A forensic psychiatrist called by prosecutors delivered a sharp rebuttal to the defense’s argument that Lindsay Clancy was experiencing postpartum psychosis when she killed her three children, telling jurors that her actions and words suggested she understood the difference between right and wrong.
Dr. Avram Mack took the witness stand Friday, Aug. 21, as the prosecution began presenting rebuttal testimony in Clancy’s closely watched Massachusetts murder trial. His testimony came shortly after the defense rested its case with psychiatrist Dr. Phillip Resnick, who described Clancy as “frankly psychotic” and said she may have been experiencing command hallucinations at the time of the killings.
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Mack reached a very different conclusion.
After reviewing Clancy’s medical history, behavior and circumstances surrounding the January 2023 deaths, Mack testified that he did not believe she was experiencing psychosis when she strangled her children.
Instead, he said Clancy appeared to be suffering from a major depressive episode while still retaining the ability to understand what she was doing and recognize that it was wrong.
That distinction is at the center of the trial.
Clancy, 36, does not dispute that she killed her children — 5-year-old Cora, 3-year-old Dawson and 8-month-old Callan — at the family’s home in Duxbury, Mass., on Jan. 24, 2023. Her defense, however, argues that she was not criminally responsible because severe postpartum psychosis, combined with psychiatric medications, had fundamentally altered her ability to understand reality and control her actions.
Prosecutors have rejected that explanation and have argued that Clancy deliberately carried out the killings.
Mack’s testimony was intended to challenge the defense’s central narrative.
One of the most significant moments came when Mack discussed words Clancy allegedly spoke while killing her children.
According to Mack, Clancy said, “Go to God.”
The psychiatrist told the court that he viewed the statement as evidence that Clancy understood something important about the children she was killing: that they were innocent.
In Mack’s assessment, the words suggested that Clancy understood the nature of her actions rather than being completely disconnected from reality.
He also characterized the killings as methodical, arguing that the circumstances did not fit what he would expect from someone who was completely psychotic and unable to distinguish reality from delusion.
Mack pointed to Clancy’s behavior in the hours leading up to the deaths as another important factor.
He testified that Clancy had interacted normally with people before the killings and had even taken Cora to a doctor earlier that same day.
“There was the ability to act normally,” Mack said.
For the prosecution, that behavior is significant because it suggests that Clancy could function appropriately and make decisions shortly before the killings.
The defense has presented a very different picture of those final days.
Throughout the trial, defense witnesses have described Clancy as a woman whose mental health deteriorated dramatically during late 2022 and early 2023. Her attorneys have argued that she was experiencing increasingly disturbing thoughts, hearing voices and becoming overwhelmed by a psychiatric condition associated with childbirth.
Resnick, the defense’s final witness, testified earlier Friday that he believed Clancy experienced what he called “command hallucinations” instructing her to kill her children and herself.
He compared her experience to being controlled by someone else.
“It was almost like she was a puppet and someone else was pulling the strings,” Resnick testified.
His testimony provided one of the strongest statements yet supporting the defense’s claim that Clancy was psychotic and therefore unable to appreciate the wrongfulness of her actions.
Mack directly challenged that interpretation.
While he acknowledged that Clancy showed signs of a serious depressive episode around the time of the killings and suicide attempt, he said depression alone did not mean she had lost the ability to distinguish right from wrong.
His conclusion was that Clancy remained capable of understanding her actions despite her mental illness.
The testimony also exposed the deep divide between the psychiatric experts presented by the two sides.
The defense has emphasized Clancy’s reported hallucinations, her psychiatric treatment and her apparent deterioration before the killings. Prosecutors, meanwhile, have focused on her behavior, interactions with other people and actions immediately surrounding the deaths as evidence that she remained aware of what she was doing.
The disagreement became particularly tense during cross-examination.
Clancy’s attorney, Kevin Reddington, questioned Mack about his professional qualifications, including his experience working primarily with adolescents.
Mack pushed back, explaining that he had broader expertise and had worked with approximately 10 women experiencing postpartum psychosis since 2001.
Reddington also questioned Mack about the terminology surrounding postpartum psychosis.
At issue was the fact that the Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM, does not currently list postpartum psychosis as a standalone psychiatric disorder.
The defense has repeatedly relied on the condition as part of its explanation for Clancy’s behavior, while prosecutors have challenged whether the evidence establishes that she was actually psychotic at the time of the killings.
Mack remained on the witness stand when proceedings ended Friday.
The prosecution is expected to continue presenting rebuttal testimony when court resumes Monday. Two witnesses who appeared on the prosecution’s Friday witness list were not called that day.
Once rebuttal testimony is completed, the case is expected to move toward its final stage: closing arguments.
The jury will then have to weigh two dramatically different explanations for what happened inside the Duxbury home in January 2023.
The defense says Clancy was overwhelmed by a devastating psychiatric illness, hearing voices and acting under the influence of delusions she could not control.
The prosecution argues that she was depressed and struggling, but that she nevertheless understood what she was doing and knew that killing her children was wrong.
Mack’s interpretation of the words “Go to God” could therefore become an important part of the prosecution’s effort to persuade jurors that Clancy retained that understanding.
The final decision will ultimately rest with the jury, which must determine whether Clancy was criminally responsible for the deaths of her three children.
