Читать книгу The Measure of Madness: - Katherine Ramsland - Страница 8

It was humid, I was sweating, and it was only eight o’clock in the morning. I realized how nervous I was walking past the old hospital buildings to find “the Annex,” a dilapidated brick building housing the psychology department. It was July 1, 1985, the first day of my internship.

I sat down in the lobby with the other six interns and started filling out employment forms. We had to choose the department where we wanted to work for our first three-month clinical rotation. The only air-conditioned area in the old “G Building” of the psychiatric hospital was the jail ward. I quickly raised my hand to volunteer.

It wasn’t that I was particularly interested in working with mentally ill defendants, but I hated the heat. To this day I am amazed that my entire career hinged on that minor decision. I became a forensic psychologist simply because it was hot that day.

Before my internship I had vague plans to develop a psychotherapy practice. That’s what I thought most psychologists did. I expected I would spend the next forty years sitting in an office, treating patients—most, the “worried well”—one per hour.

That all changed after a few weeks on the psychiatric jail ward. I recall one of my first patients was a withdrawn man charged with violating an order of protection against his neighbor. He did not seem especially interesting, until he started to describe how his neighbors installed listening devices in his apartment and “someone” was sending messages through his television. I can’t remember what message was being sent to his television, but I know the one I got—“these forensic patients are much more interesting than anxious neurotics.” Many were driven by hallucinations and delusions to hurt or kill people they loved. Their violent acts made me question my beliefs about free will, responsibility, and punishment.

It’s been a long time since I completed my internship. Over the past twenty-five years I have evaluated thousands of disturbed and disturbing defendants. As a forensic psychologist my responsibilities are different than those of other psychologists. I must put away my “treatment” hat to think more like a detective. I often remember the advice of my first supervisor on the jail unit. He’d grin while warning me, “Don’t believe everything your patients tell you.”

Perhaps the most important lesson I have learned is not to accept a defendant’s version of a crime. Instead I search for clues in their past—in court, school, and hospital records. I came to appreciate the advice of another supervisor who often said, “History is gold.”

In the following chapters I include eighteen of my most intriguing, puzzling, and challenging cases. The first part includes cases of defendants raising a variety of psychiatric defenses at trial, such as insanity and extreme emotional disturbance. In the second part I describe a series of cases of defendants undergoing two types of evaluations: competency to stand trial and competency to waive Miranda rights. Competency to stand trial is the legal term indicating a defendant can work with his attorney and assist in his defense. Competency to waive Miranda rights refers to whether a defendant understands his legal protections against self-incrimination when he confesses to a crime. In the third part I include cases concerning juveniles and the justice system and the assessment of dangerousness and malingering or faking symptoms.

All cases are real and much of the dialogue is taken verbatim from my notes. Some of the dialogue and court testimony are based on my best recollections. At the beginning of each interview I inform each defendant that our conversations are not confidential. However, I still use pseudonyms and disguise most defendants’ identities by changing or eliminating biographical or legal information.

I spend between ten to twenty hours with most defendants, and in this small window of time I try to see the world as they do. My job is not to pronounce guilt or innocence, but rather to understand what motivates them. Questions of responsibility and blame are 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.