Insanity vs mentally ill: the case of James Holmes

Apparently James Holmes has pleaded not guilty by reason of insanity. This week, copies of his notebooks were released which seem to show that he carefully selected his target (the movie theater) and also seemed to be quite aware that what he was doing was wrong. This would argue against a finding of legal insanity. He knew what he was doing and knew it was wrong.

The writings also make it clear that he was (and probably is) very mentally ill. His illness seemed to torment him, from what I’ve heard on the news. This is something I’ve seen in many of my clients over the years. Very often they know something is wrong with them but they don’t know what to do about it. I find it almost heartbreaking that Holmes seems to have studied neuroscience in an attempt to figure out what was wrong with him. I can almost imagine the despair when his studies didn’t provide him with the answers he sought.

From what I’ve gathered in the news, it seems unlikely he will be found insane by the standards in Colorado. That’s not to say that this killer isn’t sick. He most definitely is. I suppose his illness will become important again when we get to sentencing.

As an example of the difference between the legal term “insanity” and the more medical term of “mentally ill” or even “schizophrenic”, this is about as perfect as you can get.

BTW: we are dealing here with a serious mental illness like schizophrenia. We are not talking about a personality disorder or psychopathy. Please, please do not confuse psychopathy with “psychotic” or insane. Personally I do think psychopaths are “sick”, but not like Holmes. Apples and oranges, folks. Apples and oranges.

JamesHolmesColoradoShootingAndyCrossColorado theater shooting suspect James Holmes

To Fly or Not: Thoughts about the Germanwings crash

I’d like to talk about the crash in the French Alps, apparently caused deliberately by the co-pilot, but with things developing so rapidly, I hesitate. Still, I’m going to go ahead with the caveat that much of what I have to say at this point may later prove moot.

What do we know? The plane crashed. The co-pilot was in the cockpit; the pilot was not. There were apparently deliberate actions taken by the copilot that set the plane on its trajectory into the mountains. He apparently was under doctor’s care for some illness and had received at least one note providing a medical excuse from flying, including on the day of the crash.

What we don’t know: we don’t know what illness he saw the doctor for. We don’t know why he had the break in training a couple years ago. From what I’m getting on CNN, I can’t tell exactly what the note from the doc said.

I am a licensed pilot, although I haven’t flown in many years. When I was actively flying (private), I was required to see a flight doc every couple years. The rules for airline pilots are different, requiring more frequent checks. The flight doc was not my regular doc. There may have been some questions about my mood, stress, but it was cursory and easy to fake had I so chosen.

I have also worked with populations, including AF pilots, where reporting of any condition that would render them unfit for work would be required. Since I have never been a flight doc, nor worked with civilian pilots, I don’t know the requirements on the doc to report. It seems like …. and I could be very wrong here….. the onus is on the pilot to self-report. But there are a lot of reasons a pilot would not do so. One of the worst things you can do to many pilots is to remove their wings, ground them.

So, where does that leave us? I’m not sure. The story isn’t finished yet. Was Lubitz depressed? I have heard nothing credible to say that he was or wasn’t.

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There is another issue here. Let’s face it. Most people who commit suicide don’t involve other people. On the other hand, most perpetrators of mass murder do not expect to live beyond the act. Many kill themselves; others set things up so police will kill them. So, where does Lubitz fall? Suicide or mass murderer? There are some different dynamics that go with each way of looking at this. Unfortunately, mass murder has not been studied as well or written about as much as with serial killers. Perhaps one of the reasons is that so many mass murderers do end up dying before we can question them. So, we are left wondering what was going on with Lubitz. Will a diagnosis of depression really answer the questions? For some of us, probably not.

UPDATE:   A clinic Lubitz had visited in Dusseldorf just reported that Lubitz was NOT seen for depression.