Updated Thursday, May 31, 2012 at 5:01 p.m. CDT
Updated Thursday, May 31, 2012 at 4:44 p.m. CDT: TylerPaper.com video
Updated Thursday, May 31, 2012 at 1:46 p.m. CDT
Updated Thursday, May 31, 2012 at 10:40 a.m. CDT
Bingham said to the jury that even though doctors said that her personality disorder was something she was born with, that Cargill was responsible for killing Cherry Walker.
Defense attorney Brett Harrison said Cargill has not been violent during the two years she's been jailed.
Her personality disorder fueled her conduct, he said.
The prosecution and defense rested their cases Wednesday in the punishment phase of the capital murder trial for a Whitehouse woman convicted of killing her mentally challenged babysitter and setting the body on fire in June 2010.
Kimberly Cargill, 45, could receive the death penalty from the jury after both sides present their closing arguments this morning.
The defendant, who was convicted on May 18, took the stand in her own defense and said the victim, Cherry Walker, had a seizure and died while the two drove in Ms. Cargill's car. The defendant said she panicked after the death, dumped the body on County Road 2191 and set the body on fire.
Ms. Walker had been subpoenaed to testify against Ms. Cargill in a child custody hearing on June 23, 2010.
Prosecutors called two rebuttal witnesses that both said that Ms. Cargill knew right from wrong when she killed Ms. Walker, and that although the defendant is not mentally ill, she does have a mental disorder.
Both witnesses also said that treatment is often not successful for someone with a mental disorder because such patients do not see a need for a change in their behavior, and they are not motivated to change.
Dr. Edward Gripon, a forensic psychiatrist based in Beaumont, said the difference between mental illness and a mental disorder is how the two are classified in the Diagnostic and Statistical Manual of Mental Disorders, the standard reference book used by mental health care professionals in the United States.
A mental illness can be schizophrenia, depression or bipolar disorder, the doctor said. These illnesses are classified on Axis I of the DSM, and can be treated with medication. But a mental or personality disorder such as borderline personality disorder, which the defendant has, is not treatable with medication, Gripon said.
Psychotherapy can be helpful if the patient will continue to go, Gripon testified. “It's almost impossible to keep them in treatment — they usually have brief encounters with mental health professionals and hear things about themselves that they don't want to hear, then they stop going,” Gripon said.
Gripon, who testified that he has 40 years experience as a psychiatrist, said Ms. Cargill knew right from wrong when she committed the offense.
“It boils down to a judgment, a poor choice. In my opinion, Ms. Cargill knows right from wrong — it was a choice she made (to kill Ms. Walker),” Gripon said.
In Tuesday's testimony, defense witness Dr. Jonathan Lipman discussed the effects of two medications the defendant had taken for depression and anxiety, Celexa and Klonopin, which is commonly given for panic attacks.
Defense attorney Jeff Haas questioned Lipman on Tuesday about the possible side effects for someone on those medications who stopped taking them.
“For someone with borderline personality disorder, the effects can include violence and impulsive misbehaviors — if someone is suddenly removed, the person will have greater anxiety than before treatment started, and it can cause tremor, rapid heartbeat and sweating,” Lipman said.
Lipman said discontinuing the drug suddenly can cause a “rebound of depression — often worse than when it began.” People who have borderline personality disorder are “exquisitely vulnerable” when ceasing the medications abruptly, Lipman said.
After more questioning from Smith County District Attorney Matt Bingham, Gripon said he had many patients taking those medications at the same dosage as the defendant, and had never seen the effects that Lipman described.
Gripon added that Ms. Cargill's use of steroids for two autoimmune conditions, lupus and Crohn's disease, had not caused her to commit murder.
Defense attorney Jeff Haas asked Gripon if he thought the defense was blaming Ms. Cargill's behavior on the disease. Gripon responded that he did not think that.
“No one here has said Ms. Cargill is insane,” Haas said to the doctor.
“I would agree,” Gripon said.
The doctor agreed that the environment in which one is raised can contribute to the development of a mental disorder. “It occurs because of nature and nurture,” he said.
Haas then asked the doctor about his assessment that psychotherapy does not always work so well in people with mental disorders.
“Could you have imagined when you started in medicine 44 years ago that there would be the advances in treatment (for mental and psychiatric disorders) that there is now?” Haas asked.
Gripon said that he couldn't have predicted such advances and that in five or 10 years, there may be a treatment for Ms. Cargill.
Dr. Tim Proctor, a Dallas-based forensic psychologist based in Dallas, said he mostly agreed with the diagnoses of Ms. Cargill by Dr. Antoinette McGarahan, another forensic psychologist who testified on Tuesday.
Dr. McGarahan said that the defendant has borderline personality disorder with anti-social and narcissistic tendencies.
“I think it reaches the full level of narcissistic personality disorder,” Proctor said. He added that he also did not think psychotherapy would be effective for someone with a personality disorder like Ms. Cargill's.