In the last 20 years there have been at least 14 mass shootings in the United States in which 134 people have been killed, an average of nearly 10 people for each shooting. In the worst of these, 32 people were killed by an apparently mentally ill student with a handgun at Virginia Tech in 2006. The other killings have been in schools, workplaces, restaurants or other public places. Somewhere around 34 people are murdered each day in this country by gun violence. There are 90 guns in private hands for every 100 Americans - man, woman, and child.
    What can be said about the Arizona massacre? That we live in a time when extreme and hateful political rhetoric creates an atmosphere in which the most angry and unbalanced among us are inspired to kill? That the long American love affair with the gun places us all at risk? That our mental health system is inadequate to the task of serving those who are demonstrably crazy? That random acts of violence, including mass murder, have always been with us and always will be? All this and more.
    Irrationality is often based on fear. So-called paranoid thinking finds its usual expression in the idea that people and forces are conspiring against us. In political terms it is not enough that those who disagree with us are mistaken or uninformed; true paranoia requires that we believe in a malign intent to injure us, to render us helpless, to take from us what is rightfully ours, to deprive us of our rights, our property, our freedom. This idea is what pushes paranoid people toward rage and resistance. When people who believe in conspiracies are given money, notoriety, and a public bullhorn that reaches millions who can argue that their words do not affect the beliefs and actions of their listeners?
    In a rational democratic process the rules are agreed upon, e.g. the person who gets the most votes wins. If we do not like the outcome we know we will have another chance in a subsequent election and it becomes our task to organize and persuade others to our views. In a paranoid world, however, any loss is the result of a conspiracy of forces that are illegal and must therefore be opposed by all means necessary. Those in power are illegitimate or altogether alien (e.g.,The President was not born in this country.).
    Which of all these factors is controllable? Can we identify, segregate, and treat the minority of the mentally ill who are dangerous to the rest of us? With 270 million guns circulating in the most heavily armed society in the world can we keep handguns out of the hands of those with homicidal intent? Will we tone down political rhetoric that demonizes those who disagree with us? Not likely. Repeated mass murder of our fellow citizens at the hands of alienated loners is an American phenomenon matched only by the work of religiously-motivated suicide bombers. It is the chosen response of those who see themselves as weak or estranged from other human beings and is directed against forces that they imagine threaten, oppress, or ignore them.
    The President, in his healing memorial address, said, "The loss of these wonderful people should make every one of us strive to be better." And by better he meant kinder, more tolerant, and able to "question each other's ideas without questioning each other's love of country." Who among us can gainsay that? It sounds like a simple request to honor but in doing so we would have to relinquish our exclusive affection for our own view of the world, and our contempt for those who do not share it. We would also have to come to believe that we are all in each other's care and that we ignore the lonely, alienated, and ill among us to our own discredit and at our own peril.

About the Author

Gordon Livingston

Gordon Livingston, M.D., writes and practices psychiatry in Columbia, MD.

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