Can we diagnose a suspect?

[RivkahChaya]

In truth, I don't mind people bandying about ideas about historical figures who quite frankly can't be harmed by our notions as they tend to be safely dead.

It bothers me, because those idea become fact pretty quickly. You wouldn't believe how many people now "know" for a "fact" that Einstein had Asperger's. No, he did not. He didn't because it is impossible to diagnose an historical figure, and because he functioned too well on a day-to-day basis.

What is problematic, though is not that it affects Einstein in any way, but that it affects people who really have Asperger's. If Einstein and Stonewall Jackson become the public face of Asperger's-- that's even worse than when Dustin Hoffman in Rain Man was the public face of autism.

People with Asperger's aren't brilliant and quirky, and if you just leave them alone, they'll go invent something that will change the world, but you would not believe how many people I have encountered who think this, and they think this because they have never met anyone with the actual diagnosis, just read blogs where people who read other blogs speculate who among the famous went around undiagnosed in past centuries.

People with Asperger's syndrome are more like you and me than they are like Einstein (for as much as I actually know about Einstein), but they do have some problems, and need extra help, and a little understanding when they are socially awkward. The last thing they need is to be held to a higher intellectual standard than everyone else, because Asperger's means they are socially awkward, and a little compulsive, but also have a superpower that will emerge at some point.

Something was wrong with Kosminski. To the point that to an extent he cooperated with his own commitment. Now whether or not a suspect was mentally ill is really only relevant if that mental illness either caused the behavior in question, or informed it.

I feel the same. If he behaved in general the way he behaved for the people who evaluated him in the institution, I think the victims would not have let him get near them. They would probably have been on the lookout for other things that were considered red flags in 1888, which are no longer, like stuttering, and that probably lets Lewis Carroll off the hook. They probably would have avoided people whose appearance or movement was odd, even if they were totally normal, with an essentially benign condition, like Apert's syndrome (causes a sort of bug-eyed look, like Peter Lorre, only much more pronounced), or mild cerebral palsy.

So, yeah, I think it's a difficult balancing act. We certainly can't diagnose Kosminski with a axis-I, axis-II, this that, but I think we can't be so agnostic as to say that everything is unknowable, so Kosminski is a viable suspect. I think we can say "Yes, he had some sort of pathology that affected his behavior," and then stop there. And I think that for our purposes, that's all we need to say, because that's enough to speculate that women on high alert in the fall of 1888 would not solicit him.

[Errata]

I don't want to talk about what Kosminski had or did not have though, because we can't know. I just wanted to mention that when someone was considered ill in there own lifetime, and there is a lot of information, we can say with pretty good confidence that yes, the person had a mental illness.

In truth, I don't mind people bandying about ideas about historical figures who quite frankly can't be harmed by our notions as they tend to be safely dead. I would never do it to a living person, except I have recommended a few friends see a psychiatrist because I was pretty convinced that what they called "quirks" were actually a treatable condition. I think Stonewall Jackson is a very peculiar choice to an Aspergers diagnosis, But I'll listen to it, probably argue it. What I cannot abide is people who then present this as fact. "Jackson had Aspergers." Shut up. You have no idea.

Something was wrong with Kosminski. To the point that to an extent he cooperated with his own commitment. Now whether or not a suspect was mentally ill is really only relevant if that mental illness either caused the behavior in question, or informed it. Otherwise, it's just a coincidence about as relevant as the amount of teeth the guy had. Except with one caveat. If he was known to be insane, he would send up red flags wherever he went, which can make it extra hard to escape notice. But the type of disorder can dictate functionality, organization, executive function, even difficulties. And that's important in understanding the actual commission of the crime.

[RivkahChaya]

Alzheimers causes delusions, but almost never command type delusions. Typically they stick to temporal confusion and identification delusions. Meniere's itself does not cause delusions (that I've ever heard of, though hallucinations often go with vertigo), but severe alcoholism can cause both. They could test for syphilis, and did after 1905 (I think?), so that would be in his record.

Oh, I know-- and that was sort of my point about having the person in front of you. The information about Kosminski is scanty, and vague enough that if you are going around with a pet diagnosis looking for historical cases, you can probably squeeze him into several things. Schizophrenia is the most likely thing for him to have had statistically, if the historical record is correct, but that's a big if. IIRC, there is a type of Meniere's that causes panic attacks and poor impulse control, but people who have that also get bad headaches. I haven't read about it in a while. It may be that it's going under another name now.

I don't want to talk about what Kosminski had or did not have though, because we can't know. I just wanted to mention that when someone was considered ill in there own lifetime, and there is a lot of information, we can say with pretty good confidence that yes, the person had a mental illness.

When the record is lacking, we can't say anything. We cannot say, for example, that Lewis Carroll was a pedophile, just because he had a weird, kind of obsessive, hobby of photographing little girls, and didn't seem to have any normal adult romantic relationships. I know all sorts of red flags pop up, but we don't really know what happened. He seemed to be obsessed with the Liddell family in general, and it maybe that he was just shy, almost to the point of pathology, and sort of imposed himself on this family, because he was incapable of forming his own family. Or it just might have been that he like taking pictures of people, and adults didn't have the time to sit around and pose for him all day.

I also really wish the people who want to construct an incestuous relationship for Lizzie Borden and her father and then make that the motive for the murder would shut up. They know too much pop psychology, and not enough about inheritance law. Abby Borden was Lizzie's stepmother. If Lizzie's father died first, all his money, other than any specific bequests, went to Abby, and when Abby died, to Abby's family. However, if Abby died, and then Andrew Borden, everything went to Lizzie and her sister. That a really good motive right there, without any need for incest and revenge, and also explains why Abby was killed over an hour before Andrew, and the police were sent for almost immediately after Andrew was killed: his body was warm, hers was not, therefore, she died first.

That's not a "diagnosis," that's just Occam's razor. I don't know why so many people seem to want an incest backstory, unless the only way patricide can sit right with them, is if Andrew is evil. But I think they also want to find historical examples of incest, so it doesn't seem like it just started happening, because it just became news a couple of decades ago. Of course not. Of course it has always happened (it hasn't even been taboo everywhere, but when it has been taboo in some cultures, you know someone must have been doing it, for it to be labeled as off-limits). It isn't necessary to list specific cases throughout history to prove this.

[Errata]

Well, and there's differential diagnosis as well. If he had early onset Alzheimer's, we would expect to see movement disorder eventually; normal-onset Alzheimer's, he wasn't old enough for. Meniere's Disease sometimes results in psychotic behavior, but it's most pronounced symptom is hearing loss; that could go overlooked in initial intake in someone who didn't speak English, but not for years and years, I don't think. Tertiary syphilis usually kills more quickly, and is degenerative. If we trust the reports, Kosminski did not "go downhill" more than institutionalized people tend to from lack of stimulation; he lived much longer than people usually do after the onset of tertiary syphilis symptoms.

Alzheimers causes delusions, but almost never command type delusions. Typically they stick to temporal confusion and identification delusions. Meniere's itself does not cause delusions (that I've ever heard of, though hallucinations often go with vertigo), but severe alcoholism can cause both. They could test for syphilis, and did after 1905 (I think?), so that would be in his record.

Totally just got my train of thought wrecked by a video of a water-skiing squirrel. I absolutely thought that was joke about American fair culture, but there he was. Water-skiing. It's like I have to re examine my life now. If I remember what I was going to say, I'll come back.

[RivkahChaya]

And here is a perfect example why attempting a lay diagnosis may be valuable.

Well, and there's differential diagnosis as well. If he had early onset Alzheimer's, we would expect to see movement disorder eventually; normal-onset Alzheimer's, he wasn't old enough for. Meniere's Disease sometimes results in psychotic behavior, but it's most pronounced symptom is hearing loss; that could go overlooked in initial intake in someone who didn't speak English, but not for years and years, I don't think. Tertiary syphilis usually kills more quickly, and is degenerative. If we trust the reports, Kosminski did not "go downhill" more than institutionalized people tend to from lack of stimulation; he lived much longer than people usually do after the onset of tertiary syphilis symptoms.

I could go on, but you get the idea.

One the the really makes-my-head-plotz things about people who try to diagnose illnesses in historical figures is that they usually have a pet diagnosis, and go looking for people to stick it on. First, they don't consider that someone who wasn't considered ill in there own time probably wasn't ill at all, and then second, they don't consider that even if the person was ill, they may not have the pet illness, because the same collection of symptoms can have a lot of different causes.

The common cold, the flu, and strep throat present the same initially, but the flu continues to get worse, while the cold doesn't, and with strep, the sore throat becomes very bad, and the fever gets high, but it will respond to antibiotics, while the flu won't. Usually. Some people can have a flu infection that is mild, while some people, particularly immuno-suppressed people, can have a cold that gets very bad and causes a high fever. You can also get an antibiotic-resistant strep. My husband had one once, and it was hell. If the patient is in front of the doctor, the doctor can test for strep, or the flu virus. If you are dealing with an historical figure, you have to go with the odds, pretty much, and general knowledge. If the person's neighbors had scarlet fever (somebody noted the butterfly rash in their diary), then the chance is good that he had strep. If you are intent in ferreting out every case of the flu in a particular year, because you are studying the flu, and you aren't considering other things, you are apt to see flu where it wasn't, though.

Another point, though, is that pretty much everyone during Kosminski's lifetime agreed that he had something. If reports that we have are even somewhat reliable, we can make of list of possible diagnoses, and then look at common factors. Something common to most of the things he was likely to have had is difficulty in planning tasks ahead of time. I think that makes it unlikely that he committed crimes like the ripper crimes. But that depends first on reports being reliable, and second on his having a typical run of whatever he had.

I want to keep reiterating that I wouldn't be going down the road of proposing diagnoses if it were not for the fact that he was generally believed to be not just ill, but incompetent in his lifetime. But there's also the fact that really the only thing suggesting he is was the ripper, is a single eye-witness, who, as far as we know, did not witness the actual murders.

When you look on one hand at the evidence that Aaron Kosminski had some sort of illness that makes committing these sorts of crimes atypical, and on the other hand, the word of a single witness that he was merely seen with the victim (or something), and say which is more likely, that Kosminski wasn't capable, and the witness was wrong (or just didn't see what the police thought he saw), or that all the data on Kosminski is so flawed, we can't make any kind of educated guess about him, and he was institutionalized because of some kind of family conspiracy, or as an end run around a judicial system without enough evidence, and the data may even be fake, and the witness is unimpeachable, even though no details have come down to us, I think the first one is more likely. There are, of course, other scenarios, for example, that there are two different men named Kosminski, and we have confabulated them, so the one with the disorganized thinking, and the one identified by the witness are not the same person.

Oh, man this post is long. I have more, but I'm just going to end it.

[Errata]

I think we can probably safely say that Aaron Kosminsky, the man who was committed to an institution, had some kind of mental illness. I think it's fair to say that the reported symptoms sound a lot like what we now call schizophrenia. But I don't think we can ever know enough for a definitive diagnosis. It's possible he had a degenerative brain disorder, either genetic, or from an infection; the odds favor schizophrenia-- if the reports of his symptoms are reliable.

And here is a perfect example why attempting a lay diagnosis may be valuable. Schizophrenia is a good example, because without medical support, the deterioration of the brain is implacable. So If we say we have a suspect who through all available information was likely schizophrenic, and he was 50 years old at the time of the murders, likely he would not be the killer. 30 years of functional schizophrenia before serious structural collapse of the brain in 1888 would be extraordinary. Kosminski lived long after I would expect neurological symptoms to be catastrophic, something I can only attribute to his spending the majority of his life in the very constrained environment of the asylum. Had he still been on the streets, I think he would have died far sooner.

[RivkahChaya]

Thank you for saying this. It drives me batsh!t when people read wikipedia or salon.com articles on Asperger's syndrome, then go around claiming that people like Einstein or Stonewall Jackson had it. Aside from the fact that one necessary criterion for diagnosis is that it "interferes with normal daily function," you just can't do that. Any actual psychiatrist, neurologist, or Ph.D psychologist, which is to say, people who are qualified to make that diagnosis, won't diagnose someone they have not met. Most especially historical figures. At the very most, a colleague might look over someone else's notes after a diagnostic meeting, and say yes, or no, they would concur, given those observations.

That said, I think you can sometimes make a binary call over whether someone probably did, or probably did not, have mental health issues, but that is about all, and then, you would need to be very sure of your information. People have tried to pin down what exactly was wrong with King George III, and in that case, we do have lots of recorded observations by some people who were attempting to be objective. I don't think we can ever know exactly what was wrong, but I think it's safe to say "Something was wrong." He wasn't just over-stressed; there was actually a pathological process somewhere in his brain, or his endocrine system, or somewhere.

I think we can probably safely say that Aaron Kosminsky, the man who was committed to an institution, had some kind of mental illness. I think it's fair to say that the reported symptoms sound a lot like what we now call schizophrenia. But I don't think we can ever know enough for a definitive diagnosis. It's possible he had a degenerative brain disorder, either genetic, or from an infection; the odds favor schizophrenia-- if the reports of his symptoms are reliable.

The thing about King George and Kosminski is that they were not functioning well day-to-day, and pretty much everyone around them agreed that something was wrong. We're not taking someone who was perfectly fine, like Stonewall Jackson, and saying "Look how smart I am, I can figure out that this guy had something wrong with him when no one who actually knew him noticed."

Now, assessing Jack the Ripper is completely different. We don't know if he is even a real person. He could be one murderer, or five. We don't know his motivation. We don't know his age. We don't know where he grew up, whether he was capable of holding any sort of job, or possibly of appearing relatively successful. "Committing murder" is a horrible thing, but it doesn't qualify as failing to function, especially if one is not getting caught. That's actually pretty high-level functioning, in a sort of ironic way. We don't know so many things: we don't know whether he ever wrote a letter to anyone, and if he did, we don't know whether he made any spelling or grammar errors because that's the limit of his education, or because he was deliberately trying to disguise his writing.

I don't think we can make even a binary assessment of JTR, because we would be assessing a phantasm.

About the only thing we can say is that, statistically speaking, he is unlikely to be schizophrenic, or have one of the psychotic-type PDs, but is likely to have some issues either with substance abuse or depression. And that is based on stats gathered in the 20th century. They may not hold true for Victorians.

But just to add one thing: schizophrenics are not more likely than other people to commit violent crimes. They are not less likely either, except to the extent that they are often supervised much of the time. However, if you look at the statistic the other way, since a certain percentage of the general population is schizophrenic, a certain percentage of violent offenders are also schizophrenic. However, the crime is marked in type: schizophrenics don't usually premeditate violent crimes, and get away with them afterward, because they skillfully cover their tracks. In fact, because a lot of schizophrenics think other people can monitor their thought, they assume they can't get away with crimes. If a schizophrenic did commit a ripper-like murder, he'd likely be caught just standing there with the knife once he was done, and admit it to the first person who walked by-- and yes, I have known several schizophrenic people, because I was a social worker who did supervised community living situations for people with disabilities.

Thanks for posting this, Errata.

[Edward]

Random thoughts ...

Hello All -

But every disease, every behavior is more than it's definition in the DSM-IV. And the sooner people understand that, the better.

I absolutely agree that mental illness in any form should not in and of itself make a person a suspect in these crimes. Society in 1888 didn’t have the understanding of mental illness that we now have. Having said that, I feel that a person with a mental illness and a history of violence (especially against women) is worth considering as a suspect (if time and place indicate opportunity), as well as people with a history of violence not considered to be mentally ill.

DSM-IV cannot be applied in this case, simply because the observations that are used to arrive at a diagnosis must be made in a clinical setting. Testimonials and hearsay are not clinical observations. DSM-IV pigeonholes a patient into a diagnosis based upon observed behavior. It shoehorns patients into a diagnosis based upon those clinical observations. One of the criticisms of DSM-IV is that patients may not behave in their usual manner when placed in a clinical setting. It is my belief that in many cases, mental illness is a spectrum of behaviors or compulsions and not a “pure” case of one diagnosis only. DSM-IV handles that issue by assigning two (or more) diagnoses, which I, too, do not feel is an accurate picture of patients in those conditions, Errata.

In the case of the Whitechapel Murders, the killer apparently had the ability to perform at least rudimentary pre-planning (brought a knife along) and the ability to perform whatever it took to evade detection and escape the crime scene. Diagnoses that rule out those types of behaviors should probably not apply. However, must a serial killer have a mental disorder? Possibly, but then, maybe not.

Edward

[Errata]

I don't see how OCD could initiate a killer instinct either, there would have to be far more serious psychological conditions for it to play any sort of part in the role of murderer, in my opinion.

Like I said, I have heard of guy who replaced self injurious behavior with violence and murder. But I don't know how it happened. And I don't know that OCD needs to create a killer instinct, as long as it informs the method of killing. If say, he killed because he was just one of those guys, but his OCD dictated the form of the mutilations, if he had a personal ritual, that's a big problem for someone who kills out in the open, and can be interrupted. I don't know that he would be able to leave before finishing whatever it is he did. Someone with OCD isn't a killer. But a killer with OCD is going to have compulsions regarding the killing. Which makes him vulnerable.

[katemills]

I agree with what you have written Errata. I'm not a Ripperologist who is trying to unmask JtR so I don't feel the need to single any suspects out and diagnose them; I'm more intrigued by the evaluations of why each suspect is a suspect, how people have come to regard them as such, the 'suspect's' way of life, recorded personality traits/communications etc. This applies to every suspect named, aswell as the general populace and their living conditions and ways of life at that time. Granted there are those who are more interesting than others.

I have OCD and have suffered other mental health issues in the past, pretty much from my mid-primary years. All have been caused by emotional stress from varying sources. It's painful, I have memory issues through it (non-recent) but it hasn't made me a bad person or a killer or insane. It's just part of my make-up. I function well alongside the OCD which is the predominant issue nowadays. I wish it wasn't there; it's embarrassing, invasive and controlling. It fluctuates in intensity depending on my state of mind - general stress and worry is the influencing factor aswell as one singular event in my past that causes me high emotional stress which 'flares up' the OCD if I think about it at all. However, even when I don't feel stressed or worried, it is still there.

I don't see how OCD could initiate a killer instinct either, there would have to be far more serious psychological conditions for it to play any sort of part in the role of murderer, in my opinion.

[Errata]

Well eloquently is perhaps the word I was looking for but you managed to articulate something I’ve been trying to for a while but I’m far better at talking in person than translating my thoughts in a legible form by typing them out – it ends up gobbledeegook like this most likely will…
Plus something you wrote chimed very much with me personally, something again I’ve struggled to pin down./express.
I’m of the opinion that the suspect list is peopled by poor souls who were just unfortunate enough to be suffering from or whose behaviour was perceived, at the time, to be a mental disorder and that they were therefore judged more likely to be the killer than somebody who was for want of a better word regarded as “normal”. Which is of course nonsense. I can’t see any other reason or evidence that made them suspects except prejudice and false assumption really.
Poorly put by me – I told you I can’t do this very well – but I think too much stock can be put (even today when we should be more enlightened) in this guy, or this guy being more valid as a suspect/more likely to kill because they suffered mental health problems and it’s wrong.

I don't blame anyone for their fear. It isn't right, and it isn't okay, but it is perfectly reasonable. The first thing people think of when they think of mental illness is that these people are out of control. And that's true. We do not have control of certain functions that other people do have control over. Now it's no different than epilepsy, or diabetes, or MS, which are not scary. I can't control my serotonin and dopamine any more than a diabetic can control his insulin production. So why am I scary and a diabetic is not? Well, that's pretty simple. If a diabetic's system goes horribly awry, he can die. If my system goes horribly awry, I lose control of my judgement and my behavior. Now, only within certain parameters, but I do lose control. And it scares people to see me altered in that fashion. It never occurred to my friends that I was remotely a reckless person, until they saw me in a Bipolar episode for the ages. It was so out of character that they wondered what else I was capable of in that state. And I don't blame them. I know what I'm capable of, but it never occurred to me to tell them. Now, I've been training them for so long at this point that nothing phases them. They even help me when things get bad. And I am very lucky.

But what do most people know about mental illness? They know it's not our fault. Which is good. They know it's a malfunction in the brain. It affects 2% of the population. So who do most people know who have a mental illness? Ranting homeless guy, coworker's sister who committed suicide, and what they see on TV, movies, and in the news. There's a show, Homeland, in which the main character is Bipolar. It is the most realistic depiction of the disease I have ever seen, and it is still waaaaay off. Who else do we have with a mental illness in our consciousness? Jared Laughner? James Holmes? Buffalo Bill? Syd Barrett? Not really shining examples of the success of the mental health system.

You know who else have mental illnesses? Catherine Zeta-Jones, Ashley Judd, Emma Thompson, Michael Phelps, Buzz Aldrin, Rosemary Clooney, Ben Stiller, Daryl Hannah, Adam Levine, Lionel Aldridge, Stephen Fry, Ted Turner, David Beckham... a whole lot more. These are successful people, who have ADHD, Bipolar Disorder, OCD, even Autism. And these people are "out", they talk about it. Somehow those examples don't stick. When people think "mental illness" they don't think Buzz Aldrin. They think ranting homeless guy. Maybe people think that these celebrities are somehow the exception. But they aren't.

In the LVP, there was really no chance at all for someone with a mental illness, and that affects perception. There were no treatments, there were no cures. They were just out of thinking that mental illness was demonic possession, but not yet at the point of recognizing a structural problem in the brain. They thought mental illness was the fault of the sufferer. They did SOMETHING that caused it. Though no one was sure what that something was. But today we have all kinds of treatments and therapies and medications to keep us on an even keel. They didn't have that. They had an endless progression. They had nothing to stop what was happening. A few people probably cobbled together some tips and tricks to deal with certain symptoms. And avoidance was probably a popular one. But they tended to get a lot sicker a lot faster than we do now. And it's entirely possible that someone with my symptoms back then would descend to a level I will never reach. I get why they thought the Ripper was insane. I disagree, but I have access to knowledge they didn't have. And it's not impossible. But we live in 2012, and we do not have any excuse to think the way that they thought. Mental illness does not a suspect make. At most, mental illness is one of the criteria of trying to identify Anderson's suspect. Understand the illness, understand the symptoms, and then come to a conclusion. But every disease, every behavior is more than it's definition in the DSM-IV. And the sooner people understand that, the better.

[Mr Stu]

Well eloquently is perhaps the word I was looking for but you managed to articulate something I’ve been trying to for a while but I’m far better at talking in person than translating my thoughts in a legible form by typing them out – it ends up gobbledeegook like this most likely will…
Plus something you wrote chimed very much with me personally, something again I’ve struggled to pin down./express.
I’m of the opinion that the suspect list is peopled by poor souls who were just unfortunate enough to be suffering from or whose behaviour was perceived, at the time, to be a mental disorder and that they were therefore judged more likely to be the killer than somebody who was for want of a better word regarded as “normal”. Which is of course nonsense. I can’t see any other reason or evidence that made them suspects except prejudice and false assumption really.
Poorly put by me – I told you I can’t do this very well – but I think too much stock can be put (even today when we should be more enlightened) in this guy, or this guy being more valid as a suspect/more likely to kill because they suffered mental health problems and it’s wrong.

[Errata]

Let me guess: Psychology 101.



Intense?

Hell?

I seriously doubt that you will ever have the slightest semblance of an appreciation for the intensity of the agonizing hell, in which I have had to spend much of my life, because of my Obsessive Compulsive Disorder!



OCD in itself would not compel someone to kill! Period!

Actually I think I'd be able to make a pretty good guess, since I have it too. One of the really good scarring, disfiguring kinds too if it makes you feel better. OCD can compel people to kill. And it has. It is extraordinarily rare, but it has happened. And it all hangs on the delusional component.

As I imagine you well know, the compulsion has a delusion backing it up. Usually something non specific, like "something bad will happen if I don't do this thing." Sometimes it's a little more specific, like "it hurts if I don't do it" "someone will die" "I will die", etc. Sometimes it's coupled with a phobia. In such cases the fears are very specific, but the remedies are also very specific. That's where the line blurs. Because OCD has such a huge degree of magical thinking involved, any action that relieves anxiety can become a compulsion. Be it counting, washing, picking, even killing. Richard Chase was Schizophrenic, but he also had OCD coupled with his schizophrenic delusions. It's what shaped the method and reason for his killing. Blood relieved his anxiety over the delusion of illness. Much like hand washing does for others. Extremely rare. But possible.

Look I have a score of diagnoses. OCD is only one of them, but quite frankly the one that has shaped me the most. Because quite frankly if you don't think an adolescent girl with an awkward and disfiguring disease doesn't develop a whole lot of issues, think again. And I'm not a killer. And no one else I know with OCD is a killer. But my CBT therapist had one as a client. She'd drive out to the prison to treat him. Do I think Jack the Ripper had OCD? No. I really don't. But I'll entertain the possibility.

Frankly, you know damn well that mental illness doesn't make us something we aren't. There is no disease on the planet that could make killers out of either of us. You have OCD. I know that sucks. But I don't feel sorry for you, because you aren't dying, and you aren't going to go all Flowers for Algernon on us. We lose a lot. But never our own nature. And if you got offended because you thought I was some tourist spouting nonsense, then let me assure you. I am no tourist, and this is not nonsense. A monster with OCD is still a monster. But anyone who thinks people with OCD are incapable of violence are dead wrong. Rage is a HUGE component in a frustrated compulsion, and people lash out. I've done it. I've hit people who tried to grab my hands and force them down. I've screamed, I've shouted, I head butted my sister once when she trapped my hands and wouldn't let me go. People do not come between an OCD sufferer and their compulsion unscathed. As any number of school bullies have learned. Yes, most of the time we lash out verbally. But not always. And can you imagine what would happen if you swung at someone and found that the sensation of knocking someone to the floor was better than whatever your compulsion is? I can't tell you how many things I don't do, won't even try because I'm afraid of substituting behaviors.

Though since I've been doing one of mine while typing this and the left side of my face is bleeding, sometimes it's hard to imagine what can be worse than this.

I'm just trying to have an honest discussion about all of this. A lot of psych stuff gets flung around, and I do it too. I can't let people think that the mentally ill are dangerous, when the vast majority of us are not. But I don't think it's useful to pretend that we can't be dangerous. For whatever reason. I'm as dangerous as the guy who stood behind you the last time you were in the elevator. But that guy could have killed you. So if someone is going to live in fear of us, they better be damn well willing to live in fear of everybody. That's my take. Disagree if you like.

[Colin Roberts]

OCD rituals are solely for the purpose of relieving intense distress and anxiety. They can't stop. Try to stop them and they fight.

Let me guess: Psychology 101.

OCD is as intense as psychosis. And as demonstrated by the remarkable amount of compulsive behaviors that are destructive, personally harmful, and even potentially fatal, self preservation is not a factor in this disease. Frankly it's hell.

Intense?

Hell?

I seriously doubt that you will ever have the slightest semblance of an appreciation for the intensity of the agonizing hell, in which I have had to spend much of my life, because of my Obsessive Compulsive Disorder!

This is of course with the caveat that the OCD is compelling this person to kill, not that they are a serial killer who, oh by the way, washes his hands 137 times a day.

OCD in itself would not compel someone to kill! Period!

[Errata]

Fallacy!

How so? OCD rituals are solely for the purpose of relieving intense distress and anxiety. They can't stop. Try to stop them and they fight. Now there are any number of therapies available today, including medication, CBT, DBT, etc. that can make a world of difference, but those were not available back then. Not only that, but no one knew what OCD behaviors were trying to accomplish. So even if someone dragged a guy kicking and screaming away from the crime scene, he would be compelled to try and finish in some fashion.

Of course, OCPD is a different beast. It's much more akin to Generalized Anxiety Disorder, which can be pushed through if need arises. But OCD is as intense as psychosis. And as demonstrated by the remarkable amount of compulsive behaviors that are destructive, personally harmful, and even potentially fatal, self preservation is not a factor in this disease. Frankly it's hell.

This is of course with the caveat that the OCD is compelling this person to kill, not that they are a serial killer who, oh by the way, washes his hands 137 times a day.