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FORENSIC PSYCHOLOGY WITH DR. VANESSA HOLTGRAVE - 015 -

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TRANSCRIPT:


Det. Richardson:               This week, on the Writer's Detective Bureau, the real job of a forensic psychologist, psychological traits you can use to take your character creation to a deeper level. And misconceptions and differences between psychologists and psychiatrists.

Det. Richardson:               I'm Adam Richardson, and this is the Writer's Detective Bureau.

Det. Richardson:               Welcome to episode #15 of the Writer's Detective Bureau, the podcast dedicated to helping authors and screenwriters write professional quality crime related fiction. Recently, Joanna Penn was talking about Patreon on the Creative Penn Podcast. She said, "I think patronage is one of the most powerful things that you can do to support creators that you want to continue hearing from. It's one of those ways that you can support people, and encourage them to do the things that are either useful to you, or just putting good stuff in the world. Regardless of whether you support me on Patreon, I absolutely think you, as a creator of stories, should look into setting up your own Patron account.

Det. Richardson:               You can learn more at writersdetective.com/Patreon, and thanks to my patrons, Joan Raymond, Guy Alton, Natasha Bajema, Natalie Barelli, Joe Trent, Siobhan Pope, Leah Cutter, and the most recent patron, Ryan Kinmil for helping me keep the lights on in the bureau. You can find links to their author websites in the show notes, by going to writersdetective.com/15

Det. Richardson:               This week, we're doing something a little bit different. You may recognize Dr. Vanessa Holtgrave's voice from recent episodes of Take Two Pills...and Listen to This Podcast and the Sword and Scale Podcast.

Det. Richardson:               Dr. Holtgrave is a doctor of psychology, a professor of clinical and forensic psychology, a licensed clinical psychologist in the state of California, and our guest on the Writer's Detective Bureau Podcast this week. So without any further ado, let's get into the interview with Dr. Vanessa Holtgrave.

Det. Richardson:               What exactly do you do as a Doctor of Psychology and clinical forensic psychologist?

Dr. Holtgrave:                      Clinical and forensic psychology. So forensics, if you think of forensic psychology like a tree, there's several branches on that tree. You can work in police psychology, or you can work in correctional psychology, or you can work in the courts, doing competency to stand trial evaluations, or sanity evaluations. Or you can work in mental health treatment court, there's a lot of different areas where you can work.

Dr. Holtgrave:                      I think people think forensic psychology is profiling, I know we've talked about that, and it's something I hear all the time form my students in my classes, is that is what they wanted to do their whole lives, they wanted to go into forensic psychology to do profiling, and very few professionals are going into profiling, I would say a lot of the professionals that I met in profiling are actually police. And then you might have a few psychologists, but they're highly trained in profiling as well. So we're really working in anything that involves the justice system, or law. It's that intersection between mental health and law. Where you are working in the courts, or you're working in prison or jail, or you're working in police departments. There's just a variety of things you can do in forensic psychology.

Dr. Holtgrave:                      For myself specifically, I worked for probation and the sheriff's office, but I did mental health evaluations for, they were technically parolees, they were being released under the AB-109 program in California, and getting them setup with services in the community that are paid for by probation and parole, mental health treatment services and things like that.

Det. Richardson:               So are you making recommendations, then, or what exactly is your role when it comes to[crosstalk 00:04:05]

Dr. Holtgrave:                      I think the psychologist is used, is kind of the gatekeeper really to the psychiatrists as well, so there's psychiatrists in the program. They're getting a full evaluation by the psychologist, because that's our specialty, and they are getting a diagnosis. If the diagnosis is a qualifying diagnosis or it's applicable, then they're getting referred to the psychiatrist in the probation program, then they're getting treatment there if they're choosing to do so. And they might get other recommendations, like AA groups, or substance use, or they might get referred to job services and things like that.

Det. Richardson:               So are you actually interviewing each parolee?

Dr. Holtgrave:                      Yes.

Det. Richardson:               Any scare experiences?

Dr. Holtgrave:                      No, not really, I think. The only time I ever get worried is if they tell me they don't feel well.

Det. Richardson:               What's the weirdest experience you ever had?

Dr. Holtgrave:                      There weirded experience I ever had was not ... actually I had a guy ask me for a therapy pet letter for his, and this is in a prison setting too, so this isn't like he wants a therapy pet letter in his home, but he wanted a therapy pet letter for his tarantula named Knuckles, was the tarantula, and I said, "Well who named him?" And he said, "Dirty Steve named him," who was also in the prison at that time. And I said, "No, I won't write you a therapy pet letter but that was a good story."

Dr. Holtgrave:                      We had another guy who listed his 'dear dead nana in heaven', as the emergency contact, fully written out just like that.

Det. Richardson:               Did he have a contact number?

Dr. Holtgrave:                      He did not. I would like to know how to contact heaven, though. That would be great.

Det. Richardson:               So then what kind of scenarios have law enforcement officers ask for your help?

Dr. Holtgrave:                      In our department specifically I was helping a lot with the general threat assessment questions. We were working on trying to identify people that were at risk in the community for becoming involved with maybe mass violence, or targeted violence. We have helped out on cases where there's potential school shooters, and it's not the same as if we're going and we're targeting community members, but it's more so, this is a community member of concern, do we bring in psychology or not? They have teams all over California, I think the MAT teams, where the specifically assess that type of risk. So that's where you'll bring in psychologists, just to look at what are the risk factors for violence, what are some of the red flags that are going on with this person or these group of people.

Dr. Holtgrave:                      Then also we do civil commitments as well. So, does this person meet criteria for a hospitalization in the state of California against their will? We'll initiate those proceedings.

Det. Richardson:               Whether it is in the clinical setting where you are talking to people trying to get released on parole, or where you're helping law enforcement with specific cases, what are the top diagnoses or at least, traits that you've seen in the cases that you've come across?

Dr. Holtgrave:                      I think the top diagnoses would really be personality disorder. I think the media really portrays schizophrenia as being this perpetrator in the justice system, where anyone who is mental health involved in the justice system has some kind of psychotic disorder, and that's really rare. When you look a the prevalence in the community, I want to say it's around 1%, versus personality disorders are significantly higher, especially in the justice system, we have those ... colloquially it would be sociopathic traits, or psychopathic traits, it's really anti-social personality disorder. I get a lot of guys who are in there lying, so we have some problems with malingering, and that's one of the things I assess for. Really in the justice system we do see a lot of personality disorders. Substance use disorders is another one. And then very rarely we'll get a person with a psychotic disorder, but it's really not to the level that it's portrayed in the media.

Det. Richardson:               Gotcha. So similar to that, what psychological personality traits have you seen in the cops that you've worked with?

Dr. Holtgrave:                      I actually did my dissertation research, I don't know if you read it.

Dr. Holtgrave:                      From what I was seeing really, it's really called Type A personality, but we don't call it Type A in our world, in psychology. It's obsessive compulsive personality traits. I think it really serves cops positively. It's that attention to detail, orderly and organized. I think if you really want to mess with a police officer, you'll hide the label maker or mess up their desk a little bit. It might be to have order in their lives in general, because their lives are so chaotic, but also, you need a person who has an attention to detail, and who is good at report writing, and has all those qualities, and that makes them successful in their jobs as well.

Det. Richardson:               I previously made an analogy on this podcast that police departments can be like high school, or at least working in them can be like high school. Do you think that's accurate, or am I full of crap?

Dr. Holtgrave:                      Oh I think that's accurate. I laughed out loud when I heard that podcast episode. And then I think I asked you where did I fit in in that, because I was kind of this wayward being that kind of just went from department to department, where sometimes I existed in the coroner's bureau, and sometimes I existed over with the detectives, and ...

Det. Richardson:               What was my response? I'm trying to remember what I said.

Dr. Holtgrave:                      I think you called me a guidance counselor.

Det. Richardson:               That's right.

Dr. Holtgrave:                      Yeah. But I don't know how much guidance I was really providing to anyone. Yeah. But I would definitely agree with that analogy. Especially the hierarchy, too. The same can be said for the military.

Det. Richardson:               When we covered talking about the traits for the cops,

Dr. Holtgrave:                      Right.

Det. Richardson:               The attention to detail and that kind of thing, those are the kind of things that are going to be really useful for writers when they're trying to flesh out a character and give cops traits. Obviously not every cop has that, but like you said, the more successful you are, the more likely it is. That has to be ... that will be the case. So if the writers are trying to craft antagonists that have that antisocial-

Dr. Holtgrave:                      Personality.

Det. Richardson:               Personality disorder. What kind of traits could they include in their description of the character, or in the things that that character does that would be believable to make a reader come to the conclusion that they have this diagnosis without literally having to say this person was diagnoses with this thing.

Dr. Holtgrave:                      That's a good question. I think those individuals, and granted it's really a collection of symptoms, but they have these core features of lying, for example, or vindictiveness, wanting revenge. Taking advantage of others, so that victimizing of others. They might have a history of crime, they might not. So there's that sociopath next door, right? Where they've never been justice involved. We look at Dennis Rader is a good example. The BTK Killer. Where they have these core features where they're really victimizing others. Whether they're using superficial charm or not to get the means to an end, they're interacting with people in such a way where they're taking advantage of them.

Dr. Holtgrave:                      For the individuals that I was involved with, they really do have a hard time telling the truth. Even if it's something that's very minor. There's that manipulative component as well. It may or may not be sophisticated. It really depends on the level of criminality that that person has, but when I worked in the prison, these guys had multiple girlfriends, for example. And they might call one girlfriend and say, "Hey, I need you to bring me cigarettes." And call another girlfriend and say, "Hey I need you to bring me," whatever other item. And they don't know about each other, but this individual is using them as a means to an end. So it's not about building a relationship with a person, it's about, how can this person benefit you in some way? Not how you can benefit that person.

Dr. Holtgrave:                      We do see a lot of manipulative behavior, and that does come out in criminal activity sometimes. Sometimes not, but what you would see is that kind of conning persona, where you have this central component of manipulativeness, that when they're interacting with law enforcement they might be believable, but when you look into their history of how they are taking advantage of others and it looks selfish, right, it looks like it might me narcissism. It's all in the same spectrum of personality features, but really, using others. Whether or not it's a female or a male, it's a lot more common in males.

Dr. Holtgrave:                      I had a female that I worked with who, she pretended to be a lawyer, and she took advantage of elderly people who would end up foreclosing on their home, and there's a lack of empathy involved. I don't feel bad that this couple lost their home. They shouldn't have trust me in the first place. Really, just wanting to put on a persona that maybe isn't themselves. It could be a lawyer, it could be something else, in order to manipulate those people and have them believe you.

Det. Richardson:               Is there a common point of view that they have, from their perspective of the world? Or of what leads them to this ultimate ... I know not all of it is criminality, but as far as that manipulating and stuff, is there any kind of feeling persecuted or that it's their right to take what is not theirs, is there anything like that, that you've seen?

Dr. Holtgrave:                      I see a lot of righteousness. I think when you're looking at that personality type, it's just that the world is unjust, I'm going to take what I want and I need, because otherwise people will take it from me.

Det. Richardson:               I can see that definitely how it relates to property crimes. How about violent crime? Is there any kind of common, not necessarily diagnoses, but worldview, if you will, of the people that perpetuate the crimes that you've seen?

Dr. Holtgrave:                      It really depends on who they're targeting, I guess, as the victim. If it's somebody that they are related to, or they're in a domestic partnership, then I would say it's more of a power and control issue. If it's somebody in the community, it might just be that lack of concern for the other person's safety. You're in my way, or you have something that I need or I want, or you upset me. And then that vindictiveness comes out too.

Dr. Holtgrave:                      One of the things I really saw was this sense of entitlement. And then also feeling disrespected. If they felt disrespected, then you got whatever was coming to you.

Det. Richardson:               Interesting.

Dr. Holtgrave:                      Mm-hmm (affirmative).

Det. Richardson:               When you are doing your clinical interviews with these parolees that may or may not be released, what is the setting? Are you going to them? If you could describe the scene, if you will, if you are a writer trying to paint the picture of this scene, what would it look like?

Dr. Holtgrave:                      So I worked in the same building with the officers. It's a safety issue as well. We as mental health don't carry guns on us, unless you work in a federal setting, but we're just generally unprotected. I think I've never generally felt unsafe around offenders, I've worked in prison settings for a long time, and correctional settings, but I worked in the probation building, and so these offenders, they're clients on my end, are being ushered in by law enforcement, and they're brought to our office. Law enforcement are right outside the door, and we have panic buttons that are issued to us. We've never used them, or anything like that, but it is a more formal setting. They're not coming to our office, we're certainly not coming to their homes.

Det. Richardson:               Sure. So they've already been released, typically?

Dr. Holtgrave:                      They have, yeah.

Det. Richardson:               So this is not a condition of release, that they get a psychological assessment?

Dr. Holtgrave:                      No. They might get an assessment, but if that's the case, then they're getting it in jail, or they're getting it in prison, so it really just depends on if they're a post sentence, or pre sentence, yeah.

Det. Richardson:               Is this typically a condition of parole or probation that they meet with a mental health professional? Or is this just a one time thing?

Dr. Holtgrave:                      Yeah. It is under that program, that AB-109 program in the state of California. So if there is concern for mental health, say, the individual has a history of mental illness, or they claimed mental health issues while they were incarcerated, they have that category, then they would be screened as a precaution for probation when they get out, to also make sure if the person needs medication, or they need therapy, they need some kind of mental health resource. If they have any kind of history at all, they're automatically getting screened by mental health. If they don't have a history but they're not reporting, like they can't go to the groups that they're mandated to go to because of social anxiety or whatever other reason, or they're being hostile in the group< then they'll also do a mental health referral. Then we also have individuals who will have acute symptoms that pop up. They are acting psychotic, and they need to know, is it a substance use problem, are they acutely intoxicated? Or is it a mental health problem that just was never recognized, which does happen.

Dr. Holtgrave:                      A lot of the people that really need the most help are the ones that say, "No I'm not mentally ill, I don't need help, I don't know why I'm here." And then the ones that are really making a case for their mental illness to us are the ones that have some sort of ulterior motive or external gain that we're looking at, because they're putting such an effort into wanting to be perceived as mentally ill, and that's just not bonafide. We don't see that in real patients.

Det. Richardson:               Going along those lines, what kind of telltale signs are there that the person is making something up?

Dr. Holtgrave:                      Well, that's a great question. Well first of all it's making a case that you're mentally ill, putting in quite an effort to prove your case, that you have a mental illness. They'll almost always choose a mental illness that's sensationalized like schizophrenia or bipolar disorder, but there's still a real lack of understanding of what that looks like in a real person in the population, and the symptoms that are reported aren't bonafide. They're symptom combinations that would never go together. Or, it's a frequency of symptoms that we would never see, or a severity of symptoms that's really unusual. And unbeknownst to them, well, we work with people who are actually mental ill everyday, so we do know what it looks like. Usually if you've done enough assessments, and you're able to work with a diverse population of people with mental illnesses, you're able to catch on pretty quickly whether or not that person is feigning their symptoms.

Det. Richardson:               I've worked a homicide case where it was pretty apparent that our suspect was going to feign amnesia.

Dr. Holtgrave:                      Oh, mm-hmm (affirmative).

Det. Richardson:               To the point where I was filling out the booking paperwork in the interview room, after the interview, and I asked him if he had any scars, marks, or tattoos, and he'd pretend like he'd forgotten what the work tattoo mean. I'm like, I don't think that's how amnesia works. I don't know what that means. A tattoo. I don't know what that means. A permanent ink injected into your- I'm sorry I don't understand you. It was quite bizarre, but it was great because it was actually on tape.

Dr. Holtgrave:                      Oh yeah. We have tests of memory malingering that even people with dementia, and neurocognitive disorders would pass just based on chance, and they have such a score that would never even occur just by guessing, based on chance. That's usually an indicator as well.

Det. Richardson:               Intentional fail?

Dr. Holtgrave:                      The intentional fail, right. And especially in law enforcement, there's that, no I all of the sudden have amnesia. Or I can't remember where I was. And especially when you're looking at a regular person in the community, like myself. If you or another law enforcement officer were to ask me, what did I do two days ago? I probably wouldn't be able to recall it, because it's unremarkable to me. Would that look like I'm guilty because I can't remember? Maybe, or it also could be that I really don't remember, because it wasn't a remarkable day. Now if it was something significant, like a person I know disappeared, I would remember what happened that day, because something remarkable happened that day.

Dr. Holtgrave:                      I think one of the funniest cases I think of that feigned amnesia really was the Phillip Mark Hoff case, the Craigslist Killer. If you listen to his whole audio or read the transcript from his interview, he just cannot remember anything. They're like, have you gone to the cheesecake factory? And he's like, I don't know, maybe never. And they're like, we have video of you going there. And he's like, I might have walked through there. And everything is I don't know, or I don't remember, and of course that certainly looks suspicious.

Det. Richardson:               Certainly.

Dr. Holtgrave:                      Another thing to add for psychologists, forensic psychologists, not just for profiling but really the misrepresentation of us in television and movies, or even literature, is that we prescribe medications, or they'll often confuse psychiatrists with psychologists, where they're doing extensive therapy, or they're doing testing, and that's not the case.

Dr. Holtgrave:                      So for psychologists, we're doing the testing. We're doing assessments of competency or malingering, or any other forensic test of that manner, and that's not being executed by psychiatrists in any way. And we don't prescribe medications. Well, in a select few states we can. But not the state of California. So it's really that misrepresentation of our professions, the two combined professions as well, that I see the most in movies I think.

Det. Richardson:               Just for the listeners, what is the definition of malingering?

Dr. Holtgrave:                      Malingering is a legal term. It's intentional feigned symptoms with the purpose of an external gain. So if there's no external gain, it would be more of a fictitious disorder, is what we call it. We don't have anything obvious that the person in trying to gain other that maybe something internal. So externally it might be to evade a charge, or overall responsibility for that matter, if you're going for insanity.

Dr. Holtgrave:                      It might be to lessen a charge. It might be to gain some sort of monetary, like social security is one of the things I see the most, which is frustrating. But it has to be an external gain, whether it's legal, whether it's money, whether it's changing what a person thinks about you. It has to be external, and that is the reason why they're feigning symptoms.

Dr. Holtgrave:                      One of the things I saw when I worked in juvenile hall, was we had a kid who was up for charges and he had an added gang enhancement as well, and he all of the sudden started feigning both psychotic symptoms and cognitive symptoms, where, I think he forgot he had taken neuro psychiatric testing in the past, and we already had a previous IQ score for him, and he just bombed the IQ test, and we're like, did you get a head injury? What would be causing this? He said no, but I got my appendix out and ever since then I've heard things, and seen things, and I can't remember anything, and I don't know how to tie my shoes. Highly unlikely. Also at that same time was when he was facing those charges.

Det. Richardson:               Yeah. The appendix is not a very big-

Dr. Holtgrave:                      I know, I said, you know I got my appendix out. Thank god I didn't become psychotic or lose my memory from that.

Det. Richardson:               That appendectomy / lobotomy combo.

Dr. Holtgrave:                      Right.

Det. Richardson:               Thank you for listening to episode 15 of the Writer's Detective Bureau with our special guest, Dr. Vanessa Holtgrave. If you have questions for Dr. Holtgrave, send them in through the form you'll find at writersdetective.com/podcast, and I'll make sure to get them answered for you on an upcoming episode.

Det. Richardson:               Thanks again for listening, and write well.



​
Det. Richardson:               So on this pod [inaudible 00:26:15]
Dr. Holtgrave:                      That's going in the blooper reel.
Det. Richardson:               Yeah. I do it all the time.
Dr. Holtgrave:                      Blooper reels are the best part of any podcast.
 






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