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1 Michael T. Wiltsey, Ph.D. Elliot L. Atkins, Ed.D.
Borderline Personality Disorder & Murder Michael T. Wiltsey, Ph.D. Elliot L. Atkins, Ed.D.

2 Borderline Personality Disorder & Murder
Over the years, we have observed a noticeable percentage of defendants in murder cases having BPD or traits. Began to Wonder, What are we seeing? Why have we seen BPD/Traits as Often as we Have? What is the connection between BPD and Murder? In such Cases, BPD can help us understand the Murder and is informative in reference to several forensic questions.

3 Borderline Personality Disorder & Murder
Workshop Objectives: Review BPD Characteristics and Describe the Connection with Emotions that Motivate Murder Identify and Describe the Type of Murder Most Often Associated with Individuals with BPD Discuss the Relevance of this Topic to Forensic Clinicians and Attorneys Demonstrate the Connection between BPD Characteristics and Murder and How it Can Help Explain the Psychological Factors that Contributed to the Homicidal Behavior in Sentencing Evaluations

4 Characteristics of Borderline Personality Disorder
DSM-IV-TR CRITERIA A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: (1) Frantic efforts to avoid real or imagined abandonment. (2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation (3) Identity disturbance: markedly and persistently unstable self-image or sense of self (4) Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Let’s start by reviewing the DSM-IV-TR criteria for BPD. DSM-IV-TR (2000)

5 Characteristics of Borderline Personality Disorder
DSM-IV-TR CRITERA (CON’T) (6) Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). (7) Chronic feelings of emptiness. (8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). (9) Transient, stress-related paranoid ideation or severe dissociative symptoms. DSM-IV-TR (2000)

6 What is the Connection Between BPD and Murder?
Why do People Kill? “Though we may like to think that murderers are either pathological misfits or hardened criminals…the vast majority of murders are committed by people who, until the day they kill, seem perfectly normal.” David Buss (2005) In our experience, the murderers we have seen with BPD traits have rarely been violent in the past, and most have had either no criminal record one without any violent crime charges. For many of them, the murderous act seemingly comes out of nowhere. David Buss’ book, The Murderer Next Door, describes the evolutionary underpinnings of murder and presents the thesis that all humans are capable of murder given the right set of circumstances. For individuals with borderline personality disorder who commit murder, the psychopathology that defines the disorder can assist the court in understanding the totality of those circumstances.

7 What is the Connection Between BPD and Murder?
Emotions often Motivate Murder Jealousy Fear Hate Anger/ Rage Rejection Depression/Hopelessness Embarrassment (Self-Image) Combination of Emotions At the basic level of our understanding of motives for murder are the emotions that can drive murderous behavior.

8 Borderline Personality Disorder & Murder
DSM-IV-TR Cluster B Personality Disorders Referred to as the dramatic or erratic disorders Borderline Narcissistic Antisocial Histrionic Such disorders are best explained as disorders of emotion dysregulation, anger, stress reactivity and aggression. So….. And so, turning back to the DSM for guidance, we find that BPD falls within the Cluster B personality disorders. DSM-IV-TR (2000)

9 What is the Connection Between BPD and Murder?
If BPD is best explained theoretically as a disorder of emotion dysregulation, anger, stress reactivity and aggression… Then perhaps these individuals are more prone to have difficulty controlling/regulating... the emotions that often motivate murder.

10 Motivational Spectrum in the Classification of Homicide (Schlesinger, 2004)
Degree of Stimulation External (Sociogenic Factors) Internal (Psychogenic Factors) In order to understand what type of homicides most relevant to our discussion on BPD, we turn to the motivational spectrum of homicides offered by Schlesinger (2004). According to Schlesinger, “The motivational stimuli leading to a homicide is viewed as falling along a spectrum or continuum. On the one end of that continuum are murders that occur due mostly to external or sociogenic factors. On the opposite end are murders that occur mostly due to internal or psychogenic factors. The murder typeologies are divided into environmental, situational, impulsive, catathymic, and compulsive. Based on Schlesinger’s classification theme, as the motivation for murder moves along the continuum from environmentally stimulated offenses to compulsively stimulated offenses, external factors play less and less of a role. The compulsive murderer (serial murderer) is almost completely motivated by internal or psychogenic factors, whereas the environmentally stimulated murder is mostly influenced by external (sociogenic) factors, with internal (psychogenic) factors playing a minimal, if any role. To understand these murder types more clearly, let me further explain how Schlesinger (2004) conceptualizes each of these. Environmental = murder consists of socially influenced homicides, promoted by a sub-culture that supports the use of violence and murder to achieve goals. Examples include gang/drug murders, murders for profit, contract killing, and war. Situational = homicides result from intense feelings of stress influenced by a specific set of circumstances present at a given time. “Feelings of despair, helplessness, depression, fear, and anger are highly stressful, especially when chronic, and can trigger murders under the right set of conditions. Situational murders include a wide range of offenses, such as domestic homicides committed during arguments, some of which are premeditated and others of which are spontaneous.” These murders as most common type, 70-75% of all murders. According to Schlesinger (2004) Most situational murderers have no psychiatric history or current diagnosis, likely have never behaved violently in the past, and often have no criminal histories. Impulsive = homicides are committed by individuals with impulsive lifestyles characterized by no direction, randomness of action, and general unpredictability. Differentiated from situational by the multiplicity of minor anti-social acts in their background. They are not driven to commit an offense, they simply overreact to circumstances. Such individuals, according to Schleshinger, discharge inner tension through action because of their difficulty with modulating emotions. Homicides are poorly planned, poorly structured, and partially, if at all premeditated. Catathymic = Catathymic murder is often a sexually motivated murder. It serves the function of an affective catharsis, fueled by an underlying sexual conflict in which the victim is perceived as a threat to ego. Typically, the victim stimulates feelings of sexual inadequacy in the perpetrator, yielding an explosive homicidal revenge followed by psychic relief. Broken down into two subtypes – Acute and Chronic. Acute Catathymic – sudden aggressive act triggered by an individual whom the perpetrator has just met. Catathymic dynamics tap deeper sources of emotional conflict, almost always involving strong feelings of inadequacy extending into the sexual arena, which, when released, overwhelm the offenders controls and result in a violent outburst. Chronic Catathymic – three stages. Incubation, violent act, relief. These murders often occur within the framework of an intimate relationship which disrupts the offenders psychological stability. The offender often perceives the victim’s behavior as a threat to his ego and sense of self, resulting in extreme internal psychic tension. This begins the incubation period, which can be several days to a year or more, during which time the offender becomes obsessively fixated with future victim. The offender determines that violence is the only solution to the severe internal tension. The conflict usually involves strong feelings of inadequacy extending into the sexual area. Once the murder takes place, it is followed by a tremendous sense of relief. Compulsive murderers are driven by an internal irresistible urge to kill, providing a thrill comparable to that of sexual gratification. Whereas catathymic murderers typically do not repeat their acts, compulsive murders—also known as serial killers—have psychic insatiation. Thus they need to repeatedly commit their characteristic acts of torture and sexual deviancy as a means of controlling their victims, which provides them with a sexual euphoria. DIFFICULTY in differentiating CATATHYMIC resulting from deeper more complex psychological factors, from severe violence that is the result of anger and loss of control, as in SITUATIONAL homicides. Schlesinger argues that before a conclusion can be reached that an individual experienced a catathymic explosion, the offender and offense must be carefully evaluated, so that the depth of the individuals inner conflict and the triggering event can be fully understood. Environmental Situational Impulsive Catathymic Compulsive

11 Borderline Personality Disorder & Murder
Is there a certain type of murder associated with BPD? Catathymic Murder – Emotional/Psychic Tension Builds resulting in Murderous Act Acute and chronic forms. Chronic Catathymic Murder has been conceptualized as being related to violent disorders of attachment (Meloy, 1992) Three Stages: Incubation period marked by a mix of anxiety and depression intertwined with homicidal-suicidal thoughts A sudden explosive homicidal act Psychic and emotional relief Meloy (1992) Catathymic violence has a distinguished history in the forensic psychiatric literature but is a term generally unknown to most contemporary clinicians. It occurs in an acute and chronic form. The latter form is most germane to violent disorders of attachment, and is marked by three characteristics: an incubation period in which anxiety and depression are intermingled with homicidal-suicidal thoughts concern an intimate; a sudden explosive homicidal act; and emotional relief. The mode of violence is clearly affective, but there may be an extended period of planning and preparation, usually months to a year that has certain ego syntonic or ego dystonic aspects. The former may qualify for a predatory mode of violence. Catathymic homicide necessitates a borderline or psychotic personality organization, The central defense for understanding this form of violence is projective identification, in which the perpetrator attributes increasingly malevolent and controlling characteristics to the symbiotic partner. The relief following the violence has both a physiological and psychodynamic basis. It marks the end of a disruptive symbiotic attachment, which probably had its roots in early attachment pathology.

12 Catathymic Murder Wertham (1937) 8 Stage Model
1st Stage - Murderer develops continual emotional tension after experiencing a perceived psychological insult that he is unable to discharge. 2nd Stage - In an attempt to discharge the internal tension, the murderer projects blame for the tension onto the victim. 3rd Stage – The murderer becomes extremely self-centered in thoughts/behavior. 4th Stage - Idea develops that the only manner in which to resolve the intense internal tension is suicide or murder. 5th Stage – Extended period of ambivalence about whether to act on this idea, ending with an attempted or completed murder. 6th Stage – Instantly after the violence, the internal tension is released with the murderer experiencing an intense feeling of relief without insight as to why. 7th Stage – Murderer appears to return to normal functioning absent the emotional tension. 8th Stage – Over time, the murderer develops a more stable cognitive and emotional state, accompanied by increased insight. Provides the best explanation of sudden homicidal acts that seemingly occur without warning. According to Revistch and Schlesinger (1981), the term catathymia has its orgin in Greek language which translates to mean “in accordance with emotions.” Hans Maier (1912) first introduced the term catathymia in an effort to explain delusional thought content related to underlying, unresolved emotions This description is similar to that of an individual with borderline personality disorder when they engage in relationship damaging behaviors and fluctuate between idealizing and devaluing an interpersonal relationship. Meloy (1992) explains catathymic murder as that which represents an abrupt, unexplainable murder of an intimate partner. Such murders, according to Meloy (1992) fail to reveal an obvious motive and appear senseless. The offenders of such murders most often have no prior history of violence. Most significantly, following the murderous act, the offender expresses a sense of relief. Revitch and Schlesinger (1981) proposed that the catathymic crisis begins with an ego-threatening relationship. As the ego is threatened, it can result in the activation of some unresolved and conflicted sexual feelings. It may also cause the displacement of certain unpleasant emotions onto the victim from another person representing a symbolic meaning. Further, feelings of helplessness and confusion exacerbate the catathymic crisis. Chronic catathymic violence is divided into three stages (Revitch and Schlesingers (1981), consisting of incubation, violent act, and relief. The incubation period associated with these murders is much longer and can last from several days to over a year. These offenders become fixated and obsessed with their future victim. They experience a range of emotions, including depression, frustration, and helplessness. Depression is the predominant emotion during the incubation period. Furthermore, there is an awareness of the building of psychic tension. These individuals begin to fantasize about murder, and fluctuate between the desire to commit murder against the perceived object of their tension, and the desire to commit suicide. Most often, the homicidal desires are considered to be ego-dystonic. As a result, the offender will attempt to push these thoughts and fantasies out of conscious awareness, which of course is unsuccessful. In chronic catathymia, the victim is usually known to the offender, and most often represents a strong emotional attachment. In many cases, the victim and offender were involved in an intimate relationship, and may involve jealousy or rejection.

13 Emotional Dysregulation Dysregulation in Interpersonal Relationships
Is there something about the Borderline Personality Organization that makes this individual predisposed toward this type of murder? Linehan (1993) Conceptualizes individuals with BPD as those who experience severe dysregulation in multiple areas of their lives: Emotional Dysregulation Dysregulation in Interpersonal Relationships Behavioral Dysregulation Cognitive Dysregulation Dysregulation of the Sense of Self

14 Borderline Personality Disorder & Murder
What is the relevance of BPD and Murder to the Forensic Clinician? Examining a Defendant for BPD/Traits If Present, MAY help explain the murder from a psychological perspective. Ultimately, this is what society wants to know – WHY?

15 Borderline Personality Disorder & Murder
What is the relevance of BPD and Murder to the Forensic Clinician? Assessment of Criminal Responsibility Plea Bargaining Charge Bargaining Sentence Bargaining Sentencing Evaluations Melton et al. (2007) state that there are two types of plea bargaining, both of which can occur in the same case. Charge bargaining involved the def. pleading guilty to one charge in exchange for which the prosecutor agrees to dismiss or reduce other charges. In the second, Sentence bargaining, the defendant pleas guilty to the original charge in exchange for the prosecutors recommendation of a reduced sentence. Assessment of Criminal Responsibility Plea Bargaining Charge Bargaining Sentence Bargaining Sentencing Evaluations Capital Sentencing Risk Assessment The article we are preparing will cover all of these areas in more detail. However, for the presentation today, we will touch briefly on criminal responsibility, but spend most of our time talking about the area we believe is most relevant to this topic, and where most of our work in this area has been done, Sentencing Evaluations.

16 Borderline Personality Disorder & Murder
CRIMINAL RESPONSIBILITY Defense of These Cases May be Difficult Insanity Defense - might apply depending on specifics and jurisdiction Pleas of insanity usually rejected in such cases based on (Schlesinger, 2007): Psychosis not straightforward Jury does not entirely understand the relevance of dissociative symptoms Jury often associates the obsessive thoughts concerning the victim with premeditation

17 Borderline Personality Disorder & Murder
CRIMINAL RESPONSIBILITY As Meloy (1992) suggests, however, it is important for the forensic clinician to determine if the offender was experiencing psychosis at the time of the catathymic murder. As a borderline patient decompensates, there is a potential for psychotic symptoms to emerge. The presence of a marked disturbance in sensory perception and reality testing, indicated by disordered thought, delusions, and/or hallucinations, in the absence of major mental disorder, would be appropriately diagnosed as Brief Reactive Psychosis (298.80) (Meloy, 1992)

18 Borderline Personality Disorder & Murder
SENTENCING EVALUATIONS David Goldberger, Ohio State University Law Professor, states: “The jury and judge must be made to understand what caused a crime, particularly in homicides…It is the role of psychiatry and related professions to provide that understanding so a rational approach to a penalty can be taken.” Bonnie (1979): “The law seeks to make the difficult moral distinction between “a person who has chosen evil” and “the person whose homicidal behavior arose from significant impairment in his normal psychological controls.” (Melton et al., 2007, p. 297) James Podgers (1980) “The Psychiatrist’s Role in Death Sentence Debated” in American Bar Association Journal December, 1980, Volume 66

19 Borderline Personality Disorder & Murder
SENTENCING EVALUATIONS Role of MHPs in Sentencing Evaluations Explain the way in which the offender differs from stereotypical views the court might have about individuals convicted of certain offenses. Assist the judge or jury in understanding the psychological underpinnings that contributed to an offender’s inability to control his behavior. (Melton et al., 2007)

20 Borderline Personality Disorder & Murder
SENTENCING EVALUATIONS Mitigating Factors Borderline Personality Disorder led to mental impairment which negatively affected the defendant’s capacity for judgment when the offense was committed As a result of his or her BPD, the defendant was under extreme mental or emotional distress The emotional and cognitive dysfunction characteristic of BPD caused the defendant to be substantially unable to appreciate the wrongfulness of his act or conform his act to the requirements of the law Melton et al. (2007)

21 Borderline Personality Disorder & Murder
SENTENCING EVALUATIONS Assessment of Culpability Situational Factors that contributed to the commission of the offense BPD – not really free choice Educate Judge or Jury about the Defendant’s Life in General, and about BPD in particular Melton et al. (2007)

22 Examining the Connection Between BPD and Murder
What characteristics of BPD can help explain the murder to the judge and jury in sentencing evaluations? Borderline Characteristics Dysfunction in Interpersonal Relationships Fear of Abandonment Dysfunction of Emotion Difficulty Regulating Anger Lack of Control Over-control Cognitive Dysfunction Behavioral Dysfunction Dysfunction of Sense of Self

23 Dysfunctional Relationships
Unstable, chaotic, intense relationships characterized by SPLITTING Splitting Dividing the world into all good or all bad Alternating between these two views as applied to their partner As a result, alternating between clinging and distancing behaviors Trust Issues Sensitivity to Criticism/Rejection Feeling like Needing Someone Else to Survive Significant Difficulty Ending Relationships Intolerance of Being Alone Fear of Abandonment Resort to Extreme and Frenzied Behaviors in Attempt to Hold Onto the Relationship Exacerbated when involved in unstable, negative relationships Distorted Perceptions of Relationships Fear of Abandonment, Englufment, Annihilation (DSM-IV-TR, 2000; Millon, 1987; Linehan, 1993; Zanarini et al., 1989)

24 Case Example – Dysfunctional Relationships
Unstable, chaotic relationships involving splitting “We were always on again, off again. She had this way about her. She could be fabulous – the best person in the world you would want to be with. Then, there would be times she would be an absolute bitch. But I just loved her so much, you know?”

25 Case Example – Dysfunctional Relationships
Fear of Abandonment “I felt that, somehow, I’d be left behind or abandoned. We were latchkey kids. We took care of ourselves. Both of our parents worked most of the time. We’d get ourselves off to school, since first or second grade. We came home at three; I had a key. My parents came home after six.”

26 Dysfunction of Emotion
Emotionally vulnerable Pervasive difficulties regulating negative emotions Extreme sensitivity to negative emotional situations Emotionally intense Slow return to baseline emotionality Low anxiety tolerance Shifts in Mood Lasting Only a Few Hours Anger, Inappropriate, Intense, Uncontrollable Subgroup of over-controlled hostility Emotional Responses are Highly Reactive Episodic Depression, Anxiety, Irritability (DSM-IV-TR, 2000; Millon, 1987; Linehan, 1993; Zanarini et al., 1989)

27 Case Example – Dysfunction of Emotion
Over-controlled Anger/Hostility “I know I didn’t express anger. It wasn’t like they told me not to, I just held my opinions in. I was afraid to say something to them, but I don’t remember them doing anything to actually incite that fear. I just didn’t want to rock the boat.“

28 Cognitive Dysfunction
Odd thinking/unusual perceptual experiences Cognitive distortions/ dysfunctional thinking Arbitrary inferences, over-generalizations, exaggeration of the meaning or significance of events, attribution of blame to oneself, attribution of blame to others, catastrophizing, hopeless and pessimistic predictions Polarized/dichotomous thinking (Splitting) – either/or rigid and contradictory points of view they are unable to synthesize (Foundation of DBT) Transient stress related paranoid ideation or severe dissociative symptoms Tends to be short lived and non-psychotic, can be quasi-psychotic Depersonalization, dissociation, delusions Occurs in times of severe stress Feeling out of it Not being able to remember what you said or did (DSM-IV-TR, 2000; Millon, 1987; Linehan, 1993; Zanarini et al., 1989)

29 Case Example – Cognitive Dysfunction
Dissociation When asked if she had pulled the trigger, she responded, “I don’t know. I can’t understand why I did it. I was so afraid. I had never been paranoid like that.”  A witness stated, “As I began to realize what had happened, I asked her ‘Do you realize what you did? You’re going to jail.’ She wasn’t looking at me. She was looking through me. She was not responding. After she did that, I don’t think she understood the act that she had just committed, or what she did. She thought we were just going to go to the hotel for the reception.”

30 Case Example – Cognitive Dysfunction
Dissociation “I don’t remember anything after the initial confrontation. The next morning, I woke up in the jail cell and remembered thinking, this is not real.”

31 Case Example – Cognitive Dysfunction
Dissociation “I’m in the back, leaning against the door. I just see him (the pastor), nothing else in the Church. He looked so small, so far away, like two inches high.“  She then goes on to describe a feeling “like there was no one else in the Church” and that she didn’t see anyone, including the victim.  “I walked to the back, then I walked down the side. Then all of a sudden, he was just sitting there. When I was walking down the aisle, I didn’t know he was there. I didn’t see anybody. It was like all of a sudden, he was just sitting there. I don’t know what happened.”

32 Case Example – Cognitive Dysfunction
Paranoid Thoughts “I got so scared. I was there alone. I thought he was going to come in at nighttime and do something to me. He has a martial arts background. I went and got my Beretta. I slept with my gun, but I didn’t fall asleep.”  ”Saturday, I was a mess. I sat in my bedroom with my gun in my hand. I was so scared. I didn’t sleep well Saturday night. I still had the gun with me.”

33 Behavioral Dysfunction
Poor Impulse Control Impulsive Behaviors that are Radical and Create Severe Problems for the Individual (e.g., spending, sex, substance abuse, shoplifting, reckless driving, binge eating, etc.) Recurrent Suicidal Threats, Gestures, or Behavior Self-Injurious/ Self-Mutilating Behaviors Self-Destructive Behaviors (DSM-IV-TR, 2000; Millon, 1987; Linehan, 1993; Zanarini et al., 1989)

34 Case Example – Behavioral Dysfunction
Impulsive, Self-Destructive, & Suicidal Behavior “The results of psychological testing are also consistent with Mr. Smith’s history of self-damaging and self-demeaning impulsive behaviors, particularly his alcohol abuse. Also consistent with the diagnosis of Borderline Personality Disorder are the findings reflecting Mr. Smith’s suicidality, chronic feelings of emptiness, inappropriate, intense anger and severe dissociative symptoms.”

35 Case Example – Behavioral Dysfunction
Impulsive, Self-Destructive, & Suicidal Behavior “James Smith’s medical records are consistent with his self-report in documenting his dramatically deteriorating functioning over the months prior to the instant offense. During this period of decline, he was actively suicidal and was psychiatrically hospitalized on multiple occasions.”  

36 Case Example – Behavioral Dysfunction
Impulsive, Self-Destructive, & Suicidal Behavior “I had pills all over my car and I was going to take them. I was going to kill myself. No one was going to find me this time. I had wanted to die last November, and then in March and then again in July.” 

37 Dysregulation in Sense of Self
Feeling of having no sense of self Difficulty with boundaries between self and other Self-invalidation – tendency to invalidate or fail to recognize one’s own emotional responses, thoughts, beliefs, and behaviors. Unrealistically high expectations and standards for oneself. Intense shame and self-hate. Identity disturbance/ Identity diffusion. Persistent and markedly disturbed, distorted, or unstable self-image or sense of self (e.g., feeling like one does not exist or embodies evil) Chronic feelings of emptiness Feelings of isolation, alienation, out of contact, or not fitting in at all Meloy (1992) states the lack of an integrated identify in chronic catathymic violence is apparent. The manner in which the offender views himself and the victim as vascillating between good and bad across time, and are not held consistently despite changes in reality. This is primarily evident in the fluctiuation between homicidal and suicidal wishes that emerges as an obsession during the incubation phase. This fluctuation is captured by Meloy (1992) by a quote from one of his patients that stated, “Either he or I must die, something has to give.” In Meloy’s (1992) view, this statement reveals the offender’s belief that the only manner to resolve the internal psychic conflict is to eliminate the bad self or the bad object. (DSM-IV-TR, 2000; Millon, 1987; Linehan, 1993; Zanarini et al., 1989)

38 Case Example – Dysregulation in Sense of Self
Dependency “After dinner, he says to me, ‘I’m not happy. I’m not in love. I’m resentful. I’m stifled. I can’t live here anymore. If I had to, I’d kill myself.’ He said he wanted to get an apartment and to date. He got up and walked away. I lost it. I was hysterical. I felt as if someone had taken a saw and cut me right in half. I couldn’t stop crying. I went into the baby’s room and took some pills and went to sleep. I just wanted to die. I felt, how could someone hate me so much when all I did was try to help him? I never felt so bad in all my life. I had known this man for 23 years. I had never felt such pain. I felt useless. There was nothing left. He took everything away.”

39 Case Example – Dysregulation in Sense of Self
Distorted Self-Concept Regarding the development of her sense of identity and self-esteem, Mrs. Jones is rather immature and quite insecure. She would react with anxiety and undue emotionality to even minor threats to her sense of security. She requires frequent reaffirmation of her unique and special status. Her sense of self is based largely upon imagined rather than real experiences and interactions with others so that parts of her self-concept are likely distorted. These distortions about herself further weaken her ability to form realistic judgments and make effective decisions.

40 Characteristics of Catathymic Murder & Vulnerabilities of Individuals with Borderline Personality Disorder/Traits CATATHYMIC MURDER BORDERLINE PERSONALITY Begins with a perceived rejection, threat to the ego, psychological insult Internal psychic/emotional tension builds Offender attempts to relieve the tension by projecting blame for it onto the victim Fears imminent threat of being attacked, assaulted, threatened by victim; feels controlled by victim Idea develops that only suicide, murder, or both can relieve this tension Violent act takes place, resulting in release of tension Sensitive to rejection, trust issues, fear of abandonment Difficulty regulating emotions Commonly engage in projection and splitting as defense mechanisms Experience cognitive dysfunction in form of paranoid ideations, delusions, and dissociation Severe cognitive dysfunction sets the stage for poor decisions resulting in impulsive and self destructive behaviors Borderline individual often unable to reconcile/understand their impulsive behaviors, yet feel a sense of calm after engaging in such behaviors

41 Borderline Personality Disorder & Murder
SUMMARY & CONCLUSIONS: There is an important connection between BPD traits and Murder. In such Cases, BPD can help us understand and explain the Murder Understanding the connection between BPD and murder is informative in reference to several forensic questions. Particularly important in Sentencing Evaluations

42 Michael T. Wiltsey, Ph.D. Elliot L. Atkins, Ed.D.
Borderline Personality Disorder & Murder ? ? ? QUESTIONS ? ? ? Michael T. Wiltsey, Ph.D. Elliot L. Atkins, Ed.D.

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