The Jordan Harbinger Show - 755: Dr. Sohom Das | Rehabilitating the Criminally Insane

Episode Date: November 24, 2022

Dr. Sohom Das (@dr_s_das) is a consultant forensic psychiatrist who works in prisons and criminal courts to assess and rehabilitate mentally ill offenders. He is the author of In Two Minds: Stories of Murder, Justice, and Recovery From a Forensic Psychiatrist. What We Discuss with Dr. Sohom Das: Telling the difference between someone whose treatable madness is causing them to act out and someone whose irredeemable, criminal badness makes them a permanent danger to society. Over 97% of the mentally ill defendants with whom Sohom works experienced trauma in childhood. Comparing and contrasting psychopaths and sociopaths. How can a psychiatrist determine whether someone in custody is mentally ill or just faking it (and has Sohom ever been fooled)? What precautions does Sohom take for his own safety when working in close quarters with mad or bad people who mean him harm? And much more... Full show notes and resources can be found here: jordanharbinger.com/755 Sign up for Six-Minute Networking — our free networking and relationship development mini course — at jordanharbinger.com/course! Miss the show we did with James Fallon — the psychiatry professor who can teach you how to spot a psychopath because he is a psychopath? Catch up here with episode 28: James Fallon | How to Spot a Psychopath! Like this show? Please leave us a review here -- even one sentence helps! Consider including your Twitter handle so we can thank you personally!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Coming up next on the Jordan Harbinger Show. So forensic psychiatrists work in a few different environments. Right now, I do most of my work in courts. So I act as an expert witness. So to be specific, when I look at a defendant who's committed, usually some fairly horrific violence, anything you said yourself from stabbing, attempted murder, murder. And my job is to decipher, do they have a mental illness?

Yes or no? If so, did they have symptoms at the time of the offence? Yes or no. If they did, did their symptoms affect their criminal culpability? the most important question that I need to answer. And if so, do they need to be go to a prison or a psychiatric hospital? Welcome to the show. I'm Jordan Harbinger. On the Jordan Harbinger show, we decode the stories, secrets and skills are the world's most fascinating people. We've got in-depth conversations with scientists and entrepreneurs, spies and psychologists, even the occasional Russian spy,

arms dealer, extreme athlete or a cold case homicide investigator. And each episode turns our guest's wisdom into practical advice that you can use to build a deep understanding of how the world works and become a better thinker. If you're new to the show or you want to tell your friends about the show, and I love it when you do that, I suggest our episode starter packs as a place to begin. These are collections of our favorite episodes organized by topic. They'll help new listeners get a taste of everything that we do here on this show. Topics like abnormal psychology, negotiation and communication, technology and futurism, crime and

cults and more. Just visit jordanharbinger.com slash start or search for us in your Spotify app to get started. Today, I'll look inside the minds of criminals, especially violent savage criminals. Our guest today, Dr. Shaham Das, a new friend of mine, just a fascinating character. His job is to assess criminals and see if they're bad people who cannot be rehabilitated or can be rehabilitated but need punishment, or if the perpetrator is mentally ill and needs to be treated instead. In other words, are they bad or are they mad? We'll learn how these evaluations are done and hear some incredible stories,

some of which are pretty horrifying, honestly, from a life in this field. I also have some questions about whether or not it's possible to fake mental illness. You know, we often hear like, oh, they're pleading insanity. It's all fake. We'll also hear how mental illness

changes the way people think and experience the world and a whole lot more really interesting discussion with Shaham here. If you're a true crime fan, you're going to love this. If you're into psychology,

you're going to love this. If you're into criminal justice, you're going to love this. I just think it's a really, really interesting conversation. Probably goes without saying, though, no kids in the car for this one, folks. All right, here we go with Dr. Shaham Das. Thanks for coming on the show, man.

Your book was really interesting, and your YouTube channel is super interesting, and I'm looking forward to this conversation. Absolutely, me too. Thanks for having me on, Mr. Harbinger. It's a pleasure. You got it, man. Look, on your YouTube channel

and some of your videos, you discussed the psychology behind, I would say most major types of offending, including murder, stalking, arson, internet trolling, domestic violence, grooming, so like sexual abuse type grooming, knife crime, which is a major thing in the UK, I guess, gangs, really, really interesting stuff. A lot of times, in the United States, especially, we're such a litigious culture, you can't get a doctor to just be like, by the way, here's what I think about all these folks, because they will get sued into oblivion and maybe

lose their license for being, quote, unquote, irresponsible. But you don't seem to care about that. That's not an issue for you, which is cool. I don't think I'm big enough to care. I don't think I've garnered enough attention. But no, I mean, the way I see it is educating people, right? Like, I never claim to be able to specifically diagnose an individual because I've never met them. But I can talk about just using the clinical experience of many, many other individuals very similar to them. I can make quite easy judgment calls on people's personality traits, sometimes on the actual psychiatric diagnosis as well. Yeah, I think that's sort of frowned upon in the United States specifically because, well, one, if you do it to a politician or a public figure,

we have this thing called the Goldwater Rule where you're not supposed to really do that for purposes of, it's sort of, I don't know if it's frowned upon or straight up, like, unethical according to medical ethics, but we don't have a lot of that. And that's one of the reasons I like your channel. So basically, it seems like you work in a prison-like hospital. Is that accurate? So forensic psychiatrists work in a few different environments. Right now, I do most of my work in court. So I act as an expert witness. So to be specific, when I look at a defendant who's committed usually some fairly horrific violence, anything you said yourself from stabbing, attempted murder, murder. And my job is to decipher, did they have a mental illness? Yes or no?

If so, did they have symptoms at the time of the offence? Yes or no? If they did, did their symptoms affect their criminal culpability? That's the most important question that I need to answer. And if so, do they need to go to a prison or a psychiatric hospital? So that's why I work now in courts, but in previous iterations as a forensic psychiatrist, I've worked in a female prison for a couple of years, and I've worked on lots of secure units for several years as well. You're actually face-to-face with some seriously dangerous people some of the time, at least in the book. There's a lot of poor souls who are what seems like slaves to poorly understood mental illnesses, but also there are some outright dangerous people that you are in a little

room with face-to-face, and I'm thinking, you know, you can't show them that you're afraid, and you've got to put all that aside, but it would be kind of tricky sometimes to deal with those. To massively oversimplify it, I would say that there's a spectrum, right? And on one end of the spectrum, you would have mad. So when I say mad, I mean something like a psychotic illness, right? So you have people that are hearing voices, telling them to hurt people or people that have, like, paranoid delusions,

so they might attack somebody because they have a delusional belief that that person's a paedophile or that person wants to attack, hurt them or kill them. So that's one end of the spectrum. The other end of the spectrum, which would be bad, would be a personality disorder. So psychopathy would be a really well-known one. Anti-social personality disorder. So those are people who are impulsive, aggressive, that don't care about the rights and wrongs of other people. You know, these are nasty career criminals that just have a complete lack of empathy and remorse.

So, yeah, it's a spectrum. Obviously, there's, you know, how spectrum's work. There's people that have a little bit of both. I feel less comfortable around antisocial people than I will around people who are just purely psychotic. This makes sense, and we'll probably dive more into that in a bit. I've been thinking recently about the homelessness issue here in the United States. I see these guys around here and there, and my wife will always say, oh, that used to be somebody's sweet little baby. And I assume that some of these people were abused and ended up this way, either through addiction, mental

illness or both. How can trauma and childhood lead to mental illness? Is that a thing? Yeah, absolutely. So I would say that almost all of my patients, 98, 99% of my defendants, that I assess have some kind of trauma or abuse in their childhood. You said it yourself, physical, sexual abuse, sometimes they have very irresponsible, lax, neglectful parents, drug abuse is a huge, huge risk factor, homelessness, witnessing violence, gang violence. It's very rare for them not to have one of those things. And these factors often cause criminality, but they also cause mental illness. So that's why they're so common. I notice that a lot of mentally ill people, they have poor health, They have lower life expectancy.

Some of that's got to be coming from a toxic family in the first place, but is the rest of it addiction and homelessness? Or is there other things going on with mental illness that cause you to live a shorter, unhealthy life? So there's quite a lot of sort of different factors that come into play. And it's different for different people. If you've got a severe mental illness, if you're lucky enough to have a good family support structure, so, you know, relatives that care about you that will take you to a doctor that will make sure that you take your prescribed medication. then your outcome generally is going to be a bit more positive. A lot of my patients come from broken homes, a lot of them are adopted or are brought up in

the care system. Well, they simply have families that don't look out for them. And those are the people that drift into homelessness. The mental illness itself can massively damage their physical health. The really poor lifestyle, so from alcohol, drug abuse to smoking, can massively decrease their life expectancy. And also something that we cannot ignore that I'm responsible for in a way is medication. So taking antipsychotic medications, if you've got something like schizophrenia, has massive

physical implications on your health, you know, with like heart arrhythmias, for example, or increasing your lipid profile or increasing your blood pressure, et cetera, et cetera. Your risk of having a heart attack is massively increased. Interesting. Yeah, that's really said that there's side effects from things that these people can't even help that are going to kill them. I mean, that's just adding injury to more injury at that point. I won't even say insult to injury. They're already suffering and then they have to take a medication to stop that suffering. And it's like, yeah, but it's going to take a decade off your life. I mean, it's just, there's a lot of sad. I know you've said in the past that behind every

bad is usually a lot of sad. And I assume this is kind of what you're talking about. Yeah, absolutely. There are exceptions. I very occasionally see somebody who just purely has a psychotic illness and has no problems in their background or upbringing. One of the cases that I talked about in my book early on, a young girl called Yasmin, who ended up killing her two-year-old nephew would be an example of that. but that's exceptionally rare. Almost always there's some kind of trauma in that if you unpick it enough. Yeah, well, I definitely want to talk about Yasmin, because that's a terrifying tale simply because it came out of absolutely nowhere,

or at least it seemed that way from the story. I'm sure there's more to it. I know you run an assessment. I assume you run some sort of assessment in the beginning when you're talking with somebody. What do you do if somebody won't give you anything when you're trying to assess them? Like you're asking them assessment questions, and they just start singing more money, more problems. I mean, obviously, first you do notorious BIG's part at the end and crush the duet, but then what do you do?

So after the music starts, after the wrappings over, to be honest, that's not that uncommon. So if somebody's truly psychotic, especially if they have something like paranoid schizophrenia, when I assess them, especially the first time, they don't know me from Jack, right? A lot of them have paranoid delusions. So I'll be specific, really common delusions in the patients that I see would be that they're being followed by strangers, followed by the FBI. there seems to be quite a few people that seem to be connected to the film The Matrix. So they believe that there's this big kind of conspiracy and the world is not real.

So they're just very paranoid. They think they're being poisoned. They think they're being watched. So when they come and sit with me, it's really hard to elicit their symptoms. So to answer your question, the answer to that, well, there's two solutions. The easiest and the quickest way is to look at all the evidence. So when I assess an individual, say somebody's been charged with murder, I don't just take what they say at face value because they could be faking it.

this is a whole other topic. I look at all the psychiatric notes. I speak to their psychiatrist. Also, generally speaking, with psychotic illnesses, your level of functioning decreases over months leading up to the psychosis. So if somebody tells me that they're hearing voices, but they've been going to work every single day, they're going down to the pub with their friends, they're managing a normal home family life, they're socializing, then I'm going to be suspicious. So I'm looking at all of the evidence. I also see what their mental state is like from objective evidence from other people. So if they're remanded in prison, I will speak to the prison officers. And if that person says they're paranoid or is acting paranoid in front of me,

but the prison officers say that they're laughing and joking with their other prisoner inmates on the wings, then I'm suspicious. And the other tell-tale sign is that if somebody's really, really unwell, they don't have an agenda. They're not trying to convince me. They're not trying to say that they need to be in hospital because in their minds, those delusions are real. So they don't think they need to be in hospital. They don't think they need antipsychotic medication. Whereas those who are trying to put it on a little bit or try and exaggerate or fabricate, they have an agenda. They tell me straight away that they're hearing voices or that they're paranoid. That makes sense, right? Because paranoid people are not going to go, hey man, I'm really paranoid. They're going to be like,

I'm not telling you anything, man, because I'm paranoid. I'm not telling you why I'm not going to tell you anything. The point of paranoia is you don't want to tell anybody anything about why, what's going on. And just to add to that, if part of their paranoia is this massive conspiracy system, and it often is about the government, about the police, they're almost certainly going to assume that I'm part of it, right? Because they've never met me before. I'm just some guy that comes in and tells them that I'm about to assess their mental state.

But I would say that there are sections of the Mental Health Act in the UK, and I believe there's the equivalent in the states, where you can section somebody temporarily whilst they're still in the middle of their trial. What I'm saying is you can watch them in hospital. And when you have nurses observing them in 24 hours a day, even though they might not tell me their inner feelings, you can tell by the way they interact on the ward with other people. make sense that you would get, I guess you'd say background info from prison officers, other people

that know them, and you'd be able to make an assessment there. It's probably a little bit hard. I don't know if there's a hard and fast rule here. What about the voices that people say are in their heads? If you say, what are the voices saying? Are there ways where you're like, oh, that's he's making that up. And other voices, you're like, nope, that's what voices in people's heads that are actually hearing sound like? Because I think if you said Jordan, what are the voices in your head say? I'd probably tell, and if I'm being honest, I would tell you some very normal voices in my head like oh hey you're hungry you should probably eat no don't eat that you know better than to eat that again that's bad for you that's what sane maybe sane voices say in people's heads

but people who are pretending to be mentally unstable or insane it seems like you'd be able to tell because you've seen the real thing maybe the voices oh they speak in alien language you wouldn't understand you're like okay this person's legit or it's just a bunch of nonsense and you can tell they're making it up is that am i getting somewhere with this yeah yeah absolutely so there's a few tell-tale red flags. So I'll give you a few of them. Generally speaking, when people have true psychotic experiences, when they have real auditory hallucinations, they feel real. So when somebody says voices inside my head, I'm already suspicious, because an actual auditory hallucination feels as real as you hearing my voice now. So it's actually external outside somebody's head, even though people

say voices in my head is not actually that accurate. Number one. Number two, the voices generally in psychosis tend to be, how to put this, quite blunt. So if somebody says they have a really detailed, like, intellectual conversation with a voice. It's not impossible, but it's really unlikely. It's usually just one message. It's usually a negative message like, you're a piece of shit, or people think you're a paedophile, or these people want to rape you. So they're just like very short, simple phrases that repeat over and over again. That's far more realistic than these long, intelligible conversations. That's something. And you know what? That sheds some light on a lot of times when we see people who are clearly suffering from mental illness, walking through New York,

San Francisco or San Jose, they'll say something like, stop looking at me. And I'm like, whoa, they're not even talking to me. They're just yelling at somebody. And I'm thinking, how do they not know that there's no one there? And if you say, well, they're having hallucinations, auditory and possibly otherwise, they don't realize that there's not somebody behind them that's following them or looking at them. They actually see that. They actually hear that. Their brain is, their senses are not working properly, right? Absolutely. And they tend to be relentless as well. So it tends to be the same phrase over and over again. Some of the patients that I see have, what we call command hallucinations. So instead of derogatory comments, they'll say things like,

kill that man, that man's watching you, that man wants to kill you, stab him, and they're just relentless. So I've spoken to patients and some of them, not all, some of them will literally hear the same phrase over and over again, pretty much their entire waking lives, you know, over weeks and months. So I guess the point in trying to make is it's easy for you and I to say, you know, why would you listen to those voices? But if it's just this relentless, kind of repetitive impulse, it's really hard to resist over time. Yeah, it's like the Chinese water torture where they drip on you, but it's like for weeks and months at a time in the same spot. Absolutely.

Oh, yeah. Yikes. Okay. I don't know if you should answer this question, but I'm going to ask you anyway and you can pass. If you were going to fake a mental illness, how would you do it successfully, knowing what you know about mental illness? The first thing I would say is that it's really hard to do because of what I said before

that a good forensic psychiatrist will look at all of the evidence. Let's pick a hypothetical situation. Let's say that you wanted to stab somebody, yeah, and you wanted to blame it on. mental illness. If I was going to fake it, which by the way, I'm not advocating for anybody, but if you were going to do that, you can't just fake it on the day. You have to fake it for weeks and months beforehand. And it has to bleed into your functioning. So it's got to be affecting your work, probably to the degree that has come to the attention of psychiatric services or at least your family members. So people have been saying for weeks or months that this person's been acting

a little bit odd, a little bit off, a little bit paranoid. That's the first thing I'd do. The second thing I would do would be to make sure that at the time of me stabbing that person, lots of people thought that I was hearing voices. So I'd be acting bizarrely responding to myself on the streets so that the witness statements that I will read as the forensic psychiatrist from passers-by, from the police officers that arrest you consistently say that you've been hearing voices. And also another example would be the police interview transcript. So I read the police interviews after the person's been arrested.

Again, if somebody's acting completely normal in the police interview, but saying they're hearing voices, then I'm suspicious. So I would make sure that I'm hearing those voices during that police interview as well. And finally, the last thing I'd say is I wouldn't try too hard to convince the forensic psychiatrist. Like I wouldn't say immediately I'm hearing voices. I wouldn't respond to them immediately. I'd do it in a really sort of subtle way that it's just more convincing.

I think it's more subtle. Interesting. Yeah, there's a, have you heard of Vincent Gigante, Vinnie the Chin? He's a mobster from... the chin. Yes. Yes. This is right on your wheelhouse. In the mid-1960s, they started calling him the odd father because he would be shuffling around his Greenwich Village neighborhood and pajamas. He'd be wearing a bathrobe and slippers only. He'd be mumbling to himself. He would just look like this disturbed but harmless guy. But law enforcement, prosecutors, mafia defectors, you know, guys who

flipped, they would say, it's fake, it's fake. And he evaded prosecution. He was like one of the if not the biggest mafia leaders in New York and probably even up to the mid-1990s. He was one of the wealthiest mobsters. And he would just mumble around. Sometimes he would pee outside, I want to say. I could also be adding these details off of memory. But I remember people would just go, what that. And finally a judge was like, cut the shit, man.

You know, we know from, I don't know, surveillance or something that he would, you know, as soon as he gets home, be like, sits down and has normal conversations with people or something. I don't know how they caught him. but basically they eventually found that he was humiliating himself publicly, and that was the price for escaping a long prison sentence or prosecution in the first place. Really, really, like, committed to the bit, though. Yeah, absolutely.

You have to commit, like, you know, months of your life to it. And the other thing I'd say is that I think there's a misconception that if you get something like a psychiatric defense, let's say not guilty by reason of insanity, I'm sure you've heard that phrase, there's this conception that, that's it, that the case is dropped, and you're just released back onto the streets. That's very rarely the case, especially if you've committed serious violence. So somebody like him, if he managed to convince and fool the forensic psychiatrist and the judge,

wouldn't be released. He'd go to one of these secure units, possibly for years. And so, in fact, it's not that uncommon for our defendants to spend longer detained under the Mental Health Act in a psychiatric unit than the equivalent prison sentence. By the way, I found it. He said FBI agents in 1986 observed the townhouse where Vinny the Chin was, going and hanging out from a nearby rooftop post. Soon after arriving, Mr. Gigante would change into more elegant clothes, carry on fluent conversations with associates, read and watch television before retiring. About nine or ten the next morning, he would reappear in a shabby downtown clothes,

you know, like ripped windbreaker and pajamas and be driven back to Sullivan Street or nearby apartment occupied by his mom. He basically like pretended to live with his mom. And then he would go to this fancy club and hang out normally. I mean, that is weird. You know, you, Because normally, mafia guys, like, they're supposed to be these arrogance sort of, you know, reputation is everything. And here this guy is peeing in the middle of Greenwich Village wearing dirty clothes. He fooled everybody. It sounds like committed, but he didn't quite commit enough.

Right, yeah. You really want to fool the system. You have to be, it's like a method actor, I guess. You know, you have to be in that character 24-7. But then where's your life, right, at that point? What are you doing at that point? Oh, man. Is there a time that stands out where you really got it totally wrong?

You got totally duped by a patient, maybe not a, maybe not Vinny the Chin. but surely somebody's pulled one over on you during your career. Yeah, absolutely. It's happened a couple of times. I'm going to tell a slightly different story if that's all right. Sure, yeah. I think it's a bit more interesting. It's a time where kind of the opposite.

So I was convinced that a female con artist had fool the courts despite the fact that I said that she was faking it. So I talk about her in my book, I call her Darina. That's not her real name. So she was very different from most of the defendants I see. She was very well to do. She came from a very privileged background. She went quite high up in the corporate world.

So she was an investment banker, became a multi-millionaire. Wow. She was married to a CEO. She was very rich. So basically what happened is that she lost a lot of the money, partially through the divorce. And she helped her two co-defendants, so one was her own cousin, and one was a man that she had an affair with, who she used to work with. And they had these like carbon credits frauds.

I don't really understand the ins and outs of the fraud, but they defrauded lots of people, businessmen, off millions of pounds. And her role was just to siphon the money. so she didn't actually directly commit any fraud face-to-face, she just laundered the money. So the reason I was asked to assess her was because, tragically, she had a child who had a very rare form of leukemia during her trial at the old Bailey. So they stayed her trial, so they froze her part of the trial, carried on trying her two co-defendants, both found guilty, both went to prison. And she managed to evade the first court case because she was in this situation where she had to

take a kid to the hospital, etc. Fast forward a year and her son recovers, but is still kind of teetering on the edge so he could relapse at any moment. And she completely refused to engage in the court process. So she didn't answer any letters. She didn't take any phone calls from her solicitors. She just basically just went la la la la la la and tried to ignore the whole thing. And then she was assessed by quite a renowned forensic psychiatrist, one of my colleagues, and I believe that she pulled the wall over this man's eyes. So she was crying relentlessly in the assessment saying that she was too upset to even consider or talk about the crimes that she allegedly committed. And he, I think, was totally dup. So he said that she would not fit to plead and that the charges should be

dropped because she couldn't go through the court process. So the CPS, which is our prosecution in the UK, were suspicious, rightly so. So they instructed me to carry out this assessment of her, which I did. And I smelt that something was off right from the beginning. So they were just parts of the story didn't add up. So for example, she was able to tell me, she was crying pretty much the entire time, but I didn't let her get away with it. So I, you know, I was empathetic, off her tissues, but I didn't stop the assessment like the other psychiatrists. did. And she was able to tell me in detail after the tears, loads of specifics about her earlier life, education, family. But when it came to talking about the alleged offenses, she said

that she was too upset and she couldn't remember. It's super convenient, right? She just can't remember the elements of her crime, but she remembers all this other stuff in her life. Absolutely that. And I made it easy for her by giving her some options. So I said, you know, okay, you can't tell me the ins and outs of what you did or you didn't do. What kind of offense was it? Couldn't answer the question. Was it fraud? Was it assault? Was it arson? Couldn't answer the question. Who were the co-defendants in your trial? And she said that she couldn't remember. So it didn't add up to me that even if, even if she did have memory problems because she was depressed, which is possible, it didn't make sense to me that she couldn't even recall these

really basic details. So basically, I called bullshit. I mean, obviously I had to word my report very carefully, but I can't overtly say that I think she's lying. Your Honor, my diagnosis is this is bullshit. Exactly, yeah. So it's tempting to say that. I'm sure it is. But the courtroom where everybody has to wear a crazy wig doesn't sound like the place that they're going to let that slide. The opposite of what you just said happened. So the judge actually overturned my evidence. So to my absolute surprise, despite what I said, you know, I worded it very carefully. I said that, you know, there's no psychiatric explanation of why she would have this kind of memory loss, which is my polite way of saying I don't believe her without directly saying it.

To my surprise, the judge actually went with the other experts' evidence and dropped the case. I think, I don't know this from facts, but I think because they had the two main, co-defendants behind bars, I think they would, they had, like, she was just a consolation prize, so I don't think they were that bothered about putting her through the trial process, but I think it's all bullshit. Yeah, that's wild, so she got away with all that fraud. What the hell, man. Scary.

Scary that somebody like that also has a child and is like, you can get away with anything, just pretend you don't understand what's going? I mean, that's not a role model that you want to have out in society. How do you restrain someone if they're aggressive while you're dealing with them? I know, like, straight jackets probably are from 100 years ago and you don't use those anymore, right? Yeah. So if I'm doing like a one-off assessment, say, in somebody in prison, and if they get too agitated, then from my experience, there isn't that much point in kind of restraining them or forcing them to talk to me because I can't make a helpful diagnosis if they're

just not willing to talk. So in that situation, I will do what I talked about before. I will say in my court report, I couldn't do the assessment, but I look at all the other evidence, all the medical notes. But if you're talking about restraining somebody whilst they're in hospital, so when the part of my job, which is rehabilitating people, that is something that you have to get on top of. So there's like an emergency nursing team. So I wouldn't say that there's violence on the wards all the time, but certainly from my experience, once every few weeks, once every month or so, people will kick off on the ward because you've got people with a long history of violence, people that have like all these psychotic experiences we're talking about. So the first thing that

you do is you try and de-escalate the situation. If there's something specific, like the patient doesn't want extra medication or they want leave, but you're refusing to give them leave because they're too aggressive, then you try and explain that now's not the time to have that conversation because they're a bit too aggressive. If that doesn't work, then you offer them some medications. They're like a sedative. And then if that doesn't work, you press your buzzer if you think that you're in physical danger, which has happened to me a few times. And then the emergency nursing team comes in. I'd say about 50% of the time the patient will see that there's all these nurses and they will see that, you know, some shit's about to kick off. So that in itself

kind of deescalates the situation and then 50% of the time it doesn't, in which case the nursing team are actually trained. So once a year, we go through like all these holes and actually learn how to grapple with patients in the safest possible way. And the nursing team will like take them physically restrain them. There's usually like one or two per arm, one or two per leg. And if necessary, we'll put them in a seclusion room. So all forensic units have this like, it's what used to be thought of as the padded cell, but it's not actually padded. It's just like a cell with no furniture that can be picked up or weaponized. And the patient's kind of kept there and observed closely for a short a period of time as possible until they're safe to return onto the board.

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Come join us. You'll be in smart company. Now, back to Shaham Das. I feel bad for everybody involved. You probably get training for dealing with this. And certainly the nursing team that has to restrain some big dude also has training. What is it like? You grab the left arm and you grab the right. I mean, some of these guys are going to be much stronger than any other person or than many other people. You probably need four people to restrain some of these guys, right? Yeah, absolutely. And the other thing that I think sometimes gets another misassumption when you look at

these TV dramas that you get on these burly kind of orderlies in these psychiatric units, you know, these massive built men. In reality, it's not like that at all. They're just like a normal range of people, probably more female than male, usually middle aged. And as you say, sometimes they're on these medium secure units and you get these really big, dangerous guys. So, yeah, it makes my heart flutter even, like, thinking about it.

Yeah, I did assume that you had a bunch of big, former, college, high school, whatever football players. And it's like, oh, hey, we need the guys who can scare these dudes with one mean look. Nope, it's actually going to be your mother-in-law going in there, grabbing the dude's right leg, left leg, and keeping them. That just seems really dangerous, of course. What are the most common diagnoses of the violent criminals that you see? Is it psychopathy?

Is that an outdated term? I never know the difference between a psychopath and a sociopath or if it's the same thing. So in terms of the one-off assessments that I do for medical legal work, by far I would see more people with more personality disorders. It's only a very small proportion that have these psychotic illnesses and they're the ones that end up in the psychiatric units. But to answer your question, yeah, so by far the most common diagnosis would be antisocial personality disorder. Very briefly, I'll summarize antisocial personality disorder, borderline personality disorder, psychopathy and sociopathy. So antisocial personality disorder very common in the patients that I see.

So that's somebody that's impulsive, aggressive, doesn't care about the rights and wrongs of other people. They don't learn from their mistakes. So what I mean by that is they'll have repeated prison sentences and they won't change their lifestyles. So these people are career criminals. They're your natural thugs, your kind of, you know, gangsters, your drug dealers. These are people who intend to offend. They don't do it sort of, you know, accidentally or impulsively. Then you have psychopathy, which is like, I would say that's the bigger brother of antisocial personality disorder.

So it's all of those things I mentioned, but they tend to be really charming and manipulative and deceitful. It's not obvious that they're antisocial. In fact, they can be actually very charming and pleasant. They can be your friends. They can be your neighbours. They can be your work colleagues. But they will stab anybody in the back to get their promotion. So they're massively overrepresented, as well as in the prison population, also in, like, the corporate world CEOs.

Right. The difference in sociopathy. So psychopathy is a clinical psychiatric term, so diagnosis. sociopathy is more of a social informal term, but very briefly, sociopaths tend not to be quite as skilled as psychopaths of fitting into society. So they live on the fringes. They tend to sort of, you know, be outlaws and they tend to be career criminals, a bit like antisocial personality disorder. Plus, they can't contain their rage. So if you piss off a psychopath, his dish of revenge will be served cold.

He will plot for weeks or months how to hurt you when you're least expecting it. Whereas if you piss off a social, path. They don't have the emotional stability to do that. So they'll just explode in anger. And then finally, borderline, borderline is a kind of category of its own. So it's often misunderstood, as I think you just said yourself as being like a borderline diagnosis. But it's an antiquated phrase. And it came from being borderline between a personality disorder and a psychosis. That's not a very good description of it. The difference is that people with borderline, they don't intend to offend. So they're not antisocial. They do care about other people.

they do have empathy, but they have these really unstable relationships and they explode with anger. So they just can't contain their emotions. So a borderline person will act violently in the context of an argument with like their boyfriend, their mother. It's usually people that they're quite close to and know intimately. And they have the arguments like we all do, but they just explode and they lash out with anger. But the difference is they regret it immediately. So they don't mean to offend. They just can't contain their emotions. And then, you know, hours afterwards, they feel really bad. and sometimes they hurt people close to them physically and mentally and emotionally, but they regret it afterwards, whereas antisocial people, psychopaths, they don't regret it.

Tell me a little bit about how you testify in the criminal courts. These assessments we've talked about a little bit, expert witness work. I've known you've done something like 500 plus cases for criminal court alone, right? Yeah, yeah, probably closer to 1,000. Oh, wow, yeah, I'm outdated in my number here. So that's a lot of you seeing people evaluating them. Tell me about what that's like. I know in the book you rail against so-called cowboy experts where it's an expert hired by one side and one side will call their testimony pretty much only if

beneficial. I'm not 100% sure on that. And I'm thinking, isn't that all we do here in the United States? I don't think they call an expert and they go, this is devastating to my case, but we already paid the guy. I think that's all we have are cowboy experts in the States. So when you're an expert witness, you have to be completely 100% objective, honest and neutral. There's a problem with that. And the problem is that you get paid by one side. So the majority of the time you get all experts get paid, psychiatric experts get paid and instructed by the defence. Simply because the defence is the first person that gets to ask for evidence. And it's only if the prosecution doesn't believe that report or thinks that the expert is not being neutral. Like, for example, in the case of Dorino, the fraud when they instructed me. So that's only a very small proportion, maybe 10% of the time they call their own experts. So just by the nature of the work, a lot of it's, most of it's for the defence. And so if you're not a very good expert or if you're greedy or you're, you know, money hungry, if you want to grab them dollars, then it's quite easy to, I wouldn't say lie, but I'd say twist the evidence to make somebody look iller than they actually are. It's really not that hard

to do. All you have to do is emphasise the times that there is some evidence of some sort of mental disorder in the history and maybe over egg how the patient presented in front of you. It's not really that hard to do. And some people do that. And I can tell that they do it because I just read their reports and they just don't seem objected. Or I look at the medical notes and they've mentioned the five assessments where this person was suspected of having a mental illness and were sections, but they don't mention the 20 assessments that they had where there was no evidence of mental illness. So that's a really easy way to tell if somebody's kind of twisting the evidence or not. The problem with that, apart from obviously it being unethical, is that you can be cross-examined

in court. So if you've got a good barrister who's had the time to read through all the notes, which often they don't, just because the nature of they work, that they can pull. those things out and you can be professionally kind of embarrassed. And there have been cases of expert witnesses in the UK who've been struck off. So barrister for people who are like, what are you talking about? That's essentially a lawyer who can go to trial. So in the UK, you guys separate solicitors who are us paper pushing type lawyers from barristers, which are guys who can go to trial and run a case. In the States, in theory, you're qualified to do either of those things upon graduating from law school and being admitted to the bar. We don't really specialize in that way in a formal way.

an attorney who does a bunch of real estate documentation can, in theory, also go and work at a court. It's a little more complex than that, but I think people are, I want to make sure people don't go, what the hell is a barrister, I'm lost? The prosecutor or the defendant will try and pick apart an expert, and the same thing happens in the States too. Sorry, continue. Yeah, absolutely. Not to be mistaken for a barrister who serves you coffee. Some lawyers and some baristas are actually equally qualified to be in court at a given time, but that's another episode of the show. No comment from me, because I don't I want to get black balls by my legal colleagues.

But the problem with that is that, yeah, if you've got a good lawyer, they can cross-examine you and basically call bullshit if you are too one-sided. My understanding is in the States, it should be the same. It should be that the experts are neutral and objective. But as I said, if you get a good result for your solicitor, then your solicitor is likely to pay you and instruct you more for more cases. So there's always that temptation. A friend of mine right now, he is trying to take down a company that is, you know,

these two women and they defend pedophiles by saying, oh, we did forensic analysis on their computer and the stuff wasn't there. And what they're doing is they're like destroying the evidence or making it inaccessible or just ignoring that it's even there. And they're going to court and lying on the stand and getting these pedophiles free. And of course, they're being called by the defense of any pedophile who has their phone number, or I should say the counsel of any pedophile who has their phone number, because they will go up there and just blatantly lie and then cash the check, the $10,000 or whatever their fee is. It's really gross because of course you're not supposed to do that. Of course it's a crime.

It actually gets even worse. Tell me about the baby caught death doctor. Yeah, absolutely. So this is a fascinating but horrific case. So there was a lady called Sally Clark who incidentally herself was actually a solicitor. And she got accused of killing both of her two infant babies. So this was, I can't remember the exact year, I believe it was 2001, I might have got that wrong. And basically what happened was that the prosecution accused her of intentionally killing both of the children and they called for expert witnesses. And there was a man called Professor Sir Roy Meadow. So he was, you know, a sir, he was a knight. He was very well respected in his field. And to all intents purposes, he was a very good pediatrician. The problem is, is that when he

gave evidence in court, I don't believe he did this intentionally. I don't believe there's any or malice behind this. Because he's an expert in cot death, he said that it didn't look like cot death. So he stated that Sally Clark killed her own baby. And because it happened twice, he said some sort of really glib remark, like the chances of it happening in one family is one in whatever million. The chances of it happening twice in the same family is one in 63 million, I believe, was the statistic that he used. And he even made further, even more kind of glib comments about the chance that's like picking the grand national, which is a famous horse race in the UK winner three years in a row out of all of the horses. That's the same probability.

So he's basically saying that it's almost impossible for this to be caught down. Right. It's like getting struck by lightning twice in your driveway. It is never going to happen. So, and it turned out to be totally inaccurate. And this guy should probably stick to jousting or whatever. Exactly. Yeah. So it was exactly totally inaccurate. So other experts, after she'd already been sentenced to prison for murder of a two children, other experts re-examined the evidence. They said there was lots of factors like, for example, a respiratory gene, which makes him more likely for babies to die of cot death, environmental factors of the actual bed itself, which would have been the same for the two babies. So when you look at the statistics,

it's much, much lower possibility of this happening. So she was charged and convicted for murdering her own kids. She got really badly bullied in prison, as you would expect, because everyone thought she was a baby killer. When she eventually did get appealed and the evidence was overthrown, she got released and she got vindicated, and then tragically she died of alcohol abuse just within a couple of years after that. Yeah, she just drank herself to death out of stress and sadness and grief because her kids died and then she went and got blamed for it and then got tortured by the prisoners and then got tortured by the prisoners and then got out and didn't have any kids.

Oh, it's so awful. And she got separated from another third child that she had while she was in prison as well. Yeah, that poor woman. That's horrible. Oh, it's so gross that this stuff just happens. It's so scary. What percentage of the population suffers from mental illness? Do we actually have any idea?

Yeah. It's difficult to answer a question to answer simply because it depends how you define mental illness. So if you're talking about something that's fairly broad, like some degree of anxiety and depression, then it is well over, or around a half, I'd say, anywhere between 40 to 60%, depending on which study that you look at. If you're talking about severe mental illness, so the stuff that I see that can affect your criminal culpability, so if we're talking, you know, schizophrenia, that's about 1%. bipolar effective disorder is roughly about the same 1 to 2%. That seems really high. That's a lot of people. I mean, one or two in 100?

That's a ton of people. Yeah. Obviously, there's a range of how severe that is. So I tend to see the people that are on the very severe end of the spectrum, people that need to go in and out of hospital or even prison for their adult lives. That's only, you know, at the tip of the iceberg, the vast majority, managed to contain their illnesses much more effectively. Let's talk about mad versus bad.

So crazy versus bad for us, Yanks. The line is really hard to draw. Why is it hard to draw? The reason it's hard to draw is because, remember how I was saying before, there's a spectrum. On one end you've got mad, which is psychosis. On the other end, you've got bad, which is personality disorder. Because the vast majority of defendants have some element of both that I see. Remember I was talking about the confounding factors?

So because of their backgrounds, because of their trauma, physical, sexual abuse, because of homelessness, abuse of parents, drug abuse. They tend to have elements of mental illness as well as elements of personal illness. disorder and elements of criminality. So what I'm saying is there's so many factors at play that people often have a little bit of mad and a little bit of bad. Having said all that, the one thing I would say is that even though psychiatry is full of gray areas, and even though there's people that are on different points on that spectrum, the law is very black and white. So you either have a psychiatric defense, like not guilty by reason of insanity or diminished responsibility for murder,

or you don't. There's no gray areas. And when they ask me for my opinion, they either want a yes or no, they don't want to hear this, you know, possibility or, you know, he has some elements of this, some elements of this, they don't care. Well, it depends. Like, dude, what do we pay you for? Figure it out, yeah. Does it matter functionally? For society, it seems like, I don't care if they did it because they don't know that

this person wasn't an alien and thereby murder them or if they're just really a terrible person and they did it because they don't care and they're just saying this. Like, I don't care why my neighbor killed somebody else. I just don't want him to be my neighbor anymore. I want him to be behind bars. So I think there's definitely an element of society people that I talk to who have that kind of mindset that even if somebody was not responsible. So Yasmin is a perfect example of that. Even if she was having delusional beliefs at the time, she killed a nephew, therefore she should be behind bars.

I talk to people who think that all the time. I can't subscribe to that way of thinking because I'm a doctor. You know, I'm a doctor first. Then I became a psychiatrist. Then I became a forensic psychiatrist. So I personally believe that there's redemption in people who have mental illnesses when that has caused. their actions if they knew what they're doing. I understand that, right? Because you can medicate them or therapeutize them to the point where they are not actually dangerous. Yeah. And I literally do that

for a living. So there are people that will say that's not possible and you can't rehabilitate certain people that have committed certain crimes. They're not doctors. So who cares what their opinion is? Right? They're not doctors and they're not experts. So we don't have to listen to those people. Some of your cases, though, the perpetrator, they just can't understand the process or their crimes at all, right? And others, they seem to know, but they don't care about others. They feel entitled. That's the difference. So if somebody just doesn't understand what's going on, if we can get them to a point where they do, and like with, let's talk about Yasmin, because she didn't know what was going on and then she did, and that was sort of part of the tragedy, right?

Yeah, yeah. So Yasmin, as I said, it's the first case I talk about my book is probably to this day one of the, if not the most kind of emotional case that I've experienced myself. So a very quick bit of background. I mentioned earlier, she's 18 years old. At the time that she killed her two-year-old nephew, she had no antisocial behavior at all, never even got detention at school, no signs of mental illness at all, came from quite a hard-working kind of immigrant family. The whole family lived together, so she lived with her parents and her siblings who had their own children.

She had what I think is called a prodrome, so that's like a little harbinger of a psychosis. Prodrome? Prodrome, yes, yeah, yeah, exactly right. In the scenario of psychosis is called a pro-drome. So it's like a not quite full psychosis, but it's like an indication that psychosis is coming. So she acted bizarrely. She started listening to this weird chanting music. She started wearing odd baggy clothes.

She was telling her family off for watching smot on TV, even though they were watching the same sitcom that they always used to watch together. But she had to bizarrely, but no, nothing that would indicate that she would take life. And then she was babysitting her two-year-old nephew one day when she had three periods from school. She had these delusional beliefs that I fully believe. that she thought were true at the time. So she believed that her nephew had some sort of demon inside of him. And so she suffocated him with a pillow to end his life because she believed it's the only way that she can get rid of this demon. And she was convinced that she could resurrect him when the full moon came out later on that evening. So she did this. She didn't try and sort of hide her

behaviour in any way. She told her mother what she'd done when her mother came back home from work a few hours later, which to me is really telling because somebody who knows what they're doing is wrong will, you know, run away, try and hide their actions, try and make excuses, etc., so she got arrested, unsurprisingly. She got remanded to a big female prison called Holloway Prison, which is where I saw her. And I found her really hard to assess because, to be like what you were asking about before, she was really paranoid and really closed off. So she was superficially polite, but very passive-aggressive,

and she wouldn't tell me what her thought processes were. So everything about the demons that I mentioned, we found that out months later. She just literally said she couldn't remember what happened and refused to talk to me. So I managed to convince the Ministry of Justice to transfer her over to our medium-superful female unit at the time. I had to give evidence for her murder trial at the old Bailey, which is like the main criminal court in the... Yeah, I've been there. We're very intimidating place to go and have a trial. You don't want to be, you certainly don't want to be in the dock as a defendant, but even just walking in there, it's really like you're in

trouble now, even if you're just going to work. Yeah. How have you been there? When I worked in London, I used to be an attorney, so they were like, hey, do you guys want to see the old Bailey and go in there? And we went in there and we got to check out some of the wigs that the barristers use, those curly things that they still wear, which is kind of crazy and they're super itchy and uncomfortable, depending. A lot of courtrooms are like to see in the United States, where everything is wood inside and very formal, but the old Bailey, you know it's been there for a while and they've had some crazy cases in there for centuries, and a lot of people, if memory serves, there's been a lot of death sentences handed down in there hundreds of

years ago or whatever it is. So there's gravitas to the place. Yeah, absolutely. I think that's a perfect word, gravitas, yeah. So there's statues, there's sort of Latin inscriptions. So I gave evidence and it was, I've got to be honest, I was shit scared at the time because I was just a middle grade doctor. First time I'd ever given evidence in a murder trial. Plus, it was really hard to fully know what was going on with the mental health because she was so guarded. We'd observed her on the ward, so she would make really odd comments. So, for example, she asked me to print out everything on the internet about reincarnation. And then when I asked her why, she kind of took the comment back and refused to discuss it anymore.

She'd make these really odd, bizarre, religious kind of questions, like, for example, would would a Muslim person go to hell if they ham sandwich by accident? And then when I asked her why she asked me that question, again, she would shut down. So it's really hard to elicit the symptoms. But on the strength of my evidence, she ended up getting a hospital order. So she went to prison for long-term rehabilitation, whereas the prosecution were pushing for a life sentence for murder. And she almost certainly wouldn't have taken her medication in prison because she had no insight. Whereas in the hospital, we were allowed to use the mental help out to enforce injections onto her,

which luckily we didn't have to do for too long because she reluctantly agreed to take the medication. One of the interesting aspects of this case was that it took 18 months, Jordan, to medicate her to the point where her delusional beliefs ended. So she was 100% convinced for that entire period of time that she hadn't killed a nephew, that everyone else was lying that she had resurrected him. It took that long for her to actually realize. And it goes back to what you were saying about whether people feel guilty or not. So she didn't feel guilty for the first 18 months. But that wasn't because, you know, she's narcissistic or nasty or antisocials because she was psychotic. And then eventually her delusional beliefs assuaged and this tsunami of guilt encompassed her reality.

She finally realized what she'd actually done. And then she went into this massive, deep, dark depression, self-harmed on the ward. We had to treat her with, you know, therapy for a depression. We had to treat her with antidepressants as well as antipsychotics. Part of her rehabilitation was family therapy. So her brother, who's the father of the child that she killed, was part of that therapy. So I'd sit in a room on a weekly basis to try and kind of repair that relationship. So it's just really sort of fascinating.

but emotionally draining for me. I'm surprised he was willing to do that. I don't think I could forgive anybody or participate in their recovery after they murdered my kid. I don't care what their reason is. But again, if it was my sister, I don't know. What do you do?

That guy is a better man than I, I think, probably. You know, I don't know if I would do that. I think he's a better man than I as well. I think I agree with you there. But I suppose from his perspective, she was 18 years old when she did this. Therapy started maybe two years after that. So for 18 years, he's seen a normal sister

that he loves and that he's close to, I guess what I'm trying to say is maybe in his head this new mentally ill version of her is only a very short period of time compared to the 18 lucid same years that he knew her. Maybe he hang on to that, I don't know. What's scary about this is, yeah, she started listening to chanting music and dressing weird,

but was she a teenager? Yeah, 18. You know, you would never notice if a teenager is acting a little bit weird. That's their whole job to listen to weird music and dress weird. and then shaming them for watching smut on TV, you'd be like, that's weird.

But then you'd think, I should smoke in a pot in a room or something. You wouldn't think like, oh, she's literally going insane. She was in medical school, right? So she wasn't like a strange duck or somebody who had a bunch of issues already. She was, by kind of all metrics,

really going places. Unfortunately, she ended up going down the tubes because of this illness. Yeah, and I'm sure her family and a brother must have asked themselves the question, could we have done something sooner and what we could have done? Yeah.

Honestly, my professional opinion is I don't know they could have done anything different. She maybe could have had a psychiatric assessment within those few weeks, but at the level of symptomology she was showing, she probably wouldn't have been medicated. And if she was, it takes weeks for antipsychotics to work anyway. So I guess what I'm saying is this is one of those very rare occasions that even in retrospect, I don't know if the outcome could have been stopped. This is the Jordan Harbinger show with our guest Shaham Das.

We'll be right back. All right. Now, if you like this episode of the show, I would love it, since you're so smart, considerate and supportive of this show. Take a moment and support our amazing sponsors. Now, all of those codes, the discount codes, all those little URLs that get confusing, they're all at Jordan Harbinger.com slash deals. You can also search for any sponsor using the search box on the website as well.

That's all at Jordan Harbinger.com. Thank you so much for supporting those who support us and makes it possible for us to keep churning these things out week after week and keeping what I'd like to think is a high level of quality. All right. for the rest of my conversation with Shaham Das. Right, when we read about people who've done horrible things, and then it's like, oh, yeah, his neighbor's report that every night he gets up on the roof and howls at the moon and gets caught running around naked in the backyard, and he kills

small animals, you're like, what the hell you guys missed all this obvious stuff? This is partially on you, the blood's on your hands. But when it's like, yeah, she was listening to weird music and dressing weird, and then she had a temper tantrum about what we were watching on TV, it's like, okay, and, you know, just no prelude to murderous behavior. at all. There are some other people who have got real heavy-duty stuff. Tell me about the guy who removed his own eyeballs in prison. That was just horrible. That's like straight out of a saw or something. Yeah. So, Yasmin's probably my most kind of emotional case, but this man's probably the case that

it's the most extreme violence that I've seen anybody commit against themselves. I've even had other patients that have killed themselves and they don't stand out as being that kind of horrific and extreme as this man. So yeah, so this was a man who I assessed in prison. He went there for a fairly minor offence. I believe it was arson in the context of having an argument. I think it was even a suicide attempt at the time. He went to prison and he just wasn't built for prison. He got bullied targeted immediately. He's just like some fairly geeky quiet. It was in his 50s, some geeky guy. The other inmates didn't like him immediately. And they started spreading rumors about him. So they falsely started telling everybody that he was a paedophile, which is not true. And they said that he had

killed his girlfriend in the fire, which is not true. She wasn't in the apartment. And as I'm sure you'll know, in the hierarchy of prison, I know it's even more pronounced in the States than it is in the UK, but it certainly exists in the UK. People who sex offendergates children and people who hurt women are seen as the scum, the lowest of the low. So he was bullied, he was targeted, he was punched several times. He went into the protective custody wing, but people were still sort of messing with him, still beating him up. And none of this was his fault, by the way. And so he basically developed a psychotic illness very quickly that I am fairly sure was related to the stress of this. And he started having these weird delusional beliefs that people were chanting about him in the

middle of the night trying to use voodoo magic on him wasn't true. And crucially, he believed that his eyeballs contained this power and that other prisoners would want to kill him, remove his eyeballs, eat his eyeballs to give them this superhuman strength that they would use to break out of the prison. Obviously, completely delusional. So he thought in his mind that the only way to survive this, to not die, would be to remove his own eyeballs. So that is literally what he did. So he was stuck in a segregation cell. He used a plastic knife in the first eyeball, which snapped. He literally used his fingers for the second eyeball. Oh my God. The amount of mental strength it would take to do that is incredible. Yeah. I'm trying to look on the bright side. There's not a whole lot of bright side of this.

That's horrible. Did he ever get to a point where he was not delusional and was he like, holy crap, I took my eyes out, eyeballs out? Yeah, absolutely. So the reason that I assessed him was because, so I should say that I assessed him actually like two years after this happened, so I didn't see any of this happening, but I heard all about it, read all the medical notes. I interviewed the nurses that were rushed to the scene straight after it happened.

Just to end that story. So they tried to, they had to get what we call kitted up, so they had to put on their riot gear because the guy was obviously very, very dangerous. And it took about eight minutes from him beginning to take his first eyeball out before everyone got kicked in. And he just finished as soon as the second eyeball, as soon as they'd cut in. So he was trying to sue the prison mental health team for two reasons.

First of all, for not recognizing his psychosis and not treating him. And number two for not getting in there quick enough to stop him doing that. So I saw him about two years later. And he was completely sane. I have to say, because I read the notes, obviously, before I assessed him. And I was expecting somebody that had like a chronic psychosis that would be delusional or have these strange ideas. But he was completely lucid.

He still had some paranoid ideas about the prison staff at the time. Like he believed that they were conspiring against him and that they were laughing at him when he was removing his eyeballs. Obviously, that wasn't true. But he believed that as a delusional memory. But aside from that, he was, yeah, completely lucid. Your job sounds really frustrating sometimes. People don't cooperate.

They spit on you. They curse at you. They don't follow your instructions. They won't take their medication. They can be dangerous. They can be racist. They can threaten you. Why do this job?

Just raise teenagers or something. Well, I don't know. I just find it fascinating, really. I've always found criminality fascinating. I think people with mental illnesses, especially psychotic mental illnesses to hear their beliefs that they 100% invested in. Yeah, I don't have a better answer than that, I'm afraid. I just find it really interesting.

It's totally acceptable. I was just curious because in a way you're a glutton for punishment, right? It's not like a glamorous job in many ways. And you still, you went to medical school and everything. You could do all kinds of different stuff. And this is what you chose. And I think it's really interesting too. But, you know, somebody threatening to stab me with a syringe.

Pass. You know, I'll pass on that. One thing I would say, right, is I went to medical school, loads of my friends of doctors. and almost none of them have actually gone into psychiatry, let alone forensic psychiatry, and some of them are very successful and eesthetist surgeons. But there must be a sameness, right? Once you've done a shoulder operation, once you've done a couple of hundred of them, they must be very similar, whereas at least my cases, and some of them are, you know,

I'm telling you the most fascinating and the most gory, some of them are obviously a bit more routine. But it's just interesting to know about people's backgrounds and the crazy things that they've done and the violent things that have done. I'd rather read the case notes of that going into work every day than having to read operation notes of who needs their shoulder placed in what position. Okay, so I hear that. This is not a PC question, but do you feel like you've collected a new Pokemon when you find somebody with a new mental illness that you've never seen before?

And I don't mean that you didn't know existed, and I don't mean to trivialize this at all. But I'm sure there's a better way to ask this that wouldn't get me in trouble, but screw it. Here we are. If I'm you, I'm excited to see something new that I'd only read about, heard about from colleagues seen in the literature. And I'm like, oh, this is shared psychosis or whatever. You know, wow, I've never come across one of these in the wild and it's like, this is a good day because I saw this thing. You go home and you tell your wife and she's like, I don't want to hear about this.

Yes, is the answer to that. So I think like most areas of work, to see something rare is rare. So the vast majority of the people that I see will have one of the illnesses that I've already mentioned, so, you know, schizophrenia, personality disorders. But occasionally maybe less than once a year, I will come across something that is extremely rare that you read about in your textbooks. So catatonia is a good example of that. Shared psychosis, which is called Follyard Dirt, is another example of that. So it happens very, very rarely. But yeah, it is quite exciting because like all medics, you have to do all like hours and

hours of readings and exams when I was a junior doctor to qualify. So there is something satisfying about reading something that a lot of psychiatrists will never see in their career and you get to see. Yeah, I can kind of get behind that. I feel like I would feel the same way. It seems like being non-judgmental is a key trait required in your job. You're dealing with pedophiles. You're dealing with other violent criminals.

How do you manage that? Basically, my answer to that would be that I am very, very clear in my head what my role is and what my role isn't. So my role is never to decide whether somebody's guilty or not guilty. And it's never to decide the length of punishment if they end up going to prison. I can say that they should go to prison by saying that they shouldn't go to hospital by process of elimination, but I should never say how long the prison sentence should be because I trust and I have to trust in the court system. I know it's not perfect and you do get miscarriages of justice.

Sally Clark, we've already talked about today, hasn't it? example of that. My role is, have they got a mental illness? Are they criminally responsible? Do they need treatment? Hospital or prison? What level of security of hospital, depending on how dangerous they are. Those are the things I have to decide upon. If they've done something horrific, I've assessed dozens of men, women occasionally, but mostly men who've sexually assaulted, man and women, children, killed strangers, killed family members even. I'm just very clear in my head that no matter what I might feel about them personally, and I do obviously have my own opinions, I'm just very clear that I don't let that bleed into my assessment and I don't let it bleed into my evidence.

And sometimes I have to say that I genuinely think that I've seen instances occasionally of my colleagues not doing that. I can see colleagues who are very judgmental in the tones of their evidence and their report, both because they either really dislike an individual who's done something heinous or actually conversely the opposite. So sometimes I see people who have vulnerable defendants. Yasmin's a perfect example of that or women that have social issues from drug abuse to domestic abuse. and you can tell him the evidence that the expert's gone the other way that they've been too sympathetic to try and kind of influence the judge. And I can understand where that comes from.

It comes from a place of empathy, but that is not our role. Our role is to be completely neutral and objective. Yeah, you've got to separate the off from the offense for better or for worse, and that almost seems like a superpower. I don't think I could do that. I'd be like, oh, but she's so nice and she's so remorseful when she has a little kid.

And look at how she grew up, she was just dealing with so much stuff. Of course she stabbed this guy when he pissed her off. Like, I get that. He was a bastard too. look at his record. You know, I would do that, and that's the opposite of what you're supposed to do. Well, you can kind of do that a little bit. So I can certainly say exactly that situation, say somebody, a young woman who lashed out in anger after years of abuse, I can certainly write those factors down in the main body of the report and in my conclusion. And indirectly,

I can invite the judge to take those factors into consideration when sentencing. But the difference is, is that if you cross a line as an expert, you might even use the phrase like, you know, she doesn't deserve a high level of punishment. You can't say that. Basically what I'm saying is you can put factual matters down, but you can't put your opinion on what the punishment should be. When we see these in-cell losers who go and shoot up schools and stuff like that,

what characteristics do these guys have in common? Because to me, whenever I look into it, even a little, they all seem like, frigging, just dumb, entitled, narcissistic. What else? So I think you've hit the nail on the head with most of them. So they usually are quite isolated and withdrawn and marginalized. So these are not people that are popular at school and have lots of friends. Obviously, they're romantically and sexually unsuccessful, right?

But always by definition to be involuntary celibate. They tend to find their own little communities on the internet, and they kind of weaponize and encourage misogyny. So there's not just some people that have misogynistic views like Andrew Tate might have. It's somebody who actually goes into a chat room and encourages other people, or sometimes more vulnerable people to go and commit violence. But of all the personality traits that stand out, the one that you mentioned, entitlement is by far the biggest one.

So they feel entitled to sex. They feel that society is geared against them because they're not attractive, that women of the same level of attraction go for men who are more attractive than them. So they think that the whole system is skewed against them. Can we spot these people in advance? I think the problem is,

and everybody wants to know that about criminals, right? My gut says a ton of the same people, There's a ton of people out there who have the same bucket of characteristics, and 0.01% of people who are in that bucket go on to commit violence, not even that percentage, go on to commit violence. So it's probably a fool's errand to try and label those people in advance, right? Yes, I would have to agree with that. So when you look at the risk factors for people becoming violent, everything that we've already talked about before, you know, themselves being victims of bullying of violence,

of being marginalized, there's so many people that fall into that category. but as you said, only a very, very small proportion actually go on to commit violence, especially extreme violence. So the problem isn't being able to spot them or spot the red flags of the warning symptoms. That's easy. The problem is knowing which very small proportion of them will go on to actually commit violence. Having said that, the easiest, simplest and quickest predictor of future violence is previous violence. And it usually escalates.

So what I'm saying is that there are people, especially young men, can be women as well, but the vast majority of time it's young men who carry on offending and their level of aggression and violence increases. And sometimes that's because the criminal justice system itself is a bit broken. So, you know, it gives them not very good at arresting them or actually charging them. So people who sexually offenders are a very good example of this. That's one problem. Or they just don't learn from the mistakes. So they serve prison sentences, but they carry on committing violence. Those are the people that need the most kind of attention. And the other thing that I would say, it might be slightly unpopular, but I believe it to be true,

is that sometimes they have mental health issues. So we're talking about in cells before that a huge proportion of them have problems with anxiety and depression. If you take the models out of it, take the ethics out of it and just focus on it logistically, if you can help them with therapy, medication,

socializing them so they're not so withdrawn and isolated, then I believe that you will decrease the risk of future violence in a huge proportion of them. What about internet trolls? Some of these people sound like psychos online, but I'm guessing it's not really the same. I mean, you're anonymous. You kind of had a bad day.

You want to say some horrible shit to somebody. Usually you don't. But some of these people have nothing else to do. What's the psychology behind you? Have you ever sort of dived into these people, dove, into these people? Yeah, yeah, I have actually. So I've done a video about internet trolls, and I talked about this tragic suicide of a young 14-year-old girl in England

who hung herself because she was relentlessly bullied on Facebook. And then it gets even worse. After that happened, her sister and her father were also targeted on Facebook. Facebook by the same people. So it's weird because you said the term psychopaths, right? Less than 1% of the population are psychopaths. And so just very, very briefly, all the things I said before, impulsive, aggressive, don't care about other people, lack of empathy, lack of remorse, quite charming, quite manipulative. But oddly, I think that, how do I put this, I don't think everyone that's an internet troll is a psychopath, just statistically doesn't make sense.

But I think that the, if they have some of the traits, they're amplified with that anonymity. So the average internet trial wouldn't have the balls to go up to somebody they don't know and insult them to their face. But because they have this distance, not just physical location, but also sometimes temporal location. So they might make a comment and know that the target's not going to read it for hours or maybe even days. I think it kind of gives them this kind of, it's almost false courage. So it amplifies those kind of character traits of a psychopath. That does make sense. There's a lot of entitlement.

You came up with this term, I think, in a video, toxic disinhibition, where there are They can get away with it. There's no consequences. So it's like, well, I'm removed from this person in time and distance. I'm never going to see them. I'm never going to suffer the consequences. Maybe I'll tweet this horrible thing from this anonymous account or post this YouTube thing about whatever and just never think about it again.

I would assume it's cathartic in some ways for these people to do that. Yeah. And also it gives them a sense of identity and purpose. So a lot of the times, not always, but a lot of the times these internet trolls are a bit like the incels we're talking about. They're marginalized. They're isolated. They don't have a social circle.

They don't have friends. Whereas when their persona on a keyboard makes them popular because other people kind of jump on the bandwagon, we were talking off air about all these internet celebrities that say these really horrible toxic things. We were wondering about how much of it is actually what they truly believe and how much of it is just doing it for attention. I think attention, narcissism is a huge, huge part of it. People with a fragile ego who are possibly bullied themselves or at least kind of ignored by

their peers when they were children, they like to get their own sort of revenge back at those bullies by targeting even more vulnerable people on the internet. Do you only get to see the terrible cases? I would assume you're so busy that if somebody leaves your care goes on to lead a productive, happy life, you probably just never hear about that or hear from them ever again, right? Yeah, yeah, that's one of the cons of working as a forensic psychiatrist. There's not much customer satisfaction, let's put it that way, because if patients actually get better, then they tend to be discharged to lower levels of psychiatric health. So if we are following somebody who's quite potentially quite violent in the community who's got a long

history of mental illness and violence. We follow them up for like a year. And if they're stable for a year, which is good news for everyone involved, then they go to general adult psychiatry services. So we don't, we don't hear about the success stories. Man, we got to have you back, because I want to hear about drug-induced psychosis, shared psychosis, somatization. And there's, I have all these other notes here that we don't have time for. So we'll have to have you back. I want to have a talk about some famous cases that are maybe even currently ongoing and see what your analysis is as well. I want to wrap with this. You have kids too. Doesn't it scare you that some of these more dangerous people even exist in your book? And on one of your videos, you told me about this

guy who threw a random six-year-old kid off a balcony in a shopping mall for just no reason. And that that shit stuck with me for weeks, dude, because I've got a toddler and I've got a baby. And I'm like, Oh my God. I was at the Lego store the other day on the second floor of the mall. What if someone just comes up and throws them over the railing? I mean, it's absolutely a nightmare to think that there's people like that out there at all. Honest answer, Jordan, is that it doesn't bother me. It doesn't scare me because I know how rare it is.

Okay. But I actually did an assessment yesterday in a solicitor's office. It was a victim of somebody who'd been sexually abused by Scoutmasters decades ago. He's like in his 50s now. And he was telling me about his life. And it was just horrible. Like even before the abuse started, he was one of eight children and his older brothers used to pick on him because he was just slightly camp.

He wasn't gay, but he was quite camp. I never heard that. Camp is, how do I put this in a PC manner, is somebody who is quite effeminate in their interactions. Got it. Okay. So his brothers are just like, ha ha, ha, you're gay as kids do when their kids. Yeah, yeah.

But they would physically beat him up on a regular basis. And his own father used to encourage it as well. So his father just took an instant dislike to him. There's even rumours that his father wasn't his real father, but that's a whole different story. And he was telling me the story, and I was writing my notes yesterday when I was writing this report up.

And I obviously didn't say this to him, but I do remember thinking, you know, I've got two boys. And I just, I would never intentionally hurt their feelings, let alone, you know, encourage violence against them or make fun of them. I couldn't fathom doing something

that would hurt their feelings on purpose. And so I guess my answer to your question is it's not the random murderers who would, you know, abduct a child or throw them off the tape modern that affects me, is hearing the stories of people, especially when they were kids, being picked on and bullied by other kids and even their own family members. That really affects me because it's just so cruel.

Like, there's no understandable reason for that behavior. I just can't get my head around it. You know, we talk about someone like Yasmin, and even though what she did was devastating, I can understand why she did what she did, but I can't understand why an adult would hurt a child. Jahan, thank you so much for coming on the show, man. I'm looking forward to the next time.

I really appreciate it. Super interesting look inside the dark side of the human mind in many ways. and yeah, I'm looking forward to dissecting some actual cases that we see in the news. And I'm so curious what you think. We can't really talk about a lot of this in the United States with a doctor in the United States because they have to be very, very careful about that. But you're in the UK, so we're off the hook, right? You don't mind a little flak, a little heat.

So I appreciate that. Thank you once again for coming on the show, man. Jordan has been an absolute pleasure, a big fan of your podcast. And thank you for asking interesting questions. I do a lot of interviews and sometimes you get the dull routine things, but you really pushed my cognitive ability, so thank you for that. We've got a preview trailer of our interview with Dr. James Fallon on how psychopath brains function differently from the rest of us and why psychopaths thrive in modern society.

I'm a neuroscientist since about 1989. I've studied the brain imaging scans of killers, serial killers, really bad murders. And you should did one or two a year for many years. And then in 2005, 2006, I got set a ton of them. And I analyzed them. I said, oh, my God, there's a pattern. So I saw this pattern that nobody had ever described. But at the same time, we were doing a clinical study on the genetics of Alzheimer's disease.

And we had all the Alzheimer's patients we needed. So we needed normals, just normal controls. And so I asked my family, that was kind of my first mistake. I said, look, guys, you want to all get in. I have my brothers, my wife. I said, we'll test you. And the idea being that on my side of the family, there was no Alzheimer's at all. So we did it.

And the two technicians walked into my office. And on my right side, I piled all these murderers, brain scans. And they handed me the pile of my family scans. And they were covered up so I couldn't see the names. And so I went through, I went through one, two, three, four, five, six, seven. I was really relieved that they looked at the first pass, normal. And then I got to the last scan and it looked at it. I said, okay, guys.

They said, this is very funny. You kid around with each other, right? And I said, okay, you switched him. You took one of the worst psychopaths from this pile of murders, and you switched it into my family, ha, ha. And they go, no, it's part of your family. I said, you've got to be kidding. I said, this guy shouldn't be walking around in open society.

It's probably a very dangerous person. So I had to tear back the covering on the name of it. And there was my name. For more with Dr. James Fallon, including how to spot. a psychopath in the wild, check out episode 28 here on the Jordan Harbinger show. So interesting, we definitely have to have Shaham back here. His YouTube breaks down true crime cases by going into the minds of the criminals.

And he'll say, this person looks like they've got narcissistic personality disorder based on da-da-da-da-da. Really interesting stuff. We'll link to that in the show notes. I think we're going to have them back on to discuss some current cases that we're seeing here in the news. Unfortunately, there's just no shortage of those. I mean, this guy could make YouTube videos for a hundred years.

I mean, we will absolutely never run out of creepy criminals in the news. By the way, I just took a flight back from North Africa, and I just, what mental illness is it that makes people go to the bathroom on an airplane only wearing socks? That's the disorder I want to see diagnosed. It's the most disgusting thing I've seen in years. You cannot come into my house, if that's you. I don't want to know you. You'd have to douse your feet and gasoline and light them on freaking fire, and maybe I will let you in.

I'd rather have your oozing bloody stumps on my floor than the piss soaked and God knows what else soaked feet after you walk into an airplane bathroom wearing only socks. I'm not sure how I got on this subject. But geez, what is just if that's you, you should reevaluate all of your life choices. Just saying. Anyway, links to Shom's stuff will be in the show notes at Jordan Harbinger.com. Transcripts in the show notes, videos up on YouTube, advertisers, deals, discount codes, all the things that support the show. those are going to be at Jordan Harbinger.com slash deals.

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