This is the 2007 version. Click here for the 2017 chapter 14 table of contents.

An Example: Psychotic Trigger Reaction

Here is an example of the tricky issues underlying the "insanity defense." Psychiatrist Anneliese A. Pontius (1987) came across 8 patients who committed murder after an episode of confusion and hallucination. In each case, the attack seemed be triggered by a particular sight which led to a "vivid reactivation of memory for past experiences." This resulted in an intense need to eliminate the "trigger stimulus." If the trigger stimulus happened to be a person, the result was an assault or killing. The people who carried out these crimes had no amnesia: they remembered what they did afterward and felt remorseful about their acts. However, they seemed out of control when the event occurred. Were they legally responsible?

What pattern did Pontius discover? How did she explain it?

Pontius called the syndrome Psychotic Trigger Reaction She suggested it might be due to a seizure involving the limbic system.

Such a syndrome might exist. But the legal profession is unlikely to recognize Psychotic Trigger Reaction as a legal excuse for murder. To understand why, consider the scenario sketched by Paul S. Appelbaum in rebuttal to Pontius.

What was Appelbaum's rebuttal?

Imagine yourself as a criminal defense attorney. Your client is charged with committing a brutal murder. There are witnesses to the crime who will testify conclusively to your client's guilt. When asked why he committed the crime, your client replies, "I guess I just lost it. People who look like him—real nerds—drive me up a wall. I'd been here drinking and I took some drugs, and felt kind of strange all day. I was puzzled why the line for the movie was so long. When he pushed in front of me, he reminded me of my nerdy cousin, who was always trying to push ahead of me when we went places together as kids. I just saw red. I could hear that nerdy voice again. The next thing I knew I was on top of him, pummeling his with my fists until he stopped squirming, until his eyes stopped looking at me that way."

It looks like a tough case to defend. Your mind starts to wander. Maybe he could plead temporary insanity? Wouldn't it be great if you could get a psychiatrist who would testify that the guy couldn't help himself, had no control over what he did? Maybe the shrink could put a fancy name on it. Something that suggests psychosis. It would have to be something that could happen to someone with no previous psychiatric history: an attack of some kind that comes only once in a lifetime...

Appelbaum was being sarcastic, of course. The syndrome which the defense lawyer "needs" is exactly what Pontius described as Psychotic Trigger Reaction. Appelbaum was making the point that such an excuse would sound too convenient in court. It sounds like something a lawyer would dream up as a last-ditch defense in a hopeless case.

The state will put its own psychiatrists on the stand who will claim that no such syndrome exists....Most murderers, they will testify, say they don't know what happened, but that something seemed to snap inside them and set them off....The majority will have been drinking or using drugs. And any of them who think they've got a shot at an insanity defense will claim they heard voices or saw something that wasn't there. The state's experts will then [say] that if you accept that this defendant couldn't appreciate or control what he did, you'll end up letting half the people who march into the courtroom off the hook. (Appelbaum, 1987)

Why did Psychotic Trigger Reaction never catch on as a legal defense?

Perhaps this is why Psychotic Trigger Reaction never became established as a legally recognized syndrome in the United States. Juries are wary of any loophole which will allow guilty people to escape punishment. In the case of Psychotic Trigger Reaction, there is no obvious way to prove the syndrome exists or to distinguish it from lying.

Only if evidence is very compelling will the courts agree that a psychological condition excuses a defendant from criminal responsibility. Claims of multiple personality, for example, are met with skepticism when coming from people who have committed serious crimes. In one famous murder trial—that of Kenneth Bianchi, the "Hillside Strangler"—several psychiatrists hired by defense attorneys testified that the defendant had a genuine case of multiple personality. However, a transcript of a hypnotic session with Bianchi showed that the multiple personality had been suggested to Bianchi during an interview under hypnosis. The transcript read, in part:

What happened in the case of Kenneth Bianchi?

[Hypnotist] "I've talked a bit to Ken but I think that perhaps there might be another part of Ken that I haven't talked to. And I would like to communicate with that other part. And I would like that other part to come to talk to me... And when you're here, lift the left hand off the chair to signal to me that you are here. Would you please come, Part, so I can talk to you... Part, would you come and lift Ken's hand to indicate to me that you are here... Would you talk to me, Part, by saying "I'm here." (Spanos, Weekes, & Bertrand, 1985, 142-143)

What did Spanos and colleagues demonstrate?

Bianchi answered, "Yes," and that was when his "multiple personality" started. Later, when Spanos, Weekes, and Bertrand (1985) used this same transcript with students asked to play the role of a guilty serial killer, 80% picked up the cue and started acting like they had a multiple personality. It was just too obvious a way to try to avoid punishment. No wonder the Bianchi jury did not believe it.

The insanity defense is seldom successful. One observer noted that the number of successful insanity defenses in the state of New York was less than the annual incidence of poisonous snake bites in Manhattan: about one per year. Experts also point out that a successful insanity defense does not necessarily mean the defendant spends less time locked up. Carpenter and Rapoport (1992) pointed out, "The length of hospitalization after a successful insanity defense may be longer than the time served in prison by those convicted of similar crimes."

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