The devil made them do it

THE STUDY OF RHETORIC and the relationship between situations and rhetoric have critical importance for understanding and criticizing some of the more invalid practices of psychiatry. None of these applications is more apt and more important than what perhaps is the most questionable extant psychiatric role in our society--support of the insanity plea.

Aristotle defined rhetoric--as interpreted by Lance Cooper, scholar of Greek and philosophy--as the study which discovers in a particular case what the available means of persuasion are. A more recent definition from another scholar in Philosophy and Rhetoric defines rhetoric as the struggle of persuaders to establish their own agenda and infuse it with their chosen spin for specific audiences, or the fight for determining for specific audiences what is salient and what the saliency means as well as its significance.

This view of rhetoric, focusing on the persuader as controlling, limiting, and depicting what the perceived situation is, rather than the situation having independent influence, accounts for the reality psychiatry has created: a world with many felonious miscreants who are not responsible for what they do. Again, if rhetoric is composed of persuaders' choices, constrained only by the extent to which an audience will accept them, then the rhetor's responsibility for what he or she chooses to make salient (his or her agenda) and the meaning he or she infuses in the chosen situation (the "spin") become that for which the persuader ethically is responsible. Therefore, citing law-breaking and claiming that it is perpetrated by unknowing, insane lawbreakers who may be prey to irresistible urges are rhetorical acts of creating perspectives, not discovering them.

There may be no better way to understand the persuasive use of rhetoric than to look at psychiatry's employment of the insanity plea. On its website, the American Psychiatric Association (APA) introduces the field of psychiatry as "science based." Richard Weaver's landmark Ethics of Rhetoric describes "science" as a god-term used persuasively to win adherents to a field that may or may not be using the conventions of scientific inquiry.

Much of psychiatry is, in actuality, an art, not a science that can be verified and conoborated. The APA's "Position Statement" on "The Insanity Defense" reveals the significant conflict within that body regarding its consensus as to the extent to which psychiatry accurately can infer people's--in this case, criminals'--state of mind when they commit a crime, or why criminals do what they do or feel what they feel. For example, the statement argues that "The American Psychiatric Association believes that the decision to release an insanity acquittee should not be made solely by psychiatrists or solely on the basis of psychiatric testimony about the patient's mental condition or predictions of future dangerousness. While this may not be the only model, such decisions should be made instead by a group similar in composition to a parole board."

The APA's website also posts questions and answers on the insanity defense. One argument made there, and repeated incessantly in formal and informal rhetoric by psychiatrists, is that it is not the case that "many criminals try to use the insanity defense to escape severe punishment." The proof adduced for this is the fact that, in only one percent or less of cases (one assumes in the criminal justice system), is the insanity plea attempted--and it is successful in just about 25% of these instances.

Such selected facts ignore several others--thus, the selectivity of all rhetoric--including the absolute number of successful insanity pleas that are used, as well as the involvement of psychiatrists in mitigating sentencing and participating in plea bargains and the rest of the criminal justice system. As further evidence that "insanity defense is rarely used successfully by malingerers," the APA points out that much of the use of the insanity plea results from agreement between the prosecution and defense, as if that proves the validity of the plea.

For those worried about defendants found mentally ill being freed to commit more crimes, the APA states: "Studies show that persons found not guilty by reason of insanity, on average, are held at least as long as--and often longer than--persons found guilty and sent to prison for similar crimes." Well, therefore, some are, and some are not.

Let's just look at two recent examples of psychiatric participation in the criminal justice system. These are not presented as representative, only as not atypical.

In June 2006, Paul Schrum, a medical supplies salesman who loved science fiction, was attending the movie, "X-Men 3: The Last Stand" at a theater near Baltimore, Md. Mujtaba R. Jabbar, a young medical student, shot and killed the 62-year-old Schrum even though he did not know him personally nor, apparently, did he know anyone else in the theater. One local newspaper quoted detectives as saying that there was no motive for the shooting. Jabbar was convicted, but was found "not criminally responsible" because psychiatrists who examined him for the state argued that he had schizophrenia and, therefore, was unable to control his behavior. The alleged inability of a defendant to control his behavior would imply that the individual did not choose to commit a killing.