David Brooks’ column in the July 24 New York Times makes an attempt to provide apropos, if not sage, comments on the recent Aurora tragedy, particularly on the related topics of the psychiatric issues involved: (1) what kinds of problems shooting-spree culprits can generally be said to have, and (2) that there is, he suggests, a need for more treatment centers or such. The callout in the print version says the problem is not sociological, but psychological.
In a narrow, obvious sense, if it weren’t for the shooter’s psychiatric problem, there wouldn’t have been the shooting. Very true. But it’s easy to point out the person has a terrible psychiatric problem; it’s another matter to say that there’s some kind of good, systematic or formulaic solution for this, and on this there is clearly no abstract or concrete solution readily at hand.
In fact, not to grandstand with an argument for gun control (which I generally would be in favor of), but it would be an easier systematic measure to enact gun control laws closer to those of the most enlightened countries in Europe than to create some kind of blanket approach to snuffing out psychiatric problems before they lead to mass shootings.
These particular shooting-focused psychiatric issues—after all, murderous rampages occur only among a small minority of patients with the most serious psychiatric problems (see my July 24 blog entry)—crop up out of range of the potential shooter’s being recognized for what he is about to do, or being caught. This is a novel, from-the-shadows eruption—rather like Dostoyevsky’s Underground Man.
People talk about “red flags,” as was done regarding the Korean student who wreaked havoc in the Southern college a couple years or so ago. Well, whatever some people might have picked up on wasn’t enough to rein in the student before he did his deeds. Almost by definition, the murderer escaped having any red flags serve as cause for him to get decisive help.
An anecdote from 1985
I remember when a work friend of mine, when I was working at my college’s student union building, was making suicidal comments. A resident assistant we both knew, who had been doing temporary work of some kind at the student union, commented to me (in a somewhat self-righteous manner) about my friend talking suicidally, and she suggested maybe I could talk to him, because he was my friend, no? (She was trained to be on the lookout for this sort of thing, obviously, and I credit her for that much.) I was slightly annoyed at this (for a certain lack of perspective I initially felt it showed), and part of my thinking was that this friend could talk absurdly anyway….
Long story short, I talked to him one evening, in an empty office of the Program Board, a student office that arranged notable entertainment and special-presentation events. “I’d been told you were giving hints of being suicidal,” was more or less how I started. This was the most awkward conversation in my life to that point—with a friend. He had a barely tolerating, odd look as he ate a plateful of food we had mooched off some event in the building, as we often did. I think he listened to me unspeaking the entire time I spoke, and when he finished eating, he said, “Fuckin’ slop!,” and I knew this was a displaced show of annoyance at my “self-righteous” talk to him; but I also felt he had some gratitude for what I’d broached with him.
The whole situation with him, in coming weeks, got quite weird. He quit college later that season—in spring semester 1985. GWU was the third college he’d tried to get a degree at, and the last. The same basic time he quit, a large number of unsold tickets for parking in the student union’s parking garage—they were worth perhaps $1,000 total, or more—were stolen. A resultant fancy investigation involved campus security and, I believe, Washington, D.C., police. A number of us workers at the student union were questioned. As was I.
Did I know Andy had been a heroin addict? I was asked. And so on.
I knew Andy had been an addict—he had revealed it to me within the few months before. I was rather shocked at the discovery, and was concerned about him. He worked double shifts at the student union and could be in the most unhealthy mental state at times.
He was going downhill in his last several months at GWU. My talk with him about his being suicidal was one part of the whole puzzle of various things he was involved in, leading to how he, in sum, washed out. Later, he got a job doing something computer-wise at a local law firm. I didn’t see him for many months, then I last saw him in November 1986.
In 2006 I found he had died in 2003. He left two young children and a wife from whom he’d been separated or divorced. I rather fear considering the possibility that he died in 2003 as a result of suicide.
The complexity and bad-match aspects of dealing with distrait fellows
This was only the first of the major case of suicidal person I dealt with, and that when I was age 23. When, many years later, I worked with a support group in 2001-03, and I was much more up to my neck in dealing with people in crisis, I was better equipped for this. But for me as a layperson—I’m not licensed to be a psychologist, though I have a degree in the field—it was quite tiring, to say the least: not boring but exhausting. And for practical reasons, with me as a volunteer, I couldn’t help everyone equally.
Bipolar people could easily be as much trouble as someone with schizophrenia. Mr. Brooks’ blanket assumption that these shooters are eminently schizophrenic is cavalier—too crude—in the way of a psychological layperson (like himself) opining. Schizophrenia and bipolar disorder share some genetic background (as has been argued by Ivan K. Goldberg, M.D.; see End note 1 below; End note 2 will be in a July 27 blog entry); and clearly on an anecdotal level, you can easily find bipolar people who pose much worse problems than the more “quietist” schizophrenics you can find.
This is to say nothing of how readily the more troubled of all of these types get help.
Treatment centers such a panacea?
On the issue of “we need more treatment centers,” this is easier said than done. Even if you were to build and staff more centers, the quality of them can vary; some employees can be mediocre at best (this sort of topic can come up readily within patient mutual-aid groups), and other employees can be good helps to some patients, not so much to others (I know myself that some patients are easier to “get a handle on” than others). This is an area where a certain good chemistry (related to understanding, not just emotional affinity), which is almost a matter of chance with respect to some people you try to help, is essential to being a help.
I like the idea of public education on this. Hence, to some extent, this blog.
Casting a stink-eye on the “Aqualung” next-door? Forget it
Mr. Brooks says we should be on the lookout for those among us who seem like we’re going off the rails. This is even more of a cavalier pipe dream than the idea that a caring friend can always be an adequate help to a fellow who gives off more innocent “red flags.” Tacking a name (of some potential for mental illness) onto someone we really don’t know, no matter how odd they seem—“not knowing” maybe being confounded with our mistakenly thinking the person is “just a nut”—can potentiate worse problems: it can mean harassment, exacerbating a fellow’s stress, inciting further alienation creating further agitation, and so on.
End note 1.
Dr. Goldberg offered information on the genetic commonalities between schizophrenia and bipolar disorder (of course not as his only means of offering this) at a specially arranged lecture, "Why were people who are diagnosed bipolar today diagnosed schizophrenic 25 years ago? Was there misdiagnosis then, and is there misdiagnosis now?" This, along with a Q&A, was presented on August 1, 2005, to a special lecture meeting of the support group NAMI Sussex in Newton, N.J. Part or all of his presentation is on audiotape. I may post further backing information, from other sources, before long in a separate blog entry.
End note 2.
See July 27 blog entry.
