Holmes' defense team opened its case Thursday showing jurors a six-minute video of the theater shooting suspect falling on November 11, 2012, almost four months after he opened fire on a crowded movie theater in Aurora, killing 12 people and wounding 70 others.
Holmes admits to being the shooter but has pleaded not guilty by reason of insanity.
Defense attorney Daniel King suggested the video helps demonstrate Holmes' mental illness.
Several doctors who took the stand during the prosecution's case alluded to a psychotic break Holmes had in jail during November 2012 that led to him being hospitalized and resulted in treatment with anti-depressant and anti-psychotic medications.
Jason Frank, a registered nurse at the Arapahoe County Jail who tended to the medical and psychiatric needs of inmates, was asked to review the video to make sure Holmes did not injure his neck during the fall. He testified that Holmes was not seriously injured.
During cross-examination, Frank also testified that besides that incident in November, Holmes had acted like "any other inmate" and that his behavior was "nothing out of the ordinary."
The defense's next witness, however, suggested otherwise.
Dr. Jonathan Woodcock, a neurologist and psychiatrist, did a mental evaluation of Holmes just days after his arrest.
"I was asked to give an initial clinical impression," Woodcock testified. "It was my impression that he was mentally ill. That he was severely mentally ill. And that he had a psychotic mental illness. That is he had an illness which caused considerable disruption in his ability to understand reality."
Prosecution goes after credibility of witness
Immediately, the prosecution attempted to poke holes in Woodcock's credibility.
District Attorney George Brauchler questioned his expertise in forensic psychiatry, noting, among other things, that his current work specializes in treating Alzheimer's, dementia and Huntington's disease.
"Not a single one of those things is present in this case," Brauchler prodded.
"That's correct," answered Woodcock.
Ultimately, the defense succeeded in having the court admit Woodcock as an expert witness in neurology and psychiatry.
Woodcock told jurors that Holmes' psychosis was evident in two ways: Holmes had delusional thinking and emotional suppression. The latter was particularly significant, he testified.
"He had this psychosis represented by these delusions and at the same time he was suppressing his emotions so he was not either experiencing or expressing them in a normal way." Woodcock said.
"I knew about the crime and how horrific that was and so that made this mismatch between how he was expressing emotion and what I had heard about what he had done even more remarkable, and led me to the conclusion that this was a very serious disorder."
Thoughts of suicide and murder
Woodcock also testified that Holmes had symptoms of mental illness at an early age, as young as middle school. That's when he reportedly began having severe social anxiety and thoughts about killing himself and, eventually, other people.
"He didn't like either the suicidal or the homicidal thoughts, but the suicidal thoughts were, really from this early age, pretty intolerable to him. And what he discovered was that if he thought about killing other people rather than killing himself, the severity of the bad feelings would be less," Woodcock said.
King asked, "Is it significant that those thoughts began at such an early age when he was developing?
"Yes. I think it both collaborates and supports the diagnosis but it also puts him at risk for a more serious presentation of illness," Woodcock answered.
"Any doubt in your mind that Mr. Holmes was psychotic just four days after the shooting?" King asked.
"No," replied Woodcock.
Woodcock's assessment, while not a formal sanity examination, offers a conflicting viewpoint compared with the two court appointed psychiatrists who testified that Holmes was legally sane at the time of the crime based on their mental evaluations.
Which expert the jury believes could ultimately determine Holmes' fate in this capital punishment case.