Psychiatrist: Boelter writings show hallmarks of delusional disorder

Vance Boelter’s letter to the FBI about his alleged shootings of Minnesota lawmakers reveals grandiose beliefs about his importance in the world and suggests a delusional disorder, according to a former clinical director of the Minnesota Security Hospital.

Dr. Michael Farnsworth stressed that he didn’t know enough about Boelter from one letter to make a clinical diagnosis, but that the writing reminded him “of many letters of patients that I’ve evaluated over the years that were at the security hospital” in St. Peter. Farnsworth suspects attorneys will seek a psychiatric evaluation and try to use its conclusions in their criminal defense of Boelter, who is accused of killing Rep. Melissa Hortman and her husband, Mark, and shooting Sen. John Hoffman and his wife, Yvette. Boelter reportedly plans to plead not guilty.

“The whole letter smacks to me of a guy that’s got mixed delusions with grandiose and persecutory beliefs,” said Farnsworth, a forensic psychiatrist who consults with lawyers throughout the Midwest on mental health issues in criminal and civil cases.

A copy of Boelter’s handwritten letter was contained in a federal search warrant unsealed Tuesday and made publicly available. The letter appears to claim that he was targeting two unnamed state lawmakers because they were part of a conspiracy by Gov. Tim Walz to pressure Boelter into murdering Minnesota’s two U.S. senators to advance the governor’s political career. Boelter also wrote that the shootings were a “one person job” and tried to shield his family from blame.

Grandiosity is an outsized sense of importance, apparent in Boelter’s claims that he was pressured into murders to further the political careers of high-level Minnesota officials, the doctor said: “I’m an important person. I’ve been specially trained, I have a special relationship to important people and I’ve been tasked with important things to do, right?”

Persecutory symptoms include a sense of being targeted by specific people and obstructed from long-term goals, according to a summary published by the National Library of Medicine. They differ slightly from paranoid symptoms that involve a much broader range of mistrust and suspicion.

Boelter’s letter suggests clearer signs of a delusional disorder than other severe mental illnesses, such as schizophrenia, Farnsworth added. Patients with schizophrenia also have delusions, but they often have other symptoms that interfere with their daily lives and make it harder to maintain jobs and carry out plans. Writings of patients with severe, unmanaged schizophrenia are typically less coherent than Boelter’s letter, the doctor added.

Farnsworth’s career at the Minnesota Department of Human Services included serving as clinical director of the security hospital in St. Peter from 1991 to 1996 and as administrator of state-operated forensic services from 2000 through 2003.

The doctor recalled other patients who functioned day-to-day despite delusional disorders, including a woman with erotomanic symptoms who thought Prince was her boyfriend and would tell restaurants and stores to charge her bills to the famed musician. In another case, a schoolteacher tried to approach NBC broadcaster Tom Brokaw during an event in 1990 in Minnesota because she believed they were in a secret relationship that he couldn’t acknowledge.

“So that’s one kind of a delusional disorder that otherwise in her life she was functioning as a teacher and doing really fine,” she said.

Farnsworth said he didn’t know enough about Boelter to know if some claims in the letter were true, such as whether he received military training and traveled out of the country. (Prosecutors denied Boelter had any U.S. military training.) He added that delusional disorders aren’t all-or-nothing conditions and that pieces of someone’s past can contribute to their delusional beliefs.

About 20 in 100,000 people have delusional disorders in their lifetimes, according to the DSM-V diagnostic manual of psychiatric conditions.

Boelter’s letter reveals a “lack of contact with reality” but there are many possible triggers, including psychiatric disorders but also brain tumors, illicit drug usage, medication changes or life stressors such as financial ruin, said Dr. Chinmoy Gulrajani, a forensic psychiatrist at the University of Minnesota.

In the letter, Boelter shows signs of a “narcissistic injury,” an overwhelming pain or loss that causes someone to lose self-worth and focus blame for that loss, Gulrajani said.

The extensive planning of the shootings also reflects someone who got stuck, the doctor said. “They get so deeply ingrained in their thoughts that the thoughts almost gain an obsessive quality. What I mean by that is they keep ruminating about those thoughts. They’re not able to think about anything else.”

If the 57-year-old Boelter is clinically diagnosed with a delusional disorder, then Farnsworth said it is unlikely to be a new problem and that Boelter probably has had symptoms for years.

“I think it goes beyond just being an excuse or a story that he’s trying to justify his actions,” Farnsworth said. “You know, this very need for him to write ... is not different than all these people that are suicide bombers or other people that make decisions, and they want to make it public why they did what they did. And I think he’s doing the same thing here.

“Of course he believes that he’s special enough that the director of the FBI is going to rescue him and place him somewhere safe for debriefing on a conspiracy that he believes is occurring here in Minnesota.”