Mind of a Killer

   The tragic shooting spree at Virginia Tech on Monday was shocking to all. . . 

But psychiatrists in particular are likely breathing a sigh of relief along with the deep sorrow felt across the nation and world. In our worst nightmares, mass murder is probably the one thing we dread and fear more than a patient we are treating committing suicide. No treating psychiatrist wants to be associated with being the one who could have prevented such an occurence. We know that such behavior cannot be predicted with any reliable degree of certainty and that a ball park estimate of risk is about the best that can be expected in most cases.

The notorious case of the Law student in Chapel Hill, NC several years ago is a constant reminder of the unrealistic expectations a psychiatrist can face when the worst does happen. This hits home because of actually knowing the doctor who was dragged through the courts for just being associated with the psychotic gunman who randomly shot and killed innocent bystanders in a nationally covered story. The gunman voluntarily dropped out of treatment several months before committing the acts and the doctor was found liable by a jury who awarded the shooter's family $500, 000. To this day, that verdict makes no sense to me.

I listened to the interview of a Forensic Psychiatrist on the news last night and his expert opinion that majority of people committing such acts, as the student gunman at Virginia Tech, do not have a diagnosable mental illness. Apparently, it is really their close association with normality that provides the advantage to premeditate and execute succesfully such haneous crimes. People with severe mental illness usually aren't the best at organization and are more likely to act thoughtlessly or impulsively due to an immediate emotional overload. Mass murderers Are more likely to be more capable of calculating their acts and often belong to the category of Personality Disorder or what is known to mental health professionals as Axis 2 Disorders. Such individuals are quite rigid in character and idealistic, often frozen emotionally in some pre-adolescent emotional stage of development. They are more likely to be highly sensitive to criticism or rejection, sociopathic, narcissistic, or dramatic in their encounters with other individuals in society. They can be wounded deeply by treatments from others that might be overlooked by one with healthy coping mechanisms. Sometimes these emotional wounds can fester and ignite responses that are markedly disproportionate to the originally perceived offenses. They may keep their own score card which others are often unaware of. They can become walking time bombs.

On the grandest scale, when they decide they can no longer cope with the stresses of their situation and find themselves feeling boxed in they may decide to go out in blazes and take as many as possible with them. People with most Axis 1 mental illnesses as the primary diagnosis usually lack such drama and grandiosity unless they are bipolar and in a floridly manic or psychotic state or under the influence of a mind altering substance. When they do choose suicide as an escape the inclusion of multiple homicide is rare. They really just want the pain to end. Those of an Axis 2 flavor want to make as many as possible pay for their psychic pain and suffering and they wish to be remembered for doing something no one else has done and reach a state of immortality. They must have the intelligence and be able to plan and organize well. Usually it is alcohol or a psychoactive substance that lights the fuse and there is no turning back at this point.

The issue of gun control must be addressed. There are points on both sides of the argument but the current laws are obviously not working. Such killings as the recent massacre could become a trend. There are enough weapons in this country for every citizen to have five guns. The balancing act that exists is how to keep the guns away from the bad guys and avoid violating the perceived right to bear arms. Is this really possible? The alternative is to arm everyone and return to the days of the wild, wild west and vigilante justice. Personally, I don't care for guns and do not own one but if someone is coming to kill me I would love to have one if I can't depend on the police to protect me. The invention of the taser and other less lethal weapons than guns has probably saved many lives. At the very least, I think the gun laws have to be more strict than those of states like Virginia where all thats required to buy a pistol and 50 rounds of amo is citizenship and 2 forms of identification. What benefit is there to having assault rifles available to the general public? I see several people a month that probably just need one more thing to happen in their lives to push them to the point that suicide/homicide starts to  become a more attractive option. A bottle of liquor and easy access to a gun is not what they need. We should review the models of other free societies that have a fraction of the gun crimes and see what can be learned. I think this will become a hot political topic in the months to come.

Update on Sun, April 22, 2007 at 04:48PM by HEADoc

COMMENT FROM READER  SLC94@aol.com

I think that the fact that he spent time on a psych ward several months before the shooting could be a contributing factor to his break from reality.  People underestimate what this experience may have on a person's psyche.  I think that it must be mandatory that he continue to see a mental health professional after going through this experience.  He was not seeing anyone and this seems rather odd to me.  Why didn't his family have a closer eye on him?  I am baffled by this.  Plus, I think people underestimate the power of these psych drugs and the negative effects they may have.  I think we as a nation need to take a closer look at these issues.
Comment from slc94 - 4/22/07 2:58 AM

REPLY from HEADoc

The Public mental health system has become a joke. You are right that it does more harm than good in many cases but it is the fault of the irresponsible idiots voted into office that have no concept of what is needed and are too arrogant to ask someone that might know. If this person were in my state and were commited to the state hospital he could have just denied everything and would have been home in less than 72 hours. Had he followed up with the mental health center he would have been told he could see a doctor in 3 to 4 months. It would have stopped nothing. The truth is that the goverment is doing all it can to allow a merger of mental health and the jail and prison system. The goal is to not have mental health care financed by the federal government. In my state the focus is on closing all facilities. The plan has gone pretty much like the war in Iraq is going. Actually we have been quite fortunate not to have had a tragedy before Virginia Tech. This is a wake up call. There are thousands of Cho's walking around daily and have been for some time. This is not the last time we will see such a crime. I have grown to realize that the government has their own agenda and it is not saving lives. If they had their way mental health care would be completely eliminated for the citizens most in need. Systematically, this is already occuring. I speak from fact not fiction.

Mental Health Care providers are among the most dedicated professionals in the country but have an impossible job due to being constantly undermined by the lawmakers and bean counters. And it is not because of lack of money. We have already spent a trillion dollars in Iraq for an unecessary war. The general public is totally uninformed of the real truth about matters and don't seem to care until there is a crisis. The cocaine and heroin crisis hasn't even been mentioned. Prescription medication effects are negligible. It's not complying with taking them that is dangerous. My question is what do you get when you mix an emotionally troubled individual with cheap cocaine and easy access hand guns?