Natural Born Killers?: The Development of the Sexually Sadistic Serial Killer Bradley R. Johnson, MD, and Judith V. Becker, PhD Today's society seems enthralled with serial killers in the news and the media. Forensic psychiatrists often interview serial killers after they have been caught. There are retrospective studies and case reports of individuals who have com- mitted sexually sadistic serial murders. However, there exists a dearth of case reports on adolescents who have expressed serious fantasies about becoming serial killers prior to actualizing their fantasy. This article presents nine clinical cases of 14- to 18-year-olds who have clinically significant fantasies of becoming a serial killer. Similarities exist in these adolescent cases when compared with retrospective studies and case reports of serial killers on the role of sexually sadistic fantasies and actual killings. Since it has been established that sexual paraphilias may develop at a young age, one can surmise that sadistic paraphilias may also develop in some adolescents. The question is posed, can we predict which of these adolescents may go on to actually become serial killers? This article focuses on how the sexually sadistic fantasy can eventually be acted out and possible motives for the act to be repeated multiple times. Finally, recom- mendations are made about assessing and treating a youngster who expresses violent sexually sadistic killing fantasies so that attempts can be made to interrupt the progression to actual killing. Mickey and Mallory were young socio- were portrayed as being the product of paths in love, driving throughout the "bad genes" and a "bad environment." country and leaving dozens of bodies There is still little in the literature in strewn along the way. The movie, Natu- regard to the understanding of those who ral Born Killers (Warner Bros., 1994), commit homicide. Even less is known inferred that these two were the product about a select subgroup, those who com- of their culture. They were killers with mit serial homicide. Case studies have childhoods of physical and sexual abuse, been collected on a small number of "se- bad parenting, and poor education. They rial killers," but we have not learned much that is applicable clinically. For ex- Dr. Johnson is in private practice in Tucson, AZ, and works part time for the Arizona Department of Correc- ample, we know little about identifying tions. Dr. Becker is affiliated with the Department of those children and adolescents who are at Psychology and Psychiatry, University of Arizona, Tuc- son. They are both affiliated with The Mind Compass high risk for becoming a serial killer. Are Group, LLC, in Tucson. Address correspondence to: there certain biologic predispositions and Bradley R. Johnson, MD, 6060 North Fountain Plaza Drive, Suite 120, Tucson, AZ 95704. sociocultural influences that help the cli- J Am Acad Psychiatry Law, Vol. 25, No. 3, 1997 335 Johnson and Becker nician identify children who will grow up expressed homicidal fantasies to a prior to become serial killers? evaluator. As one looks back at the childhoods of Case 1 L. was a 14-year-old white such notorious killers as Ted Bundy, John male who was admitted to a psychiatric Wayne Gacey, Dennis Nilsen, David unit after attempting suicide by hanging. Berkowitz, or Jeffrey Dahmer, it is im- He reported feeling depressed and said. "I portant to see whether there were clues feel like I'm going crazy . every day I early in their lives that would have helped have to decide if I should live or kill identify their homicidal tendencies before myself." they had committed violent crimes. Al- Although initially hesitant, L. began to though many would believe that a serial speak about why he felt he was "going killer may not be treatable once he or she crazy." He reported having obsessional has begun to kill, one wonders whether, if thoughts of killing other people. In fact, they had been identified early enough, he admitted to having a plan of breaking treatment might have succeeded in pre- into a strange woman's house, capturing venting them from actually starting their her, raping her, and then stabbing her to streams of killing. death. He said, "I want to be a serial It appears that children and adolescents killer." are committing more and more violent L. admitted to using his BB gun as a crimes at an earlier age.' The authors teenager to kill various animals in the would propose that many adolescents are area around his house. At the time of his developing fantasies at early ages about admission, he had been killing up to 10 committing violent crimes such as mur- animals per day including birds, rabbits, der. As will be initially presented in case cats, and dogs. He would shoot them, examples, there are adolescents who are drown them, stab them. or light them on even experiencing fantasies of becoming fire while they were alive. to kill them. serial killers. One would wonder if these L. was intelligent, having tested at an individuals are at a high risk for acting IQ of 122. Despite his high IQ, he did out their homicidal fantasies. poorly in school. The evaluators felt that he was a clean-cut and attractive young Case Presentations man and very likable. He had fantasies of Nine adolescents who expressed a de- killing his mother by blunt force to the sire to commit serial killings have been head with a hammer until "her brains identified. Most of these youth were re- were completely exposed." He also dis- ferred to the authors for a forensic eval- cussed a recently released movie, "Si- uation after having committed a legal of- lence of the Lambs" (Orion Pictures, fense. A few were referred, secondary to 1990). He identified himself with the a mental health worker becoming con- character Hannibal Lecter. seeing the por- cerned about an unusual behavior, for a trayed serial killer as having "total control psychological or psychiatric evaluation. over other people." He went on to express None were referred for having already that he wanted to be like him, killing over 336 J Am Acad Psychiatry Law, Vol. 25, No. 3, 1997 Natural Born Killers? 100 people, being apprehended, going to ending in strangulation, necrophilia, and prison, and seeing himself on TV. He body mutilation. He fantasized about said, "then, I'd be famous." He denied keeping the sexual organs and skulls as any sexual excitement when having trophies. He also described other sexually thoughts of killing and denied any para- sadistic fantasies that always ended in philic fantasies or behaviors. death. Additional paraphilic fantasies in- Case 2 S. was a 16-year-old white cluded voyeurism, exhibitionism. uro- male who was referred by a concerned philia, fetishistic cross dressing, frotteur- social worker after he had admitted to ism, and bestiality. He had a long history multiple animal killings. He gained an of masturbation to pornographic materi- interest in dissecting animals following a als. worm dissection exercise in his sixth Finally, S. had a long history of mild grade science class. In the eighth grade, depression, and vague paranoid delusions he stole a fetal pig from his biology class and described occasionally hearing ill- and dissected it on his own. He became defined voices. curious about the textures of the animal Case 3 D. was a 17-year-old Hispanic tissues, tasted parts of it, and recalled male who claimed a history of ingesting becoming sexually excited by the dissec- human blood. He liked to prick his own tion. S. volunteered at an emergency finger or lick the bleeding wound of a room near his house where he eventually friend or family member. He had a sub- asked to witness a human autopsy, but stantial history of assaulting other adoles- this experience was denied him. He had a cents and adults, explaining that such sit- juvenile court history including shoplift- uations made him feel in "total control." ing and runaway. D. reported being rather intelligent but S. tested at an above-average IQ of dropped out of school secondary to poor 125, although he did relatively poorly in grades. He denied being depressed but school. He abused alcohol, sleeping pills, admitted to having frequent thoughts of and marijuana when he became a teen- death. He had a questionable history of ager. panic attacks or possible dissociative ep- At the age of 15, S. began to kill ani- isodes. Additionally, he had an extensive mals. First, he killed a cat, and went on to history of polysubstance abuse including kill rabbits, birds, dogs, ducks, and other paint sniffing. cats. He usually killed via strangulation D. recalled seeing the movie "Silence or stabbing. The animals skulls were pre- of the Lambs" where he became very pared and proudly mounted as trophies in emotionally "excited" by the scene show- his bedroom. On one occasion, he became ing a human that had been cut open. hung sexually excited while killing an animal up, and the internal organs of the body and placed his erect penis inside the open displayed. Since then, he admitted to hav- wound of the animal and masturbated. ing become enthralled by the viscera of S. admitted to fantasies of killing hu- humans. mans including recurrent thoughts of rape D. described having fantasies of killing J Am Acad Psychiatry Law, Vol. 25, No. 3, 1997 337 Johnson and Becker multiple people in a fashion like "Dah- ity, however, she had experienced a sig- mer." He discussed fantasies of cutting nificant history of abuse including being them open, playing with the viscera, cut- sexually molested by her mother's boy- ting the appendages off, and burying the friend at the age of 6 and raped by an various body parts in specific locations adolescent boy at the age of 13.