Archive for the ‘mental illness’ Category

And the violence, it goes round and round . . .

June 11, 2014

Let me make one thing clear.

As of May 2014 there have been at least 70 mass shootings or shooting sprees with legally purchased guns, according to Rolling Stone.

As Ezra Klein reported in 2012, while violence in general declines, more episodes of a lone individual, or team, involved in killing sprees or mass murders increase.

Why? And, as Tim Kreider recently wrote, do we really care?

No one answer can solve this problem.

Is it even worth trying? Do we have an obligation to murdered children, youths and adults? To their families?

Do we even owe it to ourselves because any of us or our families or our kids could be next?

Pundits, politicians, the NRA reach for the simple answers. Yet, no one explanation moves us forward to stopping this crazy epidemic of young men going wild upon the world around them.

Mental illness alone doesn’t cause a person to buy a gun and shoot a bunch people.

Access to guns makes violent crime easier to commit but they don’t motivate the shooter.

Exposure to violence can impact how people process information, but individuals vary widely in how they internalize violent imagery. Most violent gamers don’t become mass murderers.

Overstimulation in general can alter how a person perceives others.  Yet, many people with even the most sensitive temperaments or the propensity toward reactive anger don’t decide to kill.

The confluence, however, of persons with unregulated temperaments, who have learned violent pathways to manage emotions, and who have easy access to guns enables more people than ever to enact this complicated call from within their psyches.

So while calling for more mental health treatment, legislating new gun safety rules and placing limits on kids’ access to violent imagery, also ask this question: how come so many people with the above described profile have emerged in the past thirty years or so?

Perhaps these individuals with a particular skew toward vulnerability enact exactly what they have been taught by the world in which we live: rush to do violence.

Children around the world have this in common: suicide bombings, acts of terrorism, exposure to the effects of nuclear arms and chemical weapons, savage treatment of animals in the production of food, obliteration of the world’s beauty and environmental health, sexual aggression towards women and children, pornographic representation of said violence, idolatry of gang culture, and massive overexposure, albeit fantasized, to destructive acts between humans.

Of course these behaviors have always existed. And yes, people have always killed. Mass murders and killing sprees punctuate all of history.

The beauty of the modern world, however, resides in our exquisite technology.  The violence we can commit is so much grander. The vulnerable and confused children who grow up under its shadow can enact their vehemence with far greater power.

So limit guns and enhance mental health. In the meantime, think about this: are these troubled lone gunmen with easy access to weapons behaving any differently than that which the world reflects back to them?

Affluenza doesn’t excuse wrongdoing

December 13, 2013


from “The Guardian”

Ethan Couch’s lawyer defended him by stating that he was not responsible for driving drunk and killing four people because he had “affluenza”.The legal argument dazzles.  Psychological research doesn’t support it.


Underage Drinking: The Real Problem

June 3, 2013


The Center for Disease Control and Prevention states that alcohol use by those under the age of twenty- one is a major health problem. Research continues to demonstrate that teenage alcohol use endangers brain, liver and endocrine function. Binge drinking can also be lethal to young bodies. In New York City alone emergency visits due to teens who had consumed dangerous levels of alcohol has risen from 7, 958 in 2007 to 15,620 in 2011 according to city records as reported by The Daily News.

Yet underage drinking has other more insidious consequences.  Alcohol misuse by teens circumvents emotional development. The disinhibiting effects of alcohol enable kids to bypass the anxious struggles and subsequent lessons that come from navigating social relationships while sober.


The Harmful Consequences of Diagnostic Categories

April 12, 2013


Youthful Tendency Disorder, a term coined by The Onion, pokes fun at diagnostic categories.  It satirizes the modern psychiatric and psychological observation of pathology in normal behavior.

Given the numbers of people suffering from serious and sometimes life threatening mental illness, is this humor fair?


Mental Health as a Management Strategy

January 27, 2013


I was pleased to see Elyn R. Sak’s article in the New York Times today.  Her story opens a new dialogue about mental illness.  Instead of cultivating “patient” status and transforming people into fractions of who they could otherwise be, treatment for serious mental illness should focus on the management of symptoms.  In this way the exact symptoms of mental illness can become sources of strength if not talent.


Is it the weather?

January 25, 2013


Many people felt rather blue this week, feeling kind of sad and even hopeless.  Each person had their own personal reasons for feeling depressed. I certainly wouldn’t want to underestimate depression’s depth of feeling nor challenge its force.  It is my life’s work to help others untangle that mighty web that threatens to strangle a person’s sense of life. Yet, this depression had a collective aspect.  This week, many people felt it.

It is mid-January.  The excitement of the new year has worn off. In some places it is cold, or dark, or maybe rainy.   These things do matter. Weather can affect your mood.

That being said where is the line between individual and collective moods?

It differs for each person, in every situation.  It isn’t as important to create a general theory about where external influences end and internal forces begin as it is to believe in the significance of both.

Too often people forget that they are part of systems larger than themselves – families, communities, societies and, even, ecosystems.  External influences whether they be social or environmental can affect our moods strongly, as can our biological proclivities as well as internal conflicts.

To feel better, or to cure a depression, it is important to locate and understand the external influences while also addressing the interiority of a bad or pained mood. Some things can’t be changed or controlled and a certain degree of suffering is a healthy component of the human condition.  the part of it that any one individual can effect or change is often a fairly manageable task, especially if making use of the right support including but not limited to  the verbal expression of talk therapy, the cognitive re-patterning of CBT, medication, exercise and diet.

In some ways, this can make the mountain of emptiness that often accompanies depression easier to conquer.  Not all of it is under our control. Some piece of it has everything to do with dark days in January. The rest, that which comes from within, is a smaller piece that how it might otherwise feel.

The Fallacy of Isolation

January 21, 2011


by Matthew Saville

Is Jared Loughner a lone isolated individual suffering from schizophrenia, or another severe psychiatric disorder? Is there a correct and superior way to be a mother, whether it be Chinese or otherwise? While the Jared Loughner’s presumed killings and Amy Chua’s publicity piece in the WSJ have nothing in common, many of the discussions about Loughner’s mental illness and Chua’s mothering derive from a belief that how one becomes a person, any kind of person, is separate from both the physical and relational environment.

Anthropological and psychological data support the opposite notion. Humans are embedded in the spaces and places known as home.  The forces involved in mental illness involve an interaction between neurobiology, relationships and environments.  Mothering involves teaching children how to navigate that interaction.  Loughner’s  neurobiological stress organized itself through the symbols of the culture to which he was exposed. And there is no one way to be a good mother because the variables differ across landscapes.  Here are some examples: (more…)

Why Civility Matters

January 9, 2011



Palin aide Rebecca Mansour comments that drawing a line between the shootings in Arizona and Palin, or presumably any other, political rhetoric is “obscene”. She adds “where I come from the person that is actually shooting is the one that’s culpable.” Well, it is actually far more complicated. I would like to add a psychological perspective to Matt Bai’s sound analysis of the role of political discourse in the Arizona shootings. I’m not an expert in the psychology of assassins. I am however a mental health expert who has worked in a previous hospital position with mentally ill people, some of whom were also convicted killers, and in one case, a mob assassin. My reasons for seeing a connection between Loughner’s behavior and vitriolic political rhetoric stems from an understanding of how people function. The breaking of even minor civil boundaries supports the expression of raw and unexamined impulses in anyone, let alone someone who is mentally ill.

For example, when many people are trapped in an elevator and one person has an intense emotional outburst, other people will also lose the ability to discipline their fear. This would be especially true of children or anyone else whose defenses are more fragile.

Civility serves as a psychological boundary. Internalized social rules act to regulate behavior and transform raw emotions into thoughtful considerations of self and other. Political leaders symbolize social norms. Individuals recognize in their leaders the emulation of boundaries that delineate what is acceptable from what is not.  For some well-organized people this type of modeling is unnecessary, and they can tolerate some flexibility. They know the rules. Those who are very young, less balanced and who struggle with mental illness they need all the help they can get to contain themselves. When a mentally ill person feels the urge to kill, social mores help contain those impulses. Hopefully the containment will provide a killer time to moderate his feelings.  When social leaders flippantly use metaphors of violence, or suggest the need for armed resistance – even if done as political tongue-in-cheek – the mentally ill person who has legal access to a semi-automatic pistol will understand this as permission to act on their impulses.

The rules that govern a parliament or a congress enable intense debate to take place while preserving the social contract. The reason that it is unacceptable to accuse the President of lying in a state of the Union address, or to use shotgun crosshairs to target political opponents, or to discuss political differences in terms of armed revolt is because those boundary violations permit anyone, and I mean anyone, to disregard their internal regulatory system and instead to act upon the pull of their internal demons.   Metaphors of violence become a kind of societal permission for the relinquishing of self control.

It isn’t a cause and effect type thing. People will behave violently and assassins will kill.  Civility toward one another, no matter what the differences are between us, serves only the purpose of not providing the context that will support any person’s insanity. It won’t prevent violence.  It will however limit the power of any individual to enact their breakdown.  Gun control would also help.

A Yearning for the Past

April 29, 2010

The dark hair of a twenty-year-old female college student gleamed against her long-sleeved white shirt. Her rounded collar denied even the possibility of cleavage. Her denim skirt fell well below the knees and she wore stockings with her sneakers.  She complained that her matchmaker thought she was too picky. If I had met this woman in a Jewish orthodox neighborhood this encounter might have made sense. Instead, I met Tzipora (formerly Jennifer) in my private practice in a Manhattan neighborhood where even the dogs wear tank tops. As I heard her lament about her preference for Chassidish men, I had to acknowledge that this previously secular woman now devoting herself to Orthodox Judaism was not the first such character to wander into my office of late.  Deepening religious observance is but one manifestation of people’s attempts to tune their behavior to a different historical note. The evocation of the past seems to be a critique of American materialism, an analysis useful in understanding individuals as well as our nation’s current political turbulence.


Diagnosis, Flow and Motion

March 16, 2010

“Don’t tell me what is going on with me, help me understand the how of me.” AJ, a 24 year old male.

With the release of the proposed draft revisions (version 5) to DSM disorders and criteria, new questions have arisen about psychiatric diagnosis.  Articles like the very in-depth analysis by Louis Menand in The New Yorker wonder whether or not the classification of mental disorders doesn’t pathologize the vicissitudes of human emotional expression. Jonah Lehrer’s recent piece in the NYTimes adds another element to the discourse about what is diagnosis: what if mental illness, like depression, has value? I would like to suggest another angle to this over-due debate: Diagnosis is a process, a fluid and mutable motion between body, mind, other people, culture and the environment. A diagnosis should not be construed as a territory with fixed boundaries nor a rigid categorical definition.  A viewing lens can assist in the identification of a Downey Woodpecker but you can’t learn anything about the creature until you observe it flying and interacting with the trees.  A psychological enterprise should always engage with a person’s process, and should aim to assist a person in the discovery of how all the pieces of their life come together.  This work relies on experience and training, as well as science and art. It also depends on a deep understanding of the natural, evolutionary world in which we are all embedded.


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