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Psychotic Does Not Mean Violent: Reflections on Tucson Tragedy

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My grandfather committed suicide. So did one of my cousins. Another has been diagnosed with schizophrenia, a third with schizo-affective disorder. I too have been diagnosed with both schizophrenia and schizo-affective disorder, and I was suicidal in 1997 and 1999 when I had psychotic breaks.

I have never been a threat to anyone but myself, and the same is true of my relatives, from what I know of their lives.

I mention all of this because members of my family and I, not Jared Loughner, the alleged gunman in the Tuscon massacre, can provide an authentic voice for the mentally ill, a voice that is too often misrepresented, misconstrued and misunderstood.

After the rampage in Tucson that left six dead and at least a dozen people wounded, including Congresswoman Gabrielle Giffords (D-Ariz.), I was not surprised when broadcasters began referring to Loughner as mentally ill or unstable. This seems to be a default response by most journalists and non-journalists alike. Who else but a mentally ill person could commit such a heinous crime, goes the reasoning.

It may very well be that Loughner showed signs of psychosis. His ramblings on MySpace and YouTube in which he bashed the government, talked about "mind control" and touted a new currency do suggest a person lost in delusion.

As the New York Times wrote, Loughner's Web-based writings and videos are "consistent with the delusions produced by a psychotic illness like schizophrenia, which develops most often in the teens or 20s."

What the Times failed to say, though, is that psychopaths, people who plan violent, extremely anti-social acts for which they show no remorse and whom most psychiatrists do not consider to be mentally ill, can also be psychotic. That does not mean that most psychotics or schizophrenics are psychopathic or violent. Most are not.

As I have written before, the severely mentally ill with no substance abuse problems commit only 3 to 4% of violent crime in this country.

It is worth noting that Saturday's mass murder was not Loughner's first brush with the law. He had a criminal record, with several arrests, and had been a user of marijuana, which studies show can exacerbate psychosis.

Whereas psychotics do not plan acts of violence and are rarely violent except when they misread a situation, Loughner behaved like a psychopath in planning his killing spree.

The 22-year-old community college dropout came prepared "for war," as one eyewitness told CNN. Loughner brought with him several extra clips for his Glock semiautomatic weapon, as well as a knife. Evidence of his premeditation could also be found on an envelope, discovered in a safe at his home, on which he allegedly wrote, "I planned ahead," "My assassination" and "Giffords"; as well as on his MySpace page, where hours before the shooting, he wrote, "Goodbye friends," adding, "Please don't be mad at me."

Moreover, since being apprehended, he has refused to answer questions. Such plotting, remorselessness and silence after committing murder calls to mind Iago, a point I have made numerous times before. The villain of Othello is not remotely mentally ill; like Loughner, he is evil, a calculating killer, who is fully conscious of the destruction he causes.

By contrast, when I was psychotic in 1997 and 1999, I never became violent, and if I had, it would not have been premeditated.

As I have written previously, when I was having my relapse and thought that I would be blamed for a series of murders sweeping the country, the nurse at the UCLA Neuropsychiatric Institute called in three burly orderlies to make sure that I took my medication. I could conceivably have felt threatened by these orderlies, who told me that they had "worked with cops," but I did not attack them, nor did they attack me. Though I feared at some level that the meds might be contaminated, I had enough insight to realize that I would probably be okay, so I took the medication.

My point is that, had I gotten into an altercation with the hospital orderlies, it would not have been by design, nor would it have led to any bloodshed. My behavior was the behavior of a true psychotic, of whom I have met many over the years, at NAMI meetings and classes, as well as at psychiatric wards (where I spent time recuperating in 1997 and 1999), day hospitals and self-help groups. While I know several psychotics who have gotten into physical clashes with police officers, they did not plan those altercations.

All of which is to say that there may have been a number of factors involved in Loughner's decision to commit these atrocities, including the ease with which he obtained his weapons and the xenophobic politic rhetoric in Arizona, both of which have been much discussed.

I just hope, as further details come out, that we can continue to have a dialogue without branding an entire group of people, the mentally ill, as violent.