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When it comes to the mysterious and disturbing subject of what goes on in the minds of serial killers, popular culture has consistently been ahead of the curve. The idea of the split personality goes way back — to “Dr. Jekyll and Mr. Hyde,” and to a character like Norman Bates, who carried the identity of his mother around inside him. When the Hollywood drama “The Boston Strangler” came out in 1968, the case it was based on — that of Albert DeSalvo, who confessed to the murders of 13 women from 1962 to 1964 — became enshrined in the popular imagination, and what was haunting about the film was its portrait of DeSalvo as a compartmentalized personality: the killer who blotted out his “normal” self, the normal self who blotted out the killer. The flamboyant serial killers in “The Silence of the Lambs” and its even greater prequel, “Manhunter,” both based on novels by Thomas Harris, had homicidal alter egos that got switched on like sick inner twins.

Yet part of the fascination of “Crazy, Not Insane,” Alex Gibney’s ominously absorbing documentary about the forensic psychiatrist Dorothy Otnow Lewis, is that Lewis didn’t just become well-known for arguing that serial killers are mortally scarred, traumatized individuals whose personalities are divided off from themselves. She courted controversy every step of the way; her views were seen as subversive and unconventional. Lewis, now in her 80s, still has a perky, scampish vibe — she’s a sprite navigating the darkness. She grew up in 1940s New York hearing news about the Nuremberg trials and wondered, as a nice Jewish girl, what made those Nazis tick. And when she became a psychiatrist she transferred that curiosity. She wanted to know what made serial killers tick.

In her view, nearly every one of them has dissociative identity disorder, which used to be called multiple personality disorder (which now sounds corny — very “Sybil” — though it basically means the same thing), leading them to possess at least one inner identity that’s “responsible” for committing the crimes. Many of them have organic brain damage, as evidenced by their MRIs. None of this totally explains serial killers (maybe nothing could), but it colors in their dread-soaked enigmatic visciousness with a fair amount of clinical evidence and behavioral data.

Lewis based the core of her perceptions on close encounters with her subjects: the multiple hours of conversations that she conducted, and videotaped, with more than 20 serial killers (and more run-of-the-mill murderers as well). We see excerpts from these tapes, and look on as killers like Arthur Shawcross, a lumpy-looking night-shift cafeteria cook who haunted the Rochester area in the ’80s, enter what Lewis calls their “alter” selves (in his case, he sometimes channeled his mother berating him, just like Norman Bates). Her thesis is that “murderers are made, not born,” which means that in her view it’s virtually impossible to find a serial killer who wasn’t abused in some unspeakable way when he was a child.

Yet as Lewis became a media star, getting called on as a witness by defense teams who argued that their pathologically deranged clients were ruled by forces beyond their control, she was often excoriated as if she’d become an apologist for murder. It’s a serious legal question — one that could probably be debated forever — how much serial killers are ultimately “responsible” for their actions. But beneath the legal question lies a philosophical one: How do we view this kind of personality — as sick or as evil? Do we simply judge the horrific actions? (In that case the verdict is easy.) Or do we take into account, in some way, the circumstances that led to someone becoming this twisted and extreme?

Which leads to the question: Should serial killers be locked away forever, maybe institutionalized (which is what Lewis believes), or should they be given the death penalty? Her view is that no matter how barbaric their crimes, no society that considers itself moral should execute the insane. Those of us who are against the death penalty would agree. But starting in the ’80s, this became a culture-war question, and “Crazy, Not Insane” is full of footage of Middle Americans gathered outside prisons giving the “Na na na na! Hey hey hey!” kiss-off to killers about to be executed, holding up placards that say things like “The Only Thing That Isn’t a Lie” over a drawing of an electric chair.

For a long time, much of the psychiatric establishment stood against Lewis; the condition of dissociative indentity disorder is listed in the DSM, but some said she had turned it into a one-size-fits-all diagnosis for serial killers. In communities that had been terrorized, she was mocked and berated for the help she provided to killers’ defense teams. (We hear a radio-station parody of the song “Yakety Yak” that goes, “Hey look who’s on the stand again,/Back to defend her killer friends.”) Park Dietz, a noted forensic psychiatrist, thinks dissociative identity disorder is a “hoax,” and that interviewers like Dorothy can lead people in the direction of acting out more than one personality.

Beyond that, I have to confess that as I watched “Crazy, Not Insane,” a part of me felt as if Dorothy Lewis had embraced one truth (that serial killers are splintered and damaged) to obscure another (that their violent crimes really are evil). To me, the argument against executions is unassailable, but does the fact that serial killers compartmentalize their most savage sides mean that those sides aren’t them?

There’s a revealing scene in which Lewis interviews Sam Jones, who gained infamy as a traveling executioner, hired dozens of times to pull the switch on the electric chair. Every bit as striking as the contempt she has for him is how close she comes to equating his actions with those of the killers she studies. Jones is a cold-eyed good ol’ boy who zaps death-row inmates without a twinge, but Lewis’ judgment of him feels like overwrought liberal didacticism. There’s a part of Dorothy Lewis — maybe too big a part — that insists on viewing serial killers as victims.

Yet the last part of the movie is a knockout punch, as Lewis discusses the experiences she had talking to Ted Bundy, who became the most hauntingly paradigmatic of all serial killers. His saga generated a kind of spooky mythology, all built around the fact that he looked and acted so “normal,” and that he supposedly came from a happy family.

But as Lewis investigates Bundy’s life, she learns that the idea that he had a conventional upbringing was all fabricated; it was closer to a nightmare. And when she shows us a trove of love letters he wrote, the movie has its shuddery “All work and no play makes Jack a dull boy” moment, as we see that Bundy signed a number of them as “Sam,” the name of the violent-tempered grandfather who pretended to be his father. That name becomes a smoking gun of dissociative identity disorder, the proof that beneath his façade Ted Bundy was as fatally fractured as any serial killer; he just hid it better. You may not agree with everything Dorothy Lewis says in “Crazy, Not Insane,” but you come out of the movie alive to the place where evil and insanity meet and then fall back apart.

‘Crazy, Not Insane’ Review: Alex Gibney’s Fascinating Documentary About What Makes a Serial Killer

Reviewed online, Sept. 11, 2020. Running time: 118 MIN.

  • Production: An HBO Documentary Films release of a Jigsaw production. Producers: Erika Edeiken, Alex Gibney, Joey Marra, Ophelia Harutyunyan, Nancy Abraham, Lisa Heller. Executive producers: Maiken Baird, Stacey Offman, Richard Perello.
  • Crew: Director: Alex Gibney. Camera: Ben Bloodwell. Editor: Andy Grieve. Music: Will Bates.
  • With: Dorothy Lewis, Richard Burr, Catherine Yeager, Park Deitz, Bill Hagmaier, Laura Dern.
  • Music By: