Advocates often describe anosognosia as someone who is so sick, that they don’t know they are sick. That’s an inadequate description of the condition because it does a disservice to those who commit acts of harm toward others because of the condition. What does it mean for a person to “know they are sick” in the context of neurological detachment from reality or neurogenous “psychosis”?
Anosognosia manifests in some peculiar ways when violence occurs in many high-profile media stories. For example, the individual that kills someone, then remains at the scene, covered with blood, then willingly talks to the police, the person that openly posts plans to shoot up a school on a social media site. It appears in these cases that the individual is totally unaware that they have placed themselves at grave risk. Even when it may appear that they are revealing awareness of wrongdoing, by fleeing or attempting to conceal evidence, these behaviors may also be a deception of the neurological condition. It may be dream-like cognition in which there are stored memories and associations getting mashed up within an impaired sense of self, observations of the visual environment, and dysmentative thinking (delusions).
What we see here is a person who is unaware that their mentation and behaviors are abnormal or dangerous. What should the implications be on criminal culpability if a person is unaware that their thoughts and behaviors are disordered? Like most neurological phenomenon that involve the brain’s semblance of mind, this can be extremely difficult for some people to accept, especially if that person has a tendency to have harsh, rigid, punitive proclivities ( known in neuroscience as “Sentencer’s Brain” – people wired like this should never be on a jury but most prosecutors will not subscribe to this mentality as being the least bit pathologic). Perhaps a hundred years from now, people with Sentencer’s Brain will be screened out of juries along with people who confess to incontrovertible biases.
The following link is to a fairly informative article on anosognosia. It’s nearly impossible to get the psychology out of neurology, however, where the mind is concerned, so it goes off the rails in carving out a role for “mental health” interventions, such as “motivational enhancement therapy” – a modality that is in stark conflict with the nature of the condition. Psychosocial “Psychiatry” and psychotherapeutic ideologies propose that there is denial of illness as a psychological defense. If this were valid, then that psychological defense could be broken down. This psychoanalytical concept is nonsense as it relates to neurogenous “psychosis”.
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