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    From Cafe Racer to Santa Barbara: It's not a mental health thing

    There are deeper factors at risk in the making of mass murder.
    University of California at Santa Barbara students remember Isla Vista mass shooting victims with a candelight vigil

    University of California at Santa Barbara students remember Isla Vista mass shooting victims with a candelight vigil UCSB Vigil/Flickr

    Remembering those who died at Cafe Racer

    Remembering those who died at Cafe Racer Donna DeMuertos/Flickr

    The toll of mass murders rings with miserable persistence these days. It’s becoming dully familiar, an ongoing trauma that won’t pause long enough to let us grieve, let alone hope to prevent the next time. According to USA Today we have suffered 248 mass murders since 2006 — including this week's tragedy in Isla Vista near Santa Barbara. Even if you exclude killings during burglaries or robberies, there have been 217 mass murders.

    As the poet Stanley Kunitz said, How can the heart be reconciled to its feast of losses? Here in Seattle, we remember those who died at Cafe Racer and in the parking lot of Town Hall two years ago today. The killer was a mentally ill man whose family loved him but felt helpless to reach him, a man whose brother described him as “really angry toward everything,” and “so stubborn you can’t talk to him.” A solitary figure who was welcome at Cafe Racer except on a few occasions when he was asked to leave because he was “snapping” at people.

    The murders in Isla Vista stir another round of anguished questions. “When a mad man goes on a killing spree...who’s to blame?” asked Time. Slate considered one possible answer: “Did Elliott Rodger’s Therapists Fail?”

    “Rodger met with trained mental health professionals, the people we rely on to identify dangerously disturbed individuals, and they apparently failed to perceive the depth of his problems,” writes Slate’s Brian Palmer, noting that the Isla Vista murders happened despite Elliot Rodger’s family’s concerns, and despite a visit on April 30 by law enforcement officers who saw nothing that raised a red flag. 

    I can’t blame people for looking to the mental-health profession to prevent violence that is senseless, mad. Calls for reforms to the mental-health system have become almost as familiar as the tragedies that inspire them. And all agree that our mental-health system has serious problems, many of them stemming from the avalanche of funding cuts in recent years that makes it harder all the time for people who want help to get it.

    But as a therapist, I know how unrealistic it is to imagine that therapy, or psychiatry, or even involuntary confinement can fix what’s broken in this epidemic of violence. As a colleague said, “People don’t blame oncologists for the fact that cancer still kills people. But they expect mental illness to be something altogether simpler than cancer.” Something is killing Americans, 900 and counting since 2006, according to USA Today. Whatever it is, it’s not simple. 

    (Well, maybe one aspect of the phenomenon is simple to understand if not to solve: Many lives would be saved if we had reasonable gun control in this country to make killing much harder, and much slower, to do.)

    No mental-health diagnosis explains why some people go on killing sprees. Schizophrenia seems to gets blamed lately, more often than other disorders — but as Richard A. Friedman pointed out in a recent New York Times op-e the vast majority of people with schizophrenia never commit violence. While it’s true that some individuals with paranoid schizophrenia on rare occasions lash out at others they perceive as threatening, drug and alcohol abuse triggers far more violence than mental illness does.

    In fact, it’s probably more accurate to say that something in American culture drives the schizophrenics among us to feel particularly unsafe, and on rare occasions to act out violently. Our schizophrenic neighbors, friends and family members may be canaries in our cultural coalmine, highly reactive to stressors the rest of us are better able to tune out. Schizophrenia

    The Schizophrenia Research Foundation in Chennai, India, has found that the auditory hallucinations — the “voices in the head” — heard by American schizophrenics are much more violent than the ones heard by schizophrenics in India. Researcher T.M. Luhrmann thinks that “local culture may shape the way people with schizophrenia pay attention to the complex auditory phenomena generated by the disorder and so shift what the voices say and how they say it.” 

    Luhrmann thinks this may be partly because Americans tend to fearfully reject the whole idea of voices in the head, making the experience of having them more alarming than it would be in a more receptive culture. She cites an international self-help movement called Hearing Voices, which encourages people to engage with the voices they hear, identifying them, finding out about them and negotiating with them as a way to reduce their violence over time. 

    But it’s hard to ignore an even more obvious link. Look at how violent American TV shows and movies have become. Without judging this phenomenon or having any way to explain it in terms of cause and effect, it’s still undeniably true that Americans today share remarkably vivid, disturbing and violent imagery under the guise of entertainment. 

    The overall incidence of schizophrenia is pretty similar around the world — suggesting that there is some organic basis for it — but its symptoms and severity differ markedly by culture. A 1992 World Health Organization study found that schizophrenics fared much better in traditional or developing societies, and worse in industrialized ones. 

    If you know anyone with schizophrenia, it’s not hard to see why the industrialized world is especially challenging. Schizophrenia makes it hard to function as an individual in a competitive world.

    I once was lucky enough to spend time in an Egyptian village in the late 1970s, before technology or even electric lights had arrived there. One of the villagers had long, impassioned conversations with people no one else could see. He also had a way of seeing through everyone’s pretensions. He could tell jokes no one else could get away with. 

    counseling therapy

    Village life was not utopia. It was difficult in many ways. But this one man, who would almost certainly be diagnosed with schizophrenia if he lived in the developed world, had a secure, safe place in his village. He could wander the wide-ranging mysteries his perceptions opened to him, and if he forgot to feed himself along the way, sooner or later someone would feed him and give him a gentle push toward the door of his home. 

    Contrast his life with that of a typical client in a mental-health agency in Seattle. I remember one man, early in my training, who gave me the most baffled, hurt look when he asked me, “Why do people on the radio lie to us?” 

    “I can tell that the woman who’s talking about Macy’s isn’t really happy,” he went on, “but she’s pretending to be happy. Why?” 

    He felt injured by the woman’s lies, and I could see why, because he had a point. He was accurately perceiving the incongruence in her voice. All of the lying we do to each other in the name of advertising can’t be good for us. But most of us, whose brains aren’t quite as strongly bathed in dopamine in certain places where my client’s brain was constantly overstimulated, can tune advertising out. He couldn’t. 

    I’ve thought of him, over time. I wonder what he makes of Game of Thrones, if he watches it. I hope he doesn’t; if he does, he probably thinks it’s a documentary.

    He can’t safely wander down the street without a real risk of being robbed or beaten. He can’t help going on mental excursions, but these can be terrifying when there’s an underlying sense that the body is unsafe. 

    He can’t shield himself very well from other people’s fear or hostility. He can’t help feeling the impact of a general aura of unspoken mood in a crowd. The way his mind processes input makes it all but impossible to selectively shut out some stimuli while accurately interpreting others’ intentions — the fundamental tasks it takes to function as an individual in a competitive society.

    A colleague of mine once summed it up nicely when we were chatting at a party, using terms I think he borrowed from economist Jared Bernstein: 

    “Schizophrenics do much better in WITT cultures than in YOYO ones.”

    YOYO stands for: “You’re On Your Own,” as in competitive individualism. As in the ideology that says each of us needs to have unlimited weapons because life is a war and we’re all ultimately alone in the fight. WITT means, “We’re In This Together.” I often think that when therapy helps, it’s not because we therapists have magic bullets. It’s certainly not because we control the people who consult with us. If someone wants to end his life in a blaze of random violence, I’m not sure how a therapist could change his mind. Unless he still had some hope alive in him; unless he secretly wanted to be stopped. 

    I think what helps is that in the process of therapy, simply by meeting the way we do, we create a little WITT society of two. And that’s a way to begin repairing and proliferating WITT to the point that therapy’s no longer needed. 

    People need each other’s cooperation and care if we are to negotiate safely all the hazards involved in living. Those among us who have schizophrenia are especially vulnerable, because of the way their brains process experience. But what the most vulnerable among us need, we all need. And what drives them mad is damaging for all of us. 

    Credits: Photo at bottom of first page: Alaina Abplanalp/Flickr

    Photo on the second page: Alan Cleaver/Flickr

    Carol Poole is a psychotherapist in private practice who also enjoys writing about depth psychology in popular culture. Her writing has appeared in BenBella Books' Smart Pop series.

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    Posted Fri, May 30, 7:57 a.m. Inappropriate

    Great wisdom here, Carol. A close relative of mine with untreated schizophrenia lives peacefully and sweetly with other people unless the surrounding emotional climate makes him intolerably confused and fearful. I'll never forget what a person with schizophrenia once told one of us "normies": "We're a lot more afraid of you than you are of us." Thank you for writing this.

    Posted Fri, May 30, 8:16 a.m. Inappropriate

    The effort to blame the mental health system for gun violence is probably just misdirection by those who favor unrestricted gun ownership.

    We need to view this as a public health issue, and we need to be able to research the causes of the 15,000 gun-related deaths each year. We've decimated the death rate of motor vehicle accidents over the last 50 years with incremental changes such as requiring seat belts and airbags and mandating higher safety standards. We've greatly reduced the public health issues surrounding smoking by conducting peer-reviewed research to show its effects and have taxed tobacco to offset the public costs of the habit. But God forbid we ask the same questions about guns. God forbid we put the same effort into seeing how we can reduce the number of mass murders and unintentional shootings.

    By focusing on a lack of mental health treatment as the problem the gun industry has found a convenient scapegoat. And there certainly is a mental health component to the public health problem of gun violence. But how do you make sure that people with mental health issues don't get guns? How do you make sure that if they do have a gun that they can't use it against innocent people?

    We already have proven public health models that have reduced the death rate associated with motor vehicle use and cigarette use. We should apply the same to reduce the number of people who die in the US from gun-related causes.

    Related article in The Onion: http://www.theonion.com/articles/no-way-to-prevent-this-says-only-nation-where-this,36131/


    Posted Fri, May 30, 9:36 a.m. Inappropriate

    I'd also ask us to "make sure that people with mental health issues" get the medical help they need, which isn't just medication. How about stepping up, each of us, to give one or two an hour a week of the everyday "normal" social companionship they need, so they're not walled off in the invisible social ghetto we reserve for scary, shameful people? And how about complaining to media outlets that publish stories about mental illness only when violent acts are involved?

    Posted Fri, May 30, 9:57 a.m. Inappropriate

    In addition to gun control and being more supportive of those with these sorts of mental health problems (of course, we should be supportive of people no matter what problems they have), it would seem that addressing people's alienation and isolation would go a long way toward stopping this sort of thing. Don't ask me how, but even if there were no guns and we had a society that was more supportive of people with schizophrenia, we'd still have a problem if we didn't figure out a way to stop creating generation after generation of alienated, angry young men.

    Posted Sun, Jun 1, 11:13 a.m. Inappropriate

    Examining the role of violence on TV, videos, movies and music is the first place to start.

    Many mental health issues seemingly are also violent behavior issues in our society today.

    Posted Fri, May 30, 6:29 p.m. Inappropriate

    "By focusing on a lack of mental health treatment as the problem the gun industry has found a convenient scapegoat."

    So, call their bluff with a program to divert into treatment anyone committing a non-violent crime because of mental illness in lieu of jail time. Provide treatment to violent mentally ill in prison (most are going to get out eventually). Allow and fund 72-hour holds to assess whether someone is a threat to themselves or others based on a request from family or friends, as well as in-patient treatment beds if it is determined they are. Right now, we're just locking them up and then kicking them back out on the street untreated and worse than when they went in.

    With the current political environment, gun control/access legislation is extremely unlikely. Let's not make the perfect the enemy of the good.

    Posted Sat, May 31, 1:20 p.m. Inappropriate

    Ah, yes, the Eeevil Gun Industry. Why is it we never blame stabbings on The Cutlery Industry, or clubbings on The Blunt Instrument Industry? Just as some in the Tea Party movement blame government for all our ills, many on the left just as reflexively put the blame on business. But nobody is compelled to buy a gun. Why not declare the gun industry's customers, your friends, family and neighbors, the enemy? The millions of sane people who buy and use guns responsibly? Is it because that will raise the question of why you're blaming innocent third parties, rather than those who commit these crimes?


    Posted Fri, May 30, 9:22 p.m. Inappropriate

    Elliott Rodger was not afraid of people, and he probably wasn't schizophrenic; instead, during the period of time when he planned this crime and carried it out, he was almost certainly psychotic. Several hours of companionship is not going to prevent that situation. CrazyDonkey is much more practical in saying that we need to refund 72-hour holds, so if someone is at the point that Mr. Rodger was, we can detain and treat that person before they become violent. As it is now, if indeed those people get sent for a hold by a mental health professional, they end up on a gurney in an ER for 12 hours for lack of beds, and then they get released because there aren't enough professionals to do an examination within those 12 hours. I've heard two Emergency Department employees from two separate hospitals describe this tragic situation recently. All because taxpayers, and the legislators they elect, don't want to take responsibility for funding necessary services.


    Posted Fri, May 30, 9:34 p.m. Inappropriate

    So was Elliot Rodger a schizophrenic, a psychopath, or a sociopath? All the talk about schizophrenia is fine if Rodger was one, but if not, what's the point of the article? A ramble about India and hearing voices? That seemed to be the primary focus. Not much help nor was it particularly relevant to the issue at hand. Bottom line: there are people out there who, for whatever reason, are determined to do harm. Can the professionals help or not? If not, there's no sense dumping a lot of money in a deep hole that doesn't have a payoff.


    Posted Sat, May 31, 10:02 a.m. Inappropriate

    Epidemic of violence? Violent crime hasn't been this low since the late 1960's. I'm sorry you bought into media hype without doing a little research. Everyone has intrusive thoughts and people do their best to ignore them knowing the consequences of that action. No rational sane person plans / snaps into a mass murder frenzy. We have tons of laws and means of stopping people who shouldn't have guns, but fact of the matter some will slip through the cracks.

    As a pro gun person, I would only willing give up my only means to self defense when the last criminal and corrupt cop gives up their gun. i.e. its never going to happen. As long as supreme court continues to rule police have no obligation to provide protection / defense for civilians and I can't carry a cop in my pocket it furthers my need to be equally prepared against threats.


    Posted Sat, May 31, 2:13 p.m. Inappropriate

    Gun control laws and gun free zones are a theory that creates an illusion of safety, but unfortunately has had devastating consequences in reality.


    Posted Sat, May 31, 7:34 p.m. Inappropriate

    "Violent crime hasn't been this low since the late 1960's."

    You're comparing apples and oranges.

    There have been 14 mass killings of 10 or more in the entire history of the United States. Seven of those have been since 2007, and three since 2012.

    Street criminals seldom kill more than one to three people and then usually with some rational basis (turf war, eliminate witnesses, retribution, etc.). Truly random victims are rare.



    Posted Sun, Jun 1, 5:34 a.m. Inappropriate

    I question your sources, both of whom have in the past and at present are guilty of cooking the books to influence perception.."perception is reality"..14 mass killings in the entire history of the US that is madness on parade..what about serial killers only 14?.please you cherry pick?.say it aint so..your definition of mass killing is colored by lousy politics..and just in case most serials don't use guns, kill far more people, and are as mentally a drift as you are..not to mention the sex equality angle..It's pretty clear the implied message of misandry..isn't it?..

    Posted Sun, Jun 1, 12:51 p.m. Inappropriate

    You're comparing apples, oranges, and bananas. Serial and mass killers are not the same thing.

    If you believe there have been more than the 14 mass killings in the U.S. of ten or more cited in the sources I provided, then provide a source that shows otherwise.

    Posted Sun, Jun 1, 6:52 p.m. Inappropriate

    next you tell me just because the guy caught last year flying up and down the west coast, ridgeway, dahmer, gacy, i can go on do not meet yours or any definition of mass murder...apples and oranges...I think not...you ARE cooking the books by the tried and true POLITICAL ploy of confusing terms..mr.sotoro is very proud..if you wish to redefine terms, spree killers but, that really doesn't work either..does it?..brings forward the mental illness point even more sharply..as to sources I suggest an open mind as to current events..

    Posted Mon, Jun 2, 12:09 p.m. Inappropriate

    "I question your sources, past and present who cook the books to influence perception, "perception is reality." Their 14 mass killings in US history is madness on parade. What about serial killings? Don't cherry pick. Their definition of mass killing is colored by lousy politics. And as is the case, most serial killers don't actually store nor use 'large' gun armories, yet still kill far more people, mentally adrift. (something about "implied message of misandry"?)
    Maybe nobody here gets as many 'crazy' stares as I get.
    Some of you know this about me, the loudest/rudist alarmist:


    I've earned my crazy stripes trying
    to clue you Seathlers in. You'll thank me later.
    Mr McGinn sir, would you mind offering your services as,
    apparently, we feel now most recommend a Governors Offices stay, perhaps?
    We'll try to behave for those 4 years, we promise.

    How's that for crazy writing.
    Infrastructure, ya can't fake it anymore.
    Don't go live somewhere else and fake it there.
    MercerEast is fine, not incidentally as expected. Don't add MercerWest.
    Extend Battery Street Tunnel North with current construction.
    Lower Belltown 2-stoplight arrangement worth another look.
    A complete dive under Elliott/Western with minimal ramps isn't bad.
    Road descends beneath much larger park settings either way to the
    BOX Cut-Cover Tunnel/SOLID SEAWALL (because you might need it?)
    Least DARK concrete underpass sidewalks with traffic.
    Seawall Habitat options are actually better for salmonids/migration.
    Certainly other streetcar alignments are not yet reviewed by,
    of, and for we the people. Whatever...


    Posted Tue, Jun 3, 8:57 a.m. Inappropriate

    Is there a 72 hold period for folks who keep posting infrastructure comments in every article comment section no matter the subject at hand? That would personally make me very happy.


    Posted Tue, Jun 3, 12:03 p.m. Inappropriate

    I'd be happy if the completed bore tunnel failed its first test of earthquake resilience, numerous old town buildings collapse and Treker is found in the rubble, his last thought, "Wells was riiight..."


    Posted Tue, Jun 3, 1:14 p.m. Inappropriate

    Says the political science major with one geology course - ergo - EXPERT!!


    Posted Sun, Jun 1, 1:09 a.m. Inappropriate

    Again, CrazyDonkey's right.


    Posted Mon, Jun 2, 8:33 a.m. Inappropriate

    "In fact, it’s probably more accurate to say that something in American culture drives the schizophrenics among us to feel particularly unsafe, ..."

    It isn't just those who have a mental illness who are afraid. One only has to look at the fear that is rampant and that drives the gun culture to understand that many more of us are afraid. Otherwise, why would people wish to arm themselves?


    Posted Mon, Jun 2, 6:44 p.m. Inappropriate

    It is a mental health thing. We isolate mentally ill people and deny them love. We attach a stigma to them. We find it easier and more cost effective just to coldly and impersonally lock people up when they are off. How many people blamed Reagan for this? There you see one of the causes of the problem.

    True help only gets started when a person is violent and the police take them to harborview. There is very little follow up. Why? It is too expensive in the current system. Mental health professionals are seldom mental health advocates. IMO. They still wish to fit the mentally ill into a boxed container they will never fit in. Versus taking the time to find a one on one creative treatment program for each person.

    A family is usually the first line of identification of the problem, but they are usually unfamiliar with the proper diagnosis. A team "mentally ill person" needs to be created. Some of these medications are just gruesome and self defeating to take. A mentally ill person needs to be re taught the basics of life. How to eat, how to sleep, how to exercise, and how to self diagnose and initiate treatment. The current system is highly ineffective. A gun fetish by a mentally ill person will be readily apparent. While most mentally ill people will more likely be a victim of violent crime than a perp. We are horrified at their thinking when the few do violence. Glorifying these mass shooters in the media is an extremely bad message for the mentally ill. A separation needs to be shown become the mentally ill who choose poorly and those who choose better. Gun control will have zero effect on this type of shooter unless you can completely remove guns from society. And then they will choose knives, cars, or poison as their weapons of choice. Why? Because the anti gun folks refused to address the real problem.


    Posted Mon, Jun 2, 9:10 p.m. Inappropriate

    PDX, mental health professionals are the last people to want to fit anyone into neatly-labeled boxes, and they are the first to feel sad and frustrated at the current mental health system mess. They can't take the time to find a "creative treatment program" that doesn't exist because it isn't funded. If you wish people to solve "the real problem", then talk to your legislators about funding that solution.


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