The State of Mind and Intent of Crime


In need of some late summer reading?

court psychiatry



As I wrote in the pop-up column this past Wednesday, the jury decided the verdict for the perpetrator of the Pittsburgh Synagogue Mass Shooter. It is the death sentence instead of life without parole. Key to the decision was intent in committing the crimes. That is, was he mentally capable to resist doing what he did? The explanation that he had a serious mental illness was not persuasive enough. What was really on his mind is unknowable, even by us psychiatrists. We do not literally read minds.

On Thursday, the next day, Donald Trump was indicted with one of the charges being obstructing, or attempting to obstruct, an official proceeding of Congress, as in not certifying a presidential election. A criminal law scholar believes the key for the jurors will be Trump’s state of mind at the time of this and the related charges.1

Once again, it is currently impossible to look into someone’s mind to see someone’s intent, including that of past President Trump. Instead, the law uses other tools, largely based on actions. Consciousness of guilt is probably the leading tool. It means that behavior before and after the charge can be used as evidence of guilt and proof of intent to comment a crime.

I do not know if psychiatrist experts will be used. To me, even with our human and professional limitations, it seems self-evident that psychiatrists and other mental health professionals could best help to assess someone’s state of mind.

Although the Goldwater Rule ethically prohibits a psychiatrist from using their expertise to comment on a public figure without permission, an exception can be made when the government desires such input due to security risk. Such was the case in the work of the late psychiatrist Jerrold Post, MD, as we covered in one of our eulogies.2 Even so, there is an obvious other candidate: the psychiatrist author of the new novel, Death of the Great Man, Peter D. Kramer, MD.3 In an Atlantic interview, Kramer clearly admits that the story is based on Trump.4 It imagines the state of mind of a populist American president as well as the psychiatrist who is treating him. Presumably, poetic license makes it ethically acceptable.

And yet, as Michael Wolff, the author of 3 books about Donald Trump wrote in the New York Times article, “Down the Rabbit Hole into Donald Trump’s Brain,” capturing his state of mind might be “quite a trip down the rabbit hole,” as it seemingly has always been for Wolff in relation to past President Trump.5

Maybe Kramer’s novel and its intentional absurdities does go down that rabbit hole and, with both his literary and psychiatric expertise, leaves us with not only something entertaining, but insightful. At the very least, I would recommend reading it for some late summer reading for anyone interested in the governmental case.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.


1. Sullivan R. Trump indictment: Here’s how prosecutors will try to prove he knowingly lied and intended to break the law. The Conversation. August 3, 2023. Accessed August 7, 2023.

2. Moffic HS. A psychiatrist for our national security: Jerrold M. Post, MD. Psychiatric Times. December 7, 2020.

3. Kramer PD. Death of the Great Man: A Novel. Post Hill Press; 2023.

4. Stossel S. Putting Trump on the couch. The Atlantic. August 4, 2023. Accessed August 7, 2023.

5. Wolff M. Down the rabbit hole into Donald Trump’s brain. The New York Times. August 4, 2023. Accessed August 7, 2023.

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