TUCSON, Ariz. ? The man accused of wounding Rep. Gabrielle Giffords in a deadly shooting rampage understands that he has killed people, feels remorse about it and can be restored to mental competency within eight months, a psychologist testified in federal court Wednesday.
Dr. Christina Pietz has been treating Jared Lee Loughner at the Missouri prison facility where a judge sent him four months ago after finding him mentally unfit to stand trial.
She told U.S. District Judge Larry Burns that Loughner likely has suffered from schizophrenia for several years but has improved under her treatment.
Pietz said that when Loughner first arrived at the Springfield, Mo., facility, he would tell her that Giffords was dead, even though he was shown a video of the shooting.
"He believed it had been edited" by law enforcement, Pietz said.
Now that the 23-year-old is being forcibly medicated with psychotropic drugs, "he knows that she (Giffords) is alive."
"He is less obsessed with that," Pietz testified. "He understands that he has murdered people. He talks about it. He talks about how remorseful he is."
She said Loughner remains on suicide watch but is no longer having auditory hallucinations. Extending his stay at the Missouri facility by eight months will give him enough time to become mentally fit for trial, Pietz told the judge.
"He has already made improvements, and he has only been on medication for 60 days," she said.
Burns will decide at the hearing whether it's likely Loughner can be made competent to stand trial, and whether to grant prosecutors' request to extend Loughner's stay at the Missouri facility by eight months.
Loughner's attorneys argue prosecutors have failed to prove it's probable Loughner's mental condition can be improved so that he can go to trial.
Burns also may discuss whether to hold another hearing on Loughner's forcible medication.
As Pietz testified, Loughner sat expressionless with his attorneys as he listened quietly. He looked thin and pale and was wearing a white T-shirt and khakis. He was sporting a short haircut and sideburns.
Two federal marshals stood behind him.
The hearing was Loughner's first court appearance since an angry, loud outburst got him kicked out of a May 25 competency hearing.
Loughner interrupted that hearing by saying: "Thank you for the free kill. She died in front of me. Your cheesiness."
Federal marshals whisked him from the courtroom, and he watched the rest of the hearing on closed-circuit TV from a separate room.
The judge required Loughner's presence at Wednesday's hearing, even though Loughner's lawyers objected and argued traveling would be disruptive for their mentally ill client.
Loughner wanted to attend the hearing so he could see his parents, who live in Tucson.
Several survivors of the shooting spree were also at Wednesday's hearing, including Giffords staffer Pam Simon and Daniel Hernandez, the intern who helped Giffords at the scene. Also in the courtroom was Giffords spokesman Mark Kimble, who stood only a few feet from Giffords when she was shot.
Loughner has pleaded not guilty to 49 charges stemming from the Jan. 8 shooting that killed six and injured 13, including Giffords.
If Burns decides to extend Loughner's stay in Missouri, the judge likely will also discuss whether to hold another hearing to determine if Loughner should continue to be forcibly medicated in a bid to make him mentally fit for trial.
Prison officials have forcibly medicated Loughner with psychotropic drugs after concluding at an administrative hearing that he posed a danger at the prison.
Loughner's lawyers have been seeking to have the judge, rather than the prison, decide whether Loughner should be medicated.
Loughner was first forcibly medicated between June 21 and July 1, but an appeals court temporarily halted the medications after defense lawyers objected.
The forced medication resumed July 19 after prison officials concluded Loughner's psychological condition was deteriorating, noting he had been pacing in circles near his cell door, screaming and crying for hours at a time.
Defense lawyers have repeatedly asked Burns and a federal appeals court to halt the forced medications.
Loughner's medications include the sedative Lorazepam, the antidepressant Wellbutrin and Risperidone, a drug used for people with schizophrenia, bipolar disorder and severe behavior problems.
Pietz has said Loughner has recently made progress in making more eye contact with people, improving his personal hygiene and pacing less.
But defense attorneys said none of the changes confront Loughner's delusions and noted he remains on suicide watch.
If Loughner is later determined to be competent enough to understand the case against him, the court proceedings will resume. If he isn't deemed mentally fit at the end of his treatment, Loughner's stay at the facility can be extended. There are no limits on the number of times such extensions can be granted.
If doctors conclude they can't restore Loughner's mental competency, the judge must make another decision. If he finds there's no likelihood of Loughner being restored to competency, he can dismiss the charges.
In that case, state and federal authorities can petition to have Loughner civilly committed and could seek to extend that commitment repeatedly.
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