which you both suggest are indicative of mental defect would be difficult to fake. When I read your statement I took it to imply that he had not taken any such class and I pointed out that he had.
    Paul Heroux July 27, 2012 at 08:04 PM
    With respect to your comment above about insanity and competency, that Mr Holmes appeared "dazed and confused" would be consistent with someone struggling from paranoid schizophrenia, which, if he suffers from, could help explain what happened days earlier. Insanity and competence are not the same, but they are not isolated. Neither my instructor nor I didn't say or imply that Mr Holmes had or had not taken such a class. In fact, I would be surprised if he had not as part of his required neuroscience curriculum.
    Mark Williams July 27, 2012 at 11:30 PM
    All this shooting proves is that eugenics is under rated and got a bad rap
    Jonathan Friedman (Editor) July 28, 2012 at 12:00 AM
    Mark, please explain what you mean by that.
    Tisiphone July 28, 2012 at 01:39 PM
    Let us not forget that "insanity" is the only possible defense. An intelligent man would foresee that and act accordingly.
    deb of see-attleboro July 28, 2012 at 03:36 PM
    Paul; A very insightful column. I agree wholeheartedly that it is naive to focus too much attention on the method used by the accused to create such unimaginable horror. Since it has been reported that Holmes was seeing a psychiatrist, I have a hypothetical question. Would this professional be able to determine whether someone had a severe break from reality rather than just being a psychopath? And if the psychiatrist determines the patient is a psychopath, what happens then? If there is no treatment does the psychiatrist just hand the person a bill and send him on his way?
    Paul Heroux July 28, 2012 at 05:44 PM
    Hi, Deb, Thanks for the comment. Yes, Holmes is reported to have been seeing a psychiatrist, but this doesn't mean he is insane or incompetent to stand trial. I don't know anything about the psychiatrist in question and if s/he is a qualified forensic expert on insanity and competence to stand trial. A forensic expert requires specialized training and experience... it is not just anyone with a PhD or an MD. If there is a finding of psychopathy, this usually suggests that the defendant understood that what he was doing was wrong (think Ted Bundy or perhaps even Bernie Madoff, or fictional character Hannibal Lecter) - Holmes would therefore probably be prosecuted in a normal fashion. An insanity finding would suggest that the defendant did not know what he was doing was wrong - he would be treated differently and different standards would apply. But, this is not to say he will be walking the streets. Just think of Reagan shooter John Hinkley who has been locked up ever since. I've read that only about 1 out of 20,000 attempts (not defendants) at the insanity defense are successful, meaning it is VERY hard to find someone truly insane. Often the court orders the psychologist or psychiatrist, but the defense may also have their examiners, too. Either or both parties may end up footing the bill.
    Adam Edward July 29, 2012 at 03:22 AM
    I think that telling the police his apartment was full of traps shows he knew what he was doing was wrong. It is hard to say what is going on inside someone else's head. Treatment for him now seems like a waste because he will most likely spend the rest of his life in prison. Maybe this tragedy can help others find the help they may need but as for Holmes there is no way getting him help is going to matter.
    deb of see-attleboro July 29, 2012 at 12:05 PM
    Sorry, Paul. I guess my question was poorly phrased. I was referring to his treatment by a psychiatrist before the massacre, not after the fact. I was wondering what the protocol is if a psychiatrist concludes he is dealing with a psychopath and not someone with a serious mental illness. You wrote that there is no cure for psychopath. Frightening thought, since there seems to be more than a few who are willing to go to great lengths to commit barbarous acts. Is there treatment for a psychopath and can it be forced as a preventative measure? Or are we resigned to just sit idly by and wait for one to commit another atrocity?
    Paul Heroux July 29, 2012 at 06:29 PM
    Hi, Deb, I know in some states if a psychiatrist or psychologist believes that someone is a real specific threat to someone else, they have an obligation to report this. If my memory from 12 years ago serves me right, this came of a case back in UC Berkeley a few decades ago when a purp told his counselor he was going to harm his ex-girl friend, but the clinician thought he was bound not to report because of confidentially. We'll after the ex-girl friend was killed, that type of confidentiality restriction changed. As to someone being a psychopath, I don't think that is grounds for preventative detention, unless maybe there is specific and credible evidence that a crime is going to occur. There is no good solution for dealing with a psychopath. They are not all murders. Many are in business. Some are even in medicine or law. They can be anywhere and be anyone, although the prevalence in society is very low. There is no treatment for a psychopath. Their primary characteristic is to be 'without conscience.' Being a psychopath is not the same as being insane. These folks just don't care about others.
    Buck Farack July 29, 2012 at 09:42 PM
    Paul, I find it interesting that you choose to link people in business (and medicine & the law) with psychopaths. What about those in academia? Politicians, public service? I know your family (very nice people) & that they own small businesses. I'm sure that you didn't intend to offend anyone but given your party affiliation and obvious liberal leanings I wonder if was a perhaps subconscious connection?
    Paul Heroux July 29, 2012 at 10:39 PM
    Hello, Buck, Please note that I wrote "They [psychopaths] can be anywhere and be anyone, although the prevalence in society is very low." I did not exclude anyone in that catch all. So, yes, we can have a psychopath in politics and public service. In fact, as I responded above I was thinking of a book I read titled "The Mask of Sanity" by Hervy Cleckly, which mostly deals with the professions that I specifically noted, but not limted to. Also, I am an evidence-based person, which isn't liberal or conservative. I'm not sure what I said above that is 'liberal' and so what if it was. So, no, there was no subconscious connections. But thanks for asking. :)
    deb of see-attleboro July 29, 2012 at 10:58 PM
    I suppose if the primary characteristic of a psychopath is "without conscience" I suppose Sandusky and all those who covered up his crimes could qualify. But I guess that is true of so many professions. So the question should be asked. Are psychopaths born without a conscience? Nature or nurture?
    Paul Heroux July 30, 2012 at 12:11 AM
    Hi, Deb I think that is a bit different. I agree, what Sandusky did and the cover up that followed was the worst kind of awful. But that seems more of a situational loss of conscience - a state. Psychopaths are without conscience as a trait. Nature of Nurture is a reasonable question for this issue. Nature. The reason I say that is because psychopaths are a subset of people with antisocial personality disorder. To have ASPD one must have conduct disorder as a child; that is the diagnostic requirement. To have CD as a child, to explain it I like to use the research done by Terri Moffit on the difference between a life-course persistent offender versus adolescent limited. A LCP offender has different behaviors very early on, even before learning has fully taken course. AL offenders start later and their misconduct tapers off late teens or in the 20s. Also, the LCP offenders have different physiological makers than do the AL. This is consistent when we look at psychopaths versus non-psychopaths. Most disorders are a combination of nature and nurture, with a vulnerability towards a disorder that an environment may either make worse or protect someone from. Now, this discussion on psychopaths and ASPD and nature/nurture becomes a bit more complicated when we consider the research done by Adrain Raine, which I am not going to get into because it gets sort of complicated for a blog post response; it would help to explain if I had MRI and PET scans to use to explain.
    Paul Heroux July 30, 2012 at 12:25 AM
    PS: Buck, I'd like to add that this article is more conservative leaning than liberal. Think about it... The message of this article is one where I'm talking about having compassion for people with mental illness (and I'm not saying that Holmes has that; I'm just raising it might be possibility). Compassion isn't liberal or conservative. It is humane. And I'm also diverting the discussion AWAY from gun control to mental health awareness. What I've notice is that someone who uses a name whereby if we switch the B and F first letters of the first and last name, we get someone with obvious right leanings. Good night my friend, maybe someday we'll meet and you'll share with me your real name so I can have a real person beside your opinions... putting my real name besides my opinions is, after all, how I operate. :)
    deb of see-attleboro July 30, 2012 at 06:51 PM
    Thank you. I am sure such findings are way over my head. If psychopaths are truly born without conscience, I suppose it would be beneficial to identify such individuals early. Or maybe not. As we have seen with this case, if a little knowledge is a dangerous thing, a lot of knowledge can be catastrophic. Especially in this age of information. I have many thoughts on the subject of this massacre. Most involve social/societal ills, idolatry, moral bankruptcy etc. But I appreciate your perspective.
    Paul Heroux July 30, 2012 at 07:44 PM
    Hi, Deb, This is where it gets tricky and I made reference to research done by Adrain Raine in terms of being 'born bad.' I think an excellent book on the subject is "Without Conscience" by Robert Hare. Also, the Psychopathology of Crime by Adrain Raine. I've read them both; both very informative. What happened in Colorado was the worst kind of awful. And I don't ever want to see Holmes walk the streets again, and he won't. The point of my article was to ask the question about Holmes mental status. I'm not making any conclusions; I'm not qualified to do that. If he is suffering from a mental illness that compelled him to act as he did, then we have a very rare situation; most criminals are not 'compelled' to act with violence, even if they have a lot of risk factors. But more broadly speaking, when we (society) ignore mental illness, it is a risk factor for crime, and sometimes very violent crime.
    deb of see-attleboro July 31, 2012 at 03:40 PM
    I just recently heard a pastor explain the conscience in this way. He said that the conscience is a gift from God. So if it is true that someone can be born without one, I wonder why God would withhold such a vital attribute from humanity. There must surely be a purpose. This pastor also explained how the conscience is to work in the life of a believer. I hope I get this right.. He said that the conscience is what keeps a person's imagination in check. Without a well-developed and healthy conscience, the imagination can lead us to some pretty dark places and convince us to do some pretty unhealthy things. I suppose this is true for everyone, not just believers. It is so hard to make sense out of any of these atrocities. But I am very troubled when I hear a conservative personality say things like "there is nothing we can do about it, so just leave my guns alone". And I heard more than one say just that. I don't want to take their guns away. However, I would like to believe there IS something we can do to prevent future senseless massacres. Could happen through science or through faith. Or maybe a combination of these two disciplines. But something needs to happen.
    Addled August 01, 2012 at 03:50 PM
    Obviously the "pastor" doesn't know the Bible or what he's talking about and has come to his own conclusions.


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