Dorothy Otrow Lewis

Guilty By Reason of Insanity

VTR Date: September 15, 1998

Guest: Lewis, Dorothy Otrow


Host: Richard D. Heffner
Guest: Dorothy Otnow Lewis
Title: Guilty By Reason Of Insanity
Recorded: 9/15/98

I’m Richard Heffner, your host on The Open Mind. And our subject today, an unpleasant one to be sure, is also vitally important to any society that considers itself enlightened and civilized. Namely, what we chose to learn and then what we do about the minds of killers. My guest today is psychiatrist Dorothy Otnow Lewis, a professor at New York University’s School of Medicine and at Yale University’s Child Studies Center.

In her compelling new book Guilty By Reason of Insanity this learned psychiatrist specifically sets out to explore the minds of killers and I wonder if she would tell us precisely what she means her title to indicate about ourselves and about crime and punishment in America. After all, the traditional expression is “not guilty by reason of insanity”. So Dr. Lewis, why Guilty By Reason of Insanity?

LEWIS: The title has many nuances, I think, but taken at face value, the individuals that I write about are extraordinarily ill and some are brain-damaged, some are psychotic and because, in great measure because of their psychoses and the way they were raised, they committed incredibly violent acts. And were found guilty, although in many cases attempts were made to plead “not guilty by reason of insanity”. But they were found guilty. And they did what they did … at least in great measure because of what any, I think any, psychiatrist would call insanity. Unfortunately, the law has a different definition for insanity. And hence they were not thought to fall under the legal definition of insanity.

HEFFNER: Why are you concerned about this matter of guilty because of insanity?

LEWIS: In addition to the moral issues of … no civilized nation throughout history has executed its insane. So, from a moral point of view I think it’s extremely important. But I’m interested in studying violence because, to my mind, it is the major health issue in our country. It’s the, I think it’s the second … homicide is the second major cause of death in children between, I think, fifteen and twenty-one and twenty four. And it is the major cause of death in older Black adolescents. So that we really better find out why we’re so violent.

HEFFNER: Now you say that no nation, and I made note of that and if I can find the right reference, to where you say it … you say on page 251 that civilized societies … exonerate the insane from guilt.


HEFFNER: That’s the counterpart of what you said. Why is this a particular concern of yours? Do you want the not guilty because of insanity to prevail? Is that what you want so that there will not be punishment that will be the equivalent of your saying “this person is guilty of a horrendous crime. After all, you make the point in your book that you haven’t found an individual guilty of horrendous murders, a serial killer … you could identify as without mental illness.

LEWIS: Right.

HEFFNER: So essentially you say…

LEWIS: For lack of a better word … that’s playing with a full deck.



HEFFNER: So essentially you’re saying what? No punishment?

LEWIS: No, absolutely not. Well, what I’m saying is you don’t kill people who because of an illness act in an uncontrollable way. I’m also saying you don’t let them free, they can be very, very, very dangerous. So that sometimes people will mistake the findings of our studies for a plea to say, “well, just let these people go”. You can’t, they are very dangerous and I see some of the most violent people in the world, I guess. However, a civilized country and a moral country does not kill individuals who because of brain dysfunction or because of psychoses and because of a violent, abusive upbringing act in violent ways. I mean I think that you or I had we been raised so, and if we had those vulnerabilities, that we would be capable of doing very similar things.

HEFFNER: Why do we execute people?

LEWIS: There’s a difference between why we do and why we say we do. I think politicians say that they do it in order to deter others. However, it’s well known that capital punishment is not a deterrent. Indeed, there have been studies that have been done that indicate that after an execution, murder goes up for a short period of time. So clearly we’re not really deterring anyone. I think people are … people are very aggressive. And people also are angry and horrified and want vengeance, which is understandable. And I think that’s why we do that.

HEFFNER: We needn’t be biblical and say, “vengeance is mine, sayeth the Lord”. But why, understanding as you do the need, the real public need for vengeance, why do you not want to let that outlet prevail? And it is an outlet. Your…

LEWIS: I don’t think that does any good. Do you know…?

HEFFNER: It doesn’t do good?

LEWIS: Oh, it used to be thought…


LEWIS: … in psychiatry, in, I guess, medium-old fashioned psychiatry, that if you let a patient come in … you know, become aware of his anger, and express it … they would talk about a catharsis, that then that patient was better and would go off into the sunset and behave well. But studies have shown that individuals who are encouraged to express their violence and express their aggressive instincts become more aggressive and psychiatry, I hope, is re-thinking these methods.

HEFFNER: Then you obviously don’t accept the frequent psychiatric explanation for and excuse for … explanation of — I should say — and excuse for violence in the media … in the entertainment media as being cathartic. There are those, and I know I’ve heard them, trained in your profession, who maintain as you’ve just described it, this catharsis notion. You don’t accept that?

LEWIS: Well, I’m not certain in every area that you can make a comparison. So that I believe that individuals who are vulnerable, when they are exposed to extreme violence in the media often are encouraged to go ahead and do it themselves. And there have been incidents like that. In my own experience, in the past, oh, in the past six months I think, I have seen two cases … and I never believed this, by the way. I didn’t believe really that the media made a big difference. But I have seen two cases in which kids just prior to committing extraordinarily violent acts listened to music that encouraged them to commit violent acts. In one I heard the tape and the last eight lines of the song he was listening to before he murdered an old woman was “should we kill her, yeah, should we kill her, yeah,” and it went on eight times. And then when I asked the boy why he did it, he said, “I don’t know. I don’t know what got into my heard”.

HEFFNER: But you think that got into his head.

LEWIS: Well, he was an extremely troubled, a very abused boy. And I think that that may have been what tipped him over. Now I think that for normal kids, it would roll off of them. I don’t think that it’s a very nice lyric, but it’s … you know, it’s probably harmless for most people, but for very vulnerable kids … for a kid also who was prone to go into almost hypnotic states, I think that it was not a good thing.

HEFFNER: You say for vulnerable, very vulnerable…


HEFFNER: … kids. This is a huge nation now; we’re coming up on 300 million people…
LEWIS: Are we?

HEFFNER: … in our country. That must mean there are many, many, many very vulnerable kids. Would that be your experience?

LEWIS: Yes, and I think there are…with many kids…first of all, with our mental health system such that we really deny treatment to a great many, very, very sick people and very sick people who are trying to raise children and with our increasing drug problems and parents who are giving birth to children who have brain dysfunction because the parent was taking drugs during the pregnancy, I think that we are getting more and more abused, uncared for children, and I think it’s alarming.

HEFFNER: Then if one puts together, in terms of what you’ve said, a larger and larger population, and a larger and larger population of abused children, and an unwillingness to see that the scale can be tipped by popular entertainment, whether you’re talking about music or film or television, or whatever, you’re talking about a future that’s going to contain many more instances of violence.

LEWIS: No, I think we do something else; that’s even more stupid. I think that our violent movies, our violent TV, our violent lyrics will affect some vulnerable people. But by and large will not. But our…

HEFFNER: Excuse me, can I stop you…

LEWIS: Yes, sure.

HEFFNER: … what do you mean, “by and large will not … will not, for the population, by and large”.

LEWIS: For the ordinary population, by and large. I think … you and I have seen innumerable violent films, and violent things on television, and most kids don’t act on this.

HEFFNER: Yes, but you’ve just said that the abused population…


HEFFNER: … is getting larger and larger.

LEWIS: I think so, yes. And statistics suggest that it is. But we’re doing something else that is idiotic. May I tell you what we’re doing, that it’s idiotic, that is not…

HEFFNER: Please.

LEWIS: … in the book. Or that I think is idiotic. We are so interested in punishment that we really don’t give a damn what we know about how to create a violent person. Now we know that … scientifically we know if you keep an animal or a person in a small, enclosed place, you will lower seratonin in the brain, you will make that animal or person more violent. If you surround the person by other people of whom he’s afraid, other violent people, or the animal … by the way, animals raised with more aggressive parents than their biological parents … animals will become more violent. If you surround an animal or a person with other violent people and you make that person more and more paranoid, you will create a violent individual. And most of all, if you inflict pain on an animal or on a person you will … just discomfort will create violence and pain will create more violence. And how do we design our prisons? Exactly that way. And I think again it’s because of the wish for vengeance. You hear people say, “take away the TV from prisoners. Take away the athletics … take away the education from prisoners”. Well, then you have in your prisons a laboratory for violence.

HEFFNER: But that’s not stupidity is it? I mean it isn’t…

LEWIS: You don’t think so?


LEWIS: Why not?

HEFFNER: … what I meant is, is that the proper word? You say basic to this is the need, the desire for vengeance.

LEWIS: I think so.

HEFFNER: That’s not stupidity. That’s illness, isn’t it?

LEWIS: Well, no. I think human nature is imperfect and that we’re an incredibly aggressive animal. Especially you guys. You are nine times…

HEFFNER: Well, think of our seratonin…

LEWIS: Well, think of your testosterone.

HEFFNER: Right. I don’t want to think about it.

LEWIS: [Laughter]

HEFFNER: Please, not at 73. But, go ahead.

LEWIS: The testosterone … there’s some very interesting studies that have been done. Animal studies. For example, rats in utero … if you have a female rate in utero … and that rat is placed in the placenta between two males in that litter. That female is masculinized. The brain of that mouse or rat is masculinized and that female is a more aggressive female then the ones who are between two females. So it’s a very, very interesting phenomenon.

HEFFNER: Now, tell me what does that say, in your opinion about feminism? And the result of the feminist movement?

LEWIS: What precisely are you asking.

HEFFNER: As Rex Harrison said, “if only a woman could be more like a man…”


HEFFNER: What you’re talking about then is a … an increasing level of violence in our society … women, as well as men.

LEWIS: It’s true, actually. You raise a very interesting point. Because I believe that violence among women is rising more rapidly than among men. Or it was in the past five years or so. And I think we make a terrible mistake by trying to be fighter pilots and trying to be just as aggressive as you guys. I think that, on the other hand, we’re now appreciating that there is a feminine intelligence. It may be less abstract; it may not be as mathematical, however it has to do with picking up cues between people with empathy. And I think we should capitalize on that instead of copying you.

HEFFNER: I’ll go along with that. I don’t want you copying me … not by any means.

LEWIS: [Laughter]

HEFFNER: But I want to get back to this…


HEFFNER: … notion of your use of the concept of “this is pretty damned stupid…”


HEFFNER: … what we do. It must serve some function…


HEFFNER: … you’re the psychiatrist…


HEFFNER: … you know we don’t do anything for no reason. What is the reason we act in a way that is so counterproductive, that is so destructive.

LEWIS: I suspect … I once started to write an article or a chapter … it’s called “Chapters Never Finished” or “Articles Never Written…”


LEWIS: … saying, “I think the mob must be involved in building prisons”. Because there is some very powerful force in this country that economically has found it a good thing to incarcerate people and build prisons. And I think that there is some force politically that is taking advantage of our wish for vengeance.

HEFFNER: Well, look. I hear you. You’re saying that our worst enemies would have us do what we are doing with prisoners.


HEFFNER: Right? Okay.

LEWIS: Absolutely. Because you let them out more dangerous than they came in

HEFFNER: Right. But we’re doing it, and I think there must be some, some need satisfied, some function that that kind of act … and it can’t be stupidity…

LEWIS: Mmmmmhmmmm.

HEFFNER: … it can’t be stupidity, and if you say “vengeance, the need for vengeance,” then I have to ask you…

LEWIS: You don’t think it’s economic, also, in many ways. That there…

HEFFNER: You mean the business about the mob?

LEWIS: Well, the business of incarceration. For example, it’s become private now. Did you know that?


LEWIS: There are now private prisons, so that people are attempting to make a living on incarcerating …
HEFFNER: Yes, but Dr. Lewis … you came to the conclusions you’ve come to long before the age of privatization. Is that fair?


HEFFNER: Long before…


HEFFNER: … you could really say, “hey look, now they’re making a buck out of this stupidity”. And all I’m asking is whether, in order to deal with this problem and you describe an intensely real and destructive problem, in terms of our attitudes. In order to deal with it, don’t we have to figure out a little better what human motivations are involved here and see if we can’t satisfy them some other way?

LEWIS: Absolutely.

HEFFNER: Or say, there’s no way of satisfying that need for revenge and what we’re doing is perhaps, with some limitations, the best we can do, being these poor benighted human beings.

LEWIS: Oh, I think that we’re a very young society. The United States … I mean, compare it to Europe. Europe doesn’t have a death penalty now. And we’re slowly evolving. And the Supreme Court, I think has talked about evolving standards of decency. And, well, our work … we did, I think the only study ever done on juveniles sentenced to death. And ours is one of the only countries in the world that sentences juveniles, sixteen-year-olds, to death. But the Supreme Court, based at least in part on our studies … I’m sure based on other things and on evolving standards of decency, has raised that. So now, from fifteen, when our study was done … to sixteen. And I think that we’re just young and what I try to do…sort of sit back and just tell the facts…just tell the news, and in this book, I bring it to life, because most of my studies were done statistically and were valid…but certainly this makes it human. And I think that maybe books like this will force people to think, who are these serial killers, for example.

HEFFNER: Well, this is the question, of course, that I want you to address yourself to now. Who are they? What are they? What has happened to them? You make much of a kind of determinism…

LEWIS: I do.

HEFFNER: … here. You’re saying “under this set of circumstances, how could you expect anything other than a serial killer?”.

LEWIS: Or … yes. I think…
HEFFNER: What are the circumstances?

LEWIS: There’s no single factor that creates a violent person. For example, brain damage alone or brain dysfunction alone does not. What brain damage does is it increases emotional liability, impulsiveness, poor judgment. But most brain-damaged people are not violent. And psychoses, even paranoia … even paranoid schizophrenia does not usually create violence. Most people with this disorder are not violent. And probably abuse alone does not create a grotesquely violent individual. However, when you put these together brain dysfunction, a tendency to paranoia and early on-going horrendous abuse and violence, you get a recipe for violence.

HEFFNER: In the studies you have conducted … in terms of the persons you have visited on death row.


HEFFNER: Have these been the common denominators?

LEWIS: Absolutely. In fact, when we reported our study … I forget whether it was the one of the juveniles or the adults condemned to death. But the data on the parents and on the hideous abuse which, by the way the children and the adults did not remember…this was gleaned from other sources…but when we looked at that there was so much that we did a separate paper on it and we called it Philacidial Abuse in the Histories of Death Row Inmates because we found that about, I think half, of the inmates had parents who had tried to kill them. We had two inmates where parents had held them out of the window of moving cars as young children or infants. I mean that is extraordinary and had it happened to you or to me, I question whether we would be law-abiding.

HEFFNER: Do you think, and I don’t mean to make a joke of this by any means … but do you think parallel or similar things did happen to those people who stood outside the jail and yelled “Burn Bundy, Burn Bundy, Burn Bundy”.

LEWIS: I don’t know. I’ve never evaluated them and I’m sure they wouldn’t permit it. But I guess the closest I came and that I do have in a book…

HEFFNER: The Executioner.

LEWIS: … is yeah, I think I end the book with a chapter on … I had the dubious distinction, I guess, of interviewing at great length an executioner. And the reason that I did is I wanted to find someone who killed for a living. You know, because people said, “Come on Dorothy, hit men, other people” and possible, maybe perfectly normal people just trying to make an honest buck. And so I went down and I visited this man in his trailer. And over the course of a whole evening of talking and drinking beer and whatever, I learned that he himself had been extraordinarily violent. That he had been horribly abused by his family, and also that his thinking was distorted and illogical and in fact, I quote much of that chapter … is verbatim from the interview with him because you couldn’t even follow what he was saying. He would say things like, “I know nothing about the people that I execute”. And then he would show me a scrapbook in detail about each person he had executed. So here I thought that I was going to see the person … just a cool killer…

HEFFNER: Finally.

LEWIS: But he was just like, he was just like the people who he executed.

HEFFNER: We have a minute left, perhaps, maybe a little more. Do you think we’re changing in this regard from guilty by reason of insanity? I have the feeling we’re getting more and more deeply into that morass that you decry. What do you think?

LEWIS: I think that we’re going through a phase now. I hope that it’s just a dip because for a period of time in this country, for about ten years, there were no executions. And I guess there’s a backward and forward movement in society. And I like to think that by virtue of doing this kind of research and others are doing research on the brain and neurochemistry that we’re moving toward a more civilized way of handling very aggressive individuals. So that I see this as a blip.

HEFFNER: I’m glad you do because reading Guilty By Reason of Insanity is a fascinating experience, to be sure. And one ends up awfully, awfully depressed. Thank you for relieving my depression.

LEWIS: Pleasure.

HEFFNER: Thank you for joining me today on The Open Mind, Dr. Lewis.

LEWIS: Pleasure.

HEFFNER: And thanks too, to you in the audience. I hope you join us again next time. And if you would like a transcript of today’s program, please send four dollars in check or money order to The Open Mind, P. O. Box 7977, F.D.R. Station, New York, New York 10150.

Meanwhile, as an old friend used to say, “Good night and good luck”.

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however be a verbatim copy of the program.