Diagnosis
During his life time Albert Fish was never officially given a diagnosis for what was wrong with him. However, right before his trial he was assessed one last time. The doctor who assessed him declared him insane, and stated that Fish should be able to plead insanity in court, in order to avoid the death penalty. When it came to the trial, the doctors remarks were ignored due to the fact that the public wanted Fish to be severely punished for the horrid acts he had committed. His insanity plea was therefore thrown out and he was given the death penalty.
Looking back on this case today we can admit that this man was disturbed and most likely had a major mental disorder. The disorder which his actions most clearly match up with is known as sexual sadism disorder. According to the DSM-V sexual sadism has two major factors that make it identifiable. The first of these factors is that the individual must experience recurrent and intense sexual arousal from physical or psychological suffering of another person or themselves. This arousal often manifests itself in fantasies, urges, or behaviors. The second factor is that the individual had acted on these urges with a nonconsenting person, and or these urges and fantasies cause clinical distress or impairment in social, occupational, or other important areas of function. In order for one to be diagnosed with sexual sadism disorder, they must meet both of these criteria. The disorder must also persist for around six months. There is usually multiple victims, but there may be only one who is affected. Prevalence of this disorder is unknown, but is estimated to be between 2% and 30%. It occurs in males more often then females, and on average this disorder shows up in women at an earlier age then in men. In most cases as the person ages the desires lose their effect.
Looking back on this case today we can admit that this man was disturbed and most likely had a major mental disorder. The disorder which his actions most clearly match up with is known as sexual sadism disorder. According to the DSM-V sexual sadism has two major factors that make it identifiable. The first of these factors is that the individual must experience recurrent and intense sexual arousal from physical or psychological suffering of another person or themselves. This arousal often manifests itself in fantasies, urges, or behaviors. The second factor is that the individual had acted on these urges with a nonconsenting person, and or these urges and fantasies cause clinical distress or impairment in social, occupational, or other important areas of function. In order for one to be diagnosed with sexual sadism disorder, they must meet both of these criteria. The disorder must also persist for around six months. There is usually multiple victims, but there may be only one who is affected. Prevalence of this disorder is unknown, but is estimated to be between 2% and 30%. It occurs in males more often then females, and on average this disorder shows up in women at an earlier age then in men. In most cases as the person ages the desires lose their effect.
How Does Fish Meet These Criteria
Fish met the first criteria when he was still young and before he knew what to make of the situation. He first experienced sexual arousal from physical and psychological pain when he was put into St. John's orphanage as a small boy. Fish also met the second criteria when he mutilated and killed Grace Budd as well as Billy Gaffney and Francis McDonnell. He often inflicted pain using weapons that he called his "instruments of hell". These instruments included things such as a meat cleaver, knives, a saw, and a nail studded paddle. He often asked children to paddle his buttocks with the nail studded paddle until he bled. In addition to this, he had an obsession with pushing needles into his body. While he was awaiting his trial he had an x-ray performed and it was found that he had about 28 needled lodged in his pelvic and groin region. This enjoyment of pain and willingness to take it out on others proves that Albert Fish is an individual who suffered from sexual sadism disorder.