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Homicidal Insanity, 1800-1985

Written by Janet Colaizzi and foreowrd by Jonas R. Rappeport

Publication Year: 2009

Homicidal insanity has remained a vexation to both the psychiatric and legal professions despite the panorama of scientific and social change during the past 200 years. The predominant opinion today among psychiatrists is that no correlation exists between dangerousness and specific mental disorders. But for generation after generation, psychiatrists have reported cases of insane homicide that were clinically similar. Although psychiatric theory changed and psychiatric nosology was inconsistent, the mental phenomena psychiatrists identified in such cases remained the same. The central thesis of Homicidal Insanity is that as psychiatric theory changed, psychiatrists regarded these phenomena variously as symptoms of mental disease or the disease in itself. It is possible to trace these phenomena throughout the history of Anglo-American psychiatric theory and practice. A secondary thesis of the book is that psychiatrists have used these phenomena as predictors and markers in the practical matters of preventing insane homicide and of testifying in the courts to defend the irresponsible and expose the culpable.

For 200 years, scientific and philosophical disagreement raised controversy and brought the issues to public attention. Still, to this day no rational method exists to discriminate the dangerous from the harmless in matters of involuntary commitment, nor insanity from crime in the courts.


Published by: The University of Alabama Press


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pp. v-vi

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pp. vii-x

The last week of 1987 produced three mass murders. Russelville, Arkansas. R. Gene Simmons, Sr., killed sixteen people. "I've gotten everybody who wanted to hurt me," a witness heard him say. Shortly before he surrendered, he told a hostage, "I've come to do what I wanted to do. It's allover now." Algona, Iowa. "Seven ...

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1. The Issue of Insane Homicide

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pp. 3-9

Early in the 1980s, a person who had been under psychiatric careattempted to assassinate the president of the United States. TheHinckley to move freely in society. The expectation that doctorscould and should restrain dangerous lunatics has deep roots in theancient times to the present. But murder is far from rare, and most...

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2. The Theoretical Boundaries of Dangerousness, 1800-1840

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pp. 10-37

In the United States during the last decades of the eighteenth century, the idea that lunatics should be given medical care in asylums evolved from a number of social and intellectual changes. Among the several changes that guided this transition from family and community care to medical and institutional care, the most evident was the mere fact of population: more lunatics needed to be...

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3. The Development of a Medical Jurisprudence of Insanity

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pp. 38-46

Concurrent with the growth of psychiatry as a medical specialty in the mid-nineteenth century, medico-legal experts began to address the issue of insane homicide within the context of involuntary commitment, criminal proceedings, and release from the asylum. At no time during this early asylum period did physicians...

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4. From Static Brain to Dynamic Neurophysiology, 1840-1870

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pp. 47-63

In 1840 the idea that insanity was disease ofthe brain was the starting point of all psychiatric theory and practice. Yet, the ultimate nature of the brain was subject to intense controversy and philosophical interpretation. Some physicians conceived of it as an aggregate of parts that could become individually or collectively...

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5. The Non-Asylum Treatment of the Insane

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pp. 64-73

Over the next four decades, 1870-1910, social and scientific changes transformed the practice of psychiatry from mere superintendency of the insane to active medical care; asylums into hospitals; and superintendents into a regular medical specialty. Improved histopathological techniques and modest advancements...

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6. Homicidal Insanity and the Unstable Nervous System, 1870-1910

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pp. 74-93

The change to a strictly neurophysiological view of insanity fostered the theoretical modification of several diagnostic concepts. Rudolf Virchow's cell theory supported the concept of inflammation and renewed interest in the role that the circulation of blood, by now at the capillary level, played in producing mental...

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7. Psychoanalysis and Medical Criminology

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pp. 94-104

During the first half of the twentieth century, up until the mid 1960s, American psychiatry was deeply affected by theoretical changes and practical discoveries that altered clinical practice. By 1910 many of the old-guard asylum superintendents had passed on, and a new generation of physicians had arrived. These psychiatrists ...

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8. Somatic and Dynamic Dangerousness, 1910-1960

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pp. 105-119

By 1910 Kraepelin's classification dominated psychiatric thought. His influence upon the system adopted by the New York State Commission in Lunacy in 1909 is obvious, for example. Still, Freud and his followers introduced a new order of concepts based upon psychoanalytic thought that challenged Kraepelin's conceptual...

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9. Prediction, Confidentiality, and the Duty to Warn

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pp. 120-130

After 1960 civil libertarians invaded the cloistered, stable world of ideas in American psychiatry. Physicians suddenly found that the concept ofdangerousness in mental illness emerged as a prominent theoretical issue. When mental patients began to challenge the doctrine ofparens patriae, the legal justification for involuntary...

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10. The Phenomenology of Homicidal Insanity

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pp. 131-138

From the beginning of the nineteenth century to the 1980s, physicians believed that mental disorder could make people dangerous. At first, insane homicide was associated with insanity as a unitary disease; then, as a more critical clinical empiricism evolved, the profession associated homicide with only certain...


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pp. 139-164


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pp. 165-176


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pp. 177-182

E-ISBN-13: 9780817382674
Print-ISBN-13: 9780817311858

Publication Year: 2009