Wednesday, April 25, 2012

Is the Norway Shooter Sane . . . and Does it Matter?

For the last six days, the man responsible for the bombing and mass shooting that killed 77 people in Norway last July has been testifying at his trial. He admits that he was the person who carried out the attacks -- there is no question or controversy about that. This trial is being held to determine whether what he did was a crime and, if so, whether he was sane at the time he committed it.

The shooter's view is that this was not a crime. He has an elaborate and fairly paranoid political ideology which, he believes, justifies the attacks as part of a war against Muslims and multiculturalism. Since he was defending his people, he claims, this was not a crime. As far as I can tell, no one expects this argument to win the case.

The question of whether he is -- or was at the time of the attack -- sane is somewhat more complicated. There are two psychiatric reports in play. One says that the shooter has paranoid schizophrenia and was unaware of reality when he committed the crime. The other says that he is a narcissist, but he knew what he was doing and is responsible for his actions. The shooter, for his part, says he is sane.

This case points out some of the big problems with legal discussions of sanity. "Insanity" is a legal term, not a medical or psychiatric one. There are millions of people in the world at this very moment who have a disorder that is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) right along with paranoid schizophrenia, and they are legally sane. That is, they know right from wrong and can appreciate the consequences of their actions. In fact, there are millions of legally sane people with paranoid schizophrenia.

In fact, one of the mental disorders listed in the DSM is narcissistic personality disorder. In other words, both psychiatrists who have evaluated this man think he has a disorder. What they disagree about is which one, what type (personality disorders are considered to be in a different group or "Axis" from other mental disorders) and whether it impacted his ability to know right from wrong. (In another high profile case, the man who kidnapped and repeatedly raped Elizabeth Smart was found legally sane in part on the basis of a report that said he had narcissistic personality disorder as well.)

On an intuitive level, most of us have a sense that you can't be all there and do what this man did. You'd have to be "sick" or "crazy." But those aren't medical terms either. And obviously your view of right and wrong has to be pretty messed up to think this is OK. But most people who commit murder are legally sane, and most legally insane people don't commit murder.

Where is the line between wrong or bad or evil and insane? Where do messed up values and priorities cross the line into not responsible for your actions? I think that's a question that doesn't have an answer. We have legal standards, and we hope we'll know the difference when we see it.

In my next post, I'll take a look at the impact of the trial on the families of those who died. Stay tuned.

Tuesday, April 24, 2012

Etan Patz and Why Child Abductions Make the News

Frequent quarterbacker Alan (who blogs over at Poor Mojo) shared a new Time column today about Etan Patz, the New York City first grader who disappeared in 1979 in New York City. The case is in the news lately because police in search of clues have recently been digging up a basement near where the boy lived. The column talks about the ways we have come to expect that we can prevent bad things from happening to our children, be they stranger abductions or broken bones.

Alan comments,
The fact is your child is far more likely to die young in a motor vehicle accident than to be kidnapped by a stranger and murdered. Tens of thousands of times more likely. But car accidents are quotidian and kidnappings are good copy and so we live in terror.
I agree with Alan. We tend to vastly overestimate the chances of a child being abducted by a stranger (about 115 cases a year, with 60% surviving and only 4% remaining unsolved) and vastly underestimate their chances of being killed in a car crash. And car crashes are, indeed, "quotidian" (which I had to look up -- it means mundane or every-day). I suppose that kidnappings also make good news stories. But that begs the question, why do they make good news stories? And why don't car crashes make good stories, too?

First of all, the news tends to cover things that are unusual. If they covered everything, we'd never do anything but watch the news. This is why there is a real dearth of "good news" on as well. Good news -- or at least neutral news -- is actually much more common than bad news. For the most part, if good news is about something common, we don't expect to see it covered. There are no stories about your kid's birthday party, or the lovely bike ride you took last weekend. That's common.

Second, we also expect to see news that affects us, and this is where it gets complicated. Most of us, because it is common, are aware of the risk of traffic accidents. We believe, however, that we can master those risks. Those accidents happen to someone else -- someone not being careful, not wearing a seat belt, under the influence or otherwise foolish. We know what is dangerous about driving a car, and we don't do those things.

We also believe that we can master the risks to our children. We give them bike helmets and put them in car seats. We don't let our toddlers have small toys. We take them to the doctor. For the most part, in fact, we are right. Kids get hurt, sure, but most kids don't get killed in this country.

Stranger abductions make the news because they bring to our attention something that we don't want to admit. About 115 times a year, parents just like us have kids who are abducted. Those parents also had helmets and car seats and medical care. They kept an eye on their kids as best as they could. And someone took them anyway. They didn't master the risk. We want to know what they could have done differently so we can.

Etan Patz's story is compelling because it has to do with a child, because it was the first case to appear on a milk carton, and because it is unsolved. It is also compelling because he disappeared walking to the school bus alone for the first time ever. We all make that decision for our kids at one point or another. We all know it's a risk. We don't read about Etan because it's sensational. We read because we want it to be different for our kid.

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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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