Piquerism

[John G]

thanks Errata
This was very helpful from the clinical point of view.


Really? None?

Well I think we could make an educated guess. IMHO from what I know about serial killers and a little bit of common sense I think the ripper was:

Primarily:
Interested in post mortem mutilation-specifically what his sharp knife could do to the female.
And specifically into removing and taking away internal organs, probably as a way of reliving/prolonging the fantasy (which had a sexual component).


Secondary:
Shocking the public
relieving anger/revenge
possibly cannibalism

I think we could also make a good guess he wasn't:
a rapist killer
a torturer/ sadist
a homosexual
suffering from extreme mental disorder that would manifest itself outwardly to the public or so insane he didn't realize what he was doing was wrong.
a pedophile
a mission oriented killer

I know this is armchair whatever but that's how I see it anyway.

Hi Abby,

I think this is a very fair assessment. I'm undecided as to whether JtR may have been suffering from a form of mental illness, such as schizophrenia, or whether he was simply psychotic.

For instance, Robert Napper was a schizophrenic and, as you might expect, there were many disorganized elements to his crimes, although in other respects he seeened highly organized.

Peter Sutcliffe, the Yorkshire Ripper, murdered at least 13 women over a five year period. He claimed to be acting under divine instructions to rid the world of prostitutes, and was diagnosed as suffering from paranoid schizophrenia. However, the jury rejected this diagnosis and he was convicted of murder. Nonetheless, the diagnosis was subsequently confirmed, and he was transferred from prison to a high security mental hospital.

[John G]

Remember that every diagnosis has a code, and every code is used for insurance and billing purposes. So there is absolutely no forensic value in any DSM diagnosis arrived at after the fact. There is some value in a diagnosis that precedes an attack, but it's value is in further refining the definition of a disorder.

Also remember that the point of diagnosing anyone with a mental illness, NOS or otherwise, is to manage the behavior and hopefully treat the sufferer. Picquerism is a set of definitions that allow a person with such a fetish to be diagnosed, treated, and hopefully relieved of destructive tendencies. If a doctor diagnoses a paraphilia, it's because the behavior is a close enough to fit to build treatment on. It may not even be totally right, but it doesn't matter if the diagnosis provides a treatment plan that works. The definition does not exist to retroactively label someone with absolutely no firsthand evidence of fetish or compulsive behavior. So any attempt to do that, especially with things like Picquerism, naturally fails at some point.

Every paraphilia boils down to a single question. Does the paraphilia cause dysfunction? If yes it is treated. In some ways paraphilias are very life Obsessive Compulsive Disorders, in which you can get some pretty bizarre or even seemingly harmless manifestations of the disease, but if they cause dysfunction then they are a disorder that needs to be treated. Hand washing seems pretty benign, but take it to the point where the skin of the hands is stripped off from continued washing and it's clearly a problem. Tapping a pencil until you are crying because you can't stop. Tapping a pencil is nowhere in the DSM, yet clearly for that person it is a manifestation of disordered thinking.

Because breaking laws of the land is considered dysfunctional, there are certain behaviors that are always paraphilias, because to indulge in them is illegal, it harms oneself or others, and until recently anything that was universally condemned by society was considered a paraphilia.Which is how homosexuality was disorder. Necrophilia is illegal. If you engage in it even only rarely, you have a paraphilia. Same with true sadism, and a few of the more rare behaviors involving blood, death, rape, children etc. It is completely possible to have a paraphilia involving say, partners of a different religion, which we see as harmless, but the behavior is compulsive and causes harm. Say, the shame of it leaves you in a constant depressive state. It's how you handle it, or how it handles you that determines if it is causing dysfunction, and therefor a paraphilia. Unless it hurts people who do not or cannot consent to such treatment, and then it's always a paraphilia. And none of these definitions and diagnoses can tell you why someone does what they do. The definitions aren't meant for that, and the reasons vary from person to person, even if some parts of their story fit a theme.

Rewind it a bit, and we have no idea what got Jack's rocks off. People with picquerism usually prey on unwitting people. It's like Frotteurism, but instead of body contact they use a hat pin. It's a signature behavior, and the diagnosis of picquerism rarely comes without that specific behavior. It is unlikely that the pattern of stabbing and cutting seen in the Ripper murders are the work of a picquerist. But that's not to say no paraphilia is at play. It might not have been the stabbing he got off on. It might have been the blood. Or strangulation, or he could have been a partialist. Or it wasn't about sex at all, and was about anger, or a mission, or delusion. There are tiny pieces of these crimes that could fit a lot of different things. I could make probably 5 different arguments. He was unlikely to have five different paraphilias, so they can't all be right.

I have no idea what he was after. The DSM can't help anyone. Not for this. We need more. Like we have with Bundy or Dahmer. But we don't have that. And guessing doesn't help because pinning a diagnosis on this killer still won't tell you why or how. It might explain a surface behavior, but no diagnosis can explain everything he did. Even if he were a violent schizophrenic, that would only explain about a 10th of what he did. There are only two things I can be absolutely sure of. 1: He did what he did because he wanted to. This was a choice, and he consistently made it. Why he made that choice is unknowable. 2: No diagnosis explains all of his behaviors. He was not so insane that he couldn't reason. So any answers we may need aren't going to come from a diagnosis. They can only come from the man himself.

Hello Errata,

Of course, a major problem with the DSM is the complete failure of the bio-medical model as a means of defining mental illness. As Allen Frances explains:

"Fifty years of subsequent research confirms DSM is no more than a catalogue of syndromes-social constructs, not diseases. What we call 'schizophrenia' is a heterogeneous grab bag of symptoms and behaviours that overlap bewilderingly with its near neighbours, both in clinical presentation and on biological markers. There will not be one or a group of schizophrenia, but rather a small army of hundreds of different forms of pathogenesis and presentation. 'Schizophrenia' is just a name, not a thing-a useful social construct but also one that carries considerable baggage and risks. 'Schizophrenia' will gradually be eaten away or replaced altogether as we gradually find a better way of organising the data and naming its more fundamental constituent parts." (Frances, 2014) see: http://m.anp.sagepub.com/content/48/11/1067.extract

However, as your post implies, without some sort of codified system, however flawed, with which to base a diagnosis, how are patients to access treatment, such as therapy or medication, that might assist their condition? Clearly a pragmatic approach is called for: as Frances and Widiger put it:

"The future hope is that psychiatric diagnosis will gradually incorporate biological tests based on pathogenic understanding. The experience of the last 30 years suggests that this welcome breakthrough will be painstakingly slow in coming and will usually apply to only a small percentage of individuals diagnosed within the existing descriptive categories. With all its many limitations descriptive diagnosis will necessarily remain our most valued standby for msny, many decades. Our classification of mental disorders is no more than a collection of fallible and limited constructs that seek but never find an elusive truth. Nevertheless, this is our best current way of defining and communicating about mental illness." (Frances and Widiger, 2012). See: Psychiatric Diagnosis:Lessons from the DSM 1V Past and Cautious for the DSM V Future, Annu Rev Clin Psychol 2012; 8:109-30.

[Abby Normal]

Hi Abby,

I think this is a very fair assessment. I'm undecided as to whether JtR may have been suffering from a form of mental illness, such as schizophrenia, or whether he was simply psychotic.

For instance, Robert Napper was a schizophrenic and, as you might expect, there were many disorganized elements to his crimes, although in other respects he seeened highly organized.

Peter Sutcliffe, the Yorkshire Ripper, murdered at least 13 women over a five year period. He claimed to be acting under divine instructions to rid the world of prostitutes, and was diagnosed as suffering from paranoid schizophrenia. However, the jury rejected this diagnosis and he was convicted of murder. Nonetheless, the diagnosis was subsequently confirmed, and he was transferred from prison to a high security mental hospital.

Thanks JohnG
I think if the ripper had any form of severe mental illness, like schizophrenia, then it was what caused him to stop-ex-Kozminski. not what caused him to kill.

he was certainly a psychopath however!

[Errata]

Hi Abby,

I think this is a very fair assessment. I'm undecided as to whether JtR may have been suffering from a form of mental illness, such as schizophrenia, or whether he was simply psychotic.

For instance, Robert Napper was a schizophrenic and, as you might expect, there were many disorganized elements to his crimes, although in other respects he seeened highly organized.

Peter Sutcliffe, the Yorkshire Ripper, murdered at least 13 women over a five year period. He claimed to be acting under divine instructions to rid the world of prostitutes, and was diagnosed as suffering from paranoid schizophrenia. However, the jury rejected this diagnosis and he was convicted of murder. Nonetheless, the diagnosis was subsequently confirmed, and he was transferred from prison to a high security mental hospital.

A person can have a single delusion, or a single false belief that can make a significant change in behavior. For example the belief that killing prostitutes would protect the neighborhood. Or the belief that killing prostitutes will finally make a cold and distant father proud of an unexceptional son. Single delusions, maybe a couple of supporting ones, not part of a systemic illness, not part of a group of observable maladaptive behaviors.

People who believe that living in bunkers will protect them from the government, or cult members are some pretty well known examples.

Some serial killers seems to have these. Dahmer's belief that he could drop acid into his victims brains to make them zombies is clearly delusional (though also oddly correct), yet he wasn't ill. He had one false belief that fed into his impulses, and so was accepted. It happens to a lot of people at some point in their lives. Usually it's not harmful. Sometimes it is.

[John G]

A person can have a single delusion, or a single false belief that can make a significant change in behavior. For example the belief that killing prostitutes would protect the neighborhood. Or the belief that killing prostitutes will finally make a cold and distant father proud of an unexceptional son. Single delusions, maybe a couple of supporting ones, not part of a systemic illness, not part of a group of observable maladaptive behaviors.

People who believe that living in bunkers will protect them from the government, or cult members are some pretty well known examples.

Some serial killers seems to have these. Dahmer's belief that he could drop acid into his victims brains to make them zombies is clearly delusional (though also oddly correct), yet he wasn't ill. He had one false belief that fed into his impulses, and so was accepted. It happens to a lot of people at some point in their lives. Usually it's not harmful. Sometimes it is.

How would you categorize Richard Chase, the Vampire of Sacramento, who was diagnosed with schizophrenia? Of course, he also engaged in necrophilia and cannibalism.

[Errata]

How would you categorize Richard Chase, the Vampire of Sacramento, who was diagnosed with schizophrenia? Of course, he also engaged in necrophilia and cannibalism.

Umm... is Mad as a Hatter in there somewhere?

He was a violent schizophrenic, completely gone. He was biologically incapable of any restraint by that point. It's often true with early onset Schizophrenia, doubly true with childhood onset, which I believe his was. The brain loses the ability to edit after the disease progresses to a certain amount. He was past that point.

He certainly had paraphilias, but whether they were his or a product of his delusions I don't know. I don't know that anyone could know that. I lump them into "the least of his problems" category, because his delusions were causing him to kill, he wasn't choosing to kill to feed a paraphilia. I also think that medication removing the delusions wouldn't have helped. He was delusional so early and for so long that he likely didn't have a sense of reality to return to. Which is rare, but usually happens with childhood onset.

His main problem was his hypochondria. How that mixed with his schizophrenia was violent and unpredictable. But his core belief was that something was wrong with him, something had been done to him, there was a way to fix it with blood, but people were preventing him from doing that. It creates paranoia, it creates a need for violent action in order to satisfy a need, it creates anger. And he had a lot of sort of superstitious beliefs wrapped up in all of that. His thing with doors, for instance. And the rapes and mutilations were likely a product of both rage and some superstitions. Some belief that engaging in those activities helped him somehow. And perhaps he had a genuine sexual desire for corpses, but more likely it was mythology and punishment rolled together.

Anyone who knowingly has sex with a corpse is a necrophiliac, but a real one does it because they are sexually attracted to the dead. Those who do it for power or rage or punishment are a little different.

[Abby Normal]

Umm... is Mad as a Hatter in there somewhere?

He was a violent schizophrenic, completely gone. He was biologically incapable of any restraint by that point. It's often true with early onset Schizophrenia, doubly true with childhood onset, which I believe his was. The brain loses the ability to edit after the disease progresses to a certain amount. He was past that point.

He certainly had paraphilias, but whether they were his or a product of his delusions I don't know. I don't know that anyone could know that. I lump them into "the least of his problems" category, because his delusions were causing him to kill, he wasn't choosing to kill to feed a paraphilia. I also think that medication removing the delusions wouldn't have helped. He was delusional so early and for so long that he likely didn't have a sense of reality to return to. Which is rare, but usually happens with childhood onset.

His main problem was his hypochondria. How that mixed with his schizophrenia was violent and unpredictable. But his core belief was that something was wrong with him, something had been done to him, there was a way to fix it with blood, but people were preventing him from doing that. It creates paranoia, it creates a need for violent action in order to satisfy a need, it creates anger. And he had a lot of sort of superstitious beliefs wrapped up in all of that. His thing with doors, for instance. And the rapes and mutilations were likely a product of both rage and some superstitions. Some belief that engaging in those activities helped him somehow. And perhaps he had a genuine sexual desire for corpses, but more likely it was mythology and punishment rolled together.

Anyone who knowingly has sex with a corpse is a necrophiliac, but a real one does it because they are sexually attracted to the dead. Those who do it for power or rage or punishment are a little different.

wasn't he also kind of mission oriented as he thought that by killing people he was saving CA from the great quake? or am I confusing him with Herbie Mullin?

[Errata]

wasn't he also kind of mission oriented as he thought that by killing people he was saving CA from the great quake? or am I confusing him with Herbie Mullin?

Yeah that was Mullin. Though his illness was even less organized than Chase, so he was killing people for several reasons and just the one reason at the same time.

People think there has to be some kind of unifying theory with delusions. Some over arching explanation that ties all the various delsusions together. Chase had that. Mullin not so much. Which makes it very hard to understand, and hard to link his actions together into one long coherent act for a single purpose. Because it wasn't one long coherent act for a single purpose. Different delusions resulted in the same actions.

But it's like religion. I might think the Christian tradition of baptism is daft, but I have to accept that is how it is, and I don't get to question it. Sincere belief is sincere belief. Even if it doesn't make a lick of sense, even if the person holding the belief KNOWS it doesn't make a lick of sense.

[Abby Normal]

Yeah that was Mullin. Though his illness was even less organized than Chase, so he was killing people for several reasons and just the one reason at the same time.

People think there has to be some kind of unifying theory with delusions. Some over arching explanation that ties all the various delsusions together. Chase had that. Mullin not so much. Which makes it very hard to understand, and hard to link his actions together into one long coherent act for a single purpose. Because it wasn't one long coherent act for a single purpose. Different delusions resulted in the same actions.

But it's like religion. I might think the Christian tradition of baptism is daft, but I have to accept that is how it is, and I don't get to question it. Sincere belief is sincere belief. Even if it doesn't make a lick of sense, even if the person holding the belief KNOWS it doesn't make a lick of sense.

thank you Errata

[Errata]

But it's possible that Jack the Ripper is an example of a killer with a single delusion. That killing these women is for the greater good. For example, a man whose abusive mother was a prostitute goes around killing and "sterilizing" women to prevent other kids from being born into the life he led. He doesn't think he's the queen, he lives his life generally in bounds, he's not a raving lunatic. But when confronted with a trigger, he sincerely believes that he is doing a good thing, even if no one but him understands it. He doesn't need acclaim, he doesn't need thanks (though some do), he just needs to finish his quest. Single delusion. Maybe supporting delusions like, any woman on the streets after sundown is a prostitute. Or any woman who talks to him is soliciting him, and that makes them a target.

And it's funny, because some of his delusional beliefs may be perfectly understandable. A woman on the streets at one in the morning may well be a prostitute. An assumption any of us might make. It's hard to see that as a delusion as opposed to a mistake. But his false belief cannot be shaken. It cannot be challenged. Ours can. And we learn and change our thinking. And that's the difference. And a lot of serial killers in fact have single delusions. And they often make perfect sense to us, in that we can see why they would believe that. But they can't not believe that. They actually can't. So it's a delusion, we just kind of see it more as an odd idea.

Even we non serial killer folk pick up delusions along the way in life. Usually they go away in pretty short order, but we are susceptible to them. Ever felt your skin crawl when you go to a game without your lucky shirt on? Been convinced your team will lose because you didn't wear it? We KNOW it's nonsense. But our very nervous system is hard wired into that nonsense belief. We breathe faster, our heart speeds up, we feel dread. We are 90% of the way to a delusion. When we alter our behavior in a way that isn't good for us in order to support that belief, it's a harmful delusion. Make it all the way to the game and turn around so you can get your lucky shirt. Freak out on someone for spilling a coke on the shirt, about how now you are going to lose. Every OCD behavior ever reported was backed by a delusional belief. Every superstition, every prejudice, every phobia, even every bit of everyday folklore is backed by a delusion. Delusions in and of themselves are pretty common, generally harmless. It's when they become harmful that it becomes an issue for psychiatry.