United States v. Byron Antone , 742 F.3d 151 ( 2014 )


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  •                                PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 12-2400
    UNITED STATES OF AMERICA,
    Petitioner - Appellee,
    v.
    BYRON NEIL ANTONE,
    Respondent - Appellant.
    Appeal from the United States District Court for the Eastern
    District of North Carolina, at Raleigh.   Louise W. Flanagan,
    District Judge. (5:07-hc-02042-FL-JG)
    Argued:   December 11, 2013                Decided:   February 4, 2014
    Before GREGORY, DAVIS, and WYNN, Circuit Judges.
    Reversed and remanded with instructions by published opinion.
    Judge Davis wrote the opinion, in which Judge Gregory and Judge
    Wynn joined.
    ARGUED: Eric Joseph Brignac, OFFICE OF THE FEDERAL PUBLIC
    DEFENDER, Raleigh, North Carolina, for Appellant.        Michael
    Bredenberg, FMC BUTNER FEDERAL MEDICAL CENTER, Butner, North
    Carolina, for Appellee.   ON BRIEF: Thomas P. McNamara, Federal
    Public Defender, G. Alan DuBois, Assistant Federal Public
    Defender, OFFICE OF THE FEDERAL PUBLIC DEFENDER, Raleigh, North
    Carolina, for Appellant.      Thomas G. Walker, United States
    Attorney, R.A. Renfer, Jr., Joshua B. Royster, Assistant United
    States Attorneys, OFFICE OF THE UNITED STATES ATTORNEY, Raleigh,
    North Carolina, for Appellee.
    DAVIS, Circuit Judge:
    Respondent-Appellant Byron Neil Antone appeals the district
    court’s order of his civil commitment under the Adam Walsh Child
    Protection and Safety Act of 2006 (“the Walsh Act”), codified at
    18 U.S.C. §§ 4247-48. Four days before he was to be released
    from    federal      prison,    an    official       of    the   Federal       Bureau   of
    Prisons certified Antone as a sexually dangerous person eligible
    for civil commitment. Upon referral of the ensuing proceedings
    by the district court, a federal magistrate judge held a three-
    day    evidentiary     hearing       and    thereafter       issued   a    report       and
    recommendation that Antone should not be found to be a sexually
    dangerous person. The district court adopted the majority of the
    magistrate judge’s factual and credibility determinations, but
    it ultimately found that the Government had satisfied its burden
    under    the   Walsh     Act    to    prove      that      Antone   was    a    sexually
    dangerous person, and it committed him to civil custody.
    Upon    our    careful    review         of   the    appellate      record,      we
    conclude that the district court lacked sufficient evidence to
    find that Antone met the standard for civil commitment under the
    Walsh Act. Specifically, the Government did not present clear
    and    convincing     evidence       that   Antone’s       mental   illnesses      would
    cause him to have serious difficulty refraining from sexually
    violent conduct. Accordingly, we reverse.
    2
    I.
    A.
    Byron Neil Antone, now forty-one years old, was born in and
    raised on the Tohono O’odham Indian Reservation in south central
    Arizona. 1 Until age nine or ten, Antone was raised by his mother;
    after     that    point,    he   resided       with    his     grandmother     and   his
    godmother.
    Antone’s        mother   and     grandmother      were    heavy    drinkers    and
    Antone was often neglected and verbally and physically abused as
    a child. At seven years old, Antone was on several occasions
    sexually abused by his aunt, who was a teenager at the time. By
    the time he was fifteen years old, he had had sexual intercourse
    with at least two adult women, one of whom was twenty-six.
    Antone had serious behavioral issues as a child, which led
    to   school      expulsions      and    stints    in     juvenile       detention.   He
    dropped out of high school in ninth grade. He did not maintain
    steady     employment          thereafter,       although        he     was    employed
    seasonally       as   a   firefighter     with    the    United       States   Forestry
    1
    These facts are a summary of the pertinent factual
    findings set forth in the magistrate judge’s memorandum and
    recommendation (“M&R”), which was wholly adopted by the district
    court. To the extent conflicting inferences might be drawn from
    the magistrate judge’s findings, because the Government was the
    prevailing party before the district court, we construe the
    evidence presented before the magistrate judge in the light most
    favorable to, and consistent with, the ultimate determination of
    the district court, whose order we review.
    3
    Service and had attended specialized training classes in that
    field.
    In    1991,      when    Antone    was   nineteen    years    old,   he    was
    arrested and charged with sexual misconduct with a minor, sexual
    abuse,     and   contributing      to    the   delinquency   of    a   minor.    The
    arrest related to two sexual acts with a sixteen-year-old who
    was Antone’s girlfriend at the time. The first sexual act was
    consensual, but the second was forcible rape. Antone pled guilty
    to the sexual abuse charge in the Judicial Court of the Tohono
    O’odham Nation (“tribal court”) and served about six months in
    jail.
    In 1997, tribal authorities charged Antone with threatening
    and disorderly conduct. He admitted to rubbing the buttocks of
    his cousin, then twenty-one years old, while she was sleeping on
    the couch. He was sentenced to 60 days in tribal jail.
    From 1998 to 1999, Antone was charged by tribal authorities
    for   several     acts    of    sexual   misconduct,      which    resulted     in   a
    consolidated plea agreement and tribal judgment entered on March
    16,   1999.      The   consolidated      tribal   judgment    related      to   four
    victims and spanned incidents from 1992 through 1997:
    1) Forcible rape of a fourteen or fifteen-year-old in
    1992 or 1993.
    2) Touching of the crotch area of an eleven-year-old in
    1996.
    4
    3) Sexual assault of C.R., a woman of unknown age, in
    June 1997. During this incident, Antone tried to force
    C.R. to have sex with him, and when she refused, he threw
    her on the bed, held her hands down, touched her breasts,
    and touched her crotch area. C.R. was able to escape by
    jumping out of her bedroom window.
    4) Forcible rape of R.J., age twenty-five, in November
    1997. During this incident, R.J. awoke   to find Antone on
    top of her. He then forced her to have sex for five to
    fifteen minutes.
    Antone pled guilty to charges related to these four incidents in
    the consolidated plea agreement. He was sentenced to 3,600 days
    in jail by the tribal court.
    Almost all of the incidents described above, and certainly
    the June and November 1997 incidents, took place when Antone was
    either intoxicated from alcohol and/or high on cocaine. Indeed,
    Antone has a serious history of substance abuse. When he was
    arrested in February 1998, he was drinking 3 to 5 quarts of beer
    a day on average, and up to 11 quarts on some days. He was also
    abusing a number of drugs, including marijuana, LSD, and crack
    cocaine. As a result, Antone has little to no recollection of
    these incidents.
    In November 1999, Antone was sentenced in the United States
    District Court for the District of Arizona on a sexual assault
    5
    charge.     The        particular         charge     related       to     Antone’s     assault
    against C.R. in June 1997, which was also a subject of his
    consolidated tribal judgment. In addition, Antone admitted in
    the federal plea agreement to sexual misconduct as to all the
    incidents covered in the tribal court convictions.
    According         to    the    testimony        of   Antone’s        attorney    at    the
    time, which the magistrate judge fully credited, the federal
    criminal        charge       was    actually        initiated       by     Antone     and    his
    attorney. “The reason was to enable [Antone] to be transferred
    to   federal      custody          and    thereby     have       access    to   sex    offense
    treatment at FCI-Butner, which [the attorney] believed would be
    designed specifically for Native Americans.” J.A. 845.
    The federal district court in Arizona sentenced Antone to
    114 months of incarceration, with credit for time served, and 60
    months     of    supervised          release.        The   plea     agreement        reflected
    Antone’s request to receive sex offender treatment in federal
    custody, and the district court included a recommendation in its
    judgment        that     Antone          participate       in     the     residential       drug
    treatment and sex offender treatment programs.
    B.
    In   accordance          with       the   federal         judgment    and     commitment
    order, Antone was incarcerated in the federal Bureau of Prisons
    system from November 1999 through February 23, 2007, when the
    Government initiated the instant proceeding four days before his
    6
    expected release. Since then, Antone has resided in FCI-Butner,
    a medium security correctional institution in North Carolina,
    awaiting his civil commitment hearing and its resolution. As a
    result, Antone has been in continuous federal custody for the
    past fourteen years, or since he was twenty-seven years old.
    During the entire period of his federal custody, Antone has
    not   been     shown     to   have   consumed    alcohol       or   drugs.    Antone’s
    prison record contains no sanctions or nonsanctioned incidents
    related to alcohol or drugs, and he testified that he has been
    sober    for    fourteen      years.    The     Bureau    of     Prisons     regularly
    administers Breathalyzer tests on inmates in recognition of the
    fact that it is possible to make and obtain contraband alcohol
    within the prison. Antone has never tested positive on those
    tests.
    Antone     has     attended      Alcoholics      Anonymous      and    Narcotics
    Anonymous on his own initiative. He attended meetings during the
    first year and a half of his prison term and restarted about a
    year before his commitment hearing. He also completed a Drug
    Education Program and a non-residential substance abuse program.
    Antone’s     behavioral        problems    while    in     prison     have   been
    minimal. He has been sanctioned for four incidents, twice for
    fighting       without    serious      injury    and     twice      for   minor    rule
    7
    violations; the last of these sanctions occurred in 2004. 2 He
    obtained     his     GED   in   2001.       In    addition,      he     has       maintained
    employment      as    an   orderly      in        his   housing       unit.       His   work
    performance therein was characterized as “superior.” J.A. 843.
    Antone regularly seeks out advice and counseling from his
    prison’s counselors and treatment specialists. In particular, he
    has asked his counselors how to communicate with his son, with
    whom he corresponds by mail, and for advice on anger management.
    Antone    has   taken      classes     in        art,   beading,      meditation,       and
    guitar. He teaches other inmates how to play the guitar.
    As for sexual conduct, Antone’s record indicates that he
    has   “not   engaged       in   sexual       misconduct        during       his    extended
    incarceration.”        J.A.     882.    At       the    time   of     the     evidentiary
    hearing, however, he had not attended sex offender therapy or
    treatment. Antone and his former attorney testified that he had
    made several requests for treatment at the early side of his
    incarceration period, but it was apparently not then available
    to him because “his release date was so far in the future.” 3 J.A.
    2
    The Bureau of Prisons records also refer to three events
    that did not result in disciplinary sanction. They primarily
    stem from the attempted delivery of the magazine Maxim to
    Antone, and the presence in Antone’s cell of a number of
    pictures, cut out from magazines, of scantily-clad adult women.
    3
    When asked to explain why he had not completed a sex
    offender    treatment  program   at   any   point  during   his
    incarceration, Antone responded, “I don’t know why. Some places
    (Continued)
    8
    830.   When   it    became    available      in   September    2008,    after   the
    Government     filed    its     § 4248(a)         petition,    Antone    did    not
    participate in the treatment. He indicated that he did not do so
    because he knew that statements made during treatment “could be
    used against him” in the commitment proceeding. 
    Id. C. On
    February 23, 2007, four days before Antone’s expected
    release date, the Government filed a certification, pursuant to
    18 U.S.C. § 4248(a), of Antone as a sexually dangerous person.
    The case was originally stayed pending an appeal relating to the
    constitutionality of § 4248, see United States v. Comstock, 
    551 F.3d 274
    ,   276   (4th     Cir.   2009)    (holding   that    Congress   lacked
    authority to implement § 4248), rev’d and remanded, 
    560 U.S. 126
    , 130 (2010) (reversing on issue of Congressional authority
    but remanding for due process consideration); 
    627 F.3d 513
    , 515
    (4th Cir. 2010) (subsequently holding that § 4248 satisfies due
    process clause), cert. denied, 
    131 S. Ct. 3026
    (2011). In June
    2010, Antone filed a motion for a hearing on the merits of the
    certification, and the district court referred the matter to a
    I went didn’t have the program. . . . I was talking with some
    other brothers who are here and they said they were told they
    didn’t qualify.” J.A. 1238.
    9
    magistrate            judge    for    an     evidentiary      hearing        and    report   and
    recommendation.
    The magistrate judge held an evidentiary hearing over the
    course of three days in October 2011. As will be described in
    further detail infra, the Government presented the testimony of
    Antone, as well as two expert witnesses; Antone presented the
    testimony of a specialist and a counselor at the correctional
    facility at which he resided, a United States Probation Officer
    from    Arizona,          and    an     expert      witness.      The    magistrate       judge
    admitted the testimony of all three proffered expert witnesses.
    On April 30, 2012, the magistrate judge issued his M&R, in
    which       he    recommended         that     Antone       not   be    found       a   sexually
    dangerous person. The Government thereafter filed a series of
    objections to the M&R, to which Antone responded. The Government
    also    submitted             several       additional       notices         of    supplemental
    authority, including Ninth Circuit case law on the tolling of
    supervised release during the pendency of a civil commitment
    proceeding.
    On September 20, 2012, the district court issued its order
    and judgment on the instant certification. Although it accepted
    all    of    the       magistrate       judge’s         credibility     determinations       and
    findings         of    historical          fact,   it     rejected     the    M&R’s     ultimate
    recommendation of a finding of not sexually dangerous. It found
    that    the      combination          of    Antone’s       serious     mental      illnesses   —
    10
    namely      antisocial           personality          disorder         and        polysubstance
    dependence     –     would       cause    him    to    have      serious      difficulty       in
    refraining         from    sexually       violent          conduct      if     released.       It
    therefore committed Antone to the custody of the United States
    Attorney General as a sexually dangerous person. The instant
    appeal followed.
    II.
    A.
    The Government seeks the commitment of Antone pursuant to
    18 U.S.C. § 4248, which was enacted as part of the Adam Walsh
    Child    Safety      and    Protection         Act    of    2006.      Under       § 4248,    the
    Government may seek the civil commitment of certain individuals
    in   the    custody        of    the     Federal      Bureau      of       Prisons      who   are
    determined     to     be        “sexually      dangerous         person[s].”         18    U.S.C.
    § 4248(d). The commitment process is initiated when the Attorney
    General or his designee files a certification attesting that an
    individual is sexually dangerous as defined by the Walsh Act,
    after      which    the     respondent          is    entitled        to     an    evidentiary
    hearing. “If, after the hearing, the court finds by clear and
    convincing     evidence          that    the    person      is    a    sexually         dangerous
    person, the court shall commit the person to the custody of the
    Attorney General.” 
    Id. To demonstrate
             that    an     individual           should       be     civilly
    committed under § 4248, the Government must prove, by clear and
    11
    convincing evidence, that each one of the following criteria has
    been satisfied: (1) the individual has previously “engaged or
    attempted     to   engage           in   sexually     violent      conduct    or    child
    molestation”       (the        “prior       conduct”        element),        18     U.S.C.
    § 4247(a)(5);      (2)        the    individual      currently      “suffers       from    a
    serious mental illness, abnormality, or disorder” (the “serious
    illness” element), 
    id. § 4247(a)(6);
    and (3) as a result of such
    a condition, the individual “would have serious difficulty in
    refraining from sexually violent conduct or child molestation if
    released” (the “serious difficulty” or “volitional impairment”
    element), 
    id. See also
    Comstock, 560 U.S. at 130
    ; United States
    v.   Springer,     
    715 F.3d 535
    ,   538     (4th   Cir.    2013).    Antone       has
    conceded that the Government has met its burden with regard to
    the prior conduct element as well as the finding of a serious
    mental   illness.        He     disputes,     however,       the    district       court’s
    conclusion    as   to     the       third   element,       that   the   Government        has
    demonstrated a sufficient likelihood that Antone will re-offend.
    We review the district court’s factual findings for clear
    error and its legal conclusions de novo. United States v. Hall,
    
    664 F.3d 456
    , 462 (4th Cir. 2012). For the reasons we explain
    within, although the district court’s ultimate mixed finding on
    volitional impairment is not infected with “clear error” in the
    traditional      sense        of    that    term,    it     nonetheless      constitutes
    reversible error because it is against “the clear weight of the
    12
    evidence considered as a whole.” United States v. Wooden, 
    693 F.3d 440
    ,    451       (4th    Cir.    2012).        Put    somewhat       differently,         we
    conclude       as    a     matter    of     law    that       the    Government         failed      to
    establish by clear and convincing evidence that Antone would, as
    a   result     of        his   serious      illness       or    condition,         have       serious
    difficulty          in    refraining        from        sexually      violent       conduct         if
    released.
    B.
    The standard set forth for civil commitment under § 4248 is
    clear    and    convincing          evidence.          This    so-called       “intermediate”
    standard       is    mandated       not    only    by     the       plain    language         of   the
    statute, 18 U.S.C. § 4248(d), but by constitutional due process
    constraints, as well. See Addington v. Texas, 
    441 U.S. 418
    , 427
    (1979)     (observing            that     the     clear        and    convincing          evidence
    standard       is    required       in    civil        commitment      proceedings            because
    “[t]he     individual’s             interest       in     the        outcome       of     a    civil
    commitment proceeding is of such [great] weight and gravity”).
    When applying the clear and convincing standard, the court
    must    identify          credible       supporting       evidence          that   renders         its
    factual determination “highly probable.” Direx Israel, Ltd. v.
    Breakthrough Med. Corp., 
    952 F.2d 802
    , 810 n.7 (4th Cir. 1992).
    The    court    must       then     weigh    the       evidence       and    ask    whether        the
    totality of the record “produces in the mind of the trier of
    fact a firm belief or conviction, without hesitancy, as to the
    13
    truth of the allegations sought to be established[.]” United
    States v. Heyer, --- F.3d ---, ---, No. 12–7472, 
    2014 WL 185584
    ,
    at     *6    (4th     Cir.        Jan.     17,      2014)     (quoting       Jimenez        v.
    DaimlerChrysler         Corp.,      
    269 F.3d 439
    ,    450    (4th     Cir.    2001));
    
    Springer, 715 F.3d at 538
    .
    In applying the first two commitment criteria under the
    Walsh       Act,    the     question        is      whether    the     Government          has
    established         with     clear       and     convincing       evidence     that        the
    respondent acted or acts in a certain manner. The third element,
    however, is more complicated, in that it requires the court to
    issue a predictive judgment: has the Government met its burden
    by     presenting     clear        and     convincing       evidence      that,     in    the
    uncertain future, the respondent will have “serious difficulty
    in     refraining          from     sexually        violent       conduct      or        child
    molestation”? 18 U.S.C. § 4247(a)(6).
    We are mindful that the Supreme Court has explained that
    such    an    inquiry      “will     not    be   demonstrable        with   mathematical
    precision.” Kansas v. Crane, 
    534 U.S. 407
    , 413 (2002). Instead,
    in order to find that the third criterion is satisfied, the
    court must look for
    proof of serious difficulty in controlling behavior. And
    this, when viewed in light of such features of the case as
    the nature of the psychiatric diagnosis, and the severity
    of the mental abnormality itself, must be sufficient to
    distinguish the dangerous sexual offender whose serious
    mental illness, abnormality, or disorder subjects him to
    14
    civil commitment from the dangerous but typical recidivist
    convicted in an ordinary criminal case.
    
    Id. In other
    words, the Government must demonstrate that the
    serious      illness,      as        it    has    manifested       in     the     particular
    respondent,        has    so    significantly           diminished        his     volitional
    capacity     such    that       he    is    distinguishable         from    the     ordinary
    “dangerous but typical recidivist.” Id.; see also 
    Wooden, 693 F.3d at 460
    (framing the third criterion as “the extent to which
    the inmate is controlled by the illness”).
    We    now    assess      the        instant    record       with    this     exacting
    standard in mind. As to the third criterion, we find that the
    aggregate     of    historical,            direct,    and    circumstantial        evidence
    contained therein may be best described (as the magistrate judge
    seemed to regard it) as in equipose, or, at most, as rising to a
    level   of    preponderance           in    favor     of    commitment.      But     this   is
    simply not enough to satisfy the statutory burden of clear and
    convincing     evidence.         See       Medtronic,       Inc.   v.     Mirowski    Family
    Ventures, LLC, 571 U.S. ---, ---, No. 12-1128, 
    2014 WL 223040
    ,
    at *6 (2014) (“[T]he burden of proof . . . [is] part of the very
    substance of [the plaintiff’s] claim and cannot be considered a
    mere    incident     of    a    form       of    procedure.”)      (quoting       Garret    v.
    Moore-McCormack Co., 
    317 U.S. 239
    , 249 (1942)). We thus have no
    hesitation in finding a fatal evidentiary insufficiency in the
    Government’s presentation.
    15
    C.
    The majority of the evidentiary record consists of reports
    and testimony presented at the three-day hearing in front of the
    magistrate     judge.     At    the    hearing,           the    Government         presented
    testimony    from   Antone      himself,          and     expert      witnesses       Dr.    Amy
    Phenix,     Ph.D.   and    Manuel       E.    Gutierrez,             Psy.D.    Antone       then
    presented     the     testimony        of         Clement       Gallop,        a    treatment
    specialist    in    the    commitment         and       treatment       program       at    FCI-
    Butner; Andre Taylor, a counselor at FCI-Butner; Anne Schauder,
    a United States Probation Officer from Arizona; and an expert
    witness,     licensed      psychologist             Roy     G.       Daum,     Psy.D.        The
    magistrate judge found all of the witnesses credible, with a
    single exception related to Antone’s account of certain past
    crimes.
    Because   the      sole    issue       on    appeal       is    whether       there    was
    sufficient evidence of Antone’s future volitional impairment, we
    summarize the evidence only as it pertains to that issue.
    1.
    The    Government        first     called         respondent       Antone.        Antone
    testified    that   he    was    unable       to    recall       the    majority       of    his
    sexual assaults because he was either drunk or high at the time
    of   the    incidents.     He    then        testified          about    his       upbringing,
    substance abuse, and progress while in prison. He stated that he
    would always be an alcoholic and there would always be a risk
    16
    that he would drink again, but that he knew to stay away from
    high risk places and people. He also stated that while in prison
    he had learned how to talk to others about his problems and to
    “release [his] feelings in a positive way.” J.A. 221.
    Subsequently, Antone presented the lay testimony of Clement
    Gallop    and   Andre    Taylor.    Gallop       is    employed     as    a    treatment
    specialist in the commitment and treatment program at FCI-Butner
    and Taylor is a counselor at FCI-Butner. Gallop testified that
    he is approached by Antone on a weekly basis, and that they have
    discussed issues related to Antone’s son and anger management in
    general. Taylor testified that Antone has never tested positive
    or been observed to have imbibed alcohol or used drugs, even
    though such substances are available in prison and Taylor had
    disciplined others for alcohol-related issues. Both Gallop and
    Taylor    had     positive   impressions         of    their      interactions        with
    Antone.
    Antone also presented the testimony of Allan Duprey and
    Anne Schauder. Duprey, who was Antone’s attorney on the federal
    criminal    charges,     testified        that    the       federal      charges      were
    initiated at his urging so that Antone could have access to sex
    offense    treatment    designed     specifically           for   Native      Americans.
    Duprey     also     testified      that     he        had    inquired         about    the
    availability      of   sex   offender     treatment,        but    was   told    by    the
    Bureau of Prisons that Antone would not receive treatment until
    17
    the last five years of his ten-year sentence. Schauder is a
    United States Probation Officer in the District of Arizona. She
    explained the support and supervision that her district provides
    to sex offenders, including the utilization of halfway houses,
    sex offender treatment, and polygraph tests. 4
    2.
    The Government also presented the testimony of two expert
    witnesses, Dr. Amy Phenix and Dr. Manuel Gutierrez, who were
    admitted as experts in the field of forensic psychology without
    objection. Both Government experts testified that Antone met the
    criteria for civil commitment as a sexually dangerous person.
    Their conclusions were based on their review of Antone’s written
    records. Dr. Gutierrez was unable to conduct an interview of
    Antone, and the portion of Dr. Phenix’s report that related to
    an   interview   she   conducted     with   Antone   was   excluded   by    the
    magistrate   judge     and   the   Government   does   not   challenge     that
    order.
    4
    Schauder also testified that on November 3, 2011, the
    federal district court in Arizona had added an additional
    condition that Antone reside in a halfway house for up to 365
    days after release from custody. Antone consented to this
    additional condition and executed a written waiver. Antone has,
    of course, not yet been before any district court (in Arizona or
    in another district should his supervision be transferred) for a
    final determination as to the terms of his supervised release,
    in light of the fact that he remains in federal custody in North
    Carolina subject to the instant § 4248 proceeding.
    18
    Dr. Phenix diagnosed Antone with paraphilia not otherwise
    specified, nonconsent (“paraphilia NOS, nonconsent”); 5 alcohol
    dependence; 6 and antisocial personality disorder (“APD”); 7 and
    she testified that as a result, he would have serious difficulty
    refraining from sexually violent conduct. She opined that the
    primary       cause    of   Antone’s    volitional       impairment       was     his
    paraphilia      NOS,    nonconsent,    mental      illness.   Dr.    Phenix      found
    that Antone’s paraphilia NOS, nonconsent, caused him to deviate
    from       ordinary    sexual   impulses     and    behaviors,      and   then    his
    alcohol       dependence    would   serve     as    a   disinhibitor      and     his
    antisocial personality disorder would reinforce his paraphilic
    impulses. When specifically questioned by the court, Dr. Phenix
    added that, even if the paraphilia diagnosis was disregarded,
    5
    Paraphilia is defined as “recurrent, intense sexually
    arousing fantasies, urges and behaviors” involving, in the
    context of the “nonconsent” specifier, sexual arousal “by the
    nonconsenting aspect of nonconsensual sexual encounters.” J.A.
    848-49.
    6
    Alcohol/substance dependence is defined as a “maladaptive
    pattern of substance use, leading to clinically significant
    impairment or distress[.]” J.A. 849. There is no dispute that
    Antone suffers from substance dependence.
    7
    Antisocial personality disorder is defined as “an enduring
    pattern of inner experience and behavior that deviates markedly
    from the expectations of the individual’s culture, is pervasive
    and inflexible, has an onset in adolescence or early adulthood,
    is stable over time, and leads to distress or impairment.” J.A.
    851. At the appellate level, Antone does not challenge the
    diagnosis of antisocial personality disorder.
    19
    she would still “believe that [Antone] will go on to commit
    criminal sexual behavior.” J.A. 420.
    Dr. Phenix’s conclusion on the volitional impairment prong
    was based on (1) the pattern and duration of Antone’s offending;
    (2) his commission of additional offenses after his 1991 sexual
    abuse conviction; (3) an actuarial assessment of risk based on
    static risk factors; (4) the presence of dynamic risk factors;
    and 5) the absence of protective factors. Dr. Phenix explained
    at the hearing that her first methodology was to “look at the
    pattern      and   duration       of   his   offending    to    see   how   well   his
    behavioral controls were when he was in the community.” J.A.
    331.       She   focused    on    certain     undisputed       historical   factors,
    emphasizing        the     repeated    nature     and    aggression    of     Antone’s
    assaults and that he continued to commit assaults even after his
    first arrest in 1991. 8
    Dr. Phenix viewed Antone’s behavior while incarcerated only
    as a secondary consideration. When questioned on why she relied
    almost       exclusively     on    pre-incarceration       conduct,     Dr.    Phenix
    responded that “I think the best measure of his volition is
    8
    With respect to her actuarial analysis, Dr. Phenix
    utilized several predictive models, in which she inputted a
    number of “static,” mostly historical facts, including the
    number of prior sex offenses; whether the offender was single at
    the time of offending; and whether any victims were related to
    the offender.
    20
    prior to being in a prison where you have such strict structure
    and rules for your behavior[.]” J.A. 332.
    The    magistrate    judge    also       heard    similar   testimony   from
    Government     witness    Dr.    Gutierrez.      Dr.    Gutierrez’s     diagnoses
    matched    those   of    Dr.    Phenix    -    paraphilia    NOS,      nonconsent;
    polysubstance      (including     alcohol)      dependence;      and    antisocial
    personality disorder – and also included an additional diagnosis
    of paraphilia NOS, hebephilia. He concluded that a combination
    of all of the above-listed illnesses, or alternatively a sole
    diagnosis of APD, would “cumulative[ly]” cause Antone to have
    serious    difficulty    refraining      from    sexually     violent    conduct.
    J.A. 457-58.
    Antone subsequently presented the testimony of his expert
    witness, Dr. Roy Daum, who was admitted as an expert in the
    field of forensic psychology over the Government’s objection.
    After conducting a forensic evaluation of Antone in February
    2011, Dr. Daum diagnosed Antone with polysubstance dependence;
    frotteurism; and borderline personality disorder. 9 He agreed with
    9
    Notably, Dr. Daum did not diagnose Antone with any form of
    paraphilia NOS, be it nonconsent (when an individual is aroused
    by nonconsent) or hebephilia (when an individual is aroused by
    pubescent individuals). He explained that after interviewing
    Antone for five hours, he had not seen any evidence or admission
    by Antone — for example, an interest in deviant sexual fantasies
    or a physical arousal to certain images — that would suggest
    that Antone was aroused by forced sex. Dr. Daum also referred to
    a psychophysiological evaluation taken in 1999 in anticipation
    (Continued)
    21
    the Government’s experts that Antone met the first and second
    criteria    of    § 4248     confinement.        He   disagreed,     however,      that
    Antone had demonstrated that he would have serious difficulty
    refraining from sexually violent conduct if released.
    Dr. Daum reasoned that Antone’s offense conduct had not
    been rooted in sexual deviance, but rather stemmed from a lack
    of   interpersonal       skills    and    a     serious    substance      abuse.   Dr.
    Daum’s conclusion considered as a central part of his analysis
    certain         “dynamic”      factors          observed         during     Antone’s
    incarceration, including the absence of evidence of any use of
    drugs or alcohol or any engagement in antisocial activities; the
    absence    of    records    showing      that   Antone     had   a   general   sexual
    preoccupation;       Antone’s       positive          management     records;       and
    evidence    of     his     completion     of     several    self-help      programs,
    learning    of    vocational      skills,       and   seeking     counseling    while
    incarcerated. Of the difference between his opinion and that of
    Dr. Phenix and Dr. Gutierrez, he remarked the following:
    of Antone’s federal sentencing. Although the report did not make
    a formal diagnosis, it observed that “[i]t is possible that
    [Antone’s] sexually aggressive and sexually deviant behavior
    patterns   are  the   result  of  emotional   and  psychological
    disturbance, rather than persistent deviant sexual arousal or
    attraction[.]” J.A. 829.
    As will be discussed infra, both the magistrate judge and
    the district court adopted Dr. Daum’s conclusion that Antone did
    not suffer from any form of paraphilia.
    22
    I believe there are many factors that you look at as far as
    a civil commitment is concerned. Certainly you have heard
    the last two days of a lot of discussion about actuarials.
    One of the things that is really missing is the dynamic
    factors of how that person is now [as compared to his
    former] acts. Static, meaning it’s all said and done and
    it’s easy to score, . . . but the dynamic factors allow for
    the growth of a person to change or it allows for the
    person not to change.
    J.A. 642. Finally, Dr. Daum opined that outpatient treatment of
    Antone during supervised release could adequately address his
    sex offense and substance abuse problems.
    D.
    On   April     30,    2012,     the        magistrate    judge   issued    a
    comprehensive M&R recommending that the district court reject
    the Government’s certification of Antone as a sexually dangerous
    person. The magistrate judge concluded that the Government had
    met its burden with regard to the first element, in that Antone
    had    previously      engaged    in     sexually       violent     conduct.     The
    magistrate judge also accepted the Government’s contention that
    Antone suffered from certain serious mental illnesses within the
    scope of § 4247(a)(6). Specifically, the magistrate judge found
    evidence of polysubstance dependence, but it rejected the rest
    of the Government experts’ diagnoses, most notably paraphilia
    NOS,   nonconsent     and    antisocial      personality       disorder.   It   also
    rejected    Dr.     Daum’s   diagnoses       of    frotteurism    and   borderline
    personality disorder.
    23
    The       magistrate    judge   ultimately    concluded,   however,    that
    the       Government    had     not   presented     sufficient    evidence     to
    demonstrate that Antone’s polysubstance dependence would result
    in    a     serious    difficulty      refraining    from   sexually    violent
    conduct. The magistrate judge emphasized that the Government’s
    position on volitional impairment was “based on [a theory of]
    multiple diagnoses,” but it had decided that the Government had
    not       met    its   burden    on    any    of    those   diagnoses    except
    polysubstance dependence. As a result, the magistrate judge was
    not persuaded by the Government’s presentation as to Antone’s
    volitional impairment. It cited, for example, to Dr. Gutierrez’s
    understanding that “just a substance diagnosis alone could not
    essentially stand by itself for civil commitment.” J.A. 881.
    The magistrate judge afforded near determinative weight to
    Antone’s conduct “over the last 13 or so years,” during his time
    in federal prison. It noted that Antone had not been shown to
    have consumed alcohol or drugs or to have engaged in sexual
    misconduct during his extended incarceration. It also pointed to
    his attendance in Alcoholics Anonymous and his eagerness to seek
    out counseling for anger management.
    The magistrate judge recognized that Antone’s achievements
    while incarcerated came about in a controlled environment where
    access to his vices was limited. Nevertheless, its review of the
    evidence – including the testimony of Dr. Daum, who had stressed
    24
    the utility of dynamic factors in Antone’s case - led it to
    conclude that over the past thirteen years, Antone “has achieved
    a   level   of    sexual      self-regulation”       and    “a    measure     of   self-
    control” that significantly undercut the Government’s position
    that he would have serious difficulty refraining if released.
    J.A. 882. It observed that certain evidence relied upon by the
    Government’s expert witnesses, such as the nature, pattern, and
    duration of offense conduct, “is not as reliable an indicator of
    his behavior if released . . . because of, among other reasons,
    the    extended         intervening       period     in    which      there    was    no
    manifestation of such conduct.” J.A. 884-85.
    The magistrate judge also considered as “significant[]” the
    fact   that      Antone     would    be   subject    to    “an    extended     term   of
    supervised release.” J.A. 883. It noted that he would spend his
    first year of supervised release in a halfway house and that
    throughout       his    term,   he   would   be     subject      to   supervision     and
    participation          in   substance     abuse    and    sex    offender     treatment
    programs, periodic drug tests, and prohibitions against contact
    with children.
    In light of the “paucity” of evidence that Antone would
    have serious difficulty refraining from sexually violent conduct
    if released, the magistrate judge concluded that the Government
    had failed to meet its burden of establishing, by clear and
    25
    convincing evidence, that Antone was a sexually dangerous person
    under § 4248. J.A. 886.
    E.
    On September 24, 2012, the district court issued an order
    rejecting      the   magistrate      judge’s       ultimate       recommendation            and
    civilly committing Antone. It accepted the M&R’s findings of
    historical      fact    and    witness      credibility,        and       noted      that    it
    reviewed de novo those aspects of the M&R that were objected to
    by the parties.
    In applying the three-prong test, the district court first
    accepted the magistrate judge’s conclusion that the Government
    had    established      that    Antone      had    engaged      in    sexually       violent
    conduct. It      also    agreed      with    the    majority         of   the    magistrate
    judge’s recommendations as to the diagnoses of Antone’s mental
    illnesses.      Notably,       the    district       court      found       that      Antone
    suffered     from    polysubstance       dependence         and      that    he      did    not
    suffer from paraphilia NOS, nonconsent. In disagreement with the
    magistrate judge, however, the district court found sufficient
    evidence of a diagnosis of antisocial personality disorder and
    held    that    these     two     diagnoses,        as     manifested           in   Antone,
    qualified as serious mental illnesses.
    The   district     court      then    found       that   the       Government        had
    satisfied the volitional impairment requirement of § 4248. In
    26
    doing so, its primary focus appeared to be Antone’s admitted
    alcoholism. It stated:
    Respondent admits that he is and will always be an
    alcoholic. To his credit, respondent has participated in
    substance abuse treatment and evidently has refrained from
    using alcohol and drugs while incarcerated. . . .
    [However,] the risk that respondent will relapse into
    abusing alcohol and other substances would be much higher
    in the community.
    J.A. 1115-16. It continued, “[t]he court is convinced that if
    respondent uses alcohol he will have serious difficulty stopping
    himself   from   sexually     attacking   persons    he   finds   desirable,
    despite their nonconsent.” J.A. 1116.
    The district court looked to the combination of Antone’s
    substance dependence and APD diagnoses to predict that his past
    history of sexual attacks would continue once released. “This
    volitional impairment has resulted in a consistent pattern of
    numerous violent sexual attacks in the past, and the court finds
    that the impairment will persist if respondent is released.” 
    Id. The court
      also   relied    on   Dr.   Phenix’s   testimony    that   her
    conclusion on the volitional impairment prong would not change
    without the paraphilia NOS, nonconsent diagnosis.
    Finally, the court expressed concern that it would not be
    able to require Antone to undergo sex offender treatment. All
    parties – including Dr. Daum as well as Antone himself – agreed
    that Antone would benefit from sex offender treatment. According
    to the district court, however, under a recent Ninth Circuit
    27
    case,   United   States      v.    Turner,    a   § 4248    detainee’s        term   of
    supervised release is not tolled while he remains in custody
    awaiting a commitment hearing. 
    689 F.3d 1117
    , 1121 (9th Cir.
    2012). Assuming Antone’s period of supervised release actually
    had begun when he was due to be released from the Bureau of
    Prisons, supervision would have ended on February 27, 2012, but
    he was still civilly committed at that point. The district court
    thus predicted that without a tolling mechanism, Antone would
    not be subject to any term of supervised release under Ninth
    Circuit law. It also rejected as “irrelevant” the testimony of
    the probation officer from Arizona based on similar reasoning.
    Accordingly,      the    district       court   rejected     the    magistrate
    judge’s    ultimate     recommendation,           instead    finding      that       the
    Government had established that Antone was a sexually dangerous
    person within the meaning of 18 U.S.C. § 4247(a)(5) and (6).
    F.
    Because     Antone      has   not   disputed     the    first      and    second
    elements   of    the   Government’s      § 4248      certification,       the     sole
    issue on appeal is whether the district court erred in finding
    that he will have serious difficulty refraining from sexually
    violent conduct if released. We hold that it did.
    Under   the   clear      error   standard,      we    may   not    reverse      the
    district court’s holding even if we are “convinced that had we
    been sitting as the trier of fact, we would have weighed the
    28
    evidence         differently.”        
    Springer, 715 F.3d at 545
       (internal
    citations           omitted).         Yet    “while          clear-error         review      is
    deferential,         it   is    not    toothless.”       
    Wooden, 693 F.3d at 451
    (internal         citations      omitted).        A    reversal      is    warranted,       for
    example, if the district court failed to “properly tak[e] into
    account substantial evidence to the contrary” or its “factual
    findings are against the clear weight of the evidence considered
    as a whole.” 
    Id. at 462.
    We may then reverse if, upon reviewing
    the district court’s ultimate mixed findings, we are “left with
    the    definite       and      firm    conviction       that     a   mistake       has     been
    committed.” 
    Id. at 451.
    That is precisely what is at stake here: our review of the
    lower       court    opinion     leads      us    to   conclude      that    the    district
    court’s          inadequate      consideration           of     certain          “substantial
    evidence” – namely Antone’s behavior in the past fourteen years
    or    so     –    constitutes         reversible       error.     And      our    subsequent
    analysis of the evidentiary record leaves us with a definite and
    firm conviction that Antone’s commitment should be reversed.
    That Antone has “responded very well” to incarceration is
    not in dispute. J.A. 333. Antone has not tested positive for any
    substances while in prison, and he testified that he has been
    sober during his extended incarceration. Antone’s conduct as it
    relates to sexual deviance is equally commendable. Not only has
    he    not    engaged      in   any     actual     sexual      misconduct     or     hostility
    29
    toward women, but, just as importantly, his record is devoid of
    any    indication   that    he   has   even    desired      to   manifest    such
    misconduct.
    Instead, Antone has presented significant testimony to the
    contrary. Two employees from the correctional facility testified
    on    Antone’s   behalf,   and   the   magistrate        judge   found   credible
    their assurances that their interactions with Antone have been
    consistently     positive    and   that       he   has     demonstrated     self-
    awareness and control on a regular basis. He has for the most
    part avoided conflicts with superiors or fellow inmates. Antone
    has completed his GED, as well as other professional programs,
    and he readily seeks out the prison’s mental health resources.
    He has expressed remorse for his past acts.
    Yet the district court’s discussion of Antone’s behavior
    while incarcerated is negligible at best. It failed to discuss
    the opinions of Gallop or Taylor, the only witnesses who have
    had consistent contact with Antone since his incarceration. It
    considered the testimony of Antone only to the extent that he
    admitted that he will always be an alcoholic. 10 And it failed to
    10
    To the contrary, we note that Antone’s admission that he
    will always struggle with alcohol is a crucial and necessary
    step in his path toward recovery from substance abuse. See The
    Twelve    Steps   of    Alcoholics   Anonymous,   available   at
    http://www.aa.org/en_pdfs/smf-121_en.pdf (stating that the first
    step in addressing addiction is accepting that a problem exists)
    (last visited January 31, 2014).
    30
    mention the nearly ten-year period in which Antone has had zero
    disciplinary infractions and the nearly fifteen-year period in
    which Antone has had no sex-related incidents.
    In    fact,   in   the     “serious     difficulty”     section    of    its
    opinion, the district court’s analysis of Antone’s conduct while
    incarcerated is limited to a single sentence acknowledging his
    “evident[]” abstinence from alcohol. 11 Relying again on Antone’s
    past history of “numerous violent sexual attacks,” it concluded
    that his volitional impairment would persist if released.
    Since upholding the constitutionality of the Walsh Act in
    2010, we have disposed of more than a handful of § 4248 appeals
    involving     the    volitional    impairment      prong,    but   none   of   them
    involved      a   respondent      who    had   demonstrated        such   positive
    behavior during the extended period of his incarceration. In
    each    of   those    cases,    the     district    court    referred     to   some
    negative aspect of the respondent’s recent (that is, during-
    11
    That portion of the district court opinion reads, in
    total,
    Respondent admits that he is and always will be an
    alcoholic. To his credit, respondent has participated in
    substance abuse treatment and evidently has refrained from
    using alcohol and drugs while incarcerated. Although
    alcohol and drugs are certainly present where respondent is
    housed, they are contraband, and their availability is
    considerably limited compared to the access respondent
    would have to such substances if he were to be released.
    J.A. 1115 (emphasis added).
    31
    incarceration        or    post-release)         behavior.      In   United       States    v.
    Bolander, 
    722 F.3d 199
    , 204 (4th Cir. 2013), for example, we
    affirmed the commitment of a respondent who stole pornographic
    materials      from        the     treatment       lab     while     incarcerated          and
    collected      child        pornography          while    on     supervised         release.
    Likewise,     in     United       States   v.     
    Wooden, 693 F.3d at 445
    ,    the
    respondent had written a letter to one of his previous victims,
    and    we   concluded        that    he    had    serious      volitional         impairment
    issues. See also United States v. Heyer, --- F.3d at ---, 
    2014 WL 185584
    , at *2-3, 9 (noting respondent’s admission of “ongoing
    sexual       interest        in      children,”          including      showing         child
    pornography to a teenage boy while on probation).
    Even those cases in which the respondent was ultimately
    found not to qualify for commitment nevertheless involved some
    evidence of negative behavior during incarceration. In United
    States v. 
    Hall, 664 F.3d at 464
    , the district court considered
    the    respondent’s        ongoing     interest      in     collecting       pictures      and
    drawings of children and adolescents while in custody and his
    report      that    he     often    masturbated      to     memories        of    his   child
    victims, but it ultimately concluded that due to his abstention
    from     hands-on         offenses    during       his     twenty-eight           months   of
    release, he was not sexually dangerous under § 4248; we affirmed
    the judgment. See also United States v. Francis, 
    686 F.3d 265
    ,
    271    (4th        Cir.     2012)     (considering          respondent’s           perceived
    32
    hostility    toward   women    and   his   noncompliance    with   supervised
    release,     but   affirming     denial      of    government’s    commitment
    petition).
    Here, Antone’s behavior during the past fourteen years –
    indeed, during a period of time that spans the majority of his
    adult life – reveals no acts that conceivably come close to the
    sort of malfeasance present in our aforementioned precedent. 12 On
    these facts, there is not much more that he could have done to
    demonstrate that he is in control of his volitional faculties
    and that such control is likely to persist after his release.
    The district court should have been aware of the uniqueness of
    Antone’s    factual   record.   As   such,    it   was   imperative   for   the
    12
    The district court made reference to the fact that Antone
    had not attended sex offender treatment. Antone had, however,
    repeatedly sought this treatment at the beginning of his
    incarceration to no avail. It is true that he was eventually
    offered sex offender treatment sometime in September 2008, but
    this choice was effectively no choice at all. At that point, the
    Government was proceeding with its efforts to civilly commit
    Antone, and any treatment received would be at the cost of
    providing the Government with additional fodder to use against
    him in those proceedings.
    The district court also noted that Antone’s institutional
    conduct “has not been without incident.” J.A. 1114. It cited to
    his two sanctions for fighting, both of which occurred before
    2004, and the presence of “inappropriate materials” in his cell.
    We reject the notion that the prison’s confiscation of the
    magazine Maxim can rise to the level of malfeasance discussed
    above.
    33
    court to comprehensively address why it believed Antone’s recent
    behavior was overshadowed by his past acts. It failed to do so.
    In Wooden, we recently confronted a situation in which we
    believed that the district court had failed to consider relevant
    and     substantial           evidence          of      a      respondent’s             volitional
    
    impairment. 693 F.3d at 458-62
    . There, the district court had
    rejected the petition for civil commitment, finding that the
    Government       had    failed       to    demonstrate              clear     and       convincing
    evidence       that    the     respondent            would    have     serious          difficulty
    refraining      from        re-offending.        Our        review     of    the    evidentiary
    record   led     us    to    hold    otherwise.             Because    the       district    court
    relied    on    a     flawed    expert         opinion       and     ignored       or    otherwise
    failed    to    account        for   a    “substantial              body    of    contradictory
    evidence,” we found reversible error. 
    Id. at 461.
    Here,     as     in    Wooden,      we    have        again    been     “left      with   the
    definite and firm conviction that a mistake has been committed.”
    
    Id. The “core”
    of Antone’s case was his decade-long process of
    rehabilitation.         Antone       called           three     separate          witnesses     to
    support his position that, as a result of his efforts to obtain
    treatment, he had improved his ability to control his impulses.
    The district court’s one-sentence dismissal of Antone’s case in
    chief    does    not    sufficiently            address       the     valid      and     important
    evidence contained therein.
    34
    We hasten to note that it was not clearly erroneous for the
    district    court      to    place        significant        weight    on    Antone’s      pre-
    incarceration       acts         and   behavior        in    reaching       its    predictive
    finding.     A   respondent’s              criminal         record    “may        well   be    a
    historical factor, but it is by no means a stale or irrelevant
    one. When the question is whether an inmate . . . will have
    serious    difficulty         refraining         from       re-offending      if    released,
    consideration       of      the    nature       of    his    prior    crimes       provides     a
    critical part of the answer.” 
    Wooden, 693 F.3d at 458
    . Rather,
    the deficiency here lies primarily in the Government’s failure
    to     muster,   and     the       district          court’s    failure      to     hold      the
    Government to its obligation to muster, sufficient evidence of
    an ongoing volitional impairment in this case. The mixed finding
    that    ensues   is      “against         the    clear       weight    of    the     evidence
    considered as a whole” and constitutes reversible error.
    As both the magistrate judge and Dr. Daum recognized, in
    analyzing    whether         a    respondent         will    have     serious      difficulty
    refraining from re-offending, one must look to his past and his
    present     condition.            Here,    Antone       has     presented         significant
    indicators that he presently “has problems, takes responsibility
    for them, and seeks help for them,” and his pre-incarceration
    malfeasance cannot be the sole relevant factor of consideration.
    J.A. 883. We certainly do not fault the Government, as whatever
    evidence it had, it presented, but that evidence largely (and
    35
    certainly     equally)     serves      to     bolster     Antone’s      asserted
    rehabilitation      and   his    subsequent      capacity    for     volitional
    control.
    The   Government   contends     that    the     district    court   amply
    justified its conclusion by relying on the testimony and reports
    of its expert witness Dr. Phenix. 13 It is true that Dr. Phenix
    opined that Antone met the volitional impairment prong, and we
    are “reluctant to set aside a finding based on the trial court’s
    evaluation of conflicting expert testimony.” Hendricks v. Cent.
    Reserve Life Ins. Co., 
    39 F.3d 507
    , 513 (4th Cir. 1994). Yet we
    cannot unreservedly accept the district court’s election to give
    determinative    weight    to   Dr.    Phenix’s      opinions,    and   for    two
    reasons.
    First, Dr. Phenix’s conclusion as to whether Antone would
    have serious difficulty in re-offending was based on multiple
    diagnoses      (including,      most    importantly,        paraphilia        NOS,
    nonconsent) that were subsequently rejected by the magistrate
    judge and the district court. Indeed, Dr. Phenix testified that
    Antone’s “paraphilic disorder is primarily responsible for so
    many    incidents   of    nonconsenting       sexual    activity     and   child
    13
    The district court did not state that it relied on Dr.
    Gutierrez’s report or testimony for its conclusion on the third
    prong, and we agree that Dr. Gutierrez’s statements do not give
    rise to clear and convincing evidence of volitional impairment.
    36
    molest[ation],”         and   that    her     other     two     diagnoses,         substance
    dependence      and     antisocial    personality         disorder,         served     as     a
    “contributor”      or     “permission       giver.”      J.A.       318,   325.     But     the
    district       court     concluded    that       Antone       did    not     suffer        from
    paraphilia,       the     primary     diagnosis         supporting          Dr.     Phenix’s
    conclusions.      The     fact    that   the      court    rejected         Dr.     Phenix’s
    paraphilia       diagnosis       significantly          minimizes      the        amount     of
    persuasive       force     retained      by      her    opinion       as     to     Antone’s
    volitional impairment. 14
    Second, and more fundamentally, Dr. Phenix’s evaluation of
    Antone suffers from the same flaw as the conclusion ultimately
    put forth by the district court. The expert report submitted by
    Dr. Phenix focuses almost exclusively on events that occurred
    prior     to    1997;     indeed,     she     admitted        as     much     during        her
    testimony. Dr. Phenix explained that her decision to focus on
    pre-incarcerative         acts    stemmed        from   her     belief      that     actions
    taken while in the outside world are more accurate predictors of
    14
    When  specifically  questioned   on  her   thoughts  on
    commitment without her paraphilia diagnosis, Dr. Phenix did
    opine that she would still consider Antone to be a sexually
    dangerous person. She clarified that this was because she
    “believe[d] that he will go on to commit criminal sexual
    behavior.” J.A. 420. Dr. Phenix’s analysis of future criminality
    is not the legal inquiry at stake in § 4248 commitment, which
    looks instead to an individual’s volitional control. For this
    reason, this statement is insufficient to meet the Government’s
    heightened burden.
    37
    future behavior upon release. That is, of course, her choice,
    but as it relates to our review of the evidentiary record, it
    will not carry the day. The district court should have at the
    very     least      explained    why    it        found    Dr.        Phenix’s       unadorned
    conclusion       more     persuasive         than       that     of      Dr.     Daum,       who
    specifically critiqued the former’s technique because it did not
    allow for a respondent’s subsequent growth. We find that Dr.
    Phenix’s conclusion on volitional impairment is insufficient to
    satisfy       the    Government’s       heightened             clear     and     convincing
    evidence burden. Cf. 
    Wooden, 693 F.3d at 457
    (finding that the
    “many deficiencies” in an expert’s testimony “leave us firmly
    and     definitely      convinced      that       the     district       court’s       factual
    findings were mistaken.”).
    The   Government    next       contends         that    the     district       court’s
    consideration of Antone’s recent behavior was sufficient because
    it explicitly adopted the magistrate judge’s factual findings
    and     credibility      determinations           related        to    the     lay     witness
    testimony. We reject this argument. Even though the district
    court    acknowledged      its    awareness         of     the    testimony,          that    by
    itself does not indicate to us that it adequately considered its
    impact. If, after reading the opinion, we cannot understand how
    the district court came to its conclusions, then we will be
    unable to perform a cogent analysis on its merits.
    38
    Factfinding        is        “a      dynamic,        holistic         process          that
    presupposes for its legitimacy that the trier of fact will take
    into account the entire record before it.” Taylor v. Maddox, 
    366 F.3d 992
    , 1007 (9th Cir. 2004). When “the court’s account of the
    evidence is not plausible in light of the record viewed in its
    entirety,” then it is not entitled to deference upon our review.
    
    Wooden, 693 F.3d at 460
    . Here, the district court disposed of
    more   than   a     decade       of      evidentiary       data     points    in    a   single
    sentence, and we cannot find that it properly took into account
    all substantial evidence.
    Nor can we, on the merits of the matter, find that the
    Government presented clear and convincing evidence that Antone
    will   have   serious          difficulty      refraining         from   re-offending           if
    released.     The     Supreme          Court    has        stated    that     the       serious
    difficulty    element          is    intended       to   distinguish      the      “dangerous
    sexual   offender”        from        the   “dangerous        but    typical       recidivist
    convicted     in     an    ordinary         criminal         case    who,     having          been
    convicted and punished for one crime, proceeds through his own
    free choice to commit another.” Kansas v. 
    Crane, 534 U.S. at 413
    . Here, then, the Government must demonstrate that Antone’s
    particular manifestation of his mental illnesses are so severe
    and    controlling        as    to       deprive     him    of    his    liberty        for    an
    indeterminate future.
    39
    That is not the case. Clear and convincing evidence equips
    a   factfinder      with   “a    firm      belief    or     conviction,      without
    hesitancy,” of the truth of the matter asserted, and, on the
    record before us, we possess no such conviction about the grip
    strength of Antone’s mental illness on his behavior. 
    Springer, 715 F.3d at 538
    . We have already cited the substantial evidence
    in the record indicating that Antone has developed a level of
    general and social self-regulation; indeed, on these facts, we
    are hard-pressed to suggest much else that he could possibly do
    to undercut the notion that he would have serious difficulty in
    restraining    from     re-offending.           What’s    more,   Antone’s     civil
    commitment     is     based     on    two       mental     disorders    that     are
    undisputedly     prevalent      in   the    nationwide      prison   population. 15
    See, e.g., Kansas v. 
    Crane, 534 U.S. at 412
    ; see also Jack
    Vognsen & Amy Phenix, Antisocial Personality Disorder is Not
    15
    In Kansas v. Crane, the Supreme Court recognized the
    “constitutional importance of distinguishing a dangerous sexual
    offender subject to civil commitment from other dangerous
    persons who are perhaps more properly dealt with exclusively
    through criminal 
    proceedings.” 534 U.S. at 412
    . In fact, in
    making this precise point, the Court cited to the wide
    prevalence of antisocial personality disorder among inmates -
    one of the two mental illnesses at issue in the instant case.
    In his brief, Antone has contended that the language in
    Crane supports his position that it is unconstitutional to
    commit individuals under § 4248 who do not suffer from a
    paraphilia. Because we hold that, on the evidentiary record
    before us, Antone has not been shown to be a sexually dangerous
    person, we do not reach this question.
    40
    Enough: A Reply to Sreeivasan, Weinburger, and Garrick, 32 J.
    Am. Acad. Psychiatry Law 440, 442 (2004) (J.A. 1035-37) (noting
    that 50 to 70 percent of the ordinary prison population suffers
    from antisocial personality disorder); Dept. of Justice, Bureau
    of    Justice   Statistics,          Christopher        J.     Mumola        &    Jennifer       C.
    Karberg, Drug Use and Dependence, State and Federal Prisoners,
    2004 1 (2004), available at
    http://www.bjs.gov/content/pub/pdf/dudsfp04.pdf (finding that 45
    percent    of     federal        prisoners       met    DSM-IV         criteria        for     drug
    dependence      or    abuse)       (last     visited         January        31,       2014).    We
    conclude that, under the clear and convincing evidence standard,
    the    Government         has     failed    to     distinguish          Antone’s         alleged
    volitional      impairment         from    that    of   a    “dangerous           but    typical
    recidivist.” Kansas v. 
    Crane, 534 U.S. at 413
    .
    G.
    Finally,      we     turn    to     the    issue      of    Antone’s           supervised
    release. The         district      court’s       position      seems        to   be     that,    if
    Antone were to contest the terms of his supervised release in
    front of his sentencing court in Arizona, then the sentencing
    court would be bound by Ninth Circuit law and hold that his
    supervised      release         expired    in     February        2012.      See      United     v.
    
    Turner, 689 F.3d at 1121
    (holding that civil detention under the
    Walsh Act does not toll supervised release). On appeal, Antone
    contends   that       the       district    court      erred      as    a    matter      of     law
    41
    because it failed to consider the possibility that he would be
    judicially       estopped       from    challenging         his    expressly-agreed-to
    supervised       release     in    the    course       of    this       civil       commitment
    litigation.
    As we hold that the evidence in this record is insufficient
    under the clear and convincing standard to support the district
    court’s predictive judgment of Antone’s volitional impairment,
    we need not wade into this legal issue at this time, nor do we
    find any reason to do so. Antone has given no indication that he
    will challenge his status as a supervised releasee under the
    judgment of       the   Arizona        district    court,         and    it    is       therefore
    premature    to    anticipate       that      Turner    will       even       be    invoked     in
    front of the sentencing judge. Indeed, it is our understanding
    that the sentencing judge has accepted a recommendation by joint
    agreement    (signed       by     Antone)      that    imposes          as    an     additional
    condition of his supervised release a 365-day term in a halfway
    house     upon    his   release        from    federal       custody.          Whether        this
    modification       changes      the     application         of    Turner           is   for    the
    district court in Arizona (or another federal district court
    should Antone’s supervision be transferred) to decide, not this
    court or the North Carolina district court. 16
    16
    As for judicial estoppel, it, too, is prematurely in
    front of this panel. Antone has not at this point “adopt[ed] a
    position that is inconsistent with a stance taken in prior
    (Continued)
    42
    At oral argument before us, counsel for Antone reported
    that Antone is currently attending sex offender therapy. 17 One
    can   only    be    encouraged       by     Antone’s      commitment       to   self-
    improvement, rehabilitation, and recidivism prevention.
    III.
    For the reasons set forth, we conclude that the appellate
    record does not support the district court’s determination that
    Antone would have serious difficulty refraining from sexually
    violent conduct if released. It may be that we would affirm the
    judgment     were    the      Government’s          burden     one    of    a    mere
    preponderance, but it is not and we do not. The Government has
    not established by clear and convincing evidence that the facts
    and   circumstances      of   this    case       establish     that   Antone    is   a
    sexually     dangerous     individual           subject   to    commitment      under
    litigation,” and the Government has not invoked the defense of
    judicial estoppel. See generally Zinkand v. Brown, 
    478 F.3d 634
    ,
    638 (4th Cir. 2007). However, if the tolling issue does
    ultimately come before a federal district court, the court will
    surely consider the relevance of Antone’s consistently expressed
    intent to complete his term of supervised release upon his
    release from the Bureau of Prisons.
    17
    We note that Antone has been attending sex offender
    therapy in spite of its potential impact on future civil
    commitment hearings. See generally Jeslyn A. Miller, Comment,
    Sex Offender Civil Commitment: The Treatment Paradox, 
    98 Cal. L
    .
    Rev. 2093, 2115 (2010) (explaining that “[e]verything that an
    offender confesses during these multiple stages of treatment -
    including sexual fantasies, uncharged offenses, and gruesome
    details regarding sexual offenses - is discoverable.”).
    43
    § 4248. Accordingly, we reverse the judgment of the district
    court   and   remand   the   matter     to   the   district   court   with
    instructions to dismiss the petition. The mandate shall issue
    forthwith.
    REVERSED AND REMANDED WITH INSTRUCTIONS;
    MANDATE TO ISSUE FORTHWITH
    44