Latest / The Trauma Therapist / Forensic Neuropsychopathology with Dr. Monique M. Chouraeshkenazi

Transcript

Forensic Neuropsychopathology with Dr. Monique M. Chouraeshkenazi · The Trauma Therapist

• 0:00
  Speaker 1: Welcome to the Trauma Therapist Podcast. My name is Guy McPherson.
• 0:04
  Speaker 1: I interview incredible people who've dedicated their lives to helping
• 0:07
  Speaker 1: those who've been impacted by trauma. A big thank you
• 0:11
  Speaker 1: to our sponsors and our guests who are supporting this show.
• 0:15
  Speaker 1: So five, four, three, two, and one. Our folks, welcome
• 0:19
  Speaker 1: back to the podcast. Super excited to have as my
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  Speaker 1: guest today, Dr. Monique Kors-Konatsi. Monique, welcome.
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  Speaker 2: Thank you for having me.
• 0:27
  Speaker 3: You're welcome.
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  Speaker 1: Monique is a clinical neuropsychometrician psychology resident, researcher, professor, forensic
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  Speaker 1: neuropsychopathology expert, and the two-time international best-selling author. I have
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  Speaker 1: a feeling there's going to be a lot of misspeakings today.
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  Speaker 1: She's the founder of the Kors Ganassi Group, a multidisciplinary
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  Speaker 1: practice focused on mental health care, medical services, research, consulting,
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  Speaker 1: and education.
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  Speaker 3: A U.S.
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  Speaker 1: Air Force Global War and Terrorism Combat Veteran, she served
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  Speaker 1: for 13 years in roles related to cybersecurity, intelligence, anti-terrorism,
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  Speaker 1: and national security operations.
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  Speaker 3: Dr.
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  Speaker 1: Korshkanazi is the author of the best-selling three-volume series, Forensic Neuropsychopathology,
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  Speaker 1: Clinical and Medical Insights into Brain Behavior, Mental Disorders, and
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  Speaker 1: the Legal Systems. She's credited with developing and formally defining
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  Speaker 1: the field of forensic neuropsychopathology, an interdisciplinary discipline that integrates neuroscience, neuropsychology, neurophysiology, psychology, psychiatry,
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  Speaker 1: and the legal system to better understand the neurobiological and
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  Speaker 1: psychological underpinnings of criminal behavior.
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  Speaker 3: Monique, come on. You are, I just got to say
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  Speaker 3: at the outset of this, researching.
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  Speaker 1: Your background for this interview, I mean, damn, impressive and inspiring.
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  Speaker 1: So with that, I want to welcome you to the podcast.
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  Speaker 2: Thank you so much.
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  Speaker 3: You're welcome.
• 2:07
  Speaker 2: I'm super excited to be here.
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  Speaker 3: Awesome.
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  Speaker 1: So before we get going, share with the listeners where
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  Speaker 1: you're from originally and where you are currently.
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  Speaker 4: Oh, well, I am originally born in Bridgeport, Connecticut, but
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  Speaker 4: raised in The sticks and mountains of West Virginia. So
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  Speaker 4: I grew up there, went all the way to high
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  Speaker 4: school and graduated and went straight into the military following
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  Speaker 4: high school.
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  Speaker 2: So now I'm in the DMV area.
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  Speaker 1: Okay. And I just have to point out for those
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  Speaker 1: who are listening and not watching this, your shirt has
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  Speaker 1: the word discipline on it, which is perfectly fitting. So
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  Speaker 1: come on, how did this start for you? I mean,
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  Speaker 1: what you've done, what you've achieved, not only that, but
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  Speaker 1: correct me if I'm wrong, but to put together this
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  Speaker 1: three-volume series to kind of pioneer the integration of this
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  Speaker 1: new field, not only requires so many different elements and
• 3:13
  Speaker 1: strengths and understandings, How the hell does this start for you?
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  Speaker 4: I would say experience. You know, when I was in
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  Speaker 4: the military, I served for 13 years. My combat deployment
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  Speaker 4: was unexpected. I literally had five days to prepare because
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  Speaker 4: I was filling in for another person who failed their
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  Speaker 4: physical training requirements. So this was 2010. So even though
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  Speaker 4: mental health has been a thing, it really wasn't talked
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  Speaker 4: about when I was in the military, especially in the
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  Speaker 4: beginning of my career. So we never really discussed it.
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  Speaker 4: It wasn't something that I experienced. You know, you suffer
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  Speaker 4: from depression, anxiety, but are you paying attention when you're
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  Speaker 4: actively in the military? Not necessarily, at least in my case.
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  Speaker 4: So it wasn't until I deployed, I had to deploy alone.
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  Speaker 4: I didn't deploy with a unit.
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  Speaker 2: I went alone.
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  Speaker 4: So that was like the first thing. I'm seeing other
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  Speaker 4: units deployed together and I'm by my lonesome.
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  Speaker 2: It took us about five days to get.
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  Speaker 4: From Las Vegas, which is where I was stationed at
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  Speaker 4: that time, Nellis Air Force Base, to get all the
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  Speaker 4: way to Afghanistan.
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  Speaker 2: So that alone started, excuse me, what I'd say.
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  Speaker 4: Would be some mental health barriers because I'm like, I'm
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  Speaker 4: going in this alone combat zone. You have all these
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  Speaker 4: things running through your mind. Am I going to come
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  Speaker 4: back home to my daughter? She was five at the time.
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  Speaker 4: All these things are going on in my head. So
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  Speaker 4: this is when I'm first experiencing mental health conditions, but
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  Speaker 4: not really labeling or really taking the time to know
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  Speaker 4: what's going on. Once I got in the thick of
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  Speaker 4: my deployment and I understood what my responsibilities and duties were,
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  Speaker 4: I noticed that other people around me were totally different.
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  Speaker 4: Not necessarily going through the same things that I was
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  Speaker 4: going through, but I started seeing cognitive changes that I
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  Speaker 4: would say.
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  Speaker 2: You would see mood swings. You would see people who
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  Speaker 2: were robotic. Like, this is what I have to do.
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  Speaker 2: This is my schedule. This is how you do it.
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  Speaker 4: And I'm wondering, like, what's really going on? And then
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  Speaker 4: I realized, like, I was one of those people by
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  Speaker 4: the time I ended. Because with everything going on in
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  Speaker 4: the thick of the war, we were getting attacked very often.
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  Speaker 4: So you become immune to those things where you hear,
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  Speaker 4: you know, the alarm going off and labeling what type
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  Speaker 4: of attack it is.
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  Speaker 2: It's just like second nature.
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  Speaker 4: You hover, you get to the nearest safe location, and
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  Speaker 4: you do what you have to do.
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  Speaker 2: Just to survive. To survive.
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  Speaker 4: So I realized that I'm doing the same things that
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  Speaker 4: I was watching other service members do, but I saw
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  Speaker 4: that they were struggling and I wasn't necessarily struggling. So
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  Speaker 4: when I finally returned back to the United States, I'm like,
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  Speaker 4: I'm really interested in what's going on. Like, the war
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  Speaker 4: is really causing some different changes in our mindsets, how
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  Speaker 4: we think, the decisions that we make, etc. So that's
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  Speaker 4: when I decided to go back to school and pursue
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  Speaker 4: a degree in psychology.
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  Speaker 1: All right, let me pause you one second there. So
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  Speaker 1: you said you noticed the people around you who were
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  Speaker 1: experiencing changes, cognitive shifts, were struggling. You said you were
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  Speaker 1: experiencing the same ones, but you weren't struggling?
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  Speaker 2: In hindsight, yes.
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  Speaker 3: In hindsight.
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  Speaker 4: In hindsight, I realized that I was going through the
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  Speaker 4: same things that they were going through, but I was
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  Speaker 4: what I consider myself high performing. So I didn't let
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  Speaker 4: it distract me from the mission.
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  Speaker 2: I continued to work. I continued to do what I
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  Speaker 2: needed to do.
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  Speaker 1: Whereas it did impact the other people that you saw.
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  Speaker 3: Okay.
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  Speaker 1: Just as an aside to kind of lay some context here,
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  Speaker 1: before you went into the military, what were you doing?
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  Speaker 1: What was it like for you in high school and
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  Speaker 1: so forth? Were you like academics, powerhouse?
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  Speaker 3: You were.
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  Speaker 2: Overachiever, stressing myself out to get straight A's.
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  Speaker 3: Okay.
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  Speaker 1: Where does that come from?
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  Speaker 4: You know, I really don't know. My grandmother raised me.
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  Speaker 4: My grandparents raised me. My mom was killed when.
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  Speaker 2: I was two years old.
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  Speaker 4: So my grandparents brought me to West Virginia and adopted
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  Speaker 4: me when I was nine.
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  Speaker 2: And I always saw their strong work ethic.
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  Speaker 4: Like my grandfather was retired, but my grandmother went back
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  Speaker 4: to work to take care of me and my little sister.
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  Speaker 4: So I seen my grandmother.
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  Speaker 1: Do it all.
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  Speaker 4: Cook, clean, you know, wash clothes, keep the house clean,
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  Speaker 4: but go back and work full time. I remember her
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  Speaker 4: teaching me how to cook and braid hair at nine
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  Speaker 4: years old. And I'm like, why do I need to
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  Speaker 4: know this? Like I'm in the third grade. I'll never
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  Speaker 4: forget that. Like, why do I need to know this?
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  Speaker 4: But She told me at a young age that if
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  Speaker 4: I wanted to get married, she was like, a husband
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  Speaker 4: is not going to want a wife that can't take
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  Speaker 4: care of kids, the home, and stuff like that. Still
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  Speaker 4: didn't know why I needed to know that as a kid,
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  Speaker 4: but now I see now. So I think when I've
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  Speaker 4: seen her and always doing what she had to do,
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  Speaker 4: regardless if she wanted to do it or not, I've
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  Speaker 4: seen that strong work ethic. So I'm like, I think
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  Speaker 4: I exuded that to being a top student, a top performer.
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  Speaker 4: So I always strive to get good grades. And then
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  Speaker 4: she also told me, like, I'm not putting you through college,
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  Speaker 4: so you need to get a scholarship.
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  Speaker 2: You need to work hard. And that's what I did.
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  Speaker 4: I excelled all the way through high school, made honors,
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  Speaker 4: and had a full academic scholarship to Marshall University.
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  Speaker 2: But I decided to join the Air Force instead.
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  Speaker 3: Okay.
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  Speaker 1: So you get back from deployment, and you said you
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  Speaker 1: wanted to find out what's going on.
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  Speaker 3: What does that look like? What do you start to do?
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  Speaker 2: So the first thing I started doing.
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  Speaker 4: Was doing research on service members that deployed to operations
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  Speaker 4: Iraqi and Enduring Freedom.
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  Speaker 1: Just on your own time you started doing this research?
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  Speaker 2: Yeah, I'm still in the military.
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  Speaker 1: Okay.
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  Speaker 4: But I'm going to school, you know, part-time. Like I
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  Speaker 4: did this from the whole time I was in the military.
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  Speaker 4: I actually graduated with my bachelor's degree when I was
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  Speaker 4: in Afghanistan.
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  Speaker 1: Okay.
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  Speaker 4: Even though I wasn't able to walk because I was there,
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  Speaker 4: I had my bachelor's. So I went straight into my
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  Speaker 4: master's program.
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  Speaker 3: Of course you did.
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  Speaker 4: Yeah, so I got a master's in criminal justice, which
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  Speaker 4: I thought was the stepping stone. So I got a
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  Speaker 4: degree in criminal justice and then the psychology degree. And so, like,
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  Speaker 4: I'm focusing on that because that was the interest. That's
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  Speaker 4: where I firsthand saw things, you know. So I thought
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  Speaker 4: it makes sense to do research based on experience. So
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  Speaker 4: by this time, I'm actually a professor. So you know,
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  Speaker 4: I'm getting my psychology degree and my colleagues are actually
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  Speaker 4: my teachers guiding me through this program. And so I
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  Speaker 4: decided I'm going to do my thesis on psychopathology because
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  Speaker 4: that's when I really understood more about mental health. We're
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  Speaker 4: talking about the study of disease. Well, the if the
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  Speaker 4: brain is affected by mental health, isn't that considered a disease?
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  Speaker 2: And so that's what I started thinking about. So I
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  Speaker 2: focused on U.S.
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  Speaker 4: Service members who deployed between 2005 and 2016 in Operation
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  Speaker 4: Enduring in Iraqi Freedom, and that's where my thesis led
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  Speaker 4: me to do research.
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  Speaker 1: And you were focusing on their what level of psychopathology?
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  Speaker 2: What was the.
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  Speaker 4: Top leading mental health conditions when they returned back to
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  Speaker 4: the United States?
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  Speaker 1: Okay.
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  Speaker 3: What did you find?
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  Speaker 4: The top conditions were PTSD, major depression, and traumatic brain injury.
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  Speaker 2: Those were the leading mental health conditions.
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  Speaker 3: Okay.
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  Speaker 1: So how do things unfold from there such that you
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  Speaker 1: become interested in neuro?
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  Speaker 4: So the neuro part was actually interesting because by this time,
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  Speaker 4: I'm on my way out of the military. I separated
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  Speaker 4: in 2015 because I'm like, oh, I want to further
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  Speaker 4: pursue this and I want.
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  Speaker 2: To teach full-time because I was only teaching part-time.
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  Speaker 4: So I separated and now I'm a full-time professor and
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  Speaker 4: I'm teaching in national security, but I'm still interested in psychology.
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  Speaker 4: So behind the scenes, I'm still doing research. And I
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  Speaker 4: was surprised when I did my meta-analyses and I combined
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  Speaker 4: all the information from that timeframe that a significant majority
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  Speaker 4: of those service members, they were either diagnosed when it
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  Speaker 4: was too late, like after being medically retired or medically,
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  Speaker 4: we call it med board from the military, or dishonorably
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  Speaker 4: discharged from the military. That's where I became concerned with
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  Speaker 4: the neuro. I'm like, okay, so we have misdiagnoses.
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  Speaker 2: Some were diagnosed. Some were diagnosed.
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  Speaker 4: But did we look at the factors that led to
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  Speaker 4: the issues that led to them being discharged? Was it
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  Speaker 4: solely based on mental health condition? Was it based on
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  Speaker 4: other factors? And I found out it was based on
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  Speaker 4: other factors. So service members were getting kicked out the
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  Speaker 4: military for violent crimes that they committed when they were
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  Speaker 4: on duty.
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  Speaker 2: And so when.
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  Speaker 4: They were dishonorably discharged, I'm looking at the correlation. Okay,
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  Speaker 4: no one was necessarily treated wrong. for PTSD or major
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  Speaker 4: depression or traumatic brain injury. In hindsight, a lot of
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  Speaker 4: them were diagnosed after the fact. And so now we're
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  Speaker 4: leading to issues where, okay, why wasn't this diagnosed before?
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  Speaker 4: Did these violent crimes, the mental health conditions have a
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  Speaker 4: factor in that? So that's where I continue to further
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  Speaker 4: my research and go more towards, okay, I'm going to
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  Speaker 4: study how this impacts the brain.
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  Speaker 3: Oh, my God. So this.
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  Speaker 1: brings up one of the questions that I had, and
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  Speaker 1: I'm sure you get all the time.
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  Speaker 3: To what degree.
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  Speaker 1: Are those diagnoses.
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  Speaker 3: Responsible?
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  Speaker 2: You know, significantly.
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  Speaker 1: And a follow-up question here, Monique.
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  Speaker 3: Does that.
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  Speaker 1: Infer culpability? Like is someone, can you blame someone I mean,
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  Speaker 1: are they– yes, they're responsible, but how then do– what
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  Speaker 1: consequences do they deserve? It almost sounds like a kid, right,
• 13:48
  Speaker 1: who can't really help their behavior. How do you punish them?
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  Speaker 1: What consequences do you give them?
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  Speaker 4: That's what led to my clinical dissertation. That's what led
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  Speaker 4: to forensic neuropsychopathology. When I looked at the crimes– I
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  Speaker 4: looked at the correlation. I was like, 50% of the
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  Speaker 4: crimes committed, the violent crimes committed by these service members,
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  Speaker 4: they had PTSD. They had traumatic brain injury. They had
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  Speaker 4: major depression. Why wasn't that considered? By this time, some
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  Speaker 4: of them are still on active duty. Some of them
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  Speaker 4: have been discharged. So I don't want to say punishment,
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  Speaker 4: but I would say.
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  Speaker 4: The consequences of their actions either led them to be
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  Speaker 4: discharged from the military dishonorably or they ended up in
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  Speaker 4: military jail in Leavensworth, depending on what those crimes were.
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  Speaker 4: And in my clinical dissertation, that's where forensic neuropsychopathology came
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  Speaker 4: to be because I'm looking at how these conditions and
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  Speaker 4: the relationship with brain behavior is being treated within the
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  Speaker 4: legal system, number one.
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  Speaker 2: Number two, I'm really focusing.
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  Speaker 4: are we paying attention how these mental health conditions impact
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  Speaker 4: the brain? Because nobody was really talking about that. We
• 15:08
  Speaker 4: do have the discipline in psychology called neuropsychology, not neuropsychopathology
• 15:14
  Speaker 4: from a legal standard. What are the implications within the
• 15:17
  Speaker 4: legal system? How are we going to hold people accountable?
• 15:20
  Speaker 4: And then you've got to look at those factors. We've
• 15:22
  Speaker 4: got to look at, like you said, criminal responsibility, culpability,
• 15:26
  Speaker 4: the weaponization of mental health conditions. And then people who
• 15:30
  Speaker 4: are really suffering and they commit crimes, are we treating
• 15:34
  Speaker 4: them or are we just sending them to prison?
• 15:36
  Speaker 2: So that's where all that came from.
• 15:39
  Speaker 1: I could just imagine like you sitting down planning out.
• 15:47
  Speaker 3: This book with all these different.
• 15:50
  Speaker 2: Oh, it was a hot mess.
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  Speaker 1: How did you come to the decision to create this? This, what, genre,
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  Speaker 1: this book, this series? How did that come about?
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  Speaker 2: Well, it came from my research.
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  Speaker 4: Once I published the dissertation, once I graduated, I worked
• 16:12
  Speaker 4: with this company called, well, they're not a company. They're
• 16:15
  Speaker 4: a journal, a publishing journal. And they are a subsidiary
• 16:20
  Speaker 4: of Taylor & Francis. So they published the dissertation there.
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  Speaker 4: And I continued to do research. Then I did a commentary.
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  Speaker 2: I added updates.
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  Speaker 4: I changed the definition of forensic neuropsychopathology because you realize
• 16:34
  Speaker 4: once you feel like you're birthing a concept, it changes
• 16:38
  Speaker 4: as you continue to get new information. You get new
• 16:40
  Speaker 4: information as you continue to research. So the years of
• 16:44
  Speaker 4: research is what led to the book because I want
• 16:47
  Speaker 4: that forensic neuropsychopathology to be recognized by the American Psychological Association.
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  Speaker 2: And in order to do so, you have to have research.
• 16:56
  Speaker 2: You have to have, you know, established books, classes to really.
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  Speaker 4: Identify what is she talking about? Why is it legitimate?
• 17:04
  Speaker 4: Why should we recognize it?
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  Speaker 3: Right.
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  Speaker 4: Because there's so many different sub-disciplines. I feel like this
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  Speaker 4: one is another important one just as well.
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  Speaker 1: Can you give us kind of an idea, like a
• 17:17
  Speaker 1: case study that kind of, what symbolizes what we're talking
• 17:24
  Speaker 1: about here? So if I.
• 17:27
  Speaker 4: Could think, I've done so many assessments and evaluations. I
• 17:34
  Speaker 4: can make up one because I tell you one that
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  Speaker 4: I actually did one forensic neuropsychopathology like evaluation a couple
• 17:42
  Speaker 4: of years ago. But what I will do is I
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  Speaker 4: would say, I'll just take a case study from one,
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  Speaker 4: let's say a hypothetical service member who was dishonorably discharged
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  Speaker 4: from the military. So they come to me and they're like,
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  Speaker 4: I need an assessment because I was dishonorably discharged. I
• 18:03
  Speaker 4: was actually arrested for domestic violence against my spouse. But
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  Speaker 4: I feel like I have PTSD and I wasn't diagnosed
• 18:12
  Speaker 4: while I was in the military, but now I've been
• 18:15
  Speaker 4: in therapy and my therapist thinks that I might have
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  Speaker 4: PTSD and I need to get tested. So as a
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  Speaker 4: clinical neuropsychometrician, I do the disclaimer, I'm a scientist.
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  Speaker 2: I'm not a psychologist. I'm not licensed yet as a psychologist.
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  Speaker 2: I'm licensed as a psychology resident. So what I used
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  Speaker 2: to do as.
• 18:35
  Speaker 4: A clinical neuropsychometrician, under the supervision of a psychologist, test
• 18:39
  Speaker 4: and assessment, focusing on neuro. So if this person was
• 18:43
  Speaker 4: to come to me and say, I think I have PTSD...
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  Speaker 4: The first thing I would do is a diagnostic interview,
• 18:50
  Speaker 4: looking at medical history, mental health history, social, biopsychosocial.
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  Speaker 2: Histories, you know, jobs, relationships with people.
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  Speaker 4: Get all that information to determine what type of assessment
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  Speaker 4: and testing that they need.
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  Speaker 2: Formulate this test battery is what I call it.
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  Speaker 4: It's a combination of testing and assessment alongside what informant
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  Speaker 4: information from.
• 19:12
  Speaker 2: Spouses, coworkers, friends.
• 19:15
  Speaker 4: To justify or even provide information to say, like, yeah,
• 19:19
  Speaker 4: I think that they exude these different, you know, conditions
• 19:23
  Speaker 4: that might be PTSD because they're surrounded by this person.
• 19:27
  Speaker 4: Test that person, evaluate it, look at the results, analyze
• 19:32
  Speaker 4: and interpret those results.
• 19:33
  Speaker 2: Write a report.
• 19:34
  Speaker 4: And if a diagnosis is there, what happens is I
• 19:38
  Speaker 4: will look at that diagnosis and ask them to coordinate
• 19:41
  Speaker 4: with their medical doctor specifically either their primary care provider
• 19:45
  Speaker 4: or a neurologist, to see based on the PTSD diagnosis,
• 19:50
  Speaker 4: they've had this for a long time. So I would
• 19:53
  Speaker 4: imagine if they had it for a long time and
• 19:55
  Speaker 4: it went untreated, it's definitely affecting their brain. So I
• 19:59
  Speaker 4: would recommend they talk to their doctor to get a
• 20:02
  Speaker 4: specialist like a neurophysiologist or a neurologist.
• 20:06
  Speaker 2: To check and do a functional MRI to.
• 20:09
  Speaker 4: See what type of activity we see in the brain,
• 20:14
  Speaker 4: particularly the prefrontal cortex and the frontal lobe area. Because
• 20:18
  Speaker 4: if there's any changes in that part of the brain,
• 20:20
  Speaker 4: we know that that impacts.
• 20:22
  Speaker 2: Reasoning, judgment, decision-making. Could these issues be a factor in?
• 20:27
  Speaker 4: We're not making excuses because if he did allegedly abuse.
• 20:31
  Speaker 2: His spouse, we're not making excuses for that. But we're
• 20:35
  Speaker 2: trying to see....
• 20:37
  Speaker 4: How, you know, PTSD has impacted the brain over time.
• 20:42
  Speaker 4: And then neural imaging, in addition to a diagnosis, in
• 20:45
  Speaker 4: addition to concerns from the therapist, you have all this
• 20:49
  Speaker 4: legitimate information to determine a person is diagnosed.
• 20:52
  Speaker 2: So now you have to look at the.
• 20:53
  Speaker 4: Factors when you are going to, you know, if he
• 20:57
  Speaker 4: has to go to court and he's facing jail time,
• 21:00
  Speaker 4: these are the factors. We're not using it as an
• 21:02
  Speaker 4: excuse for him to get out of a sentence because
• 21:05
  Speaker 4: if he did it, But look at these factors, and
• 21:09
  Speaker 4: then we need.
• 21:09
  Speaker 2: To have some alternative methods.
• 21:12
  Speaker 4: If you're going to put them in jail, get them
• 21:14
  Speaker 4: some type of treatment. There's no purpose in giving a
• 21:16
  Speaker 4: person jail time, releasing them, and then they're going back
• 21:18
  Speaker 4: and doing the same thing if they're not being treated.
• 21:22
  Speaker 2: So that was the whole purpose of me doing what
• 21:24
  Speaker 2: I'm doing because I've seen a lot of that.
• 21:28
  Speaker 1: So as you said, we're not looking for excuses. You're
• 21:31
  Speaker 1: looking for causative.
• 21:32
  Speaker 3: Factors, i.e., What? Explanatory reasons.
• 21:37
  Speaker 1: Reasons.
• 21:38
  Speaker 3: Why did this happen?
• 21:39
  Speaker 2: Right.
• 21:41
  Speaker 1: Again, one of the questions I have is, okay, let's
• 21:44
  Speaker 1: say that was the reason. Or can you even do
• 21:51
  Speaker 1: a one-to-one and say, yes, that was the reason? Maybe
• 21:54
  Speaker 1: it's highly likely it was a causative factor. To what degree,
• 22:00
  Speaker 1: and I don't know if this is your wheelhouse, but
• 22:03
  Speaker 1: to what degree then is that person responsible, culpable to blame?
• 22:11
  Speaker 2: Well, that's where it comes to the legal system.
• 22:14
  Speaker 4: Because in my dissertation, even though it might not be
• 22:18
  Speaker 4: considered clinically or statistically significant, 1% of the service members
• 22:25
  Speaker 4: that I had did the research study from the master thesis,
• 22:29
  Speaker 4: I took that information from my dissertation.
• 22:31
  Speaker 2: So 1% of that.
• 22:34
  Speaker 4: They were held not liable for their activity due to
• 22:37
  Speaker 4: what they call criminal defect. That's what they call it
• 22:40
  Speaker 4: in the military. So they were not held criminally responsible
• 22:44
  Speaker 4: for their actions, for the violent crimes that they committed,
• 22:48
  Speaker 4: because they were diagnosed with PTSD. But you have to think,
• 22:52
  Speaker 4: the military justice system and the civilian criminal justice system
• 22:56
  Speaker 4: are different. So what were the factors that the military
• 22:59
  Speaker 4: justice system looked at to say, hey, this person's not
• 23:02
  Speaker 4: criminally liable?
• 23:03
  Speaker 2: For their actions. And that's what I'm trying to further.
• 23:08
  Speaker 4: Because if that's the case, what are we going to
• 23:10
  Speaker 4: see in civilian legal systems?
• 23:13
  Speaker 2: Are we going to see the same thing?
• 23:15
  Speaker 4: And when we're talking about culpability, you also got to
• 23:17
  Speaker 4: look at the situations of insanity at the time of
• 23:22
  Speaker 4: the crime, competency. And then, yeah, I really look at
• 23:25
  Speaker 4: the damage of PTSD. Like, PTSD has so many different factors.
• 23:29
  Speaker 2: And what it's called is polytheric.
• 23:32
  Speaker 4: Meaning that every person doesn't have to have the exact
• 23:35
  Speaker 4: same symptoms to be diagnosed. As long as you meet
• 23:38
  Speaker 4: the criteria of any of the systems, not systems, but
• 23:42
  Speaker 4: the criteria within PTSD, then you can be diagnosed. So
• 23:46
  Speaker 4: you can have people that have severe cases of PTSD,
• 23:51
  Speaker 4: and with severe, you might have psychotic episodes, psychosis, and
• 23:56
  Speaker 4: they really look at those things to determine, oh, that
• 23:59
  Speaker 4: person wasn't criminally responsible.
• 24:01
  Speaker 2: They had a a psychotic episode.
• 24:03
  Speaker 4: So they didn't know what they were doing at the
• 24:05
  Speaker 4: time when they abused their spouse because they were experiencing episodes.
• 24:09
  Speaker 4: So you really have to look at those factors to determine.
• 24:13
  Speaker 4: And that's like the more significant cases.
• 24:18
  Speaker 1: Well, it just reminds me or makes me think about
• 24:20
  Speaker 1: when we hear of these school shootings, you know, you're
• 24:25
  Speaker 1: thinking to yourself, you know, how the hell could any
• 24:32
  Speaker 1: sane person, quote unquote, do something like this? There's got
• 24:35
  Speaker 1: to be something going on. Any person in their right
• 24:39
  Speaker 1: mind would not commit such an act.
• 24:42
  Speaker 3: How do you tease out.
• 24:46
  Speaker 1: These questions? You know, is that person, again, are they
• 24:53
  Speaker 1: responsible for that?
• 24:55
  Speaker 3: Yes, they're responsible. Can you blame them if.
• 24:57
  Speaker 1: They have, if they're a mental health issues going on.
• 25:02
  Speaker 3: Right.
• 25:03
  Speaker 4: And I don't like answering, you know, a question with
• 25:06
  Speaker 4: a question, but I will ask you, how many school
• 25:10
  Speaker 4: shootings have we seen that the perpetrator did not have
• 25:14
  Speaker 4: a mental health issue? It seems like everyone that we've seen,
• 25:18
  Speaker 4: there was a history. People were aware, you know, it
• 25:22
  Speaker 4: was known, but this seemed like, I don't know if
• 25:27
  Speaker 4: it was consistent treatment or denial of treatment. or just
• 25:31
  Speaker 4: being misdiagnosed and not being handled effectively. But if you
• 25:34
  Speaker 4: think about it, it seems like every one of them
• 25:36
  Speaker 4: has some type of mental health history, and it always
• 25:39
  Speaker 4: comes out after the fact, right? It's always after the
• 25:43
  Speaker 4: perpetrator had some mental health condition. And I will say
• 25:49
  Speaker 4: that is the kicker and the big question that still
• 25:52
  Speaker 4: hasn't been answered yet because it still continues to happen.
• 25:57
  Speaker 3: The big question is what?
• 25:59
  Speaker 2: Why does this continue to happen?
• 26:02
  Speaker 4: If people do have history of mental health conditions, why
• 26:06
  Speaker 4: are they not being properly treated to prevent things like
• 26:09
  Speaker 4: this from happening?
• 26:10
  Speaker 2: Because we're not just talking about, you know, school shootings.
• 26:12
  Speaker 2: We're talking about mass shootings.
• 26:14
  Speaker 4: Now we're talking about random shootings. Just here a couple
• 26:17
  Speaker 4: weeks ago, a guy pulled out an AR-47 or something, AR-15,
• 26:22
  Speaker 4: whatever he had, and he's just shooting in the middle
• 26:24
  Speaker 4: of the street. Right.
• 26:26
  Speaker 2: You know, it's just.
• 26:27
  Speaker 3: Was that Cambridge, Mass.
• 26:29
  Speaker 2: No, I'm going to say it was here in Virginia.
• 26:33
  Speaker 3: It happened in Cambridge, Massachusetts, too, a week ago.
• 26:36
  Speaker 4: Okay, so that's probably the most recent one. The one
• 26:39
  Speaker 4: I'm talking about is about two, three weeks ago.
• 26:41
  Speaker 2: I mean, see, that's sad. It's happening so often. We
• 26:44
  Speaker 2: don't even know which ones we're talking about because it's
• 26:47
  Speaker 2: just happening. People are getting angry.
• 26:51
  Speaker 4: They don't have that filter of what I call self-discipline, self-regulation.
• 26:57
  Speaker 4: if you're upset to be able to regulate yourself, it
• 27:00
  Speaker 4: always resorts to violence. For example, an issue here on 495,
• 27:08
  Speaker 4: I guess it was a fender bender and it led
• 27:10
  Speaker 4: into a woman and a dog getting killed on a
• 27:14
  Speaker 4: major highway.
• 27:15
  Speaker 2: It's just stuff like that.
• 27:17
  Speaker 4: It makes you wonder how do people resort to violence
• 27:21
  Speaker 4: that quickly? Is it a mental health condition or is
• 27:23
  Speaker 4: it something else? That is my concern when we're talking
• 27:28
  Speaker 4: about these issues. How do we delineate the difference between
• 27:31
  Speaker 4: somebody can't self-regulate and being very reactive or seriously being
• 27:36
  Speaker 4: a mental health condition and either they're not medicated, they're
• 27:39
  Speaker 4: not being treated properly, or they're not being treated at all?
• 27:44
  Speaker 4: And that's what I talk about when I talk about
• 27:46
  Speaker 4: the weaponization of mental health, using it as excuse to
• 27:49
  Speaker 4: get out of crimes committed because we're It could be
• 27:53
  Speaker 4: just somebody using that as an excuse just to get
• 27:56
  Speaker 4: out on their crime because they know if we put
• 27:58
  Speaker 4: mental health out there, now we have to check and
• 28:01
  Speaker 4: see all these factors before considering sentencing and things of
• 28:06
  Speaker 4: that nature when it comes to the legal system.
• 28:10
  Speaker 1: At what point is someone responsible for their actions when
• 28:17
  Speaker 1: they have the cognitive capacity, when they have the wherewithal
• 28:23
  Speaker 1: to be able to make these decisions, you can say, yes,
• 28:29
  Speaker 1: they were aware of what they were doing at the
• 28:31
  Speaker 1: time of the action.
• 28:33
  Speaker 3: Therefore, they are what? Responsible and culpable.
• 28:38
  Speaker 4: Well, you actually answered your question, guys, based on competency.
• 28:42
  Speaker 4: So if you go before the court and it's found
• 28:45
  Speaker 4: that you were competent and you are competent, that's when
• 28:48
  Speaker 4: you should be held responsible.
• 28:51
  Speaker 1: Okay.
• 28:51
  Speaker 2: You know... I can't even tell you.
• 28:53
  Speaker 4: Because I don't have the statistics, so I don't want
• 28:56
  Speaker 4: to misquote. But just think about how many people in
• 28:59
  Speaker 4: the United States suffer from at least one mental health condition.
• 29:02
  Speaker 4: Just because you have a mental health condition doesn't.
• 29:05
  Speaker 2: Mean you're not responsible for your actions. Right.
• 29:08
  Speaker 4: So that's where it really comes down to. The person
• 29:12
  Speaker 4: knows right from wrong. They know exactly what they were
• 29:14
  Speaker 4: doing at the time that they did, whether it was.
• 29:16
  Speaker 2: Right or wrong.
• 29:17
  Speaker 4: And there's certain things that you can factor in and
• 29:20
  Speaker 4: assess for to determine that.
• 29:22
  Speaker 2: If they knew right from wrong.
• 29:24
  Speaker 4: And then we have tests that will actually check for
• 29:28
  Speaker 4: malingering and fiending to determine if somebody's trying to fake competency.
• 29:32
  Speaker 3: Right, right. Monique, what would you say is your, as
• 29:38
  Speaker 3: we kind of.
• 29:40
  Speaker 1: take a 20,000-foot approach, if you will, what is your
• 29:44
  Speaker 1: main interest in all this we're discussing today?
• 29:48
  Speaker 2: Like the overall goal of what I'm doing?
• 29:50
  Speaker 1: Yeah, yeah.
• 29:52
  Speaker 2: So.
• 29:53
  Speaker 4: Like I said, my overall goal is for forensic neuropsychopathology
• 29:57
  Speaker 4: to be recognized by the APA because if so, it
• 30:00
  Speaker 4: becomes a legitimate discipline. I would like to get the
• 30:04
  Speaker 4: proper funding to really establish a program under this discipline
• 30:10
  Speaker 4: to really work with the legal system, medical, and mental
• 30:14
  Speaker 4: health professionals because I think a multidisciplinary approach when you're
• 30:19
  Speaker 4: talking about things like this is necessary.
• 30:21
  Speaker 2: We can't do it alone.
• 30:22
  Speaker 4: Mental health professionals can't say, oh, we'll take this and
• 30:24
  Speaker 4: we'll handle it. You have to work with the legal system.
• 30:27
  Speaker 4: You have to work with legal professionals. You have to
• 30:30
  Speaker 4: work with medical professionals. And when I was doing my
• 30:32
  Speaker 4: clinical work, that's what I was doing. I always had
• 30:35
  Speaker 4: a collaborative approach. Like I was talking to my patients' doctors.
• 30:40
  Speaker 4: I was talking to their attorneys. I was doing those
• 30:43
  Speaker 4: things because when you do that, you can better understand
• 30:46
  Speaker 4: what that person is going through, number one. So that's
• 30:50
  Speaker 4: my plan, to be recognized, to get funding, to have
• 30:53
  Speaker 4: this big task force of medical professionals, legal professionals, mental
• 30:57
  Speaker 4: health professionals, and we all work together to improve mental health.
• 31:03
  Speaker 1: Why was this field never solidified prior to your work?
• 31:10
  Speaker 3: I don't know.
• 31:11
  Speaker 4: To be honest, I looked and looked because I definitely
• 31:14
  Speaker 4: didn't want to take an idea from somebody else.
• 31:16
  Speaker 2: I wanted to see who coined.
• 31:18
  Speaker 4: Neuropsychology, who coined neuropsychopathology. And one thing that I could
• 31:22
  Speaker 4: not find is somebody who coined neuropsychopathology.
• 31:25
  Speaker 2: I'm not going to take credit for it because it existed.
• 31:27
  Speaker 4: Before me, but forensic neuropsychopathology, when you're putting the legal
• 31:31
  Speaker 4: science and mental health and psychology together, that it was,
• 31:37
  Speaker 4: it didn't exist, but that's what I'm looking at. I'm
• 31:39
  Speaker 4: looking at crimes. I'm looking at the science behind crimes.
• 31:43
  Speaker 2: I'm looking at.
• 31:43
  Speaker 4: Mental health standards. I'm looking at mental health conditions and
• 31:46
  Speaker 4: I'm looking at the brain. So what I was doing,
• 31:49
  Speaker 4: it made sense to me. And I'm like, I'm just
• 31:51
  Speaker 4: going to put it together. And this is going to
• 31:53
  Speaker 4: be my dissertation. This is the birth of this. And
• 31:56
  Speaker 4: now I want to legitimize it. So that's the point
• 32:00
  Speaker 4: of the three-volume series, because I wanted to bring awareness
• 32:03
  Speaker 4: to it.
• 32:05
  Speaker 1: Right. Wow. I'm curious, has the military reached out to you,
• 32:12
  Speaker 1: given your experience?
• 32:14
  Speaker 2: No, honestly, no. Even though it was.
• 32:17
  Speaker 4: I actually worked at the Pentagon. That was about 10,
• 32:20
  Speaker 4: 11 years ago. So the people that I were connected to,
• 32:23
  Speaker 4: they're no longer in the Pentagon. But I haven't came
• 32:27
  Speaker 4: to that step yet. I wanted to reach out to
• 32:30
  Speaker 4: them because I wanted to make sure I had all
• 32:32
  Speaker 4: my ducks in a row. I want to make sure
• 32:34
  Speaker 4: I have certain, you know, credible sources on board like APA.
• 32:39
  Speaker 4: You know, I want to make sure my book was established,
• 32:41
  Speaker 4: research is established. I still have more experiments and research
• 32:46
  Speaker 4: to do, too. before I would want to have discussions
• 32:50
  Speaker 4: with them about this. I'm just simply right now just
• 32:53
  Speaker 4: bringing awareness at this point.
• 32:56
  Speaker 1: Finally, as we kind of wind down here, what would
• 32:59
  Speaker 1: you say is your kind of superpower in the work
• 33:03
  Speaker 1: that you do, in the breadth of topics and subject
• 33:09
  Speaker 1: matters that you've been able to kind of coalesce and synthesize?
• 33:17
  Speaker 2: So if I could sum it up in one word,
• 33:19
  Speaker 2: I would say this. It takes a lot of this
• 33:22
  Speaker 2: to be able to do what I do.
• 33:24
  Speaker 3: Discipline. You're disciplined.
• 33:27
  Speaker 4: I'm very disciplined. I still act like I'm in the military,
• 33:30
  Speaker 4: and I do that to myself. I have to hold
• 33:32
  Speaker 4: myself accountable. So, yes, it takes a lot of discipline
• 33:36
  Speaker 4: to be able to do what I do and try
• 33:38
  Speaker 4: to reach these goals.
• 33:41
  Speaker 1: Damn.
• 33:42
  Speaker 3: Amazing. Monique, you are, again.
• 33:46
  Speaker 1: So frigging inspiring. The book series is called Forensic Neuropsychopathology,
• 33:52
  Speaker 1: Clinical and Medical Insights into Brain Behavior, Mental Disorders, and
• 33:56
  Speaker 1: the Legal System. How do people learn more about you,
• 34:00
  Speaker 1: reach out to you, and get the book? What's the
• 34:02
  Speaker 1: best way?
• 34:03
  Speaker 4: So the best way to reach out to me would
• 34:05
  Speaker 4: be my website, which is www.moniquemiddleinitialsmhareshkanazi.com. Dude.
• 34:13
  Speaker 2: Should I spell my name?
• 34:14
  Speaker 1: I think people will get it.
• 34:16
  Speaker 3: No, we'll have it linked up here.
• 34:17
  Speaker 4: That's where you can email right through that website.
• 34:22
  Speaker 2: I get all the emails. I check my email daily. Okay.
• 34:26
  Speaker 1: Do you, I don't know if you're going to hate
• 34:29
  Speaker 1: me for asking you this, but do you mentor people?
• 34:32
  Speaker 2: I do, actually.
• 34:33
  Speaker 3: I think you'd be an amazing mentor.
• 34:37
  Speaker 2: I do. You know, it's one of those things. I've
• 34:39
  Speaker 2: been a full-time professor, too. for 17, almost 18 years.
• 34:45
  Speaker 4: And so, you know, it's very rewarding when that one
• 34:49
  Speaker 4: student graduates and comes back and they're like, Dr.
• 34:52
  Speaker 2: Mo, I need you to be my mentor, like ASAP.
• 34:54
  Speaker 2: And I'm like, on it. That's so amazing. So yes,
• 34:59
  Speaker 2: I do.
• 34:59
  Speaker 1: I do.
• 35:00
  Speaker 3: Monique, I love it. Love to have you back at
• 35:02
  Speaker 3: a later date. Just, you're awesome and so inspiring. Thank
• 35:07
  Speaker 3: you so much for being here.
• 35:08
  Speaker 2: Thank you.
• 35:09
  Speaker 1: I really appreciate it.
• 35:10
  Speaker 2: Thank you so much.
• 35:10
  Speaker 1: All right.
• 35:11
  Speaker 3: Take care.