Monday, August 20, 2012

DID in defense of crime: the case of William Bergen Greene and his therapist

mugshot of William Bergen Greene
William Bergen Greene was a troubled man who started with a troubled childhood.  He apparently suffered severe abuse as an early child until he was made a ward of the state at age eight.  He suffered further abuse in foster homes and institutions.  At age 17 he escaped from his institution and started his adult life of chronic criminality.  He was so frequently convicted of sexual offences that he spent the vast majority of his adult life in prison.  He remains incarcerated today in Washington State.

He became a prison sex offender patient after a 1988 conviction.  His prison sex offender therapist, known to the public only by the initials M.S. (because she later became another victim of Mr. Greene's many sex offenses), was the first to diagnose him with Dissociative Identity Disorder (DID) otherwise known as multiple personalities.

Her course of therapy started with hypnosis.  With this extremely questionable (if not negligent) technique she proceeded to draw out (or co-develop) some 24 personalities in her patient, not the least of whom were "Auto," a non-human robot personality, and "Smokey" the dragon.  Yes, a dragon personality.

Another therapist at the prison disagreed with M.S.'s diagnosis.  Instead he diagnosed Greene with Malingering.  Incidentally, malingering is listed and described in the psychiatric diagnostic manual and is designated with code V65.2.  V-codes generally indicate a diagnostically important factor or condition that is not itself a disorder.  Malingering, of course, is not a disorder that is treatable under Medicaid but is described as "the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives."  Typically, external incentives have to do with financial gain, or avoidance of responsibilities or consequences.  In this case, Greene was already convicted and incarcerated.  The dissenting therapist warned that Greene's malingering was motivated by his life-long pursuit of sexual victims.  He warned that Greene was setting his therapist, M.S., up for a future assault.  The dissenting therapist's assessment proved to be prophetic, but sadly failed to influence M.S.  Not only did she continue her work treating Greene's purported DID, she seemed to become increasingly close to her patient.

Greene was released from prison in 1992.  Within days of his release, M.S. quit her job at the prison and took Greene on as a private patient.

Was it coincidence that she quit immediately after his release?  I can't say, but it is suggestive of a therapist who was severely enmeshed with her patient.

She met him for therapy on a routine of bi-weekly sessions, but if so, they must have been extremely long sessions, because by the end, when he finally assaulted her in 1994, she had racked up over 2000 hours of therapy with this single patient.  By comparison, standard out-patient therapy is generally in the range of 12 to 54 hours of therapy per year.  Yet more evidence of enmeshment if not outright obsession on the part of the therapist.

M.S. received a phone call from a distressed Greene on April 29, 1994.  She knew he was under stress from several things and she was worried he might be suicidal, so she went to meet him at his apartment.  He was talking very slowly with a childlike voice.  He kept referring to himself as "we."  I will add here, the "royal we" is a common trait or affectation among DID patients and it seems unlikely it was the first time he used it in M.S.'s presence but later, in court, she would use it as one of the evidences of his personality fragmentation at the time of the crime.

At some point, as M.S. tried to console the oddly behaving Greene, alone with him in his apartment, she figured out that he was on cocaine.  In a moment of good judgment, she chose to leave.  Unfortunately for her, he barred her way out.  They struggled and M.S. fell.  He ripped off her shirt and bra and touched her, ignoring her protestations and clear statements for him to stop.  He took her to the bathroom and held her there for two hours.  He continued to molest her there, taking breaks only to shoot up a drug, presumably cocaine.  Throughout this incident, Greene's behaviors were later described by M.S. as childlike with frequent but brief bouts of crying. Near the end he removed his own pants and touched himself but failed to achieve a result and soon after said she could go, but when she tried, he changed him mind, tackling her and left her bound and gagged as he removed himself from the scene in M.S.'s car.

Once Greene had fled, M.S. was able to remove her bonds and escaped to a hospital across the street where she called the police.  Greene was soon apprehended and charged with kidnapping and indecent liberties.

Greene plead not guilty by reason of insanity, but in his first trial, Judge Thorpe ruled that DID could not be used in an insanity defense due to lack scientific consensus on the existence of the disorder.  The defense attorney, David Koch, was not permitted to even mention DID.  Greene himself assisted his defense attorney, telling his attorney that one of his alter personalities was trained in law.  Without DID as a defense, the case rested solely on whether or not Greene had committed the deeds.  He was quickly found guilty on both counts.

In 1998, Greene and Koch appealed to the Washington Court of Appeals.  Appeals continued back and forth up to the U.S. Ninth Circuit Court and, in the end, he was granted a retrial.

A pre-trial hearing was held to determine if DID could be used as an insanity defense.  The defense team brought in expert Dr. Robert B. Olsen who testified that DID was generally accepted in the field but conceded after interviewing Greene, he could not say who Greene really was much less determine his sanity due to the number of alter personalities.  The prosecution brought in their own expert, Gregg J. Gabliardi who failed to challenge DID, stating that he agreed it was generally accepted.  His only contribution to the prosecution was to testify that it would be impossible to determine the sanity of each separate personality or determine which personality was responsible for which of the actions Greene had taken.

This was clearly a low point in the field of psychiatry when two psychiatrists under oath fail to mention any controversy related to this diagnosis.  One wonders if Olsen or Gabliardi had in fact believed they could determine guilt and responsibility of one specific personality out of 15, what the criminal justice system would be expected to do with that information?  How do you incarcerate one personality out of many?

With the given experts, it is not surprising in the retrial the defense was allowed to use DID as an insanity defense to claim that Greene was not legally responsible for his actions.  He had two new public defenders in the second trial, Teresa Conlan and Marybeth Dingledy.  The second trial took place over five days in September 2003 in Snohomish County courthouse.

In one of the strangest twists in the history of DID being used to avoid truth and consequences, Greene's victim, his former therapist, the now 53-year-old M.S. demanded to testify in his defense.  In the retrial she was permitted to do so.  She claimed that only she could explain the impact of his terrible disorder, DID, on Greene and its role in causing his behavior on the night of his attack on her.  M.S. testified before the court that it was not Greene himself who had attacked her but actually three of his alter personalities:  Sam; Tyrone, a three or four year old; and Auto, a robot.  She explained to the jury it was not Greene, but Auto the robot who grabbed her and held her down.  It was not Greene who molested her for two hours, but Tyrone the child.  The personality Sam appeared for only a moment and tried to save her, but was quickly taken over by the other two personalities.  M.S. testified her belief that the chronic sex offender Greene was not responsible for the attack because he was not present during the attack and had no awareness of it until he was informed of it later when he was in police custody.

In an odd about face, the expert witness, Dr. Olsen, who had originally testified for the defense, switched sides and testified for the prosecution in the actual trial itself.  He now said he believed Greene was malingering.  In the trial, the prosecution also brought in a new expert witness, psychologist Richard Packard who testified that Greene did not have DID at all.  Packard diagnosed the chronic sex offender with antisocial (AKA psychopathic) personality disorder and a sexual paraphilia disorder.  Packard further stated his doubt about the veracity of DID as a legitimate disorder.  Packard firmly believed that Greene had simply been faking DID from the beginning.  Greene's cellmate, a certain Eric Fleischmann, testified that he too attempted to fake DID with Greene's coaching but had failed.

Defense witness, Dr. Marlene Streinberg, then vice president of the International Society for the Study of Dissociation, testified that DID was real and that Greene fit the profile.  In spite of Dr. Streinberg's rather weak assertions and in spite of the frantic testimony of an enmeshed and obsessed therapist, Greene lost his second trial and was again found guilty on both counts.  The jury deliberated for five hours and were done in time to go home for dinner.  Greene was sentenced to life as a three-strike felon

Now in prison, Greene has since been charged with the 1979 rape and murder of a 25 year old woman by the name of Sylvia Durante in Seattle.  Greene's DNA from his sperm was found on Ms. Durante's body.  He was convicted of her murder in 2005.

Not everybody is a believer in DID.  No matter how self important and self righteous the tone of its promoters like Streinberg, jurors, and most people with any level of critical thought or common sense, remain unconvinced.  Juror, Jim Camp, from Greene's retrial, stated the jury "just didn't believe it."

Sullivan, Jennifer; Insanity defense fails for attacker; The Seattle Times; Nov. 21 2003; as viewed on web 8/2012. 
Fersch, Ellsworth; Thinking About the Insanity Defense: Answers to Frequently Asked Questions; iUniverse, Lincoln, NE: 2005

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