Usable Insight – Getting to the Truth in the Colorado Shooting
It seems that in incidents like the tragic Colorado shooting, people want to know why the shooter did what he did? And by why, they mean, what motivated him? Was he mentally ill as in suffering from schizophrenia or from another psychotic condition or was he psychopathic (i.e. evil… but that is also a psychiatric condition as well, it’s just that it is very resistant to treatment)?
There is a procedure that may help illuminate whether this is a case of schizophrenia, psychosis or psychopathy, but because of an accused person’s Miranda rights to remain silent it goes against their legal rights.
It is call the amytal interview (also the agent used can be other barbiturates or even benzodiazepine medications) which employs what has been referred to as Truth Serum. In this procedure a person is administered, usually by IV, an agent that induces in essence a state of cognitive dysinhibition.
It’s not always the case, but when someone is truly disorganized in their thinking because of acute schizophrenia or another psychotic state, the medication will cause them to become even more disorganized. This is not doing something cruel, because that will usually pass after the medication is administered. On the other hand if someone is “faking it” or engaged in cunning thought and behavior, they may start to chuckle or become even smug as if they are the “cat who swallowed the canary” and in a state of dysinhibition are taking delight in thinking how smart and crafty they are.
Beyond the violation of Miranda rights, another reason to not use this procedure in a legal setting is that people in their “drunken” state can also have their thinking contaminated by the questions asked and with leading questions, especially under pressure as the legal system is known for doing. Perhaps that is the reason for retaining procedures such as the polygraph test (but that is also problematic in that a certain percentage of psychopathic individuals can beat that procedure too and therefore prosecutors might want to avoid that).
The amytal interview is rarely used now even in therapeutic setting, but has been used with benefit with people who have been in what’s referred to as a dissociative state in which their mind literally pushes something out of its awareness, because it is too awful to think about. It has been used selectively and beneficially in a therapeutic setting with people who suffered a deep past trauma that continues to intrude into their ability to think and impairs their function in their current lives.
I trained as a psychiatrist long enough ago to have used it selectively with some of my patients who had been traumatized. When I did, it was helpful not only in their revealing a trauma that they had gotten past, but never got over, but in helping me more deeply understand them and be more helpful in our psychotherapy together. In the cases I used it, I would only use it when there appeared to be a reasonable amount of trust from my patient (and as you can imagine, these were not particularly trusting individuals) and an already ongoing therapeutic relationship. Without that trust and a context in which to use the information obtained from this interview, such a procedure may run the risk of “retraumatizing” the person.
I don’t have an answer to the philosophical dilemma of wanting to get to the truth by procedures such as truth serum or administration of polygraphs (or torture in war), but not wanting to violate a person’s civil and legal rights. However it may be worthy of renewed debate.
I will be on Canada AM on Monday, July 30 at 8:05 AM EDT to discuss psychopathy vs. psychosis and how that might relate to the Colorado shooter.