Psychotic

by Tory Butterworth

I don't know about you, but I'm not a big believer in the, "Not Guilty by reason of insanity," plea. I've worked with many clients from dysfunctional families, including sadistic and/or abusive parents. Some of these clients are the nicest people you'll ever meet, with a great capacity for empathy with others' pain. Of course, some sadistic and/or abusive people also come from such backgrounds. Still, it proves to me that there can be many different responses to the same dysfunctional environment.

I was reminded of why we need the insanity defense when I met a patient I'll call Joe (not his real name.)

Joe believed the FBI was chasing him. He got on a bus and rode across the country, exiting somewhere in Utah. Scared he was being followed, he stole the nearest car, and in due time was caught and arrested.

Now, I don't know about you, but if I thought the FBI was chasing me, I might well have done the same thing. The problem, of course, was that the FBI didn't have anything to do with it. It was all in Joe's head.

Joe complained that the people next door where listening in on his thoughts. He said he wanted to move to Minnesota to get away from it. I asked him how it would be different for him in Minnesota. He said, "In Minnesota, if they're listening, they don't talk about it!"

This is what clinicians call, "psychotic," being out of touch with reality. A number of conditions can cause psychotic symptoms, including dehydration, severe lack of sleep, and abuse of certain substances. Several different psychiatric disorders, including bipolar disorder and depression with psychotic features, can also cause psychosis.

The most common cause of psychosis, however, is schizophrenia. Epidemiologists estimate one in 100 people in this country are schizophrenic. Average people sometimes use "schizophrenic," to mean having a split personality. The mental health diagnosis, however, is part of a much broader disease that can lead to progressive mental disorganization.

To follow up on the, "Creating Believable Villains," theme of my last few blogs, I believe that psychotic people can make sympathetic villains, if the author can show how their actions arise from their distorted thoughts. However, it is usually difficult to disguise psychosis (most people can tell that someone who's psychotic is acting weird, even if they don't understand why) and so it may be difficult to make it a surprise that this type of villain committed a crime.

Any of you crime writers out there considering making your villain guilty by reason of insanity?