The public furor over the Lindsay Clancy case concerning the Massachusetts mother who admitted she strangled her three young children shows that Americans have very little idea what “insanity,” “psychosis,” and other terms mean in the courtroom.
There are no reliable polls of the general public that can accurately establish what percentage of the public is sympathetic to Lindsay Clancy. But social media discourse appears to show substantial and widespread sympathy. However, it’s likely that many people who feel that way misunderstand the specific psychiatric and legal claims being made by the defense and the prosecution. They might change their view with a more specific understanding of terminology.
Clancy’s defense rests on the proposition that she had a mental defect or disease that made her incapable of being criminally responsible for the killings. In lay terms, this is what’s called “not guilty by reason of insanity.”
Bipolar or Borderline?
The same handful of terms and concepts come up in online and media debates over the Clancy case and similar crimes.
Some people claim Clancy was “bipolar” (the newer term for what we called “manic depression”). Bipolar is a mood disorder. Sufferers generally cycle between “manic” states of excitable behavior and longer states of profound depression.
Experts in the Clancy case disagreed on whether she displayed any signs of bipolar disorder. An argument can be made that Clancy’s behavior aligns more closely with a different condition: Borderline Personality Disorder. Borderline is a personality disorder, which is different than a mood disorder like bipolar/manic depression. Borderline Personality Disorder describes individuals with rapidly shifting extreme moods and difficulty controlling their emotions and behavior.
Even professionals confuse these conditions. A 2010 study in the Journal of Psychiatric Research found that of 610 psychiatric patients surveyed, 52 patients met the criteria for Borderline Personality Disorder. Of those 52 patients, 40 percent reported having previously been misdiagnosed with bipolar/manic depression.
Neither mood disorders like bipolar nor personality disorders like Borderline qualify as “insanity” under the legal system’s definition.
Psychotic or Psychopathic?
“Psychotic” and “psychopathic” are frequently confused with each other when people describe extreme mental states.
This confusion has been obvious in online commentary about the Clancy case. Even people who believe that Clancy knew what she was doing and should be held criminally responsible for killing her children seem to be mistakenly calling her “psychotic” when they probably mean “psychopathic.”
This post could stand in for hundreds or thousands:
A psychopath has a personality disorder characterized by having no conscience or remorse (“psychopath” is a term used colloquially and professionally for what is formally called “anti-social personality disorder”). Serial rapist and murderer Ted Bundy is widely accepted to have been a psychopath. He had no regard for his victims, and no remorse about visiting horror and violence on them.
But “psychosis” means that a person is not in touch with the real world around them. Psychosis can be brought on by schizophrenia, sleep deprivation, a severe head injury, or drug overdose. Otherwise mentally healthy people can and do sometimes enter psychotic states, though rarely.
What Legal Insanity Is and Is Not
There’s a disjuncture between what the lay public and the U.S. legal system mean by “insane.” The everyday definition people use includes many things we find weird or inexplicable. People will call violent criminals “insane” when those criminals know perfectly well what they’re doing.
The Clancy trial discourse demonstrates this. Many people who appear unwilling to accept that women and mothers are capable of evil acts as much as men and fathers have decided that a murdering mother must be “insane.” This is circular reasoning and has the effect of morally excusing violent and evil actions.
U.S. jurisprudence has a very specific definition of “insanity,” and only a minority of defendants in criminal cases meet the test. In the U.S. system, a person is considered “insane” only when shown to be unable to tell the difference between right and wrong. In some states, there’s an additional prong to the insanity test — was the person unable to conform his behavior to the law. USLegal.com describes it this way:
[T]he American Law Institute (ALI) designed a new test for its Model Penal Code in 1962. Under this test, ‘a person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law’.
This is a difficult standard to meet, which is why the insanity defense is only successful in a minority of cases where it’s pleaded. A benchmark 1991 study found that 26 percent of insanity pleas are successful. It’s unclear if that rate has changed substantially over the years.
This is why it’s crucial to understand exactly what is meant by terms like “psychotic” and “psychopathic.” For a defendant to prove that she was in a psychotic state that rendered her not criminally responsible, she must prove to the law’s satisfaction that she was unaware of right and wrong and/or she was unable to stop herself from committing the crime.
A psychotic often doesn’t know right from wrong. A psychopath (without psychosis) knows the difference, but doesn’t care.
Cluster B personality disorders by themselves without additional or aggravating factors do not count as mitigating factors in the insanity test in U.S. courts, because these personality defects don’t mean the defendant did not know right from wrong.
An article in the Mitchell Hamline Law Review summarizes the general position of U.S. courts:
For purposes of the insanity defense, personality disorders do not, and should not, qualify as severe mental illness . . . . Those with personality disorders are excluded because they, by their disorder’s very definition, do not qualify under the insanity test.
Burden of Proof Reversed
Another legal peculiarity in the Clancy case has stymied public perception. Massachusetts is one of only seven states that reverse the burden of proof when the insanity defense is raised.
In most states, if a defendant claims to have been insane, he has to prove it. But in seven states — Colorado, Massachusetts, Mississippi, New Mexico, North Dakota, Oklahoma, and West Virginia — it’s the other way around. If the defendant claims she was insane, the prosecutor has to prove that she was not. This asks the state to prove a negative: “No, you were not insane, and here’s how we can prove that beyond a reasonable doubt.”
That portion of Massachusetts law may be the reason the Clancy case dragged on for so long before the judge declared a mistrial on Sept. 4. The jury was likely arguing over whether the prosecution had proven that Clancy was sane and therefore criminally responsible, which prevented them from straightforwardly finding her guilty of the killing of her children, even though she admitted doing it.
