Louis Theroux's 'By Reason of Insanity': The Dangers of Guilt and Denial

However, there were a couple issues that came to light through the programme, one of which was the danger of denial with the mentally ill, and another being the place of guilt on those with mental illnesses.

On Sunday night BBC Two aired the first part of Louis Theroux's brilliant new documentary series 'By Reason of Insanity', observing mentally ill patients who had committed serious crimes and were consequently confined to an Ohio state psychiatric hospital. The programme was on the whole fascinating and positive, showing the potential for rehabilitation with patients like Jonathan, who came across as a kind-hearted, sober man. However, there were a couple issues that came to light through the programme, one of which was the danger of denial with the mentally ill, and another being the place of guilt on those with mental illnesses.

For the few of you who haven't ever watched any Louis Theroux documentaries, he is the king of representing the underrepresented. Whether that be the mentally ill, or sex workers, he always tries his best to present a kind, fair, unbiased view of marginalised groups to great success. Which is why I was alarmed to see him ask several of the patients if they felt any guilt regarding their crimes. This might seem like an innocent, fair question to ask someone who has committed a crime, but when those people are mentally ill, I think the question actually poses danger to the individual. Guilt comes hand in hand with many mental illnesses. As a bipolar sufferer, I spend a great majority of my time feeling horrific guilt about being a burden on those around me. This is a common trait of bipolar and of depression amongst other illnesses. So when Theroux poses that question to the patients, I can only feel like what he is really saying is 'you SHOULD feel guilt. Why don't you feel guilt? You did something wrong.'

Thankfully, one of the braver patients retorts back 'I don't feel guilty...I wasn't in my right mind, it wasn't my actions, it was my illness', which is exactly why these patients have been deemed 'NOT guilty by reason of insanity'. Yes, several of them speak about how they feel horrible about what has happened, but we shouldn't encourage that feeling, but rather focus on the positive rehabilitation of these patients. When society places blame and guilt on the mentally ill, it only hinders them and leads them deeper down a path of insanity, ostracising them rather than rescuing them and helping them get stability.

Working at the BBC, I had the privilege of seeing Louis talk about the new series, and had the opportunity to ask him why he focused on guilt when interviewing the patients. Louis responded:

'It was a feeling, not so much that he should feel guilt, but that it would be understandable if he did feel guilt. ..I had heard that quite commonly with serious crimes committed in psychosis, that months might pass before medication kicks in and only then do you realise the gravity of what has taken place and the feelings of guilt and remorse take place. It was a tricky interview, I felt that in a small way I needed to get him to look at his crime and see how serious it was, in the interest of reflecting what a lot of people would feel.'

In light of the response from Louis, it is understandable that in order to combat stigma, difficult questions sometimes need to be asked. They address the wider publics concerns and give opportunity to those questioned to respond to assumptions, something that Louis does incredibly well.

The other issue that came to light was that of denial, with both patients like Judith in denial that they have a mental illness, and parents of patients in denial that their child could have a mental illness. This really struck home for me. I was in denial that I had bipolar for years, going from doctor to doctor looking for a different diagnosis. Eventually, six diagnoses down the line, I had to accept that bipolar was going to be a permanent fixture in my life. My parents took longer to acclimatise to the illness. It's only really now that I am writing these articles that they are beginning to understand what it is I go through, and that I can't just 'think positive and be happy' and all my problems will magically be solved.

The acceptance of the illness by yourself and those around you is crucial to rehabilitation and finding stability. For one thing, it's hard to justify taking medication when you don't believe you're actually ill. For another, it means you allow yourself to indulge in the illness, and view it as normal behaviour, when really your point of reference is skewed. I felt pain for one patient when his mother said right in front of him 'I didn't give birth to a nut'. Rather than supporting her son and helping him get better, she classifies the mentally ill as crazy and stigmatises the illness her son has. This view echoes that of wider society: that the mentally ill are as pictured in horror movies - crazy lunatics that you should be afraid of. This just isn't the case, but thankfully there are people like Louis Theroux out there, helping bring mental illness into public conversation and showing that even those who have committed crimes out of mental illness can be rehabilitated and reinstated in society safely.


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