By Michelle Gray with Dr. Marc Feldman, M.D.
Please join ICB in welcoming our newest contributor, Dr. Marc D. Feldman, M.D.
Dr. Feldman is the Clinical Professor of Psychiatry at the University of Alabama (UA), Tuscaloosa. He was formerly Vice Chair for Clinical Services at the University of Alabama, Birmingham (UAB) and Medical Director of UAB’s Center for Psychiatric Medicine. With a specialty in Factitious Disorder, Dr. Feldman is an international expert in Munchausen syndrome, Munchausen by proxy, and malingering.
He is a Distinguished Fellow of the American Psychiatric Association and the author of 90 peer-reviewed, published articles in the professional literature as well as the following books, Patient or Pretender: Inside the Strange World of Factitious Disorders, Playing Sick: Untangling the Web of Factitious Disorder, Wenn Menschen krank spielen, Munchausen Syndrome, Munchausen by Proxy, and Malingering, The Spectrum of Factitious Disorders, and Stranger Than Fiction: When Our Minds Betray Us.
Dr. Feldman’s work has been the subject of stories in more than 200 magazines and newspapers, and he has appeared on numerous television and radio programs. His credits include, The New York Times, The Los Angeles Times, The Chicago Tribune, the Philadelphia Inquirer, and USA Today, Good Morning America, Larry King, Dateline, 20/20, ABC World News Tonight, Court TV, CNN, Discovery Health, MSNBC Nightly News, Fox News, CBC News, CBS News, Donahue, and National Public Radio.
Readers can look forward to an ICB series featuring information on Factitious Disorder, Munchausen by proxy, Munchausen by Internet, Munchausen by pet (there’s a new one), false victimization, and that’s just the beginning.
To kick things off I asked Dr. Feldman if he would mind giving ICB readers his brief thoughts on the case coming out of Austria regarding Josef Fritzl and his daughter, Elisabeth. As most people following the case are aware Josef Fritzl has recently claimed that he couldn’t help himself, he is, alas, addicted to incest. Damn the luck, poor bastard… And his attorney has told the world that his poor unfortunate client is nothing less than insane.
Dr. Feldman: As far as my own thoughts go, they have to be viewed as largely rhetorical at this point because so few facts about the players have been released. The case may also be unprecedented in its scope and magnitude, so comparisons apparently can't be made. Like so many people, my only knowledge of the case is what I have gleaned from the media.
The father is now claiming he was "insane" throughout, and I don't buy that for a minute. Psychosis, which is what would underlie virtually any insanity defense, is not a single, unwavering clinical process that could last for decades. There also was too much deliberation in creating the dungeon, enforcing the "rules," etc., for any psychiatric disturbance to fit--except antisocial personality disorder and narcissistic personality disorder. People with either diagnosis deeply lack empathy and are utterly self-absorbed, and obviously the father fits.
Everything the father has to say at this point has to be viewed as dubious. Incest is not an "addiction." In fact, the APA doesn't even recognize "sexual addiction," though that might possibly change in the next version of the DSM (some want Internet addiction to be added, too). There is so much careful premeditation here that it is hard to view the father as extremely impulsive, as an addict tends to be.
Dr. Feldman is the Clinical Professor of Psychiatry at the University of Alabama (UA), Tuscaloosa. He was formerly Vice Chair for Clinical Services at the University of Alabama, Birmingham (UAB) and Medical Director of UAB’s Center for Psychiatric Medicine. With a specialty in Factitious Disorder, Dr. Feldman is an international expert in Munchausen syndrome, Munchausen by proxy, and malingering.
He is a Distinguished Fellow of the American Psychiatric Association and the author of 90 peer-reviewed, published articles in the professional literature as well as the following books, Patient or Pretender: Inside the Strange World of Factitious Disorders, Playing Sick: Untangling the Web of Factitious Disorder, Wenn Menschen krank spielen, Munchausen Syndrome, Munchausen by Proxy, and Malingering, The Spectrum of Factitious Disorders, and Stranger Than Fiction: When Our Minds Betray Us.
Dr. Feldman’s work has been the subject of stories in more than 200 magazines and newspapers, and he has appeared on numerous television and radio programs. His credits include, The New York Times, The Los Angeles Times, The Chicago Tribune, the Philadelphia Inquirer, and USA Today, Good Morning America, Larry King, Dateline, 20/20, ABC World News Tonight, Court TV, CNN, Discovery Health, MSNBC Nightly News, Fox News, CBC News, CBS News, Donahue, and National Public Radio.
Readers can look forward to an ICB series featuring information on Factitious Disorder, Munchausen by proxy, Munchausen by Internet, Munchausen by pet (there’s a new one), false victimization, and that’s just the beginning.
To kick things off I asked Dr. Feldman if he would mind giving ICB readers his brief thoughts on the case coming out of Austria regarding Josef Fritzl and his daughter, Elisabeth. As most people following the case are aware Josef Fritzl has recently claimed that he couldn’t help himself, he is, alas, addicted to incest. Damn the luck, poor bastard… And his attorney has told the world that his poor unfortunate client is nothing less than insane.
Dr. Feldman: As far as my own thoughts go, they have to be viewed as largely rhetorical at this point because so few facts about the players have been released. The case may also be unprecedented in its scope and magnitude, so comparisons apparently can't be made. Like so many people, my only knowledge of the case is what I have gleaned from the media.
The father is now claiming he was "insane" throughout, and I don't buy that for a minute. Psychosis, which is what would underlie virtually any insanity defense, is not a single, unwavering clinical process that could last for decades. There also was too much deliberation in creating the dungeon, enforcing the "rules," etc., for any psychiatric disturbance to fit--except antisocial personality disorder and narcissistic personality disorder. People with either diagnosis deeply lack empathy and are utterly self-absorbed, and obviously the father fits.
Everything the father has to say at this point has to be viewed as dubious. Incest is not an "addiction." In fact, the APA doesn't even recognize "sexual addiction," though that might possibly change in the next version of the DSM (some want Internet addiction to be added, too). There is so much careful premeditation here that it is hard to view the father as extremely impulsive, as an addict tends to be.
I believe that the serial rape was not an "irresistible impulse," but was carefully planned. Even if it were, one would have to ask why, as far as we know, no one else in history has done what he has done (barring perhaps the fundamentalist Mormons--I don't know enough about their stories). I still think he simply has antisocial and narcissistic personality disorders, and neither diagnosis would let him off the hook in any way--after all, many, many other criminals carry these diagnoses too and we don't avoid incarcerating them for that reason. That said, CEOs often have those diagnoses too!
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