Philip Markoff, the 22-year-old accused Craigslist killer of model Julissa Brisman, may seem like the least likely of killers.  But when all the facts are known, Markoff’s story (if he is convicted) will start to make sense.  Granted, he’s a reasonably affable medical student without a criminal record ― but Scott Peterson was a friendly fellow and seemingly good neighbor before murdering his wife Laci and their unborn son, Conner.  Dr. Richard Sharpe,  the Harvard dermatologist (and cross-dresser, it turns out) was a respected physician prior to shooting his wife to death in front of their children.  Dr. Jonathan Kappler, a California anesthesiologist who murdered my friend and colleague Paul Mendelson back in 1990, had worked for decades as an anesthesiologist prior to accelerating to 60 mph in his car and intentionally mowing Paul down as he jogged. 
 
Psychiatric instability is often invisible until we look for it, in retrospect, after a terrible event triggers the inquiry.  But the evidence of that instability and the causes of it are never absent once we start digging. 
 
In the case of Philip Markoff, we could start excavating the roots of his violence by looking at his gambling habit.  If it is true that he owed gambling debts that motivated him to rob women-for-hire in hotel rooms, then he may have been someone deeply moved by the wheels of fate — by risk or ruin being determined by the alchemy of skill and the luck of the draw at a poker table.  In my experience treating gamblers, their connection to fate often comes from having little or no control over their lives as much younger people.  Sometimes, that adds up to having had parents who could have cared less about their feelings or desires. Sometimes, it adds up to not knowing when the next beating was going to come. And sometimes, it adds up to too many sudden losses. 
 
But it always adds up. When someone shoots a woman, then calmly walks to his car sending off text messages, he is unmoved by the cruelest roulette life can serve up.  Somewhere deep inside him, he is used to destruction because he has been destroyed.  He is without feelings because he has tried desperately to wall off his own — whether fear or grief or rage.
 
If I were with Markoff right now, I’d want to know why gambling spoke to him.  Why was Foxwoods the kind of place he felt at home?  Why was it the place he reportedly planned to marry his fiancé? 
 
Markoff also allegedly preyed upon women.  He didn’t pistol whip drug dealers and make off with their cash.  Maybe, if he’s guilty, he’s had it in for women.  Maybe he harbors deep feelings that his life was “stolen” from him with the dissolution of his parents’ marriage and its aftermath.  Maybe he thinks they’re all prostitutes when it really comes down to it.  Maybe he thinks they’re dangerous enough to him emotionally ― or even physically ― that they need to be tied up.  We don’t know — yet.  We never know, until we ask the relevant psychological questions.
 
I’ve been a forensic psychiatrist now for many years.  And I’ve learned one thing for sure:  No killer comes out of the blue.  No child is born into this world evil.  Every act of destructiveness can be explained.  And no one, not even a medical student whose fiancé loves him very much, is ultimately much of a mystery once you decide to burrow beneath the surface.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

Dear Mr. Brown:
We have never met.  I don’t presume to know your life story.  If the allegations against you are true, however, and you did brutalize your girlfriend, I do know something very important about you. 

First, you should know a little about me.  I am a forensic psychiatrist who has treated violent men and women and testified as an expert in state and federal courts in cases involving rape, assault and murder.  On more than one occasion, I have testified about the underlying psychological dynamics that resulted in men killing women.  I also wrote the New York Times bestseller Inside the Mind of Scott Peterson.  You would have been just 16 when Peterson was sentenced to death for the murder of his wife Laci and unborn son Conner.  I tell you all this to increase the chances you might actually take what I have to say to heart before you ruin your life and destroy someone else’s. 

Here’s what I know about you, if you are guilty of the charges against you:  You are different from the vast majority of men.  You have been emotionally and physically violent toward a woman, and I believe you’ve done it before.  Men who find themselves in court for assaulting females rarely have the good fortune to be caught—and, hopefully, get help—the first time. 

Psychologically speaking, what you are up against is like psychological cancer—a malignancy that is life threatening and hard to treat.  Just when you think you’ve overcome it, it can overtake you.  It is deep in the marrow of your mind or brain or both.  I don’t like your odds against it—even a little bit.  Defeating it will take an act of will greater than any you have summoned before.

For one reason or another, you lack the empathy or impulse control that would have allowed you to restrain yourself from lashing out when anger surged inside you.  This is no small matter.  Empathy is a miraculous human quality that allows one human being to imagine the suffering of another and seek to minimize it whenever possible (not inflict it).  Impulse control is closely linked to having empathy, but can also depend on parts of the brain—especially the frontal lobes—functioning appropriately.  Impulse control also depends on being sober.  Alcohol or an illicit drug is often the culprit when violence erupts.

If you lack empathy, your character is badly damaged, and it is essential that you figure out how that occurred.  You need to examine which events in your life were so painful that you stopped feeling your own sadness and hurt and tried to keep everything buried inside you.   That doesn’t work.  The things you bury never go away, they get more intense, then spill out of you in ways you can’t predict or control.   Only a skilled therapist can help you look at yourself in the way you need to now, to unearth the emotions you’ll need to in order to have any hope of remaking yourself into the kind of man you deserve to be—a man of character who can form loving relationships, not abusive ones.  And only a psychiatrist can prescribe whatever medicine might be needed in the short or longer-term to help you keep your demons from getting the upper hand again while you wrestle with them.

Character pathology often goes hand-in-hand with alcohol and drug problems.  That’s because alcohol and drugs are another way people try not to feel the turmoil inside them.  But, trust me, it’s a sucker’s game.   Ultimately, booze or coke or heroin only fuel the ugly things inside a person.   If you’re using and think you can stop on your own, think again.  You’re in a war, and you’re losing.  Check yourself into a rehab, if you have to.  Get to AA or NA, if you have to.  Do more than you think you need to.  You’ll underestimate your enemy.  Every alcohol or drug abuser does.

Go see a neurologist, for good measure.  Tell him or her that you need to know if there’s any damage to your brain—maybe from prior head trauma—that could leave you without normal neurological defenses against your underlying anger. 

You’ll mount a vigorous defense in court, of course.   Nobody wants to go to jail.  But don’t defend against the truth you know in your heart of hearts.  Whatever unresolved rage is inside you isn’t under your control, and you’d better get the upper hand over it—and soon.  Someone could end up dead.  You could end up living a life behind bars.  You weren’t born for either tragedy.  You can do better.

One last thing:  Think about your children.  I know you don’t have any today, but you might some day.  Think about the fact that they’ll see your girlfriend’s battered face on the Internet years from now.  They’ll know what people said about you.  Let yourself feel some shame over that.  You’ll want to be able to tell them how much you’ve changed, how it wasn’t easy (because it won’t be), but how they, too, can defeat any ugliness they find inside them, if they don’t try to run away from it.

Turn and face the truth about yourself.  One day, with a lot of hard work, a lot of help and some luck, you could be proud of what you see.   It’s a noble goal—maybe the most noble of all.  Now is the time to embrace it.
 
-Keith Ablow, MD

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

The brazenness of Illinois Governor Rod Blagojevich allegedly attempting to sell a U.S. Senate seat and securities trader Bernie Madoff allegedly bilking investors (including charities) of about $50 billion in a Ponzi scheme may seem inexplicable.  But having evaluated dozens of white-collar criminals and very violent offenders over the past decade (and having testified about them in local, state and federal courts), I’ve realized many of them share recognizable psychological characteristics with convicted murderer Scott Peterson.  Peterson, you will recall, is the Modesto, California man who murdered his wife Laci and his unborn child Conner in the midst of an affair with massage therapist Amber Frey, then helped lead the search for his victims.

Like Scott Peterson, Blagojevich and Madoff (if guilty) have to possess a sense of narcissistic entitlement that allows them to feel justified in manipulating others to their ends.  Probably to hide internal feelings of unworthiness, weakness, or impotence, such men (or, in other cases, women—including, perhaps, Blagojevich’s wife) create an over-inflated sense of self.  Their minds build towering fortresses of ego immune to the reticence most of us would feel about putting ourselves first and everyone else second.  

The narcissistic traits of Peterson, Blagojevich and Madoff (none of whom I interviewed) mean that they not only feel entitled to live special lives that don’t include following rules — they may well believe they are so intelligent or clever that they will never be caught breaking those rules.  That partly explains the outlandish nature of each man’s behavior.

Peterson fashioned his own cement anchors to weigh down his wife’s body in the San Francisco Bay.  It didn’t occur to him that making anchors and taking his boat out on the bay might implicate him in the disappearance of Laci. 

Blagojevich challenged authorities to monitor him and even reportedly wheeled and dealed on a telephone he knew was tapped.

Madoff delivered outsized returns to his clients every year, apparently not worried about the fact that doing so seemed impossible to some.  In his own mind, he was that special.  He never lost — until it was all over.

Narcissism, however, doesn’t explain all of Scott Peterson’s murderous violence or Blagojevich’s and Madoff’s alleged schemes to sell a piece of the United States government or steal money.  There also has to be a failure to recognize both the importance of the rule of law and a failure of empathy.  All three men were seemingly unmoved by the rights or the suffering of others.  To steal a life may seem wholly unrelated to stealing someone’s life savings or someone’s vote, but they are closer cousins than you might believe. 

Unfortunately, the outsized nature of what is likely the Peterson-Blagojevich-Madoff brand of personality structure attracts, rather than repels people.  Peterson had no shortage of women.  Blagojevich had no shortage of voters.  And Madoff had no shortage of investors.  They seem so certain of everything, so much larger than anything that might contain them, that they seduce mere mortals, burdened as we are by self-doubt and respect for others — and a respect for our society and the rule of law.

Dr. Ablow is a Fox News contributor and the author of the New York Times bestseller “Inside the Mind of Scott Peterson.”

Yesterday, Neil Entwistle greeted his conviction for murdering his 27-year-old wife Rachel and their 9-month-old daughter Lillian Rose with a subtle shaking of his head, with no tears, no yelling out in disbelief, no terror, no collapse. 

The man whose mask of amiability and success had dissolved on January 20, 2006 –  revealing a killer capable of shooting his wife and his child pointblank with a Colt .22 –  was wearing the mask again.  He could have reacted the very same way to news that the dry cleaner didn’t have his shirts ready or that the Lakers had lost the NBA finals.  

Entwistle has had a long experience wearing what the great psychologist Hervey Cleckley called “the mask of sanity.”  He impressed teachers in his working class neighborhood in England, was one of the few to go on to college, landed a job as a computer programmer, won the love of a pretty woman, maintained friendships for decades and impressed neighbors with his intelligence and seeming success here in America.

When reality didn’t sustain his desire to be seen as smart and affluent, he tried to reinforce the mask with a kind of psychological Crazy Glue.  He lied about making a small fortune in Internet businesses that were really shams offering others the false promise of easy money and better sex (two things, it turns out, he dreamed about having himself).  He lied to friends, even after the murders, about owning the home he rented in Hopkinton, Mass.  He pretended to be happily married and satisfied with his family life when he was really addicted to porn and on the prowl for sex with strangers through AdultFriendFinder.com.

But like every web of lies, Entwistle’s could not be sustained.  The truth always wins.  His real limitations—interpersonally or emotionally or creatively or intellectually—translated into being unemployed, his shady businesses unsuccessful, and his financial situation perilous to the point of bankruptcy.  People weren’t “buying” Neil Entwistle.  He was about to be revealed as a failure.  Perhaps his wife had already learned that he was a fraud.  And that much reality he could not bear.  That made him want to clear the stage of the actors he had cast in leading roles in his fake life, to hit the “reset” button on the psychological cat-and-mouse game he was playing. 

Because the subsoil of Entwistle’s psyche is likely nothing more than chaos, a black hole of self-hatred and seemingly unanswerable questions (though they always are, with the right help) about whether he has any worth at all and any level of manhood to speak of, never mind the raw, sexual kind that he kept watching graphically play itself out on the Internet.

Men like Entwistle — the Scott Petersons of this world — feel like stripping their masks away is tantamount to killing them, because they believe those thin, synthetic disguises are all that keep them from dissolving into nothingness and feeling the full weight of unspeakable emotional turmoil, with roots that always reach deep into their pasts.

Neil Entwistle will be jailed for life.  But, as he showed yesterday in a Massachusetts courtroom where genuine sorrow and love resided in the hearts of Rachel Entwistle’s family, he won’t even be present in the cell.  His real self is but a distant echo in his mind and soul, very nearly as lifeless as his victims.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.