Lisa Nowak: Space Oddity

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It was one of the more unusual public relations nightmares to envelop NASA in the final rocky decade of its shuttle program. Four years ago this month Orlando police arrested astronaut Lisa Nowak after she assaulted (and, police believed, attempted to kidnap or murder) her rival for the affections of fellow astronaut William Oefelein (aka "Billy O").

As NASA launches its final three space shuttle missions, one of which the certifiably heroic Captain Mark Kelly is helming (Gabrielle Giffords's husband was Nowak's shipmate in 2006 and offered her moral support during the media frenzy that followed), 20/20 is giving over a solid chunk of its prime time Friday night to the story of Colleen Shipman, the woman Nowak attacked and the world forgot.

I viewed a complete pre-air of 20/20's story yesterday courtesy of ABC. Colleen proves to be one of Chris Cuomo's better interview subjects. She's clearly been waiting to tell her side, and it's time we give her a listen. Here's a clip.

When Nowak, disguised in an oversized trench coat, wig, and red glasses, chased down and pepper sprayed Shipman early February 5, 2007, Shipman believed Nowak intended to kill her. It's a reasonable assumption. Yet the court never considered it.

A personality disorder is not something you have, Dr. Siegel tells me. "It's something you are."
Nowak's first-rate lawyer succeeded in barring the cache of incriminating evidence police collected from any potential trial. That evidence included the steel mallet, knife, air pistol, gloves, and plastic tubing Lisa had ready in her car, all part of a mission she meticulously planned over three weeks, all the way down to her supply of high-absorbency space diapers (Nowak's 900-mile car trip from Houston to Orlando only required two). 

In the end Nowak got off with a plea bargain of two days of time served and a year's probation. Shipman got post traumatic stress disorder. Like Nowak, NASA booted Billy O.

Her lawyer's skill meant Nowak never had to use the insanity defense he had ready and waiting for her, preemptively filed in the Florida court system like an insurance policy. Nowak's insanity filing included an assessment by psychiatrist Richard Pesikoff, who offered up diagnoses including bipolar disorder, obsessive compulsive disorder, Asperger's syndrome and insomnia as factors diminishing her culpability for her actions. 

Paul Siegel, an assistant professor of psychology at Purchase College, isn't buying any of it. 20/20's piece features Dr. Siegel's opinion on the case, and I interviewed him this week. 

"If [Dr. Pesikoff] was paid by her defense lawyer, he needs to come up with some sort of diagnosis to support her defense," Siegel tells me. "I'm not getting paid anything."

Asperger's would leave a wake dating back to Lisa's childhood, and made it more unusual to see her marry and have children, or start that affair with Billy O in the first place. Bipolar disorder does not mesh well with the Navy flight schools where Lisa excelled and surely would have been apparent in her work at NASA.

Moreover, if Dr. Pesikoff planned to place this all on a psychotic episode, bipolar mania does not last for the weeks on end Lisa used to prepare her quest.

It may seem like anybody could disintegrate under the pressure cooker intensity that was Lisa Nowak's career. Her spaceflight seven months before attacking Colleen Shipman was only the second manned mission after the 2003 Columbia disaster. That event that shook NASA to its core.

For Nowak the explosion also meant losing her close friend, Columbia astronaut Laurel Clark. Nowak stepped up her game accordingly in the ratcheted-up flight training that followed in the heavily scrutinized post-Columbia era, all while stepping in to care for Clark's family in addition to her own. It would not be long before her marriage fell apart and she would begin her infamous affair with Billy O. 

So why doesn't temporary insanity explain what the high-flying Lisa Nowak tried to do that night to Colleen Shipman? As her lawyer said, clearly the whole episode was out of character. 

Not at all. Her character actually is the problem, says Dr. Siegel. 

"Typical mental disorders, like bipolar disorder or depression, are characterized by a pattern of sickness," Dr. Siegel says. "You can't concentrate, you're not eating and sleeping, etcetera."

A personality disorder is not something you have, Dr. Siegel tells me. "It's something you are."

Nowak doesn't have symptoms of illness. Rather, she has personality traits. Specifically, in the way she behaved toward Colleen Shipman, as you'll see on 20/20, Siegel identifies elements of antisocial personality disorder on display (she's not a perfect fit -- individual categories -- there are currently ten of them, don't describe most cases).

Personality disorders are disturbed patterns of thinking, feeling and behaving that come to the surface especially in relationships. In day-to-day life, in settings such as work, many people with personality disorders will behave normally. In Nowak's case, that meant grace under fire in 70-hour work weeks. 

But jealousy is a primeval emotion, a twisted concoction of anger and insecurity, that easily unboxes the beast waiting to get out. 

It's a cardinal feature of all personality disorders -- an unstable grasp of one's own identity. Who you are, how you act, can shift markedly with your surroundings.

"The Lisa Nowak who terrorized Colleen in the airport that night was not the astronaut and suburban supermom raising three kids who likes to grow African violets in her garden," Siegel assures me. "An entirely different side of her emerged, a much darker side."

It's easy to see why NASA didn't see it coming. NASA is more concerned with seeing astronauts manage the stress that comes with flying rickety old rockets than in whether they can move on in the midst of unrequited love. To identify Lisa's problem would require putting her under extreme emotional stress in a test specifically designed to pick up on signs of personality disorders. And no test is perfect.

Dr. Siegel trained at Weil Cornell under Paulina Kernberg who along with her husband Otto are central figures in the history of personality disorders. 

The collection of personality disorders, once termed "psychopathies," are among the more uncomfortable diagnoses in abnormal psychology. They're laden with the ethically fraught implication that a person with a personality disorder isn't so much "mad" as he is simply "bad." 

Most mental health professionals hold little hope for identifying an effective treatment in any particular case (dialectical behavior therapy and cognitive behavioral therapy are attempted). And that slim chance only happens if patients seek treatment -- most people with personality disorders don't see a problem. Lack of self awareness is part of their disorder.

Without truly objective assessments or lab tests, personality disorders are always ripe for scientific critique. They're currently the subject of one of the major revisions in the DSM-V, due out in 2013. Some suggest chucking the personality disorder rubric in favor of "adaptation disorder" to emphasize an ongoing struggle rather than a fixed facet of one's character.

Whatever we call it, mental health professionals know personality disorders when they see them. Unfortunately they're quite common -- 9.1% of Americans in any given year, according to NIH statistics. Dr. Siegel is sticking his neck out somewhat in offering us his diagnosis on the basis of publicly available information. He hasn't examined Lisa. He isn't privy to events in the rest of her private life.

But between the court records, Lisa's videotaped police interview, disclosed emails, and media interviews with just about everybody concerned but Lisa herself, Dr. Siegel has far more information about Nowak's case than some others.

"I see a lot of personality disorders whenever I go to the post office," he admits. 
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Ford Vox, MD, is a physician based in Atlanta, who specializes in caring for people with complex brain injuries. He has written for Newsweek, Slate, and the Los Angeles Times.

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