What We Get Wrong About Serial Killers, According to an Expert

Dorothy Otnow Lewis's research into murderous urges is featured in 'Crazy, Not Insane,' a new HBO documentary from Academy Award-winning director Alex Gibney.
Dorothy Otnow Lewis cross examined in ted bundy's trial
Image via HBO

The day before Ted Bundy was strapped into the electric chair at Florida State Prison, he spent more than four hours talking to Dorothy Otnow Lewis. The meeting was arranged at Bundy's request, and Lewis, a renowned clinical psychiatrist, professor, and author, asked why he'd wanted to spend the afternoon sitting in a small glass cubicle with her. Bundy said it was because everyone else he'd spoken to was interested in what he did, but she was the only one who wanted to know why he did it. 


Lewis has spent the past several decades studying murderers, serial killers, and death row inmates, trying to determine what causes them to commit such horrific acts of violence. "It's taken me 30 years to get to this point, but we could have learned a whole lot more from [Ted Bundy]," she said. "We could've learned a lot about serial murderers. But they killed him." 

She and her research into murderous urges are featured in Crazy, Not Insane, a new HBO documentary from Academy Award-winning director Alex Gibney. The film is a riveting combination of interviews with the now eighty-something doctor, intercut with archival footage of her evaluations of a wide range of subjects, including convicted killers, condemned inmates, and an electrician-turned-executioner who is disturbingly indifferent to the requirements of his job.

Earlier this week, VICE spoke with Lewis, to talk about capital punishment, criminal behavior, and whether it's possible for anyone to become a killer. 

VICE: How were you approached about being profiled in a documentary? 
Dorothy Otnow Lewis: I wasn't approached about a film like this, not at the start. Alex Gibney had heard about me somehow, and had heard that I'd done a lot of work on death row. He was planning a miniseries with Laura Dern, about a female psychiatrist who sees patients on death row, and he called and asked if I would consult. I was delighted, and we sat down and I told him a bit about what I do. I brought some of my tapes [of interviews with inmates], and Laura and I sat for hours listening to them. At some point after that, Alex said, 'I want to do a documentary about you,’ and it blew my mind. It was just out of the blue, but that's when he started to create Crazy, Not Insane. The miniseries, I think, has been on the back burner for a while (Although Dern's narration does appear throughout the documentary.) 


Did you have any concerns about making yourself the subject? 

It was a startling turn of events, but no. I had the feeling that Alex was a very honest, straightforward person, and I trusted him. A year prior to his call, I had been called by three other producers who were interested in doing something on Ted Bundy. I had vowed to myself that I was not going to make a living on Ted Bundy––which is I think why [Bundy] trusted me. I'd said no to them, but when Alex approached me, it was to consult on [the miniseries]. He's been working on the documentary for four or five years, and I think he's made a startling film. 

You admitted in the film that you've always tried to “figure people out,” and even as a kid, you asked yourself whether you or anyone else could “get that way,” as far as becoming a killer. I'm sure you've since answered it for yourself, but what about the rest of us? Does everyone have the capacity to kill? 

First of all, I don't think people are born evil. It just doesn't happen. But I think that if anyone of us was treated the way these individuals were treated as children, and if we had the same vulnerabilities to psychosis, or if we had brain dysfunction, I think sure, any one of us could become a murderer. I was brutally teased as a child, over and over again, and my sister, who's five years older than I am, sometimes gave me a rough time. I remember lying in bed at night, wondering how come I don't kill any of these people? As I grew up, I had the opportunity to ask the question in a more organized way. But sure, I did wonder. 


Many of your interview subjects and the killers you've profiled have dissociative identity disorder (DID). In the years since you started your work, that diagnosis—especially as a predilection for violence—has become a film trope. What do we lose when [DID patients] become just another movie villain? 

Movies and TV have absorbed some of these things. Primal Fear was a brilliant depiction of DID, but they really cheated the public by implying that maybe he was faking it at the end. I didn't believe that DID existed until I had a patient, a murderess, who suddenly switched on me. I was leaving the interview and this person changed. Her voice changed, her demeanor changed—it was scary as hell. I was frightened because when I turned around, instead of this kind of wimpy female who reminded me a bit of myself, there was clearly a male teenager sitting with his legs spread, and his hands on his knees, saying “Don't go, there's something I want to tell you.” One of the other things this taught me was that you don't go into an interview with a murderer alone. It's just stupid. I don't do that anymore, because many of the patients I've seen can turn on a dime. 

You were called to give expert testimony during serial killer Arthur Shawcross's trial and, while watching the film, it was hard not to feel frustrated on your behalf, by the way you were treated in the courtroom, and by the way your ideas were dismissed. Did you feel like your findings were quickly disregarded because they weren't just novel, but because they were being presented by a woman? 


Yes. Absolutely. The first day I saw Shawcross, he had the symptoms of psychomotor seizures, as well as dissociation, his MRI was abnormal in the temporal lobe, and he had scarring on the frontal lobes. I said to his attorneys, “Do not do a dissociation defense, because no one will believe it. You have wonderful neurologic data, run with it.” And they refused. He was found guilty and I was laughed out of town. A few months later, he was on trial again, and a reporter came to me and said “You know, they did the computerized EEG that you recommended.” He gave me the report, which said not only was there seizure activity in the temporal lobes, but in the frontal lobes as well. I felt like I'd been right the first time, and because of those attorneys, the world lost a chance to better understand the kinds of things that cause this grotesque behavior. 

You've said that sometimes when you interview these inmates, that you can see them as vulnerable and innocent. Is it hard to convince others to see them the way that you do? 

What on earth makes you think I ever convinced them? I kind of stumbled into working on violence, and I was not too popular. And then after decades, when I recognized the phenomenon of dissociation, I was doubly ridiculed. I have never convinced anyone, and I imagine there will be people who see this documentary and say “Oh, she's still full of crap.” 


Or there could be others who watch it and say “What she's saying is as valuable as it's ever been,” because, as the film notes at the end, [Attorney General] Bill Barr has ordered federal prisons to resume executions. 

The thing is, there are certain acts that are, on the face of them, crazy. Barr is planning to execute a woman who sliced open the belly of someone and took her baby out. I don't think you need psychiatrists to tell you that this woman is badly impaired, or that her behavior demonstrates that she had to be out of her mind. How you can kill a woman like that, I don't know. 

In her case, and in the cases of some of the others you've worked with, what is the best course of action for treating them? What does our justice system continue to get wrong? 

I think this country and its justice system have accepted a definition of insanity that goes back to 19th century England, when a man was trying to shoot the Prime Minister but he shot and killed someone else. The criteria that they created for being insane was that either you didn't know the nature of what you were doing, or you didn't know it was wrong. That's just such a low bar. I think it's time that psychiatrists define for the law what we think is insanity, and what we know is insanity. We should have a more sophisticated way of determining whether somebody is culpable, and a more reasonable and psychologically sound definition [of insanity] than we had in the 19th century. I mean, come on.

This interview has been edited for length and clarity.