Could this be true? (Case described by Oliver Sacks)

(Might really belong in GD. Mods, feel free to move!)

I just finished re-reading Oliver Sacks’* The Man Who Mistook his Wife for a Hat*. It’s a fascinating collection of stories from the author’s practice as physician with a speciality in neurology. He describes a number of cases where neurological damage has caused interesting and sometimes almost incredible effects in the sufferers.

However, I have my doubts whether he is being totally truthful or sometimes has an agenda which drives him to twist facts. Especially one of the cases he describes raises my suspicion.

In the chapter appropriately named “Murder” he tells the story of a man who, allegedly under the influence of the drug PCP, murdered his girlfriend but afterwards had no memory of his horrible deed. Years later, though, after a frontal brain damage due to totally unrelated cause, the memories of the crime reappeared with devastating effects.

I shall quote the first few paragraphs of the story of the murderer:

First thing, it seems to me as “Donald” would have gotten away with an awfully light sentence for murder. Nothing is mentioned of previous psychological issues, and presumably he took the illicit drug on his own free will. So I don’t really see how the fact that he was under the influence could have been of any help to the “unfortunate” Donald.

(But I don’t know when this is supposed to have happened – the book was written in 1985, and maybe courts were more lenient back in the 60’s or 70’s?)

Second, the text gives the impression that some rather unconventional methods, like drugs and hypnosis, were employed prior to the trial to somehow try to recall the defendants memories. Would that have been legal, and what use could it have served? Even if the defendant (and, even more unlikely, his attorney!) were willing to make him subject to such treatment, would any statements made in those circumstances have been permitted as evidence in court?

(It seems more likely that such treatment could have been tried after the sentence, as part of the rehabilitation. So Sacks may be guilty of manipulating the timeline a bit here, no worse.)

Thirdly, and this is what bothers me most: the idea of** the court discussing evidence not disclosed to the defendant** seems to fly in the face of all ideas of legal certainty held in any reasonably free and democratic state. Nazi Germany or North Korea, quite possible. But the US?

I think Sacks was making up stuff here, or at least exaggerating facts greatly. Was there ever, indeed, a case like Donald’s? Is there any way to know for sure?

Sacks was a brilliant writer, and no doubt a highly qualified neurologist, but this particular story makes me wonder whether he was not deliberately being dishonest in trying to build a case for “repression of memories” as a factual thing.

Any thoughts?

And of course, how could they prove that he didn’t remember it? The only source of evidence they could possibly have for that would be his own word, and the word of a defendant in a criminal trial is inherently suspect, especially since his word in this case got him a far less severe penalty than he would have had if found sane and guilty.

I’m pretty sure it’s true.

  • It probably happened in the 1960s when sodium amytal was in vogue.
  • Obviously, the legal question was one of mens rea.
  • The defendant must have agreed to the use of hypnosis and sodium amytal, in order to prove that he really didn’t remember.
  • The court accepted that he was not criminally responsible. He was therefore committed to a psychiatric hospital for the criminally insane, not to a prison. That meant he could be released when the institution felt that he was no longer a danger to society.
  • If the defendant was excluded from hearing the details, either on the grounds of mental health or that it would undermine his defense, then no doubt his lawyer was present to look after his interests.

That’s, obviously, where the sodium amytal and hypnosis come into play. If not conclusive, they (if ever employed!) at least seem to corroborate the story.

Two points:

  1. Is not remembering committing a crime somehow a defense for committing said crime? Or would it have any significance in deciding the punishment?

  2. On exactly what grounds could a defendant be excluded from hearing the details discussed in court? Could it happen against his/her own will? Could the attorney be prevented from communicating with him/her later?

Just wanted to add that TMWMHWFAH is the first book by Sacks that I read. Since then, I’ve read everything I could find that he wrote. Never disappointed. Cycad Island, Uncle Tungsten, Island of the Colorblind - all great stuff.

What an interesting guy (with his own share of peculiarities).

I’m far from a lawyer but from what I remember about trying for the insanity defense is that you basically have to admit you did it. After you admit you did the crime the only question is whether you will go to prison or the psych ward. You can’t think of the trial as a normal trial with the defense trying to dispute the crime. They admit to the crime, then they go to great length to show the crazy.

SD, IMHO:I am physically incapable of remembering a moral harm I committed. Help define the discussion…

Fixed link. https links don’t work on the domain.


Don’t know why that happened. Did my usual Google, find archive, re-vive, copy.

I thought the question was going to be whether he could ever remember the events, even after a blow to the head. I have read everything by Elizabeth Loftus, the country’s, possibly the world’s foremost expert on memory, and it’s my understanding that if you don’t make a memory, you don’t make a memory, period. “Repressed memory” is a myth. In fact, if a memory is disturbing, it’s going to be invasive, not repressed-- that’s what PTSD is-- you can’t stop remembering something upsetting.

Anyway, I could believe that Donald’s memory process was disrupted by PCP, and he had no memory of what he did, but I’m more inclined to believe that he remembered all along, and he pulled a fast one, hypnosis and sodium amytal not being as advertised; in other words, he was deliberately repressing, or suppressing the memory, or in layman’s terms, “dealing with it.” When he developed temporal lobe damage, which can damage inhibition, he lost the ability to deliberately suppress the memory, and began to suffer from PTSD.

I’m guessing, but similar things have been observed in people in the early stages of Alzheimer’s who experienced something upsetting once, but were coping with it. They developed PTSD in response to the upsetting experience that might have happened 20 or 40 years earlier, because one of the first things to go was inhibition, and they couldn’t suppress memories at will. Later, when their memory became more severely damaged, the upsetting memory might disappear, and the PTSD resolve.

Sachs reports the event with a 1985 understanding of memory, which was the height of “Repressed Memory Syndrome,” Satanic Panic, and people recovering memories and accusing people of long-ago crimes. Sometimes there was an actual unsolved crime, but sometimes there was no crime on the books, and yet the police were convinced by someone’s “recovered” memory to dig up parks, and drain lakes looking for bodies.

Most psychiatrists and neurologists, as well as Ph.D psychologists who study memory agree that recovered memories are bunk. Loftus has a whole book on the subject.

I can’t explain Donald’s light sentence, except that “temporary insanity” was a thing back then, and “guilty but mentally ill” was not.

Also, does it say how old he was? Juveniles had almost no rights in the 1960s, and moving a juvenile to adult court was almost unheard of. If he was 17, 5 years was probably the maximum he could be sentenced to, because that is the maximum for juveniles, even for murder, in many places. It would also explain how Donald did not have the right to participate in his proceedings nor hear the details of the crime. Juveniles could be excluded from their proceedings, because like I said, they pretty much had no rights in the 1960s.

It happens because our board software apparently gives Google https links for some reason, even though they’re never valid.

ISTM that both answers are the same: he wasn’t convicted by reason of insanity (or was found incompetent to stand trial), and instead was ordered into a secure inpatient psychiatric facility. The court could not withhold admissible evidence from the defendant, but could consider otherwise inadmissible evidence in determining competency. Donald’s lawyer may have requested that the court review evidence in camera with his client’s agreement (or that of his guardian if he had already been determined incompetent).

Donald wasn’t sentenced at all, so talk of light sentencing is misplaced. He was instead committed to a hospital, which is what happens when you are found not guilty by reason of insanity. Insanity is a complex concept in law, and does not necessarily map onto medical ideas about it.

As to claims of absence of memory, I recall a psychiatrist once testifying that something like 50% of people who have killed claim not to remember the moment of killing. That rarely means they are not guilty.

The approach of the medical profession to these things has changed since the 80s.

Doctors were once fascinated by the deliciously spooky idea of “automatism”. For instance, after a head knock (say, in a football game) people were reported as playing brilliantly after the blow, but not remembering anything of it later. This was modelled as the body moving without the will being engaged.

Later, a combination of ideas led to retreat from this. The footballer who played a blinder example led to people wondering how it was possible to undertake such complex behaviour that was not purely muscle-memory driven and required complex interaction with the environment, without any executive functioning being engaged. The existence of drugs like Midazolam allowed observation of apparently normal (albeit somewhat sedated) behaviour including meaningful conversation that was not remembered by the patient later.

This led neurologists to prefer a model that described these losses of memory as involving the presence of executive decision making at the time but without accessible memory being laid down.

Now to the murderers. There is always a strong prospect that they are lying. “Truth drugs”, as observed above, do not work as advertised on the tin.

But that might not be the whole story. It may be that some memories are too traumatic to confront, so people choose not to peek, so to speak. This is not repressed memory in the Freudian sense, and does not really contradict Loftus on the topic. It is a sort of habituated pretending. But if the killing involved apparently coordinated, goal directed behaviour that was congruent with its apparent purpose, then claims of mere loss of memory don’t count for much by themselves. After all, there is necessarily some functional memory going on, if only at an operational level, to direct moment to moment behaviour.

Since the 80s, the DSMs in their various iterations have defined a thing called drug induced psychosis. This is a psychotic state of mind different from merely being high. It can persist, or even emerge, long after the drug (often speed) has left the system. It seems the drug has a long term cascading effect on the person’s mental functioning.

That does not seem to be what Sacks is talking about, because he implies that Donald was actively intoxicated by PCP at the time.

Does Sacks have an agenda? Perhaps, but it was a common enough one at the time. The unnuanced equation of no memory = no guilt requires further examination.

Suppose I murder someone. On the way home, I’m in a car accident, resulting in brain damage and loss of memory of the murder. If I am mentally otherwise normal and competent to stand trial, does this loss of memory of the event have any bearing on my guilt? I would think not.

Surely voluntarily taking a mind-altering drug prior to a murder is not exculpatory. So I don’t understand why it should be that loss of memory due to such a drug is exculpatory in the case that Sacks describes. It would seem to me that if the drug has left the perpetrator unfit to stand trial, that’s one thing: then they should be committed to a mental institution, but should stand trial for murder if ever released.

If something alters your mental state to the point where you could not have the mens re to commit the crime, then that changes a lot of things.

And what you are describing basically creates an incentive for the person to never try to get better, since, once they do, they’ll face trial.

The point is to fix the problem, so that the crime does not happen again. If the institution accomplishes this, what is the point of further punishment?

I totally agree with the answers there, BTW. Feelings have nothing to do with it. You need to recognize what you did was wrong, and do what is necessary not to do it again. That is repentance.

Hell, it’s the entire point of the criminal justice system, in theory. The punishment is provided to keep you from doing it.

It is a little more complicated than that. Memories don’t exist as facts (they are streams of thought, with all the uncertainty that implies): and not everything you remember is indexed in a way that makes it easy to find.

Not that I believe the Sacks example. I think there are alternate explanations that are more likely.

I think that’s important. The whole idea of repressed Memory is that only about 1/10th of what our senses perceive is observed consciously, but the rest is stored subconsciously and can be accessed with the right methods - hypnosis, Meditation, the right drug etc.

This has now been proven to be false, for lack of storage place for start. The new Imaging methods like MRI have greatly changed previous theories about brain, mind and Memory.

I remember reading about a study on how to help Trauma survivors - sudden Trauma like plane Crash, not ongoing - and the psychologists found that if People were kept awake for about 10-12 hrs and then let sleep, they would remember far less than letting them sleep immediatly. Apparently by keeping them up the brain would just overload and not form detailed memories.

Also - esp. because of the proper Research by scientists (not therapists) into repressed Memory during the 80s Hype - it was found that Memory does not work like Video tapes that once made are unchangeable Facts, but rather, that minds make up stories that fit with the emotions; and that memories are fluid. They showed People famous Pictures (like the Chinese tank man) altered and People did not notice the Change, because it still fit a narrative.

I think that is the simple solution. Sacks was correct by the knowledge of his time; new studies have brought new Facts which have changed the theories, so we Interpret the Situation different today.

We should also keep in mind that trauma is processed differently in the brain than typical narrative memory. This may result in somatic memory with no narrative memory - a physical sensation, an emotional state but no narrative to attach it to. I have PTSD and experience both types of memory, depending on the trigger. In my experience, somatic memory is far worse because you have nothing to grapple with. I’d be interested in seeing the crash studies because I’m not convinced that being unable to remember details of a traumatic event necessarily makes it less traumatic. (I seem to recall a study in which subjects were hypnotized into forgetting a disturbing memory, and while they had no recollection of the disturbing event, they were still affected by it. In fact, the study was presented here, on the Dope, in response to my claim that repressed memories are bullshit. I still believe that repressed memories are bullshit. While you can apparently be made to forget minor incidents via hypnosis, hypnosis cannot mystically recover a lost memory.) This is a sobering reality for those of us living with PTSD. I have one solitary gap in my narrative memory of trauma, replaced completely by somatic memory, and I hate it. It’s the worst of my trauma, the not knowing, and knowing that I will never know. It feels like endless darkness.

I don’t know as much as I wish I did about the fragmentation of traumatic memory, but I do know that a lot of it is stuffing all the sensory chaos into a cohesive narrative. We do that with the knowledge that the narrative will contain inaccuracies. That’s what people don’t understand, and why it’s pointless to quibble with trauma victims over details that don’t add up. The little things might not add up because we had to invent them in order to make sense of what happened.

A person might be in a serious car accident. Their traumatic memory processes something like: *Bright lights. Oh god, pain. Oh god, I’m going to die. *

They are going to have to take that mess of pain and emotion and make some coherent sense out of it. They might find out afterward they had a fractured skull, and were struck from the rear. So those details become a part of the memory too. Eventually they can tell the story: I was driving my car and was struck from the rear. I felt a searing pain in my skull and I was terrified.’’

But it takes a *lot *of fucking work to get there.

While some facts may be lost during integration, the emotional truth remains. I have some memories of events that are obvious conflations of two or three different events. For the purposes of piecing my life back together, it’s the best I’ve got. I can’t remember if I was twelve that one time or fourteen or sixteen, but I remember the gist of every event, and most critically the helplessness, fear and rage that went along with each one, I live out how I felt every day of my life. After I became an adult, my mother would do this to me all the time: she would push me to the breaking point with her denial, I would write some angry letter detailing all the shit she put me through as a kid, and she would find one thing that was inaccurate, or that she thought was inaccurate, and hyper focus on it while ignoring the reality of everything else. It’s basically Holocaust denial for the child abuser.

Then there’s the fact that in the immediate aftermath of a trauma, events are better recalled after 72 hours of rest. It’s the reason any police officer who shoots someone in the line of duty waits 72 hours before debriefing, and it’s the reason rape victims frequently get raked over the coals for having inconsistent stories. They remember better after a few days. (This coming from the forensic nurses at the domestic violence/sexual assault org where I work, so I don’t have a readily available citation.) You can see with all the complexities of traumatic memory how tricky this shit gets in criminal investigations.

When you talk about the emotional fluidity of memory, I think that is the central conceit of EMDR, which I am in the middle of right now. I’ve been through about six sessions and it seems to be changing my emotional relationship to those memories, and it’s doing so at a rapid-fire pace that seems nothing short of miraculous.

One thing we have learned, though, is that mass debriefing - getting people who have experienced trauma together to talk about it, such as 9-11 victims – makes it worse. This is because other people’s traumatic memories fill in the gaps of everyone in the group until they effectively remember experiencing things that they did not personally experience. I theorize that this is one reason why 9-11 had such a traumatic impact even on those who didn’t directly experience it. As a nation, we manufactured a collective traumatic memory.

I love Oliver Sacks, may he rest in peace. I eat this stuff up, it’s one of the single most fascinating subjects in existence.