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Mark Goulston, M.D.

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Jared Loughner: Understanding the Arizona Shooter from the Inside Out

Posted: 01/10/11 12:00 AM ET

Over the next few days to weeks, we will try to piece together what could have caused Jared Lee Loughner to attempt to assassinate Congresswoman Gabrielle Giffords, kill six and wound fourteen others.

We will learn of a long trail of "red flags," and questions as to why there was not some earlier intervention will arise. We will hopefully nail down whether this was the act of a lone individual or part of some conspiracy. Forensic and other psychiatrists will weigh in on this being the act of an untreated, mentally disturbed and psychotic individual. Political extremist groups will be -- if you pardon the bad taste -- targeted as contributing to what may have triggered Loughner.

And, of course, we will have the benefit this time of a living perpetrator, so we will no doubt learn a number of answers from Loughner himself. However, even when he opens up, we may learn little more than that we are dealing with a psychotic, paranoid if not schizophrenic person.

This situation and the information coming out about Loughner has caused me to try to understand what could have caused his action, drawing on my 30 years as a clinical psychiatrist and behavioral analyst.

From listening to many suicidal and rageful/violent people and hearing information similar to what we are beginning to learn about Loughner, I believe that four factors may have contributed to his actions. (This is not in any way to excuse his heinous acts, but to gain a better understanding of his psyche so that we might prevent such tragedies in the future).

  1. Prisoner of his own imagination*: When someone is a loner and not regularly in conversation with others, they run the risk of their imagination obscuring their contact with reality. In fact, most people have experienced their imaginations taking over when under stress and lying awake at 3 a.m., unable to fall to asleep or shut their mind off. Furthermore what if someone's imagination caused them to feel as if the world (both real and on the Internet) was continually trying to either control them (with rules), reject them (as we know from his attempt to enlist in the armed services) or laugh at them (more likely a nervous laugh from people feeling anxious around them)? What effect might that have on someone's psyche?
  2. Reality-based persecutory fantasies: Much of Loughner's paranoia about government control, etc. is likely delusional, but there is one area where his persecutory beliefs are grounded in reality. When someone acts bizarre and rants and raves in public, they do trigger fearfulness and avoidance in those around them. And if that someone has no awareness or insight that they are triggering such reactions, they will come to perceive that those people who are acting awkwardly are out to get them, when in reality they are out to avoid them.
  3. Loss of executive function: The less one is able to use the reasoning part of their mind and upper brain to do a reality check on their perception and their runaway imagination, the more they become prey to being controlled by their emotional middle brain and "fight or flight" lower brain. A person's lowest and most primitive brain works more according to reflex than to reason, and there is also a tendency to react back at the world at an equal, "eye for an eye" level of intensity to the way they perceive the world has treated them. Therefore, the more Loughner perceived that the world was after him (because in fact the world was indeed trying to avoid him when he acted crazy), the more he felt the need to get back at it in a more massive way than a single, focused murder.
  4. Revenge of the "nobody": In this world, many people suffer from "somebody envy." To many people, being "anybody" can feel like being "nobody." That may explain some of the massive appeal of shows like "American Idol," "Dancing with the Stars," "The Biggest Loser," etc. where "anybodies" get to become "somebodies."

Worse than being a "nobody" is feeling put down and pushed away, as Loughner may have experienced with the multiple rejections in his life. And when people with a disturbed mind such as Loughner feel put down and pushed away, they often find a way to get back in and get even.

*Many mental health professionals and others will say, "This is much more than a wayward imagination; this is delusional and psychotic thinking that requires treatment, including medication." That is all true, but the challenge is how to gain cooperation and with it, the willingness to comply with and then continue treatment and medication. Unfortunately, establishing sufficient trust with a paranoid individual to cause them to be williing to cooperate with treatment, especially when there will be many uncomfortable side effects, is often a painstakingly long and frustrating process. Much of psychopharmacologic research is aimed at finding medications that have fewer of those side effects so that there might be greater cooperation and compliance. My aim in laying out the four factors above is that they may enable a conversation to take place with these individuals that is sufficiently empathic to tip the scale towards cooperation. One of my mentors once told me, "When you get where people are coming from and care and understand them when you're there, they're more likely to cooperate with where you'd like them to go."

If you have any thoughts or solutions in 140 characters or less, please tweet them to me @MarkGoulston.

 
 
 

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Over the next few days to weeks, we will try to piece together what could have caused Jared Lee Loughner to attempt to assassinate Congresswoman Gabrielle Giffords, kill six and wound fourteen others.
Over the next few days to weeks, we will try to piece together what could have caused Jared Lee Loughner to attempt to assassinate Congresswoman Gabrielle Giffords, kill six and wound fourteen others.
 
 
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10:34 AM on 01/16/2011
It is irresponsible for Dr Goulston and the media to continue to use the word "loner" to describe people who commit crimes. "Alienated" would be a better word because there are many individuals who prefer to be alone who would never hurt anyone.
Personally I think we are witnessing politics creeping into the space that was historically taken by religion. It is becoming the most "charged" topic of our time, and it isn't hard to see that if someone's brain isn't functioning normally, how it could lead to obsession. It is a distorted need to control.
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MerrieWay
08:56 PM on 01/12/2011
People, including parents,teachers,friends,co-workers,strangers are frightened by bizarre behavior, Laughing out loud during class without apparent reason, isolating, ideations, etc. were some of the reported symptoms regarding Loughner.

He clearly suffered from the 4 examples given here. The 5th consideration: No one took the initiative to intervene and help him. Mentally and emotionally challenged, he operated from a delusional, victim or survivalist reality. Whether he would accept help is another issue. Arizona cut the mental health services by 50% in 2010, meaning, were they even available to him?

MerrieWay's Plea: Living in a society of lost ethics, with media centered abusive bully-pultpit-ing, demonstrates the lack of respect for everything of sacred value.
Let's stop badgering on bully pulpits. Can we boycott vicious media, slanderous outbursts, and politically charged hypocrisy? We the people are decent, it's time to model that strength of high-mindedness to our children. Peace.
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06:59 PM on 01/12/2011
We can all agree he was mentally ill and we all agree he should have been stopped, but how?

Passing laws gives us the sense that we've fixed the problem, but laws don't enforce themselves. Passing laws excuses us of the responsibilities we've collectively neglected, but neglecting responsibility is what got us here in the first place.

Which is to say, where were the people close to him in his life? Where were his parents, his teachers, his friends? Didn't anybody feel like taking responsibility for him? Do we really think a policeman or clinician is a viable alternative? In a few cases, maybe, but overall no, because they don't care like family and friends.

And maybe that's what this was all about to begin with; detachment. They didn't care, so he didn't care.
12:03 PM on 01/12/2011
There is no understanding in crazy. That's why it's called crazy.
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07:48 PM on 01/11/2011
The whole article is moot - no matter what was wrong with him, or what treatment is best, here in America if you are sick, you are on your own unless you have mad loot, or insurance (that will OK treatment). It's even worse for mental health...
06:14 PM on 01/11/2011
Our brains are highly complex , the product of billions of years of evolution and the idea the a pill that alters the brain structure and fuction will not increase entropy and will result in some type of benefit seems absurd to me.
06:11 PM on 01/11/2011
Autopsies on the brains of schizophrenics show no differences between the brains of schizophrenics who never took meds and the brains of non - schizophrenics Schizophrenics who took psychiatric meds , in contrast show serious brain damage on autopsy. These drugs do organic brain damage.Tdr goulston has a mortgage to pay so you wont hear the truth from him.
04:41 PM on 01/11/2011
Psychiatric medications make people worse in the long term . It doesn't make sense that there are pills that would make an irrational person such asLoughner rational and there are no such pills.Not only do psychiatric medications have terrrible side effects such as tardive dyskinesis, epilepsy , stroke, Prkinson's , studies show that they are ineffective , no better than placebos over a short term and worse than placebos in people who take tham a long time . If these pills worked so well , why do we have so many shootings in contrast to times when these drugs were not used ? There was a mass shooting in Austin Texas decades ago but that man had a brain tumor . These drugs make people worse and result in disinhibition syndrome,which , as it sounds ,means that peop[le become unable to control their impulses . Before you take these drugs you might want to read -
"Anatomy of an Epidemic" and "Mad in America" by Robert Whitaker
"Medication Madness" and "Your drug May be Your Problem" by Peter breggin MD
Whenever we have one of these shootings , the media claims it to be a result of the shooter going off his meds. Thes drugs no not decrease violence . While many people feel worse after stopiing medication, these people are suffering from withdrawal just as heroin addicts temporarily feel worse when they stop heroin . You will be better off going through withdrawal rather than using these drugs indefinitely.
09:48 AM on 01/11/2011
The fourth point, "revenge of the nobody," is the closest that anyone has come to explaining what Loughner was going through before he snapped. Before the massive downsizing and restructuring program known as Reagonomics took hold, it wasn't so bad to be a "nobody." You were able to have a good job with decent pay, good benefits, a pension plan, and could get married and have children if you wanted to. Today these things are out of reach for a significant portion of the population.

He had no job, no access to an education, no prospects, and no future. Any country where the "winners" are treated like gods and goddesses and the losers are treated like horse manure (and constantly reminded that it's their fault that they're poor) is setting itself up for these kinds of disasters.

If this guy had a job (a real job, not a McJob) or was going to school or was in a job training or job placement program where he was learning a skill, he wouldn't be going to a store to get a gun with a 30 round clip for the purpose of killing six people. Because when you're invested in the system and feel part of the system, and have that sense of purpose that a job provides, you don't have a reason to harm others.
03:20 PM on 01/13/2011
Umm... you did catch the part where he was kicked from school because he was a bit off, right?

Most likely, he got kicked from the Army recruiters (one of the few jobs with a real pension and benefits) because of his psych issues and/or drug history--likely related to his psych issues.

The crazy probably caused the asociality, not the other way around.

Additionally, it's often social connection--through family, friends, other networks, that allow people to get the "good job with decent pay, good benefits, [and] a pension plan". Although, the way the tax system is set up today, it doesn't pay companies much to offer a pension anymore.

(I'm not sure how you tied that into Reagonomics.)

Some people are simply different and don't respond to having a "good" social or economic background, regardless...
09:14 AM on 01/11/2011
Opponent, I certainly respect your opinions about mental illness, as one who has lived it and also experienced the inadequate mental health system in our country. Do feel that psych meds have no place in mental health treatment?
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poeticjustice4all
Past = Prologue
02:07 AM on 01/11/2011
We cannot trust what Loughner placed on those websites. For all we know, they were prepared for effect and do not in any way reflect his actual thinking.
02:43 PM on 01/11/2011
beyond subterfuge the truth is always lurking...it is obvious we can't couldn't trust Loughner...and if he prepared anything he put on the web it is still a reflection of what is going on in his inner dominion regardless of whether he is lying publicly about it or not...I would imagine it is relatively safe to assume most of what he put on his sites is rhetoric...quite dangerous at that...
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snesich
01:18 AM on 01/11/2011
I agree that this is one seriously disturbed individual. And, unlike most seriously disturbed individuals, this one acted out. And the results are unspeakable and horrific.

However, you mention the killer's paranoia about "the government". Where did this hatred and distrust of "the government" come from? Did it arise out of thin air? Did the killer come to hate and fear "the government" all on his own? Why would he have anything against "the government"?

The killer is 22 years old. Which means he was 4 years old when Bill Clinton took office. Since that time, our airwaves have been filled with constant, 24/7 hate speech---almost all of it directed towards "the evil government" and "the Democrats". This boy grew up hearing that "the government" was to be hated and feared. He leaned that "the government" was run by disloyal, corrupt people who are responsible for everything that is wrong in your country and in your life.

This hatred and fear of "the government" comes from the stench of vile, odious hate talk spewed out by well-paid conservatives on radio, Fox "News" and many, many other places, including much of today's Republican Party.

This tragedy wasn't an isolated, disconnected incident. It's directly related to the viciousness of today's political climate.

For those conservatives that still retain an conscience and some common sense, it is your responsibility to speak up and condemn those who would continue this madness.
03:14 AM on 01/11/2011
BTW, in preview it didn't look like the embedded link showed, so here it is: http://zombietime.com/sf_anti-war_rally_3-20-2010/
09:00 PM on 01/10/2011
I would guess you're not going to get a decent healthcare system with universal, non-profit coverage until the victims of some of these neglected mental cases start suing the government for not providing psychiatric care, the legislators who vote against it, the insurance companies that turn them down, and so on.
03:18 AM on 01/11/2011
Yep, that's what this country needs--more lawsuits! More lawsuits will create a universal, non-profit health care industry. Then free life-saving drugs and medical equipment will fall from the sky, and doctors and nurses will all gladly work for free, and everything will be OK. AND it won't raise the deficit one dime!
04:46 PM on 01/11/2011
Therer is far more psychiatric treatment today than in the past but the rate of suicide in the armed forces is way up and the rate of these school,, work place and, other shootings is way up
Many people who knew Loughner in high school say he was fairly normal until he started taking drugs..
08:57 PM on 01/10/2011
You forget, number 1, he was able to buy automatic weapons two months ago.
02:33 AM on 01/11/2011
Actually, no he wasn't. Automatic weapon sales are strictly regulated, even though they've only been used in less than 1% of all crime since 1934. In fact, there have only been 2 verified cases of homicide with a lawfully purchase automatic weapon in that time, and one of those was a law enforcement officer. But since this shooter wasn't using an automatic weapon, or even an assault weapon, this entire line of reasoning is moot.
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snesich
06:46 PM on 01/11/2011
Oh please, stop trying to run from the obvious.

Technically, speaking, the killer was using a "semi-automatic" weapon, which is designed for one purpose only: to kill as many human beings as possible in the shortest time available.

This was a weapon of mass destruction and it was far from the first time that a semi-automatic weapon was used for mass murder.

At least stick to the facts, buddy, whether you want to defend what this guy did or not.
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NebDem78
Protector of Herland
06:23 PM on 01/10/2011
This may be the only post I make about the tragedy. It is hard for me to offer an opinion, because it is a tragedy, and I do not like where the conversation about this tragedy is leading, per partisan conflict.

I saw the books Loughner included on his face-book. It is in my opinion that he got lost in distopian thought, and never made the decision to climb out of it, maybe it was because he was still so young, but, It doesn't really matter now. What is the proper way to bring one out of it?

There are so many things to read to remove one from reality, but reading and thinking for so long only about the darkness in things can lead a person to think that nothing in this world is good. There needs to be balance. There needs to be a desire to remove oneself from their own view of the world, instead of going further into it. This boy didn't grow out of the prison of his own mind, and it had consequences.

"The Mortal No: Death and the Modern Imagination", by Frederick J. Hoffman, is a insightful book. I would highly suggest it to Dr. Goulston, and everybody else.

This situation is a tragedy. The books that he may have read, aren't the only books. I'm certain that talk of guns and misgivings of government will permeate the other articles on the Huffington Post, I will only suggest Walt Whitman, among others.