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Authors: Corey Mitchell

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FIFTY-SIX
Perhaps the most interesting portion of the penalty phase was the testimony of two psychiatric expert witnesses: Dr. Fred Berlin and renowned forensic psychiatrist Dr. Park Dietz.
Dr. Berlin testified on behalf of Rex Krebs beginning on April 30, 2001. He graduated with a Ph.D. in psychology and has a medical degree. He is chief resident in psychiatry at Johns Hopkins Hospital in Baltimore, Maryland. He is a board-certified psychiatrist as well as a certified forensic psychiatrist.He is also an associate professor and an attending physician at Johns Hopkins. He is the founder of the Johns Hopkins Sexual Disorders Clinic and the director of the NationalInstitute for the Study, Prevention, and Treatment of Sexual Trauma. He then described his three main responsibilities:clinical care, teaching, and research.
“My primary area of interest is the area of sexual disorders,”Dr. Berlin informed the court.
The doctor spoke about his numerous publications for such prestigious journals as the
New England Journal of Medicine
and the
American Journal of Psychiatry
. His articles ranged from chemical causation of sexual offenses, to recidivism rates of sexual offenders, to genetic causation for sexual disorders. He also published articles on sexual sadism. Specifically, the case of Connecticut sexual serial killer Michael Ross, a CornellUniversity graduate with a 122 IQ, who raped and murdered eight women in Connecticut, and possibly New York, in 1985.
Dr. Berlin also testified on behalf of one of the country’s most infamous murderers: Milwaukee serial killer and cannibalJeffrey Dahmer.
“Have you evaluated Rex Krebs clinically?” defense attorneyWilliam McLennan asked Dr. Berlin.
“Yes. I did see Mr. Krebs on two occasions. March of last year. Then I saw him in January of this year. The amount of total time I spent with him is about twelve-and-a-half hours.”
When asked what the purpose for examining Krebs was, Berlin replied, “Trying to make a determination whether or not he had a psychiatric disorder.”
Berlin continued, saying that “I don’t want to be a psychiatristwho is excusing by labeling it psychopathology and get somebody off the hook who is of sound mind.”
“When you are doing an evaluation of a prior rapist,” continuedMcLennan, “are there guidelines and principles involved?”
“I’m going to look at it from three perspectives. The behavioritself. The consequences of the behavior. Then I’m going to try to appreciate the mental state of the individual out of which this behavior emerged.” He was then asked to give a couple of examples of the different types of rapists.
“One who rapes might be a self-centered person, an opportunisticperson. Someone who is antisocial. He comes upon a woman who is vulnerable.
“A second example of rape—and it’s rare, but it does happen—are people who have psychotic illnesses. These are conditions in which people are delusional. They are completelyout of touch with reality. They may believe if they rape, for example, they will conceive the Messiah.
“Let me give one more that is pertinent to this case. That’s where people commit a rape because they have some sort of a sexual disorder. They are driven by abnormal sexual cravings to repeatedly engage in this kind of criminal behavior.”
Dr. Berlin laid out the examples to show that he needed to know what he was getting into before he could make an evaluation.He moved to the actual interviews with Krebs.
“There seemed to be a very ritualistic nature to what he had done. In the (1987) case where he raped the woman, he cut off her clothing in a particular fashion. In the two incidents that we are talking about here, Rachel and Aundria, there was evidence that he had bound these women up in a particular fashion. He had hog-tied them. He had seemed to want to be dominating them. If you looked at the description in the way Aundria Crawford was tied up, it was in a very ritualistic way.
“This is someone who is motivated to rape out of a very specific pathology. This is likely a sexually disordered person who is enacting some sort of fantasy in a ritualistic way, but not somebody who is of sound mind and antisocial.”
Dr. Berlin sped through his testimony. He spoke so rapidly that the court reporter had to ask the judge for him to slow down.
“I’m trying to concentrate on slowing down,” Dr. Berlin apologized.
“Dr. Berlin, in the case of Rex Krebs, were you able to make more than one diagnosis in the case?”
“I made two diagnoses with conviction. The first diagnosisis of sexual sadism, which is one of the sexual disorders. The second diagnosis I made was of alcoholism. And the third one, which I considered and debated pretty closely in my mind, was antisocial personality disorder.”
“You said you diagnosed sexual sadism. Can you tell us what a sexual disorder is?”
“There is a tremendous spectrum of differences amongst human beings in their sexual makeup. There’s really two ways in which people differ from one another sexually.
“The first way is regarding the kind of partner that he or she is or isn’t attracted to. An example of sexual disorder based upon that would be pedophilia, which is a condition in which some individuals are attracted to prepubescent children.
“A second way is regarding the kinds of sexual behaviors that either do or don’t excite them or arouse them erotically. One example of a sexual disorder based on that is trans-vestiticfetishism. In everyday English that refers to a condition in which a person is very aroused, usually a man, by dressing in the clothing of the opposite gender. Now, you couldn’t pay the average man enough money to do that, and yet clinically I have seen men who are aroused by dressing in that way that they have to struggle if they stop doing it.”
Dr. Berlin gave one more example of a sexual disorder. “Sexual masochism. That’s a condition in which a person is extremely aroused by their own suffering, degradation, humiliation.It’s one of the few sexual disorders that occurs as often in women as it does in men.
“Now most of us haven’t the slightest sense (of) being aroused by having someone denigrate us, humiliate, and injureus. And yet I have clinically seen cases of people who are aroused by behaving in this way, aroused sexually.
“Now this case, sexual sadism is kind of the opposite end of the coin from sexual masochism. The degradation, the humiliation,in some cases, the suffering or injury of another person is what is arousing to the individual. And again clinically I have seen cases where people are much more aroused sexually by engaging in coercive and sadistic sexual acts than they are by consenting acts. They will leave the availability of a consenting partner because the urge to engage in coercive or sadistic activitiesis so much more powerful. That’s not normal. That’s a sexually disordered person when you see something like that.”
McLennan asked for Dr. Berlin to recite the definition of “sexual sadism.”
Dr. Berlin read from the
Diagnostic and Statistic Manual of Mental Disorders
. “If you read the definition, it would indicatethe individual with a sexual disorder experiences intense, recurrent, erotically amusing fantasies about somethingthere.
“If it were pedophilia, that something would be about havingsex with a little child. In sexual sadism, that would be about having fantasies about having sex in a coercive and sadistic fashion rather than in a consenting fashion.”
“In the case of Rex Krebs, what does he specifically experienceat these reoccurring urges?”
“The urge is to enact the fantasy. In Mr. Krebs’s case, there is a theme of domination, of wanting to be in control and dominating a woman. There’s very much a preoccupation about tying women up and tying them up in a particular fashion.There also seems to be an aspect of this about cutting off the clothing of women in a particular way.
“The specific fantasies he has can vary, but the common theme in all of them is he has a woman who is at his mercy. He is dominating this woman. He has her tied up and he’s cut off her clothing.
“I apologize. I know this is pretty gruesome.”
“What is it about this behavior that is sexually arousing for him?” prodded McLennan.
“Again it is the enactment of the fantasy. Having sex in the conventional way is not what’s arousing for him. He had the availability of a consenting partner.”
“Does the
Diagnostic and Statistic Manual
divide sadism into any types of subtypes?”
“The one major subtype is whether it’s present in an exclusiveor nonexclusive form. In the exclusive form the only way in which a person could become sexually aroused is by engaging in these abnormal kinds of sexual behavior.
“In the exclusive form of sexual sadism, the only way a person could be aroused sexually is by engaging in sadistic behavior. That’s why it’s exclusive. They can’t be aroused by consenting behavior.
“In the nonexclusive form, the person is capable of being aroused by conventional sexual activity, and that is the case with Mr. Krebs.”
“Dr. Berlin, is this diagnosis of sexual sadism based on behavioralone?”
“No. I think an important point to appreciate about sexual sadism is that we are talking about an abnormality in the mental makeup of the individual. In their sexual makeup.”
“Is it ordinarily difficult for a person such as Rex Krebs to resist acting on these urges?”
“Obviously, from what I said, it is. I don’t think it takes a mental-health expert to appreciate what a problematic and, in this case, dangerous situation that can be.”
“Do you have an opinion if the sexual sadism of Rex Krebs impaired his ability to be in full control of himself?”
“Yes, I do have an opinion that his ability to be in full controlof himself was impaired.”
“Is there a specific treatment for sexual sadism that demonstrates that impairment of volitional capabilities?”
“I think there is. One of the kinds of treatment is medicineto lower the intensity of their sexual drives. People have heard of this so-called chemical castration, which I think is misleading. Essentially, it is medicine that lowers testosterone,which is the hormone that fuels sexual drive in males.
“The medication has conferred upon them a capacity of self-control that they didn’t have before the medication came aboard.”
“Dr. Berlin, if the evidence showed that Rex Krebs had premeditated and planned these crimes, and then he took effortsto cover up the acts that he’s done, is that proof that he could control himself?”
“No.”
“Could Rex Krebs have gained control of his sexual sadism through masturbation?”
“No. When most people masturbate, it doesn’t make them no longer want to have sex. Mr. Krebs said he was masturbatingas often as three or four times a day. I don’t mean to be cynical here, but if it was that simple, we would take everyonewith a sexual disorder and have them come into a back room of a doctor’s office and have them masturbate three times a day and the problem is solved.”
On that note Judge LaBarbera requested a lunch break.
“In a secure prison setting,” McLennan resumed his questioningof Dr. Berlin in the afternoon session, “is this something that might cause Rex Krebs to be in some way a danger?”
“My opinion is no. To help explain why I’m saying no, I want to talk about a very simple concept that talks about internalcontrols and external controls. Internal control means the ability for a person himself, the control is within him to be in control in a given situation. External controls are those things that control the situation outside of the individual.
“Now, to give an example of how they interact and to answerit with respect to Mr. Krebs, if a man were standing next to a very attractive woman and his wife is standing next to him, he’s going to be far less tempted to approach that attractivewoman in a sexual way because his wife is, in effect, an external control that’s affecting the situation.
“The real test for the man is his wife’s not there—the externalcontrol is removed—then the temptation can be much stronger. And if this happens to be a man with a sexual disorderwho’s impaired in his internal controls, that’s where the real test is going to come.
“So in a prison setting where there are all sorts of external controls present, men with sexual sadism tend to be model prisoners.”
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