by Patrick Cleveland M.A.
Right now there is a massive manhunt underway for
ex-police officer turned renegade avenger Christopher Dorner after he murdered
a police officer, a police captain’s daughter, and her fiancĂ©. There has been a
lot of hype in the media about his mental status as to whether he has a ‘mental
illness’ or not. While watching coverage of the story after police found Dorner’s
abandoned and burned out truck in Big Bear, CA., the psychological experts
appeared on television to convey their opinions. While watching Anderson Cooper
360, he had a psychologist on the show who stated that it is ‘very hard to
discern if Dorner is suffering from any recognizable mental illness’ and that
he simply appeared to be an angry man on a vengeful rampage. Given my own reluctance
and distaste for diagnoses, I pretty much agreed with that assessment. However,
not even an hour later, Piers Morgan had a psychiatrist on his show who said
that Dorner was ‘clearly suffering from a mental illness’. I broke out laughing when I heard this! These
were supposed to be two experts, why did they have such differing opinions? For one thing, it speaks to the epistemological
shakiness of the supposed ‘scientific’ foundation of psychology as a whole and
how diagnosis can be such a tricky business. Some practitioners swear by
diagnoses and the importance they have on treatment. The range of their usefulness for me is based
on the setting in which it is applied. In a private-practice setting I have
found them to be almost useless whereas in a community mental health setting
they are more useful for treatment, but mostly just for billing purposes. The two different perspectives portrayed on both shows prompted me ask myself the question: is Dorner mentally ill after all? Here is the conclusion I have arrived at. After reading through various diagnoses in the psychotic spectrum of the DSM IV (Diagnostic and Statistical Manual of the American Psychiatric Association) I arrived at a diagnosis that could fit Dorner if certain factors in his case were indeed true.
The diagnosis is
known as Delusional Disorder 297.1, and
its criteria are as follows
A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration.
B. Criterion A for Schizophrenia has never been met.
Note: Tactile and olfactory hallucinations may be present in Delusional
Disorder if they are related to the delusional theme. A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month's duration.
C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.
D. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.
E. The disturbance is not due to the direct physiological effects of a substance(e.g., a drug of abuse, a medication) or a general medical condition.
Now here’s the clincher. In the criteria for category A it
mentions ‘non-bizarre’ delusions meaning the delusions do pertain to one’s
perception of reality in relation to events that actually happened. For example, if Dorner thought he is the
prince of Zaire, that would be a bizarre delusion but Dorner thinking that the
LAPD persecuted and fired him wrongly could
be a non-bizarre delusion. I say could be because it could be true and
thereby not a delusion! No criteria for category B are met in this case since
Dorner clearly does not have schizophrenia for reasons not even worth going
into here. Once again, if Dorner is
wrong, he also meets the criteria in categories C and D as the vengeful behavior
is typical of persecutory delusions and the mood he is acting out of is clearly
one of anger fueled by a perceived betrayal and injustice. Dorner does not meet
criteria for category E as he is not a drug user and this episode was not
triggered by drug use. So the conclusion is that if the LAPD rightfully fired
Dorner for the charges against him then Dorner is currently suffering and
acting out of a mental illness as a result since his beliefs about being
persecuted are false. However, if Dorner is right, and the LAPD staged a cover
up for the officer in question in the incident in which he was fired for and
Dorner was persecuted for being a whistle blower in that event, than he is
merely acting out of anger and revenge for the betrayal and injustice persecuted
against him and is in no scientific or psychiatric way suffering from a mental
illness. In that case, he’s just a really pissed off guy going on an all-out
vendetta. That is of course, until the American Psychiatric Association chooses
to name something like ‘obsessive vendetta disorder’ into the DSM and say it is
a mental illness, but how silly would that be? Silly or not, it could happen.
The DSM I published in 1952 contained 106 diagnoses. That number grew quite significantly
to the current edition of the DSM IV published in 1994 consisting of 365
diagnoses. How is this possible one could ask? That is a subject for another
day. The main purpose of this story is to show how in Dorner’s case the main
factor involved in diagnosing him with a mental illness is truth. But are you really ill or sick if you are just
drastically wrong? If you perceived the circumstances against you falsely does
that makes you sick or just grossly mistaken? These are questions to take up on
another occasion, but for now, the misperception of reality continues to be the
key criteria for the psychotic spectrum of mental illness. I’m interested to
see how Dorner’s story unfolds and how the media and the so-callled
psychological experts will portray his unfolding. I wonder what the truth will actually be.
Published by Patrick Cleveland
www.patrickcleveland.com
Long Beach, CA. 2/12/13
Sources:
http://kadi.myweb.uga.edu/The_Development_of_the_DSM.html
DSM IV