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.


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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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