Forensic Psychiatrists Weigh in on What the Ramblings in the Colorado Theater Shooter's Journal Mean

From the outset of the ongoing trial of alleged mass shooter James Holmes, the journal he'd been keeping during the lead-up to the horrific crime was clearly one of the prosecution's prized possessions.

Holmes has been charged with murdering 12 people and injuring 70 more during a spree at the Century 16 cinema complex in Aurora, Colorado, on July 20, 2012. Earlier this week, the prosecution submitted the journal, a 36-page catalogue of his neuroses, into evidence, and the document was made available for public perusal not long after.

In court Thursday, a psychiatrist spoke briefly about the journal just before the lunch recess, according to ABC News. "Whatever he suffered from it did not stop him from forming the intent and knowing what he was doing and the consequences of what he was doing," said Dr. William Reid, who examined Holmes after the incident three years ago. His will go down as the first psychiatric analysis of the suspect offered to the jury, but it's nowhere near the last.

Holmes's diary features philosophical ramblings, plans for the shooting, and a narrative of his attempts to find help for his mental health problems. As the New York Times reports, it includes phrases like "mass murder spree," "maximum casualties," and "broken mind."

In other words, it's a pretty rich resource for both the prosecution and the defense.

The trial, notable for having had the most potential jurors ever summoned for a trial in US history, began on April 27. Like the recently-concluded trial of Boston Bomber Dzhokhar Tsarnaev, the case doesn't hinge on whether the defendant committed the crime, a point which his lawyers concede. Instead, the defense insists their client is not guilty by reason of insanity. That means a nice, long look inside Holmes's mental state is going to be almost as critical as expert testimony.

The journal itself appears to be a brown computational book by Ampad, designed to be used by college students for solving long math problems. Holmes inscribed his name on the front, and on the line marked "course," he wrote, "of life." That might have been a prescient choice of words, since the prosecution is pursuing the death penalty, and using this notebook to prove he was insane is likely the defense's best chance at keeping Holmes off death row.

Two forensic psychiatrists offered statements to VICE conditionally, provided we note that they don't constitute an analysis of Holmes, just a peek into the journal as a piece of evidence.

"There is no question that the notebook demonstrates major cognitive difficulties, and a major psychiatric dysfunction. He's not of sound mind," Maria Lymberis, MD, an honorary UCLA psychiatry professor and forensic psychiatry expert witness, said.

In the early pages, the notebook is indeed full of ruminations about life, death, and morality. "He's been trying to understand what's wrong with him," Lymberis said, describing Holmes as "in search, trying to find out what is the meaning of life and what the hell was happening to him."

From a section in the notebook marked "Alternatives to death," Lymberis added that we can ascertain that "he was desperate. It was life and death for him, as life increasingly had lost all meaning and value. He was totally preoccupied with death."

Although she cautioned that neuroscience hasn't advanced to the point where we can look at a brain's physiology and definitively point to a lack of criminal intent, there are conclusions to be gleaned from the sheer negativity of the notebook's content. "When we are in that kind of negativity, modern science says that the brain produces chemicals that are toxic," she said.

Related: Read about how experiencing violence can rewire your brain to make you more violent, too.

Clinical and forensic psychiatrist Nathan Lavid was rather more skeptical about using the journal as evidence for the insanity defense. He pointed out that after a mental illness is established in court, there's still the thorny issue of proving that the patient didn't know right from wrong. He thinks that will be fundamentally tough in this case. "He used a gun. I know that he knew what a gun does. He wasn't going around with a banana," Lavid said.

The journal includes not only sections in which theaters are evaluated for desirability as targets based on the number of likely victims, but also contains Holmes's estimates of how long it will take for the cops to arrive at any given location. "Looking at law enforcement is not indicative of an individual who is impaired by mental illness so that they don't know the difference between right and wrong," Lavid told me.

The scariest parts of the notebook are probably the bizarre, morbidly mathematical bits about the value of human life. But asked if the above page suggested the onset of psychosis that could meet the legal definition of insanity, Lavin replied, "Probably not."

"It sounds like the person has emotional problems," he added. "It's not bizarre or detached from reality to such an extent that it would meet the insanity criteria."

But while Lavid makes it sound like the defense is in a tough spot, Holmes's attorneys don't have to prove he was insane, as in most states. Instead, the burden of proof is on the prosecution, which must show the accused was sane at the time of the act. Then again, as the Denver Post reported in 2013, it's been decades since any mass shooter in America won a mental health case. Holmes's attorneys hope to reverse that trend.

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