Expert: Bruce Borkosky, Psy.D. - 8/1/2011

Question
QUESTION: Hi There,
I am doing some research for a screen play i am writing, and would really appreciate your time.

I am trying to better understand the Forensic Psychology profession and the people who do this Job, how its like and how they think.

Here's the setting for my Story:
A serial killer is caught, and sentenced for execution.
Before that, the judge orders a forensic psychiatrist to evaluate the criminal to see if he is competent for execution.
(The killer seems insane)

In Such a setting

1)How would a psychiatrist approach such a patient?

2)What type of questions might be asked?

3) Is it beneficial for a psychiatrist to get involve in such a case, will it benift his/her career?

4)Would you be interested in such a case?

I am just really trying to get into the mind of the psychiatrist in such a scenario. How would you think, feel and respond to such a case, if it was offered to you?

Thanks very much for your help,
Aaron.

ANSWER: Hi, Aaron, thanks for your question. It's a great one!

Firstly, I don't know how a psychiatrist might evaluate such a patient; in general, they do not have the education or experience in testing, statistics, or science that psychologists have.

In general, a psychologist would have obtained a general background, in terms of researching the  Supreme Court cases and the research literature regarding competency to be executed.

It's hard to answer what kinds of questions one would ask. In general, the criteria is that the person understands that the government is killing them because of the crime(s) they committed.

First, though, one would have to interact with the inmate, and ask general questions, in order to determine if the inmate had a mental disorder and, if so, what kind of disorder they might have. One would, essentially, be making a differential diagnosis, no different from that of any clinical or treating psychologist.

Assuming that the inmate suffered from a disorder, then one would go about applying the observed problems, to the criteria for or against competency to be executed. For example, if the inmate had a delusion that he was Jesus Christ, and believed that he was being put to death for the sins of mankind, then one would document the nature and extent of the delusion, how entrenched it might be (does the inmate stick to the delusion despite proof that it is wrong?), and how that prevents him from understanding the execution.

It's hard to say if any particular case benefits ones career. It is, however, emotionally difficult and stressful work - one is literally dealing with the life and death of another human being. I am personally opposed to the death penalty, so I struggle with a number of issues, in the death penalty cases I have worked on. Is it personally ethical to be involved in such cases? What if the inmate is competent? Should I testify for the state? What if it is a difficult case (such as one involving allegations of faking)? If one believed that the inmate was not competent, how does one go about forming the best testimony - that would be persuasive to the court? e.g., if one is unpersuasive, then perhaps the inmate would be wrongly executed...

Such a case would make for a good story I think - a difficult, questionable case (like that NY mob boss --forget his name right now-- who pretended to be psychotic), and the psychologist who is ethically torn about whether to testify at all, then finally deciding to testify for the defense, then struggling with being cross examined by a tough state atty.

Hope that helps........

---------- FOLLOW-UP ----------

QUESTION: Hi Bruce,
Thanks very much for the quick reply.

Sorry, I got mixed up between a psychologist and a psychiatrist. I assume the court would request a forensic psychologist to do the evaluation, correct?

Your answer has really helped me, and thanks for taking the time to share your thoughts

A few follow up questions:

Q1)Most people see serial killers as monsters and inhumane creatures. How do you see them? Or, how would you approach them in a clinical setting?

Do you feel they are: "Damaged souls in need of help"?
or: "A interesting curiosity, that should be studied"?
or the more extreme: "These are hopeless people, and should be locked up for good" .

Would you feel any empathy for a serial killer who has committed atrocious crimes? A killer with a whole host of psychological problems and childhood issues?

Q2)I understand your Job must be very difficult at times and I respect you for your work.
Why do you do what you Do? What motivates you and what gives you the most pleasure in your work? What do you seek to pursue in your career?

Thank you for taking the time to answer these questions!!

Answer
Hi Aaron, sometimes psychiatrists do forensic evals, too.

There are as many types of killers as there are other types of ppl. IMO, the more complex the personality of your characters, the better the story.

how would you approach them in a clinical setting? --- this question does not really compute, because mental health does deal with murder. We help ppl deal w/ mental health problems, such as depression or schizophrenia.

Would you feel any empathy for a serial killer who has committed atrocious crimes?
-----imagine you have a 30 year old serial killer. Say he killed a LOT of ppl - 30. Let's say he spent an hour torturing and killing each on. Are you aware that that is less than 1/10th of 1% of their life?

Why do you do what you Do? What motivates you and what gives you the most pleasure in your work? What do you seek to pursue in your career?
-----It is the same as any other professional.....
BB