Predicting Extreme Fatal Violence
Tarasoff and the Duty to Warn
Prosenjit Poddar attended the University of California at Berkeley in the late 1960s and met Tatiana Tarasoff at a dance. They became friends, and he developed a strong romantic interest in her. When they shared a quick New Year's Eve kiss, he interpreted this as a sign that they were engaged. Tatiana was uninterested in such a relationship, which confused Poddar, an Indian immigrant. He developed a delusion that she had feelings for him, and this obsession became increasingly more intrusive. He soon suffered an emotional breakdown and attempted to end all contact, but she called him to tell him how much she missed their discussions. His obsessions returned and became paranoid to the point that he believed he would have to kill Tatiana.
During the summer of 1969, Poddar sought outpatient psychiatric services at a hospital in Berkeley. The treating psychiatrist diagnosed paranoid schizophrenia. He prescribed antipsychotic medication. He then referred Poddar to a psychologist, Dr. Lawrence Moore, for counseling. Despite their sessions, Poddar persisted in his delusion that Tatiana would one day love him. To prove himself, he purchased a handgun to orchestrate a life-threatening situation from which he could rescue his beloved. Dr. Moore, learning of this from Poddar, stated that he might take steps to restrain him, which sent Poddar angrily from his office. His honor, apparently, was at stake.
Dr. Moore talked with colleagues about these threats and informed campus police that Poddar was unstable and threatening to kill a girl. Officers found and questioned Poddar but thought he appeared rational. He promised to stay away from the girl. Moore's department chief believed that he had over-reacted to the situation and ordered him to change the records to remove his contact with police.
Then in October, Poddar's delusions reached a breaking point and he went to Tatiana's house, armed with a knife and pellet gun. She ran from him and he shot her, then stabbed her fourteen times, killing her. Poddar turned himself in and at his trial pleaded not guilty by reason of insanity. He was convicted of second-degree murder and after serving five years was released.
Tatiana's family instigated a civil case of negligence against the Regents of the University of California. In 1974, the California Supreme Court found that, despite patient-psychotherapist confidentiality, a duty to warn exists when the therapist determines a warning is essential to avert a danger rising from the patient's condition.
The mental health profession quickly responded to this decision, claiming that they have no inherent ability to predict violence and that such a ruling violated their "special" relationship and would prevent patients from trusting them. It could also generate false positive predictions as a means of diverting liability just in case something happened. Overall, this would be a detriment to those needing treatment, as well as a deterrent to clients who might otherwise expose their violent fantasies.
The court agreed to rehear the case and issue a second opinion. It still found that therapists have a duty to potential victims, but they need only use "reasonable care" to protect the person. That is, the therapist may only have to civilly commit or voluntarily hospitalize the patient to avoid the potential for harm. Most jurisdictions now recognize a Tarasoff-type duty, although some are less stringent than others.
Psychologists cannot be expected to be clairvoyant, but they can make an informed assessment whether a patient is likely to act out, and devise a behavior management plan to decrease the likelihood of actual violence against a specific target. There are several standardized instruments for assessment, but among the hindrances to effectively using them are the secrets that potentially dangerous people keep. One man's fatal obsession went almost completely unnoticed by those who knew him.