Political commentary

The Ripper and the doctors

Ferdinand Mount

He does not look 'meek' or 'insignificant.' He looks frightening. The newspaper photographs whiten and soften his features. There is nothing bemused or simple about his appearance. He is a robust, oliveskinned young man in his prime, not sickly. He may be mad, but if he is, he is cunning-mad. You can see why the prison officers immediately thought he was fooling the psychiatrists.

The poor psychiatrists. The whole court is well aware that it is they who are on trial. The policemen sitting in the dock around the defendant exchange smiles every time a shrink is made a fool of; after lunch, two of the policemen nod off.

How pale and mild the doctors' faces are. They have none of Sutcliffe's cruel, sardonic curves of lip and nostril and eyebrow.

How did they test whether Peter Sutcliffe was shamming? How did they know he had not copied his symptoms — the voices, the divine mission, the fatuous smile at the wrong moment — from his wife Sonia who had had all these symptoms, too, and who had thought she was the Second Christ?

There are certain standard practices, apparently. You ask the questions in a jumbled order, switching from topic to topic so that the patient does not have the chance to develop and memorise a set pattern of answers. You also ask him questions in layman's language, so that if psychiatric terms do crop up, you can infer that he may have been mugging up the subject. In talking to Dr Terence Kay, Sutcliffe used only one – 'depression', not exactly a technical term these days.

Is that all they go on — conversation? Dr Malcolm MacCulloch is said to have formed his initial diagnosis within half an hour of meeting Sutcliffe — incapsulated paranoid schizophrenia. If it only took him half an hour, why has everyone been hanging about in the Old Bailey for ten days? Dr MacCulloch did not consult Sutcliffe's family, his friends or his workmates. Didn't need to.

Nor did he need to cross-check with Sutcliffe's statements to the police. Dr MacCulloch's 'fine questioning' was directed solely to the 'psychiatric elements' in Sutcliffe's story — the voices and the divine mission to kill prostitutes.

But how was it that so many of the victims' were not prostitutes, and obviously not? Then there was Sutcliffe's own statement. that 'eventually the feeling came welling up. Each time they were more random and indiscriminate. I now realised I had the urge to kill any woman and I thought that would eventually get me caught.' Surely that is the end of the divine mission to kill prostitutes.

Not necessarily, said Dr .MacCulloch. 'Delusional percepts are very rapid. Because of the nature of the mental events, he believed them to be prostitutes.'

Mr Harry Ognall QC (prosecuting, and masterfully so): `I'm using his words as to his thoughts. "Each time they were more random and indiscriminate."

All three psychiatrists appear primarily concerned to protect their diagnosis in the same way that the schizophrenic protects his delusion against the rational world. To the layman they almost seem to be engaged in an imaginative conspiracy with the patient to reconstruct his 'delusional system'. Their language slides so rapidly between the observation of externals and the divination of internal 'mental events'. Yet both come from the same source — the lips of the patient.

But what about the other words that come from the same lips? The words of the rational criminal trying to escape detection: 'I thought this would eventually get rue caught... I realised things were hotting up for me in Leeds.'

These, we are told, come from 'the relatively intact part of his personality.' An incapsulated paranoid schizo — 'one of the 17 sub-types ' of schizophrenic in the psychiatric literature' — has this bubble of madness floating in an otherwise unimpaired personality.

And in any case, ultimately, Dr Kaye says: 'a normal man doesn't usually start killing people in large numbers.' And if he is not a schizophrenic, 'then he must be a criminal psychopath and then the origins must be sexual.' But although Sutcliffe shared some of the characteristics of the sadist — neatness, quietness, control — he lacked Most of the others. A sadistic killer can rarely relate to other women and so is rarely married; he has a rich sexual fantasy life, reads sadistic pornography, likes to see his victim suffer slowly. Sutcliffe was married, attacked from behind and killed quickly.

Dr Kay brushed aside the sexual brutality in the later killings by saying: 'as schizophrenia goes on, it tends to erode the finer sensibilities and they are able to commit quite brutal acts'. Is there no element of pleasure in the killing?

Behind all these neat divisions and sub-divisions, is not he doctor being driven onto the commonsense view that 'only a madman would do such things' — and that his madness consists primarily in the fact that he does do such things? How much real distinction is there between 'an otherwise unimpaired personality' who hears the voice of God telling him to go out and convert the Chinese and one who hears the voice of God telling him to go out and kill prostitutes? If we call one good, why cannot we call the other evil?

Would not many of these classic symptoms of schizophrenia — flattening of emotion, passivity, inappropriate joviality, readiness to lie to save your skin — have applied to the guards at Auschwitz'? The commonsense view seems subtler in that it talks of people succumbing to delusions, of people deluding themselves, of evil feeding on itself. We relinquish only with great reluctance the principle of personal responsibility for our own conduct. The concept of 'mental illness' may not be quite the myth invented by psychiatrists that Thomas Szasz claims it is. But most people hesitate to accept it as a distinct, hard-and-fast category of illness, like chicken-pox, which just hits you ont of the blue and which you either have or you have not. It is only in dramatic criminal cases that the psychiatrist is liable to have his daily clinical methods thoroughly inspected by laymen. And it cannot be denied that they make a shoddy impression. So much has to be shored up by professional flannel: 'As a psychiatrist, I am of the opinion [I think] . • • medical examination revealed what we call a delusional system derived from auditory hallucinations [he told me he heard voices]...'. And behind this professional flannel, there seems to be a quasi-religious determinism at work. For while the psychiatrist does not lay himself open to derision frorn his this-worldly audience by admitting that the voices did come from God, it is a logical inference from his diagnosis that the patient was bound to act as if they did. These decent, kindly doctors would not hurt a fly. But if, as they tell us, Sutcliffe's words are to be taken as true statements of his belief only when they confirm his divine mission, then the logical conclusion must be that the doctors are validating that mission, and that it is the forensic psychiatrist who himself helps to diminish the responsibility of the defendant he examines.

It is neither insensible nor philistine to thank heaven for Mr Justice Boreham, an English jury and the plain language of the courts. Some psychiatrists have complained that the delicate coherence of their professional assumptions ought not to have been so rudely 'tested to destruction'.

Yet psychiatrists cannot expect to be exempt from lay interrogation. They are; after all, maintained at public expense and granted considerable licence to operate on minds and bodies.

The term 'schizophrenia' was invented only in 1911; doctors still disagree whether it describes a mental illness, a reaction to intolerable social pressure, mostly from the family, or a symptom of some physic 21 affliction, like birth trauma or brain tumour. In these circumstances, it might he going too far to hope for an end to the psychiatrists' reign of terror; but it is at least reasonable that they should be taken in fer questioning.