Doctor Anonymous on the psychological autopsy by mainstream media:
I could be wrong, but I’m starting to see people in the press making the association between depression and murder. Of course, this kid had mental illness and of course he was undergoing treatment for it. But, the implication that everyone with mental illness has the potential “to snap” and kill people – as being suggested in the media – this bother[s] me.
Update:
On the flip side, Ed Silverman wonders if Cho will be the new face of antidepressants.
Related posts:
- Mental illness and voting
- A UK doctor fired over a blog link
- The "John Q" murder and media bias
- Violent video games and mass murder
- Talking about mental illness
- Is depression over-diagnosed?
- What do psychiatrists think of the new ACP depression guidelines?
KevinMD.com on Facebook
{ 10 comments }
I have to agree with Dr. A. Most people with depression do not go around mass killing people. To blame it on that is utter BS. This guy was an absolute nutcase who probably really just hated Americans. What I really dont get is why these people who know they are going to end up killing themselves, dont just go off some place and do that dead and leave the rest of the world alone.
No, not just depression: paranoia, alienation, anger, projection, depression and particularly hoplessness and thoughts of external loci of control. There is very definitely a loss of reality testing. Almost always it involves a triggering event in the life of the perpetrator: loss of job, of a marriage or equivalent or of significant amounts of money. Sometimes the loss is more imagined than real. Revenge fantasies, grandiosity, and a notion of just retribution through violence and access to firearms fulfill the necessary requirements of the mass murderer.
The same character is consistent across all of the recent mass shootings crimes: San Ysidro, CA, Kileen, TX, Hobart, Tasmania, Dunblane, Scotland, Quebec, the San Francisco Law Firm shootings, and the numerous post-office and factory mass-killings, and also Virginia Tech.
It is about a certain personality type, psychosis, and access to weapons and usually a significant personal loss in the life of the perpetrator, real or imagined.
Any chance he was borderline autistic? That was my first thought as I read the various accounts of his personality.
Any possibility that he was a simply a mean socially incompetent immature evil tweerp? Not everyone who does crazy things is mentally ill. Why do my pateints have to get smeared with paint off these guys. I have practiced psychiatry for 20 years and non of my patients have ever killed anybody. Usually they are the victims of mean people, not mean people themselves.
>>”Any possibility that he was a simply a mean socially incompetent immature evil tweerp? Not everyone who does crazy things is mentally ill. Why do my pateints have to get smeared with paint off these guys. I have practiced psychiatry for 20 years and non of my patients have ever killed anybody. Usually they are the victims of mean people, not mean people themselves.”
It is a rare event, which makes it so shocking. To give you some comparison, more innocent civilians were killed by bombers in the past ten days in Baghdad than have died at the hands of school-work shooters in the past three decades.
The fact that none of the patients you have seen in your practice has done something as violent as what happened at Virginia Tech is besides the point, or perhaps is exactly the point; it is a rare event. And the possibility that he was “mean” and “socially incompetent” doesn’t mean that he wasn’t also clinically ill with paranoid ideation and other features of major thought disorders. But as an experienced psychiatrist, I would think you don’t need to be reminded of that.
If you look at the persons who commit these crimes, there is a common feature of depression, anger, social isolation, perceived external locus of control with malevolence and a catastrophic personal loss that is a triggering event: death of a close family member, loss of job or of a significant amount of money or of an equivalent dispute, as in a suit. The killers are suicidal but perceive themselves as being forced to their deaths, and the murderous violence they inflict before suicide is the displaced rage at their circumstance.
Your surmising that they were merely evil is a primitive conclusion, not something I would expect of an experienced mental health professional.
Well, he was evil!…This is going to be a bad rap for mentally ill people every where. the fact that it will be sucks. Not all Koreans are evil. Not all Muslims are evil. Not all depressed people are evil. but, this guy was.
Why are we a country who must medicalize every behavior known to man? There are EVIL people in this world. Why not just accept that? Instead we must find reasons and excuses for what they do.
He knew exactly what he was doing and probably been planning it for a long time. It doesn’t matter if he hated rich kids or not. In reality he had been in college for almost 4 years and would have been graduating next month. He surely knew if he thought these people were intolerable that his time with them was almost up. He would have left college and never had to see any of these folks ever again. No, he planned this to happen exactly when he made it happen. He was an “evil” bastard! Quit making excuses for him. And quit making it sound like all depressed people must now be considered potential mass murderers.
>>”Well, he was evil!…This is going to be a bad rap for mentally ill people every where. . . .
“Why are we a country who must medicalize every behavior known to man? . . .
“Quit making excuses for him”
Who is making excuses? The comments posted above yours are valid regardless whether you label the acts evil or not. There being mental illness in the perpetrator has nothing to do directly with evil, unless you think the mere fact of a diagnostic classification is an automatic excuse for culpability. You are confusing the medical and the moral, and not considering that judgments about both might apply. Refusing to see the high probability of preexisting pathology is blindered in the extreme. In fact it is ignoring overwhelming evidence on its face. And mentally ill people are capable of doing some very bad things, sometimes with what should be enough moral judgment to know what they have done is wrong.
It seems you can’t bear the thought that this guy did the things he did as a mentally ill person, almost as illogical as thinking he couldn’t have done the same things as a diabetic.
I can bear the thought that he was mentally ill, I just don’t accept it as an assumption. It is a false assumption to conclude that because what someone did is outside of the realm of our imagination means that they are ill. Illness and evil overlap but are different. He may just be evil, mentally ill, or both. I have treated many people with command hallucinations telling them everyday to do things like this, but they do not act on commands that they believe to be from God because their moral sense tells them it is wrong. Others have no moral sense. Was he hallucinating? I don’t know, I have heard no evidence that he was. Was he unhappy. Clearly. Was he clinically depressed? Maybe, none of us know enough to know. It that a sufficient explanation for what he did even if he were? Absolutely not. He had the energy and initiative to formulate and implement a novel action efficiently and without visible hesitation–that is not someone with severe depression adequate to override his moral reasoning if he had any to start with.
Is it “primitive” to suggest that he was just evil? No, it is a clear possibility that is really all there was to it, that he was isolated from others by his incapacity to appreciate the positives of humanity and enjoyed basking in anger, victimization, and imagining inflicting suffering on others, which he finally acted on. Much of human nature, is in fact, quite “primitive”.
I’m the guy that thought he was “borderline autistic”. I’m not a doctor, so that was just my ignorant, wild speculation.
I tend to be a little draconian, in that I believe there should be almost no exceptions when it comes to sentencing. For me, the only question is where we “warehouse” a particular person who should be removed from the civilian population … which depends on what kind of state he/she is in.
His evilness doesn’t interest me as much as the fact that he is another “data point” or example to be studied in the attempt to prevent analogous episodes in the future.
I work with the mentally ill in Virginia, and this is not a surprise to me or to any of the other professionals with whom I work. Virginia’s “system” for hospitalizing the mentally ill is one of the worst in the nation. Cho was obviously a delusional paranoid schizophrenic, as was evident if you saw even a portion of his video. He could very well have responded to treatment, but instead our incompetent mental health system set him free with nothing but unenforced paper restrictions. As to those of you who think there is no link between “depression” (how about schizophrenia?) and violence, we have had many incidents in Virginia of unmedicated unrestrained schizophrenics killing police officers, killing small children, stalking and harming strangers, and hurting themselves or their family members. The common thread in all of these cases is that people RECOGNIZED the severity of the problem, REPORTED it to the proper authorities, and were REBUFFED because there were NO inpatient psychiatric beds available in the state. So now I guess we get to do “Incompetent Mental Health System: The Lawsuit.” What a crying shame.
Comments on this entry are closed.