Mass Murderer Psychobabble Misses Gun Policy Point
Mass Murderer Psychobabble Misses Gun Policy Point
In his recent New York Times piece, David Brooks1 provides a psychological analysis of mass murderers, concluding that “the crucial point is that the dynamics are internal, not external. These killers are primarily the product of psychological derangements, not sociological ones.” He goes on to make the astounding claim that better relationships and treatment can help prevent mass killings.
Brooks’ naive psychobabble allows him blithely to dismiss the role of public policy. He would have us focus our attention on the mind of each individual mass murderer, ignoring the issue of why the US consistently produces so many mass murderers. There is no reason to assume that we have the highest gun death rate in the developed world because we have more deranged people—it’s just that our potential killers are so much better armed. Brooks misses the point of both disciplines when he so ardently embraces a psychiatry he doesn’t understand and so casually dismisses a sociology that actually can provide important data.
Psychiatry has no way to predict mass murder and no way to prevent it. Many mass murderers never see a mental health worker before going ballistic. Even those who do are as impossible to identify as needles in a large haystack. Violent thoughts are not uncommon among psychiatric patients, but vanishingly few will ever act on them. Future mass murderers are far too rare to be selected out of the crowd before the deed is done. Psychiatry can do wonders in treating psychiatric disorders but strikes out in predicting or preventing violence. Brooks is misinformed to offer treatment as a solution—his other suggestion (better relationships) is even more fatuous.
Sociology first became a valuable informant of policy more than a century ago when mile Durkheim noted the statistical predictability of rates of suicide and violence and their systematic variability in different countries. It is impossible to predict which specific individual will kill himself or others (and certainly to say when and how), but it is easy to predict how many people will kill themselves or others in each country in any given year.
There is no indication that psychiatry can change the statistics of violence or the proclivity of the violent. We need to look instead to sociological data and their policy implications. Statistics tell us that we have a saturation of extraordinarily deadly weapons unparalleled in our own history and unique in the developed world—and simultaneously that we also have the highest rates of gun-related injuries. The burden of proof is on those who want to refute the seemingly obvious causal connection and to deny its policy implications.
Brooks’ command of facts is as weak as his theories. According to Brooks: “People are trying to use the Aurora killings as a pretext to criticize America’s gun culture or to call for stricter gun control laws. This doesn’t happen after European or Asian mass killings.” He ignores the fact that after the 1996 Port Arthur mass murder, a conservative government in Australia overcame strident opposition (especially among its own conservative constituents) to replace lenient gun control measures with tight and effective ones. And Brooks should know that people in other developed countries don’t have to soul search about a gun culture because they don’t have one and don’t have to call for stricter gun control laws because they are already in place.
Homicide is as old as Cain. The capacity to kill had clear survival value, is built into the human genome, and will never be completely eliminated. But killing can be enhanced or contained depending on public policies. People will always find ways of killing people, but the number killed depends on the number and nature of the weapons available to the potential killers. It is a statistical numbers game and we stack the odds against the victims when we allow the killers easy access to semiautomatics and thousands of rounds of ammo.
Brooks should stick to expressing his policy views (he supports gun control) and drop any attempts at amateur psychologizing. His observations would be silly, but harmless, were he not such an influential voice. As it stands, Brooks facilitates the existing suppression of a serious policy discussion on gun control that allows a mindless spread of ever more destructive weaponry. Gun control shouldn’t be shouted down, or lobbied away, or rationalized with pop psychology. We need a sustained and serious debate on how best to deal with the public health problem of violent death, not wishful thinking.
Reference
1. Brooks D. More treatment programs. New York Times. July 23, 2012. http://www.nytimes.com/2012/07/24/opinion/brooks-more-treatment-programs.html. Accessed August 2, 2012.
Thank you, Dr. Frances. Hopefully, at least some psychiatric thinkers are able to keep their heads straight about the gun issue, and are willing to articulate well what would seem to be matters that ought to be clearly understood and not subject to obfuscation.
Before we dismiss the "amateur"policy makers among our colleagues, perhaps we ought
to ponder the bleeding nightmare the "professional" policy makers have created for us.
I mean, of course, the craven legislators who would do anything to avoid the ire of the NRA
lobby, whose leadership continues to dictate the firearms policies of this country (often
in opposition to the views of their own membership). Let's just review for a minute where these policies
have left us:
1. The U.S. has the highest per capita gun possession rate in the world, at about 90 guns for
every 100 citizens (Small Arms Survey 2007 by the Geneva-based Graduate Institute of
International Studies)
2. The United States has a homicide rate 6.9 times higher than those in the other high-income
countries, driven by a firearm homicide rate that was 19.5 times higher; for 15-24 year olds, the firearm homicide rate in the United States is 42.7 times higher than in the other high-income countries
[Richardson & Hemenway, J Trauma. 2011;70: 238-243].
3. The US firearm suicide rate is 5.8 times higher than those in other high-income countries
(Richardson & Hemenway, J Trauma. 2011;70: 238-243)
4. Across the U.S., the "gun-show loophole" allows buyers to purchase from unlicensed sellers
without having to go through a criminal background check.
5. According to Fairfax City Police Chief, Richard J. Rappoport--past president
of the Virginia Association of Chiefs of Police--"A person can go on the Internet using the
pseudonym 'Fred' and arrange to buy a semiautomatic weapon from someone using the pseudonym
'Sam' and meet in a dark parking lot and money exchange hands and weapons exchange hands."
[http://www2.timesdispatch.com/news/virginia-politics/2012/jun/27/tdmet02...
officials-back-closing-the-ar-2015984/]
When it comes to firearms regulations, I, for one, am ready to consider "amateur" policy makers, like Dr. Frances.
Ronald Pies MD
My thoughts articulated by Rick Robertson | August 07, 2012 7:49 PM EDT
Unfortunately, brilliant psychiatrists continue to put on display their ignorance of the Second Amendment and its history. The Second Amendment is not about hunting or even defending your home from armed intruders although that is certainly a fringe benefit. The founders of this great nation came here to escape tyranny and religious persecution. So, not surprisingly, the First Amendment to the Constitution is about religious freedom and the Second Amendment, about the defense against tyranny. The situation in Colorado was tragic and heartbreaking. However, when individuals "go off", they kill people in the dozens. When governments "go off", they kill people in the millions. Between 50 and 100 million people were killed in the 20th century after being disarmed by their own governments in the name of "gun control", the most famous being Germany. Germany was the most educated and technically advanced country in the world at the time and yet murdered 20 million of its own people after disarming them the less than 70 years ago.
Even today people are being murdered all over the globe, people who have no ability to fight back. As far-fetched as it may seem to some, it can happen here as we are neither more moral nor civilized than the Germans in the 1940s. People in government are people and not automatically more trustworthy than your neighbor. ... The best way to stop tragedies like the one in Colorado is an armed citizenry since the only way to stop a bad man with a gun is a good man with the gun. All mass shootings in this country have occurred in "gun free zones."
I will send as much money as I can afford to political candidates and politicians who support the Second Amendment so that I can decide what kind of gun I own and how much ammo I can buy. Rick Robertson, MD
"There is no reason to assume that we have the highest gun death rate in the developed world because we have more deranged people-it's just that our potential killers are so much better armed."Allen Frances, MD
The Federal Fireams Act of 1934 regulated the sale & ownership of machineguns by private citizens. Prior to about 1932, anyone could own one. When I was young, every hardware store sold rifles, shotguns & pistols. There was no paperwork. I remember looking at flyers I got through the mail, advertising guns I could buy. I only had to say I was 18 years old & send a check. Today, I can go to any one of dozens of "trader days" through out my state & buy any "assault rifle" I want. New York City & Washington, DC have had oppressive gun control laws for decades. So, why does my state have a much lower violent crime & murder rate than they do?
Dr. Frances should stick to expressing his medical views and drop any attempts at amateur policy setting (he supports gun control).
George Moses, D.O, M.A., F.A.P.A.
In response to several readers' comments on the Second Amendment and the hypothetical risk of a government-imposed "tyranny", I asked attorney and author Joshua Horwitz, J.D., to provide another perspective (see bio, below). It is my privilege to present his comments on this critical issue. -Ron Pies MD
From Mr. Horwitz:
Sadly, the insurrectionist interpretation of the Second Amendment now dominates the modern pro-gun movement. This view posits that individuals should be allowed to prepare for war with their own government, as a counterbalance should the government become "tyrannical."Citizens who care about our Constitution and the vast array of rights it affords us might think twice before adopting this flawed and radical interpretation as their own.
There is not one shred of evidence to suggest that the Second Amendment's purpose was to safeguard an individual right of insurrection. The amendment's author, Federalist James Madison, did articulate that its purpose was to split the military power of the new nation between the states and the federal government. But Madison also made it clear that any opposition to federal tyranny would come from state Militia forces "officered by men chosen from among themselves, fighting for their common liberties, and united and conducted by governments possessing their affections and confidence." [emphasis added]
Furthermore, the Constitution itself clearly states the purpose of the Militia is to "suppress insurrections," not to foment them. The Constitution is not a suicide pact that gives individuals the "right" to decide when the government becomes tyrannical and act on that belief through personal, political violence. Remember, what looks like "tyranny" to one man might look like "health care reform" to another.
Regarding the experience in Germany prior to World War II, far from providing validation to the insurrectionist argument, it instead shows the danger of allowing political violence to influence the political process. A careful review of the historical record shows that prior to Hitler's appointment as Chancellor, the Nazi party had a larger body of men under arms than the German military itself, and frequently used violence to intimidate and kill its political opponents. The Weimar Republic teaches us that if a government cannot maintain its monopoly on the use of force, then individual rights can neither be protected nor vindicated. Remember, too, that both Chairman Mao and Fidel Castro were self-described "anti-government freedom fighters" who successfully completed armed insurrections with disastrous results.
The claim that governments with strong restrictions on firearms put citizens at risk of government genocide is also without basis. Dictators and strongmen kill their citizens. Democracies do not, regardless of their gun laws.
As Abraham Lincoln made clear in 1863, "Among free men, there can be no appeal from the ballot to the bullet." Allowing individuals to arm for a potential war against our government serves only to increase the risk of civil war and diminish our cherished democratic institutions and rights as defined in the Constitution.
***************
Joshua Horwitz, J.D., is Executive Director of the Coalition to Stop Gun Violence (http://www.csgv.org). Mr. Horwitz received his bachelor's degree from the University of Michigan, and his law degree from George Washington University. He is a visiting scholar at the Johns Hopkins Bloomberg School of Public Health and co-author of the book, Guns, Democracy, and the Insurrectionist Idea (University of Michigan Press, 2009)
Re: "Gun control shouldn't be shouted down, or lobbied away, or rationalized with pop psychology. We need a sustained and serious debate on how best to deal with the public health problem of violent death, not wishful thinking."
Right you are, Al! Thanks for being a clear and brave voice in the wilderness (or should I say, "in the Wild, Wild, West"?). I have detailed comments on your earlier piece (7/30) re: the need for sensible regulations on semi-automatic weapons and high-capacity clips.
At the same time, I would not underestimate the role of proactive psychiatric assessment, not in "predicting"violence--that is not really the issue here--but in determining that someone with a serious psychiatric disorder is in a high-risk category; i.e., is statistically more likely to commit a violent act. A classic "red flag" profile would be someone with untreated or poorly-responsive, active psychosis; a past history of violent acts; co-morbid substance abuse; recent threats of violence (albeit not directed at a specific person, which would activate a Tarasoff-type warning); and easy access to firearms or other lethal weapons.
In principle, such individuals who refuse voluntary psychiatric treatment may be candidates for so-called "outpatient commitment" or court-mandated outpatient treatment.(1) This is not appropriate for all patients with serious psychiatric illness, and does have the potential for curtailing civil liberties. Moreover, the research is not yet clear in showing that outpatient commitment prevents violent acts, though it appears to reduce victimization of the patient (2) (Let's recall that those with serious psychiatric illness are more likely to be victims of violence than perpetrators of it).
Of course, as Dr. Frances rightly argues, none of this should serve as an excuse for legislative inaction, with respect to passing sensible gun and ammunition regulations. Nor should the outpatient commitment option replace more broad-based reform of our mental health care system, so that more individuals have access to comprehensive, voluntary care.
These issues notwithstanding, I believe that--when properly adjudicated--individuals with a high propensity for violence may benefit from proactive, outpatient psychiatric treatment--before they get hold of lethal weapons and act on their violent impulses.
Regards,
Ron Pies MD
1. Appelbaum PS, Thinking Carefully About Outpatient Commitment. Psychiatric Services 2001; doi: 10.1176/appi.ps.52.3.347
2. Kisely SR, Campbell LA, Preston NJ. Compulsory community and involuntary outpatient treatment for people with severe mental disorders. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD004408.