Anatomy of an End – Episode 1, Part 2: Susan – The Person

Who was Susan before she became the subject of an investigation?

In Part Two, we move beyond the scene itself and examine the life of the young woman at the center of this case. Through her relationships, personal struggles, behavior patterns, and the perspectives of those who knew her, a more complete picture begins to emerge.

Understanding a death requires first understanding a life. Before we can explore the events that led to Susan's final days, we must understand who she was, what she carried with her, and how others experienced her.

This episode contains discussion of suicide, self-harm, mental illness, and death.

If you or someone you know is struggling, call or text 988 in the United States or contact your local crisis service.

Additional Voices Provided By:

-Major Trakida Malodonado, MA LPC Unit Commander Gwinnett County Sheriff's Office Mental Health Task Force

-Col. Ben Haynes, Gwinette County Sheriff's Office

-Major Donnatae Royal, Gwinnett County Sheriff's Office (Ret.)

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Subscribe on YouTube! https://www.youtube.com/@AnatomyOfAnEndPod

Transcript

SPEAKER_00 0:03

Welcome to Anatomy of an End, a podcast where we retrace the final days of those lost to suicide through the lens of forensic psychological autopsy. Each episode, we take a step back through time to understand what was happening beneath the surface and what might have brought someone to the edge. Our goal is not to cast dispersions or assign blame, rather, we want to understand. We hope to shine a light on warning signs, missed opportunities, and the delicate complexity behind these all-too common tragedies. This series contains discussion of suicide, drug use, and mental illness. Listener discretion is advised. I'm Davis Henry, and joining me once again is forensic psychological consultant and clinician, Dr. D. Edward Tatum. We're going to call him Dana. That's how I know him, so you're going to know him that way too. In our last episode, we spent our time in 1997 processing the physical evidence at the scene in Unit Z1. We looked at the how and the where. But Dana, as as we've discussed, a physical autopsy is designed to tell us how a person died, whereas a psychological autopsy is designed to tell us how they lived, correct?

SPEAKER_04 1:16

That's right. Psychological autopsy is a tool we use to try to understand the decision-making process, the thought process that led a person uh to that fateful day.

SPEAKER_00 1:27

And Susan R., the individual will be talking about, which we did talk about in our first episode, and we'll be talking about in this one. She was only 22 years old. And to understand why that room in Unit Z1 became the final chapter, we have to go back to the first chapter. We have to look at the 22 years of life, history, and personality that the crime scene photos can't show us. So, Dana, for those just joining us, you've spent over 30 years investigating the why behind these tragedies, correct?

SPEAKER_04 1:55

That's correct. We have to understand um the developmental process that was there, or the lack of a developmental process that was there throughout a person like Susan's life, um, so young, 22 years old. And you stand there and you see this person lying on this cold floor, and you see what should have been, and you know that at that moment you have to embark on what was. What was her life like? What led her to this? There's so much to that. And it begins with, you know, as we did last time, we talked about the observational issues. You know, what what do we see in the moment, uh, in the cell on her person, and and so on. But I think now uh we embark upon the actual uh psychological autopsy, meaning we we embark upon her thought processes and her, like we said, her development.

SPEAKER_00 2:46

Well, let's just start with her. Who was Susan and where does her story actually begin?

SPEAKER_04 2:52

It's impossible to negate her life prior to being locked up. People like to separate those two things. Oh, they did a bad thing, they got locked up. There's a journey from birth to that bad thing, we'll call it, that starts this entrance into the criminal justice system. There's a journey there. What was her journey? And that's where we start. You know, I left off talking about her cell, the cell, the physical components of her cell. But those just create more questions about who she is. At one glance, her cell is this highly, meticulously ordered scene. Her bed was made uh military style. So we can observe that, but then wait a minute, why? Why is it like that? And we're gonna ask ourselves, you know, questions like that. And you may at home, you know, wherever you may be, at a, you know, you wonder, why is he talking about that? A person hang themselves and he's talking about the bed. So I just want to say that, you know, before I take you through this process and the recounting of the particular psychological autopsy that we're gonna do, you'll hear me make a lot of statements of findings and notations of observations that may not make sense to everyone. It may not make sense to you in that moment. You may ask yourself, why is he telling me that? Or what does that have to do with anything? Or so on. I'm gonna ask you to please be patient with me. Please let me have my process. Because one thing I have uh found over all these decades doing this work, and unfortunately, I really hate this part. I'm gonna have to refer to Freud. But nonetheless, I've learned that all behavior is significant. In other words, paraphrased, you know, from Freud, no behavior is truly random. And that is something that I've learned and learned more and more with each one of these psychological autopsies I've constructed. That's true in the construction of a psychological autopsy, and it is also true in each of our normal lives. So when you hear me state things that seemingly mean nothing to you, um seem insignificant, um, I'm not just feeling time here. I promise it will all make sense in the end. So, you know, please bear with me. It would have been expected that the other first responders would have uh a sense of loss or some put up a front of not caring. But in this case, especially when it's young people, um, I'm moved by a sense of loss by all those involved, even though, as you're going to learn today, this was not a pleasant person in everyday life. And I think we're gonna get into that now. I left her cell looking at uh and thinking, why was it so neat? Did she get up from her bed, make her bed nicely, and then decide to harm herself, to hurt herself? Did she not sleep at all? Was she up all night pacing? Was she just sitting and thinking? Was it planned to look this way? Or did it always look her cell always look this way? I'm gonna learn more about her. I have met her twice before this, but this part of her obviously I did not know. And so we move forward, not with just the observational and visual aspects gained in the moment of the life-saving measures and expectations and and rather the inspection of herself, but as we go backwards now into a psychological autopsy of Susan.

SPEAKER_00 6:21

So, how far back were you able to take your investigation with Susan?

SPEAKER_04 6:25

I was able to go pretty far back for this reason. She had actually engaged in psychotherapy within the facility this time. Most of her stays in this facility, she's very opportunistic. She sought to make the environment her environment, sought to bend the environment around her needs, her wants in a very manipulative way, sometimes very aggressive way. She's a very difficult person to manage in this environment because she would get in trouble a lot. She would have no regard for rules. She wasn't fearful, you know, of the rules. She wasn't uh in in any way um displaying any anxiety about, oh, I'm I'm in jail and they told me to sit here or stand here or what have you. That's not Susan. Susan sought to make the jail her jail, and she was known for this. And because this time she did engage in psychotherapy, I was able to read those notes and learn and talk to the actual uh, you know, licensed therapist that was there. That along with my two meetings with her, starts the foundation of where I learn more about her and learn about her decision making. You ask, how far back could I go? Well, I have the anecdotal information about her childhood uh as given by her to her therapist. I'll tell you that other times that where she was offered therapy through her other 11 stays in this facility, you know, she would manipulate. She would try to get the therapist, she would call in a therapist, say that put in a request for mental health services, and then turn the session into something like that well, well, something that had nothing to do with uh personal growth or mental illness. Uh she would typically get a young therapist that would show up, she would size them up if they were young, especially, or or what have you. And then she would try to get them to call her lawyer or uh get a hold of her uh probation officer or call make calls for her on the outside for to other people because they're only allowed X number of calls a day or access to a phone certain times a day, things like this. Um, she would utilize the medical department if she would try, she would see uh another uh detainee uh receive a snack because maybe they had a special snack at night ordered because of uh uh of their medical condition or diabetes or something like this. Well, of course, she had to have one too, and she would try to manipulate the situation. She was placed on medications at times because she would want to see the psychiatrist, and she finally she did have an actual diagnosis of bipolar disorder, uh bipolar one disorder, and also um uh borderline personality disorder. So, you know, if Davis, if you like, I can go into more. Yeah, yeah.

SPEAKER_00 9:02

By all me, I was gonna ask you, so any any abuse history, emerging personality patterns, therapeutic disclosures, all that stuff. That's all I think that's all relevant here and important to address.

SPEAKER_04 9:13

Absolutely. And it's part of the process. So, you know, when I first um well, let me go to where I first met her. Sure. Which prompted me to go, hey, wait a minute, this is this person's uh uh a little different. Let me go look at her chart, you know. I was in my office one day, a week or two before the event, and uh an officer called from that unit saying that Susan, we'll just say Susan R is demanding to see a mental health counselor now. Now, there's a process, right? I mean, we're talking about a place with over a couple thousand folks. There's a process. You put in a request. That request is then triaged, and then you're first come, first served from that request. Obviously, there's not a licensed therapist for every person in there, so it takes time. Nonetheless, she knew how to work the system and jump the line, so to speak. She knew what words to say that would cause the officer to not tell her to put in a request, but that caused the officer to call directly to the mental health department and say, Hey, I need somebody in my unit right now. She knew how to work that well, especially with a new officer, which she had in that unit. On that day that she called, her regular therapist was not in. And uh, we'll call him Joseph. And Joseph was not there. He was a new therapist, but yet fully licensed, and he was uh highly skilled. Her past with therapists were one or two, you know, visits and she wouldn't show up anymore. Oh, by the way, another ploy would be that she would want to see a therapist during lockdown times. So what does that mean? Okay, well, when they have free time, she doesn't want to see anybody because she wants her free time. She smoked, and at that time that facility allowed that. She wanted to go outside in the wreck area of that unit, smoke, and and also, given her personality, she needed to engage with all of her minions within the unit. And so if a therapist showed up during free time, she would refuse it. She wanted them to show up when she wanted them to show up. I mean, this is the nature of the case.

SPEAKER_00 11:15

I get the impression she didn't much care for lockdown.

SPEAKER_04 11:17

She didn't like lockdown very much, and uh it was a point of pride to her that she could remain out of her cell longer than other people. You know, this becomes important later because of her status in the unit was something very important to her, and we'll come back to that. So when an officer calls the mental health department, typically, it's usually because someone's in imminent danger to self or someone's uh presenting in such a way that the officer is not able to handle the situation. Uh it's not a typically a dangerous situation, it's more so an emotional situation, a crisis, or what have you. Maybe the person just got really bad news, things like that. I like to make sure we we go see the officer because they're they're by themselves in that unit. And so I didn't put the officer through a bunch of QA, like, what does she want? Why is she why can't she fill out a request, you know? So I just hopped up, went down there. Now, the instant I hit the door, they're on lockdown, and uh which is probably why she reached out, she sees that I'm not Joseph right away, and she's mad. She's angry. She wanted to see Joseph. She did not want to see me. Now, she had the history of writing grievances and making official complaints about therapists, mental health professionals, nurses, medical personnel, and even officers. When she saw it wasn't Joseph, she was very, very upset. So I recognized right away what I was dealing with. I was dealing with a manipulative person, and I was. I was dealing with a person who was used to getting her way on that unit. And once I you know, I had I had heard about her in the past for some very significant reasons, though I had never met her. She was very proud of the following uh things. In prior stays in that facility, unfortunately, she was able to, through the lack of integrity on the officer's part and lack of judgment on an young officer's part, and her high level of manipulation and ability to read people, she had an affair, a sexual affair with an officer, for the sole purpose of getting him in trouble. For the sole purpose of then turning the tables on him and making a big show of it in front of the entire unit. And she did, and she was successful at that. This um very foolish, very just embarrassing officer, you know, an embarrassment to his entire profession, crossed that line with her at her request and ended up uh having charges because you cannot uh by law, a detainee and inmate cannot consent to sexual encounters. Trevor Burrus, Jr.

SPEAKER_00 14:00

She was pretty self-aware, intelligent, and had very her ability to use people for her own ends was pretty adept.

SPEAKER_04 14:06

Trevor Burrus, Jr. Oh, uh extremely high level of pathology there in regard to what we call sociopathy, uh very high levels of pathology. I mean, she's willing to give her body to a person for the sole purpose of getting that person in trouble, not but not for the purpose of and also for the purpose of status amongst a transient population of people that should have no real meaning in her life, the other detainees. You know, uh a person without that pathology is in jail and they're thinking about their their case. They're thinking about when do I get out, thinking about building a life, not her. She's thinking about the moment. She's living in this moment where she must be the queen of that moment. And he was dispensable and she knew the right person to choose. She chose the right person, right? And it worked. To paint the picture of her personality. I wasn't Joseph. She wanted Joseph, she's mad, and I set a boundary with her, which is people with borderline personality, such as hers, or people with her overall personality type, they are not really good with boundaries. I set a boundary. I said, Well, okay, I'll just leave. She goes, Well, no, you're here. And I said, Well, okay then. What do you need? Well, I need to see Joseph. Again, Joseph's not here. Well, I need to talk to him. I'm really upset. And I said, I understand you're upset, but I'm not gonna be able to help you. Well, this officer won't let me use the phone. I said, Well, that's not my purview when the officer uses phones or anything else. You're gonna have to follow the rules of the unit. She curses me out, obviously, because that's her first point, you know, F you and all this stuff. One thing she was uncomfortable with was when people looked at her and really saw her. She did not like to be actually seen. Do you understand what I mean by that? When she got the inkling that the person she's speaking to could see through her, see what she was really like someone was trying to work her out. Yeah. Yeah. Then that made her very uncomfortable. And of course, she would lash out. When lashing out didn't work, she went to flirting. When flirting didn't work, she went back to lashing out. I saw all those extremes within about a five minute period.

SPEAKER_00 16:14

But you're sitting there going, like, all right, I know exactly what's happening here. She's going through the she's she's testing the different locks to see which one's there.

SPEAKER_04 16:22

Absolutely correct. She's looking at, well, I'll intimidate first. No. Don't you know who I am? Because she's very famous there. Doesn't work. They they called her the legend, right? She was the legend there. She had uh my story about the officer, that actually happened twice. She was able to wear wire for internal affairs the next time and got a second ridiculous person to follow, you know, in her little footsteps into that world. She's made complaints about a nurse, a pill nurse before, but she didn't realize there was a camera in that area and didn't work, and she got in a lot of trouble for that. This was her daily life, finding ways to get her way and manipulate others and also stay, you know. She really wanted to always have a status amongst the entire environment, even if it meant putting herself in danger or really disrespecting her own body and her own her own integrity. So I cut that session off. I said, Well, you can put in a request next time, and Joseph will come to see you as per your request, uh, if you're not already scheduled. Until then, you will not be seen. You can't see people every single day. Of course, yeah.

SPEAKER_00 17:40

You got a lot of people you have to work with.

SPEAKER_04 17:42

Now I want to clarify something because there's a lot of lot of stereotypes out there. Facilities such as this one I'm talking about have incredible medical departments. We're talking about a medical staff of 120, 130 uh professionals. We're talking about a mental health staff of ten or more licensed, fully licensed mental health professionals, psychotherapists, psychiatry, mid-level psychiatry, psychiatric nurses, round the clock. Okay. So we're not talking about some stereotypical situation where somebody may come by once every three months. These are highly organized and highly applied standards of professional care as you would find on the outside, but even greater. She knew that and she used it to you know the detriment of others. So I walk away and I start to think I hopefully Joseph has not stepped in this trap. Hopefully her her insistence on Joseph sent up flags for me, considering not because of Joseph, but just considering her track record. Because it's it's no um it's not lost on me that every other therapist that she rejected was a female. But then Joseph, who was uh attractive young young man, comes in and is offering a therapeutic ear that she would see that as weakness and plus being a male that possibly she could get his uh attention.

SPEAKER_00 19:04

Did did she have you mentioned this uh this dichotomy between the male and female therapist? Did she have adversarial relationships with all females?

SPEAKER_04 19:13

All females that didn't fall in line, that didn't give her her way. This is a problem which led her to being in disciplinary in that disciplinary air area instead of back in her regular cell. When she had a cellmate, that cellmate generally became someone that was like a a minion, uh, uh, a flunky to her. And generally that cellmate would give their store call to her, that cellmate would uh do her beckoning for whatever it is from other inmates and and so on. She ran it. And in this case, uh with the disciplinary action and her being placed in the disciplinary cell, that was because the store call rules had been broken, and the officer recognized that because they have to give their order for store call to the officer. The officer recognized that she had all this store call in her room for her, but she didn't order any of it. And you can't border and pick and choose. There's no, you know, uh economy that's supposed to be taking place within the unit. You buy your own, you keep your own.

SPEAKER_00 20:14

Right. This isn't like where you see in movies and people are like buying stuff with cigarettes and stamp books and all that stuff, right?

SPEAKER_04 20:20

I'll give you three honey buns for that, you know. Not the case. So the officer observed, saw, and so she moved the other girl out. Well, that really made her mad, and she went completely off on the officer in front of everyone and thought it would work. And the officer didn't care who she was or her background, didn't care if there was going to be a grievance and put her in disciplinary. But and we'll circle back to that morning that that happens very important time.

SPEAKER_00 20:46

That's gonna be pivotal later.

SPEAKER_04 20:47

Yes, it's gonna be pivotal later.

SPEAKER_00 20:49

What I'm curious about is what is it that you found out about her history that what is it that happened in her life that made her this way?

SPEAKER_04 20:57

Well, we can we can speculate, we can try to connect the dots. What happened to her in her life, uh, if it happened to someone else, wouldn't automatically make them make the same decisions or uh behave the way she behaved or and and so on. But uh more often than not, it is a factor. And and going back and reading uh her therapist notes, Joseph's notes, after my first meeting with her, uh I was enlightened about a childhood that she, you know, she really disclosed quite a bit, and it made sense. Her mother abused her. Her mother uh was she had a mother and father in the home. She was the only girl. Her father worked nights. He's actually was an officer, a police officer, a road officer. Her mother would entertain men while dad worked overnight. She would bring these men into her home. Um there was a tremendous amount of drug use, a tremendous amount of alcohol use. These visitors to mom were introduced to her, Susan, at an incredibly early age, probably early elementary school age, and um she was sexually abused by the People it is Susan's uh contention that mom made that happen, not just allowed it to happen or accidentally uh happened. She did say and several times that there were times her mother was passed out and these people would come into her room. But later, as she grew older, pre-pubescent and then later adolescence, her mother saw her as competition for uh male attention. Add to that abuse being sexualized at such an early age and s for such a long time, you add to that early use of substances, alcohol, all easily accessible to her by her mother and these people that her mother brought into the home. And having to keep secrets, she learned at an early age how to keep secrets because obviously her father wa was not allowed to know these things and he didn't creates a personality type, creates a way of manipulating but and even in fairness, a way of mitigating uh your way through this world. And we all have problems growing up. We all have stressors and benchmarks we're expected to meet. We all have dreams as a little kid. Our scope is wide open as a child, right? As we get older, that scope is less and less wide open. Some realities, you know. You may want to be an astronaut when you're a little boy or a little girl, but later you realize maybe you don't have the math scores.

unknown 23:34

Okay.

SPEAKER_04 23:35

But you know, your scope becomes limited. For a child like her, her scope was limited at the earliest of ages. She learned how to get things from people in an incredibly maladaptive way from her mother. She was beaten, she was exposed to these horrific things. So, how did she become this person? Well, she was raised. She was raised to be this person. And she said in one note, I found it very telling, in one note, when asked about her experiences with these incidents with these two officers over earlier stays in the jail, she said the following. She said, I spin men like nickels.

SPEAKER_00 24:16

Pretty telling.

SPEAKER_04 24:18

And she said, she went on to say, I learned that from my mother.

SPEAKER_00 24:21

There you go.

SPEAKER_04 24:22

So your question is, where did she come from? How did she get this way? I think there's a clear path there for us to understand.

SPEAKER_00 24:30

I was gonna ask you something about her relationship with her parents in addition to what you've just explained. Um, so you've mentioned that in in her time in jail, and she was institutionalized eleven times, correct?

SPEAKER_04 24:42

Just in this one jail. Just in this one jail. I'm sure she was in uh others as well.

SPEAKER_00 24:47

So clearly very high recidivism, and she she uses this manipulation tactic a lot in jails with uh her her pattern of triangulation. Was that something she did as a child with her mother and father? Did did she try to pit them against each other ever? Is there any evidence that she did that stuff at a young age?

SPEAKER_04 25:04

She made statements uh that by the time she was in high school, and this is statements taken from the transcripts of her sessions, that the time by the time she was in high school, she could get what she wanted from her father, uh, but she could only get what she wanted from him when mother was not around. So she knew from an early age about timing as well. She knew from an early age of who to ask for what. Everything she wanted from men was the same thing she wanted from her father. She did not want love and protection from him because she knew from the earliest ages that was probably not going to be possible. Her mother painted her to be this really bad child. So it was the old thing, you know, when dad gets home, he's gonna whoop your butt, you know, and so on. So dad was the enforcer, mom was the manipulator, though mom was physically abusive as well. So here we have this triangulation where who do I turn to? So what does she do? Very resourceful because of her high intellect. She used dad, she used him for the material things she needed. She even used her mother's boyfriends for these material things, but that required competition with mom. There was no competition when she wanted things from dad. And uh that dynamic is alarming.

SPEAKER_00 26:19

So I think we have a pretty good picture of of Susan R at this point. Is there anything uh pertaining to her backstory that you that we've left out or anything else you think our listeners need to know about?

SPEAKER_04 26:29

Well, I I would say her her relationships outside of Jill are something we probably should cover because they're important.

SPEAKER_00 26:36

And and we are going to cover those via a couple of uh tools. You have some transcripts from some phone calls she made when she was incarcerated, correct?

SPEAKER_04 26:44

I do. I absolutely do.

SPEAKER_00 26:45

So and can you we'll we'll listen to these. We're going to provide a a a reenactment of sorts so that the listener gets a good idea of the dynamic in these conversations, but can you just speak about them a little bit?

SPEAKER_04 26:56

Sure. I I think you'll see that she's well adept at changing her tone and approach, even her verbiage, depending upon the situation and the person and what she needs from that person. She's a chameleon. And that goes right into her borderline personality and her and her narcissistic features. Keep in mind, she would have on the phone calls, and part of a psych autopsy is we we listen to phone calls from the outside or or from her to the outside. They're recorded, as in all institutions, to get a uh find out whether maybe somebody knew she was going to do this and didn't let us know, this kind of thing. Uh in her case, her phone calls were very mission-oriented. She had one fellow she called and called he thought obviously he was her boyfriend. She wanted money to put on her books, and that was his job. And she'd had very little small talk for him. And the more stern she was with him, the more he would acquiesce. So she knew his personality type required sternness and directness, and he needed to be led. Again, very much operating at a high level there.

SPEAKER_00 27:58

A high level.

SPEAKER_04 27:59

Another phone call to another fellow. This was also a textbook borderline feature, he was in control. And she was the beggar. She was the flirt. She was wanting to know where he was, who he's with. And the more she asked, the more he shut her down. Now, the borderline personality, in many cases, would chase to the ends of the earth the person that would treat them very badly and deprive them of love and affection, and treat very badly the person that would give them the world. This is a feature. It is not a universal feature, but it is a dominant feature of that personality type due to their upbringing, typically. Because remember, personality disorders, they are developmental disorders. They are not clinical disorders. There's nothing different about the brain or brain chemistry. It is about their development as anyone else's development. She had narcissistic features, but this second fellow who was in control of her actually had her calling other people to give him money because he was going on a trip and he wanted money. And he was mad at her because it hadn't happened quick enough. And she acquiesced. She completely submitted to him. Her voice tone is completely different than her voice tone with the other gentleman who she is demanding, embossing, and threatening.

SPEAKER_00 29:21

But there there is some difference between some individuals being mad at her, like person A is mad at her and she doesn't seem to care. Person B is mad at her, but it affects her deeply. What's the reason to for that?

SPEAKER_04 29:33

Well, it it's more uh in her case, it's more um how she sees herself being viewed by men uh in regard to these phone calls. You know, relationships, romantic relationships. It's very difficult for her to have one. A borderline personality is called borderline because they're on the border, the fence between admiration and repulsion or love and hate. There's very there's no middle ground.

SPEAKER_00 29:55

And it's easy to knock that person out.

SPEAKER_04 29:57

Easy to come off that border. You know, one day this person is, you know, hung the moon, the next day they they don't they can't stand them. But they always have someone next. She covers all the bases. She has the guy that supply her with her material needs, though she cares nothing for him, but she lets him uh think that she does. And she has the guy that she cares for. Now, that's the maladaptive part. Why would she care for the guy that treats her so badly instead of the guy that would give her things? That's the maladaption of the borderline personality.

SPEAKER_00 30:28

This all sounds like it takes a tremendous amount of energy.

SPEAKER_04 30:31

I it does. I think it takes a tremendous amount of energy, which is why persons who suffer from this have such a tumultuous life. They they they do end up in the criminal justice system, or they do end up in multiple, multiple broken relationships, they do leave a leave a wake of destruction in their path uh most of their life. It's very difficult to treat because it's a developmental issue that comes about over many years. Things we learn at five are much more engraved and much much deeper than things that we learn at 30.

SPEAKER_00 31:04

Right. Because you you if an individual like this was seeing a therapist, it's not just about fixing an acute issue, it's about backing a truck off of a history of building these mechanisms over a long period of time, and undoing them isn't as easy as just popping a pill or having one therapy session. They're built in.

SPEAKER_04 31:22

You're so correct. And there's many therapists when they realize they're in the in a session with a new client and that person is a borderline, they'll they'll refer them, you know, to maybe to a therapist they don't like. Nope. And that's a shame because it is treatable. Dialectical behavioral therapy and cognitive behavioral therapy uh are effective, but it requires the person receiving the therapy to really accept that their modus for moving through this world is wrong.

SPEAKER_00 31:51

Would you say compulsory therapy is never effective?

SPEAKER_04 31:53

I would.

unknown 31:54

Okay.

SPEAKER_04 31:55

I would be having had people court ordered to see me in the past, uh typically they're waiting for the number of sessions they were ordered to be completed and get their piece of paper. I mean, it's it's a cliche, but it's still true. You have to want to change. Okay. Very nice. And if you don't understand why you need to change, then where do we go from there?

SPEAKER_00 32:15

I mean, it's yeah, you're already at a brick wall. If you don't think there's anything that you need to change about yourself, there's no point you even being there.

SPEAKER_04 32:22

Yes. And look, Davis, we stand on the outside looking in and we're like, what in the world? Why would you think that? Why would you want to do this instead of that, or or what have you? But we didn't grow up in that development lane that they did. Susan, unfortunately, and this is a tough phrase for some people to hear, some clinicians get upset, but Susan was textbook in regard to her borderline features, her narcissistic features.

SPEAKER_00 32:55

Yes.

SPEAKER_04 32:56

She, if you looked at the diagnostic criteria in the DSM 5 for borderline personality disorder, she hit all the marks. Fair enough. Does that mean that she's just like every other borderline? No, that's not what I'm saying. I'm saying that diagnostically, all the features were there, as well as some of the features for narcissistic personality disorder, and a bit of histrionic personality disorder. Now remember, in the old DSMs, the personalities were divided into what we call clusters. Cluster B was antisocial personality, narcissistic personality, borderline personality, and histrionic personality disorders. They are a hierarchy up to the top, antisocial, which is formally known as sociopath, down to histrionic, which is someone uncomfortable in any situation that is not about them. People can have features of all those, but not have the diagnosis. She definitely hit the criteria for borderline and some of the features of narcissistic personality.

SPEAKER_00 33:55

Well, I think that's an adequately substantive deep dive into her psychological history. So we're going to listen to these phone calls now. Uh, this first one, do you mind explaining what we're about to hear?

SPEAKER_04 34:04

Sure. This first call is with the young man I mentioned earlier who's completely submissive to her and um to all of her demands, and uh think it's very telling. All right, let's take a look.

SPEAKER_01 34:16

Hello. This is a collect call from an inmate at the Colville County Correctional Facility. This call is subject to monitoring and recording. The inmate's name is Susan Robertson. To accept this call and the charges, press one now to refuse this call.

SPEAKER_03 34:34

I should be happy. I mean, it's just a technical violation. It's not like people. This is some bullshit. Would you keep doing this shit? He wouldn't do that. I think he wants some mess too. Even in here. Just get it from your brother and then this morning on Friday when you get paid. I'm still here. You ain't good every day. You're supposed to take care of me, and you got me begging for crumbs. I'll try and see what I can do. When? This week. Today, baby. I'll try.

SPEAKER_04 36:25

Well, that was uh very interesting. You hear a very dominating, manipulative Susan. I want you to really sit tight because the second phone call juxtaposes two sides of Susan. This phone call coming up is Susan the submissive, and for very good reason. She needs something. And this one, it's not money, it's love.

SPEAKER_00 36:46

All right, let's take a look.

SPEAKER_03 36:48

I miss you, baby. I miss you too, baby. You waiting for me?

SPEAKER_02 36:53

You know it. You sure? You know it. You ain't gonna keep asking. I'm sorry, baby. I just miss you so much. Going out of town for a minute. Where you wanna? Got some business to handle. Who you owe it? Don't worry about it. Who you owe it? Look now. You can't be in my business. I want you to know something, so you'll know it. I ain't gonna listen to nobody's nonsense.

SPEAKER_03 37:18

I'm sorry, baby.

SPEAKER_02 37:19

I know you wouldn't believe I trust you, baby.

SPEAKER_03 37:26

I did.

SPEAKER_02 37:30

Every time I reach you, I get no answer. She told me. I need some things in my trip. When I'm supposed to leave this week.

SPEAKER_03 37:40

When you put him back.

SPEAKER_02 37:42

There you go.

SPEAKER_03 37:44

It's just hot in here.

SPEAKER_02 37:47

You want to call her? Tell my swing about tonight to pick that up.

SPEAKER_03 37:52

I love you.

SPEAKER_02 37:53

Look here. I got to go. These calls cost money. I love you. I'll talk to you later. Don't forget to call her. Bye.

SPEAKER_04 38:03

Well, wasn't that different? I mean, I I'm sure we can all sense the difference in her tone and her presentation, and it's um it's also very sad.

SPEAKER_00 38:13

If you read that transcript and you don't see the names, it seems like two completely different people.

SPEAKER_04 38:19

Exactly. Very different. But this is the chameleon that is Susan. She has to be different people. And where did she learn that? At very early ages.

SPEAKER_00 38:29

Well, let's let's talk about you you mentioned Joseph a little bit earlier in this episode. He he's her primary clinician, and he's he's a newer clinician, you know. So this is this is an experience for him to have to deal with an individual like Susan, correct?

SPEAKER_04 38:43

Yes. It was quite a quite an experience. Uh you know, very difficult. Uh so a new clinician, um, and he jumped right into the deep end, coming to a large metropolitan jail to work with some of the most acute people you can possibly work with in a stressful situation. Uh, here he is, he landed one day, luck of the draw, he got a request in the box and he picked it up. He didn't know who she was, went down the unit and began. And there's no doubt in my mind that because he was a male, because he was a good-looking young man and a new face, that Susan saw the opportunities immediately. But he is skilled, and he did get her to talk, and she didn't quit even when the going got tough, and when he required that she talk about some things that she probably didn't want to expose about herself. Because remember, exposure to her is weakness. Now, her previous therapist I read in the chart described her as vengeful, manipulative, and even uh and aggressive. But that therapist did not offer any etiology for those uh for those words. As I said earlier, she was diagnosed bipolar, she was diagnosed uh as borderline personality, and and also uh she was I failed to mention she was diagnosed with trichotillomania.

SPEAKER_00 39:58

And and what is that exactly, for those for those listeners who aren't familiar with that particular condition?

SPEAKER_04 40:02

Aaron Powell It has been related diagnostically to forms of anxiety. It is a behavior, a manif uh a manifestation of emotional uh uh distress where one uh habitually pulls their hair out, eyelashes, eyebrows, uh scalp hair, and also they it goes further, they begin to pick at their skin, and and uh the signs are obvious, uh, which ties together now makes sense after reading that. I didn't put it together immediately when I saw the hair in the cell. Uh it makes sense why the hair was there. She had trichomotillomania, she suffered from that, uh, which is compulsive, which ties into her cell being so meticulously put together and things ordered in certain patterns. That is those are compulsive behaviors. So, you know, we'll come back to that, but I found that tied some things together for me about Susan. Um, but Joseph, he was able to take it further. And it probably helped being a male, as I said earlier, but it I'm not I don't want to take away from his from his uh skill as a as a therapist and just say it was because he was a guy. She had was prescribed medications throughout every stay there, but she was only about 60% compliant with them. She was uh prescribed medication for bipolar disorder, depicotes, and she's prescribed uh several others, you know, over the over time that were different. But depicot was uh the main component for a medication regimen this this last day there. However, uh she again she's only about sixty percent compliant with that. Now in Joseph's notes And and six compliance is the taking of the regular take the offered daily at the prescribed times, but they can re they obviously everyone has a right to refuse, and she would refuse at least 40 uh percent of the time, if not more. Uh she was prescribed uh you know depict and cyrax, but she wanted benzodiazepines. So when she couldn't get a benzodiazepine, which of course is Xanax or other related um medications that give you uh secondary benefit, obviously, and they're addictive. They don't prescribe those there. And so she would always try to manipulate to get those, and when she couldn't, she would quit all meds. Well, I'm not taking anything, you know. And and this was typical for a lot of folks that come in with addiction issues as she did, or at least substance use issues. They want benzonezepines or pain relievers, things like that. When she couldn't get what she wanted, she would file grievances. She never filed a grievance on Joseph, even though he did set some boundaries with her.

SPEAKER_00 42:27

And how did she react in the moment? If you pardon my interruption when the first time did he ever mention the first time he tried to set a boundary and what her reaction was?

SPEAKER_04 42:38

Yes. He had been ill, and when he came back from his illness, I felt I needed to talk to him because I didn't want him to fall into any traps. This is before she she died. And I called him in and he was very much self-aware of how his presence with her one-on-one affected the session, being who he was, being a male, and and so on, near her age. Her past attempts to reach her through professionals were uh women, most a lot of times they were older than her. Uh, and she put up her boundaries right away with those those therapists. But Joseph had an end, like it or not. He was well aware of it. But he was also being new, you know, I was concerned about uh could he be manipulated at some point. Uh, we had a good talk about boundaries, maintaining boundaries. I explained to him that I had met with her and my boundary setting was understood by her. My second meeting with her, she tried again. She wanted something that I was not going to provide. I I I believe it was she wanted uh um uh me to call someone, I believe, something like that. And I refused, and she cursed me out. I said, Okay, I'll see you later. I never met her level of emotion. The louder she got, the lower my voice tones would go. That is a proper way to address that. And then so she turns from her aggression, of course, to flirting, and she gets the same response. Response, nothing. And I stand up and end the session abruptly, she curses me again, and I say, Well, see, there you go.

SPEAKER_00 44:06

You know, this reminds me of something. You've seen Jurassic Park, right? Yes. Do you know when they're talking about the Velociraptor and they're like, it's testing the fence for weaknesses. Right. Yes. Not to, you know, not to say anything this or that about this individual, but she's clearly seeing what she can get away with with different people and where their threshold for her behavior is.

SPEAKER_04 44:25

Well, there, you know, there is the issue, her developmental life, her developmental stages where we all, all of ours, where we learn to interact with people. This is what she learned, this behavior. This is what's worked. Human behavior continues as long as it works for the person. Now, from the outside looking in, it doesn't look like it's working, but to her, this is how it's done, and it was working. Because sometimes she did get her way with certain people. Nonetheless, Joseph informed me about more about the mother, more about the issues, but she also informed me of one person that Susan did try to please, and that was her grandmother. But nonetheless, she did lie quite a bit to her grandmother. But she did try to please her. She held her tongue and saw the grandmother as maybe one anchoring place in her life. But again, she did try to manipulate her as well. And we have a phone call between her and her grandmother, as well as one between her and her mother. And they are completely opposite in regard to how Susan is received by family. In the other phone calls, we saw how Susan treats others. We're going to see in these phone calls how Susan is handled, I would say, or received by so-called loved ones, people who are supposed to care about her.

SPEAKER_00 45:44

What do Joseph and her grandmother have in common?

SPEAKER_04 45:47

Well, they listened without judgment. Now her grandmother was always in her corner. Her grandmother always saw a way out for her. It's always someone else's fault. Joseph didn't do that, but Joseph didn't judge. Joseph didn't try to put uh try to influence her. Joseph actually held up a mirror for her, which is very tough with a with this type of personality to hold up that reflective mirror and and get that person to see. Uh that's not to say she didn't have Rocky times in her therapy sessions, but I will say this, she hung in there with that until something exterior to the sessions happened in the unit. And that's where we are at this point in the process. We've heard how she reacts and uses people in her life as objects. We've got some insight on her past attempts at you know, introspect through a through a professional. We saw some promise through her interaction with Joseph that I believe could have been beneficial. But as far as the psychological autopsy, it's at this point, it's time for me to move a little deeper into the day-to-day aspects of her life on the unit in interactions, and then try to tie that into her developmental and psychological background to make sense of this decision and to answer some of the questions that we need to answer in the psychological autopsy.

SPEAKER_00 47:08

So when we step back and look at her interactions with Joseph, what becomes immediately clear is that we are not seeing a person who is emotionally shut down or unreachable. In fact, in that setting, we begin to see moments of openness, moments where the presentation is less performative, less controlled, and arguably more emotionally vulnerable than what we heard in the phone calls. Now, it would be very easy at this stage to isolate individual clinical details or focus narrowly on things like compliance, treatment, or specific institutional procedures. But from a psychological autopsy perspective, and I'm sure you'll agree, Dana, that would actually risk missing the larger picture. Because deaths like this rarely hinge on a single moment. They unfold within a context, a daily environment, and a routine. And we're gonna talk more about that next time, and we're gonna we're gonna learn a little bit more about her environment leading up to this and perhaps even see some revelations that that change the entire dynamic of this whole story.

SPEAKER_04 48:05

Yes, indeed. I'm I'm looking forward to it. We're gonna take a look at the environment from a day-to-day process leading to an event, an event that is completely different than one would expect given her past behaviors.

SPEAKER_00 48:18

Again, thank you all for joining us. If you're in the U.S. and you're thinking about suicide, or if you're in crisis, call or text 988. If you're in immediate danger, call 911. If you're outside the U.S., look up your local crisis line because there are equivalents in many other countries. Look, if you know somebody, even if you don't know them well, but you think something's going on in their life, engage. Engagement can save lives. You can save lives. Thanks so much for joining us. We'll see you next time.