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What does it mean to be “crazy?” I’ve spent much of the past few days stewing on the story of Lindsay Clancy. For context, she is a mother who, in the throes of postpartum something-or-other, whacked her three kids. Killing your own offspring is, on its face, an unambiguous evil. Only the most fanatical (and likely also psychotic) of anti-natalists would suggest otherwise. Clancy has not been characterized as an unambiguous evil. The exact nature of her mental illness is still at issue in the trial, but many figures have converged on the idea that Clancy was not of sound mind and thus is not culpable the way you or I would be. I suspect that no matter what her sentence is, a vocal chorus of mental health advocates will decry it as excessive. I sympathize here — having worked with the severely and persistently mentally ill, living with acute psychosis is hardly living at all.
I think this case is an interesting segue into something I’ve noticed more and more about how we adjudicate moral harms in the public sphere. I’d like to soapbox for a moment. Cool? Thanks. The experience of harm, at least colloquially, is limited to two parties: the offender and the victim. These people experience the qualia of the situation with their own eyes, ears, limbic systems, pain receptors, and memory banks. Unless we were physically present, the rest of us schmucks don’t have that privilege. We can only experience the event through language. We describe what happened. We ideate on the nature of the harms, the observed damages, and the more latent impacts. Most importantly, we construct a theory of mind for those involved. We daydream about what they might have been thinking, or, in cases like Clancy’s, if they could think at all. Bluntly, we want to know if we should treat them harshly or if there are, say, intervening factors that reduce their culpability. All of this is mediated by language.
Many of these intervening factors can be modeled on a spectrum. Someone can be more or less psychotic, more or less cognitively impaired, more or less ignorant to their situation. For the sake of discussion, let’s assume that Clancy experienced severe psychotic symptoms. In this case, minimal gymnastics are required to describe her nature as such. Clancy is psychotic → therefore she didn’t know what she was doing → therefore she’s off the hook. Thus, it is written. However, how should we treat someone who was a little less psychotic? How about a little less than that? What if they had psychotic symptoms, but they were subclinical or didn’t neatly fit diagnostic criteria? This is where language fails us. Human qualities may be modeled on a spectrum, but language is discrete. And so, the spectrums get “sticky,” and the labels gain outsized importance. A line must be drawn. The person must be sorted.
These sticky spectrums exist for a variety of traits. If you’re “just” poorly socialized and have a blind spot for a particular social norm, you’re expected to do better. If you’re diagnosed neurodivergent, it’s more tolerable to break the norm because you “can’t control it.” If you’ve had a few drinks and crack skulls in a bar fight but are otherwise a normal chap, you’re probably on the hook for assault. However, if you’re a person in the throes of capital-A alcoholism, you can break into a family’s home, sleep on their child’s bed, and avoid charges because you’re burdened by a sickening disease. If your IQ is 70, you can be sentenced to death. If your IQ is 69, you’re much too intellectually disabled for that to be fair. In each of these cases, the mental states at the time of the offense are similar if not near-identical, and yet resulting judgments vary based on how we categorize the offender’s nature. We don’t adjudicate based on “sort-ofs” and “somewhats.” In common parlance, either you’re an alcoholic or not. Either you’re intellectually disabled or not. Either you’re culpable or not. This strikes me as unfair.
I suppose I’m advocating for the spectrums to be less sticky, or for words to have less of a gravitational pull. Clancy will likely receive a modified sentence based on her state of mind. Yet, what ought we to do with people in the midst of mild, manageable psychosis who may still yet have impaired judgment? Maybe they don’t get away with a full insanity defense, but their sentence could be modified accordingly. This is why I oppose mandatory minimum sentencing. The job of the court — and the court of public opinion for lesser matters — is not just to determine what happened, but to determine the appropriate consequence. The question is whether or not this is a utopian suggestion. Is human nature too punitive to implement this mindset at scale? Are we interested in justice or just blood?
Relevant Scott: The Categories Were Made For Man, Not Man For The Categories
A single IQ point determines whether you are responsible enough for a death sentence, because we have laws. Laws should be legible, consistent, and standardized tests provide both. If it is more cruel to execute a person who scores a 69 IQ person than one who scores a 70 it is because we or [this code] say(s) so. The spectrum of culpability or responsibility is typically done via sentencing, as you note, but if someone clears the bar for insanity we also say it has to be a threshold. It must be, because the judgment is binary. As for your questions on psychosis specifically, as I understand a psychosis diagnosis is not a get out of jail free card. One must suffer the kind of trial going on now where either the state or a defendant proves why a specific instance of psychosis means one should or should not be held accountable for a crime.
My hot take: it means shrinks observed something enough times to give it a name and stuck it in the DSM. These observations, decisions, and writing are all indeed mediated by language.
Allow me to be a punk and consider something really crazy. There is and has been an ongoing epidemic of an unnamed affliction which primarily effects young men. It is an old affliction, possibly as old as time. There are differences in observable rates of this condition demographically speaking, but it's definitely higher in the general population of young men.
The generalized case sees a young man taken in the blink of an eye with blind rage. A man with this condition is overcome and engages in swift, brutal, disproportionate violence against another -- most often another man. Without proper studies early researchers of the condition have informally dubbed it Insulted Shoe Disorder, or ISD. The name stems from one case discovered by researchers in the field which involved a man who upon hearing an insult (made against the shoes he was wearing) flew into a blind rage, beat another man to death, and took the victim's shoes. The police arrived to the scene shortly afterward and immediately arrested the man. In custody, the man repeatedly stated he couldn't say what came over him, he could not say why he flew into a blind rage, and he could not say why he took off the man's shoes. "I don't know," is all the man could say, face in hands. While awaiting trial, the man's lawyer arranged for several psychiatrists to come and see him. Each time he told the same story, "The man insulted my shoes, I saw red. I don't remember much after that. The next thing I know my fists are covered in blood and I'm looking at two cops pointing guns at me, a shoe in each hand."
Sociologists, always ahead of medicine, have visited areas with suspected cases of ISD to draw comparisons between them. They found that even while adjusting for things like culture and race that young men separated by thousands of miles were generally at risk of suffering the affliction. They regarded this as a natural kind of illness, though the sociologists admitted they were unqualified to definitively say. Sometimes they found the young men had a history of violence prior to their first documented ISD episode. In other cases, the sociologists found that the young men had no history of violence at all. Seemingly, they found something just inexplicably snapped within these men at one moment in time which evoked a reaction that could not be undone or considered sane.
What could be more crazy than to kill someone simply because they insulted your shoes, truck, hat, or mother-- is it not a mental illness because it is more common relative to cases of filicidal mothers? But of cognizance and choice, what sane thinking person would choose throw their life away over that? Certainly there are some who exhibit signs of ISD while still being responsible for their irresponsible actions, but there must be those afflicted who had little choice in the matter. The sociologists even tell us this responsibility may be diffuse, perhaps medicine could confirm this. Medicine could recognize few young men want to experience an episode of ISD. Identifying which ISD cases might suggest a temporary insanity and separating them from the hardened thugs is a moral imperative. We are talking a massive scale here. Potentially tens of thousands of young men a year unfairly prosecuted as if they had control of their actions to an extent they should be held criminally liable.
These can be and often are the same thing.
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