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Crazy, Not Insane focuses on serial killer expert Dorothy Otnow Lewis, so what are her credentials? The HBO documentary doesn’t begin with an official credited introduction, but rather informs audiences about Lewis’ background through on-camera interviews and video clips. As a result, Crazy, Not Insane has a more organic feel than most true crime docs, as Lewis speaks candidly about her life’s work in a conversational tone.

Directed by acclaimed documentarian Alex Gibney, Crazy, Not Insane focuses primarily on Lewis’ belief that many serial killers suffer from various forms of brain dysfunction. During the early-to-mid 1980s, the FBI’s Behavioral Science Unit was still relatively new, and so investigators were still learning about the psychological nuances of certain cases. Back then, Lewis’ psychiatric evaluations of serial killers were both groundbreaking and controversial, as she attempted to understand the complete life stories of her subjects, rather than just applying convenient labels as a way to explain their behavior.

Related: Des: True Story Of David Tennant’s Serial Killer Dennis Nilsen

In Crazy, Not Insane, Lewis recalls growing up in New York City and trying to figure out the motivations of Adolf Hitler; she later graduated from the Yale University School of Medicine. During the 1980s, Lewis established a name for herself by testifying in high-profile murder cases as a clinical psychiatrist. Crazy, Not Insane shows clips of Lewis discussing her work with Diane Sawyer, and also reveals that Martin Scorsese reached out while preparing for his 1991 crime thriller Cape Fear. Whereas Lewis’ cultural persona is indeed emphasized in Crazy, Not Insane, the documentary prioritizes her personal and professional relationships with serial killers who were diagnosed with having multi-personality disorder.

Crazy, Not Insane spotlights Lewis’ experiences with Arthur Shawcross, a serial killer who was convicted of murdering 11 women between March 1988 and December 1989. Lewis’ evaluation revealed that the murderer had a cyst on his right temporal lobe, which stimulated his limbic system and, theoretically, led him to kill. Shawcross also had Post Traumatic Stress Disorder from serving during the Vietnam War, and had presumably been sexually abused by his mother as a child. In Crazy, Not Insane, Lewis defends her evaluation of Shawcross and multi-personality diagnosis, though it’s also implied that she may have been manipulated by the killer.

Lewis also had a professional relationship with Ted Bundy. In January 1989, she met with Bundy one day before his execution, presumably because Bundy knew that the psychiatrist understood him better than most people. In Crazy, Not Insane, Lewis speaks about Bundy’s claims that he had a relatively normal upbringing, when in fact it’s been theorized that his birth was the result of an incestuous relationship between his grandfather and mother. Lewis even reveals that Bundy admitted to having a sexual encounter with his own sister, and that he later targeted women who looked like her. Ultimately, Crazy, Not Insane is a character study about Lewis, as she openly discusses her fascination with serial killers and why evaluating their brain activity is so crucial to understanding their behavior.

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