A psychiatrist says the man who killed 10 people in Toronto's van attack has never shown aggression towards others, just himself.
Dr. Alexander Westphal is testifying in the defence of Alek Minassian, who has pleaded not guilty to 10 counts of first-degree murder and 16 counts of attempted murder.
Westphal is expected to testify that Minasisan is not criminally responsible for his actions on April 23, 2018, due to autism spectrum disorder.
He says Minassian's only known aggression in life was when as a young child he would thrash his head against the wall.
Westphal says the 28-year-old from Richmond Hill, Ont., was terrified of girls and women.
Minassian has admitted to planning and carrying out the attacks so with his state of mind at the time is the sole issue at trial.
"Given that he was completely not aggressive in other contexts, the only form of aggression was his own hitting, hitting his head against the wall," Westphal said. "He never exhibited aggression towards others."
Westphal, a U.S. psychiatrist with a specialization in autism, said Minassian struggled socially and was terrified of women and girls.
Minassian was diagnosed at five years old with pervasive developmental disorder, which is now considered part of autism spectrum disorder.
In school, Minassian would see girls and jump back, saying "don't hurt me, don't hurt me," Westphal testified.
He was so uncomfortable around women that he could not give his order at a restaurant if the wait staff was female, Westphal said.
Minassian has never had a relationship with a woman, Westphal testified.
"The closest he got to any romantic relationship was a girl who he got her phone number from and when he texted her, she didn't text him back," Westphal said.
One of Minassian's stated motivations for the attack is retribution against society for years of rejection by women. He has told various psychiatrists as well as the police that he became entangled with the so-called "incel movement" online where men discuss their hatred of women.
Incels believe they are on the lowest rung of society and large-scale attacks would destabilize society, which would then give incels the chance to come out on top.
Another psychiatrist previously testified that Minassian did not show any anger toward women and, at one point, recanted his hatred towards women as his motivation.
Minassian has also said he was motivated by the notoriety an attack would bring as well as "extreme anxiety" related to starting a new job.
Minassian was teased and bullied throughout school, the psychiatrist said.
"Being picked on because of his disability is something that occurred throughout his childhood," Westphal said.
"It’s one of the things he's identified in as much he's identified a causal reason for his actions."
One of the earliest signs that Minassian had autism came in the form of his lack of eye contact.
He'd eventually learn to make eye contact after being taught.
"His eye contact is poorly modulated," Westphal said.
"When you're with him, it's like he's staring you down."
He also did not smile much, Westphal said.
"He didn't smile socially, it was just not part of his facial repertoire."
Last week, Westphal refused to testify if court didn't seal his videotaped interviews with Minassian and play the clips to court in secret.
The judge begrudgingly gave in to sealing the videos after the psychiatrist warned they could incite more violence, but will allow journalists to watch them.