Arthur Shawcross, the Genessee River Strangler

To be considered insane in New York State, Shawcross's team had to show quite specifically that at the time of the various offenses---every single one---he suffered from a mental defect such that either he did not know what he was doing or could not appreciate that it was wrong.  He had to suffer from some type of organic brain disease, extreme emotional disorder, or ongoing dysfunctional psychosis.

The defense attorney hired Dr. Richard Kraus, a psychiatrist, in Wayne County for the Elizabeth Gibson murder, and Murante from Monroe County brought in psychiatrist Dorothy Lewis from New York's Belleville Hospital.  Olsen contains chunks of the psychiatric interviews with Shawcross in The Misbegotten Son but does not attribute them to any specific person.  They seem most likely to have come from Kraus's report.  The questions are often leading in the context of attempting to get information that would support an insanity conviction.  Shawcross shows annoyance to many of them, especially those that imply he might be making things up, and he often refuses to answer.  

In the end, after spending $19,000 on  professional  evaluation, Krause admitted that the man was deceptive, muddled, sociopathic, sane, not suffering from  PTSD, prone to making up stories that change dramatically in detail, unlikely to have been a victim of child abuse, and not significantly brain damaged.  He found it interesting that much of his life was characterized in the context of women he hated, including in Vietnam.  Most of the enemy he described killing were women.  Kraus probably spent the most time with Shawcross of any of the experts (and was paid the least), and his assessment might well be the most accurate.  Olsen shows the painstaking detail Kraus took in tracking down every possible cause for Shawcross's violence--even those theories that had been discredited.  His efforts make for an intriguing map for understanding this killer and a credible interpretation.

Kraus was not willing to pronounce insanity where there clearly was none, and he was curious enough about the killer to keep going back.  He describes how the stories change after other people interview him (Shawcross would add gruesome details never cited before, as well as psychological interpretations he'd never thought of before), which makes him suspicious about their validity.  The stories of cannibalism, for example, formed only after others had interviewed him.  He did find that Shawcross had a substance in his urine that was related to mood swings, aggression, an inability to tolerate stress, and short-term memory problems.  He did not have brain damage or seizure disorders, but did have poor impulse control and hypersensitivity.  He had a neurological impairment in his ability to exercise sound judgment.  Yet Kraus never got to testify.   Nevertheless, he handed in a 20,000-word report.

Guilty by Reason of Insanity, by Lewis

In Monroe County, Dr. Lewis had the spotlight for the defense.  She writes about her experience in Guilty by Reason of Insanity, pointing out that she never had the chance to prove what she believed to be true about the killer.  She viewed him as ill-proportioned and paunchy, aged beyond his actual years.  She knew that his lawyers had determined (through a test requested by Kraus) that Shawcross had an extra Y chromosome and accepted the tenuous theory that such men were more violent than others.  She also claimed that an MRI examination had indicated that at the tip of his right temporal lobe was a small fluid-filled cyst.  She found that significant. 

"The brain is a sensitive organ," she writes.  "The tiniest scar or tumor or cyst can, under certain circumstances, trigger abnormal electrical activity and hence seizures." 

She adds that abnormal electrical foci at the backside of the temporal lobe have been implicated in animalistic behaviors.  She believed Shawcross's admission that he had cut out the vagina of one victim and eaten it, though there was no evidence of this.  He'd removed the genital lips of two victims but had not cut out a vagina.  (Possibly he wanted to, but the corpse had been frozen.)  He had never mentioned having eaten it to any of the investigators.  Now that his sanity hung in the balance, he appeared to have a story that would shock people.  At the least, Lewis should have checked with the pathologist, as Kraus did.

She thought he had all the symptoms of temporal lobe seizures, such as impaired memory, bright lights before a violent episode, and deep sleep afterward.  She found in her sessions with him that he often confused one murder with another.  He'd not had that kind of trouble with the police.  With Blythe and Borriello, he knew the names of each of his victims and exactly how and why he had killed them.  Lewis had read these statements, yet she accepted that he could not recall the details.  He seemed to know what to say to convince her of his psychiatric impairment, though he had not told any of these things to the police.  He was like a chameleon, delivering to each person who questioned him what he sensed they wanted him to say.  (Lewis has recorded some of her sessions with clients and her style is to lead, encourage and reward.)  Lewis did not offer an explanation as to just how he could return to a body he barely recalled and mutilate it.

She asked the attorneys to call her partner, neurologist Jonathan Pinkus, and hire him to conduct an extensive neurological examination.  Instead, they said they had an MRI and had hired a neurosurgeon from Harvard with a good reputation to conduct tests, including an EEG.  Although she never saw the results of any such exam, she succumbed to pressure to write her report so she could testify.  She decided that while Shawcross probably suffered from a seizure disorder, he also experienced dissociative states brought on by trauma and abuse.  In other words, multiple personalities.

In her sessions, Lewis placed him under hypnosis as a means to uncover earlier traumas that might have caused such violent anger against women.  He described severe abuse, such as his mother sticking a broom handle into his anus (in other accounts it was a toilet brush, but he apparently changed that when it was pointed out that at the time his family used an outhouse), and Lewis accepted every detail. Under hypnosis, he "became" his berating mother and "Ariemes," a 13th-century cannibal with a bloodlust. 

Getting medical records, she found that he'd been hospitalized for partial paralysis at the age of nine and ten, from which he had quickly recovered.  There was no mention of physical trauma, but Lewis decided that it must be hysterical paralysis brought on by trauma.  Her subsequent analysis was filtered through this interpretation.  Because school records described his mother as "punishing and rejecting," Lewis took that to mean she was abusive.

Still, she wanted that neurological analysis, because she knew how the courts treated a defense based on dissociative disorders.  Such material was not forthcoming, so she went ahead and wrote a report based only on her observations and beliefs about the case.  In her book, she calls this her "first big mistake."

Among Shawcross's prison records, she found descriptions of what she believed were "seizurelike" episodes.  He'd fallen to the floor, he'd fainted, and he'd blacked out.  Relatives confirmed that he'd been like this as a child.  Lewis felt confident of her diagnosis.  Yet she was not as ready for trial as she believed.