When Chicago forensic psychiatrist Carl Wahlstrom was asked by defense attorneys to evaluate a sex offender pleading “guilty but insane” to a multiple murder charge, the request should not have been an unusual one. An instructor at Rush-Presbyterian-St. Luke’s Medical Center, Wahlstrom is an authority on mentally disordered criminals, and regularly evaluates alleged offenders at the Psychiatric Institute attached to the Circuit Court of Cook County. But this particular defendant was no garden-variety criminal–he had already earned an undisputed slot in the forensic hall of fame, his crimes the stuff of grisly legend.
Chris Dickinson: At what point did you develop this interest in the criminally mentally disordered?
CW: The public, and I’ll include myself in that, is very frightened about someone like Jeffrey Dahmer being out on the street. Really, the trial was about what building does he go to. Should he be treated in a mental hospital, or should he be put in a prison and attempted to be treated there? Because certainly there is psychiatric treatment that goes on in prison. It’s of variable quality; sometimes it’s quite good and sometimes it’s not. Usually more intense psychiatric treatment is going on in a mental hospital. Just because someone is mentally ill certainly doesn’t qualify him for the insanity defense. Illinois has something called “guilty but mentally ill,” so they recognize someone has a mental illness. They want to bring that to the attention of prison officials so they will get treatment in prison, but it’s not been seen in the trial itself that there is a connection between that mental illness and the crime itself.
CD: Concerning the interface between psychiatry and the law, in the Jeffrey Dahmer trial, prosecutor E. Michael McCann read an early statement by Dahmer that sounded very normal. He then asked you if that sounded like a psychotic person. How do you deal with the adversarial nature of cross-examination, having to answer yes or no to complicated questions?
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CW: Naturally, vigorous cross-examination is going to make me uncomfortable. If it doesn’t, the person cross-examining me is probably not doing his job. However, an expert is not ordinarily restricted to answering just “yes or no.” So that can allow you to elaborate and say things that might be objected to, but nonetheless to elaborate. So when someone reads a short statement and says “Does this sound psychotic?” that statement taken out of context may sound very rational. The public view of someone who is psychotic may be a disheveled person screaming on the street, they don’t stop for 24 hours a day, they’re completely dysfunctional. That’s more in a textbook, or an extremely rare, case. Most people that have even severe mental illnesses are not dysfunctional in every aspect of their lives. Many work, get up in the morning, they dress, they shower, they watch TV, they read the newspaper. They may become psychotic only during periods of severe stress. I think Jeffrey Dahmer had both borderline personality and schizotypal personality disorder. Part of the characteristics of those disorders is that under severe stress someone can become psychotic, and that could be an internal or an external stress.
CD: Before you first met with Jeffrey Dahmer, when you looked through all the paperwork, did you form any opinion or were you keeping it as open as possible?
CD: Do you think that if Jeffrey Dahmer had been examined a few years earlier, when he was given the option of psychiatric treatment after his arrest for child molestation, would someone have recognized how serious his problem was?
