Killers are Made as Well as Born
James Holmes, charged in Colorado mass shooting
By Gretchen Gibbs
David Brooks slays me. There’s so much that’s right about the New York Times columnist, and I want to be able to say, “I like some Republicans, for instance David Brooks.” But then in the midst of saying something interesting, he gets it all wrong.
Like his July 23 comment on the latest Colorado massacre, in which he said that we need more treatment programs to deal with the potentially violent. As a psychologist, I applaud any call to increase the number of treatment programs for the emotionally troubled. Let’s ignore for the moment that the mental health profession is not adept at either identifying potential violence or treating it. What I want to address is the thrust of his essay, the need for psychological approaches, not sociological critiques, to address violence. There’s the rub. Psychological factors operate within a social context and we ignore that at our peril.
All forms of mental disorder vary according to cultural norms. For instance, the percentage of individuals with eating disorders exploded in the 1970s as the approved image for women became thinner. Self-cutting and other self-mutilation became a serious clinical problem only in the last 15 years or so, along with the acceptability of body piercings and tattooing.
It’s hard to know what the factors are that contribute to our culture of mass violence, other than the notoriety that the perpetrators attain. Shooting a lot of people is a sure-fire way of attaining attention for individuals who feel they are not receiving their just desserts. There’s a copy-cat aspect, as when a teen commits suicide and then others who hear about it also make attempts. Perhaps restricting the amount of publicity the killer receives would be a good plan. Let’s focus on the victims.
Gun control plays some role, as it’s clear that having assault weapons available leads to a higher degree of potential havoc when somebody has a violent outburst. Michael Moore explored the topic in a film, using the previous Colorado massacre, and concluded it wasn’t the guns per se, as Canada has similar gun availability yet much lower levels of violence than in the U.S. Moore concluded that it was a culture of fear and distrust in the U.S. that led to so much violence.
We need to figure out what the factors are and address them, not just act as though a mass killer is some deviant human being in isolation from society. I see David Brooks’ attitude as part of a larger picture in which cultural factors are ignored in attempting to understand emotional problems.
The American Psychiatric Association is about to come out with a new version of its diagnostic manual. Lest you think this boring, remember that your insurance will only pay for psychological treatment for diagnoses that exist within this manual. For instance, if you have a marital problem, you’ll have a devil of a time getting your treatment paid for, as there are no diagnoses for marriage difficulties.
The premise used by the APA in this new version is that mental illness is an actual biological illness, to be treated medically. Seventy percent of the committee working on the revision of the manual has ties to the pharmaceutical industry. Some of their revisions seem an attempt to broaden drug treatment. For instance, at the present time there is a distinction in the manual between depression and experiencing grief after a loss. This distinction was going to be eliminated, meaning that normal reactions to a death or other tragedy would be labeled as illness, and millions of ordinary people would receive unnecessary prescriptions, with sometimes serious side effects.
Grief is painful, but it’s different from depression, and drugs are not the answer. After much criticism, the manual will retain the distinction between depression and grief. The committee, however, has not responded to the extensive criticism it has received from over 50 mental health organizations and 11,000 clinicians, including me, protesting the exclusively medical orientation.
What’s happened to the last 60 years of discoveries from psychology, sociology and anthropology? Has everybody forgotten we’re products of our environment?
gretchen@zestoforange.com
Tags: Colorado, David Brooks, mass shooting, psychiatry
August 3rd, 2012 at 1:08 pm
Excellent piece, Gretchen. There is certainly a place for drugs in the treatment of mental illnesses and many patients have been helped in recent years by development of new agents. But that is not enough for pharmaceutical companies that measure success in terms of the revenue derived from prescriptions. Hence, the sort of “disease mongering” you describe occurs in psychiatry as well as many other medical specialties. I’m glad the “rank and file” APA members resisted the attempt to label normal grief as a disease.