Oslo tingrett: Dom (Breivik)

[Psykopatologia]

L o v d a t a http://www.lovdata.no/

Oslo District Court (Oslo tingrett) – Judgment. (48 p, in English)
Oslo tingrett – Dom. (46 s.)

INSTANS: Oslo District Court (Oslo tingrett) – Judgment. http://www.lovdata.no/nyhet/dok/toslo-2 ... 7-24e.html

DATO: 2012-08-24

PUBLISERT: TOSLO-2011-188627-24E

STIKKORD: The 22 July case. Criminal law. Murder. Terror. Sanity. Preventive detention. The Penal Code section 147a first subsection paras. a and b, cf. the Penal Code sections 148 first subsection first penalty alternative and 233 first and second subsections, and 233 first and second subsections, cf. section 49, and the Penal Code section 147a first subsection para. b, cf. sections 233 first and second subsections, and 233 first and second subsections, cf. section 49.

SAMMENDRAG: A man b. 1979 was sentenced to preventive detention for a term of twenty-one years and a minimum period of ten years for two terror acts by which among other things 77 people were killed.

The defendant killed 8 people while 9 persons were seriously injured when he detonated a car bomb in the Government District in Oslo. The explosion also caused extensive material damage.

The same day the perpetrator killed 69 people, of which the majority were participants at the Workers' Youth League (AUF)-run summer camp at Utøya Island. Most were killed by shooting or as a consequence thereof. In addition 33 youths were seriously injured. Besides the physical injuries a considerable number of people suffered mental aftereffects.

The court found the defendant to be sane, i.e. not psychotic, at the time of crime, and was thereby liable to penalty. The defendant had acknowledged having committed the acts of which he was accused, pleaded not guilty to the charges. (Summary by Lovdata.)

SAKSGANG: Oslo District Court (Oslo tingrett) TOSLO-2011-188627-24E (11-188627MED-OTIR/05). The judgment has legal force.

PARTER: The Public prosecuting authority (Public Prosecutor Svein Holden, Public Prosecutor Inga Bejer Engh) vs. A (Advocate Geir Lippestad, Advocate Vibeke Hein Bæra, Advocate Tor Eskild Kvinge Jordet and Assistant Lawyer Odd Ivar Ausnes Grøn.

FORFATTER: Presiding judge: District Court Judge Wenche Elizabeth Arntzen. Professional judge: District Court Judge Arne Lyng. Lay judges: Ernst Henning Eielsen, Diana Patricia Fynbo, Anne Elisabeth Wisløff.
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6. Criminal sanity [p. 30 - 46]
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6.1 Section 44 of the Penal Code and the standard of proof [p. 30 - 48]
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6.2 The work and conclusions of the expert witnesses [p. 33]
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6.3 On psychosis in general [p. 33 - 34]
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6.4. Paranoid schizophrenia [p. 34 - 41]
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6.5 Paranoid psychosis [s. 41 - 43]

The experts Aspaas and Tørrissen have assessed whether the defendant may have had a paranoid psychosis at the time of the reported acts. Paranoid psychosis (F22) is a more limited delusional disorder that is presented with six diagnostic criteria in the Green Book, including the following:

A. A delusion or set of related delusions, other than those listed as typically schizophrenic in criterion G1 (i) b or d for F20.0–F20.3 (i.e. other than completely impossible or culturally inappropriate) must be present. The commonest examples are persecutory, grandiose, hypochondriacal, jealous (zelotypic), or erotic delusions.
B. [...]
C. The general criteria for schizophrenia (F20.0-F20.3) are not fulfilled.
[...]

Translated into Norwegian this means that the disorder is characterised by a delusion or a set of related delusions that should not be bizarre, exemplified, inter alia, by paranoid and grandiose delusions. Since the experts Husby and Sørheim believe the defendant suffers from paranoid schizophrenia with allencompassing delusions, they do not discuss this diagnosis. As already mentioned, they nonetheless make the remark that the defendant's marked flattening of affect is incompatible with a paranoid psychosis.

In their report, the experts Aspaas and Tørrissen present a SCID-1 interview, which is a structured interview under the parallel American diagnostic system DSM-IV. Below follows their assessment of paranoid psychosis found on pages 262 – 263:


« As stated above, the expert witnesses have not found any psychotic symptoms. [...] He has had ideas of heightened selfworth, power and knowledge that may be reminiscent of what is observed in the case of delusional disorders. Not least the ideas concerning the Knights Templar appear peculiar. He has however rationalised this and has explained that it is a willed idea. The experts attach importance to the fact that the observee in police interviews and interviews with the experts is capable of arguing and presenting nuanced statements. He has a capacity for being corrected that is not found in persons with delusional disorders. It does not seem to be of interest to discuss grandiose ideas about his own finances, since income of a certain level has been documented in the course of the investigation.

Another important observation is that he has managed to keep his plans concealed from others. This is not very compatible with ideas of a psychotic nature, where precisely the urge to assert the perceived injustice will be prominent. The observee has demonstrated an unusually stable and good impulse control, which he also demonstrates during detention.

Clinically assessed, one does not find in the observee the psychotic nature that characterises delusions. There may be obvious reasons to apply the concept of flawed perception of reality to his extremist political views; however, as described above these are ideas he shares with a subculture that expresses the same opinions.

Issues concerning surveillance and possible somatic delusions have been discussed above. It is thus the experts' assessment that the observee does not have nor has had any delusional disorder. »


In the general diagnostic assessment of whether the defendant may have suffered from a psychotic disorder at the time of the reported acts, they present the following conclusion on pages 302 – 303 of their report:

« As stated above, the experts have not assessed his ideas as being manifestations of psychotic thought processes, but as extreme political views, combined with the conscious disregard for opposing views. The experts assume the existence of an ideological subculture that shares the observee's ideological and political views. Consequently, there are no grounds for a delusional disorder (F22.0 Paranoid psychosis). »

The experts Aspaas and Tørrissen interpreted the defendant's fear of surveillance by the Police Security Service (PST) and isolated instances of him using a face mask as exaggerated caution and fear of illness during the planning of the terrorist acts, and not as psychotic delusions. Contrary to the experts Husby and Sørheim, they have not perceived the defendant's use of the word « we » instead of « I » to be an identity disturbance, but an expression of him intending to speak on behalf of likeminded persons.

In its statements of 23 April and 21 May, the Board of Forensic Medicine has questioned the validity of the defendant's answers to, inter alia, the SCID-1 interview, considering his tendency to answer strategically. In their introductory description of SCID-1, the experts Aspaas and Tørrissen have addressed this issue, writing that they, inter alia, have taken as a point of departure and have confronted the defendant with his earlier statements in police interviews, in conversations and in the compendium. Next, these statements have been « weighed against the clinical impression and the way in which he answers ». Also in the introductory general remarks on page 12 of their report, they raise the question of whether the defendant in his conversations with them « has adapted himself to his knowledge at any given time of the case complex, the police investigation, the previous forensic psychiatric report, etc ». Against this background, they have assessed and « compared his statements to the expert witnesses in February/March 2012 with what emerged during the early stages after his arrest (documented in a police interview recorded on DVD), as well as his statements to the health service and the earlier expert witnesses in July/August 2011 ». Additionally, the questions of dissimulation and a possible false negative conclusion are discussed in connection with the diagnostic assessments on page 300 and in the supplementary report of 30 April 2012.

The Court agrees that the defendant's tendency to adapt his answers in tests and in his conversations with the experts may, considered in isolation, weaken the value of the observations of the experts Aspaas and Tørrissen. Notwithstanding this, the Court notes that as early as in the first conversation on 9 September 2011 with psychiatrist Arnhild Flikke, the defendant described himself as a « foot soldier », see the above quote. Flikke is a senior medical officer within the Specialist Health Service of Bærum Municipality, the District Psychiatric Centre (hereinafter DPS), and she has been a member of the « Ila Team » since 2007. Also in a police interview on 18 October 2011 did the defendant moderate statements in the manifesto that he has also cited during early police interviews as well as in conversations with the experts Husby and Sørheim. In the police interview he said, inter alia, that the way he had « described the Knights Templar, it is a glossy picture of the Knights Templar, but in practice the Knights Templar is in the process of being established », see the quote from this interview on page 82 of the report of the experts Aspaas and Tørrissen. Additionally, policemen who carried out the interviews of the defendant confirmed at the trial that they noted a certain toning down of the defendant's previous statements from the police interview on 18 October 2011, and a marked toning down from the police interviews in March 2012. It is furthermore clear that the defendant toned down the description of the Knights Templar and his own political role in his conversations with the experts Aspaas and Tørrissen, and also in his statement during the trial.

The Court believes that the circumstance that the defendant is capable of moderating his statements is also relevant diagnostic information. On pages 296 – 297 of their report, the experts Aspaas and Tørrissen describe the defendant's high opinion of, inter alia, « his own importance for the future of the country and Western Europe ». Here, they draw a parallel with a condition that in specialist literature is termed « pseudologia fantastica », and which refers to conditions where a person with theatrical personality traits makes up stories that make them important. They write the following about the difference between persons with such personality traits and psychotic persons:

« It is characteristic that these kinds of stories are toned down when the person concerned is confronted with facts or opposing views. In psychotic patients, the opposite is often observed; when they are confronted with ambiguities and improbabilities, their statements will become increasingly unclear and improbable, and when patients are subjected to pressure they may show signs of stress and psychological decompensation. « Pseudologia fantastica » is not a separate diagnosis in the diagnostic systems, but the phenomenon may provide a basis for personality diagnoses. »

Also other expert witnesses within psychiatry described at the trial how genuine delusions normally are defended by the patient in the case of resistance. Patients often turn aggressive and angry or sulky and silent when their delusions are challenged. Overall, psychotic patients have limited capacity for moderation. There also seems to be agreement among these witnesses that a psychotic person hardly would manage to adapt during hourslong interviews in pressed situations. According to the information provided, the police interviews lasted for up to 11 hours. The defendant's statement at the trial also lasted for many hours every day for more than a week. If one disregards the contents of the defendant's statements, under the circumstances he gave evidence in an inconspicuous way. He gave the impression of being controlled and collected. He let himself be corrected and moderated, and he demonstrated a capacity for flexibility in various contexts.

Against this backdrop, the Court agrees with the expert witnesses Aspaas and Tørrissen's conclusion that the defendant's use of terminology and various statements including historical references about civil war, power takeover in Norway, ethnic cleansing, breeding institutions and genetic testing of our future regent can all be understood in a political context. The same goes for the use of the plural « we » as a reference to the defendant's fellow rightwing extremist peers. The defendant's periodic use of mouth mask and his feeling of being under surveillance seem also to have plausible explanations. No similar behaviour or statements by the defendant have subsequently been reported.

The prosecution has focussed on whether the defendant's conception about the Knights Templar can be regarded as psychotic delusions under the presumption that the organisation does not exist. Investigations have not produced any evidence to indicate that such an organisation exists.

The expert witnesses Aspaas and Tørrissen write the following about the Knights Templar on page 295 of the report's diagnostic evaluation:

« The expert witnesses take for a fact that militant movements sometimes develop a system of rank titles, uniforms, greetings, etc. Despite this, the description of the Knights Templar, and not least the uniform the observee has had made, is characterised as eccentric, theatrical and grandiose. The fact that he has deliberately conjured up a future vision can, nevertheless, not be understood as a sign of psychosis. In the opinion of the expert witnesses, he has all along known that the idea of the Knights Templar is a product of his own imagination. »

At the trial, the defendant maintained the basic features of the compendium's description of the founding and structure of the Knights Templar. Among other things, he explained that he met a Serbian war criminal in Liberia whom he later represented at the founding meeting in London in 2002. He also maintained that there were three single cells in Norway and approximately 15 to 80 in Europe, and that the cells have no contact with one another because of the risk of being detected by the intelligence service in the various countries.

The Court believes that the defendant may have various reasons for insisting on the existence of the Knights Templar. By anchoring the acts for which he is indicted in an alleged organisation, he can give others an impression of grandiosity and legitimacy and can thereby also help promote future recruitment. In addition to this, an alleged organisation can give rise to fear in the population, a motive which goes to the very core of the terrorism provision on which the indictment is based. Retracting what he has said about the Knights Templar, which forms such a vital part of the compendium, can ultimately appear to be psychologically or ideologically impossible.

Ever since the defendant was apprehended, he has been reluctant to answer questions about the Knights Templar, including questions about its supporters and foundation, despite the fact that other information has flowed from him like « water from a faucet », to use the words of the expert witness Husby. As mentioned above, he has also toned down his presentation of the organisation and significance of the members. During the compulsory observation, he did not focus on the Knights Templar according to the observation team from Dikemark. The Court is also of the opinion that these circumstances speak against concluding that the defendant carries a genuine psychotic conviction about the organisation's existence.

The expert witnesses Aspaas and Tørrissen believe that the defendant suffers from personality disorders, which they believe can explain a lot of his symptomatology. One may query whether these expert witnesses' interpretations of potentially psychotic symptoms were influenced by them having found, on possibly shaky grounds, such alternative explanation models.

The expert witnesses performed, inter alia on the basis of a SCID-II interview based on the parallel US diagnostic system, a thorough review of the special criteria for various personality disorders in ICD-10 and concluded that the defendant had the diagnoses « F60.8 Other specified personality disorders, narcissistic », and « F60.2 Dissocial personality disorder ». The Board of Forensic Medicine stated in its letter of 31 May 2012 to Oslo District Court that it can not « see from the premises that it has been adequately discussed whether the observee from childhood and/or adolescence displayed firmly entrenched and persistent behaviour patterns which were expressed through rigid reactions to a broad range of personal and social situations ».

Under the general criteria for personality disorders in the Green Book, the personality deviation must be stable and of long duration, « having its onset in late childhood or adolescence ». In the US diagnostic system, from which the diagnosis of narcissistic personality disorder is taken, the time of onset is specified to « the beginning of early adulthood ». The expert witnesses seem to agree that the personality deviation must have manifested itself before the age of 18 years. In their supplementary report, the expert witnesses Aspaas and Tørrissen elaborated on the examples of dissocial characteristics from the defendant's childhood, adolescence and early adulthood, maintaining their previous explanation for the manifestation of his narcissistic characteristics. At the trial, Aspaas specified that the narcissistic personality disorder was the main diagnosis.

The Court has not considered how developed and comprehensive the personality deviation must have been before the age of 18 years to satisfy the general criteria for a personality disorder in the Green Book. Beyond the methodological source of error as to interpretation now discussed, the diagnosing of personality disorders does not have any direct impact on the question of the defendant's criminal sanity. Nevertheless, the Court mentions that the diagnosis « F60.2 Dissocial personality disorder » found little support during the presentation of the other evidence. As will be discussed below, the diagnosis « F60.8 Other specified personality disorders, narcissistic », was however supported by therapeutic health personnel at Ila who where part of the specialist health service. Randi Rosenqvist also took note of the defendant's narcissistic personality characteristics.
Still the Court finds no grounds for disavowing the expert witnesses Aspaas and Tørrissen's assessments of the psychosis question on the grounds that the general criteria for personality disorders in ICD-10 have possibly not been met. Irrespective of whether the defendant meets the general criteria for a personality disorder, the Court takes for a fact that he displays both dissocial and narcissistic personality characteristics.

6.6 Other health personnel [p. 43 - 45]
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6.7 Compulsory observation [p. 45 - 46]
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6.8 Summary [p. 46]
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Rettspsykiatrisk erklæring (1) 29.11.2011
Torgeir Husby og Synne Sørheim, 239 s.
Forensic psychiatric statement — Anders Behring Breivik http://www.document.no/2012/02/forensic ... breivik-i/

Rettspsykiatrisk erklæring (2) 10.4.2012 [täydennys 23.5.2012]
Terje Tørrissen og Agnar Aspaas, 284 s. [273 + 11]

VG 6.6.2012 http://www.vg.no/nyheter/innenriks/22-j ... vurdering/
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