Homicidal Insanity, 1800-1985

8. Somatic and Dynamic Dangerousness, 1910-1960

Somatic and Dynamic Dangerousness 1910-1960 8 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 framework. Psychiatric nomenclature continued to change over the next fifty years as practitioners theorized and debated about the essential nature ofmental disorder. I The phenomena associated with homicidal insanity remained the same, even though the nomenclature changed. In studies of large populations of the criminally insane, psychiatrists identified insane homicide associated with aberrations of intellection , emotion, and volition. These studies still demonstrated that homicide was most often identified with the thought disorders of dementia praecox and paranoia.2 A substantial number of insane homicides were also attributed to conditions that, however named, were characterized by a lack ofmoral feelings or emotions, by psychopathic personality, and by mental deficiency. Finally, these tallies showed that patients with conditions characterized by a failure of behavior control, particularly epilepsy, committed insane homicide. 105 106 Homicidal Insanity, 1800-1985 Intellectual Insanity: Thought Disorder in Dementia Praecox Anglo-American medical writers of the 'teens and 'twenties believed that insane homicide was positively associated with the peculiar disordered thought processes of dementia praecox. As psychiatrist AaronJ. Rosanoff, for example, stated in the sixth edition ofhis Manual ofPsychiatry (1927): "It is not rare to encounter, especially in the beginning of the disease, attacks of very pronounced anxiety, suicidal ideas and attempts, or violent tendencies ."3 Frederick Peterson, in the ninth edition of Nervous and Mental Diseases (1919), associated delusions of persecution with insane homicide.4 In addition to, or subsequent to, disordered thought processes, psychiatrists regarded impulsive behavior patterns as dangerous and unpredictable. William A. White, in describing the symptoms of catatonic dementia praecox, wrote: "Quite characteristic of this condition, too are the impulsive acts of these patients. They will suddenly and with absolutely no warning whatever commit some act of violence.... The attacks come out of the clear sky, cannot be foreseen, and make these patients at times very dangerous ."5 Peterson, too, called attention to the dangerousness of impulsive behavior.6 Criminologists maintained that it was the characteristic impulsive behavior of patients with dementia praecox that largely accounted for their criminal tendencies. Criminologist Sheldon Glueck suggested in 1925 that these individuals were more the criminal type "than Lombroso's atavistic or epileptic, 'born criminal.'''7 William Healy, in 1913 the director of the Juvenile Psychopathic Institute, in·Chicago, related this example in his chapter on criminology that he contributed to White and Smith Ely Jelliffe's textbook: ... under the influence of morbid impulses and hallucinations, appearing early in the course of chronic mental disease, offenses may be committed, the psychopathological basis of which it may then be difficult to legally or even medically determine. A patient, after her marriage ... became with her young husband greatly interested in religion, and they occupied themselves much with their devotions. During this Somatic and Dynamic Dangerousness 107 access ofpiety, at one ofher menstrual times, she heard the voice ofGod commanding her to raise her beloved mate out ofthis wicked world. She attempted homicidal assault, which was easily thwarted. Soon afterward , at another monthly period, she procured his revolver and shot him. He lived, but carried the ;bullet at the base of his skull. Then she was placed under observation in a private sanitarium where it is said that absolutely nothing out ofthe ordinary was observed. Her husband stated that it was then advised she become pregnant. A few months after giving birth to a child her menses reappeared, and with them the call came to get her child away from worldly contamination. She therefore battered in the side ofits head against the table. Seen then in the hospital for several months she was quiet and well behaved. . . . Lacking the diagnosis of insanity . . . her treatment under the law could not consist ofpermanent detention against the wish of relatives, and once more she was taken out by them, became pregnant again, and . . . a few months after its birth, she effectually saved her second child from all earthly evils by putting it into the fire. 8 Healy did not speculate about the dynamics ofthis patient's criminal behavior. Schizophrenia and Insane Homicide Eugen Bleuler introduced the concept of schizophrenia as a dynamic interpretation of dementia praecox...