NCR: Clouding Thoughts and Circumstance
June 25, 2015
Hey there! Glad you’re back for the second part of my NCR discussion. Just to refresh your memory, here are the 21 easy steps that I subjectively created, from Section 16. (1) of the Canadian Criminal Code. What follows will be a discussion on points 8 and 9.
1- If you have a mental disorder or illness
2- Like Schizophrenia
3- An illness well known to cause many symptoms
4- Distorting the environment with hallucinations
5- Disorganizing reality with cognitive symptoms
6- And/or with strong delusions sometimes ruling over thoughts
7- Any of the above 3 types of symptoms capable
8- In the correct circumstances
9- Of clouding what one thinks is right or wrong
10- To the extent that if you killed someone
11- Even in a horrific manner that no person ever deserved
12- Especially Tim
13- While in a severe psychotic state of mind at the time
14- And could prove it with reasonable evidence
15- And it made probable sense
16- Then you cannot be found guilty of a crime
17- You can still be isolated, to protect society
18- And detained in a hospital
19- To ensure you received treatment
20- Until you were able to rejoin society
21- In specific, monitored steps
The correct circumstances often relate to person, place and time. There is some discussion out there in social-media-land that Li ‘stalked his victim’, or targeted McLean in some way prior to the bus. While there is no way to verify the gossip, it may be worth discussing.
The reasons you stalk someone are often to accomplish the following:
To learn the target’s patterns throughout their day
To determine a vulnerable moment to engage a victim
While ensuring there are no witnesses
The last point is particularly important if you are hoping to get away with whatever you are doing. If you are trying to ‘get away with it’, logically it follows that you recognize ‘it’ is wrong. In other words, you know it is wrong, so if you still choose to do it, you want to make sure that you don’t get caught. Witnesses make the ‘not getting caught’ part much harder.
It is possible that Li was stalking McLean, and some believe this is an indication that he was either not psychotic or knew it was wrong. It seems unlikely, however, that he chose to follow him from one city to another without a clear plan as to where he would stay, or sleep, and those kinds of things. Although if he was stalking in this way, it indicates Li was at the very least acting impulsively, and not logically.
Many stalkers in general, psychotic or not, believe they are justified in stalking their victims. Over time, they often see the people they are fixated on as their personal possession, making it easier to violate the victim’s sense of privacy or safety.
Whether Li stalked or not, it is clear that at some point, he decided that McLean was his target. If he was psychotic, Li possibly fixated on McLean, due to hallucinations or paranoia.
There is a type of hallucination called a ‘COMMAND’ hallucination. The most common are auditory hallucinations of a threatening voice, telling a person with Schizophrenia to engage in a specific action. This oppressive flow of thoughts over days or weeks can be relentless; like water torture eroding your will, until you give in. These are particularly troubling symptoms, especially when it supports an already existing Delusion.
This clinical scenario can occur in Paranoid Schizophrenia. When this combination leads to violence, the person often winds up detained by law enforcement, or an ambulance, at some point.
Paranoia, besides it’s propensity towards fear and violence, is an interesting phenomenon. Delusions can be created when neurons in the dopamine system either activate, or fail to activate.
Dopamine is important because the brain naturally gets a boost of it, every time we learn something new, or experience something important. This boost influences other parts of the brain, and may create a feeling of enjoyment. We are conditioned to pay more attention to the people and events we associate with this feeling.
In Schizophrenia, the dopamine turrets of the brain are hijacked, and fire at random times, sometimes due to stress. When dopamine neurons do not activate, or fail to ‘fire’, we miss important events because there is no pleasing chemical incentive. Such a person cannot be enticed, by a pair of dice or paradise. Without pleasure there is no interest, the person fails to notice, or even care. This pattern often leads to negative symptoms.
Other times the brain is overactive, and liquid mortars fly into the MESOLIMBIC sky. During these mismatched moments, the brain tells the mind to pay close attention to something randomly flagged, in the surrounding environment. This has the effect of placing targets on neutral objects, subjecting people to possible psychotic ‘friendly fire’. And by ‘friendly’, I mean in the sense that both people are on this side, of ‘team Homo sapiens’.
This mental illustration helps us picture this exact moment; Li waiting in a Bus Depot, to purchase a ticket. As he surveyed the room, his eyes gazed through paranoia tinted lenses. Behind these stolen Ray Bans, were even shoddier neuronal frames, with dendritic faults ready to fracture.
The bus depot was the scene of the first eruptions, misguided dopamine launched, sending new mail of THREAT and FEAR, to other parts of his brain; causing a mind under imminent fire, to scan for enemies.
That millisecond of excited malfunctioning brain cells, intersected with lenses glossing over a crowded landscape of lives. He did the math, put internal feeling and external situation together, but was dead wrong. In the miscalculated error of his mind’s eye, a psychotic sniper’s rifle fixated on a random, innocent target.
In the paranoid war, the victor is the one who strikes first, and without warning.
From that moment on, it is possible that Li’s brain melded his mind’s eye to McLean, perceiving him as an enemy that may do him harm. And it is possible that he watched McLean closely, waiting for a vulnerable moment. Then in a psychotic perversity that likely only a psychotic Li could explain, he surprised his enemy, an innocent young man, enlisted into an unwinnable fight.
They both lost a battle at that moment, but only McLean lost his chance at a future on this earth.
And a tragic irony is that Li, in many ways, has been saved from the private war in his mind, by his detention and treatment. Those walls both keep Li in, and those with torches out.
The indication that Li did not appreciate right from wrong is partially woven into the circumstances of place and time. Committing such a horrific act, with so many witnesses, certainly implies that Li either didn’t realize he would be caught, or didn’t care. When people don’t care if they are caught, it again implies that either they didn’t believe what they did was wrong, or they are hoping to be taken into custody for some reason.
There are certainly more peaceful paths to prison, and it doesn’t appear that this was ever Li’s motive.
The most important ‘circumstance’ in this event, was Li’s untreated psychosis. The others are a vulnerable (defenseless while sleeping) target, and access to a weapon.
There are many things that can cloud the brain, causing it to think differently.
Some of these things are due to strong emotions present at very important moments in life. I remember having to call an ambulance for a very sick loved one, and when the operator asked for my phone number, I had no idea. At that moment, the stress of the situation short circuited my brain, and reality was a blur.
Other times, our judgment can become skewed due to things that are much more trivial; like being too busy, too distracted, or too important. Our thoughts shift around over time, influenced by new personal and social pressures, and moved by people or institutions. Recall how your own preferences and values have matured over time, as you grew out of your parent’s home, and created your own.
The interactions between our genes and environment influences the egocentricity of our waking reality, causing us to subjectively decide what is right and wrong; in ways that work in our favor.
It is similar to how many religious individuals swear by certain passages, of their ‘chosen by birth’ Holy Book, but ignore others.
Or, in the way we rearrange life in our mind, to become racist, sexist, or oppressive in some other way.
Or the way we abhor killing, but seek the death penalty for those that kill.
Or the way heroes ignore every survival alarm ringing, when rushing towards danger.
My point is that most of us start out with primitive concepts of right and wrong, but then we tweak them over time, so we can benefit within the unique context of the lives we are living.
If you are skeptical or feeling offended, let me remind you of the time when you drank a bit too much, and still drove home. Then there was the moment, when fear loomed so large that you were paralyzed, even though you needed to help. Or how about those several close calls you had while checking Facebook behind the wheel. Or when you vocally judged someone for something you were doing yourself. Or when anger or jealousy took over, and everyone got hurt.
All humans, at some point, do bad things. It would be interesting to think about what we tell ourselves in those moments, or in reflection afterwards. Most of us really only have ourselves to blame, as we are essentially in charge of our actions.
How many of us have psychosis as a defence, for the bad things we do? If we don’t have such a ‘convenient’ reason, just what is our alibi anyways, to explain the part in all of us that Dr. Jekyll tries to Hyde? Could it be, that we could all be ‘better’ people, in almost every waking moment?
There are many other things that can physiologically affect our ability to think clearly, and at these times, it is just not our fault. These are the circumstances, where we truly are beyond responsibility for our actions. That is not to say there are not always moments, prior to our being biologically offline, when we could have changed the course.
But if we ever lose ourselves, or others become lost, in these organic Netherworlds, our society has decided that our actions cannot be criminal.
Some examples of times when the brain or body takes over, and we are arguably no longer in charge of our mind, even when our actions result in death, may include:
Temporal Lobe Epilepsy cases of homicidal violence
Diabetic shock or coma while driving
Accidental medication overdose, toxin exposure, or alcohol/drug intoxication, producing DELIRIUM; where the person is not oriented to person, place, time, or planet
Accidental shooting by a (legally irresponsible due to immature judgment) minor while ‘playing’ with a loaded weapon
Brain tumors, Traumatic Brain Injuries, Strokes, or Dementia causing aggressive changes in personality
Lung conditions causing low oxygen levels to reach the brain, leading to irritability, delirium, and aggression
Kidney or Liver failure, causing a build up of cellular waste products in the blood, some of which can enter and disturb the brain, causing delirium (again)
Hemochromatosis, Porphyria, Vasculitis, Lupus, Huntington’s, Parkinson’s, and a host of other brain disorders, equally capable of both causing brain abnormalities, and causing my early demise in a National Spelling Bee.
Well, you can see that the list could go on and on, as there are at least another dozen or so neurological disorders that can significantly affect thinking, just like there are plenty of different disorders that can affect the heart’s ability to pump blood.
Some of you may recall an elderly gentleman with dementia, killing another elderly peer in a Nursing Home within the past few years. It is hard to argue that the demented man is guilty of ‘murder’, or that putting him in jail for a few years will either rehabilitate him, or help society properly treat dementia.
How many of the individuals, in the above list of brain diseases (well, immaturity is not a disease) would be guilty of a crime, even though technically it was solely ‘their’ body that caused a tragic event to occur?
How many people are guilty of a heart attack, when the heart fails to pump blood properly?
What if during a heart attack, the heart shot out of the chest, like a cannon ball?
Would we blame those having ACUTE MYOCARDIAL INFARCTIONS, if, during a heart attack, they killed someone else?
There are several other mental illnesses that display biological markers, using MRI, CT, and fMRI (Functional Magnetic Resonance Imaging). While the science is still being discovered, we now know that there is a ‘malfunctioning’ brain process for almost all mental disorders.
The NCR controversy, seems to balance on how responsible we should be for our actions, when are minds are not in charge.
Or, put another way, whether people believe there are mental states that prevent one from determining right from wrong.
You may feel that the NCR designation was appropriate, indicating without mind, it does not matter what the body does. Or you may argue that ‘you are you’, and whether ‘your’ mind, or ‘your’ body is behind the act, all of ‘you’ should suffer the consequences.
I believe severe, untreated psychosis, can biologically alter thoughts, sometimes distorting a person’s ability to tell what is right and what is wrong. Psychosis, in severe forms, can paradoxically lead one to believe that violent actions are actually helpful, in some tangential way.
If the tragedy of untreated psychosis leads to an arguably worse one, in the death of a loved person, the person with the mental illness still deserves treatment, and society deserves protection until recovery occurs.
Join me next time for Part 9.
Simon Trepel, MD
Simon Trepel, MD FRCPC, is a practicing Child and Adolescent Psychiatrist, in Winnipeg, Canada. He is an Assistant Professor, at the University Of Manitoba, in the Faculty of Medicine, and the Co-founder of the GDAAY Clinic. He is, more importantly, the proud Father of 2 beautiful Daughters. He writes in his spare time about things he knows something about, and occasionally about things he doesn’t; like Yoga, and Italian flavored coffees. He was not referring to coffee that tastes like an Italian person.
Check out his Blog, called Simon Says Psych Stuff, at