SALT LAKE CITY — A veteran forensic psychiatrist testified Tuesday that Brian David Mitchell suffers from a severe personality disorder — not a mental illness.
Dr. Noel Gardner, who is the director of South Valley Mental Health and has undergone hours of extensive, formal training in religion, spent the entire day on the witness stand Tuesday and was scheduled to return today for another hour to 90 minutes to finish cross-examination.
Much of Gardner's testimony was technical and often times complicated and sounded more like a classroom lecture as prosecutors went through several terms as defined by the "Diagnostic and Statistical Manual of Mental Disorders," such as delusional disorder, schizophrenia, personality disorder, anti-social disorder and malignant narcissism, as well as discussing the difference between a delusion and an over-valued idea, and how the brain functions.
The DSM IV is published by the American Psychiatric Association and considered the authoritative reference for mental illness.
Gardner has been involved in one form or another in studying Mitchell's case since shortly after the former street preacher's arrest in 2003. He believes Mitchell has a personality disorder, narcissism and anti-social disorder. None of those are classified as a mental illness.
When forming an opinion on Mitchell's condition, he said he looked at three general categories: whether Mitchell was delusional, devout or delinquent.
When it came to delusional, Gardner looked at Mitchell's religious beliefs and whether they could be classified as either non-bizarre or bizarre delusional beliefs.
Earlier, Dr. Paul Whitehead, the clinical director of the forensic unit at the Utah State Hospital, testified that he believes Mitchell had a delusional disorder because his beliefs were non-bizarre, meaning they were plausible but highly unlikely.
Richart DeMier, a veteran psychologist who examined Mitchell at the federal prison in Missouri, believes Mitchell was paranoid schizophrenic because he considers Mitchell's delusional religious beliefs as bizarre, meaning they were not plausible at all.
On Tuesday, Gardner said the beliefs Mitchell claims to have are similar to those held by many fundamentalist Mormons, and in some cases mirror mainstream LDS beliefs, thereby making them non-bizarre.
But the reason he did not suffer from delusional disorder was because a person with that illness firmly believes the delusion. Mitchell's religious ideas were not fixed, Gardner said.
"The defendant does not suffer from a fixed delusion," he said. "Because he can change them very quickly."
Even when considering the idea of a so-called "encapsulated delusion," Gardner said Mitchell did not qualify. People with encapsulated delusions could seem normal for the most part, but when that delusion is triggered, it is nearly impossible for a delusional person to resist it, he said. Gardner compared it to an itch just waiting to be scratched.
Mitchell, he said, had several occasions in which he was able to put his religious ideas aside when faced with discussions about religion. The itch was triggered but nothing happened.
Gardner went on to say he believes Mitchell has several different personas that he uses at will, based on the situation and whichever one will get him what he wants.
"So when it's useful, he can change a whole set of ideas or presentations," he said.
"The most striking overall part of this story is that he's very skilled in identifying what every person he is dealing with is likely to respond to."
Gardner listed several general personas of Mitchell for the jury that he came up with: the intimidator, the humble penitent, the sadist, the clever magician and the religious chameleon. Mitchell's sadistic persona could further be broken down into several subcategories — the humiliator sadist, the torturing sadist and the religious sadist.
Gardner said it is "simply impossible, in my opinion," for a person with severe mental illness to have such a range of clever, successful presentations that are consistently self-serving.
Furthermore, Gardner said delusional disorder is rare and there have not been many opportunities for doctors to study it.
Another reason Gardner said he did not find Mitchell to be schizophrenic is due to his interaction with him when he attempted to interview Mitchell.
"He immediately sat down and stared deeply into my eyes," Gardner said. "It was an incredibly intimidating stare."
But Mitchell refused to talk.
Gardner called this "intense, deep" stare both uncomfortable and unusual but said that diagnostically it was very helpful. He said it is impossible for the most delusional patients to maintain that kind of eye contact.
Gardner said ultimately he responded by trying to just stare back at Mitchell. "It was quite apparent I was no match for this guy and I was so uncomfortable."
Because Gardner did not believe Mitchell was sincere about his religious beliefs, he also felt Mitchell did not qualify in the category of "devout."
That left the category of "delinquent," or someone who consistently violates the basic values of morality and ethics and the laws of the land, he said.
That led him to his conclusion of anti-social personality disorder, malignant narcissist and a pedophile.
When asked how certain he was that Mitchell did not suffer from a delusional disorder, Gardner said of all the cases he's ever examined, "This is the one I'm most certain about because I've spent by far the most time and done the most meticulous work."
During cross-examination, Gardner was asked about the difference between his diagnosis and the evaluations of DeMier and Whitehead.
With DeMier, he said it may have been a cultural difference. Many of Mitchell's ideas may sound more familiar to a person in Utah than to others who live outside the state. But Gardner said the bottom line is that Mitchell's beliefs aren't fixed.
"Most times it seems to me he doesn't even believe his own ideas," he said.
When questioned why Mitchell would even bother having a "wedding ceremony" for Smart before raping her if he didn't believe his religious delusions, Gardner said he believed the ceremony was more about retaining control over Wanda Barzee and getting her to be a co-conspirator to assist him in his plan.
Gardner admitted, however, during cross-examination that delusional disorder and narcissism could sometimes overlap.
Both DeMier and Whitehead may have also had something he called "confirmation bias," Gardner said, or a misguided belief going into the evaluation that something was wrong with Mitchell, so they had to find something wrong with him.
The case is expected to go to the jury by Friday.
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