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Certain Factors Pertaining to the Value of Narcoanalysis in Securing Testimony

MICHAEL M. MILLER, M.D.

Division of Neuropsychiatry, Howard University Medical School and Freedmen's Hospital, Washington, D.C.

OR centuries it has been known that certain drugs such as alcohol, hashish, mescal, cocaine, opiates and others could in varying degrees reduce an individual's conscious self-control and volition and might cause him to reveal feelings, experiences and ideas which he otherwise would not express. The Latin expression "in vino veritas" illustrates that the ancient Romans were aware of such effects. Not only are the psychic inhibitory functions affected varyingly by the above drugs, but further, the capacity to experience danger or threat to one's security is altered. For instance, there is a reduction in the awareness of disturbing feelings of anxiety and guilt which often underlie inhibitory defensive reactions. In more recent years, certain rapidly acting barbiturates such as sodium amytal and pentothal administered intravenously were found to be particularly useful for such purposes.1 In World War II, psychiatrists made extensive use of these two barbiturates, particularly for purposes of abreaction and catharsis of traumatic emotional experiences resulting from combat. (Horsley,2 Grinker, Spiegal 3 and many others). The author has recently attempted to potentiate the psychic inhibitory releasing effects of these barbiturates by using them intravenously in combination with dilute alcohol (7.5%o to 15%o).4 Verbal productivity was notably increased and inhibitory feelings such as anxiety and guilt were more effectively relieved than by the former method. The clinical results were generally more satisfactory than with sodium amytal and pentothal alone,* particularly, in cases in which there was no conscious recall of the traumatic experience. The application of the so-called misnomered "truth serum" to forensic psychiatry as an aid to the courts in criminal proceedings is relatively recent and in most courts is left to the discretion of the presiding judge. I have had the opportunity to conduct over two hundred sodium amytal and
*

Recovery time in ambulatory patients was markedly reduced.

pentothal interviews on both defendants and psychiatric patients. As a result I have arrived at certain conclusions concerning the value of this procedure of obtaining testimony in criminal cases. In criminal cases where there are frequently important pertinent facts consciously suppressed, sodium amytal or pentothal may fail sufficiently to inactivate conscious defensive mechanisms as long as the defendant is at all conscious. It is important to note that the aforementioned barbiturates can elicit unconsciously repressed feelings and ideas much more readily than consciously suppressed material. This corresponds rather closely to what is usually observed under frank hypnosis. Nevertheless some degree of impairment of the effectiveness of ego defense mechanisms occurs so that the capacity willfully to conceal facts is reduced and the possibility of obtaining contradictory responses is increased. In many instances, strong feelings of guilt, anxiety or rage which the individual is unable to express consciously can be released and may be markedly contributory to the determination of motives for various acts. I have observed it is possible to establish verbal communication under sodium amytal and pentothal and to effect the release of blocked feelings, wishes, ideas and episodes in their past even in cases with marked inhibitions as encountered in catatonic and depressive stupors during which such patients may have been uncommunicative for months and years. Although there exists considerable doubt as to whether consciously suppressed material can be elicited by means of narcoanalysis, nevertheless, it is often possible for a skilled and experienced examiner to release blocked feelings, ideas, and experiences which may be of considerable value in establishing inconsistencies and discrepancies in court testimony. Marked contradictions in the emotional responses of the witness in the courtroom as compared to their affective responses under narcoanalysis may be of considerable significance. The

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tendency to contradictions which may occur in repeated taking of testimony is usually enhanced under the effects of these barbiturates. For instance, recently I had the opportunity, following a somewhat unprecedented request by a judge, to examine the plaintiff in a case in which a young woman had brought charges of sodomy and housebreaking against a young man, who had already been subjected to two sodium amytal interviews at the suggestion of his defense counsel. The young woman who had a disability and shortening of one limb following poliomyelitis some years earlier, stated in her testimony to the court that she had been unjustly attacked by the defendant who had broken into her apartment, terrorized her and forced her to submit to several indecent perverse acts. "I had to give in," she stated, "because I was afraid for my very life." The sodium amytal interview with the defendant did not support her story; in fact there was marked variance. He stated that he had been introduced to the young woman, that she had invited him up for a beer, that she had unlatched the door for him and asked him in, that she talked with him for quite a while, that after a little beer they became amorous, that she did not resist his advances but cooperated, that he attempted normal intercourse but lost his erection too quickly and that she became somewhat angry and insisted on sexual gratification. Further, she had informed him of a certain soldier who could thrill her and told him of the fact that they had engaged in cunna linguus and fellatio and how gratifying it had been. Under sodium amytal, the plaintiff for the most part confirmed the defendant's story and admitted she was attracted to him-"What girl wouldn't be?" she exclaimed. When asked why she had brought charges against the defendant, she broke down sobbing and exclaimed bitterly, "So many men have made love to me but they never really had any serious intentions because I'm a cripple. They just used me. I've been so lonely." When asked why she hadn't brought charges against the sergeant who had actually been extremely cruel and perverse with her repeatedly, she then admitted, "I stood it because I wanted so much for him to like me and he had promised not to leave me like the others-but he did." "I had all I could take." It was obvious that the defendant had become the object of her accumulated bitter vengeful feelings and that as she stated had made up her mind to "make him pay" for the others also. When asked

if she knew he could pay, she told of how he had boasted about his family and how well off they were. This testimony from the plaintiff had consciously been withheld on the witness stand. The presiding judge for the first time in the history of a federal court permitted the evidence obtained under sodium amytal to be admitted as testimony. He concluded by pointing out in his decision of acquittal that although testimony obtained under the effects of such barbiturates was not fool-proof and might be subject to error, nevertheless, in the case in question, very significant discrepancies in testimony were revealed which had been very helpful to the court in the evaluation of this case. I recall another case in which a male patient suffering from paranoid delusions and hallucinations had withheld information about an incident which appeared to trouble him greatly. Under sodium amytal, he revealed: "Some years ago I was driving a cab-picked up a man who was somewhat intoxicated and wanted me to take him to a house of prostitution. I did. However, when we got there after climbing a couple flights of stairs, the door was locked. The man became quite angry-cursed, and as we were descending, he reached for his pocket. I thought he was reaching for a gun-so I pulled out my gun and shot him. The patient admitted that he had been very fearful for some time, expecially of men and that he had armed himself because of his acute anxiety. At the time the patient was positively convinced he had shot the man in self-defense. The patient who has recovered from his paranoid psychosis is now devoting his time to religious and social work, which appears to allay his guilt concerning the act. In a similar case, I was called to examine the defendant in a murder trial. The defendant manifested an almost complete amnesia about the circumstances surrounding the crime. Under narcohypnosis*, he revealed his acute anxiety of being attacked by large powerful males and that he would frequently carry a weapon to protect himself. Further, that he was somewhat shy, self-conscious and withdrawn and that he didn't make many friends-that people didn't like him and that he often felt others were talking about him in a derogatory manner. He admitted that he drank consider* This is a term the author employs to differentiate the state of hypnosis which is drug induced as contrasted with frank hypnosis.

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ably and had been drinking at the time of the incident. He told of how he was drinking at the bar in a tavern and became quite insistent upon having another drink and was refused by the bartender. His recollections were vague. He created a disturbance and a Marine talked to him and succeeded in quieting him for a moment. When he again began to demand his whiskey, a big fellow came up to him and told him he was going to throw him out if he didn't quiet down, whereupon they came to blows and then began to wrestle. "He was grabbing for my throat and I was scared he was going to choke me, so I managed to get hold of my gun and shot him," he related. Further data which was obtained supported the conclusions that this patient was suffering from paranoid schizophrenia and an underlying latent homosexuality. Although the defense had adopted a plea of insanity following the psychiatric diagnosis, he was convicted of manslaughter. Several months later under confinement his psychotic condition became so marked that he was transferred to a state hospital ward for the criminally insane. On one occasion, we had a young female patient cn our acute psychotic ward who had delusions that a big man was attacking her in the night and was trying to strangle her. Actually one of our internes was apprehensive of her because she had tried to grab him by the throat. It was obvious that she was quite hostile towards males but made no effort to attack any of the female personnel. She would alternate between states of overt hostility and periods of apparent guilt and depression. She persistently refused to reveal the identity of her supposed assailant nor the reasons why she felt pursued by him. Under narcohypnosis, she revealed how brutal her father had been to her mother and to her. There was a large family-eight children. "We lived in poverty and misery. I guess we'd have all ganged up on him (father) and killed him-but he was our only means of support-what could we do! When I was but a girl, I swore that I would never let a man lay his dirty hands on me the way father used to do mother. Sometimes I hated her for taking it the way she did. When that James tried to grab me-I saw red-I grabbed a knife and I stabbed him-stabbed him dead, Doctor -right in his heart." She was seventeen at the time. She seemed to express doubt, however, that he was dead and repeated that "James is always coming to me at night to haunt me and to get revenge on me."

Her recollection of the experience under narcohypnosis helped to allay her fantasied fear that he was still alive pursuing revenge. I recall a case in which a middle aged man revealed that he was in a serious predicarment. His wife had started divorce proceedings because she had discovered him in an amorous embrace with a quite voluptuous blonde. The wife refused any move towards reconciliation although the husband insisted it was all a tragic mistake and he really loved his wife but that she had lost her faith in him. Since the husband begged me to use every possible means to restore the situation, I finally decided to attempt an interview with him under sodium amytal to test his feelings with the object of having his wife sit in, providing she was willing. After some initial resistance, she consented to sit in on the examination. After some preliminaries during which the husband expressed his disappointment and resentment at his wife for neglecting him and giving so much time to the hotel business which she had inherited, he exclaimed, "Why she'd even get up on Sunday mornings to answer that d --- phone. She was married to the d --- hotel, not to me." And so it went-a series of protests. Finally, I presented the big question. "Joe," I said, "if you had your choice between a beautiful blonde plus one hundred thousand dollars or your wife, what would be your decision? Now think it over," and I repeated the proposition. The wife, I could see out of the corner of my eye, was straining to hear that answer. "D --the blonde and the money," cried out Joe, "I want my Mary." Well, of course, you know the restMary began to sob and there was a tearful reconciliation. Some years have passed now and when I see them occasionally, Mary seems to have only one concern. Her Joe wants to fly his plane too much and she doesn't like his taking such chances.
DISCUSSION

Narcoanalysis may reveal important unconscious motivating factors affecting testimony of witnesses which may be overlooked entirely. These discrepancies in affective reactions obtained under narcoanalysis may be of marked significance. Affective reactions associated with an act, which have been repressed, can often be elicited and provide valuable data in regard to the emotional motivating background of a crime. Amnesic and emotionally motivated memory

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blocks may be overcome in part or entirely and the witness often is thereby enabled -to reconstruct episodes and situations which he formerly was unable to recall. Affective discharges under barbiturates may set off emotional chain reactions resulting not infrequently, in extensive catharsis. The deeper the patient is put under narcohypnosis, the greater the degree of inactivation of repressive inhibitory mechanisms (ego-defenses) and the greater the subsequent release of factual material as well as of repressed affect. This occurs up to a point at which conscious wakefulness is not too markedly depressed. Very frequently, however, in narcohypnosis as may also occur under frank hypnosis, strong emotional discharges as evidenced by outbursts of sobbing, tears and rage may occur in the initial lighter phases of narcosis. Marked discrepancies are more apt to occur under narcohypnosis than in full consciousness. Although the defensive functions of the conscious and unconscious egos may not be entirely inactivated, nevertheless, their defensive capabilities are mark-

edly reduced. A note of caution is, I feel, indicated. Narcohypnosis and analysis to be highly effective requires: first, as much background history as can possibly be secured in advance; second, proper dosage and careful administration of the drug; third, an expert, skilled and experienced in its use and qualified to evaluate the findings logically and objectively. If possible in criminal proceedings, it is suggested that the test be conducted by more than one expert and recorded for the court's study. It is often of great value to repeat the procedure for comparative purposes in order to confirm the findings and search for the existence of discrepancies. It must be remembered that patients may be highly suggestible under narcohypnosis as in frank hypnosis and every effort must be made not to introduce any external material but simply to probe the patient's mind. The value of all testimony is, after all, purely relative. Every person who takes an oath with one hand on the Bible does not necessarily tell "nothing but the truth" on the witness stand. Every person who takes that oath is capable of forgetting, confusing, distorting and misidentifying facts, persons and details related to the case. This may be due to the limitations of the human mind or due to unconscious repression or in some instances conscious wilful supression. Testimony rendered under

narcohypnosis is in may experience, usually more reliable than that obtained from a fully conscious witness. I am positive that there are judges or jurors who under the influence of narcohypnosis would disqualify themselves. For instance they might exclaim: "That defendant-I don't like him." Why? "Because he reminds me of an S.O.B. I once knew." Recently I had occasion to testify concerning the sanity of an old lady in another jurisdiction. I was convinced of her sanity as were all the witnesses on her behalf. Although the old lady displayed complete sanity in court, the judge did not order her release from the hospital. Later, privately in his chambers, the judge remarked to her attorney, "Why, I wouldn't let that woman out-look at the trouble my mother has caused me." This reaction is not at all surprising. These are universal human reactions. We often don't know what we feel and rarely express our real feelings about anyone. We all react spontaneously to individuals we meet for the first time either positively or negatively, with few in-betweens. Neutrality is a fiction to appease the conscience with which we have to live. In the first case, the judge took unprecedented position that not only the defendant, but also the complainant be given sodium amytal to clear up contradictory testimony. Psychiatrists have become increasingly aware of this need. Often, criminal cases do not provide sufficient time for detailed and careful evaluation and it frequently takes a long time to overcome fearinspired defenses and resistances of a defendant. However, methods which have proved useful in uncovering the truth in many instances should be employed in the pursuit of more enlightened and humane administration of justice.
LITERATURE CITED

1. HOCH, P. H. and P. POLATIN: Narcodiagnosis and Narcotherapy, in Specialized Techniques in Psychotherapy, Ed Bychowski, G. and Despert, J. L., New York, Basic Books, 1952, pp. 1-23. 2. HORSLEY, J. S.: Narcoanalysis. London, Oxford University Press, 1943 3. GRINKER, R. R. and J. P. SPIEGAL: Men Under Stress. Philadelphia, Blakiston, 1945. 4. MILLER, M. M.: Combined Use of Amobarbital (Sodium Amytal) and Ethyl Alcohol for Ambulatory Narcoanalysis. Arch. Neuro.-Psych. 67; p. 620-624,
1952.