The Moors murderer Ian Brady carried a pen to use as a weapon against other patients, who he feared might "jump him" at his secure psychiatric hospital, his mental health tribunal has heard.
The 75-year-old has become "almost nocturnal" since having the pen confiscated, after staff feared he could lash out at others in Ashworth mental hospital in Merseyside.
Brady hopes to prove his sanity so that he can be transferred from Ashworth to a prison. For the past 14 years he has been force-fed via a feeding tube, which was visible hanging from his right nostril at his tribunal.
On Tuesday, the hearing, held in a room inside Ashworth and relayed by video to Manchester Civil Justice Centre, was given details of Brady's daily life inside the secure hospital and features of his behaviour.
Brady – who, along with his partner Myra Hindley, killed five children in the 1960s – has tried to "evade security" at Ashworth, the hearing was told. Since the confiscation of his pen last year he has been sleeping in during the day – often fully clothed – and then staying up all night writing letters and watching television.
"He now leads an almost nocturnal existence, only coming out at night time when other patients are not present," said Eleanor Grey, QC, for Ashworth hospital, which does not believe Brady should be transferred to jail.
She described Brady as contemptuous of his peers, showing anger that can erupt over minor matters and with a tendency to unleash verbal tirades against staff and other patients. He targeted specific individuals, both staff and patients, attempted to manipulate others and bent the rules of the hospital to suit himself. He would only deal with people "high up" the hospital hierarchy – consistent with his narcissistic personality disorder, the tribunal heard.
Brady claims he has faked psychotic episodes by "acting" in the past.
On Tuesday, the second day of what is expected to be an eight-day tribunal, forensic psychiatrist Dr Adrian Grounds was cross-examined by Grey.
Grounds, who was called by Brady's legal team as an independent witness, has interviewed Brady for 17 hours on 10 occasions in the past 10 years. He has told the tribunal that he does not believe Brady's mental illness is such that he needs to be treated in hospital (though he does not necessarily consider a move to prison "wise"). Instead, he believes Brady suffers from a "severe narcissistic paranoid personality disorder", which is untreatable.
Grey told the tribunal that Brady does not always tell the truth – either because he is deliberately lying or is hallucinating. She referred to one incident last year when Brady complained that another patient had been deliberately slamming the door of a locker and making "pig noises", which he was certain were directed at him. But when staff investigated, a nurse present said the other patient was "doing no more than reading a magazine".
She suggested to Grounds that Brady's claim was "not only inaccurate but also delusional". Grounds accepted that it was certainly "a paranoid response". But he insisted that such episodes were relatively rare. He said Brady's personality had not changed much since his conviction in 1966.
"The descriptions of Mr Brady right at the beginning when he was in prison are of someone who was aloof, disinterested in others, didn't have close relationships and I think in prison he would in effect isolate himself from interaction with others … these are aspects of his personality characteristics. Having seen him over 10 years I've not seen evidence of a deterioration of the typical kind you can see in schizophrenia."
The tribunal heard that Brady goes to great lengths to avoid appearing "weak".
In May last year after Brady was feeling physically unwell, he was noted saying about his fellow patients: "In these penal shitholes, any sign of weakness and this lot will jump you."
He had never been assaulted on the ward, the court heard.
After suffering a seizure last July, he remarked that he did not want to appear weakened if he had to walk down the hospital corridor in full sight of other patients following treatment.
Hospital notes recorded him saying: "If I have to, I will never let them see me in pain. I will act as if I have not a care in the world."
Grounds said Brady had acted similarly in prison and that "this is a man who is not essentially fearful of others". But, he added, it would be entirely rational for Brady to be scared of his fellow patients: "It is an entirely reasonable fear to have in a high security hospital. He is an elderly man who is unwell at times."
The tribunal also heard more details of Brady's 14-year hunger strike, which Grounds argued was not a suicide bid but a controlled protest. He said Brady now administered his own feeds rather than being force-fed: "The reality is that he is not force fed in the sense that he is being restrained and administered feed against his will. He has always been co-operative with the process … He has been more flexible with his eating patterns to the extent that the ward staff feel they don't need to check that two feeds are being taken on a regular basis."
He added: "His refusal to eat has been a very longstanding and determined protest at how he was treated. It is consistent with a personality disorder because it is part of a pattern of utterly determined pursuit of a cause, a complaint, a protest which he has done from time to time and indeed did in his years in prison before he came here."
Brady showed "masochistic" levels of self-control, said Grounds: "Mr Brady is an extraordinarily self-disciplined man, who will engage in battles with resoluteness that is remarkable … The word masochistic has been used to describe the degree to which he will suffer pain without showing any compromise, without backing down. His ability to suffer deprivations is quite high."
Grounds said Brady would not act in prison without thinking through the consequences: "He is a very astute observer, strategist, calculator. He will be thinking through the consequences of what his behaviour is. He puts a lot of thought into the consequences. This is someone with an ability to weigh up what might happen to him if he misbehaves seriously in prison. He might not care about the consequences, for example of being segregated. He is a stoical man who weighs things up."
Brady and Hindley lured children and teenagers to their deaths, with the victims sexually tortured before being buried on Saddleworth Moor above Manchester.
Both were jailed for life at Chester assizes in 1966. Hindley died in jail in November 2002 at the age of 60.
• This article was amended on 20 June 2013 to correct the spelling of Eleanor Grey, from Gray.
