THE GRAHAM DWYER trial has heard that Elaine O’Hara began having persistent, obsessional thoughts and fantasies at the age of 12.
As an adult, she had allowed someone to inflict harm on her, but had asked this man to stop some years before Mr Dwyer is alleged to have murdered her.
The jury heard the evidence from the psychiatrist who treated her from 2007 until the day she went missing in August 2012 when, he said, she gave no indication of suicidality.
Mr Dwyer (42) is charged with Ms O’Hara’s murder at Killakee, Rathfarnham on 22 August 2012, hours after she was discharged from a mental health hospital.
The Cork-born father of three of Kerrymount Close, Foxrock, Dublin has pleaded not guilty to murdering the 36-year-old childcare worker on that date.
Dr Matt Murphy of St Edmundsbury Hospital in Lucan testified today on the 16th day of Mr Dwyer’s trial at the Central Criminal Court.
He said he became Ms O’Hara’s treating psychiatrist in late 2007 following the death of her previous psychiatrist, Professor Anthony Clare. She had first presented to Professor Clare in August 1992 with persistent, obsessional thoughts and fantasies.
The court heard that she had been getting these thoughts from the age of the 12 and also had a play in her head.
She was concerned about being restrained and imprisoned and she acted out those thoughts herself to some degree. She saw Professor Clare and a number of other therapists and had cognitive behavioural therapy in more recent years.
Pregnancy
Over the years, she was prescribed a combination of anti-depressants and tranquillisers.
By her late teens, there had been a little bit of concern about her diagnosis and the gradual emergence of a possible psychotic illness.
However, Dr Murphy said she had never been diagnosed with psychosis and the tranquillisers were used because of her agitation.
“I think the diagnosis we’d all have concurred with would have been borderline personality disorder,” he said, explaining that this illness involved extremely low self-esteem, feeling worthless and valueless.
He said that self-harm could also be a feature and that patients with the disorder could get extremely depressed. This was the case with Ms O’Hara.
However, the witness said that there were also indications of harm being inflicted by others in a context where she participated. He described this as masochistic behaviour, which was when a person had pain inflicted on him or herself.
He said that she had spoken about this in an indirect and evasive way and that the first mention of it had been to Professor Clare in late 2006.
She had reported from April 2008 that she had told the man in question that she wanted to desist from the practice. By February 2009 she reported that it had stopped but that she felt like contacting the man again.
In July 2011, she reported that she’d been pregnant but that she had lost the baby at four or five weeks.
Relapse
Dr Murphy said that by 2012 she was on a reduced dose of medication and was receiving cognitive behavioural therapy.
“I would have thought she was doing pretty well,” he said. “Particularly in the last year of her life, there was a significant improvement.” He said he could see distinct progress in her that year.
“There was a sense that she was maturing and able to manage her moods and feelings in a more capable way,” he said.
However, he said she phoned the hospital in July 2012 to say she felt depressed and was thinking about suicide. He made the decision to admit her. He said he didn’t want her to feel rejected by the hospital as she was prone to feelings of rejection.
The doctor said she was pretty calm as her stay progressed. Over her four weeks there, she was in much better mood, he said, ‘probably as good as I have ever seen her’.
He said that she was planning the immediate future and had plans to get back to work and on with her life.
Asked if there was any indication of suicidality at her discharge on 22 August, he replied: ‘No, none’.
“She was talking in different terms about life, doing things, engaging in life,” he said, adding that there was no talk of self-harm.
Discharge
Under cross examination by the defence, Dr Murphy agreed that her 14 admissions to the hospital over the years were more than the average number.
He agreed that, following her disappearance, he told Gardaí that her final admission was ‘something of an emergency in that Elaine had suicidal thoughts’.
When asked about the triggers for self-harm, Ms O’Hara had said she just wanted to mark her mental pain ‘by it becoming physically real’.
“Some people get relief from mental anguish by replacing it with physical pain,” explained the doctor.
He was asked would the risk to patients be higher on discharge.
“The immediate aftermath is seen as a high-risk period,” he confirmed.
However, he said that what was impressive in Ms O’Hara’s case was that she had immediate plans in place to do certain things. He said he thought the immediate risk was low.
“It was the commonly-held view in the hospital that she was making ground,” he said.
Meeting people over the internet
A clinical nurse manager from the hospital also gave evidence of his dealings with Ms O’Hara.
Damien Lanigan agreed that, years ago, she had mentioned soliciting someone to harm and possibly kill her. He was also aware that she previously had an interest in the S&M lifestyle and had met other parties to engage in sexual practices.
He said he saw no evidence of self-harm during her 2012 stay in hospital and that her father used to visit her there.
Under cross examination by the defence, he confirmed that he was aware that Ms O’Hara had taken part in strange sexual practices with strangers. He was aware that she had arranged to meet these people over the internet.
‘Graham’s phone number’
The jury also heard that a phone number attributed to a person called Graham was stored on Ms O’Hara’s laptop.
Detective Garda Eimear Nevin of the computer crime investigation unit said she examined a forensic copy of the hard drive of Ms O’Hara’s Apple laptop in September 2013.
She testified that she used special software to look at the computer’s calendar entries and identified one of interest from 30 June 2011.
The jury was then shown screen shots of the entry as Ms O’Hara would have seen it on her screen.
It read: “Graham’s phone number,” followed by a number beginning with the prefix 083.
The trial has heard that Ms O’Hara was last seen in Shanganagh, South Dublin on the evening of 22 August. Her skeletal remains were discovered at Killakee on Friday, 13 September 2013. A cause of death could not be determined.
The trial continues on Friday before Mr Justice Tony Hunt. The jury of five women and seven men is excused until Monday.
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