We Live in Different Realities….

 

 

“We don’t have to like the reality that we live in, but it is the reality we live in.”  JD Vance comment on Apalachee High School shooting in Georgia that left 4 dead and 9 injured.

 

The school year began with a school shooting and all the associated irrationality of mass shooting in the US.  One of the most irrational comments is posted above and was made by the MAGA party vice presidential candidate.  When I say irrational – I mean that what Vance refers to as “the reality we live in” was in fact created by his party, its judges, gun extremists (who are undoubtedly all from his party), and the gun lobby in Congress.  They have created a parallel universe where there are minimal to no gun regulations, people can openly carry weapons, people are encouraged to use firearms, the country is saturated with guns, and the expectation that there will be no problems.  If there are problems it is always due to somebody else – as further elaborated by Vance:

“I don’t like that this is a fact of life.  But if you’re—if you are a psycho, you want to make headlines, you realize that our schools are soft targets. And we have got to bolster security at our schools… We’ve got to bolster security so if a psycho wants to walk through the front door and kill a bunch of children, they’re not able to.”

As far as I can tell nobody has confronted his statement about bolstering security in schools.  We just witnessed former President Trump’s near miss as he was protected by a full contingent of secret Service Agents and snipers. Even that impractical level of protection at every school in the country is no assurance that children will be safe.  In the case of this incident, an armed security officer at the school engaged the shooter in about 120 seconds and forced him to surrender. By that time, he had already shot 7 people.  His other theory is that the increasing numbers of mass shootings are due to increasing numbers of "psychos".  That term really has no meaning other than a pejorative one.  If he is referring to mental illnesses there is no evidence that mental illnesses are causal in mass shootings.  He leaves out the most likely causes of gun extremism and a mass shooter culture as well as easy availability of guns.

The other argument that seems to be gaining traction is blame the parents. As I predicted this is being sold as a solution to the problem rather than going directly at the culture of gun extremism. I heard several television commentators saying this was a “wake up call” to parents who allow their children to have access to guns.  I really doubt that it is.  The analysis will always be complicated by how the parents are portrayed in the media, but even without the parents in the picture we still have very easy gun access and a cultural basis for mass shootings that nobody ever addresses.  Having been a kid, I can’t think of a teenager who could not defeat their parents access prevention security measures – whether it was reading material, phone access, or weapons.

Many of the same commentators are also blaming smartphones. The context seems to be that parents are not able to deny their children access to smartphones anymore than they can deny their access to guns.  They cite as an example recent legislation that bans smartphones in schools.  Apparently it is much easier for politicians to limit smartphone access than it is to limit gun access.  Smartphones are not nearly as dangerous.

The blame the parent argument may have some application, especially in states where the gun laws specify that parents are responsible for their child’s use of a firearm. In many cases those laws are currently complicated by the fact that a child may possess a gun in certain circumstances – even if they are not eligible to purchase one. The smartphone argument is a weak one.  Banning smartphones in educational venues and where specific decorum is required – but smartphones clearly have nothing to do with mass shooting.  Not being able to say “No” to your kid doesn’t either. Gun extremists and the mass shooter culture has everything to do with it and it requires serious action.  It is time to get back to reality and acknowledge what we already know from American history.   Gun regulations save lives and lots of them.

I will cite what is known by most people in my generation and a frequent reference to the Old West that I have used before.  In the 1960s, 1970s and the years before – there was no mass shooting problem in the US and certainly no problem with children being shot in schools. Many middle school students took the National Rifle association Hunter Safety course.  In that course safe use of firearms was emphasized including treating every gun like it is loaded and never pointing a gun at anyone.  The middle schoolers in these courses were about the same age as the most recent shooter.  They had no access to high-capacity semiautomatic weapons or handguns.  The basic idea was – learn how to safely handle guns and use them for hunting and target shooting. There was no discussion of needing them for personal protection or needing to always carry them. There were no politicians promoting gun extremism.

There is evidence that the period of gun safety extended back to when frontier towns noticed that armed citizens were problematic and law enforcement started to insist on voluntary disarmament when people rode into town.  I have posted the Tombstone Arizona statute from 1881. There is also an article in the Smithsonian (1) that outlines some of the highlights of early gun control law including the association of the Gunfight at the OK Corral with Tombstone’s gun law.  Strict gun control laws existed in several other towns and the 1881 law in Tombstone is much stricter than the laws that exist today.  Today you can carry a gun without a license or permit in Tombstone. There was a contrast between frontier towns that had disarm laws and those that did not – with the latter having a higher gun homicide rate.  

A political gun extremist movement has endangered the lives of every American and made schools an unsafe place. We are well past the time to get rid of these extremists and their gun violence rhetoric.  The reality that most Americans want to get back to is to be able to walk down the street or go to school and not have to worry about getting shot.  That knowledge goes back to the Old West and it kept us in that reality right up until the 1970s.  The only strong message that needs to be sent here is that gun extremist politicians and excuse makers need to be voted out.  Even then there will be a lag time because of the gun extremist judges they have appointed.

Apart from gun extremism as a bizarre populist issue on its own – it also reinforces autocratic ideology.  The autocrat playbook reinforces political violence as a good idea.  That includes all the autocrats of the 20^th and 21^st century who typically target the “elites” in their population and encourage political violence against them.  The practical way it plays out today is self appointed militias showing up to intimidate elected officials,  self appointed law enforcement showing up to intimidate protestors, and verbal threats that the more heavily armed will prevail in any controversial elections.  

Never doubt that there is a gun extremist agenda in the United States.  I have pointed out the features in many posts on this blog. The gun extremist agenda is currently indistinguishable from the MAGA agenda.  It is more than a little ironic that the mass shooters it creates are labelled “monsters” and “psychos” by members of this political movement.  That is the reality that JD Vance is talking about and it will continue as long as these authoritarian politicians are elected and maintain that reality.    

 

George Dawson, MD, DFAPA

References:

 1:  Jancer M.  Gun control is as old as the Old West.  The Smithsonian Magazine.  https://www.smithsonianmag.com/history/gun-control-old-west-180968013/

 

 Graphics Credit:  Click directly on the photo - it is linked to Wikimedia Commons and all of the information about this phot and the CC license.  

Mass Shooters - The American Gun Extremist Superman

I had dinner the other night with a long-time friend and psychiatric colleague.  She and I ran an acute care unit for many years where we were charged with assessing and treating some of the most difficult problems in psychiatry. By definition, that also means the associated social problems.  That work included a significant number of civil commitments and in Minnesota associated hearings about medications.  The conversation turned to politics and then the recent attempted assassination of Trump.  Before I could say anything, she commented about how absurd it was that there was endless speculation in the media about “motive” and the fact that there was no motive. I agreed with her completely on that point.  What motive can you have for picking up a high-capacity military weapon and deciding to shoot and kill someone and anyone else who happens to be around?  And of course – why does it predominately happen in the US? 

As I pondered our conversation over the past couple of days and what I have written here about it – I came up with the idea of the American Gun Extremist Superman. This is not a traditional superman role or even the antihero role.  It is a superman role that can occur only in a culture of gun extremism.  I have written in the past about how this is quite definitely a cultural problem and the people who have been the source of the culture – extremist politicians, judges, and other gun extremist advocates largely blame everything else.  Incredibly they blame the lack of an armed staff in schools, a shortage of firearms in the most heavily armed country in the world, and more recently law enforcement and parents. They never examine the fall out of gun extremist policies that have been accumulating over the past 40 years.

Here are the features of the gun extremist superman that I have so far.  They are not diagnostic criteria by any means.  This is a societal and cultural problem more than anything.  It obviously exists only in the US.  There are undoubtedly people with psychiatric disorders who acquire these traits – just like people with psychiatric disorders assimilate other social and cultural traits.  But a psychiatric disorder does not explain most of these shootings.  I am using the pronoun he in these cases for the obvious reason that practically all of the shooters are men and boys.   

He is disgruntled and dissatisfied:  This is a common nonexplanation for mass homicide. It is basically a marker for what causes an unexplainable behavior.  When you study human behavior, these changes can occur from internally driven psychological states, external states, and all points in between.  To what extent is their insight, judgment, and decision making affected? To what extent does their moral decision making have an impact on what is occurring?  It is complicated by what is known about a person’s baseline.  For example, are they quiet and non-disclosing about their internal states or are they more demonstrative?

He has no problem at all attributing his state to the actions of others even when that is completely displaced.  In other words, displaced onto completely innocent coworkers, bystanders, school children, etc.  In psychiatry we call this projection and historically it is listed as a defense mechanism.  It is typically seen in persons with psychotic disorders and moderate to severe personality disorders.  It is a common experience to feel like you are being unjustly blamed during interactions with people using this mechanism or in the extreme case where that person is reacting to you as though their accusations are true.  Even though it is difficult to research this mechanism in mass murders – it seems intuitive that it has to exist at some level given the discrepancy between their real victims and the purported abusers (if any).

He knows that there is a burst of fame associated with each shooting and endless speculation about his motivations.  Although there is little information about the Trump shooter – it is known that he had details about a previous mass shooter on his electronic devices and this has also occurred with previous mass shooters. Anybody experiencing the news cycle in the US following a mass shooting notices a flood of information and speculation about that shooter that can go on for weeks followed by other bursts from associated court cases, documents, computers, web sites documenting mass shootings, legislation, and scientific literature.  Mass shooters seem to be guaranteed immediate and sustained notoriety – despite some concerns expressed in the literature that this is reinforcing the behavior.  The psychology of mass shooters is difficult to investigate, but I would not be shocked to learn that revenge fantasies go hand-in-hand with the expectation of notoriety from the act. 

He feels some justification by identification with previous mass shooters and cultural revenge themes.  As noted above many aspiring mass shooters have immediate access to the mass shooter literature as well as a wealth of revenge-based video games and movies.  The preponderance of this information depicts the shooter as the good guy meting out justice and revenging either his own victimhood (real or imagined) or that of his loved ones.  A secondary theme is that the usual channels of justice – law enforcement and the courts are too weak, do not apply to him, are too slow, or too negligent to be useful.

He sees it as a singularly masculine activity – especially with the use of firearms.

Most of the cultural figures engaged in this activity are men.  Armed men are typically the graphic elements of disaffected groups of society but their rhetoric has creeped into the political mainstream.  You don’t have to look too hard to find opinion that in the battle over “gun rights” – the correct interpretation of the Second Amendment will go to the winners of an armed insurrection or that the more heavily armed political party will “win.”  In that atmosphere was it an accident that we witnessed an insurrection on January 6^th?  Nobody steps back to point out that gun rights are there in the Second Amendment and the real battle is between gun extremism and common-sense guns laws.  In the common discussion nobody has advocated to take guns away from law abiding and responsible citizens.  At this point the US is awash in guns to the point that collecting all of those guns or buying them back is impractical.

Societal reinforcement of the Gun Extremist Superman. 

At first that seems like an extreme idea.  How can American culture and society reinforce this behavior? I have touched on the very real aspects of gun extremism and the cultural aspects that are reinforcing but there are others. Whenever mass shootings occur – politicians show up make the typical statements about “sick individuals”, offer “hopes and prayers”, and in some extreme cases have encouraged the affected communities to “move on.”  Mental health becomes a distraction, when politicians use it as a cause for the incident but never do anything constructive to address it.   The condemnation of the shooter is trivial compared with what has occurred. And no effective measures are ever suggested or accomplished. If anything, many politicians come up with a series of rationalizations about why the shooter was not stopped – the teachers were not armed, law enforcement response was inadequate, the only way to stop a bad man with a gun is a good guy with a gun, etc. Specifically, no measures to counter gun extremist laws are ever suggested and we are supposed to pretend that getting as many guns out on the street is a remote problem from the problem of mass shootings.  The real message to mass shooters is that “we are not going to do anything to stop or interfere with you.”

There is an additional message that is the direct result of gun extremism and that is – shoot first and ask questions later. Stand your ground and castle doctrines or statutes are a relatively recent development in the gun extremism landscape.  Stand your ground statutes basically say that there is no duty to retreat before using deadly force. Before these laws self-defense laws included the provision that the person who is unlawfully attacked needs to exercise judgment to try to avoid the use of deadly force by retreating if necessary.  Stand your ground laws were passed initially in 2005 in Florida and since then these laws exist in 38 states. The details are available at this site, including references to the fact that it probably increases the crime and homicide rate.  Although these laws were passed primarily in the past 20 years, they are the culmination of gun extremist rhetoric that has emphasized the need for people to be armed and dispense justice with firearms.  My conceptualization of the mass shooter is that he likely believes he is dispensing justice, even though nobody would agree with that premise.

The additional cultural change that preceded stand your ground was the idea of the armed citizen.  In the 1960s, the people who owned guns were predominately hunters.  The focus of the National Rifle Association (NRA) was hunter safety. When I took that course one of the mainstays was never pointing a gun at a person and always assuming a gun was loaded.  As firearms become more important as political rhetoric there was a sudden shift to the idea that there needed to be more guns out there for personal protection.  Since then there has been a steady escalation in gun extremist rhetoric and the idea that there are defined preconditions for shooting someone.

Psychosis is not an exclusion from societal or cultural factors:  Although the majority of these shooters are not mentally ill there is a lot of confusion over whether mental illness excludes the person from societal and cultural factors - making the psychosis in itself an explanation for the behavior.  It does not.  Just as computer chips, microwaves, and surveillance satellites were incorporated into delusions as they became incorporated into society - gun extremism has the same effects.  There is no reason that they and the folklore of mass shooters cannot be incorporated into a delusional system of thinking and acted upon.  In other words - there is no de novo psychosis of mass shooting - it happens in a gun extremist society.

All of the above elements are more important to him than self-preservation.  Many mass shooter incidents occur with the death of the shooter by homicide or suicide.  The high mortality rate suggests that mass shooters are unconcerned about their own life in carrying out their actions. This information is readily available to potential mass shooters and I would argue is part of the Gun Extremist Superman stereotype.  

He has easy access to high-capacity firearms – both handguns and rifles. Easy access to legally purchased firearms is well documented in many of these cases.  In some cases the firearms are borrowed and in other cases they are purchased from licensed firearms dealers.  One of the common gun extremist slogans is “if guns are criminalized only the criminals will have them.”  It is obvious that firearms are legally available at this point to anyone who wants to commit a serious crime like a mass shooting. It is also obvious that there are loopholes that allow gun purchasers to bypass existing laws.

What I have described here is a Nietzschean superman who clearly rejects traditional moral values of society and adopts his own – even though they are morally reprehensible to almost everyone else.  There are currently numerous patterns in American culture and society that reinforce this pattern of activity.  We are on a course for that to continue unabated.  It may worsen as the pattern of gun extremism worsens.  There are two potential solutions as far as I can see.  Reverse gun extremism back to the gun rights laws of the 1960s or preferably the 19^th century.  If the 19th century seems  too radical - see the Tombstone ordinance at the bottom of this post.  A second more public health focused measure would be on mass homicide prevention – by identifying the problem and trying to intervene while researching it.  

At the time I am writing this - neither intervention seems likely.

 

George Dawson, MD, DFAPA  

Supplementary:  If you have any doubt about the lack of motive for most firearm related homicides - I suggest watching crime TV like The First 48.  These shows typically have investigations by experienced homicide detectives that include interrogations of  suspects, witnesses, and family members.  In some cases court proceedings are included. The majority of cases are attributed to senseless violence and that typically means somebody got angry, there was a firearm available, and it was used to commit homicide.  Mass homicides can be viewed as taking the senseless violence theme to the next level.  Senseless violence is a predictable outcome of widespread gun availability and gun extremism. 

The American Gun Protection Fantasy and the Secret Service....

 

Ten days ago, a lone shooter attempted to kill former President Trump at a rally in Pennsylvania. About 6 minutes after he began speaking, Trump is noticed to turn his head to the right and then grab his right ear and drop to the ground. He is swarmed by Secret Service agents and after a period that seems too long is escorted off the stage and taken to a local hospital for assessment and treatment.  Three people in the audience are shot – one dead and two seriously wounded.  They were all in the line of fire seated behind Trump.  About one minute later the Secret Services Counter Assault team returns fire fatally wounding the shooter.  Weeks later it is learned that the shooter may have fired as many as 8 rounds based on shell casings found near his body on the roof.

There is immediate speculation and controversy about the incident. Quite incredibly several members of the Republican party blame the incident on Democrats even though they are the party that has been espousing political violence and gun extremism. Preliminary reports suggest that although the shooter is a registered Republican – he donated $15 to a liberal cause a few years earlier.  The shooter was using an AR-15 rifle that he borrowed from his father and he had purchased 50 rounds of ammunition.  At the time of this post there is no information on whether he was using a high-capacity magazine or not.  The state of Pennsylvania has no prohibition on assault rifles or high-capacity magazines.

We subsequently learn that the shooter did not make the cut for his high school shooting team, but did belong to a local shooting club.  He was described as a loner who was bullied in school. Some people described him as bright and eccentric.  All agreed that there was no suggestion that he was a potentially violent individual and nobody ever heard him make any threats. It was later learned that he did some drone surveillance of the site and had saved materials on several people from both parties.  To at least one analyst this data suggested that his goal was a mass shooting rather than an assassination.  Others speculated that it may have been a “suicide by cop” scenario.  Some information leaked from the preliminary investigation suggested he was searching “major depression” on the Internet. 

We also learn that the shooter had a picture of a recent mass school shooter whose parents were also convicted for allowing him access to firearms.  The shooter in this case places his father in the same predicament, although there have not been any statements from the parents.

At this point there are signs that there were significant security lapses.  That led to Congressional testimony by the Director of the Secret Service on July 22.  Several members of Congress demanded an immediate resignation and she subsequently resigned on July 23. She did accept full responsibility for the security lapse, an administrative maneuver that is apparently expected only in the government.  She resigned at a time when the results of the investigation of the incident are still pending.

The public has been presented with interviews of people who saw the shooter on the roof and tried to get the attention of law enforcement including the counter assault team without success.  The shooter was approached on the roof by a police officer who apparently had to back down because the rifle was pointed at him and he was not able to draw his weapon in defense.  There was a story today that Secret Service agents were located at the roof level on the interior of the same building that the shooter was on but did not see him.  The shooter was identified as a “suspicious person” but not a threat because his rifle was not seen initially. If he had been identified as a threat – Trump would have been sequestered in a safe area until the threat was neutralized.

I have not heard any information about the perimeters established for security.  I heard initially that there was a Secret Service perimeter closest to Trump and extending out for 200 yards.  The meant that Secret Service was responsible for anything inside that perimeter and local law enforcement was responsible for the next tier beyond 200 yards.  That may explain the aborted attempt by the police officer to intervene moments before the shots were fired at Trump. 

Most significant to me as a psychiatrist is the continued “search for a motive” or that “no motive has been found.”  That is a routine finding in these events.  There really are no rational motives for picking up a gun and trying to kill the former President or anyone else.  There is no motive for essentially firing into the crowd beyond Trump and killing a spectator and seriously injuring two more.  Most firearm related homicides are irrational acts – related to angry disagreements and firearm accessibility.  The fact that motives are lacking is probably the reason mental illness is often considered to be a factor in firearm homicides. 

That takes me back to my hypothesis of mass shooters that can probably also be related to lone shooters in this case.  The United States has a long history of cultural memes related to firearms.  Film and television is a rich source of revenge stories where the hero/antihero is wronged and proceeds over the next 90 minutes to kill everyone who wronged him.  That has extended in the media to include mass shooters and school shooters. Many are described as “bullied”, loners, or mentally ill.  The overriding story is the revenge meme – whether it is accurate or not.  For several decades the meme involved postal workers "going postal" due to workplace stress and mismanagement although a subsequent investigation showed the incidence of post office violence was not greater than other workplaces.   All it takes is a marginal person without self-control ability to decide to project their problems onto an available individual or group and extract their revenge.  The method of choice in the US is a firearm.

There is another group and cultural factor that may be important in these cases and that is the American sniper.  There are thousands of snipers in the US military.  They typically operate at a range of 600-1200 meters, although several shots have occurred at much greater distances. The IMDB database lists 18 sniper movies dating back to 1963. Just inspecting that list suggests to me that there are many more. And of course there are constant real-life stories about mass shooters.

My point about snipers is fourfold.  First, it reinforces the shooter meme in that a sniper is generally seen as a very competent person who is shooting people for the right reason.  Even the cinematic revenge version often has the audience primed to see the shooter's viewpoint.  Second, snipers are generally portrayed as cool and professional.  Third, there are any number of weapons that can be used to become a self-styled sniper.  The first mass shooting I became aware of was the Texas Tower mass shooting of 1966.  The incident occurred at the University of Texas and the shooter fired from the same clock tower position.    Snipers are generally portrayed as possessing some special talent to shoot well – but the reality is that anyone can shoot well – even at a distance if they have enough practice. Fourth, gun access in the US is easy.  The problem of how long mass shooters experience thoughts about shooting people is unknown and probably an impossible study.  That leads to a certain politics of explaining the motives.  To gun extremists the shooter is just “a bad guy with a gun.” who needs to be stopped by a “good guy with a gun.”  Many of these same gun extremists tend to blame the behavior either on mental illness or the treatment of mental illness even though most incidents are not related to either.  This group rigidly avoids acknowledging their possible role due to cultural changes and the widespread availability of guns.  They are joined by some mental illness advocates for not treating mental illness who suggest the behavior is due to medical treatment.  In the past, I have suggested going after the problem directly and approaching it as a public health problem.  That is – if you have homicidal thinking call an emergency number for intervention.  Acute care psychiatrists intervene in the problem when it is precipitated by severe psychopathology, but in most cases that is not the issue.  It is safe to say, the problem and successful interventions cannot be well studied in the current landscape.

Getting back to the shots fired at the Trump rally, Trump was speaking 430 ft away from the shooter or about 131 meters.  That is well within typical sniper range.  Further – given the military sniper range suggests that the Secret Service would need to secure the entire area out to 10 times the distance to that rooftop and even then, that may not be far enough.  If there are two important lessons from this event it should be that guns are inadequate protection from a shooter with an element of surprise and a long-range weapon.  You can make the argument that the Secret Service snipers may have stopped a mass shooting event, but at this point that seems to be highly speculative.  Secondly, the perimeter is very significant.  If the initial descriptions of a 200-yard perimeter are accurate – new strategies are required and even then, I would question the likelihood of stopping catastrophic results from single shot fired by a sniper who was trained in evasive action.  These are important considerations when the political solution at this point appears to be an investigation focused on who to blame for security lapses.  Members of Congress are saying all that is needed is a thorough and transparent investigation.  So far – very few details of the investigation are available.

It is doubtful that the obvious cultural factors like gun extremism, widespread availability of weapons and military style weapons, and the cultural phenomena of the lone wolf shooter will be addressed. It is doubtful that public health approaches to the problem will be discussed. I expect a final report several hundred pages long focused on what law enforcement and the Secret Service should have done.  I look forward to reading that report to see what perimeters and measures are considered and anticipate that they will be woefully inadequate compared with any determined shooter from a long range. 

And then there are the legal considerations. After the Reagan assassination attempt, the Brady Bill – a modest modification of existing gun control laws was eventually passed 12 years later.  Since that time there have been decades of gun extremism put into the law, basically because one of the major parties needs the issue for political purposes.  This has made the United States less safe for everyone including Presidential candidates.  The most striking example is that the city of Milwaukee was not able to ban firearms outside of the hard security perimeter at the Republican National Convention that occurred 2 days after Trump was shot at.  Wisconsin law prohibits local municipalities from banning firearms.

Over the past 30 years we have gone from a nation of common-sense gun laws – to a nation of gun extremism.  That is almost entirely due to the actions of the Republican party and its politicians.  There has been a clear association with increased firearm deaths and there has been no resulting retracing of the path to gun extremism.  Gun extremism puts everyone at risk including Presidential candidates. I will refrain from the usual political platitudes about how I hope everyone will be safe out there. Hopes and prayers for the victims of firearm violence have not changed anything so far and I expect more of the same until the party of gun extremism decides to change their mind or they are voted out. 

These are my observations about this Trump rally. It was a shocking event, but probably not shocking enough to change any gun laws or the steady march towards gun extremism that is oddly enough in the hands of the party whose candidate was targeted. 

George Dawson, MD, DFAPA

References:

1:  Update on the FBI Investigation of the Attempted Assassination of Former President Donald Trump Update: July 15, 2024, 3:05 p.m. EDT:

https://www.fbi.gov/news/press-releases/update-on-the-fbi-investigation-of-the-attempted-assassination-of-former-president-donald-trump

2:  Neuman S, Westervelt E.  Trump's close call: A detailed time line.  NPR:  https://www.npr.org/2024/07/19/nx-s1-5041734/trump-shooting-assassination-crooks-bulter-secret-service 

 

Supplementary 1:

I decided to write this essay ahead of any investigation results because it appears that will be a very slow process. I will read those reports as they become available.

Supplementary 2:  This article became available after I completed the above post.  It is based on testimony by the FBI Director Christopher Wray.  He states the AR-15 used by the shooter had a collapsible stock and therefore was easier to conceal.  He also said the shooter flew a drone for 11 minutes over the site about 2 hours before the event.  And in terms of the motivation:   

"Wray said investigators haven’t found a manifesto or obvious motive for the shooting. He said pictures were saved in the cache of Crooks' electronics from news searches, rather than necessarily because of a specific search for a public official."

https://www.yahoo.com/news/fbi-director-wray-set-house-143641332.html

Supplementary 3:  Additional fragments of information today in the news. There were 8 expended cartridges next to the shooter's body.  No word on the location of the other 42 rounds or whether there was a high capacity magazine.  Some data from the shooters laptop showed that he did a Google search on the JFK assassination searching on both Kennedy and Lee Harvey Oswald. 

Graphics Credit:

Click on graphic to get full information and CC license on Wikimedia Commons.

 

 

 

 

Gun Extremism Not Mental Illness

With the most recent school shooting in Uvalde, Texas the familiar repetition persists. There is public outcry to do something.  Many commentators make the comparison to the Sandy Hook Elementary School shooting a decade ago that produced public outcry but no effective response.  In fact, since Sandy Hook there have been 266 additional incidents of school shootings. Member of the pro-gun party have already spoken out and it is clear that their position of supporting gun ownership at all costs is essentially unchanged. That includes access to military grade weapons and high capacity weapons, with minimum and in many cases no regulations.  We keep hearing about all of the polls of “responsible gun owners” who support more reasonable regulation of firearms and more reasonable firearms – but they are generally drowned out by the aggressive tactics of the gun extremism faction.

Before going any further, I will provide my assessment of gun extremism. It is based on my personal observation about how guns have essentially been radicalized over the past 50 years.  When I was in middle school in the early 1960s living in a small town in northern Wisconsin, gun ownership by adults was common.  That gun ownership was focused on hunting seasons – primarily water fowl and deer hunting.  Middle schoolers took the NRA Hunter safety course in order to be able to handle firearms and hunt. Gun safety was taught primarily with the use of lectures and pamphlets. I can still recall some of the passages in the pamphlet with captions like “alcohol and gunpowder don’t mix” and a page with suggestions about what a safe target was. There was no explanation about why a crow is a safe target. The practical side of the training was with BB guns and then a .22 caliber rifle. Even though the common deer hunting rifles at the time were larger calibers like 30.06 there was no training with those guns. There was a competition series based on accuracy and most people in the class were eventually awarded Distinguished Marksman if they practiced and submitted enough targets. Memberships in the NRA was required and for $18.00/year – you got the National Rifleman magazine sent to your home every month.  The centerfold of that magazine was an array of inexpensive rifles, often “sporterized” surplus rifles from WWII.  They typically held 5 cartridges and could be used for hunting.

But like most kids taking the course. I never went hunting or acquired any additional firearms. My family was not a family of hunters and we did not have a typical cabin in the woods where everybody gathered during hunting season. The course was taught by an instructor who had been doing it for years. His overriding message was that guns had to be taken very seriously. In fact, one of the prerequisites for taking the course was that students had to vow never to “play” at guns again. That involved never pointing a gun at a person, even accidentally on the gun range. He described a number of incidents where people were accidentally shot by relatives to emphasize that point.  We all took it very seriously and there were no close calls in the class. There was no emphasis on “gun rights”, the need for self-protection, or the Second Amendment.  Handguns were not discussed because they were not used for hunting and you had to be 21 years of age to own one.  Gun rights was not an issue in any political campaign.

I don’t want to create the impression that the firearm situation was idyllic during my childhood.  Two classmates died by firearm suicide and one was killed in a hunting accident. I knew all three of them.

That is the backdrop against which gun extremism has evolved and it contains several elements.  First of all, politics. There are obvious contradictions when politicians say it is not a time for politics in the wake of the next mass shooting after they have passed laws that allow people to avoid background checks, carry military grade weapons with high capacity magazines, allow large purchased of ammunition, carry guns without permits, carry guns openly, and not have to “stand down” in confrontations – even when their opponent is not armed. That is all politics and if you are trying to deal with the aftermath pf a shooting – you are dealing with the aftermath of that politics especially if your politics facilitated that.

At a broader political level what has to be considered is how most polls show that Americans favor “common sense” gun laws – but the gun extremists continue to have their way.  In the decade following the Sandy Hook Elementary School Shooting, nothing has been done at the federal level.  Even the most basic fix of eliminating loopholes in the background checks laws has been avoided. Even when a law has been passed in the House (HR8) that makes a few changes – to the background check law there is practically no chance that it will pass in the Senate, even though the Republicans in the Senate represent 44 million fewer people. This situation has been referred to as the tyranny of the minority or a highly motivated smaller group of people dictating in this case the laws of the nation. That tyranny is even more complicated by Republican appointed Supreme Court making decisions on both gun laws and probably abortion consistent with what the minority party wants. Demographically that comes down to white, rural, less college educated voters making the laws that in the case of guns carry out an extremist agenda.

What do I mean about gun extremism?  Basically, all of the interventions over the past two generations that have allowed lax background checks and registration, lowered minimum age to purchase handguns and high-capacity military grade weapons, the increased carrying of weapons (both concealed and open) in many cases without permits, and stand your ground laws that say there is no obligation to retreat in a confrontation – even in the case where one of the parties is unarmed. There is an associated lack of gun safety and that has clearly been a factor in accidental death of adolescents and teenagers, suicides, carrying firearms into schools, and even arming mass shooters. That lack of basic gun safety is a likely contributing factor to firearm deaths being the leading cause of death in children and adolescents (1). And finally, there is a constant stream of pro-gun rhetoric that routinely distorts those facts about gun availability and usefulness.   There is good evidence that this gun extremism began in the 1970 and 1980s and has been unabated since then. 

Since the school shooting in Uvalde, gun extremists jumped to the defense of permissive to non-existent gun laws.  They offered alternate explanations for the school shooting. Governor Abbot of Texas suggested the shooter had a “mental health challenge” since anyone who shoots someone does.  That is clearly not true.  Recent evidence from high profile media cases where a homicide occurred during a fight over a firearm are cases in point. The vast majority of homicides by firearms does not involve mental illness of any kind.  In carefully selected samples – probably biased because they are selected based on forensic criteria – only 10-25% of the sample is described as having a mental illness diagnosis (2,3).

If mental illness is not an explanation for a mass shooter or mass school shooter behavior what is more likely? Given the fact that this behavior has been going on for at least 2-3 generations at this point it likely represents a subcultural phenomenon.  Subcultures are cultural groups within a larger culture that hold beliefs at variance with the larger culture.  American culture in general is steeped in violence and crime largely through entertainment and news media outlets. There are well known violent subcultures in the United States including organized crime, gangs, domestic terrorists, and various hate groups that perpetrate violence against specific people.  These other crimes are frequently seen in the news. It is easy to ascribe some of the behaviors of these groups to individual psychopathology. You can see these efforts in many true crime television shows. Crime dramas are likely to emphasize profiling as a way that the crimes are solved. Practically all of these cases lack features that are typically seen with individual psychopathology. Instead, we hear about a profile of social factors and circumstances that are cited as motivations for the violence and aggression. Those factors are also not uniform explanations for all of the violence and aggression seen across all categories and typically are collected long after the commission of the crime and by people who seemingly have unlimited time to do that task.  A good example was a forensic psychiatrist giving a profile of the Uvalde, Texas shooter describing him as a marginalized loner who had been bullied in the past and pointing out that many shooters have this profile but only a small number of people with the profile ever engage in firearm violence.

I think it is highly likely that the mass shooter and mass school shooter have become a meme that is passed in this subculture of primarily men or boys who feel that they have been victimized and they begin to see this as acceptable payback for their perceived victimization.  It is subculturally acceptable even though it produces outrage and is completely unacceptable in the larger culture and that is why the questions about “motivation” always go unanswered. Firearms and secrecy are obviously a big part of this meme and the way it is typically enacted. Gun extremism makes it much easier to enact.  In analyzing these situations, the usual starting point is where the individual perpetrator has gone wrong.  From the perspective of an alienated subculture these people and those who identify with them consider what they are doing to be correct for various reasons and more importantly widely accepted in that subculture (7). There are many reports that these subcultures are reinforced and more accessible through social media sites where manifestos, threats, time lines, and in some cases photos and recordings of the violence are posted.

In addition to the subcultural effects, important developmental effects are seldom considered.  In the past 20 years development and brain maturation has been the object of increasing neuroscience scrutiny and in addition to structural brain changes – correlations with culture, socioeconomic class, and social network/peer environment have also been investigated. In an excellent review of this topic Foulkes and Blakemore (3) point out that averaging of large samples has been used so far to get to statistical significance – but they discuss the benefits of looking beyond the averages at the total variation of normal brain development. They illustrate significant variation in the brain volume of subcortical grey matter structures over the course of ages 7 to 23.3.  I think it is generally accepted that brain maturation by these indices is not complete until mid-20s for most people, but the graphs also suggest that there may be quite a lot of variation even at that point. Beyond that they discuss several aspects of cognition and social cognition that develop in the transition from adolescence to adulthood including reasoning, risk perception, risk taking, the varied effects of social exclusion, and the use of others’ perceptions in decision making. They demonstrate what appear to be specific cultural, socioeconomic and peer effects and discuss the neuroscience correlates where they are known.  An analysis of mass shooters at this level of detail may provide better answers in terms of prevention.

What can be done to interrupt this cycle of school and mass shooter violence? Plenty can be done.  A basic time-tested public health intervention is to remove the means for perpetrating the violence and injury. This has worked in the case of suicide prevention by specific methods as well as preventing gun violence.  In a previous post, I pointed out that Tombstone had an ordinance in 1881 forbidding the carrying of deadly weapons within the city. This was a time commonly referred to as the Wild West (1865-1895).  This period is typically idealized by movies like Gunfight at the OK Corral. That was a 30 second gunfight between three Earp brothers and Doc Holiday and 5 cowboys that occurred in 1881.  One of the precipitants of that gunfight was violation of the city ordinance about carrying deadly weapons. Contrary to most accounts – both Wyatt Earp and Doc Holliday were arrested and charged with murder.  They were released after a three-day probable cause hearing. Even during America’s Wild West days, people knew that removing deadly weapons would lead to less violence.

In many ways American streets are less protected from gun violence than they were in Tombstone in 1881.  All 50 states allow people to carry handguns.  Twenty-four states require no permit to carry a firearm.  Federal law requires a handgun holder to be 18 years of age and 21 years of age to purchase a handgun. There are currently 21 million concealed carry permit holders in the US.   There is no minimum age for possessing a rifle or a shotgun.  There was a ten-year ban on assault rifles at the federal level from 1994-2004.  The ban grandfathered in all assault weapons before 1994 and there were also many other qualifications that decreased the overall impact of the bill.  Despite these limitations the ban may have decreased the frequency of mass shootings when it was in effect. (6).  Considering that there are 258.3 million Americans over the age of 18, the manufacture and importation of firearms is brisk to say the least as well as the concentration of handguns. (Click to expand the graphic)

Concluding this post, the most clearcut path to reducing gun violence of all kinds is to improve gun regulation.  The evidence is clearly there in terms of reductions in suicides, homicides and accidental deaths. The idea that gun regulation has no effect on gun deaths or that the Second Amendment is a sacred clause that mandates gun extremism is pure misinformation.  Even as I typed this post today, the Prime Minister of Canada announced stricter handgun regulations in the interest of safety.  There is absolutely no reason that high-capacity military grade weapons are necessary in society and there are many groups of responsible gun owners who openly acknowledge that fact.

Gun extremists’ additional rhetoric about how mental illness is the real problem rather than gun access is also incorrect.  Mental illness is not defined by homicide, but by constellations of findings and associated disability. There are general developmental, socioeconomic, cultural and subcultural trends associated with violence and aggression – but none are precise enough to allow for predictions of who will likely perpetrate mass homicide.  It will take continued large longitudinal studies to examine all of these factors close enough to produce an effective population wide intervention. One of my suggestions since I started writing this blog is explicit homicide prevention.  You won’t be able to find that is a book or research paper – it is based on my experience in acute care psychiatry. In that context, I encountered many people with acute homicidal thinking who ended up on my inpatient unit.  Irrespective of any psychiatric diagnosis, we were able to help them resolve that crisis.  Before the rationed mental health system takes on another significant task, it has to be adequately funded.  And beyond the mental health system – social services are required to address many of the factors associated with violence and aggression.

George Dawson, MD, DFAPA

 

 

References:

 

1:  Goldstick JE, Cunningham RM, Carter PM. Current Causes of Death in Children and Adolescents in the United States. N Engl J Med. 2022 May 19;386(20):1955-1956. doi: 10.1056/NEJMc2201761. Epub 2022 Apr 20. PMID: 35443104.

2:  Stone MH. Mass murder, mental illness, and men. Violence and Gender. 2015 Mar 1;2(1): 51-86.

3:  Hall RCW, Friedman SH, Sorrentino R, Lapchenko M, Marcus A, Ellis R. The myth of school shooters and psychotropic medications. Behav Sci Law. 2019 Sep;37(5):540-558. doi: 10.1002/bsl.2429. Epub 2019 Sep 12. PMID: 31513302.

4:  Firearms Commerce Report in the United States: Accessed 05.29.2022:  https://www.atf.gov/firearms/docs/report/2021-firearms-commerce-report/download

5:  Foulkes L, Blakemore SJ. Studying individual differences in human adolescent brain development. Nature Neuroscience. 2018 Mar;21(3):315-23.

6:   DiMaggio C, Avraham J, Berry C, Bukur M, Feldman J, Klein M, Shah N, Tandon M, Frangos S. Changes in US mass shooting deaths associated with the 1994-2004 federal assault weapons ban: Analysis of open-source data. J Trauma Acute Care Surg. 2019 Jan;86(1):11-19. doi: 10.1097/TA.0000000000002060. PMID: 30188421.

7: Simon Cottee (2021) Incel (E)motives: Resentment, Shame and Revenge, Studies in Conflict & Terrorism, 44:2, 93-114, DOI: 10.1080/1057610X.2020.1822589

8: Rostron A. The Dickey Amendment on Federal Funding for Research on Gun Violence: A Legal Dissection. Am J Public Health. 2018 Jul;108(7):865-867. doi: 10.2105/AJPH.2018.304450. PMID: 29874513; PMCID: PMC5993413

9:  Loftin C, McDowall D, Wiersema B, Cottey TJ. Effects of restrictive licensing of handguns on homicide and suicide in the District of Columbia. N Engl J Med. 1991 Dec 5;325(23):1615-20. doi: 10.1056/NEJM199112053252305. PMID: 1669841.

Graphics Credit:

Photo by Ed Colon, MD

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