Monday, February 28, 2011

Narcoanalysis - spies, lies and truth serum

narcoanalysis - the 'truth' might set us free
The 'truth' might set us free
Permission for narcoanalysis on a spy was refused by the Pune courts a few days ago. The investigating authorities have perceived this as a setback in arriving at the ‘truth’.

Method

In a clinical settting narocoanalysis and narcotherapy are conducted in a treatment room. The patient lies quietly with an iv line in place. While the psychiatrist recapitulates the patients history in a low monotone a nursing assistant injects thiopentone sodium to terse instructions of “push 50” or “25 slow”. Thiopentone sodium is no rare drug. It is used everyday to induce general anaesthesia. At lower doses in willing patients it produces a state of relaxation. You have to be careful the patient does not doze off or start slurring in speech. At the start of the narcoanalysis attention has to be paid to the patient's posture and eye movement. Horizontal eye movements indicate a state of sufficient relaxation to proceed with the deeper probing interview. Subsequent aliquots are adjusted with the aim of maintaining this state during the rest of the interview.

Psychiatric indications

  • The aim of narcoanalysis is to produce an abreaction in hysteria and other disorders in which there is an element of dissociation. During abreaction the patient recalls traumatic experiences and, by talking about them, discharges associated disturbing emotions. Abreaction facilitates subsequent and sometimes dramatic recovery (Breuer & Freud 1957). However, there are only anecdotal - though fascinating and highly readable - reports for the effectiveness of narcotherapy (Miller 1954, Denson 2009). The theory is based on the unconscious suppression of emotion through use of psychological defense mechanisms. It may not apply when suppression is done consciously as in most forensic cases .
  • Narcotherapy is effective in relieving catatonic mutism (McCall et al 1992).

Drawbacks

(Jesani 2008)
  1. Narcoanalysis was never considered as a method to get at the ‘truth’. It was just the patients perception of whatever he or she believed at that time. A similiar process occurs every night in the bar when a garrulous, intoxicated person talks about whatever is bothering him or her.
  2. A person can consciously lie during the procedure and get away with it.
  3. At times it is difficult to separate actual events from fantasy.
  4. You can even plant an idea into a persons mind through leading questions and later they would have no doubt it was their own.

Present status

A PubMed search using the MeSH term ‘narcotherapy’ gives just two articles in the last ten years. There are no randomised control studies - the scientific standard - to demonstrate the reproducibility of results obtained by narcoanalysis for information gathering, abreaction, or lie detection. Randomised control studies would give us an idea of the procedures sensitivity - the number of actual cases that would not be detected; and its specificity - the number of innocents who would be implicated. Presently all we have to go on are anecdotal reports of narcoanalysis practitioners . Not enough evidence to rely on narcoanalysis for deciding the fate of an unwilling subject. Not even for spies caught in Pune. Even the judiciary is sceptical of narcoanalysis..

References
  1. Breuer, J. Freud, S. 1957. Studies on Hysteria. New York: Basic Books.
  2. Denson R. Narcotherapy in the treatment of post-traumatic stress disorders: a report of two cases. J Psychoactive Drugs. 2009 Jun;41(2):199-202.
  3. Jesani A. Willing participants and tolerant profession: medical ethics and human rights in narco-analysis. Indian J Med Ethics. 2008 Jul-Sep;5(3):130-5. PubMed
  4. WV McCall, FE Shelp and WM McDonald. Controlled investigation of the amobarbital interview for catatonic mutism. Am J Psychiatry 1992; 149:202-206.
  5. Michael M. Miller. Certain Factors Pertaining to the Value of Narcoanalysis in Securing Testimony. J Natl Med Assoc. 1954 July; 46(4): 238–241. PMC
  6. PubMed. PubMed MeSH search for 'narcotherapy'. Accessed 27-Feb-2011.

8 comments:

  1. i like this analysis, but of late narco analysis seems to find takers among the poilce. the classic case being that of aarushi murder cases...
    I wonder how narco analysis has assumed an aura of conclusivity or even iffalibility...is it that in cases where the results are inconclusive the questios were not framed properly...?

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  2. Thanks Ravishanker. The results of a narcoanalysis would not make good forensic evidence. Its not the 'truth'. But it could give leads for further investigation.

    Ideally a narcoanalysis is conducted with an event or situation in mind. A dialogue unfolds during the session. Its more of "hmmm... then what happened?" and not "did _ _ _ happen?". There should be no specific pre-framed questions. And if nothing happened we can't really say the results are inconclusive.

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  3. Is Narcoanalysis can be used as a Treatment for some psychological problems such as social Anxiety.

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  4. No. Not for Social Anxiety Disorder. CBT with or without medication would be best for that.

    The current psychiatric indications are mentioned in the article.

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  5. Can narcoanalysis be used to elicit extramarital affairs?

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    Replies
    1. Confirming or refuting extramarital affairs is not an indication for narcoanalysis.

      However, you may like to read http://blog.pathfinderclinic.com/2010/12/how-do-i-know-if-my-partner-is-cheating.html to learn what to do if you suspect your spouse of having an extramarital affair.

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  6. Why would nacoanalysis not be indicated. If both spouses agree to the test, what would be the accuracy of the test?

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    Replies
    1. Narcoanalysis for an extramarital affair is not indicated for the same reasons that its use was denied for interrogation of the 'spy' - it doesn't reliably give the 'truth'. Narcoanlaysis is effective for uncovering unconscious drives and desires that are causing psychological symptoms.

      The accuracy of narcoanalysis has not been studied. So we don't have any indication of its reliability as a diagnostic or investigative instrument. We don't know how likely it is for narcoanalysis to give the actual picture (sensitivity) or to distinguish the actual picture from any other (specificity). It remains unreliable for legal use. It is known to be effective for medical use.

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