Psychiatry, the Law, and Depravity: Profile of Michael Welner, M.D. Chairman, The Forensic Panel
Threat of Suicide
Occasionally, forensic psychiatrists are engaged after a trial has concluded, and the case of Dr. Richard Sharpe is a good example. His Massachusetts trial in 2001 had inspired a media frenzy that defined the man in a perverse, bizarre manner.
The millionaire dermatologist, 47, was charged in 2000 with the murder of his estranged wife, Karen, whom he repeatedly claimed to have loved. He was alleged to have gone to her home with a shotgun one evening, stood in the doorway, and shot her in the chest as she stood in the foyer. He then disposed of the gun, which he had stolen, and fled to New Hampshire.
The prosecutor said it was an intentional, premeditated homicide to prevent his wife from taking his money in a divorce. That team worked hard to present Sharpe as a controlling manipulator — as evidenced by his inattentive behavior throughout the trial. Sharpe's actions prior to and after the incident, it was claimed, indicated awareness of guilt and appreciation of right and wrong — from the way he had parked his car that night to the way he orchestrated his behavior and appearance at his trial. A ballistics analysis showed that the murder weapon was a different gun from the one reported stolen, which added to the prosecutor's case that Sharpe's theft was merely part of his attempt to stage the premeditated incident as a heat-of-the-moment act.
The defense team said that the defendant was suffering desperately over the abandonment by his wife of 26 years and he had lost control. They offered an insanity plea, claiming he was temporarily deranged by stress and panic.
Both sides had psychiatric experts to support their respective cases. The defense presented an abused childhood that had rendered Sharpe incompetent to appreciate what he was doing on the day he killed his wife. The three children testified for the prosecution that Sharpe had been verbally and sometimes physically abusive with their mother. His recreational cross-dressing was revealed, making daily headlines and defining him for America as unstable and sexually-confused, but this activity was not considered evidence of a serious mental illness. He ended up just looking like a pathetic man who had nevertheless acted with clear intent.
In the end, on November 29, Sharpe was convicted of first-degree murder and sentenced to life without parole.
While in prison in Bridgewater, Mass. he complained about his medical and mental-health treatment, and twice attempted to commit suicide, resulting in hospitalization in intensive care. The possibility that he might try again seemed likely, so Sharpe's lawyer for his appeal retained Dr. Welner to conduct a psychiatric assessment.
The medical records indicated that his Bridgewater doctors had already arrived at an appraisal of Sharpe as a manipulative, narcissistic malingerer who acted as if he was entitled to what he wanted. They discounted Sharpe's knowledge of medicine and psychopharmacology, as if his being in prison had erased his prior intelligence and medical competence. They did concede that the inmate had bouts of interrupted sleep, tearfulness, implacable grief for the loss of his family, and depression, but since he appeared to be animated when on the telephone, they believed he was faking his symptoms to get attention. Sometimes they withheld medications from him that he claimed made him feel better.
When Dr. Sharpe had developed a relationship with a woman who came to visit him, she was denied all privileges for unexplained reasons. His anxiety levels increased and he claimed to suffer frequent panic attacks. The doctors wrote that he was acting out because he could not get what he wanted.
After eleven hours of face-to-face contact with Sharpe, Welner came away with a different impression. He reviewed Sharpe's history of interpersonal relations, administered several assessment tests, checked Sharpe's mental status, and reviewed the input of fellow inmates, all available records, even the writings of letters Sharpe had mailed to acquaintances in preceding months. Welner concluded that objective evidence demonstrated Richard Sharpe to be quite seriously depressed. That he was anxious and depressed was understandable, given the many setbacks he had suffered, including his close brother's recent death from cancer. His symptoms hinted at borderline and dependent personality features, major depressive disorder, and some hint of post traumatic stress disorder. Sharpe had poor strategies for reducing tension, and thus became suicidal and self-mutilating.
Sharpe was desperately afraid of being alone, which could account for his animation on the phone. Welner found that Sharpe had not been tested for malingering by those who had assigned him that diagnosis. Standardized assessment measures influenced his conclusion that Sharpe's psychopathology was real and being cut off from significant others had only exacerbated it. He did not meet criteria for narcissistic personality disorder. Those behaviors interpreted thus were merely his way of gaining contact and compassion.
Welner wrote his report with suggestions for how Sharpe's treatment providers needed to change their attitudes from that of confrontation, scorn, and antagonism to that of care-giving. Otherwise they would contribute to his risk factors, not help him to get better, and he would continue to be a difficult patient, and ultimately attempt suicide again. Welner noted the degeneration of the treatment relationship into a childish power struggle, whereas a supportive alliance would benefit everyone, and Sharpe could get to work on developing a constructive sense of self. The case warrants considerable interest, as it is situated in the very same facility in which John Salvi, a convicted abortion-clinic gunman, later killed himself, spawning charges of indifferent care.
Welner looked to those things that historically had provided Sharpe with a sense of self-esteem and stress reduction, namely, his work. He suggested that Sharpe's medical and computer expertise could be utilized in the prison setting, making him feel productive and busy while benefiting those who learn from him. In addition, the staff should show sensitivity to important anniversaries, such as the date of his wife's death, and they could effectively engage him, based upon his interest, in music therapy for reducing anxiety, as an alternative to medications they preferred not to give.
"There is no more pertinent redemption for the killing of another," Welner concluded, "than to save lives. Dr. Sharpe's knowledge and skill can save many, and he is motivated. It is a debt of servitude he would be glad to pay."
And that he did. For Sharpe was transferred to a unit, as a result of Dr. Welner's work, where he could teach and give to others. The dramatic incidents stopped and Sharpe became that much more manageable an inmate. He is serving his time without recent incident.
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Dr. Welner will continue to probe forensic frontiers that could benefit from closer study, through his own research and at the request of courts and attorneys who seek him out. One such project is an examination of the factors that influence false confessions in wrongful convictions. Dr. Welner is evaluating cases listed as false confessions for convictions having been overturned by DNA. He is looking at the vulnerabilities of suspects and conditions of questioning that may have contributed to the false confessions. "We've already learned a number of interesting things," he says, "and we want to see if those trends will hold up."
With the understandings gained, he hopes to teach law enforcement how to be more sensitive to how interrogations with specific types of suspects can lead to false confessions. That will not only help the defendants to avoid unnecessary prison time (and trauma) but can also assist many jurisdictions in avoiding the subsequent civil lawsuits. Furthermore, this will better clarify the false confession issue, which while he acknowledges is real, Dr. Welner believes has been both exaggerated and distorted.
Extending beyond his dedicated casework, forensic peer-review, and research on criminal depravity and everyday evil, Dr. Welner has plans to unveil a number of other groundbreaking projects as well. As he continues to challenge the limitations of the quality of answers forensic psychiatry can provide, it's possible that his innovations could even make legal history.