Compulsive Homicides in Historical Context

The word compulsion is derived from the Latin compellere, which means to compel, force, urge, or drive on. Unfortunately, the term compulsion—or compulsive—has been used to label very different forms of behavior and symptoms: the compulsive offender, the compulsive personality, and the obsessive-compulsive neurotic (see Table 7.1). The compulsive offender lies on the extreme endogenous end of the motivational spectrum (see Chapter 3) and is least influenced by external or sociogenic factors. From a clinical perspective, the compulsive offender has a powerful urge to act out his violent thoughts and fantasies, with a strong potential for repetition. He knows that the urge is dangerous and often plans his actions first in his mind and then perhaps through some behavioral tryouts; finally, often years later, he commits a criminal act. Other times, the compulsive offender acts out his fantasies in an unplanned, spontaneous manner when a victim of opportunity crosses his path.

The individual with a compulsive (or obsessive-compulsive) personality is totally different from the compulsive offender. The compulsive personality is characterized by inflexibility and a preoccupation with orderliness, perfectionism, and mental and interpersonal control. Individuals with this personality disorder are rigid and difficult to get close to since they often have detectable anger right at the surface that emerges easily in interpersonal situations. They may be excessively devoted to work and productivity, overly conscientious, stubborn, scrupulous, and unbending regarding matters of morality and ethics.

Both the compulsive person and the compulsive offender are different from individuals who have an obsessive-compulsive disorder, or what has sometimes been referred to as an obsessive-compulsive neurosis. Freud (1895) described this neurosis under the name Zwangneurose, which comprises both obsessions and compulsions. Clinically, this condition is characterized by rituals such as repetitive hand-washing, checking and rechecking, counting, or repeating words silently—intrusive, inappropriate obsessional thoughts, which are ego-dystonic, concern contamination, doubts, or what Rado (1959) has referred to as “horrific temptations.” “In his fit of horrific temptations the patient, suddenly beset by the urge or idea to kill someone (characteristically a close and loved relative), shrinks back in horror from a temptation so alien to his entire being” (p. 325). The obsessive-compulsive neurotic does not want to act out and knows that he will not act out his “horrific temptations”; however, he fears that he might and so seeks reassurance from strong and supportive figures. Revitch and Schlesinger (1981) reported the case of a man so obsessed with the idea that he might kill his entire family that he left a ceremonial sword at another location in order not to be tempted to act on his horrific temptation.

The compulsive offender, however, does not have ego-alien temptations but rather has a compelling urge to act out dangerous fantasies. Here, the criminal act, such as murder, is itself eroticized (or sexually gratifying). These homicides do not necessarily involve rape or genital contact, as the murder itself is sexually arousing and sufficient. Thus obsessive-compulsive neurotics and compulsive offenders both have an urge for some type of

Table 7.1

Differing Uses of the Terms Compulsion and Compulsive

Terms	Symptoms and Behavior
Obsessive-compulsive neurosis Obsessive- compulsive disorder	The individual experiences obsessional thoughts as intrusive and inappropriate. He also exhibits repetitive behaviors, the goal of which is to prevent or reduce anxiety. Self-doubts and rituals (e.g., hand-washing) are common. Occasionally the individual has “horrific temptations” to hurt a loved one, which he realizes he will not act on.
Compulsive personality Obsessive-compulsive personality	The individual exhibits traits such as rigidity, orderliness, perfectionism, neatness, control, inflexibility, and interpersonal anger.
Compulsive offender	The individual has a powerful urge to act out dangerous fantasies, with a high potential for repetition. The offender knows this urge is dangerous and plans his actions methodically, or the compulsion may break through spontaneously when a victim of opportunity is present. The criminal act itself is sexually gratifying.

behavior, but the clinical features of the acting out and the underlying psychodynamics have nothing in common. In the obsessive-compulsive neurotic, defense mechanisms of isolation and undoing separate emotion from ideas. The same may occur with compulsive offenders, but their compulsions stem from a fusion of sex and aggression, quite different from those of the neurotic. Both, however, should generally be considered a repetition compulsion as described by Freud (1920), inasmuch as they involve an obligation to symbolically repeat a traumatic situation through action in order to avoid anxiety by gaining mastery of the repressed memory of the trauma.