Should we have second thoughts about Kaczinski?

By Drew Westen, PhD
Harvard Medical School

Society finds it harder to forgive a killer with a diseased brain than to forgive a person with heart disease whose collapse at the wheel kills a pedestrian.

Ted Kaczinski?s paranoia was infectious. As an academic, and a former colleague of one of the Unabomber?s targets, I can remember a few paranoid moments of my own when I received a strange package in the mail without a return address?only to find that my mother had run out of return address labels. So, like most people, I?m relieved that Kaczinski will not be sending any more missives.

But as a clinical psychologist, I wonder if this case shouldn?t lead us to rethink some of the ways we address mental illness in the courts. Kaczinski apparently chose to plead guilty because he couldn?t endure the thought of hearing evidence of his mental illness in court. It?s worth noting that ardent denial of having any illness is one of the symptoms of paranoid schizophrenia.

Pause to wonder

If Kaczinski truly suffers from schizophrenia, however, should his choices really have been life in prison or death? Two reasons might give us pause to wonder. The first is that paranoid schizophrenia, like bipolar disorder, can sometimes lead to criminal or violent behavior during a psychotic episode. But both disorders can sometimes be treated effectively with medication and psychotherapy. If successfully treated, Kaczinski might spend the rest of his life behind bars completely sane.

The second is that we now know much more about the causes of mental illness than centuries ago, when legal concepts of sanity and competence were forged in an era in which presumed experts debated the role of demons in mental illness.

Schizophrenia is a brain disease. Brain-imaging techniques have begun to pinpoint precisely where the damage is, and genetic studies have shown a substantial role of heredity in the disorder. Is Kaczinski any more morally responsible for his acts than a person who becomes impulsive or dangerous after a damaging blow to the head? A famous early report of such a case was a responsible, likable railroad construction foreman named Phineas Gage. In 1848 an explosion sent a metal bar of more than an inch in diameter through his skull. Miraculously, he lived, and he showed few of the characteristics people typically associate with brain damage.

Yet the personality that came to inhabit his body was no longer Gage. Gage?or his new incarnation?was now a socially inappropriate, impulsive, self-centered man who could not keep a job or sustain a relationship. And neurologists have seen many Gages in the intervening century and a half.

A blow to the chromosomes?

We impose criminal penalties on people who break the law to punish them, deter others, protect society and, if possible, to rehabilitate them. When a criminal is clearly psychotic, the major criterion in assigning a penalty should be his danger to society. We find it much harder to forgive a killer with a diseased brain than to forgive a person with heart disease whose collapse at the wheel kills a pedestrian.

Emotionally, it?s difficult to ignore the intent that intervenes between the disease and the act when the diseased organ is the brain rather than the heart. But if Kaczinski is in fact psychotic, his brain is no more intact than that of Phineas Gage?the only difference is that the damage to Gage?s soul came from a blow to the head, whereas for Kaczinski the culprit was likely a blow to the chromosomes.

If he?s psychotic, the major question should be whether he?s treatable and whether society could be assured of his lifelong compliance with treatment if he were ever released. In Kaczinski?s case, we?ll never know.

Drew Westen is chief psychologist at the Cambridge Hospital in Cambridge, Mass., and associate professor in the department of psychiatry at Harvard Medical School.

©Copyright National Public Radio, Inc. 1998. This report by NPR commentator Drew Weston was originally broadcast on National Public Radio?s ?All Things Considered?® on Jan. 23, 1998, and is used with permission of National Public Radio, Inc. Any unauthorized duplication is strictly prohibited.