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Monday 18 December 2017

Graham Dwyer Trial: Elaine O'Hara had been suffering from 'obsessional' fantasy about being restrained since age of 12 - psychiatrist

First spoke to doctors about 'play in head' while in her teens, court told

Graham Dwyer (left) and Elaine O'Hara
Graham Dwyer (left) and Elaine O'Hara

ELAINE O’Hara had been suffering from an “obsessional” fantasy about being restrained or imprisoned since the age of around 12, the Central Criminal Court has heard.

One of her treating psychiatrists, Dr Matt Murphy said notes on her treatment showed she first spoke to doctors about a “play in her head” in her teens in 1992 but the obsession went back much earlier.

Dr Murphy was giving evidence in the trial of architect Graham Dwyer today.

Mr Dwyer (42), of Kerrymount Close, Foxrock, is pleading not guilty to the murder of Ms O’Hara (36) at Killakee, Rathfarnham on August 22, 2012.

Read More: Elaine told friend she met man who 'liked to cut her', court hears

Ms O’Hara, a childcare assistant from Killiney, was last seen alive near Shanganagh Cemetery in Shankill that day.

Her remains were found by a dog walker in undergrowth in the Dublin mountains on September 13, 2013.

The prosecution maintains Mr Dwyer killed her for his own sexual gratification.

Read More: 'Lonely' Elaine thought she 'wasn't born for life'

Dr Murphy said he took over Ms O’Hara’s care after the death of her previous psychiatrist, Professor Anthony Clare in 2007.

He referred to Dr Clare’s notes on her earlier care while giving evidence to the jury.

Read More: Graham Dwyer Trial: Elaine O'Hara felt she 'wasn't born for life', that nobody liked her and she was a bad person, doctor noted in medical records

Dr Murphy said Ms O’Hara was first seen at St Edmundsbury Hospital by Dr Clare on August 5, 1992.

She presented with persistent obsessional thoughts or fantasies but it was a little unclear exactly what she meant.

She talked a good deal about a play in her head and there was “some uncertainty about how to interpret that” in psychiatric terms.

She had been experiencing this from the age of about 12, the notes stated.

Read More: Graham Dwyer Trial: Seventh man tells court of his contact with Elaine O'Hara through 'alternative' website

Sean Guerin SC, prosecuting, asked Dr Murphy what the details of the thoughts or play were.

“I think it concerned being restrained or being imprisoned, she had acted out those thoughts to some degree herself,” he said.

She received regular outpatient care for a time after that for a number of years and had therapy.

Her second admission was some years later, in 2000. She had had cognitive behavioural therapy, but more so in recent years.

She had been on a combination of anti-depressant medication and major tranquilisers.

Read More: Graham Dwyer trial: Elaine contacted six men on sites for 'alternative' sexual tastes, jury told

Dr Murphy explained that this was because there was initial uncertainty about her diagnosis and it had been thought there had been a possibility that there was an emerging psychotic illness.

He explained that psychosis was where someone might lose touch with reality and have delusions and hallucinations.

Read more here: Graham Dwyer Trial: Elaine O'Hara felt she 'wasn't born for life', that nobody liked her and she was a bad person, doctor noted in medical records

This sometimes emerged in the late teen years, Dr Murphy said. Professor Clare had kept a watching brief on whether the process of psychosis was actually happening.

As time progressed, however, the feeling was that what she was suffering from was nearer to a personality problem.

He told Mr Guerin there was never a diagnosis of psychosis and the tranquilisers were used because of her state of extreme agitation.

“I think the diagnosis that we all would have concurred with, certainly in the latter part of our acquaintance with Elaine was borderline personality disorder,” he said.

He explained this was where someone registered emotions very acutely and strongly, and might have low self esteem and think themselves to be worthless and valueless.

Self harm might be a feature of this and it could overlap with depression, Dr Murphy said.

The trial continues before Mr Justice Tony Hunt and a jury of seven men and five women.

Yesterday, the jury heard Ms O’Hara told a friend she was having a relationship with an architect she met online who liked to cut her about a year before she disappeared.

The friend, Edna Lillis said she warned Ms O'Hara that she was playing a "dangerous game."

The jury at the Central Criminal Court also heard Ms O'Hara told a nurse at St Edmundsbury Hospital  the day before she disappeared that she had met a man with an interest in bondage who was "constantly coming to her apartment."

The jury heard from her medical records that Ms O’Hara felt she “wasn’t born for life,” that nobody liked her and she was a bad person. She was admitted to a mental health hospital 14 times over the years and on one occasion, she described having a “play in her head in which she was being persecuted,” the jury heard.

The records described Ms O’Hara as having a “very lonely life with no friends.”

The trial continues before Mr Justice Tony Hunt and a jury of seven men and five women.

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