Prudence Gourguechon, M.D.

Prudence L Gourguechon M.D.

Psychoanalytic Excavation

Shooting in Alabama: Stress does not cause Massacres

The problem of the disappearing diagnosis of psychosis

Posted Feb 13, 2010

Once again, a horrific story about a mass shooting is in the news-Alabama Biologist Amy Bishop allegedly shot and killed three colleagues and wounded three others.

Every story in the media I've seen so far mentions the fact that she was recently denied tenure.  This is  an experience likely to lead to feelings of anger, humiliation, shame, and resentment in any human being.

A paragraph in the New York Times is typical of the media coverage of this and similar stories:

"The shootings opened a window into the pressure-cooker world of biotechnology start-ups, where scientists often depend on their association with academia for a leg up. Ms. Bishop was part of a start-up that had won an early round of financing in a highly competitive environment, but people who knew her said she had learned shortly before the shooting that she had been denied tenure at the university." (NY Times, Feb 13)

These feelings, these life events, do not lead to mass murder.

This has become a habitual approach for the media in stories of this type. When Major Hasan killed 13 fellow service people at Fort Hood last November, the media reports focussed obsessively on the stress of working with veterans returning from combat, Dr. Hasan's immanent deployment to Iraq and his opposition to the war, and burnout among military mental health professionals. Early in the reporting cycle, the media showed much interest in PTSD, which was especially irrelevant because the shooter had not even been in combat and turned out to have suffered no particular trauma.  A case like Hasan's case could be a complex interaction of extremist belief and mental illness.  But it has nothing to do with PTSD, burnout, or frustration.

Stress, disappointment, PTSD, frustration, burnout, loss,  shame and humiliation DO NOT LEAD A HUMAN BEING TO PICK UP A GUN AND START KILLING HIS OR HER FELLOW HUMAN BEINGS. Not having examined them, I can  not know what is wrong, psychiatrically, with these killers, but I know that something is. And it's not these human difficulties I just listed that are constantly referenced in the media stories. 

It is important to distinguish between triggers--what might light the fuse--and the explosives that lead to the catastrophe.

Getting it wrong in the media does us all a disservice. If true but irrelevant facts are continually referenced, we start to think these things (eg stress) are relevant and truly causal, as opposed to possible triggers. And, the media rarely or never mention the factors that are more important to consider: Delusions. Paranoia. Major Mental Illness. Schizophrenia. Psychosis. The vast majority of human beings who suffer from these symptoms or disorders are not violent or dangerous and can do very well with appropriate treatment. But these might be the things that lead a few human beings pick up a gun and shoot their colleagues. That, plus easy availability of firearms.

Why have we substituted "stress" for psychosis as a causal concept?  Why have we confused triggers for causes? What is the consequence for our society? One consequence I fear is that there will be a continually diminished tendency to consider and diagnose and treat psychosis and major mental illness, and therefore there will continue to be undiagnosed and untreated disordered minds picking up guns and going to a meeting to kill.

Society needs to know and be reminded that people can-- in rare but significant instances-- lose touch with external reality, and substitute a dangerous irrational inner world where, for example,  they feel persecuted and terrorized.  

I would like to thank my friends Doug and Judy Logue for sharing their thoughts about this subject with me.