May 27, 2010

NY v Junco: Sex, Civil, Hygiene, and Mental, All In One Post

gavel and stethescope.jpg
when you lay down with dogs, you come up with fleas


Forensic psychiatrist James Knoll writes The Political Diagnosis: Psychiatry in the service of the law.  You should read it (short) now, I'll wait.

If you have the great misfortune to live in NY, as I once did, for three years in a miserable art deco apartment building near 180 and Broadway, sandwiched between Hellfire and Damnation, fighting thugs to get into an apartment you had to fight roaches to get out of-- but I digress.

In any event, the state of New York is pleased to offer civil commitment of sex offenders.  How do you determine who is "a sex offender requiring civil management?" 

According to the Mental Hygiene Law (yes, it's called that)

" '[s]exual offender requiring civil management' means a detained sex offender who suffers from a mental abnormality. A sex offender requiring civil management can, as determined by procedures set forth in this article, be either (1) a dangerous sex offender requiring confinement or (2) a sex offender requiring strict and intensive supervision."

The second sentence is indecipherable.  I think it says, "a person requiring commitment is a) a dangerous person requiring commitment or b) a person requiring commitment."

Leaving us with the first sentence:  "... is a sex offender who suffers from a mental abnormality."

Mental abnormality is: a condition that "predisposes him to the commission of conduct constituting a sex offense and that results in his having a serious difficulty in controlling such conduct."

Which makes sentence 1: "a sex offender requiring commitment is a sex offender who suffers from a condition that makes him a sex offender."  Which, of course, means anything you want it to.

II.

Douglas Junco was sentenced to 15 years for attempting to rape a woman because she gave him a ride home from a bar.  After serving out his sentence, the state tried to civilly commit him further, but the jury refused to play along, so Junco went to Georgia and raped a 48 year old relative.

You'll probably want to say that he should have been civilly committed after all. 

So what psychiatric testimony was presented to get him committed?  The psychiatrist diagnosed him with:

Axis I: Impulse Control Disorder NOS. 
Axis II: Antisocial Personality Disorder.

I will post a naked picture of myself punching a dolphin if anyone can tell me what the difference between those two diagnoses is in this case.   Which one of these constitutes the mental abnormality?  Explain your answer using evidence.  It's a trial, right?

The judge:

...the court expresses its concern that although the respondent had been subjected to numerous psychiatric evaluations while in custody over a prolonged period of time (since 1992), he never was diagnosed with impulse control disorder NOS until the evaluation by Dr. Gonzalez on March 15, 2007. The court is further concerned that Dr. Gonzalez was generally not aware of the circumstances surrounding the numerous "tickets" issued to the respondent while in custody; that the doctor apparently gave some consideration to a criminal charge against the respondent in 1991 which was in effect immediately dismissed; that a determination had been made in a separate proceeding that as to the instant offense there was a lack of sexual contact; and, finally, that the doctor apparently was not provided with, nor did he therefore consider, any favorable reports submitted as to the respondent while he was in custody.
If you are thinking the psychiatrist didn't do a good enough job of presenting evidence to commit, you're missing the point.  The psychiatrist did everything exactly the way every other psychiatrist does things, i.e. half-assed and disinterestedly. But that same evidence could easily have gotten a man committed forever.  The reason he wasn't diagnosed with Impulse Control Disorder while in prison is because there was no external reason for the diagnosis.  There were no services to provide or deny him on the basis of a diagnosis.  And the reason Gonzalez did diagnose him with that is because that's what he needed for a commitment, in the absence of good stuff like psychosis.  Expediency.  It's that simple.

In addition to reviewing numerous documents and reports concerning the respondent, Dr. Gonzalez conducted a telepsychiatry interview of Mr. Junco which lasted approximately one hour. Incredibly, the doctor did not take any notes during the interview. 
Incredibly?  Your Honor, what was incredible is that it lasted an hour, and by incredible I mean completely and utterly impossible.

Again, to clarify: we're upset he didn't do a good enough job to commit, but a judge could easily have just taken the psychiatric testimony at face value and locked him and his mom and his fish and his car for a century.   The hoax is that there is any evidence to present at all.  What evidence?  What does a shrink know about future behavior, of human nature?  I'm not saying intelligent things aren't known; I'm saying they are not more known by shrinks.  Hell, why wouldn't you just ask other sex offenders for their testimony? 

The reason this guy was able to get out and rape again is the same reason why other people who won't ever hurt anyone will be held indefinitely with no recourse:  political expediency masquerading as science.

III.

Just a piece of advice.  If you are ever arrested, make sure to ask for a jury.  As for two juries.  If your lawyer says the words "bench" and "trial" at any point in the same paragraph, flee to Argentina.  Those 12 idiots, imperfect as they are, are one of the only things protecting you from a top down, hierarchical, classist, flow chart wielding government clusterfuck that has no time, interest, or money to deal with people as individuals, so it deals with them as groups, types, diagnoses and organ banks.

 





Comments

Oh, shit. We're fucked up!<... (Below threshold)

May 27, 2010 5:28 PM | Posted by Alex-5: | Reply

Oh, shit. We're fucked up!

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Millions of dollars paid fo... (Below threshold)

May 27, 2010 6:57 PM | Posted by bbj: | Reply

Millions of dollars paid for unscientific evaluations by so-called professionals in the field of psychiatry and psychology. Dr Knoll reports that one psychologist made 1,5 million dollars doing SVPs, that is sexually-violent-predator-evaluations.

Greed, expediency, prejudice, no integrity, noe ethics, no spine seems to be what it takes to be a successful breadwinner in the inglorious, unscientific field of psychiatry.

Vote up Vote down Report this comment Score: 7 (7 votes cast)
If your lawyer says the ... (Below threshold)

May 27, 2010 6:59 PM | Posted by Anonymous: | Reply

If your lawyer says the words "bench" and "trial" at any point in the same paragraph, flee to Argentina.

Depends on your lawyer. I also guess it depends on the seriousness of the crime. If you have a lawyer who is
the best a bench trial can have advantages over a jury. But usually such lawyers are rare (maybe a handful per county), require a referral and they cost lots of $$$$$.

In general, it is true that most lawyers (and people working in the criminal justice system) are interested in expediency. You would be too if you had to get home in time for Grey's.

Then again the "expediency" issue pertains to any career. Unfortunately it is indicative of our time, not just any one branch of society.

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From my limited experience,... (Below threshold)

May 27, 2010 11:55 PM | Posted by Anonymous: | Reply

From my limited experience, seems that the problem is that none of us want to admit what a fine line there is between "normal" people and sexual deviants/predators/etc. I don't think anyone honestly wants to know what is going on there, or why it's happening, except if it would serve some larger purpose, political or otherwise.

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Could you please post the p... (Below threshold)

May 28, 2010 12:21 AM | Posted by Anonymous: | Reply

Could you please post the picture of yourself naked punching a dolphin anyway? There's a crisp $5 bill in it for you if you do.

$10 if the dolphin is wearing your clothes.

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Heck, flee here, to Colombi... (Below threshold)

May 28, 2010 1:30 AM | Posted by corronchilejano: | Reply

Heck, flee here, to Colombia instead. If a Colombian isn't pressing charges against you, you're free to do whatever you want, EVEN IF IT IS ABSOLUTELY OBVIOUS YOU DID SOMETHING. I'm serious.

Also, I second the dolphin with your clothes thing. I put in another 10 bucks.

In Topic: Politics in science is the reason research on stem cells won't make people walk, see, get cured from cancer, etc.

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BTW, can I run a PCL-R test... (Below threshold)

May 28, 2010 3:14 AM | Posted by Alex-5: | Reply

BTW, can I run a PCL-R test somewhere online? Wanna know if I can score below 30 or I should never travel to America...

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Denny Crane.... (Below threshold)

May 28, 2010 4:31 AM | Posted by MH: | Reply

Denny Crane.

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You pretty much said it.</p... (Below threshold)

May 28, 2010 8:12 AM | Posted by Anonymous: | Reply

You pretty much said it.

How much of what a by-the-book (there therefore not "negligent") psychiatrist does could be boiled down into a manual less than 150 pages ? 90% ? 95% ?

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The article by James Knoll ... (Below threshold)

May 28, 2010 9:49 AM | Posted by Jack Coupal: | Reply

The article by James Knoll and comment by editor Ron Pies (love that name!) is on target. Did readers make comments on the article?

The tendency to see people in bunches - rather than as individuals - is the enabling step toward more politicians gaining a stranglehold over the practice of medicine (or practice of anything else) to ease their creation of more nonsense "laws".

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Which is exactly why people... (Below threshold)

May 28, 2010 1:07 PM | Posted by Eneasz: | Reply

Which is exactly why people who try to get out of jury duty (and brag about it, no less!) should all be hung. Without a jury.

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Do I get CMEs? Where are th... (Below threshold)

May 28, 2010 3:25 PM | Posted by Anonymous: | Reply

Do I get CMEs? Where are the four bone-head simple questions at the end of the article? What med am I supposed to prescribe upon gaining this knowledge? Oh, wait, the article was not handed to me by a drug rep.

The tautology jumped out of me like dolphin leaping out of one of those stereogram pictures. Actually, more like Alice in Wonderland logic. The limit to the logic of such a diagnosis as "crime-committing personality" is that there is no longer a way to commit a crime other than through some pathology of the psychiatric type.

When I was a kid, I used to steal candy from the store. Why did I steal candy? I knew it was wrong. I believe I did it because I had the opportunity and the sweet tooth, and I could get away with it. Now, I know it is because I lack insight regarding my "criminal-committing personality."

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Alex-5: I could assess you ... (Below threshold)

May 28, 2010 4:21 PM | Posted by medsvstherapy: | Reply

Alex-5: I could assess you on the PCL-R, but then I would be obliged to pre-emptively incarcerate you. It is Friday afternoon, and getting someone involuntarily committed is really difficult on Friday afternoons.

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I think the idea of using m... (Below threshold)

May 28, 2010 4:28 PM | Posted by Anonymous: | Reply

I think the idea of using mental health in any aspect of criminal justice is pretty much wrong. This is essentially "future crime" convictions, and the man himself has no opportunity to question the results of the pycho-judge's findings. If Dr. Psychaitrist says you'll commit a crime, that's it.

What a perfect way to deal with whomesver the state decides is undesireable. Eventually, disagreeing with the offical policy of the president is going to be mental illness. Or being a "socialist" or whatever other label catches people's fancy.

Long story short, I think this is about circumventing the justice system (what little remains of it anyway) rather than anything to do with paedophilia.

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"How much of what a by-the-... (Below threshold)

May 28, 2010 4:39 PM | Posted by medsvstherapy: | Reply

"How much of what a by-the-book (there therefore not "negligent") psychiatrist does could be boiled down into a manual less than 150 pages ? 90% ? 95% ?"

It is not the 95% of the time that things are straightforward that you are paying for. It is getting that work done by someone who should know when he or she is looking at the 5% that are out-of-the-ordinary.

I have a ratio of time spent in training regarding suicidal management/ time spent in suicide intervention; and a ratio of time spent in general psychotherapy training to time spent doing psychotherapy.

For the average psychologist, you don't want these two ratios to be the same.

Efficiency is usually a desirable characteristic in the workplace. But think about this: you don't want a fire station to be efficient.

"A man was suffering a persistent problem with his house. The floor squeaked. No matter what he tried, nothing worked. Finally, he called a carpenter who friends said was a true craftsmen. The craftsmen walked into the room, and heard the squeak. He set down his toolbox, pulled out a hammer and nail, and pounded the nail into the floor with three blows.

The squeak was gone forever. The carpenter pulled out an invoice, on which he wrote the total of $45. Above the total were two line items:

Hammering , $2
Knowing where to hammer, $43"

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I will post a naked pict... (Below threshold)

May 28, 2010 5:09 PM | Posted by Matt: | Reply

I will post a naked picture of myself punching a dolphin if anyone can tell me what the difference between those two diagnoses is in this case.

You used to stab harp seals, now this. Man, what have you got against aquatic mammals? It's okay, you can tell us.

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^^^ Excellent piece of trol... (Below threshold)

May 28, 2010 8:46 PM | Posted by Anonymous: | Reply

^^^ Excellent piece of trolling.

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From what I understand, pol... (Below threshold)

May 28, 2010 11:15 PM | Posted, in reply to corronchilejano's comment, by greenpad: | Reply

From what I understand, politics is the only reason anybody *does* embryonic stem cell research. They've had much more success with other stem cells, but by claiming they can make people walk, see, get cured from cancer, etc., they keep the money flowing from the pro-abortion side, who would just love to have a scientific basis for their political leanings.

Vote up Vote down Report this comment Score: -1 (3 votes cast)
Woman with hospital phobia ... (Below threshold)

May 29, 2010 7:57 AM | Posted by Anonymous: | Reply

Woman with hospital phobia must be forcibly treated for cancer, judge rules.By Martin Beckford, Stephen Adams and Laura Roberts 26 May 2010
Experts questioned whether lawyers and doctors should be allowed to over-ride the wishes of patients and whether the use of force was ever justified in providing medical care.

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The biggest problem with mo... (Below threshold)

May 29, 2010 8:12 AM | Posted by Dr. Mo: | Reply

The biggest problem with most of the psychiatrists I've known is that they lack depth on of insight--they're incapable of seeing character in dynamic terms. They see behavior and "symptoms," but they have no idea about the dynamic "why" of thought, affect and behavior. Typically, they dismiss the concept of the "why," except as some sort of physiological process. Or they become one trick ponies, obsessed with one personality or one diagnosis, seeing it as the organizing construct behind all intrapsychic life and culture (I exaggerate here, only a little). This state of affairs makes for very disappointing, boring professional lives. I've seen too many psychiatrists with a cynical, resentful edge take it out on patients. There is only one small step to renting out one's soul, when the soul isn't deeply invested in the work.

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Anon - Depends what you mea... (Below threshold)

May 29, 2010 12:32 PM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Anon - Depends what you mean by "normal" - narcissistic behavior has been normalized in our society...it's the new normal. But just because narcissism (or sociopathic or any kind of behavior) is "normal" doesn't mean it's actually healthy. There is actually a pretty big - and easily observable difference - between healthy and unhealthy social behavior, or prosocial and antisocial behavior. It's just that "normal" people who are themselves essentially antisocial see this behavior as "normal" and conflate "normal" with "healthy". (Also, a lot of people think antisocial means "not good with other people" which is completely off the mark. Lots of antisocial people socialize a lot and are very good at manipulating people to do things that are essentially against their own best interests, particularly narcissists who desperately need to see the image they construct of themselves reflected in other's eyes to affirm their existence and have a hard time being alone a lot of the time.

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What's the point in talking... (Below threshold)

May 30, 2010 1:31 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

What's the point in talking about narcissism without giving some kind of example ?

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Y'all should see "Don Juan ... (Below threshold)

May 31, 2010 11:49 AM | Posted by Alex-5: | Reply

Y'all should see "Don Juan de Marco" movie. A cute movie about psychiatry at service of law.

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If you commit crimes becaus... (Below threshold)

June 2, 2010 3:44 PM | Posted by dr. bean: | Reply

If you commit crimes because you're sick, then we can keep you in jail oops! I mean hospital until you're cured. I think "anti-social tendencies" can be the catch-all diagnosis of the future. We're going to take you to the hospital now, because you were going to commit a crime. . .

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oh, and you're cured when w... (Below threshold)

June 2, 2010 4:07 PM | Posted by dr. bean: | Reply

oh, and you're cured when we say you are, and not before. Sit down now, this will hardly hurt at all...

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Just another reason for pat... (Below threshold)

June 2, 2010 7:23 PM | Posted by Anonymous: | Reply

Just another reason for patients to resist going to the psych ward. A patient is much better off spending that money on a spa vacation instead. As they keep putting more and more criminals in the psych ward the more the psych ward resembles a prison, and the more the staff act like wardens. And they wonder why people fight to get out of there? Lack of insight? Not so much.

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Have you heard of a man by ... (Below threshold)

June 2, 2010 7:36 PM | Posted, in reply to Anonymous's comment, by Andrew T Ator: | Reply

Have you heard of a man by the name of Tucker Max, or Tibor TaMpAX, as he prefers to be called?

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Impulse Control Disorder NO... (Below threshold)

June 2, 2010 9:09 PM | Posted by L: | Reply

Impulse Control Disorder NOS implies that all we have to do is tattoo his forhead with "Poor Impulse Control" and our citizens can consider themselves forwarned with a relatively low price. So it's not that serious.

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Judges are generally famili... (Below threshold)

June 2, 2010 9:44 PM | Posted by Anonymous: | Reply

Judges are generally familiar with the law and will follow it (with exceptions, as always). Juries vote for the outfit they like or whether the defendant speaks proper English.

I'd rather convince one disenfranchised person than 6 or 12.

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"There is no pain you are r... (Below threshold)

June 2, 2010 10:26 PM | Posted, in reply to dr. bean's comment, by Anonymous: | Reply

"There is no pain you are receding."

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You're retarded. Defining ... (Below threshold)

June 2, 2010 10:30 PM | Posted, in reply to Andrew T Ator's comment, by Anonymous: | Reply

You're retarded. Defining thinking is a bitch, ain't it?

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Murder, battery, theft, tho... (Below threshold)

July 2, 2010 8:17 AM | Posted by Anonymous: | Reply

Murder, battery, theft, those things are understandable and there is no need to worry if there is a risk some people will do them again if released. But sex is just sick, we cannot take any chances there.

Seriously, what the hell is with this obsession with sex crimes over other things that hurt people horribly? Beating someone with a metal pipe, possibly to death, is an acceptable risk in comparison? If not, does that mean nobody should ever be released who has or might hurt another person? This whole thing is completely irrational BS.

An authoritarian belief that this should be applied to all violent offenders, sexual or not, would be shortsighted but at least it would be sane. This singling out of sex criminals is like some sort of politically correct mass hysteria.

I've come to the conclusion that it is mentally healthy to have the right amount of sociopathy to enjoy these games. Too much, too little, both are defects. Too little sociopathy is praised because it is in someone's best interest to encourage others to be easily fed off off. Reality doesn't care if a few people want right/healthy to be different than that. It is what it is, and it is the way most people want it. Who are the defective who cannot deal with this to argue, to have the world exist in a way everyone else clearly does not want just for their own peace of mind?

If that makes you a loser in life, a defective, then so what? We all accept that some people are. You think anyone else wants that for themself? No, we all like to think that our own innate nature just happens to be the correct one.

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