CENTENNIAL, Colo. - An expert on schizophrenia says she believes that the Aurora movie theater shooting can be traced directly to the gunman's mental illness and said she found no non-psychotic reasons for the mass murder that occurred on July 20, 2012. She also compared the gunman to the Unabomber in court Tuesday.
Dr. Raquel Gur saw the gunman, James Holmes, for a total of about 28 hours in six separate meetings.
She is the star witness in the defense's case. They are trying to convince the jury that the gunman should be found not guilty by reason of insanity for the shooting that killed 12 people and injured 70 others.
WATCH LIVE: Dr. Gur's testimony continues
The first meeting between Gur and the defendant was on Dec. 19, 2012, about a month after he was hospitalized at Denver Health. She also saw him on Feb. 9, May 2 and Nov. 18, 2013, before submitting her first report in June 2013.
After that, Gur met with the gunman two additional times – on Nov. 20 and August 5, 2014.
Gur also reviewed more information about the case, including the gunman’s notebook, a CAT scan of his brain taken in November 2012, reports from other doctors, jail records, writings he produced in jail and the entire 22-hour videotape of Dr. William Reid’s interviews at the Colorado Mental Health Institute in Pueblo.
"Gradually, [the delusions] became the preoccupation and force in his life," Gur testified.
-- The gunman's writings --
"Did you review the writings Holmes made, both in the notebook before the crime, and the writings from the jail house?" King asked. "Did you opine in your reports that you found in those writings evidence of both delusions and disorganized thinking?"
"Yes I did," Gur answered.
"The symbols he has presented in his writing and described, I have never seen before. They did have a bizarre and pervasive nature - in the sense that he was building on it. It was one step after another. And you can see how the delusion builds," Gur continued.
"Higher functioning people, namely those who have greater intellectual capacity, are the ones who come up with the most bizarre delusions."
"Why is that?" Public Defender Dan King asked.
"More elaborate thinking, much wondering about the nature of the universe, that most of us just don't think about," Gur answered.
"The only person that - one person that I've evaluated and evaluated the writing - most people do not produce extensive writing - was Ted Kaczynski, with his bizarre delusions. He had a similar level of intellectual functioning to Mr. Holmes."
-- The gunman's delusions --
"He said repeatedly, throughout the sessions, that he believed the world is coming to an end. I explored with him, 'Is it going to be like a meteor... that is going to hit the planet or anything like that?' And he said this was not how he [expected] the world to come to an end," Gur testified.
"Everybody is going to die anyway. The way I feel, that there is no purpose in life... and I'm going to put them out of their misery. Life is miserable for everybody," she paraphrased the gunman as saying.
"When I told him, 'Do you think all people feel like you? People enjoy life. People want to live.' His response was like... wide-eyed," Gur said.
"Did you explore with him... whether or not he acted out of anger when he went to the theater?" King asked Gur.
"Repeatedly. Repeatedly. 'Did anybody wrong you?... Were you mad with anybody? Did you want to take revenge?' And the answer was consistently 'No.'"
"Did you find a non-psychotic reason for the shooting?" King followed up.
"I did not."
"Do you have an opinion, as to whether but for this psychotic illness, there would have been a shooting at all?" King asked.
"I agree. There would not have been a shooting at all," Gur answered firmly.
-- The 'last straw' --
Gur said that the gunman's experience in graduate school was the "last straw." She testified that he perceived himself as a failure in the neuroscience program, which removed his school work from his available coping mechanisms. Additionally, she said, the vague references to his developing plan that he made to classmates like his ex-girlfriend made him feel that his "mission" was unavoidable.
“He was engulfed by the thought that the only way out was to complete his mission," she said.
"It was like a storm that in some ways he tried to stop, by seeking help with student health, by [seeking help from] his friends - who didn't do much about it except telling him 'it will be OK.'"
Gur said her opinion on the gunman did not change after repeated visits.
"His premise is still unshaken. He still believes this way today. So it is a very pervasive delusion," Gur stated.
"Dr. Gur is the defense's most important witness by miles,” said 7NEWS legal analyst Dan Recht. “Their case comes down to Dr. Gur and whether the jury buys her opinion."
-- The gunman’s MRI --
Gur was also asked to testify about potential physical indicators of the gunman’s declining mental health.
"What did the volumetric analysis of Mr. Holmes' MRI show, in your opinion?" King asked.
"His brain parameters, brain measures, were compared to 79 healthy people,” Gur explained. “There were several significant differences that were noted in his brain, compared to the normative sample."
- The right frontal orbital part of the brain (important for emotional processing and decision making) was close to 3 standard deviations below that of healthy people.
- The amygdala ("important brain hub for emotion processing") is 2 standard deviations below average.
- The right medial frontal lobe ("important for decision making") is 2 standard deviations below average.
"So there is evidence on the MRI that, when compared in a rigorous way to healthy people, he shows decrease in brain volume, in brain structures that are pertinent to emotion processing and to decision making," Gur concluded.