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Psychiatry
Mass Shootings in America: Crisis and Opportunity
Looking within to understand the everyday psychiatry of mass murder
Posted February 12, 2015
I recently wrote an article for Aeon magazine originally titled “Running Amok: The Crisis and Opportunity of Mass Shootings in America” (the editors went with a more abbreviated version and their own subtitle hook). The point of the essay was to suggest that despite popular opinion, the root cause of mass shootings has little to do with guns, bad parenting, video games, violent movies, popular culture, or mental illness. That’s not to say that there’s no connection at all between these things and mass murder, but rather that they aren’t in and of themselves the direct cause. Instead, the inextricability of guns in US culture, the widespread popularity of fantasy violence and revenge, and the sense of entitlement implicit in the American dream are a reflection of something within us all, both as individuals and as a society, that in select cases can conspire to create murderous rage. Inasmuch as we harbor these seeds of violence collectively, effective solutions must avoid knee-jerk reactions that identify a foreign entity that can be removed from society (e.g. guns, video games, violent movies, mental illness) in favor of looking within ourselves and within our community networks for better solutions. To stretch the seed metaphor a bit, reducing mass shootings isn’t about finding noxious weeds that can be pulled out of the ground, it’s about how to identify those sprouts that are headed in the wrong direction, so that that we can enrich the soil in which they grow and cultivate them into something that can coexist in a garden.
Some would argue that regardless of root causes, gun control is a potential solution. Clearly this is a matter of intense debate in this country, with strong opinions on both sides, as evidenced by many of the comments in response to my article. While I specifically avoided getting into the gun control debate there, it’s something I plan to return to here in this blog in the future, particularly with regard to the psychology behind pro- and con- arguments about gun ownership. For now, suffice it to say that guns do obviously figure into the calculus of mass murder and as I say in the Aeon article, guns may not kill people, but people do kill people with guns.
Then there’s the issue of mental illness. The automatic assumption that mass shootings are carried out by those with mental illness has become both a trope and a presumed tautology. To many, the mere fact that someone has committed such a socially deviant act as mass murder must mean that they are “crazy” or “insane.” But clinically speaking, those terms have no meaning and although mass murderers are often assumed to be psychotic (roughly defined as lacking the ability to distinguish reality from fantasy, exemplified by delusional beliefs and hallucinations), the majority of mass murderers have not been found to suffer from psychotic disorders such as schizophrenia.
Still, with this popular myth firmly in place, news reporters, purported on-air experts, and armchair psychiatrists at home all cull through available reports looking for evidence of psychosis in the psychiatric history of a perpetrator. It isn’t hard to find supporting evidence when you’re looking—media reports in the days following a shooting are prone to significant bias and error and if there’s one thing human brains are particularly skilled at, it’s detecting false patterns in noise (see my recent blogpost on the “White Christmas Effect”). As but one example, many news articles suggested that the perpetrator of the 2007 Virginia Tech shooting had schizophrenia (e.g. see ABC’s report here). However, two years later, an extensive review of the shooter’s psychiatric history for the Governor of Virginia found little to support those claims and instead painted a picture of a young immigrant with extreme shyness, introversion, and trouble acculturating.
To be sure, there have been mass murderers that seem to have genuinely suffered from psychosis. But beyond the fog of media misinformation that follows shootings, good evidence to support the diagnosis of a psychotic disorder among perpetrators of mass shooting is not the rule. The same can be said of occasional conspiratorial claims that nearly every mass shooter was being treated with psychiatric medications. Where’s the evidence that this is actually the case, that medications were prescribed and were actually being taken around the time of the murders? In fact, despite various claims, we’re rarely privy to accurate details about a perpetrator’s psychiatric history in most cases of mass shooting, such that few of us, regardless of psychiatric expertise, are in a reliable place to speculate on diagnosis (see the Goldwater Rule in my most recent blogpost, “The Psychology of ‘Serial’”).
When more reliable data has been available, as was used for a joint analysis of school shootings by the US Secret Service and the US Department of Education in 2002, the kinds of mental health issues experienced by mass shooters don’t typically support the presence of major mental illness, but rather experiences on the more normal side of the mental health-mental illness continuum. These include a history of depressed mood (an emotion), but not necessarily major depressive disorder (a psychiatric syndrome). Antisocial traits, but not necessarily antisocial personality disorder. The perception that the perpetrator has been wronged or bullied and that others are to blame for their problems, but not actual delusional paranoia. As I wrote in the Aeon article:
“…herein lies the rub—while this kind of profile implies that mental illness could be an important risk factor, what we’re really talking about are negative emotions, poor coping mechanisms and life stressors that are experienced by the vast majority of us at one time or another. These risk factors are not necessarily the domain of mental illness, but rather the ‘psychiatry of everyday life’.”
So while a few mass shooters in history have indeed had serious mental illnesses, the more typical shooter has experienced the kind of milder difficulties with mood, anxiety, and social interactions with which most of us have some personal familiarity. That’s not to say that nothing was “wrong” or that they mass shooters are “normal,” but rather that they aren’t the distinct “others” that we make them out to be, particularly in the years or months leading up to murder where interventions might be most helpful.
In my first eponymous blogpost “Psych Unseen” here at Psychology Today and in my first article for Aeon called “A Mad World,” I discuss the overlap between mental illness and mental health and the potential for psychiatric intervention to be valuable in this grey area. Judging by the comments in response to both pieces, it seems some are reluctant to concede this overlap, as if mass murderers must be insane, while the rest of us, with our flaws and foibles, can’t possibly have a little psychopathology that would benefit from seeing a therapist. But what we know about mass murderers says otherwise. The line dividing extreme acts and mild acts is blurry and many normal people can empathize—at least to a degree—with the sentiments that lead to murder and the suffering that leads to suicide. What I’m suggesting is that this kind of empathy is what’s really needed—not only from mental health professionals, but all of us—if we’re going to find success in preventing mass shootings before a perpetrator crosses that line.
To read more about the psychology of the gun control debate and about mass shooters, see:
The Psychology of Guns
Guns in America: What's Freud and Sex Got to Do With It?
Worshipping the AR-15: Cult, Church, or the American Way?
Mass Shootings, Psychiatric Medications, and Rick Perry
Active Shooters: Not Mentally Healthy, But Not Mentally Ill
When Racism Motivates Violence
