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Psychiatry
Psychiatric Illness is Only One Reason for Violence
Newtown can happen anywhere.
Posted December 24, 2012
We are getting too familiar with this. A mass shooting of school age children in a wonderful, Connecticut suburb, not far from my home town, numbs the mind. Last year, a murder suicide occurred in another neighborhood where I happen to work. That alone was too much – including the aftermath .
The list goes on; on August 3, 2010, not far from Newtown, a disgruntled employee took the lives of eight innocent men, in a murder-suicide involving a work dispute. And if you can’t think of other cases of heinous violence, consider the events of the recent past when Jovan Belcher of the Kansas City Chiefs killed the mother of his child and then himself.
Much ink has been spilt and given that we've been writing about malignant divorce for so long, violence comes as no real surprise. People get upset and they sometimes kill.
Reasons abound:
• Pundits will point to the easy availability of guns. The gun lobby will tell you that people kill, but they would be killing far fewer choosing a knife over an automatic weapon.
• You can blame a society that’s alienated and disconnected – or to a demoralizing and cold economy. There is a huge cost to the pressure most people feel now-a-days. Sometimes, even healthy people feel that it’s each man (or woman) for himself.
• Then, there’s the marginalized young men (and some women) that can’t find work and live at home trapped in an unhappy dependency. A better economy may have given them hope. Now, so many are stuck, suffering from under-treated psychiatric problems, self-medicating with pot or drink, or marinating in video games and resentment. It is tough.
• Still others, like New York Times columnist David Brooks (http://www.nytimes.com/2012/07/24/opinion/brooks-more-treatment-programs.html?_r=0), will point to the complete collapse of the community mental health system in our country, with the neediest patients having so little access to quality care. I am glad we have an influential voice for the mentally ill.
Somehow, one explanation does not suffice.
So, I vote for all of the above plus more.
On August 1, 1966, Charles Whitman stood on top of a tower at the University of Texas and randomly killed people passing by below – 15 in all. This terrifying act garnered national attention and opened our consciousness to mass murder. In addition, Whitman murdered both his mother and wife prior to his rampage. But, there is one fact that often escapes our attention.
The University of Texas perpetrator had an invasive brain tumor.
In fact, it’s been reported that Whitman had asked for an autopsy in a note prior to the killings. Perhaps he was disturbed by his own compulsion to kill. Brain tumors can and do affect the central nervous system and rarely cause someone to act in a radically different way. This kind of behavior can happen anywhere and at anytime. It is completely biological and extremely rare.
What we are now seeing is a steady rash of murder suicides, often involving divorce, work place violence and worst of all, mass killings in malls and schools. I have not yet heard of brain tumor as a cause.
What happening is that something fundamental has shifted in our culture. Robert Putnam tried to get at in his classic work, Bowling Alone, where he shows how bowling leagues have being slowly dying to be replaced by small groups and individuals. Culture is losing its sense of community – its currency of shared social capital.
In the past the social matrix included a heavy sense of community with strong ethnic and religious ties. The commandment, Thou Shall Not Kill, permeated everywhere. Modernity has brought much good; we have rights for women, minorities, gays and even, atheists. While we have a strong national culture, the ties that bind us may be looser as well as the rules. I wonder if some of the core values of faith have been diluted in our efforts for progress.
On another front, we now operate in a social milieu that’s changed the very mechanics of relating. We may connect to our friends and peers through Facebook and the internet, but we are increasingly cut off from our neighbors, our schools, our doctors and even our families. Many forces alienate us from each other. I can give you an example from my profession. The family doctor has been taken away by specialists and by insurance companies that reimburse relationships so poorly - and procedures so well. Patients are becoming numbers and doctors are becoming providers. Both patients and doctors lose.
A few years ago, I got to meet a BBC producer who covered Bosnia during its terrible civil war. He told me what it’s like to be in a place that has lost its social matrix. “You don’t realize all the invisible rules that hold a society together, until it’s not there.” He went on, “in Bosnia in those days, you could meet a stranger who would kill you for money, or food, as if nothing had happened. The rules of restraint did not exist.”
We are not there yet. But I bet the murderers and mass killers we hear about in the news, including this alleged killer in Newtown, all fell short of the Brain Tumor standard. In psychiatric language they may have had a Paranoid Disorder, Schizophrenia, a Personality Disorder, a Mood Disorder or a Drug or Alcohol problem.
It takes a disturbed mind to hurt another person, whether it’s domestic violence (which happens every day) or mass murder – which doesn’t. But our culture helps direct how the disturbed mind will express its rage. We had deeply unhappy people 100 years ago, but they attacked with their fist or with a knife. Deadly yes, but not that deadly. Now, the barrier of entry to extreme violence has gone down. It’s easier to kill – and you don’t have to be as sick to do it.
What I suggest is that we go over each of the “causes” and bring our humanity back to our culture. We desperately need the gun lobby to carry more ambivalence, and realize that you can’t always get what you want. To those in the NRA who are religiously inclined, I invite them to the mountain and hear a contemporary Old Testament prophet – his name is Michael Bloomberg.
We must somehow strengthen our synagogues, mosques and churches, while modernizing religious doctrine beyond the age-old paradigm of us versus them. The Reverend Martin Luther King and Rabbi Abraham Joshua Heschel still have much to teach us so many years after their deaths.
Our culture of casual violence, whether in music, movies or video games does create a standard. While, I do not believe that people are provoked to violence by the games they play, I do think that unhappy minds marinate in such violence to no good end. The Columbine killers are a good case in point.
And, a big yes to David Brooks; community psychiatry was dismantled in the 1970’s and never recovered. We may not be Bosnia in a civil war, but we do have disturbed people that are poorly treated by modalities that work – when used properly. It just takes a stressed Personality Disordered patient to kill these days. We have a responsibility as a society to protect such people from themselves as much as we want to protect them from us.
One final thing: I don’t know how one rebuilds a matrix of people all feeling like their neighbor counts. Maybe we have to slow our lives down a notch. Maybe we need to take interest in people, just because it’s the right thing to do. Capitalism does encourage a certain degree of narcissism, but human beings require more. Maybe we can have a grander vision of America than just a place where you can get ahead, but rather a land where you belong.
There is no good answer for what happened in Newtown, just sorrow and outrage.
We can do better.
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