Tim Kendall: Psychiatrists must get under his skin and into his soul

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The Independent Online

At this stage, we're not talking about Fritzl being treated so he will not offend again. The psychiatrists will be assessing him to see if he's got any serious underlying mental illness, such as schizophrenia, and if he does not, then they'll come to the same conclusion as the psychiatrist who has already assessed him: that he is a very rare and very serious type of psychopath.

The psychiatrists' job will be to assess him through a series of extensive interviews and observation. They will watch carefully how he interacts with other patients – if indeed he is able to mix with other patients – and also observe what he is like when he is in solitary confinement.

In that sort of situation, you can't judge a person: your job is to establish whether they have an underlying illness and, if so, how best to help them. It's not your job to punish them, it's to act as an impartial but engaged psychiatrist. That will mean getting under his skin, getting into his shoes and getting into his soul – it's not always a very pleasant thing to do with somebody who is so disturbed, and can awaken strong feelings in you.

If they do find an underlying psychotic illness, there's no doubt he'll spend the rest of his life in a psychiatric hospital, but I think it's very unlikely that this will be the case. By all accounts he's simply somebody that most people would call a psychopath, or to use an even more common term, "evil".

There is a remote possibility the assessments so far have mistakenly not found an underlying mental problem, but to my mind, if they establish that he is merely a psychopath (ie that he is not suffering from any mental illness which would have meant he had no control over the way he acted), he deserves to be put in a normal prison, just like any other criminal.

In some ways, I think it's a terrible shame to mix up psychiatry with this, because it's not necessarily the issue. He has done some absolutely heinous things and in court he gave his reasons why, saying he was mistreated by his mother as a child. So it's no coincidence that he decides, when his daughter is ready to leave home, to overpower her and treat her in the way he wished he'd been able to treat his mother. He is very disturbed, but that's why most people do evil things: because bad things have happened.

What he did was awful, but we should be asking social questions as well as psychiatric ones. Why, for a quarter of a century, was he was able to live in this way without anybody noticing?

The writer is a consultant psychiatrist and deputy director of the Royal College of Psychiatrists' Research Unit