Did Casey Kill Caylee? A Clinical and Forensic Psychologist Comments on the Case (Again)

Filicide is defined as the killing of a child by his or her parent. The motives for filicide vary, from so-called "altruistic" filicide or supposedly well-intentioned mercy-killing of sick and suffering offspring, to "accidental" filicide during severe child abuse or neglect, to angry retribution against an offending spouse as in the ancient Greek tragedy Medea, to the overwhelmed or self-serving solution of killing unwanted, demanding, cumbersome, socially inconvenient children, to the paranoid delusions and command hallucinations of acute psychosis.

How does a forensic psychologist evaluate evil deeds like parents murdering their own children? I have published two previous posts on parents who killed their kids.

Now, in another high profile trial just starting in Orlando, Florida, Casey Anthony, 25, is charged (but remains innocent until proven guilty) with first degree murder for having allegedly killed her own 2-year-old daughter Caylee in 2008. When it comes to sensationalistic trials like this, the public seems equally repulsed and fascinated. Such disturbing cases beg the psychological questions: If found guilty, what makes a young, vivacious mother murder her only child? Is she evil? Mentally ill? Or both? Who commits filicide? And why? (See my two most recent posts on this case here and here.)

In the surprising opening statements, Casey Anthony's defense team abruptly declared — contrary to everything Casey had consistently claimed since Caylee's "disappearance," namely, that her daughter had been kidnapped by some now apparently fictional nanny — that little Caylee accidentally drowned in the family swimming pool. And that both Casey and her father, Caylee's grandfather, former homicide detective George Anthony were present, subsequently conspiring together in covering up Caylee's death.

For good measure, the defense team additionally alleged that George had started sexually abusing his daughter, Casey, when she was 8 years old, something he has already denied under oath in open court at the trial, along with any involvement in concealing Caylee's death. Of course, perpetrators of incest almost always deny their actions when confronted. So, if it turns out that George Anthony did, in fact, sexually molest Casey over a period of years, as alleged by the defense, after denying it under oath, the entirety of his testimony may become suspect. Which could conceivably work to the defense team's advantage.

However, even if the allegations of sexual abuse are true, which is certainly possible, it would appear to this observer that the defense is desperately trying to deflect the focus of this death penalty murder trial from the defendant onto her father, George, by implicating him in both the cover-up and by bringing in the sexual abuse aspect. Anything to suggest that the defendant did not kill her daughter Caylee in cold blood, and to explain why she reacted (by partying heartily) the way she did right after Caylee's supposed drowning death or disappearance. Or, failing that, beginning to build a case for some sort of mitigating mental defense like "diminished capacity" (abolished in California after the notorious "Twinkie Defense" during the Dan White trial) or reduced sentencing (something short of death) based on the alleged history of chronic sexual abuse of Casey by her own father. Interestingly, in one of my prior postings on this case, I speculated that the defendant might have accidentally rather than deliberately caused, by way of asphyxiation, her daughter's death, or that she might have accidentally drowned in the family pool. But the prosecution clearly believes Caylee's death was no accident. Can they prove it?

What typically causes women (and some men) to commit such incomprehensible crimes? In the Andrea Yates filicide case, chronic mental illness in the form of postpartum depression and psychosis seems to have been a factor. In others, personality disorders play a primary part. Could the defendant in this case be psychotic, like Andrea Yates? Bipolar? Borderline? Narcissistic? Or is Casey Anthony a stone-cold sociopath, as some television pundits prematurely suggest? What is the relationship between sociopathy (antisocial personality disorder) and pathological narcissism? I will address some of these matters from my own experience as a forensic psychologist, generalizing based on what we know about evaluating violent offenders who commit such evil deeds.

Narcissistic personality disorder (NPD) shares certain commonalities with antisocial personality disorder (APD). Sociopaths or psychopaths tend to be narcissistic, and narcissists tend toward certain antisocial traits. Narcissists believe themselves — without sufficient merit — to be special or superior to others, harboring a grandiose sense of entitlement that they sometimes feel lifts them above the law and gives them the right to disregard the rights and boundaries of others. They have a marked lack of empathy for the feelings and needs of others. It's all about them. Sociopaths share this distinct lack of empathy, along with a callous lack of remorse in general for having killed, raped, hurt, mistreated, or stolen from others.

Deceitfulness and pathological lying are typical in antisocial personality disorder but are also commonly seen in narcissistic personality disorder, especially in the form of interpersonal manipulation. They can both be superficially attractive, charming, and even charismatic characters. Antisocial personalities also exhibit impulsivity, failure to plan ahead, reckless disregard for the safety of self or others, and persistent patterns of irresponsibility. By definition, however, APD requires significant evidence of such problematic behaviors (conduct disorder) at least since 15 years of age. Background information on Casey Anthony in this case (other than the recently alleged childhood sexual abuse and reported pattern of pathological lying) has not to my knowledge been made available to the media at this time but would be critical in arriving at an accurate psychiatric diagnosis. Any prior history of mental health treatment, psychiatric medications, hospitalizations, etc. is especially important. Another basic commonality between APD and NPD, in my view, is an underlying rage: profound anger at parents, authority figures, society, and life. In fact, I see both APD and NPD as types of anger disorders, unconsciously fueled by severe narcissistic injury and resulting narcissistic rage. (For further discussion, see my prior post on "Detecting Disguised Personality Disorders" and the chapter on the psychology of violent offenders titled "Violence as Secular Evil" in the textbook Forensic Psychiatry: Influences of Evil. )

According to the massive media coverage, then 22-year-old Casey Anthony appears to have been carrying on an elaborate charade preceding her daughter's mysterious disappearance that summer. It seems she told friends and family she continued to work at Universal Studios, when in fact she had lost her job there (if she ever had one) years ago. Casey apparently hadn't worked since. One of her numerous boyfriends allegedly describes her as a chronic liar. She reportedly regularly stole significant amounts of money from her parents prior to Caylee's disappearance, and later, from one of her female friends. It also appears she was reluctant to accept full responsibility for Caylee's care, relying on or delegating much of that to her mother, who had strongly supported her daughter's possibly unwanted pregnancy.

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Moreover, it appears from some news stories that Casey stormed out of the house following an argument with her mother shortly before Caylee went missing. Coincidence? Perhaps. But could Casey's anger with her mother somehow motivate murder? Anger, rage, jealousy, spite, and revenge are some of the prime motivating impulses in murder cases. If a murderous crime was committed in this case, as prosecutors contend, by placing duct tape over the victim's mouth and nose, was it a crime of passion directed against Caylee? Or was it a cold-blooded, premeditated act of vengeance? Could Casey have been so enraged with her mother that she deliberately killed her own daughter to spite Cindy Anthony? Was she jealous and resentful of her mother's close, caretaking relationship with Caylee?

Convenience is another potential motivation. In the months prior to Caylee's disappearance, Casey had apparently desired to accompany friends on a vacation in Puerto Rico but reportedly was prevented from going because she could not find anyone with whom to leave her daughter. Was Casey resentful of Caylee? When she decided to leave her parents' home, with no money and no job, where could she go with a 2-year-old in tow? Could this possibly be sufficient motivation to kill one's own child? Freedom? To live la bella vita, the good life, as the prosecution argues?

This seems to be exactly what happened in the infamous Susan Smith case. Smith, then 23, drowned her two sons (both around Caylee's age) in her car presumably so she could be with her new boyfriend. Prior to confessing, she blamed the murders on a phantom carjacker. Smith had been emotionally wounded during childhood, sexually abused, was suicidally depressed, and may suffer from some sort of personality disorder. Extremely immature, narcissistically injured individuals can have great difficulty placing their own selfish needs second to those of their children.

Narcissism is a pathological form of selfish immaturity. Another report suggests that following the falling out with her mother, Casey Anthony called a boyfriend asking if she could stay with him. He supposedly responded that she could, but not with Caylee. So Casey may have tried to sedate Caylee with homemade chloroform, leaving her asleep in her car so she would be able to spend the night at her boyfriend's apartment. Indeed, searches for chloroform recipes prior to Caylee's mysterious disappearance were allegedly found on Casey's computer. This tragic scenario suggests the possible unintentional death of her daughter due to a lethal combination of narcissism, immaturity, naivete, and stupidity, and a subsequent extensive cover-up. Police apparently have testimony from witnesses who say Casey mysteriously and briefly borrowed a shovel from a neighbor two days after Caylee went missing. Was she burying the body? Or digging it up to place it in her car trunk?

How, we wonder, could Casey have denied her own daughter was dead — by "accidental" drowning, asphyxiation, or by her own hand — and carried on ostensibly afterward as if nothing had happened? Where was her conscience? Is she a conscienceless psychopath, as some simplistically suggest? How could her father, and possibly his wife, Cindy, supposedly have done the same, knowing that either their granddaughter drowned in the pool or had died at the hands of her mother? How could they so passionately defend their daughter to the press and police? As regards the parents, love is one answer: the unconditional love of parents for their daughter, no matter what, and the desire to protect her at all costs. The other answer is denial.

Denial, as they say, is not just a river in Egypt. Denial is a powerful defense mechanism. None of us are beyond deceiving ourselves. Such self-deception, which, in its most extreme and pathological forms we deem delusional, is much more pervasive than most imagine. Consider the ordinary example of some heated conflict with a spouse, lover, relative, or close friend. How is it that after the fact, each participant can have a completely contradictory version of what happened? Objectively speaking, first A happened, then B occurred, then C was said, D followed, etc. But what if the objective facts or our own behavior don't comport well with how we see ourselves? We distort the facts to support our particular point of view and to sustain our beliefs about the kind of person we are or want to be.

When the objective facts threaten the ego and its integrity, we experience what social psychologists call confirmation bias, a kind of cognitive dissonance known more recently as "Morton's Demon": We dismiss certain facts incompatible with our myth of ourselves in favor of other less threatening and more corroborative ones. We twist the truth. And we become convinced of the veracity of this twisted truth. And we do all this unconsciously. We don't even know we're doing it. This goes beyond mere "cognitive distortion," resulting in a radical rewriting of history and reality for the purpose of preserving our precious self-image or persona. In its most extreme form, such self-deception can lead to certain delusional beliefs symptomatic of psychosis.

From the start, Casey denied any culpability, claiming steadfastly that her daughter was abducted by her non-existent babysitter. Now, her (or at least her defense team's) story has suddenly changed to the accidental drowning. If this new version of events originated from Casey, is this the objective truth? Or is it also a lie? If it is a lie, is it a conscious lie or an unconscious one? In other words, does Casey know she's lying? Or does she actually believe the lies? If she turns out to be completely convinced that the lie is true, is she really lying? Or is she telling the truth as she sees it? If the latter turns out to be the case, then Casey could be considered delusional. From a forensic psychology perspective, this could conceivably become a key component of her legal defense. But, for now, there has been no assertion of an insanity defense in this trial so far. At least not yet.

I do not know whether Ms. Anthony is guilty as charged and have had no direct involvement in this matter. Nor can I speak definitively to her state of mind past or present or that of her family without having interviewed them directly. However, as I mentioned in a previous post, this case brings to mind a clinical syndrome called shared psychotic disorder or folie a deux, trois, or perhaps quatre. This unusual phenomenon typically involves a primary person or "inducer" becoming delusional and others close to her or him to differing degrees adopting that distortion of reality. Of the four immediate family members, George, the former homicide detective, may be the least in denial about what happened, which could explain his suicidal reaction: some studies suggest that depressed individuals perceive reality more clearly than non-depressed people. But it would appear that both Casey's brother, Lee, and his mother, Cindy, if not consciously covering up, may still be under the spell — despite having been physically separated from Casey by her incarceration. If Casey could be depicted to a jury as having been psychotic, for example, at the time she allegedly killed her daughter Caylee — as opposed to being perceived as merely selfish, immature and manipulatively lying to escape responsibility and punishment for this evil deed — could this be the basis for a forthcoming insanity defense?

In my first posting on this case in 2008, I raised this same question, which, without extensively evaluating such a defendant, is impossible to answer. Could Casey possibly suffer from Bipolar Disorder? If it were convincingly shown that the alleged crime occurred during a severe manic or depressive episode — either of which can sometimes turn psychotic and include delusions — this could possibly support an insanity defense. This could also explain Casey's seemingly manic or hypomanic behavior, elevated mood, shopping sprees and possible hypersexuality in the weeks and months following the alleged crime.

Now that the allegation of incest with her father has been made, this begs the question of how someone deals psychologically and emotionally with having been sexually involved with her own father over a period of years. Having both evaluated and treated incest survivors in the past, I can say that, again, denial plays a prime role, as does the defense mechanism of dissociation. Dissociation is the cutting off or repressing and compartmentalization in the unconscious of unacceptable or intolerable feelings, a "disruption in the usually integrated functions of consciousness." (DSM-IV-TR). Victims of sexual abuse, especially incest, learn early to lie to others and themselves, to act as if nothing is wrong, and to live with profound feelings of guilt, terror, shame and anger. Most, if not all, sufferers of borderline personality disorder, for example, have experienced some form of emotional, physical and/or sexual abuse as children. So, particularly if Casey is an incest victim, borderline personality disorder bears consideration in this case. Such a history of physical or sexual abuse is not uncommonly found in patients with antisocial personality disorder, bipolar disorder, substance abuse disorders, dissociative identity disorder, and some psychotic disorders.

In the unlikely event that there were to be a shift of strategy to an insanity defense in the Casey Anthony case, her attorneys would need to prove that Casey could not differentiate between right or wrong at the time of the alleged crime, and did not appreciate the nature and quality of her evil deed. The insanity defense is difficult: Less than 1% of jury trials attempt to prove legal insanity. Of those, only about one-in-four succeed. The finding of Not Guilty by Reason of Insanity (NGRI) is generally a hard-sell to juries. The defendant may be demonstrably mentally ill, or, here in California, clearly in a state of diminished mental capacity at the time of the crime, yet still not technically legally insane. Legal insanity is a high bar. The mere presence of serious mental disorder or psychosis does not necessarily meet the stringent standard for legal insanity. Nor does the diagnosis of a personality disorder alone or having been under the influence of or addicted to some licit or illicit substance when committing the crime.

Florida's insanity defense statute, like California's, allows defendants to acknowledge that they committed the act for which they have been charged, but argue that they should not be found guilty because they have a mental illness or defect. The defendant's mental state must have been so severe as to prevent her from knowing what she was doing and the consequences of her behavior when committing the crime. Alternatively, the defendant may have understood what she was doing and the consequences of her actions, but can still invoke the insanity defense if she did not understand that her actions were wrong. As in California and most other states, the Florida insanity defense is based on the M'Naghten rule, named after a famous mid-nineteenth century British case in which a severely delusional man, Daniel. M'Naghten, tried to assassinate the Prime Minister, mistakenly killing instead the Prime Minister's secretary. He was found not guilty by reason of insanity, but due to public outcry (not unlike that which followed the John Hinckley, Jr. trial in 1982 here in the U.S.), the so-called M'Naghten standard was established, requiring that for such a defense, the defendant, due to a "defect of reason," must be proven to have not known the nature and quality of his or her actions or that those actions were wrong.

Just this week, an Arizona court found Jared Lee Loughner, the evidently psychotic young man (see my prior post) who went on a deadly shooting spree in Tucson last January, incompetent to stand trial. The forensic psychologist and psychiatrist evaluating him for the court reportedly concurred on a diagnosis of paranoid schizophrenia, which, in and of itself, does not make a defendant incompetent or unfit to stand trial. Competency has to do with the defendant's state of mind currently, and his or her capacity to cooperate with defense counsel in a rational way, comprehend the criminal charges, and understand, at least fundamentally, how the proceedings and legal system work, i.e., the role of the judge, jury, prosecutor, etc. In all likelihood, if Loughner ever is deemed well enough to be tried for his heinous crimes, his lawyers will invoke the insanity defense.

Controversial as it is, the insanity defense goes to the very heart of the notion of personal responsibility: Are we always fully responsible for our behavior? Are there certain disorders, diseases, syndromes, dangerous states of mind, or mitigating circumstances that can negate or reduce personal responsibility? If so, what are they? And where do we as a society draw that line? These are precisely the sort of complex existential, philosophical, psychological and legal questions Casey Anthony's defense team — like that of Jared Lee Loughner — would have to tackle were they to decide to invoke the rare and risky insanity defense. But, thus far, there is little indication of them moving in that direction, having chosen instead to deny that a murder was committed at all, claiming accidental death by drowning, and pointing the finger of guilt at the defendant's father, their latest scapegoat or (possibly inwardly willing) sacrificial lamb.