Guilty by Reason of Insanity: A Psychiatrist Probes the Minds of Killers

"We met no Jimmy Cagneys or Robert Mitchums among the inmates in the prisons we visited. We found ourselves, rather, in the company of a pathetic crew of intellectually limited, dysfunctional, half-mad, occasionally explosive losers. Long before these men wound up on death row, their similarly limited, primitive, impulsive parents had raised them in the only fashion they knew.... These brutish parents had set the stage on which our condemned subjects now found themselves playing out the final act. It was a drama generations in the making."

Psychiatrist Dorothy Otnow Lewis, working in a professional partnership with neurologist Jonathan Pincus, has been steadily accumulating and publishing (in medical journals) evidence that almost all vicious criminals have some combination of (1) a childhood of abuse and/or neglect, (2) brain injuries through accident or abuse, and (3) psychotic symptoms, especially paranoia. This fascinating and well-written book, aimed at a wide audience, takes the form of a memoir in which Lewis tells us about the events that led her to study violent patients and about some of her more interesting cases, especially those on death row. Far from being another shallow "oh wow" book about conversations with horrifying killers, this is a thoughtful, humane examination of the horrible experiences that most murderers have endured, and a penetrating analysis of how subtle signs of brain damage in these people have been missed by other researchers. Lewis has an engagingly humble and personal way of writing about her experiences, which makes her findings all the more credible. --Fiona Webster