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In this excerpt from his new book exclusive, psychoanalyst Darian Leader is the extraordinary case of Dr Harold Shipman, the worst serial killer in Britain, to argue that our ideas of normality and madness is in urgent need of revision

over a Cuckoo's Nest

Girl, Interrupted

A Beautiful Mind

, why is it always the madness becomes so visible, so tangible, so audible? People talk about imaginary friends, foaming at the mouth, with terrifying hallucinations that chatter constantly, to rant about a conspiracy against him. As a rule, are either incredibly smart or incredibly stupid, such as engineering or raw, but few of them. There is no doubt that madness is sometimes accompanied by symptoms striking, but what about the case of the man who quietly goes about his business and family life, one day going to work, does its job perfect , then goes to a public place, pulls a gun and shoots him a public figure? There is nothing abnormal in his behavior greatly so far. It may indeed have been a model citizen, responsible, respectable and fair. But in the time before his murderous act, can we really say that he was not crazy?

are no better than the teams in the case of the most prolific murderer in Britain. Harold Shipman went about his business for decades before the suspicion, yet his good citizenship and modest life combined with rampant murder. Although there is some disagreement on the number of its victims, killing at least 250 people, and probably many more. Despite this unprecedented passion, murderous and extraordinary, were it not for Shipman rampage, not a socially unacceptable behavior, there is no system of his delusion that he felt compelled to issue . In fact, when Shipman was interviewed by psychiatrists found no evidence of "mental illness".

History

Shipman is fascinating not only as a case study in quiet madness, but also by showing us how society responds to questions of madness and murder. The responses of the media focused on the evil within in this strange doctor. How can a man do such things? What motive could he have? The lack of an easy explanation that the etiology has become invisible and intangible, a kind of inside force of evil. Interestingly, exactly the kind of thinking that is sometimes found in the explanations of their murderous actions: the act of killing, they said evil in the heart of his victim

read expert opinions in the case of the Shipman Inquiry is a disturbing experience. Not only show a lack of depth in the area, but the testimony of a dead sad to psychiatric knowledge. Despite more than 270,000 pages of evidence and a budget of more than 20 million pounds, the results show a little more could be obtained by a questionnaire on the Internet: Shipman is considered to suffer from an "addictive personality", " low self-esteem, "" a corruptible conscience "," rigid and obsessive personality "and" a deep need to control people and events ", in fact, probably many of the qualities that characterize us. They tell us absolutely nothing about him or why he committed his crimes, and it is even more remarkable that the reports could detect no signs of psychosis.

Shipman never said why he did or he did, and many families of his victims felt that his suicide in January 2004 robbed answers. What questions should we do to get more information? The killings were a sign of madness or, indeed, a desperate attempt to deal with situations that had blocked his normal daily madness and race?

Shipman was born in January 1946, the second son of Harold Shipman truck driver and his wife, Vera, the illegitimate daughter of a lace cutter. Not much is known about his childhood in a district of Nottingham, despite the school photos show elegantly dressed in a bow tie, unlike their classmates. Several accounts describe a special closeness with his mother, a "telepathy" between them, petted and loved Harold, sneaking into bed with her parents when her father was at work or in the pub. Vera, it is said, had high hopes for his son, and at 11 won a scholarship to the floor of the school.

Shortly after 17 years of Shipman, Vera was diagnosed with lung cancer and died less than six months later at the age of 43 years. During these months, your doctor regularly visited the house to administer the injections of morphine, and Vera and her son, apparently spent many hours talking. Devastated by his death, he stayed a year longer in the high road to take A-levels, before starting the medicine at the University of Leeds. Shipman met his future wife, Primrose, on the bus on the way to school, and it was not long before she was pregnant. It was apparently a scandal for both parents, creating a gap that never heal. They were married in November 1966, with none of the blessings that the couple can expect from their families, and their first child, a daughter, was born about three months later. They have three children, all boys, born in 1971, 1979 and 1982.

After graduation, Shipman began working at Pontefract General Infirmary, where he remained for four years until 1974. He took a degree in child health and obstetrics and gynecology, and was probably in Pontefract who began his first serious use of the drug. Shipman would use pethidine, a drug often used to relieve the pain of childbirth or as a pain reliever before going to the morphine which was injected with the drug regularly. In April 1974, took a new job at Abraham Ormerod Medical Centre near Todmorden, and later stated that the use of pethidine that began in May because of depression caused by the opposition of senior officials for their suggestions on improving practice. However, he was quickly promoted by the physician assistant, and hard work and dedication earned him the admiration of patients and colleagues.

"He was a saint, a very good person," recalls one of his patients Todmorden. He became a respected member of the company's local channel, helping to clean and maintain the canal that runs through the Valley Todmorden. Yet at the same time, he began to kill.

in the summer of 1975 that his colleagues Shipman began to notice that something was wrong. He had gone through surgery and then at home, who played for the first time the effect of "stress". Shipman injections of pethidine, in fact, has grown from a local pharmacy and did not realize the enormous amount of meperidine is prescribed, often falsifying documents. Shipman had come through the hoop in an interview with an inspector from the Ministry of Interior in July of drugs, however, the chemical was satisfied that the requirements are not legitimate. The partners of surgery compared Shipman, who admitted his drug use, and he retired from practice. A police investigation followed, and Shipman once admitted his addiction to pethidine and agreed to ask for help. Shipman's family to move to Durham County, where he continues to block medical research and liaison work by September 1977, when he got a job with the House Donnybrook practice in Hyde, near Manchester. Enthusiastic, committed and hardworking, Shipman won new respect for patients and colleagues. As long hours, joined the brigade of St. John Ambulance, volunteer medical education and training caregivers. He started killing in his new practice soon after his arrival in Hyde. His victims were aged men and women often suffer from a chronic illness or recent bereavement. The killings began slowly, Hyde, sometimes one a month, however, may increase during the 1980s, with Shipman murders carried out by four or five months, the group in the period from December to February. It would be theft in the homicide scenes, involving items of little apparent value or use.

In January 1985, Shipman's father died of a heart attack. Sister Pauline Shipman had lived with his father and after his death, sold the house and moved with his younger brother, Clive. He said the house would stay with her, and it seems that Harold had been completely excluded from the estate. At work, Shipman seemed more withdrawn, and the partners and staff of the practice felt that something was wrong, almost always a great doctor with his patients, could be arrogant, gentle and controlled with the staff. No doubt this was one reason why, after almost 14 years in Donnybrook, which was the creation of their own practice, with some staff members with him to found the market practice. This could follow his own philosophy of health care relative control: to prescribe drugs that he chose to avoid unnecessary admissions to devote individual attention to their patients. When the health authority asked why not have a nurse on duty at the facility, Shipman said he would do all the work himself. This really was the scene of a doctor.

Murder starts to rise now in 1992 / 3. There was a list of about 3100 patients, and the murders continue, until his arrest in 1998, peaking in 1995. Subsequent research produced an image of crime scenes Shipman as a kind of tableau vivant. I went to visit a patient of advanced age who usually live alone. They inject their victim to the powerful opiate diamorphine, usually causing death within minutes. It was the assertion that they were dead when they arrived or who died after his visit. The body was found fully clothed, usually in a chair. Explain how he gained entry to the property, which used to say he had left the door latch. At times, then went with a neighbor who had a key to the property to "discover" the body. As often change their ratings, indicating that the death was expected, either before or after death. The manufacture of most municipalities in his notes was to invent a history of heart problems. This method is attractive because of its consistency. We can see that not only involves a murder, but also directed at the discovery of a body and be there on the spot.

The discovery of the Shipman murders occur through a series of strange errors, which suggested to many analysts who have sought his own fear. He crudely forged the will of one of his victims, Kathleen Grundy, leaving all his possessions and sent to a local firm. Contact with his daughter lawyers Grundy, who was a lawyer and she had a copy of a genuine commitment to his mother, who left the farm with her own. She knew instantly that the second will was fake and called police.

The scope and scale of Shipman's death come to light quickly. He was convicted of murder and sentenced to spend the rest of his life in prison. Imprisoned, he was always the doctor who provides medical care to inmates and staff, the surgery took place Saturday in his cell. It should be treated as "doctor", and Shipman, wrote several times from prison to his local member concerns about the quality of care received by patients during his absence. In particular, he worries that the substitutions to replace this would be to use a limited list of drugs instead of their choice more expensive and carefully chosen. This concern for appropriate medications often echoed in his advice to detainees, who said that drugs to ask doctors to prison.

has been catastrophic for Shipman when he was transferred from his regular cell to a new location next to the hospital wing because it deprives him of his surgery in prison. Now made a first suicide attempt, trying to hang himself with a piece of fabric, only to end his days by hanging 13 January 2004.

With Shipman, a number of key dates: when his wife Primrose reached the age of Shipman's mother when she died, and when Shipman arrived at the age of his father when his mother died 1995 was the year of his assassination really start to climb, on the death of his father, dates of births of their children. Although there are other important moments, this time in particular, seem to emerge as the times when something has changed or is exacerbated by Shipman. All seem to have much in common, which is implicitly present is a very specific question:. The symbolic transfer between generations
This is particularly important in psychosis, as it uses a symbolization of the difference between generations and what happens between them, often embodied by the contents of an inheritance. We could stop here to recall the circumstances of the fall of Shipman: the falsification of the will of Grundy. In a very professional effort and weak, he wrote a will on your part, using his own typewriter. Most commentators Shipman, I can not believe he thought he could get away. He knew that his daughter was a lawyer and Grundy were incredibly crude forgery. If we take seriously the issue of heritage here, we ask what role was played by the death of the father of Shipman. The latter had died from heart disease, and perhaps no coincidence that the most common counterfeit marks of the patients was the invention of a history of heart problems. Known as noted Shipman became more distant and cold, after the death in January 1985, when the house was his sister, Pauline, Shipman division of the paternal inheritance.