Eros and thanatos: at the origins of family, life and death. A forensic-psychiatric case

Abstract

Although every homicide is a tragic event, the ones committed by psychiatric patients have a special impact on public opinion, where they are perceived as unforeseeable, irrational, even threatening. Particularly disturbing are the homicide-suicides that happen within the family, which is usually viewed as a refuge in which affections are cultivated. It is in this refuge indeed, that sometimes not only the flowers of love, but also the deadly berries of thanatos grow. From time immemorial poets have known that one can lose one’s mind through love or hate and that it is not always possible “to find it again on the moon” or, in contemporary fashion, at the psychiatrists, who do their best to interpret this magma of love and hate, life and death. In literature we can find several attempts to classify homicide-suicide on the bases of the psychiatric disorder of the killer, the relationship between killer and victim and possible trigger events, in order to help clinicians to establish the risk of the occurrence. A part from the many cases of infanticide, a profile that emerges from this analysis, is that of the elderly depressed man who kills the sick wife that he is caring for. The purpose of our work is to analyse an uxoricide and failed suicide case within our forensic practice, committed by a man, almost 70 years old, who was no longer capable of taking care of a wife, who was suffering from dementia, was not self-sufficient and who was due to be admitted to an elderly clinic within a few days. In order to understand this case, be it on a clinical or forensic level, we tried to identify the psychopathological signs and symptoms of the patient that could result in a disorder, but primarily to elucidate the mental and motivational dynamics that brought him to kill his wife. We also tried to evaluate how much these dynamics affected his capacity. The story emerged from the patient under observation was that of a great love that could not end and above all that could not end with the abandonment and betrayal of a defenceless wife. The dynamics he presented were on one side those of “I can neither save you nor abandon you” and, on the other side, of “nec tecum nec sine te vivere possum”. It is at this level that the question of the differential diagnosis crops up, between euthanasia as a gesture of love or a depressive anguish that renders the patient unable to be indicted.