Psychiatry, free speech, school safety, and cannibalism

Over the past few days, an article has circulated about a 23-year-old middle school teacher in Cambridge, Md., who was suspended from his job because of two futuristic novels he wrote, including one about a school massacre 900 years in the future. The story was reported in The Atlantic under the headline, "In Maryland, a Soviet-Style Punishment for a Novelist."

The article, by Jeffrey Goldberg, said the young teacher had self-published his novels some time ago under a pseudonym. In addition to his being suspended, an "emergency medical evaluation" was ordered, his house was searched, and the school was swept for bombs by K-9 dogs. No charges have been filed as of this writing.

This response was deemed an "overreaction," and certainly has been good for book sales but probably not so much for the young man’s teaching career. The idea that artistic expression must conform to a specific standard or jeopardize one’s job leaves those with creative pursuits to worry and civil rights advocates to protest.

Soon after, the Los Angeles Times published an article stating that the issue was not the novels – the school knew about those in 2012 – but rather the content of a four-page letter the teacher had written to the school board suggesting that the teacher was suffering from some type of psychiatric condition and might have included indications that he was suicidal or dangerous. With this information, it was not as clear if the police response was an overreaction, and such determinations are generally made in hindsight: If a bomb is found, the decision was heroic, if not, it was an overreaction and a civil rights violation.

The case reminded me of the story about a New York City police officer who had Internet discussions about his desire to cook and eat women, including his ex-wife. While the officer never ate anyone, he was part of an online community called the Dark Fetish Network, which has of tens of thousands of registered users who discuss violent sexual fantasies. The officer, known in the media frenzy as Cannibal Cop, lost his job and was convicted of plotting to kidnap, a crime that could carry a life sentence. He reportedly had graphic discussions of plans to kill, roast, and eat specified victims, and he claimed that he had the means to do so. An investigation revealed that he did not own the implements that would enable him to carry out such a plan. His lawyer insisted that he was engaged in a role-playing fantasy, but he was convicted by a jury in 2012. In July, his conviction was overturned and he was released on bond. By that time, Cannibal Cop had served a year and a half in prison, with several months of it in solitary confinement.

Situations in which a person has done nothing illegal but has spoken or written words that indicate he or she might be a threat to public safety are fraught with concerns. While violent fantasies might be seen as "creepy" at a minimum, the criminal justice system is left to decide where the line is between fantasy and plan, and when a real threat exists. A person has the right to his dark fantasies, and the First Amendment right to free speech allows for discussion of those fantasies, while artistic endeavors allow for their expression. At the same time, if there are named or presumed victims, those individuals should not have to live with the terror of wondering if the fantasizer is going to act on the fantasies.

Invariably, psychiatrists end up being involved, even if the individual in question has no psychiatric history or obvious diagnosis. In a New York magazine article about the police officer titled, "A Dangerous Mind," Robert Kolker noted: "Pre-crime and psychiatry often go hand in hand. Legal instruments like institutionalization and sex-offender registration all share the goal of preventing crime from taking place, and for better or worse, they’re based on a psychiatric rationale."

As we all know, it can be difficult – if not impossible – to distinguish those who are having fantasies from those who are planning to commit a dangerous act. As psychiatrists, we deal with this uncertainty for patients who have suicidal thoughts on a regular basis. Often, even the patients don’t know for sure if they will act on their impulses. Fantasies that involve harming others are more unusual in clinical practice, and our risk assessment often begins with the stated intent of the individual. Our strongest predictor of future behavior continues to be past behavior, and neither the teacher nor the police officer in the stories above had criminal records.

To make it even more confusing, the Internet has added to the uncertainty; people have always had dangerous and fetishistic fantasies, but now there are ways others can learn the content of what was once very private. The risk, of course, is that fantasies and artistic endeavors become subject to both psychiatric scrutiny and criminal prosecution in a way that threatens civil rights and squelches creativity.

Dr. Miller is a coauthor of "Shrink Rap: Three Psychiatrists Explain Their Work" (Baltimore:The Johns Hopkins University Press, 2011).

Over the past few days, an article has circulated about a 23-year-old middle school teacher in Cambridge, Md., who was suspended from his job because of two futuristic novels he wrote, including one about a school massacre 900 years in the future. The story was reported in The Atlantic under the headline, "In Maryland, a Soviet-Style Punishment for a Novelist."

The article, by Jeffrey Goldberg, said the young teacher had self-published his novels some time ago under a pseudonym. In addition to his being suspended, an "emergency medical evaluation" was ordered, his house was searched, and the school was swept for bombs by K-9 dogs. No charges have been filed as of this writing.

This response was deemed an "overreaction," and certainly has been good for book sales but probably not so much for the young man’s teaching career. The idea that artistic expression must conform to a specific standard or jeopardize one’s job leaves those with creative pursuits to worry and civil rights advocates to protest.

Soon after, the Los Angeles Times published an article stating that the issue was not the novels – the school knew about those in 2012 – but rather the content of a four-page letter the teacher had written to the school board suggesting that the teacher was suffering from some type of psychiatric condition and might have included indications that he was suicidal or dangerous. With this information, it was not as clear if the police response was an overreaction, and such determinations are generally made in hindsight: If a bomb is found, the decision was heroic, if not, it was an overreaction and a civil rights violation.

The case reminded me of the story about a New York City police officer who had Internet discussions about his desire to cook and eat women, including his ex-wife. While the officer never ate anyone, he was part of an online community called the Dark Fetish Network, which has of tens of thousands of registered users who discuss violent sexual fantasies. The officer, known in the media frenzy as Cannibal Cop, lost his job and was convicted of plotting to kidnap, a crime that could carry a life sentence. He reportedly had graphic discussions of plans to kill, roast, and eat specified victims, and he claimed that he had the means to do so. An investigation revealed that he did not own the implements that would enable him to carry out such a plan. His lawyer insisted that he was engaged in a role-playing fantasy, but he was convicted by a jury in 2012. In July, his conviction was overturned and he was released on bond. By that time, Cannibal Cop had served a year and a half in prison, with several months of it in solitary confinement.

Situations in which a person has done nothing illegal but has spoken or written words that indicate he or she might be a threat to public safety are fraught with concerns. While violent fantasies might be seen as "creepy" at a minimum, the criminal justice system is left to decide where the line is between fantasy and plan, and when a real threat exists. A person has the right to his dark fantasies, and the First Amendment right to free speech allows for discussion of those fantasies, while artistic endeavors allow for their expression. At the same time, if there are named or presumed victims, those individuals should not have to live with the terror of wondering if the fantasizer is going to act on the fantasies.

Invariably, psychiatrists end up being involved, even if the individual in question has no psychiatric history or obvious diagnosis. In a New York magazine article about the police officer titled, "A Dangerous Mind," Robert Kolker noted: "Pre-crime and psychiatry often go hand in hand. Legal instruments like institutionalization and sex-offender registration all share the goal of preventing crime from taking place, and for better or worse, they’re based on a psychiatric rationale."

As we all know, it can be difficult – if not impossible – to distinguish those who are having fantasies from those who are planning to commit a dangerous act. As psychiatrists, we deal with this uncertainty for patients who have suicidal thoughts on a regular basis. Often, even the patients don’t know for sure if they will act on their impulses. Fantasies that involve harming others are more unusual in clinical practice, and our risk assessment often begins with the stated intent of the individual. Our strongest predictor of future behavior continues to be past behavior, and neither the teacher nor the police officer in the stories above had criminal records.

To make it even more confusing, the Internet has added to the uncertainty; people have always had dangerous and fetishistic fantasies, but now there are ways others can learn the content of what was once very private. The risk, of course, is that fantasies and artistic endeavors become subject to both psychiatric scrutiny and criminal prosecution in a way that threatens civil rights and squelches creativity.

Dr. Miller is a coauthor of "Shrink Rap: Three Psychiatrists Explain Their Work" (Baltimore:The Johns Hopkins University Press, 2011).

Over the past few days, an article has circulated about a 23-year-old middle school teacher in Cambridge, Md., who was suspended from his job because of two futuristic novels he wrote, including one about a school massacre 900 years in the future. The story was reported in The Atlantic under the headline, "In Maryland, a Soviet-Style Punishment for a Novelist."

The article, by Jeffrey Goldberg, said the young teacher had self-published his novels some time ago under a pseudonym. In addition to his being suspended, an "emergency medical evaluation" was ordered, his house was searched, and the school was swept for bombs by K-9 dogs. No charges have been filed as of this writing.

This response was deemed an "overreaction," and certainly has been good for book sales but probably not so much for the young man’s teaching career. The idea that artistic expression must conform to a specific standard or jeopardize one’s job leaves those with creative pursuits to worry and civil rights advocates to protest.

Soon after, the Los Angeles Times published an article stating that the issue was not the novels – the school knew about those in 2012 – but rather the content of a four-page letter the teacher had written to the school board suggesting that the teacher was suffering from some type of psychiatric condition and might have included indications that he was suicidal or dangerous. With this information, it was not as clear if the police response was an overreaction, and such determinations are generally made in hindsight: If a bomb is found, the decision was heroic, if not, it was an overreaction and a civil rights violation.

The case reminded me of the story about a New York City police officer who had Internet discussions about his desire to cook and eat women, including his ex-wife. While the officer never ate anyone, he was part of an online community called the Dark Fetish Network, which has of tens of thousands of registered users who discuss violent sexual fantasies. The officer, known in the media frenzy as Cannibal Cop, lost his job and was convicted of plotting to kidnap, a crime that could carry a life sentence. He reportedly had graphic discussions of plans to kill, roast, and eat specified victims, and he claimed that he had the means to do so. An investigation revealed that he did not own the implements that would enable him to carry out such a plan. His lawyer insisted that he was engaged in a role-playing fantasy, but he was convicted by a jury in 2012. In July, his conviction was overturned and he was released on bond. By that time, Cannibal Cop had served a year and a half in prison, with several months of it in solitary confinement.

Situations in which a person has done nothing illegal but has spoken or written words that indicate he or she might be a threat to public safety are fraught with concerns. While violent fantasies might be seen as "creepy" at a minimum, the criminal justice system is left to decide where the line is between fantasy and plan, and when a real threat exists. A person has the right to his dark fantasies, and the First Amendment right to free speech allows for discussion of those fantasies, while artistic endeavors allow for their expression. At the same time, if there are named or presumed victims, those individuals should not have to live with the terror of wondering if the fantasizer is going to act on the fantasies.

Invariably, psychiatrists end up being involved, even if the individual in question has no psychiatric history or obvious diagnosis. In a New York magazine article about the police officer titled, "A Dangerous Mind," Robert Kolker noted: "Pre-crime and psychiatry often go hand in hand. Legal instruments like institutionalization and sex-offender registration all share the goal of preventing crime from taking place, and for better or worse, they’re based on a psychiatric rationale."

As we all know, it can be difficult – if not impossible – to distinguish those who are having fantasies from those who are planning to commit a dangerous act. As psychiatrists, we deal with this uncertainty for patients who have suicidal thoughts on a regular basis. Often, even the patients don’t know for sure if they will act on their impulses. Fantasies that involve harming others are more unusual in clinical practice, and our risk assessment often begins with the stated intent of the individual. Our strongest predictor of future behavior continues to be past behavior, and neither the teacher nor the police officer in the stories above had criminal records.

To make it even more confusing, the Internet has added to the uncertainty; people have always had dangerous and fetishistic fantasies, but now there are ways others can learn the content of what was once very private. The risk, of course, is that fantasies and artistic endeavors become subject to both psychiatric scrutiny and criminal prosecution in a way that threatens civil rights and squelches creativity.

Dr. Miller is a coauthor of "Shrink Rap: Three Psychiatrists Explain Their Work" (Baltimore:The Johns Hopkins University Press, 2011).