A Dark Night in Aurora

by Dr. William H. Reid

  She reviewed much of the available record with him, asking for his version of information from past reports and observations by his family, teachers, friends, and the jail staff. She asked whether he had fallen or jumped from his bed on November 11; he said “a little of both” and that he had done it “to protect you guys … from me.” In a later interview, he said that he expected “the shadow” to catch him when he fell. Holmes seemed puzzled or confused by some of Gur’s questions, even though they were straightforward, as if his mind were guarding against surprises and needed time to frame a safe answer. That was probably a psychological defense, not a conscious one, and not the same as being intentionally evasive.

  At several points in Dr. Gur’s first interview with Holmes, when she was pressing him repeatedly about feelings-laden topics, his flat, restricted affect broke down. Gur described him as becoming emotional, grimacing red-faced as if he were crying, shaking, breathing hard, and unable to talk. The reaction was most pronounced when he was, in her words, trying to express “his hopelessness, despair, pain, and the hurt he caused to the family members of those killed.” Those impassioned-appearing behaviors with Dr. Gur were the most intense outbursts, the only ones really, reported by any of Holmes’s evaluators or interviewers. They are also among his few indicators of remorse.

  Holmes told Gur that he was afraid.

  “Of what?” she asked.

  “Of people … all people,” he responded, including her. He didn’t know what she was going to do to him. He spoke of seeing shadows, indicating the wall behind her.

  With regard to the shootings and their planning, Holmes spoke more poignantly to Dr. Gur than he would to future psychiatrists and psychologists. He talked about a sense that a “master power” had taken over his life. He wanted to stop the thoughts of killing himself and others that had been building for years, but he couldn’t. He wanted other people, such as Dr. Fenton, to stop him, but the part of him that pressed for killing thwarted his veiled efforts to get the psychiatrists to stop the process. He saw no future for himself, the world, or the universe; death was a rational step. “No life for me,” Gur quoted from her February 2013 interview, meant “no life for others.” He wasn’t angry with other people; this wasn’t revenge, but “it had to be done…. I was called to action.”

  That phrase, “called to action,” would raise controversy at the trial.

  Dr. Robert Hanlon, a Chicago neuropsychologist hired, like Gur, by the defense, tested Holmes extensively in 2013 and 2015. “Neuropsychological” assessments are different from ordinary psychometrics (intelligence tests, personality inventories such as the Minnesota Multiphasic Personality Inventory [MMPI], or the Rorschach “inkblots,” for example). Most of Hanlon’s testing was specific for certain kinds of neurological and combined neurological-physical capacity, yielding data about brain function rather than simply psychological topics. Neuropsychological testing is also helpful for revealing faked (malingered) or unusually exaggerated symptoms; there was no significant evidence for either in Dr. Hanlon’s results.

  Hanlon’s assessment in April of 2013 indicated that Holmes was in the “superior” IQ range, that he had above-average memory function, that his ability to process information and coordinate his brain and motor functions was very good, and that his ability to pay attention to visual and auditory tasks was intact. In spite of problems initiating and responding to social interaction, there appeared to be nothing physically wrong with his brain’s ability to express things verbally, find words or generate responses, or accurately comprehend oral or written materials. His cognitive (thinking) flexibility, ability to inhibit inappropriate responses, make decisions, and regulate his behavior, all known as “executive functions” in neuropsychology parlance, were within normal limits, but a bit variable and below expectations for his level of intelligence. His reasoning capacity, including forming verbal and spatial concepts and abstracting ideas, was intact. Even his social cognition, as measured by such things as accurately recognizing facial expressions, speech patterns, and social interactions, was found to be within normal limits at the time he was tested.

  After her first four interviews with Holmes and reviewing voluminous records and Dr. Hanlon’s testing, Dr. Gur reported her findings in writing to the defense attorneys. She was quite certain that Holmes suffered from schizophrenia and that symptoms of schizophrenia were evident and increasing well before he carried out the shootings. She believed that Holmes was so removed from reality during the several weeks before July 20, 2012 that he was acutely psychotic. In her opinion, he had been insane at the time of the shootings.

  The prosecution retained its own experts to help assess Holmes and his insanity defense. The primary prosecution expert was Dr. Phillip Resnick, a Cleveland forensic psychiatrist with extensive experience in murder cases, a long record of work with both prosecutors and defense attorneys, and great credibility in the field. He would consult with Dr. Kris Mohandie, a Southern California forensic psychologist and violence expert whose career included years of law enforcement consultation.

  Neither Dr. Resnick nor Dr. Mohandie was ever able to examine Holmes. Access to a defendant is largely controlled by the defense, and Holmes’s lawyers wanted to limit prosecution opportunities as much as possible. Dr. Resnick reviewed all of the evidence and other information gathered and critically reviewed the testing and reports done by others who had examined Holmes. He and Mohandie helped DA Brauchler and his team to evaluate those findings and played a role in how some of the examinations would eventually be viewed by the Court.

  Federal and state investigative agencies gathered an enormous amount of information about Holmes’s behavior and psychology. Their results were provided to both the prosecution and the defense, but most of it helped the former. Investigators talked with Holmes’s professors and friends on the Anschutz campus, former schoolmates, and fellow employees in California and even sought out Gargi Datta, Holmes’s former girlfriend, who was on summer vacation in India. The FBI’s Behavior Analysis Unit provided their General Assessment Questionnaire (GAQ), a standardized, comprehensive witness information form, for use with Datta and at least one of Holmes’s other friends, Ben Garcia.

  The GAQ is designed to be a “proxy” psychological test in which a friend, coworker, or relative answers narrative questions about the target person (in this case James Holmes) and the person’s life, personality traits, behaviors, and attitudes as best he or she can and then rates almost two hundred individual characteristics as they might apply to the target person. The result is used by specially trained agents to psychologically analyze the person in absentia. GAQs from Datta and Garcia figured in an early 2013 psychological summary about Holmes created by a special agent from the National Center for the Analysis of Violent Crime. Interestingly, that analysis turned out to be largely inaccurate (in my view), missing several relevant factors found by psychiatrists and psychologists who reviewed huge portions of the chronological record, interviewed dozens of people, performed direct—rather than proxy—psychological testing, and interviewed Holmes himself.

  Judge Samour appointed his own expert to evaluate Holmes for the Court itself rather than for either side: Dr. Jeffrey Metzner, a Denver psychiatrist with extensive forensic and clinical credentials, experience, and credibility. Metzner was to develop findings and opinions about Holmes’s competence to stand trial, his criminal responsibility (legal sanity), and death penalty mitigation, then present his results to Judge Samour, who would then share them with both the defense and the prosecution.

  Dr. Metzner had Holmes flown to the Colorado Mental Health Institute at Pueblo (CMHI-P), where he could be examined in a secure clinical setting rather than the jail. After extensive record review and interviews of Holmes’s parents and other relevant people, Metzner spent over twenty-five hours interviewing Holmes on four days in August 2013. He also ordered psychological and neuropsychological testing by Drs. B. Thomas Gray and Rose Manguso, CMHI-P forensic psychologists who were i
ndependent of the defense and prosecution.

  Holmes spoke to Dr. Metzner about lots of things, including an attempt to differentiate some internal self from his “normal” self. He described, somewhat disjointedly, attempts to shift the responsibility for planning and carrying out the shootings from his primary self to a different, “possessed” or “crazy” (Holmes’s words) persona. Holmes was aware of both of those “selves”; he could tell them apart. He didn’t seem to be talking about fooling a judge or jury, but about dealing with his own psyche, finding a way to mentally reconcile the part of him that planned, shot, and killed in June and July of 2012 with another part of him that was, he thought, normal.

  Holmes’s descriptions and statements to Dr. Metzner differed in some ways from the known record and what he had told Dr. Gur a few months earlier. For example, Dr. Gur wrote that he chose the Century 16 theater because he liked movies, but the record is clear that it was a strategic choice designed, among other things, to increase casualties. Holmes told Gur that he shot randomly, but there is evidence that he planned to aim as carefully as he could (in his choice of sighting systems, for example), actually did aim at people, and aimed for specific reasons (such as to prevent them from escaping). He told Dr. Metzner that his rifle jammed after only fifteen shots, but some sixty-five spent .223 casings from the rifle were found on the theater floor, as well as empty magazines that held thirty rounds apiece.

  Dr. Metzner asked at length about Holmes’s concept of “human capital,” something that apparently had not changed since before the shootings, even after months of antipsychotic medication. Holmes talked about the value of different kinds of people, how much a surgeon’s time is worth compared to a janitor’s, and how increasing his own human capital, if he could do it by killing others, would somehow make his life more meaningful. Assigning more or less worth to different people is left out of most of Holmes’s other statements about human value. In other settings, including my own interviews, he steadfastly asserted that each life was worth one “point,” no more and no less, and the more points he could amass for himself by killing, the better.

  Holmes still believed that the killings brought greater value to his life, but the twelve additional life points he thought he got from his victims hadn’t made him feel any better. The other significant purpose he gave for the shootings, to alleviate his depression and make him feel better, hadn’t worked, either. He surmised at the time he saw Dr. Metzner that depression has to do with having no purpose and he, Holmes said, had no purpose. He estimated that killing people had had a fifty-fifty chance of making him feel better, but it failed. Holmes would say later, and he seemed to sense during his delirium at Denver Health Medical Center, that trading people’s lives for a fifty-fifty chance at feeling less depressed was selfish.

  Dr. Metzner’s mental status exam, the part of his evaluation that described how Holmes looked and acted at the time of his interviews, indicated symptoms and signs similar to those seen by others. Holmes had a flat affect, with little emotion about the killings, injuries, or families of the victims. His ability to think abstractly, as contrasted with “concrete” thinking (that which focuses on the literal meanings of words and sentences), was limited. That’s not a reflection of intellect or brain function in Holmes’s case, but of the way his mind needed to keep its thoughts simple and unconflicted—predictable, with no surprises.

  Holmes was fully oriented. He knew where he was and understood his situation very well. His memory was good. He sometimes said he couldn’t remember things, but with a little urging he gave information about his past history, both before and after the shootings, that was generally consistent with the various records and what he had told others. He often answered straightforward questions vaguely or expressed confusion about what the examiner meant, deflecting topics that might lead to something uncomfortable.

  Although Holmes didn’t appear blatantly out of touch with reality, Dr. Metzner believed that his continuing thoughts about human worth and acquiring more worth by killing were delusions, not simply an odd personal philosophy or value system. That, to Metzner, coupled with other statements and behaviors in the interviews, defined Holmes as psychotic.

  Dr. Gray’s testing at the time of Metzner’s interviews included several standard psychological instruments: current versions of the Minnesota Multiphasic Personality Inventory (MMPI-2), Personality Assessment Inventory (PAI), Rorschach “Inkblot” Test, and a test for malingering. The MMPI-2 and PAI are known as “multifactorial” tests. They rely on statistical comparisons of the examinee’s answers to those of many thousands of other people. Patterns of answers are analyzed to arrive at the likely psychological characteristics of the examinee at the time of the testing. The Rorschach is a “projective” test that attempts to discover hints of a person’s unconscious thinking by interpreting his or her responses to standardized-but-ambiguous images (the inkblots).

  Gray’s psychological instruments generally agreed with Dr. Metzner’s findings. There was a high likelihood of depression and psychotic thinking at the time of testing, consistent with a serious condition such as schizophrenia or schizoaffective disorder. The results also suggested anxiety and signs of personality pathology (a term that describes the long-standing overall ways in which a person deals mentally with people and life). Personality pathology and personality disorders may or may not indicate mental illness, but Holmes’s testing indicated “perceptual distortions reflective of very poor reality testing abilities.”

  Dr. Manguso’s neuropsychological testing, which incorporated something called the Halstead-Reitan battery, had results largely consistent with Dr. Hanlon’s of four months before. Holmes functioned well but not perfectly. There were a few areas that suggested brain dysfunction, and on some subtests with “average” performance, a person of his education might have been expected to be above average. He might have fared worse if he hadn’t been taking antipsychotic medication.

  The testing instruments Dr. Gray and Dr. Manguso used also had elements to uncover different kinds of malingering, lack of interest in answering, and random answers. “Malingering” is a more complicated concept than simply trying to look sick when one is actually well. Some people try to “fake bad,” to appear sicker or more mentally ill than they are. Others, including some criminal defendants who don’t like the idea of being called crazy, try to “fake good”—that is, to look normal. Many examinees with real symptoms exaggerate their symptoms to some extent; sometimes that doesn’t mean much, and sometimes it’s tantamount to malingering. It is important to understand that defendants who are genuinely mentally ill may try to malinger more symptoms than they really have. The mere presence of malingering doesn’t mean the person doesn’t have a serious illness.

  Metzner incorporated his interviews of Holmes and other people, Dr. Gray’s and Dr. Manguso’s test findings, and the entire record available at the time—some seventy thousand pages and hundreds of CDs and DVDs of interviews, surveillance, photos, and paperwork—into a very detailed forensic and diagnostic report that he submitted to Judge Samour. The judge passed it on to the prosecutors and defense lawyers.

  In his report, Metzner offered his diagnosis of significant mental illness in Holmes, both current and at the time of the cinema shootings. He also opined, however, that from a legal perspective, Holmes was capable of criminal intent (implying legally “sane,” though that finding must be made by a jury, not a psychiatrist) at the time of the shootings and was competent to proceed to trial. That is, in spite of serious mental illness, Metzner believed that Holmes could distinguish right from wrong with respect to the shootings, and his mental illness did not prevent him from forming a culpable mental state, intending to commit a crime and knowing that his actions were criminal.

  Not surprisingly, neither the defense nor the prosecution was completely satisfied with Dr. Metzner’s report. The defense wanted Holmes to be more mentally ill than Metzner opined, especially at the time of the shootings; the prosecution h
oped he would be virtually normal. Metzner’s opinions, formed independently on behalf of the Court rather than for the prosecution or defense, didn’t support either of their cases as fully as they would have liked.

  Judge Samour scheduled a hearing in which the lawyers argued their points and petitioned for a new expert. The judge decided in February of 2014, with no prejudice against Dr. Metzner or his excellent work, that the Court would embark on a search for a different expert, one who would address the issue of criminal responsibility anew and attempt to answer a list of questions raised by the two sides. I was appointed the following month.

  ______________

  1 Colorado Revised Statutes Title 16 Criminal Proceedings §16-8-1015. Insanity defined—offenses committed on and after July 1, 1995. “Obliquity” is an old term apparently used here to refer to simple dishonesty or perversity.

  2 “Acute” psychosis is a disconnection with reality that is active and obvious, not subtle, often with significant hallucinations, illogical speech, and/or markedly inappropriate behavior.

  12. My Interviews of James Holmes

  “… kind of like hating broccoli … not a fiery, angry, passionate hate.”

  (James Holmes, when I asked about his “hatred of mankind”)

  Judge Samour’s orders for the new expert were complex. I was to try to reach expert opinions about topics related to Holmes’s sanity at and just before the time of the shootings, including psychiatric diagnoses he might have had and whether or not he cooperated adequately with my evaluation. I would offer opinions, if I could, about Holmes vis-à-vis relevant parts of Colorado’s test for sanity. (The jury, not the expert witness, is the final arbiter in that regard.) Any opinions I offered would have to meet a legal threshold of reasonable medical certainty. Reasonable medical certainty isn’t all that “certain” in court settings. Most jurisdictions, including Colorado, define it simply as more likely than not, about 51 percent sure. There were other tasks, but I was not to address factors that might mitigate a jury’s consideration of the death penalty if he were convicted, nor his current competency to stand trial; those had been well addressed in Dr. Metzner’s report.