Crazy, Not Insane Review: HBO Serial Doc Examines Haunted Minds

HBO’s Crazy, Not Insane is a personal and provocative probe into a pioneering death row investigator.

Crazy Not Insane
Photo: HBO

“Bigotry and insanity are different,” Psychiatrist Dr. Dorothy Otnow Lewis says at the beginning of HBO’s documentary Crazy, Not Insane. The idea that someone can kill for perfectly sane, yet irrational reasons goes to the heart of the controversial doctor’s work. Her mother seemed to be able to name every famous anti-Semite. Henry Ford, Richard Wagner, Joe Kennedy and “even Walt Disney,” Lewis lists. The man who made Bambi, which made Lewis cry as a little girl, hated Jews, she bemoans as the film unfolds. You never know what lies underneath even the most innocent appearing exteriors, director Alex Gibney’s (The Inventor: Out for Blood in Silicon Valley, HBO’s Agents of Chaos) documentary, highlights.

The documentary then cuts to one of Dr. Lewis’ earliest cases, the serial killer Joseph Paul Franklin. He preferred to be called a multiple slayer. While Lewis explains how she hoped, at the time of her interviews, she would not be prejudiced, the documentary explores how these were swept aside when the depth of hidden personalities became the focus. Dr. Lewis’s entire career is about deep work into the darkest parts of the mind. She breaks her personal prejudices in ways most people never contemplate. Dr. Lewis is interested in why people kill, and in finding the reasons, she empathizes with human beings who most people prefer keeping at a safe distance.

How do these killers get that way, she wants to know. But more than that, Dr. Lewis’ earliest questions were whether she could become a murderer. This is where she differentiates herself from other mental health advocates. It is why she was called on so many times by defense attorneys. Lewis interviewed Ted Bundy four times in 1986 at the request of the defense. The documentary shows excerpts of the conversation, taped just before execution. The audiotape clearly expands conventional wisdom about Bundy. It also shows why Dr. Lewis became such a controversial figure. She and her frequent partner Catherine Yeager pioneered psychiatric legal avenues by exploring trauma as root causes of horrific crimes in many cases. She modernized psychiatric criminal investigations.

Crazy, Not Insane deftly takes the viewer through the sequence of events which led Dr. Lewis to change how killers are perceived, both legally and in the media. In one telling sequence, media pundit Bill O’Reilly tells her hate crimes are caused by hate. She counters by explaining that’s much too simplistic. Evil is a religious concept, not a scientific one. The film and the documentary make the case that murderers are made, not born. The film follows the doctor as she goes through death row interviews, finding many of the people who wind up there suffered neurological dysfunctions, some of these were caused by being shaken as babies, others more dramatic.

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Gibney captures a happy Dr. Lewis. She’s obviously enjoyed her work and can even laugh easily at her memories of the over 20 serial killers she’s interviewed. The convicted murderers are fascinating subjects, and the film gives just enough time with each of them to bring out new revelations in each. Some of the people profiled are well known, others less so. One of the most interesting is a young woman named Marie Moore. Convicted because she was given up by the actual killer, Marie comes forward as a “multiple,” a shortened term for multiple personality, which is now called Dissociative Disorder or DID.

The multiples make up the secondary cast, which often threaten to overshadow the main subject. Each of the alter-personalities appear chillingly unique from the core personality we see in the establishing shots of the interviews. Under hypnosis, the population of the inner landscapes of each of the killers videotaped, are allowed to fully develop. They also form a larger community. Some of the alters blame other personalities for the crimes they’re on death row for, others explain why they did what they did and why they let other personalities take the punishment. It is chilling, and somehow exhilarating, especially to Dr. Lewis. But what does it all mean in court? You can’t lock up one personality in a system of entirely whole consciousnesses.

The documentary traces Lewis’ career to her work with violent juvenile offenders. She becomes an advocate for advanced mental health procedures. Many of the experts at the time credit her, in the interviews, with opening their eyes about how childhood physical and sexual abuse, coupled with neurological damage impact impulses in adults. When Dr. Lewis testified in death penalty cases, her conclusions were challenged by experts in both legal and psychiatric circles. In an interview with Dr. Park Dietz, the esteemed forensic psychiatrist who often faced off against Lewis, still believes dissociative identity disorder is a hoax.

Beyond the interviews and archival footage, Gibney also adds contemporary cinema verité, capturing Dr. Lewis with her family, going over notes and as she gives herself over to painting. He animates her hand-drawn charcoal images to bring some id to the subjects’ superego. The documentary reveals how Dr. Lewis’ works are as much an art as a science. During the segment about “traveling executioner” Sam Jones, an electrician who administrated hundreds of death penalty sentences, Dr. Lewis finds the keys to his psyche in the paintings he made after his executions.

Laura Dern (The Tale, HBO’s Big Little Lies) gives understated readings of Dr. Lewis’s notes and excerpts from her 1999 book Guilty by Reason of Insanity: Inside the Minds of Killers. It completes the narrative, and adds insight into the findings. Ultimately, Lewis wants to stop the causes of murderous criminality before the acts are carried out, or at least minimize them by bringing them to the surface.

Crazy, Not Insane also competently questions whether the death penalty is a deterrent to violence. It points out that states with the death penalty tend to have higher murder rates than those without. Lewis is dispirited about today’s move toward a federal death penalty. The film underscores the movement with footage of people cheering execution. Some of it looks like it could have come out of a Universal horror picture, but it is archival and real. Once again, the documentary implies something happening below the surface. 

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The title Crazy, Not Insane refers to the problems the legal system has with defining grave mental illness, and Gibney does a commendable job traversing some very difficult language and landscape. He also offers a very revealing portrait of a driven scientist who allows her work to get personal. At one point in the film, Lewis says she regrets never being able to examine Bundy’s brain for forensic clues into his motives. She also says that about Adolf Hitler’s brain. The little girl who was raised to despise anti-Semitism in all its forms is still able to look for shaken-baby syndrome in Hitler. Experts can question Dr. Lewis’s conclusions, but the documentary leaves no reasonable doubt as to her passion and commitment.

Crazy, Not Insane debuts Wednesday, Nov. 18 at 9 p.m. on HBO.


4 out of 5