Having a child with a chronic illness or disease requires parents to be caring and supportive throughout the child’s life. This care and support could take many forms, including assisting with mobility, helping the child adhere to their schedule, or closely monitoring the child’s medication and treatment.
With modern medical advances, medications have been created to alleviate the symptoms of many chronic diseases, but they are not without dangers or side effects if used improperly. It is imperative that parents monitor what medications their children are taking. Doctors can only do so much to protect their patients, but the parents are the first line of defense against abuses or misuses of medication.
For children with chronic diseases, having parents that pay attention and take an active role in their care can make a huge difference. Unfortunately, not every parent can be trusted with such a huge responsibility.
A recent Law & Order: Special Victims Unit episode is an extreme example of how a parent’s “care” for a child could do much more harm than good. Titled “Pathological,” the episode originally aired on January 10, 2018.
At the beginning of the episode, SVU detectives are called to a school for children with special needs after a suspected rape. After interviewing the two children involved in the incident, Mariel and Cody, the detectives determine that neither child truly understood the concept of rape and that their actions were consensual.
However, the behavior of Mariel’s mother Dawn causes Detective Rollins to be suspicious that something else is going on. Dawn refuses to allow the doctor to examine Mariel at the hospital and opts to wait for her pediatrician to arrive. When the pediatrician comes, Dawn tells him that Mariel needs to be sedated even though she seems calm.
Because these actions raised her suspicions, Rollins enlists the help of Dr. Warner, the medical examiner, to examine Mariel’s current list of medications. During her review, Warner discovers that all of Mariel’s medications, when taken together as she has been doing, can cause symptoms mimicking those of epilepsy, muscular dystrophy, and even cancer.
It is eventually revealed that, despite taking all of these medications, Mariel is not sick at all. Instead, her “diseases” are being caused by the doses of medications her mother has been giving her for practically her whole life.
This revelation is obviously traumatizing for Mariel, who is initially reluctant to believe it but soon begins to harbor intense fear and hatred for her mother Dawn. After Dawn tries to visit her at the hospital, Mariel becomes even more afraid that Dawn will continue trying to harm her. This leads Mariel to go to Dawn’s apartment and violently murder her with a hammer.
This case and its aftermath, as depicted in the episode, illustrate some of the many intersections between psychology and law.
Clearly, Dawn’s actions were not typical or acceptable by any means, so it is necessary to consider psychological causes for this type of behavior. Also, the effects of Dawn’s actions on Mariel are also profound and can be examined through a psychological lens.
In addition, perhaps the most easily identifiable link between psychology and law presented in the episode was the forensic psychologist, who was called in to examine Dawn’s mental state. Finally, the events surrounding Mariel’s murder trial are impacted by psychological and circumstantial factors specific to her situation.
In its discussion of learning theories, Chapter 3 in the text explains differential association reinforcement theory; applying this theory to Dawn’s case can provide insight into how her detrimental behavior went on for so long. According to the text, differential association reinforcement theory states that “criminal behavior is acquired through operant conditioning and modeling” (Greene & Heilbrun, 2014, 60).
It seems that operant conditioning was more at play for Dawn than modeling. Dawn did not learn to give her daughter a dangerous combination of medications from someone else who came before her, but she came to believe that this behavior was “acceptable” after interactions with doctors throughout Mariel’s life.
In an interview with the detectives during their investigation, Dawn’s ex-husband reveals that, for years, Dawn had purposely moved from state to state to find different doctors for Mariel and conveniently “lost Mariel’s medical records” each time so that the doctors would not know her previous medical history. This pattern was able to continue for so long because, according to the ex-husband’s story, there was always a doctor who would believe Dawn’s pleas and prescribe what seemed to be the appropriate medications.
According to differential association reinforcement theory, “a person behaves criminally when reinforcement for such behavior is more frequent than punishment” (Greene & Heilbrun, 2014, 60). As more and more interactions with doctors took place, Dawn “learned” that falsifying her daughter’s medical history was a behavior that would allow her to achieve her goal of getting the medications. These doctors unknowingly conditioned Dawn to associate the behavior of deceptive falsification of medical history with the “reward” of getting the medications she felt her daughter needed.
Over time, she was reinforced enough times to continue her criminal behavior for fifteen years of Mariel’s life.
As Dawn had been learning that her behavior is “appropriate,” Mariel had been learning that she is helpless when it comes to her own medical care. Every time Mariel is in the presence of a doctor during the episode, Dawn steps in and makes decisions on her behalf without checking to see what Mariel feels she needs.
It can be assumed that the dynamic has been similar throughout Mariel’s life, and that she has learned over time that her mother will make medical decisions for her without consulting her first. This relates to the concept of learned helplessness, defined in the text’s glossary as “a condition in which people come to believe that they have no personal influence over what happens to them” (Greene & Heilbrun, 2014, 376).
Mariel had learned from a young age that she has no control over what happens to her medically because her mother is always taking charge. Unfortunately for her, she had learned at such a young age that she was not able to question her mother’s constant searching for doctors and insistence that she needs medications.
The text explains that those with learned helplessness “passively endure aversive treatment rather than to try to control it” (Greene & Heilbrun, 2014, 376). Because she was so young, Mariel did not even know that the treatment she was enduring was aversive.
Perhaps if she had been older when her mother started her on the regiment of medications, she would have known enough to stand up for herself and try to take control of her own life. Instead, she continues to endure the treatments without knowing that they are harming her instead of helping.
Because this case was so unique and complex, the detectives needed to reach out to a forensic psychologist, who, according to Chapter 10 in the text, applies “knowledge and techniques from the behavioral sciences to answer questions about individuals involved in legal proceedings” (Greene & Heilbrun, 2014, 237). Dr. Olivet, the forensic psychologist for the show, was called in to conduct a forensic mental health assessment on Dawn to uncover potential causes of her behavior. In this capacity, Olivet was “offering consultation to law enforcement agencies and personnel” (Greene & Heilbrun, 2014, 375), which is one major task that forensic psychologists are often asked to complete.
As a result of her evaluation, Olivet determines that Dawn had Munchausen syndrome by proxy. WebMD defines this as “a psychological disorder marked by attention-seeking behavior by a caregiver through those who are in their care” (“Munchausen Syndrome By Proxy”). WebMD also explains that “the person with MSP gains attention by seeking medical help for exaggerated or made-up symptoms of a child in his or her care.
As health care providers strive to identify what’s causing the child’s symptoms, the deliberate actions of the mother or caretaker can often make the symptoms worse” (“Munchausen Syndrome By Proxy”). This definition is consistent with Dawn’s actions with Mariel throughout her life.
Once she recognized that her own mother had been harming her for years, Mariel is distraught and overwhelmed. She goes to confront Dawn at her apartment, and ends up murdering her with a hammer. Viewers first learn that this takes place from a phone call Mariel makes to detectives a short time after the murder, so they do not have a clear idea of Mariel’s motivation to murder Dawn.
Though Mariel’s intentions at this point in the episode are unclear, some would argue that she was taking a retributive approach. In the glossary, the text defines retributive approach as “the notion that punishment should be exacted on a person who has taken something from another” (Greene & Heilbrun, 2014, 379). It adds in Chapter 14 that retribution “implies that an offender deserves to be punished and that the punishment should be proportionate to the severity of the wrongdoing” (Greene & Heilbrun, 2014, 322).
Using this definition, one could say that Dawn deserves severe punishment for robbing Mariel of health and stability for the first fifteen years of her life. Because this crime is so extreme, advocates of a retributive approach may suggest just as extreme a punishment, perhaps life in prison or even the death penalty. To some, these punishments would seem somewhat proportionate to the harm Dawn inflicted on her daughter for so many years.
In the next segment of the show, Mariel is put on trial for murder of her mother. The prosecutor Barba, uncomfortable with the possibility of sending Mariel to prison, discusses the case in front of jurors and thus causes a mistrial.
The case is then moved to family court, where it is revealed that Mariel will serve three years of probation. An argument could be easily made that Barba’s actions and the family court sentencing were influenced by mitigating factors in the case.
In the text’s glossary, mitigating factors are defined as “factors such as age, mental capacity, motivation, or duress that lessen the degree of guilt in a criminal offense and thus the nature of the punishment” (Greene & Heilbrun, 2014, 377). Because Mariel was both traumatized by the news of her mother’s actions and in the middle of detoxing from the medications, it can be argued that her mental capacity was diminished.
Chapter 10 of the text addresses the concept of diminished capacity, which “focuses on whether defendants had the state of mind to act with the purpose and the intent to commit a crime—that is, to consider the consequences of their contemplated actions—not on whether they knew the crime was wrong or whether they could control their behavior” (Greene & Heilbrun, 2014, 234).
In Mariel’s case, her diminished capacity to think rationally about her actions and their consequences was a mitigating factor that influenced the outcome of her murder trial.
Ultimately, the case of Mariel and Dawn portrayed in the Law & Order SVU episode “Pathological” addresses many of the ways that psychology and law intersect and influence one another. Over the course of the episode, differential association reinforcement theory, learned helplessness, forensic mental health assessment, retributive approach, and diminished mental capacity all come into play. Each of these psychological terms can be applied to the episode and its characters by closely analyzing their actions, words, and motivations.
Though the story described in the episode is tragic, it serves an important purpose of illuminating numerous psychological and legal concepts for viewers.
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Works Cited:
- Greene, E., & Heilbrun, K. (2014). Wrightsman’s Psychology and the Legal System (8th ed.). Belmont, CA: Wadsworth.
- Munchausen Syndrome By Proxy. (n.d.). Retrieved May 2, 2018, from https://www.webmd.com/mental-health/munchausen-by-proxy#1
