Monday, December 31, 2012

Mental Health and Violence: Thoughts and Contemplations from a Clinical Psychologist (In training, of course)

What a way to begin a blog wouldn't you say? It's nearly 5am here and I'm sitting on a loveseat thinking about what to say on the recent violence that has swept across America in just a few short months. Why can't I sleep? Oh I don't know, lots of reasons. But there has been one thought running through my head since I opened my gifts on Christmas Eve, a thought that makes me churn with such emotion it's hard to even type: How are the parents of the 20 children who died at Sandy Hook Elementary School spending their Christmas? Had they already bought gifts for their children?

I think of what Christmas will be like for those families in the years to come and then remember I'm a man--and men don't cry--and if I want to stay a man then I probably shouldn't dwell on a thought like that for too long. I fail--miserably mind you--at being a man. And I'm proud of it. There should not be things one forgets so easily, and out of sight out of mind should not be this slippery slope one enjoys sliding down so well. But one does. We all do. How many of us, in the midst of our love life, family life, social life, and jobs, forget about others, even our closest friends, let alone people we don't know that maybe live thousands of miles away? And psychologically speaking, it may be a healthy way for us to cope with our lives: if we could never, dare I say, neglect for a time the emotional suffering of the world around us and in our personal lives, we may not function very well. I guess it has its advantages--out of sight out of mind, I mean.

We all ask ourselves: How could this have happened? What makes someone do this? Why this? Why that? Invariably questions will arise in regards to gun prohibition, security and safety of our children, governmental policies that should be changed, and every reporter will from here to everywhere will ask psychologists to get into the mind of the person who committed such an atrocity. Let's just be clear on this: he doesn't matter. Why is it we can remember the name of the shooter and not one name of a child that was shot that day? He.does.not.matter. Leave his name to forensic and clinical psychologists who work in that area, who get into that mind to prevent it from happening again, and not so the person can be discussed about extensively in the media. It's an urge we must resist--the urge to comprehend, for it causes us to bring attention to someone who deserves none of it. Humans seek understanding, reason. Reason allows us to fit events such as this into a neat little box so that we can deal with it in a manner that prevents our brain from exploding... In my opinion, there is no true reason for this: some people are just plain evil, though if I take this side do I concede my hope on the matter?

It would only be fair to say that people--especially in my field of study--would disagree with this notion, evidencing numerous psychological articles and referencing disorders such as Oppositional Defiant Disorder, Conduct Disorder, and Intermittent Explosive Disorder as a few big ones. I don't stand to purely contradict that idea, but let me say this: after killing his mother, a kid went into a school with semiautomatic weapons and put bullets through children and adults alike. Think on that for a moment. Think about the type of mentality someone would have to have in order to actually go through with something like that. I'm a hypocrite. I said not to discuss him and here I am doing it...

A year ago I was finishing up my adult psychopathology class at my place of study. Throughout my time in that class, a major topic was brought up that came down to basic philosophy. I used to disagree with my professor on a very important concept. I used to believe that people should not be held accountable for every action because there are some instances--like schizophrenia, like PTSD--where a person's mind is essentially not their own: They suffer from hallucinations, delusions; street signs are interpreted as messages from God; voices tell them to kill certain people; flashbacks cause a dislocation of reality; and hypersensitivity and avoidance behaviors change the very fabric of someone's identity. Like I said, I used to believe that if a voice told a schizophrenic person he or she should go kill someone--and they did--then they couldn't be fully held accountable, by moral law or jury law. I repudiate that notion: People are acting agents and disorders do not encapsulate every aspect of their personality or character. You always have a choice, albeit sometimes not the best one, but a choice nonetheless (if you wish to read more on choice and accountability in regards to psychology, look up a few articles by Thomas Szasz and, ironically, decide for yourself).

It's getting late (almost 6am here), and so I will finish with a few comments on how the role mental health can hopefully stop another horrible tragedy like this. Sadly, there are so many things. I believe the first important factor would be psychoeducation. Parents, teachers, social workers, truck drivers, police officers, firefighters, waitresses, you name it--anyone and everyone that can benefit from learning a small amount about mental health can and should. It removes stigma associated with mental health, which makes it easier to discuss, and educates individuals on psychological symptoms and problems a parent, teacher, waitress, or whoever may have missed in their son or daughter if they did not know otherwise.

Let me provide a better example: I'm not a medical doctor, but I can tell when my mother is feeling under the weather, and if need be, when normal medication won't work and hospitalization might be needed. The same goes for psychological problems. People need to know common symptoms of depression, anxiety, etc so that we can get treatment to individuals in need faster. I will mention a slight tangent here: Stigma needs to be removed. The idea of talking about your feelings needs to not be so looked upon in a derisive manner. People think because its psychological that they could control it or if they were only stronger they would be able to "beat it". Wrong. 50-80% of Bipolar Disorder is genetic. The statistics for Schizophrenia are even higher. Individuals with addictions like alcohol hover around 50%. And similar results are reported for most depression and anxiety disorders. Remember that.

Health Care is another big issue: What plans are available for individuals? Are individuals able to receive the proper treatment they need, or do they not have the money for the right plan? What about the uninsured? Also, who is making diagnoses? A diagnoses, in my opinion, is only useful if it can provide a psychiatrist or psychologist a blueprint with which to create a treatment plan and make communication between professions simple. "So and so suffers from this...Okay let's proceed in this manner." But who makes the diagnoses? There are some individuals who do not receive the proper training and make the wrong diagnosis and thus causes individuals to not receive proper treatment/medication. There is also a lack of communication between psychologists and psychiatrists. Normally, though not all the time, psychiatrists emphasize the medicinal aspect and neglect the therapeutic avenues one could take, which creates problems. Not everything can or should be solved with a pill. There a number of reasons for this, reasons which I don't have the time to go into.  

A final notion regards gun control. If someone wants to buy a gun, criminal records as well as mental health records should be available to make a careful decision on whether or not this person should have a firearm in their hands (now how someone regulates this and decides who gets what is up for debate obviously). Bear in mind: It was the kid that had the weapon, not the mother, which means its likely violence like this can't be fully prevented. But this could help. Also, my two-cents about guns: why any normal civilian needs a semiautomatic weapon is beyond me. I'm not talking about rifles. You want to spend a weekend with your father hunting? Fine. But what NEED do you have for the weapon that was used by that kid at Sandy Hook?

It's 630am here on December 31st, the day before the new year. A tumultuous time it is, a time of trepidation. And here in this chair, I think about those families who are now childless, whose gifts still probably lay under the christmas tree because they don't want to admit to themselves their children are gone... But there is hope. And Christmas/New Year is perfect time for it. I will finish with a quote that I found particularly moving, a quote by Alfred Lord Tennyson (used in the movie Skyfall):

"Though much is taken, much abides, and though we are not now that strength which in old days, moved earth and heaven; that which we are, we are; One equal temper of heroic hearts, made weak by time and fate, but strong in will to strive, to seek, to find, and not to yield." All the best and stay safe.

--Matt




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