DSM5 in Distress

The DSM's impact on mental health practice and research

Mass Murderer Psychobabble Misses The Gun Policy Point

David Brooks should stick to policy and drop psychology

In his recent New York Times piece, David Brooks" provides a psychological analysis of mass murderers, concluding that: "The crucial point is that the dynamics are internal, not external. These killers are primarily the product of psychological derangements, not sociological ones." He goes on to make the astounding claim that better relationships and treatment can help to prevent mass killings.

Brooks' naïve psychobabble allows him blithely to dismiss the role of public policy. He would have us focus our attention on the mind of each individual mass murderer, ignoring why the US consistently produces so many of them.

The US doesn't have the highest gun death rate in the developed world because we have more deranged people than other places. The thing that distinguishes the US is that our potential killers are so much better armed than any in the past or anywhere else.

Brooks misses the point of both disciplines when he so ardently embraces a psychiatry he doesn't understand and so casually dismisses a sociology that actually does provide important answers.

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Psychiatry has no way to predict mass murder and no way to prevent it. Many mass murderers never see a mental health worker before going ballistic. Even those who do are as impossible to identify as needles in the haystack. Many patients have violent thoughts; but vanishingly few ever act on them—mass murderers are too rare to be selected out of the crowd before the deed is done. Psychiatry can do wonders in treating psychiatric disorder, but strikes out in predicting or preventing violence and it is irresponsible to offer it as a solution to mass murder. Brooks' other solution—better relationships—is even more fatuous. 

Sociology first became a valuable informant of policy more than a century ago when Durkheim noted the statistical predictability of rates of suicide and violence and their systematic variability in different countries. It is impossible to predict who will be suicidal or violent and certainly to say when and how. But if you collect a big enough sample, it is possible to be precise in calculating how many people will kill themselves or others in each country in any given year.

There is no indication that psychiatry can change the statistics of violence. We need to look instead to sociological answers and their policy implications. Statistics tell us that we have a saturation of deadly weapons unparalleled in history and unique in the developed world—and simultaneously that we also have the highest rates of gun related injuries. The burden of proof is on those who want to refute the seemingly obvious causal connection and deny its obvious policy implications.

Brooks' command of the facts is as weak as his theories. Here is Brooks: "People are trying to use the Aurora killings as a pretext to criticize America's gun culture or to call for stricter gun control laws. This doesn't happen after European or Asian mass killings." He ignores the fact that after the Port Arthur mass murder in Australia in 1996, a conservative government overcame strident opposition (especially among its conservative constituents) to replace lenient gun control measures with tight ones. And people in the developed countries of Europe and Asia don't have to soul search about a gun culture because they don't have one. They don't call for stricter gun control laws, because they already have them. Our lack of reasonable gun control makes us an egregious outlier.

Homicide is built into the human genome and is as old as Cain. It will never be eliminated, but can be enhanced or contained depending on public policies. People will always find ways of killing people, but the number killed will depend on the number and power of the weapons available. It is a statistical numbers game and we stack the odds against the victims when we allow the killers to arm themselves with semiautomatics and thousands of rounds of ammo. 

Brooks' should stick to expressing policy views and drop the amateur psychologizing. His observations would be silly, but harmless, were he not such an influential voice. As it stands, he gives aid and comfort to the suppression of a serious policy discussion, allowing a mindless spread of ever more destructive weaponry. Gun control shouldn't be shouted down, or lobbied away, or rationalized with pop psychology. We need a sustained and serious debate on the public health problem of violent death, not wishful thinking.

Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.

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