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Guilty by Reason of Insanity: Inside the Minds of Killers
A psychiatrist and an internationally recognized expert on violence, Dorothy Otnow Lewis has spent the last quarter century studying the minds of killers. Among the notorious murderers she has examined are Ted Bundy, Arthur Shawcross, and Mark David Chapman, the man who shot John Lennon. Now she shares her groundbreaking discoveries--and the chilling encounters that led to them.
From a juvenile court in Connecticut to the psychiatric wards of New York City's Bellevue Hospital, from maximum security prisons to the corridors of death row, Lewis and her colleague, the eminent neurologist Jonathan Pincus, search to understand the origins of violence. Guilty by Reason of Insanity is an utterly absorbing odyssey that will forever change the way you think about crime, punishment, and the law itself.
From a juvenile court in Connecticut to the psychiatric wards of New York City's Bellevue Hospital, from maximum security prisons to the corridors of death row, Lewis and her colleague, the eminent neurologist Jonathan Pincus, search to understand the origins of violence. Guilty by Reason of Insanity is an utterly absorbing odyssey that will forever change the way you think about crime, punishment, and the law itself.
352 pages, Mass Market Paperback
First published January 1, 1998
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About the author
Dorothy Otnow Lewis
5 books43 followersDorothy Otnow Lewis is an American psychiatrist and author who has been an expert witness at a number of high-profile cases. She specializes in the study of violent individuals and people with Dissociative Identity Disorder, formerly known as Multiple Personality Disorder. Lewis has worked with death row inmates as well as other prison inmates convicted for crimes of passion and violence, and was the director of the DID clinic at Bellevue Hospital, associated with New York University in New York City. She is a professor of Psychiatry at Yale and New York Universities and is the author of Guilty by Reason of Insanity, a book she wrote based on research done with the help of neurologist Jonathan Pincus.
Books:
Delinquency and psychopathology (with David A. Balla), 1976
Vulnerabilities to Delinquency, 1981
Guilty by Reason of Insanity, 1998
Books:
Delinquency and psychopathology (with David A. Balla), 1976
Vulnerabilities to Delinquency, 1981
Guilty by Reason of Insanity, 1998
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Displaying 1 - 30 of 109 reviews
December 8, 2015
The more we understand about the genesis of violence, the harder it is to draw a clear line between guilt and innocence, sanity and insanity. We, as a society of thinking and feeling human beings, struggle within ourselves to cope with competing interests and motivations: the need for protection from dangerous people, sane or insane; the desire for revenge; the knowledge of the psychobiological and environmental influences on violent behavior; and the wish to adapt evolving standards of decency and morality. Guilt was a lot easier to measure before we recognized that free will, like sanity and insanity, is a constantly fluctuating intellectual and emotional continuum and not a fixed, immutable capacity or state of mind. In response to our struggles to strike balances between what we feel we'd like to do to people who commit grotesque acts of violence no matter what their mental state, and what we think perhaps we ought to do and ought not to do, jurisdictions have swung back and forth, changing from one definition of insanity to another, then back to the first, often in response to a sensational case of the moment.
I am extremely interested in the reason we believe some of the crazy things we believe and ultimately do some of the horrible things we do. This fascination has led me to read any number of true crime books in conjuction with books that explore the biological and environmental basis for behavior.
Lewis' book seems to fall firmly in the middle of those two genres. Partly a true crime book, it is also a summary of her extensive career, which has led her to interview many famous and many not so famous killers and which often times describes even if only in general detail the cases. The book is a fascinating read if only for the questions its author raises about the nature of violence.
Lewis seems to believe that only a "crazy" person could commit the grizzly crimes her clients/patients on death row (patients like Ted Bundy and Arthur Shawcross) have committed. Unfortunately, being crazy isn't the same thing as being insane, at least not in the eyes of the US legal justice system. And therein lies the meat of her narrative. How do we deal with violent criminals in a way that acknowledges the mitigating circumstances (often mental illness consistent with a psychiatrists definition of insane even if not with the law's interpretation) that often leads to the most vile and heinous crimes, without feeling as though by doing so we've let them literally get away with murder.
There is also some interesting evidence presented for the existence of multiple personality disorder, which I know isn't universally taken seriously, but that was still worth reading as her experience.
Though I don't agree with all her arguments and feel as if she was a little too quick to arrive at certain conclusions (after all, she was generally hired to find mitigating circumstances for the purpose of having a death row sentence revoked), I still felt this was a fascinating read. Many of the questions she raises about our views of violent criminals and our inability or rather reluctance as a society to accept that freewill isn't this concrete, tangible, or well-defined human attribute is well stated. This idea that we would all be capable and even likely to become murderers given the right combination of biological and environmental conditions seems a no-brainer, yet still we execute people insisting it is a deterrent to these ghastly crimes.
Beneath all the neuropsychological meanderings is a valid and poignant discussion of the death penalty which culminates when Lewis interviews an executioner, who she quickly paints as being more like the men he helps to kill than he might realize.
As an aside, some of her clients' histories (many clients were children at the time they committed the murders and were sentenced to death) were beyond shocking and heartbreaking. The extent of abuse inflicted on these kids--physical, emotional, sexual--is sickening. The idea that these things are allowed to happen is a sad comment on our society. We spend weeks and months and years not only talking about terrorist attacks but waging war on these would be invaders...which don't get me wrong is understandable, yet we somehow forget about all the children that are tortured and terrorized by our own citizens right in front of us. I'm sure if someone tallied up the number of Americans or even humans around the world directly affected by terrorism from some extremist group and those affected by unspeakable abuse (terrorism) from their mothers, fathers, aunts, uncles, neighbors, and trusted community leaders, the numbers wouldn't even be in the same ballpark.
Good stuff for those interested in this sort of thing.
June 2, 2014
Throughout my legal career I wound up working with a numberof convicted sex offenders and discovered some startling similarities (besides the offence itself). One of those was a history of familial violence and sex abuse. I remember thinking "this can't be a coincidence." Although I have had nothing to do with violent killers, I recognised the same patterns that Dorothy Lewis was highlighting in this book. Lewis found herself working with violent murderers - both youngsters who snapped and went on a rampage and serial killers, who tend to go about things in a far more methodical way.
There are two main mental disorders explored in this fascinating book. The first is one that has been dismissed as hokum by most psychiatrists: multiple personality disorder. The second details Lewis's search for a true sociopath, someone who hurts people with no remorse or compunction for no apparent reason. What she found is, in my view, much more disturbing.
I think the point Lewis is making is that happy, well-adjusted people do not commit violent crimes, only "crazy" people do. Therefore most, if not, all violent criminals are, to some extent, insane. They are guilty by reason of insanity.
I found the book fascinating and disturbing. I truly sympathised with Lewis as I know what it is like to work in a field where you are confronted with disturbing cases that are nevertheless fascinating, a field which can easily destroy relationships and consume the lives of the unwary. I heartily recommend this book to anyone as Lewis has a masterful ability to break down difficult concepts in an interesting way. She is also unflinching in her description, in some parts I found myself simultaneously engrossed and disturbed.
There are two main mental disorders explored in this fascinating book. The first is one that has been dismissed as hokum by most psychiatrists: multiple personality disorder. The second details Lewis's search for a true sociopath, someone who hurts people with no remorse or compunction for no apparent reason. What she found is, in my view, much more disturbing.
I think the point Lewis is making is that happy, well-adjusted people do not commit violent crimes, only "crazy" people do. Therefore most, if not, all violent criminals are, to some extent, insane. They are guilty by reason of insanity.
I found the book fascinating and disturbing. I truly sympathised with Lewis as I know what it is like to work in a field where you are confronted with disturbing cases that are nevertheless fascinating, a field which can easily destroy relationships and consume the lives of the unwary. I heartily recommend this book to anyone as Lewis has a masterful ability to break down difficult concepts in an interesting way. She is also unflinching in her description, in some parts I found myself simultaneously engrossed and disturbed.
December 22, 2008
A fascinating and disturbing book, by a shrewd and compassionate doctor who has made it her life's work to study human violence and violent humans. The author uses her experiences in a number of cases to tell, in a matter-of-fact way, how she and a colleague learned important things about the human mind and soul, and had to unlearn much of what they had been taught in medical school.
As a psychotherapist myself, I find that this is one of the most interesting and informative books I've read. I also find that her conclusions about her patients are different from, but compatible with,
much of what I learned in working with a similar group of clients, first as adolescents whose lives were wrecked by family violence and mental illness and then later in the psychiatric hospital serving the state prison system.
Powerful, strongly opinionated about both violent criminals and the legal and penal systems, and hard to put down. I challenge anyone who views issues like capital punishment or the role of insanity in deciding guilt as clear and simple to read this book.
As a psychotherapist myself, I find that this is one of the most interesting and informative books I've read. I also find that her conclusions about her patients are different from, but compatible with,
much of what I learned in working with a similar group of clients, first as adolescents whose lives were wrecked by family violence and mental illness and then later in the psychiatric hospital serving the state prison system.
Powerful, strongly opinionated about both violent criminals and the legal and penal systems, and hard to put down. I challenge anyone who views issues like capital punishment or the role of insanity in deciding guilt as clear and simple to read this book.
March 31, 2025
În peisajul adesea sumbru al literaturii dedicate crimei și psihologiei criminale, puține lucrări reușesc să pătrundă atât de adânc și cu atâta rigoare științifică precum „Vinovați de demență” („Guilty by Reason of Insanity”), semnată de reputata psihiatră Dorothy Otnow Lewis. Departe de a fi o simplă colecție de studii de caz senzaționaliste, cartea reprezintă o cronică meticuloasă și profund tulburătoare a deceniilor petrecute de autoare în cele mai întunecate colțuri ale minții umane – cele ale ucigașilor multipli, ale condamnaților la moarte și ale indivizilor ale căror acte de violență extremă sfidează înțelegerea comună.
Lewis, o voce respectată, dar adesea controversată în domeniul său, își construiește argumentația pe o premisă provocatoare: violența extremă, irațională, nu este, în majoritatea cazurilor, o manifestare a „răului” pur sau a unei alegeri morale deliberate, ci rezultatul unui cocktail toxic de factori neurologici preexistenți (adesea leziuni cerebrale traumatice), abuzuri severe în copilărie și tulburări psihiatrice complexe, precum tulburarea de identitate disociativă sau psihoza. Cartea este, în esență, o pledoarie implacabilă pentru o înțelegere mai nuanțată a responsabilității penale, contestând vehement noțiunile simpliste care stau adesea la baza sistemului juridic, în special în ceea ce privește pedeapsa capitală.
Forța cărții rezidă în combinația rară dintre rigoarea clinică și o empatie surprinzătoare, deși niciodată indulgentă. Lewis nu se sfiește să prezinte detaliile brutale ale crimelor comise de subiecții săi, însă o face nu pentru șoc facil, ci pentru a contextualiza istoricul medical și personal al acestora. Prin interviuri aprofundate, examinări neurologice și o analiză atentă a dosarelor medicale și juridice, ea demonstrează, caz după caz, prezența unor traume craniene nediagnosticate, a unor episoade psihotice ignorate și a unor istorii de abuz fizic și sexual de o cruzime inimaginabilă. Personaje notorii precum Arthur Shawcross sau Joseph Paul Franklin (și chiar tangențial Ted Bundy) sunt disecate nu ca monștri unidimensionali, ci ca produse tragice ale unor circumstanțe biologice și ambientale devastatoare.
Lewis, o voce respectată, dar adesea controversată în domeniul său, își construiește argumentația pe o premisă provocatoare: violența extremă, irațională, nu este, în majoritatea cazurilor, o manifestare a „răului” pur sau a unei alegeri morale deliberate, ci rezultatul unui cocktail toxic de factori neurologici preexistenți (adesea leziuni cerebrale traumatice), abuzuri severe în copilărie și tulburări psihiatrice complexe, precum tulburarea de identitate disociativă sau psihoza. Cartea este, în esență, o pledoarie implacabilă pentru o înțelegere mai nuanțată a responsabilității penale, contestând vehement noțiunile simpliste care stau adesea la baza sistemului juridic, în special în ceea ce privește pedeapsa capitală.
Forța cărții rezidă în combinația rară dintre rigoarea clinică și o empatie surprinzătoare, deși niciodată indulgentă. Lewis nu se sfiește să prezinte detaliile brutale ale crimelor comise de subiecții săi, însă o face nu pentru șoc facil, ci pentru a contextualiza istoricul medical și personal al acestora. Prin interviuri aprofundate, examinări neurologice și o analiză atentă a dosarelor medicale și juridice, ea demonstrează, caz după caz, prezența unor traume craniene nediagnosticate, a unor episoade psihotice ignorate și a unor istorii de abuz fizic și sexual de o cruzime inimaginabilă. Personaje notorii precum Arthur Shawcross sau Joseph Paul Franklin (și chiar tangențial Ted Bundy) sunt disecate nu ca monștri unidimensionali, ci ca produse tragice ale unor circumstanțe biologice și ambientale devastatoare.
May 7, 2017
I am conflicted with this one. It is somewhere between two and three stars.
In the books defence it was written over ten years ago. Psychology and understanding has continued to develop since then. It may have been a better read when it was first written.
What I didn't like about the book is that the author never considers the possibility that the prisoners that she interviews are not completely telling the truth. In a different novel, regarding the son of Sam, the interviewer then tells SoS "to cut the crap" (in regards to multiple personalities now DID) and to his amazement he did. There are some motives to lying in these interviews and I had my doubts about some of the cases.
The interviews are summaries..some are phrased in the interviewee dialect but then switch to clinical dialect when describing more upsetting scenes such as rape. The problem with this is it made it seem less genuine.
It is a interesting read in its own respect, especially if you want to learn more about why people might torture and kill. But take the information with a pinch of salt.
In the books defence it was written over ten years ago. Psychology and understanding has continued to develop since then. It may have been a better read when it was first written.
What I didn't like about the book is that the author never considers the possibility that the prisoners that she interviews are not completely telling the truth. In a different novel, regarding the son of Sam, the interviewer then tells SoS "to cut the crap" (in regards to multiple personalities now DID) and to his amazement he did. There are some motives to lying in these interviews and I had my doubts about some of the cases.
The interviews are summaries..some are phrased in the interviewee dialect but then switch to clinical dialect when describing more upsetting scenes such as rape. The problem with this is it made it seem less genuine.
It is a interesting read in its own respect, especially if you want to learn more about why people might torture and kill. But take the information with a pinch of salt.
June 26, 2011
Dr. Lewis studies violence and its frequent roots in violent abuse and nerological damage. And her case stories are very interesting. And as her views evolve over her years of study and experience, she becomes an expert at trying to determine the "why" of appearingly senseless crimes. A very intense read.
August 16, 2024
This is a fascinating read. For about 125-150 pages. After that, things get a bit repetitive. Dr. Lewis sheds some very important light not just on the minds of killers, but also, their pasts, their legal representatives, and their own childhood abuses. In some of the cases presented, it’s clear that the inmate had no idea what it meant to be executed, especially in the chilling example of the soon to be executed man who asked if he could have his Jell-O until after the execution.
At a minimum, despite the repetition, Dr. Lewis provides tremendous food for thought regarding what constitutes mitigation and how that intersects with the TYPE of crime committed, the race and make-up of the victim, and the availability or lack there of, for neurological testing of death row inmates.
At a minimum, despite the repetition, Dr. Lewis provides tremendous food for thought regarding what constitutes mitigation and how that intersects with the TYPE of crime committed, the race and make-up of the victim, and the availability or lack there of, for neurological testing of death row inmates.
July 21, 2016
This is an excellent examination of the ongoing issue of whether sociopaths are born or made. Points made by this book:
-Nearly every killer studied by the author and her colleague Jonathan Pincus proved to have suffered humiliating abuse (mostly sexual) during childhood. Although she had a few interviews with Ted Bundy, she could not spend enough time with him to test her hypothesis. She was also unable to interview Mark David Chapman, John Lennon's killer, about his childhood because he immediately pleaded guilty and was sentenced.
-Of the killers she WAS able to interview in depth, some of whom were believed by both psychiatrists and judges to be pure sociopaths by nature and thus not candidates for childhood history examination, she discovered after lengthy interviews that ALL of them had deeply repressed memories of childhood abuse that were so bad that they couldn't admit them into consciousness. Some had even developed multi-personality disorder, in which they assigned unbearable events into experiences of alters so they themselves would have no memory of the abuse. Her continued conversations with them eventually revealed accounts of horrible childhood abuse. This was usually the last and deepest and most repressed of all their memories.
-She interviewed an executioner about his own background and feelings he had for criminals as he pushed the button to execute them and discovered that, although he had never been arrested for a crime, he had towering rages against people that he thought had wronged him in life. He was the only person in this area of psychological investigation that could not have been a sociopath, yet he was filled with angry memories.
-The greatest hindrances to the examination of killers' childhoods is the effect of two groups: psychiatrists that dismiss the idea of childhood abuse as a factor in sociopathy because it conflicts with their current beliefs; and judges who dismiss it out of hand for the same reason.
-The most common cause of becoming a killer is paranoia; it is not schizophrenia, because psychotics in a schizophrenic break are not organized enough to carry out murders.
-Parents and abusers would rather see a killer die than to have to acknowledge the kinds of abuse perpetrated on them because the shame is too great.
-Ted Bundy said to her, "You are the only one who wants to know why I did it."
-"Protector" personalities in multiple personality disorder are in charge of secrecy and safety, which is usually why the abuse is never allowed into consciousness.
-The grotesqueness of a homicide or multiple homicides clouds clinical judgment of psychiatrists as well as legal judgment of attorneys and judges.
-A significant number of killers had been in "special ed" while in school.
-Many judges would dismiss the author's thesis about killers she had interviewed as unimportant or wrong before any further consideration
This is a fascinating book because it proposes that killers have all had disturbing incidents in their childhood, and there is no such thing as a "born killer."
-Nearly every killer studied by the author and her colleague Jonathan Pincus proved to have suffered humiliating abuse (mostly sexual) during childhood. Although she had a few interviews with Ted Bundy, she could not spend enough time with him to test her hypothesis. She was also unable to interview Mark David Chapman, John Lennon's killer, about his childhood because he immediately pleaded guilty and was sentenced.
-Of the killers she WAS able to interview in depth, some of whom were believed by both psychiatrists and judges to be pure sociopaths by nature and thus not candidates for childhood history examination, she discovered after lengthy interviews that ALL of them had deeply repressed memories of childhood abuse that were so bad that they couldn't admit them into consciousness. Some had even developed multi-personality disorder, in which they assigned unbearable events into experiences of alters so they themselves would have no memory of the abuse. Her continued conversations with them eventually revealed accounts of horrible childhood abuse. This was usually the last and deepest and most repressed of all their memories.
-She interviewed an executioner about his own background and feelings he had for criminals as he pushed the button to execute them and discovered that, although he had never been arrested for a crime, he had towering rages against people that he thought had wronged him in life. He was the only person in this area of psychological investigation that could not have been a sociopath, yet he was filled with angry memories.
-The greatest hindrances to the examination of killers' childhoods is the effect of two groups: psychiatrists that dismiss the idea of childhood abuse as a factor in sociopathy because it conflicts with their current beliefs; and judges who dismiss it out of hand for the same reason.
-The most common cause of becoming a killer is paranoia; it is not schizophrenia, because psychotics in a schizophrenic break are not organized enough to carry out murders.
-Parents and abusers would rather see a killer die than to have to acknowledge the kinds of abuse perpetrated on them because the shame is too great.
-Ted Bundy said to her, "You are the only one who wants to know why I did it."
-"Protector" personalities in multiple personality disorder are in charge of secrecy and safety, which is usually why the abuse is never allowed into consciousness.
-The grotesqueness of a homicide or multiple homicides clouds clinical judgment of psychiatrists as well as legal judgment of attorneys and judges.
-A significant number of killers had been in "special ed" while in school.
-Many judges would dismiss the author's thesis about killers she had interviewed as unimportant or wrong before any further consideration
This is a fascinating book because it proposes that killers have all had disturbing incidents in their childhood, and there is no such thing as a "born killer."
June 23, 2020
The book is a fascinating journey of a psychiatrist who had spends decades studying delinquent youth and convicted killers on death raw. She tries to answer the question: why do people kill? She finds that almost all of them have something in common: neurological impairments, caused by birth circumstances and repeated head traumas along their lives. They also carry histories of being heavily sexually and/or physically abused in their childhood and youth by parents and/or relatives.
The book isn’t for the faint of heart. It describes many gruesome details about the murders and childhood abuse endured by the murderers. Nevertheless, it provides a strong moral reflection about the role of the justice system and of us as a society to decrease the chances that abused children become murderers. (Or get abused in the first place).
The book isn’t for the faint of heart. It describes many gruesome details about the murders and childhood abuse endured by the murderers. Nevertheless, it provides a strong moral reflection about the role of the justice system and of us as a society to decrease the chances that abused children become murderers. (Or get abused in the first place).
September 25, 2022
I discovered while in law school that I tend to have more sympathy for murderers than other people do. Part of that is because of the underlying unfairness to defendants in the legal system and the other part is their mental state. Dr. Lewis explains, quite well, how people who murder are simply not sane. The majority of them have been brought up in horrible households, which, in turn, completely controlled their mentality for the rest of their life. I was utterly enthralled by her recounts of different types of mental illnesses - specifically multiple personality disorder. This was written almost 20 years ago, so a lot has changed in the psychiatric world. But yet, the root of these murderers’ tendencies continue to be created by their environment.
March 23, 2010
Wow. This was a really honest and disturbing book. Are "evil" murderers more Gomer Pyle than Hannibal Lector? Why do some murderers end up on death row and other actually get the chair? What kind of people volunteer and look forward to become the executioner?
Now, it's been a couple weeks since I actually finished the book. I happened to be traveling outside the country and it really made me wonder why the USA is the only major global player who has a death penalty? Have all the other nations civilized or softened?
It made me really think about patterns and how we so often re-enact our childhoods when we become the parents. Or in other words, we do become our parents.
Now, it's been a couple weeks since I actually finished the book. I happened to be traveling outside the country and it really made me wonder why the USA is the only major global player who has a death penalty? Have all the other nations civilized or softened?
It made me really think about patterns and how we so often re-enact our childhoods when we become the parents. Or in other words, we do become our parents.
April 25, 2007
This book really made me think twice before making opinions about criminals. It delves deeply into the similarities that so many criminals share (i.e. the hardships they've suffered as children, etc). Although it doesnt excuse any criminal behavior, it exposes the truth behind so many of these "monsters" motives and personal histories.
December 16, 2012
Although I do put forth a disclaimer that once you read this, you cannot take back the horrific images you encounter, I could not put this book down. The criminals Lewis examines changed my perspective on so many aspects of how we treat brain damaged individuals in our society. Quick and easy to read, but you may find yourself reading parts over and over just to believe your eyes...
June 13, 2019
Self indulgent. The book was more interested in name dropping and the writer giving a one sided view of a very complicated system.
July 29, 2023
Dorothy Otnow Lewis was the last woman to kiss Ted Bundy on the cheek the day before he was executed. She had spent four and a half hours interviewing him. He had kissed her first.
Lewis started her career as a psychiatrist in Connecticut working with violent juveniles. She later moved to Bellevue Hospital, the notorious venue in New York City. One resident there had cut off his father's head and penis. He disposed of the body parts through the window. I ♥️ NY.
A public defender in Florida saw her appearance with Diane Sawyer in a TV interview and her life was changed forever.
The cases reviewed are horrific, with incest and torture being a frequent common denominator. A mother teaches her six-year-old son to perform oral sex on her. A woman, Marie Moore helped her young lover torture and kill a girl of thirteen. Lewis was a nonbeliever in multiple personality disorder until meeting Marie. A man named Joe emerged during a session and described the little girl being sexually assaulted with a pencil by her father. He later impregnated her and she had an abortion.
Johnny Frank Garrett was seventeen when he raped and murdered a nun in Texas. Like Marie Moore, the boy was clearly out of touch with reality. Lewis recorded him on death row when other personalities spoke with her about vicious sexual abuse by four stepfathers. Mom had spent some time in a nut house. Johnny was sodomized repeatedly, sometimes with a soda bottle. A cousin swore in an affidavit of sexual abuse by grandpa. What a family! Bye bye Johnny.
Arthur Shawcross is next and he pled guilty to the murders of ten women. Lewis pointed out that his black outs during seizures were caused by lesions in his brain which were clearly shown on an EEG.
An executioner is interviewed and he showed the good doctor a scrapbook of the men he had fried in "Old Sparky."
The book is very good but I was looking for more on her interviews with Bundy. A Youtube video with an audio of Ted gives a hint of the possibility of his first two murders in New Jersey in 1969. They remain unsolved.
Lewis started her career as a psychiatrist in Connecticut working with violent juveniles. She later moved to Bellevue Hospital, the notorious venue in New York City. One resident there had cut off his father's head and penis. He disposed of the body parts through the window. I ♥️ NY.
A public defender in Florida saw her appearance with Diane Sawyer in a TV interview and her life was changed forever.
The cases reviewed are horrific, with incest and torture being a frequent common denominator. A mother teaches her six-year-old son to perform oral sex on her. A woman, Marie Moore helped her young lover torture and kill a girl of thirteen. Lewis was a nonbeliever in multiple personality disorder until meeting Marie. A man named Joe emerged during a session and described the little girl being sexually assaulted with a pencil by her father. He later impregnated her and she had an abortion.
Johnny Frank Garrett was seventeen when he raped and murdered a nun in Texas. Like Marie Moore, the boy was clearly out of touch with reality. Lewis recorded him on death row when other personalities spoke with her about vicious sexual abuse by four stepfathers. Mom had spent some time in a nut house. Johnny was sodomized repeatedly, sometimes with a soda bottle. A cousin swore in an affidavit of sexual abuse by grandpa. What a family! Bye bye Johnny.
Arthur Shawcross is next and he pled guilty to the murders of ten women. Lewis pointed out that his black outs during seizures were caused by lesions in his brain which were clearly shown on an EEG.
An executioner is interviewed and he showed the good doctor a scrapbook of the men he had fried in "Old Sparky."
The book is very good but I was looking for more on her interviews with Bundy. A Youtube video with an audio of Ted gives a hint of the possibility of his first two murders in New Jersey in 1969. They remain unsolved.
July 16, 2025
A wonderful writer with a fascinating (albeit depressing and gory in parts) story to tell. Dr Lewis has had a difficult career in dealing with serial murderers, rapists and other violent offenders, but more so her with her peers, lawyers and the courts. Unlike many of us and many of her colleagues, she hasn’t simply written those convicted off as evil and deserving of the death penalty. She, with her neurologist colleague, have tested and analysed the death row inmates they have interviewed and assessed for legal testimony, and delved deeply into the links between their biologic and psychologic nuances, illustrating one having a direct effect on the other, and producing evidence to support that evil is not born, it is created. This book is truly heartbreaking. Violence begets violence and the court system has failed time and time again to recognise that upbringing is vital to a person’s mental wellbeing and future. Dr Lewis’ book shows a rare compassion and understanding of how the law doesn’t recognise how mental illness affects personal culpability and how to deal with it appropriately for all concerned.
July 12, 2025
It’s really 4.5. It’s good, the experiences in the field are super interesting. Last couple of chapters were not needed and from what I gathered, pleading insanity is incredibly difficult to obtain. Worth the read.
November 11, 2024
Really interesting stuff on trauma and dissociation, but supremely graphic. Hard to read.
May 5, 2018
THIS BOOK IS NOT ABOUT TED BUNDY!!!!!
Now that I've gotten that out of the way.
I picked this book up with the knowledge that Dr. Lewis had examined Ted Bundy shortly before his death. She was the only person to ever admit that he was insane, and so I hoped for a deeper look into the details of that. I was also hoping for a bit more detail about his confessions, since the three books I've read about him don't really delve that deeply into his confessions.
That was not the point of this book.
So, because of that, I feel a little bit mislead. Part of the low rating is because I feel that, despite the description of the book naming other killers, it seems that Bundy's name was somewhat "dropped" in to generate interest in this book, when in fact he hardly played a role in it at all.
The second reason for the low rating is because this seemed to be more of an autobiography than anything else. At the least, I was expecting more stories about the convicts she spoke with and the people she has treated. Instead, about half of the book is just a running internal monologue about what she was thinking/feeling or circumstances surrounding her own life, rather than explaining the cases. It wasn't a bad thing; it was just very unexpected, and it did get to the point that it was overbearing.
The third reason for the low rating was because the author was just so out of touch with the people she was interviewing.
You can tell she grew up in the middle class on the coast. Some of the things she said, the places she named, just spoke of such privilege. I also grew up in a middle-class family, but I also grew up in the Midwest.
I thought perhaps it was just me overanalyzing, but I've seen some of the other reviews left, and others came to the same conclusion that I did. Lewis put way too much value on the things that the convicts told her. She repeatedly overanalyzes the mispoken words and contradictions of her interviewees. However, it seemed to me that she completely ignored the fact that 1) people in different parts of the country (specifically, the South and Midwest) have a tendency to speak with their own colloquialism, that doesn't always fit into the standards of "correct" English linguistics; and 2) two seemingly contradictive statements aren't necessarily unnoticed by the person speaking them.
Granted, there were times when the interviewee very clearly contradicted themselves. They obviously were not paying attention to what was coming out of their mouths. In those cases, I would put less credibility on the interviewee's story (which Lewis did not do), because obviously the discrepancies could stem from half-assed stories and excuses. Lewis took her interviewees at their word, and I feel like that was a mistake.
But often, I feel like she just misunderstood what the convict was telling her. There were moments that contradicting statements were made that made sense to me, but they went right over Lewis' head. Instead of looking deeper into the words being said, to understand the meaning beneath them (because who, even in their right mind, just comes out to honestly answer private, secret things?), Lewis just took the words at face-value, at surface-level analysis, and then was confused when the ideas didn't line up in the most base interpretation of them.
But as Lewis mentions in the book, she has limited amounts of time to conduct her interview. Perhaps that is why she doesn't seem to really dig deeper into the stories she is told, and analyze more critically the way the stories are told to her.
But as Lewis also mentioned, hurrying is the biggest downfall of an interview; and despite saying multiple times that she knew "hurrying" would be a big mistake, she repeatedly hurried through interviews and analyses to get the information that she wanted, rather than listening for the information that each interviewee actually provided.
Now that I've gotten that out of the way.
I picked this book up with the knowledge that Dr. Lewis had examined Ted Bundy shortly before his death. She was the only person to ever admit that he was insane, and so I hoped for a deeper look into the details of that. I was also hoping for a bit more detail about his confessions, since the three books I've read about him don't really delve that deeply into his confessions.
That was not the point of this book.
So, because of that, I feel a little bit mislead. Part of the low rating is because I feel that, despite the description of the book naming other killers, it seems that Bundy's name was somewhat "dropped" in to generate interest in this book, when in fact he hardly played a role in it at all.
The second reason for the low rating is because this seemed to be more of an autobiography than anything else. At the least, I was expecting more stories about the convicts she spoke with and the people she has treated. Instead, about half of the book is just a running internal monologue about what she was thinking/feeling or circumstances surrounding her own life, rather than explaining the cases. It wasn't a bad thing; it was just very unexpected, and it did get to the point that it was overbearing.
The third reason for the low rating was because the author was just so out of touch with the people she was interviewing.
You can tell she grew up in the middle class on the coast. Some of the things she said, the places she named, just spoke of such privilege. I also grew up in a middle-class family, but I also grew up in the Midwest.
I thought perhaps it was just me overanalyzing, but I've seen some of the other reviews left, and others came to the same conclusion that I did. Lewis put way too much value on the things that the convicts told her. She repeatedly overanalyzes the mispoken words and contradictions of her interviewees. However, it seemed to me that she completely ignored the fact that 1) people in different parts of the country (specifically, the South and Midwest) have a tendency to speak with their own colloquialism, that doesn't always fit into the standards of "correct" English linguistics; and 2) two seemingly contradictive statements aren't necessarily unnoticed by the person speaking them.
Granted, there were times when the interviewee very clearly contradicted themselves. They obviously were not paying attention to what was coming out of their mouths. In those cases, I would put less credibility on the interviewee's story (which Lewis did not do), because obviously the discrepancies could stem from half-assed stories and excuses. Lewis took her interviewees at their word, and I feel like that was a mistake.
But often, I feel like she just misunderstood what the convict was telling her. There were moments that contradicting statements were made that made sense to me, but they went right over Lewis' head. Instead of looking deeper into the words being said, to understand the meaning beneath them (because who, even in their right mind, just comes out to honestly answer private, secret things?), Lewis just took the words at face-value, at surface-level analysis, and then was confused when the ideas didn't line up in the most base interpretation of them.
But as Lewis mentions in the book, she has limited amounts of time to conduct her interview. Perhaps that is why she doesn't seem to really dig deeper into the stories she is told, and analyze more critically the way the stories are told to her.
But as Lewis also mentioned, hurrying is the biggest downfall of an interview; and despite saying multiple times that she knew "hurrying" would be a big mistake, she repeatedly hurried through interviews and analyses to get the information that she wanted, rather than listening for the information that each interviewee actually provided.
May 7, 2019
Though I did not finish this book I would like to give my thoughts on the parts I did read. I picked this book with the assumption that it would be similar to the show Criminal Minds, as it turns out the book was far too scientific for me to enjoy. This book is a nonfiction account of murderers and other criminals. I liked that this book was extremely raw and unfiltered in telling the stories of all the criminals. However, the terms were far too advanced for me, a mere civian, to fully understand. This book is probably more appropriate for college students looking to get into the field of criminal justice who are equip with the basics of psychology and the legal process. I hope that at later point in my life I can try to read this again.
November 26, 2015
Excellent but very disturbing book about how serial killers are made. Otnow, an experienced psychiatrist presents some very controversial theories, but psychiatry is considered a "soft" science for a reason. Her findings of DID in death row inmates are too significant to be ignored, yet I suspect any changes in treatment and legal outcomes from this research won't materialize quickly, if at all. I'm not convinced that this information was obtained by following a scientific model, but I didn't get the feeling that this book was intended as scientific proof for her theories. I felt it was more a personal quest trying to understand the capacity for violence that exists in all of us, but is more pronounced in certain individuals. In her search she came across brain injuries, undiagnosed mental illness and childhood histories of profound and sustained physical, mental, and sexual abuse in the men and women she interviewed on death row. My own experience in forensic psychiatry mirrors Otnow's in case histories. However, in 15 years of psychiatric nursing practice I didn't treat a single individual with multiple personalities. But that's not to say those patients don't exist. As Otnow showed, patients are often completely unaware of the personality changes themselves, and every single psychiatrist I worked with felt it is a bogus disorder. If you don't believe something exists, you aren't likely to go looking for it. When I started my training, scientists still believed that the brain was an easily injured organ with no capacity for change or repair. Since then we found evidence of a marvellous thing called "neuroplasticity", and with it a humbling new understanding that when it comes to the brain and our psyche, we have been wrong for a long long time. We know far less than we ever thought we did. So I want to keep an open mind, and read more about dissociative disorders. But one thing I know for sure after reading Otnow's fascinating book: Mental illness and brain injuries not withstanding, Violence begets violence, no matter who you are.
March 3, 2021
Congratulations to the Author very well written and a little spooky though.
This book keeps you on the edge. I keep on wanting more. Five star *****
Warm Regards Robert Sherriff. Here is my theory as an uneducated man who only went to grade three.
These losers craved love as a child and they were rejected, they were bullied at school.
From an early age they could see the pain they were inflicting.
There was never any moral up bring God Church Faith. No friends.
Homosexual, lesbian Someone who hates the world.
Someone who wanted to be famous.
Someone who wants to be remembered for their evil acts of KILLING A 'PRESIDENT'?.
The problem America has IS NRA America needs a President to stand up to NRA.
How many more school shootings?320 million Americans.600 million guns.
The problem America has it is fascinated by death.
Understandable with someone like Trump who preached hate who should of been charged with murder and treason.
The press has to take 60% of the blame as the next killer might be reading your books or newspapers at this present moment.
You by naming them and talking about their crimes this then is sending a message on how far will the next guy go? go? go? go?
Then you have all different Races?
Is Mr Biden doing a good job?
Who will be President in 2024? you have already killed four 1865, 1881, 1901, 1963.
Was the mother a drug user? Ice
Was the Father a drug user? Ice
Was the child a drug user? Ice
Was alcohol a major problem?.
Did this child fantasise about killing?
Started killing mice, birds and animals?
Did this child run along the dark streets at night?
Or was this child just born evil?
Was this child sexual abused?
Has this child ever been caught self-mutilating Sexual fantasies ?
Stole lunch money? Stealing?
Political correctness?
In front of TV all day computer?
Games W-fi?
IF THIS IS SOMEONE YOU KNOW? RUN. Robert Sherriff. robtsherriff871954@gmail.com
This book keeps you on the edge. I keep on wanting more. Five star *****
Warm Regards Robert Sherriff. Here is my theory as an uneducated man who only went to grade three.
These losers craved love as a child and they were rejected, they were bullied at school.
From an early age they could see the pain they were inflicting.
There was never any moral up bring God Church Faith. No friends.
Homosexual, lesbian Someone who hates the world.
Someone who wanted to be famous.
Someone who wants to be remembered for their evil acts of KILLING A 'PRESIDENT'?.
The problem America has IS NRA America needs a President to stand up to NRA.
How many more school shootings?320 million Americans.600 million guns.
The problem America has it is fascinated by death.
Understandable with someone like Trump who preached hate who should of been charged with murder and treason.
The press has to take 60% of the blame as the next killer might be reading your books or newspapers at this present moment.
You by naming them and talking about their crimes this then is sending a message on how far will the next guy go? go? go? go?
Then you have all different Races?
Is Mr Biden doing a good job?
Who will be President in 2024? you have already killed four 1865, 1881, 1901, 1963.
Was the mother a drug user? Ice
Was the Father a drug user? Ice
Was the child a drug user? Ice
Was alcohol a major problem?.
Did this child fantasise about killing?
Started killing mice, birds and animals?
Did this child run along the dark streets at night?
Or was this child just born evil?
Was this child sexual abused?
Has this child ever been caught self-mutilating Sexual fantasies ?
Stole lunch money? Stealing?
Political correctness?
In front of TV all day computer?
Games W-fi?
IF THIS IS SOMEONE YOU KNOW? RUN. Robert Sherriff. robtsherriff871954@gmail.com
April 27, 2019
I just finished reading "Guilty by Reason of Insanity: A Psychiatrist Explores the Minds of Killers" By Dorothy Otnow Lewis, MD. It's a 1998 book that had somehow escaped me before now. An excellent, excellent book. It’s very accessible--she writes about an incredibly difficult subject with a dry humor, empathy, and an incredible lack of judgment about people who live lives and do things most of us do not want to contemplate.
She writes about what she's learned from a lifetime of interviewing violent criminals, many of them on death row. And guess what? (A spoiler?) Virtually if not all men she interviewed had massive neurological problems (often caused by violent injuries) and unimaginably brutal childhoods, coming from generation after generation of abuse.
When we hear about the terrible tragedies in our communities, including the 5-year-old that was murdered by his parents in Crystal Lake this week, we are all horrified. As the details come out, it's clear that his short life was brutal and full of fear and violence. For the far too many children who survive these childhood environments and make it to adulthood, what do we expect to happen to them? Do we expect them to be contributing members of society who do not fill our prisons or land up on our Social Security Disability rolls due to addiction/health problems/mental health issues? Not that some people do not surmount terrible environments...but can we truly blame them if they can't/don't?
She writes about what she's learned from a lifetime of interviewing violent criminals, many of them on death row. And guess what? (A spoiler?) Virtually if not all men she interviewed had massive neurological problems (often caused by violent injuries) and unimaginably brutal childhoods, coming from generation after generation of abuse.
When we hear about the terrible tragedies in our communities, including the 5-year-old that was murdered by his parents in Crystal Lake this week, we are all horrified. As the details come out, it's clear that his short life was brutal and full of fear and violence. For the far too many children who survive these childhood environments and make it to adulthood, what do we expect to happen to them? Do we expect them to be contributing members of society who do not fill our prisons or land up on our Social Security Disability rolls due to addiction/health problems/mental health issues? Not that some people do not surmount terrible environments...but can we truly blame them if they can't/don't?
January 8, 2019
I was given this book as a gift from a friend who knows Dr Lewis, with the added remark of “this was written by Ted Bundy’s psychiatrist!” Being as interested in true crime as I am, I started reading the book almost the moment it was safely back at my house. I have since learned that Dr Lewis is truly so much more than “Bundy’s psychiatrist.”
This book did not disappoint. Every three chapters or so is a different story, none being as well known as the infamous Bundy, but, to me at least, each vastly more interesting than the last. I looked forward to reading about Marie Moore and Johnny Garrett’s cases, as well as the several other studies that were documented in this book. Dr Lewis gives insight into not only what methods are used to diagnose death row inmates, but also how those methods have changed over time. Her book is a record of how psychiatric practice, and her own methods, have changed over time, and it’s absolutely fascinating.
I never got bored while reading this book. Dr Lewis is witty and well spoken, and her writing style flows so smoothly that I never once felt like I was caught off guard, even as the book occasionally jumped between case recountings and, at the time of publishing, more present day events.
Overall, I fully enjoyed reading this and would recommend it to any true crime fan looking for more information about the psychology of criminals.
This book did not disappoint. Every three chapters or so is a different story, none being as well known as the infamous Bundy, but, to me at least, each vastly more interesting than the last. I looked forward to reading about Marie Moore and Johnny Garrett’s cases, as well as the several other studies that were documented in this book. Dr Lewis gives insight into not only what methods are used to diagnose death row inmates, but also how those methods have changed over time. Her book is a record of how psychiatric practice, and her own methods, have changed over time, and it’s absolutely fascinating.
I never got bored while reading this book. Dr Lewis is witty and well spoken, and her writing style flows so smoothly that I never once felt like I was caught off guard, even as the book occasionally jumped between case recountings and, at the time of publishing, more present day events.
Overall, I fully enjoyed reading this and would recommend it to any true crime fan looking for more information about the psychology of criminals.
December 12, 2020
Right up my alley
For me this book addressed one of the questions I have been fascinated about as far back as I can remember. I have always wanted to know why people do what they do. The one thing I
enjoyed most about this book is the authors willingness to talk about herself in personal term and not just as an observer. Having worked for many years with psychiatrists and lawyers I found it refreshing to hear a psychiatrist willing to talk about her own limitations as well as her willingness to discuss the reality that her real knowledge came through her experience and not just as a result of her education. I praise her for giving a realistic view of what it is like to work in the world of the judicial system and how that system and others like it,are only as good as the people in charge. She was able to show that often those individuals make decision about other peoples lives based often on their own biases or based on outside influences that might affect their own futures. For me this was a look at how the real world works and how limited our societies knowledge of mental health issues is and has been during my lifetime. I wish there were more mental health professionals like the author of this book.
For me this book addressed one of the questions I have been fascinated about as far back as I can remember. I have always wanted to know why people do what they do. The one thing I
enjoyed most about this book is the authors willingness to talk about herself in personal term and not just as an observer. Having worked for many years with psychiatrists and lawyers I found it refreshing to hear a psychiatrist willing to talk about her own limitations as well as her willingness to discuss the reality that her real knowledge came through her experience and not just as a result of her education. I praise her for giving a realistic view of what it is like to work in the world of the judicial system and how that system and others like it,are only as good as the people in charge. She was able to show that often those individuals make decision about other peoples lives based often on their own biases or based on outside influences that might affect their own futures. For me this was a look at how the real world works and how limited our societies knowledge of mental health issues is and has been during my lifetime. I wish there were more mental health professionals like the author of this book.
July 30, 2022
Seldom you find non-fiction books which leave you speechless, shaken, disturbed to say the least. The book takes you on a journey of one such unchartered territory. The author describes actual case studies involving juvenile / adult death row inmates where insanity defense was part of the public records.
The author over her 25 years of practice evaluated dozens of such cases and thus multiple times clarifies that murderers are not born but made. Damage to certain part of the brain and traumatic experiences in childhood leads to paranoid impulsiveness, extreme emotions specially rage and thus dire outcomes which may not always be in control of the offender.
One question raised by the author made me think hard. “When you read about witches being burned at the stake, do you identify with the witch or with the people looking on”. Judges, lawyers, doctors and law enforcers dealing with serious crimes have to live with this predicament every day. Do they support a conviction when they aren’t absolutely sure or they acquit and run the risk of the individual committing more horrendous crimes? I don’t know the answer myself.
A word of caution that the descriptions in the book are not suitable for everyone but indeed is an eye opener.
August 31, 2022
Netflix is full of documentary series about serial (and all other kinds of) killers. What attracts people to this topic? Is it the gruesomeness of the crimes? The more details the better? Or is it the reasons behind the awful felony? Why on earth would anyone ever do that?
Let's deep dive even further, "could any one of us become a murder? Could anyone in the world become murderer?" Well... Dr. Lewis introduces her reasons for a 25 year long research on the delinquents. "Most people don't realize that the United States has a death penalty for juveniles", neither did I. Hence, to get into the legislative system's back stage from a perspective of a psychiatrist was interesting to tell the least. The cases she has studied are discussed in detail and gives an outlook on how "serial killers are not born, they are made".
Lot's of medical terminology, lots of passion for the topic and the fuming frustration towards injustice in death row trials. This book really grabbed my attention.
So what did I take from this book to myself?
How on earth could we fix the society in a way that serial killers would no longer be made? How can we protect our children from becoming monsters?
Let's deep dive even further, "could any one of us become a murder? Could anyone in the world become murderer?" Well... Dr. Lewis introduces her reasons for a 25 year long research on the delinquents. "Most people don't realize that the United States has a death penalty for juveniles", neither did I. Hence, to get into the legislative system's back stage from a perspective of a psychiatrist was interesting to tell the least. The cases she has studied are discussed in detail and gives an outlook on how "serial killers are not born, they are made".
Lot's of medical terminology, lots of passion for the topic and the fuming frustration towards injustice in death row trials. This book really grabbed my attention.
So what did I take from this book to myself?
How on earth could we fix the society in a way that serial killers would no longer be made? How can we protect our children from becoming monsters?
July 18, 2014
Concise, relatable, compassionate, and definitely one of the best books I've read on the subject. Lewis is unique in her analysis because, unlike many psychiatrists, she is not afraid of relating to the killers. She sees them as humans rather than animals. The cases she documents are also fascinating. The controversial multiple personality disorder was found in many of her patients and she closely interviews many who have suffered from it. Lewis does have a tendency to unnecessarily dramatize scenes but that can be looked past.
Lewis's ultimate conclusion is that saying one is "not guilty by reason of insanity" is ludicrous. It is impossible to find a person who doesn't suffer from mental conditions/past trauma that will commit murder. Even a state executioner, who she interviews, suffers from mental conditions. The book is very much against the death penalty, and it has convinced me to be the same.
Lewis's ultimate conclusion is that saying one is "not guilty by reason of insanity" is ludicrous. It is impossible to find a person who doesn't suffer from mental conditions/past trauma that will commit murder. Even a state executioner, who she interviews, suffers from mental conditions. The book is very much against the death penalty, and it has convinced me to be the same.
August 18, 2012
Well written and interesting. I thought this book would be broken into chapters based on the killers and interviews from them. It was, but in a unexpected way. It was not grotesque like I expected. It read like a novel and was a easy read. She discussed why and how she went into the work of studying violence. I like that the author did not omit herself from the book. A very controversial subject matter- death row and how we handle criminals who are indeed insane - done in a very tasteful and thought provoking way. If you are looking for another random book on WHAT murders were committed and HOW this is not the book for you, however there are a insane amount of them out there. If you are interested in why these violent acts occur than read on.
I bought this book at either a library book sale for pennies, or the goodwill.
I bought this book at either a library book sale for pennies, or the goodwill.
December 4, 2012
An interesting book by a psychiatrist who studies people on death row. She often consults with their defense attorneys, presenting mitigating factors to judges & juries. At least from her perspective, pretty much all of these types of murderers are seriously psychologically damaged. At least from her sample, most are subject to horrible neglect & abuse as children. She talks about several who are so severely abused that they suffer from multiple personality disorder (book was written in 1998, before the term was changed to dissociative identity disorder). I'm not the biggest fan of the death penalty (it doesn't exactly deter crime), so this was a strong argument that it's pretty useless & usually doesn't take into account the mental illnesses of perpetrators. At least the ones she talks about. Pretty good.
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