Did Nidal Malik Hasan suffer from compassion fatigue or vicarious traumatization?

November 6, 2009

There are many tragic questions emerging from today’s massacre at Fort Hood. The one I’m interested in is why a reportedly mild-mannered psychiatrist, a specialist in disaster and preventive psychiatry no less, would make the decision to open fire on his fellow soldiers.

Did Nidal Malik Hasan suffer from compassion fatigue or vicarious traumatization? One reason may be so-called compassion fatigue, also known as vicarious traumatization or secondary traumatization.

According to the Psychiatric Times, the condition is defined as “indirect exposure to trauma through a firsthand account or narrative of a traumatic event. The vivid recounting of trauma by the survivor and the clinician’s subsequent cognitive or emotional representation of that event may result in a set of symptoms and reactions that parallel PTSD (e.g., re-experiencing, avoidance and hyperarousal). Secondary traumatization is also referred to as compassion fatigue and vicarious traumatization.”

It’s certainly possible. Todd Essig, over at True/Slant, paints a vivid, plausible scenario:

Imagine every day trying to help young men and women somehow put their lives back together despite their night terrors, flashbacks, and chronic sleeplessness. While you reach out to help, they mistrust your every move and respond with hair-trigger tempers, not to mention all the physical symptoms, alienation, and hopelessness. Surrounded by thoughts of suicide–and homicide–you try and keep faith with the honor and challenge of providing care.
But soon the line between their experience and yours starts to blur until, well, something like what happened at Fort Hood today becomes an all too real possibility.

Combined with the fact that he was due to be deployed to Iraq, extremely reluctantly if reports are to be believed, we can surmise that his thought process was compounded an already fragile mental state.

But wait. That explanation may too simplistic, according to Mindy B. Mechanic, an associate professor of psychology at California State University, Fullerton. She says that such an extreme reaction, even in the setting of vicarious traumatization, is unlikely: “They might get depressed or have some emotional fallout from it, but to go on a shooting spree is not part of what happens to people from having to deal with trauma survivors all the time.”

It’s obviously too early to come up with anything conclusive. More will almost certainly come out in the ensuing days.

But if anything, this event brings much needed light to the mental health issues plaguing both soldiers, and apparently, their doctors.

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Lockup Doc » Fort Hood Shooting Spree: November 6, 2009 at 7:40 pm

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← Previous Comments

1 Nick November 8, 2009 at 12:44 am: This cannot be just a moment of rage. Killing 12-13 and wounding more than 30 requires certain determination and planning. I hope the investigation will bring up the motives of this crime, but I will not be surprised if the military will not leak them out.
The question is: should the military have released him from service given his desire and his views as expressed in the past?
2 Marie C November 8, 2009 at 8:50 am: Oh, no, no, no MMCQuarterback, you totally misunderstood me. Or rather, I did not make myself clear because I was being flip.
I have no doubt, no question at all about the existence of many forms and levels of compassion fatigue.
What I was metaphorically rolling my eyes at was the insult rendered to people who do suffer from it. By comparing them to this man, who has been an obvious ticking time bomb for years having nothing to compassion fatigue, they are done a great disservice. Good hearted, dedicated providers experience vicarious suffering due to their empathy and diligence. They do not go on murderous rampages.
I am embarrassed that I was so unclear and misinterpreted.
3 MMCQuarterback November 8, 2009 at 11:31 am: MarieC — sorry to cause you angst! I agree completely. I think sometimes we are in such a rush to be “understanding” we blow past the people who really need it and paint them with the same brush as we paint real acts of horror. Actually, in some interesting way, there’s a parallel here between the ways in which some commentators have said, “Well, of course, he was Muslim” and how some of said, “Well, of course, he had compassion fatigue.” Neither of these things cause mass murder, and innocent caring people are lumped in with those who clearly don’t know right from wrong.
4 Marie C November 8, 2009 at 12:25 pm: MMC, exactly. I’m glad you understand.
And don’t worry, I’m a rollicking bundle of angst under the best of circumstances. lol It takes very little to provoke a histrionic overreaction. lol
5 Honey November 8, 2009 at 1:22 pm: Too bad this “compassion fatigue or vicarious traumatization” didn’t manifest itself in suicide, instead of murder.
6 Lili November 8, 2009 at 10:25 pm: Wow it didn’t take long for this to hit mainstream
http://www.time.com/time/nation/article/0,8599,1936407,00.html
title:
Hasan’s Therapy: Could “Secondary Trauma” Have Driven Him to Shooting?
By Tim McGirk
Read more: http://www.time.com/time/nation/article/0,8599,1936407,00.html#ixzz0WKE8Ycwd
7 ninguem November 9, 2009 at 5:18 pm: If Hasan had been a Christian Fundamentalist who shot up an abortion clinic, or a gay bar, they wouldn’t be calling it “compassion fatigue” right now.
8 lili November 9, 2009 at 6:09 pm: ninguem November 9, 2009 at 5:18 pm
If Hasan had been a Christian Fundamentalist who shot up an abortion clinic, or a gay bar, they wouldn’t be calling it “compassion fatigue” right now.
Ninguem thanks for missing the point. Did the Christian fundamentalist serve as a doctor to other traumatized Christians? Was he a priest or pastor? Did he counsel gays? Where would the compassion fatigue have come from? That IS the point of the article or did you miss something?
9 ninguem November 10, 2009 at 1:45 pm: The guy was in contact with Al Qaeda operatives. His performance record (mediocre to poor) and his scary talk about Islam is coming out, even in the left-biased media like NPR.
“Compassion fatigue”. I’d be laughing if it werent so sad and dangerous.
10 lili November 10, 2009 at 1:49 pm: Let’s try compassion fatigue in a different light. Your mom,sister, and nana get violently gang raped. You know every single horrific detail. Nothing is done, the convicts go free, and it eats at you constantly. Your family says YOU are to blame because you didn’t protect them. Is it funny now?
People will always argue,evade, and use sadness and anger to avoid the bottom line:
People are insane for whatever reason, they are dangerous, and you are not, and will never be, safe. Why? Because excuses make people safer than actual action.
11 ninguem November 10, 2009 at 2:11 pm: You won’t even consider the possibility that his radical view of his religion had anything to do with what he did?
>>Oh and one other thing. Hasan was the last suspect caught.(Remember when everyone thought he had been killed?)The other two suspects were NOT Islamic. Nor were they “brown-skinned”. They were White. So had they been coerced into “joining Islam” or were they protesting against unnecessary war?
In the initial confusion, looks like they picked up two other suspects who were questioned and released. Seems they had nothing to do with the shooting, unless you have unique sources of information.
You’re making up elaborate excuses for the guy. You’re the one jumping to conclusions.
12 lili November 10, 2009 at 2:19 pm: I consider ALL points but I never pin one thing on a situation. If it comforts you to blame his belief in Islam go ahead BUT go out of your way to meet peaceful Islamic people or be a hypocrite.
Surf world news. I make excuses for nothing. I jump to nothing. I just call it as I see it. People want to be “safe” by “blaming”. If it helps you sleep-do it. I cannot stop you. And you cannot stop me.
13 ninguem November 10, 2009 at 3:14 pm: I wonder if Dr. Josef Mengele had compassion fatigue?
Dr. Karl Brandt? (executed at Nuremburg)
Dr. Aribert Heim? (still on the loose I believe, and by some reports converted to Islam)
Dr. Fritz Klein? (hanged in 1945 for what he did at Bergen-Belsen)
I could go on. All Nazi physicians. The Third Reich did not find these physicians (there are dozens more), simply by picking names at random from the German Medical Association. Most physicians refused and most were left alone, though they might not have prospered. Some LIKED what the Nazis were doing. Some people are just evil. There is a strain of Islam that is as bad as anything the Nazis believed, the only thing missing is the ability to carry it out.
14 ninguem November 10, 2009 at 3:18 pm: I’m a physician. I work with peaceful Muslim physicians every day. They do have the common sense to realize that there is a strain of their religion that’s just plain bad news. Same as any other religion.
I wish you had that common sense.
The facts as they are coming in do not support your “compassion fatigue” excuse.
15 Montana November 12, 2009 at 12:19 am: I guess the US military will carry out detail questioning as to why he did it and will prove all of us wrong.
After that happens, I know some will still believe there point still has some some merit.
Interesting comments but the Nazi physicians comparison makes me believe that Ninguem is not a physician, or at least one without any comprehensive logic. Too funny.
16 Charles W Patterson November 12, 2009 at 8:39 pm: Did I miss someone mention the most likely explanation, that this guy suffers from schizophrenia and his religious preoccupations, peculiar ideas, and behavior are simply symptoms of this disease?