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The disorders that are most often linked to violence are those that alter one's sense of reality--psychosis or the flashbacks associated with PTSD--or severe impulse control or antisocial personality problems. Teasing apart the reasons someone has done or threatened violence to themselves or others is typically done by mental health professionals, and if it's serious enough, done in locked psychiatric hospitals. It's hard work. And what I've learned from doing this work for twenty-five years is that there is, even in the most deranged individual, an interior logic to what they do. No one acts entirely randomly, putting their shoes on their feet one day and on their hands the next. We act in predictable enough patterns that once someone has given us a cue to their interior logic--once they have done or threatened harm to to themselves or others--we can almost always figure out what mostly drove that behavior, if they cooperate with trying to stop it. The thing is, bad things happen before we pick up on those initial cues, and they don't always cooperate with the mental health help offered. Maybe both those things happened with James Holmes.
A book I read and loved this week, This Bright River, starts out with what is likely a murder, and in the next chapter we are told there has clearly been a death. This is a pivotal event for one of the two main characters as the death is of his cousin who, it turns out, was in some ways crazy. The book is really good and about more than this, but since it is written in the first person from multiple points of view we get more than one glimpse into the interior logic of a violent individual, one so graphic I could not read it. It wasn't work--I didn't have to.
My daughter Caitlin works in a school for autism-spectrum kids and had a rough week. One of the students developed a new "chain," a murky pattern of behavior that led to headbanging and self-injury, and then to aggression towards the adults trying to stop him. Despite trying to change everything that might be fueling the chain it was getting worse, in part because the changes they were making to break the chain were highly distressing, and Cait got hurt. When I saw her on Friday night she looked battle-weary, injured by her efforts to help a violent individual.
It didn't help that her week had started with violence at home. One of our sons has a psychotic disorder and chronic depression. He got his Xbox back more than a year after he became obsessed with shooter games (like Call of Duty) and became violent when we tried to limit his use. He posted advice on his Facebook account (which he hadn't had access to in all that time) not to go after one's parents if one still had to live with them. Sound advice, and the kind of very strange logic I'm talking about. He gets a lot of help from said professionals, and parents--and Caitlin "liked" this statement on his wall, though I couldn't make myself do it. He got his Xbox back sans shooter games--he wants Minecraft, which we've agreed to. He will likely still get obsessed. We'll see if that's the main factor, or the violence in he games. Sometimes it's trial and error.
But that's not the main event in terms of violence at home this week. On Monday night, as my husband and I were watching Lizzy and her team win the state championship (woo-hoo) another of our adult sons was doing his own chain. He was caught sneaking candy from our room, where we keep little potty treats for our two-year-old granddaugher, and sent to his room for a time-out. He swore at her for stopping him, then started to smash holes in his walls. He has schizophrenia and mental retardation and this is his chain--do something, get caught, swear, get a time out, react violently. By the time we got home he had smashed nearly through his door trying to get to her.
So while the vast majority of people with a mental illness are not violent, it is also my experience that for mentally ill people who are violent, they do an incredible amount of damage, and are deserving of all the treatments we have available, and more that we've yet to develop. For all our sakes.