Obscene remarks about her childhood sexual abuse triggered a loss of control by a woman accused of the murder of her boyfriend, a psychiatrist told a jury yesterday.
The woman was "an eight-year-old girl in a big woman's body" who inflicted wounds on her own body in a desperate attempt to get help for the abuse she had suffered, the Central Criminal Court heard.
Ms Kathleen Bell (36) admits the manslaughter but denies the murder of Mr Patrick Sammon (42) at her home in Camilaun Park, Newcastle, Galway, on June 20th, 1997.
Dr Brian McCaffrey, a clinical director of psychiatry at the Eastern Health Board, said obscene remarks made by Mr Sammon just before he was stabbed reminded Ms Bell of her past sexual abuse and were "a major factor in triggering off her loss of control".
The jury has heard she stabbed him six times with a kitchen knife she concealed under her jumper when an argument developed at her house early on June 20th.
She did not know how to deal with Mr Sammon's taunting about her past, the psychiatrist said.
"She was trapped. There was nothing new about being trapped - she was trapped for years - but this was the apex of the mental torture and harassment."
The psychiatrist was retained by the defence and interviewed the accused three times. In addition, he saw her give her direct evidence and studied notes of her previous hospital admissions, he told the court.
He said the dose of tablets Ms Bell took after she learned of her sister Mary's death from a drug overdose would make any ordinary person "disorientated" and "certainly drugged".
The type of tablets she took were tranquillisers or benzo diazapines, linked to Valium but more addictive. The combination of eight Lexitan and six Zanax tablets she said she had taken on the day before the killing would have a very marked effect on a normal person.
He personally did not prescribe either drug, considering them "too addictive, especially the Zanax". The excessive amount of tablets she took combined with the alcohol she consumed on the night would be very toxic.
Dr McCaffrey quoted from an Irish Pharmaceutical Healthcare Association compendium and an American neuropsychiatry textbook warning of the side-effects of the drugs on a standard dosage.
The US textbook warned that, rather than calming a patient, they could in certain patients have the opposite effect. The Irish book urged extreme caution in prescribing to patients with a personality disorder.
Dr McCaffrey said Ms Bell clearly had a personality disorder and was not a normal person because of her background and past abuse.
It was important not to remove her psychological condition from the equation, he said. Her background could reasonably explain why she acted out of control on a temporary basis.
The jury has already heard she was abused first by a female staff member at an orphanage in Moate and then by the son-in-law of foster parents she stayed with in Dublin.
The length of time she suffered physical and sexual abuse was extreme, he said, and later she developed a habit of cutting herself, with major incisions, in a "desperate attempt to relieve the internal turmoil she felt".
Dr McCaffrey told Mr Patrick MacEntee SC, defending, he had over 20 years' experience and a special professional interest in cases of women involved in deliberate self-harm. Research showed that in 80 per cent of such cases there was a known history of sexual abuse.
The jury was shown photographs of the body scars. Dr McCaffrey said that one blade wound on her body was larger than what would be left by a surgeon after removing a lung.
The photographs also included five separate knife wounds inflicted by Mr Sammon on Ms Bell's body in the course of five different fights they had.
The psychiatrist said notes from Ms Bell's many hospital visits made scant reference to her childhood sexual abuse, though there were references to an unhappy childhood.
It became clear to him that no one had ever sat down and talked to Ms Bell about the abuse, he said.
What she needed was somebody to listen to her. From his interviews with her, he believed she could be helped. "She is really like an eight-year-old girl in a big woman's body," he said.
He noted a comment from one of her visits to the maternity unit in the Regional Hospital in Galway which recorded that she was "over-talkative". "She was probably desperately trying to get people to help her", the doctor said, "but here were the professionals letting her down."
He agreed that her experience of having her baby daughter taken from her for adoption when she was 17 had added to her feeling that doctors and nurses and nuns could not be trusted.
She ended up in a "pathological relationship" with Mr Sammon, who taunted her about her past abuse.
"It must have been horrific for her," the psychiatrist said. Patrick Sammon was "throwing abuse at her" and yet nobody she sought help from responded.
And consistent with many from abused backgrounds, she said she loved her torturer.
The psychiatrist told the court he believed Ms Bell had the features of "an extreme form of posttraumatic stress disorder" which lay underneath a myriad of other emotions and turmoils.
Cross-examination of Dr McCaffrey continues before a jury and Ms Justice McGuinness.