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Sunday, November 22, 2009

Fort Hood: A Case of Evil

"You think you know a person by seeing them, by how they act, but sometimes you’re wrong," Patricia Villa, neighbour of Major Nidal Malik Hasan

Although our knowledge of mental illness has come a long way since the time that we burned witches, I am humbled by our utter ignorance when faced with Satanic evil. We are no closer to understanding the darkness lurking inside the human heart than the day that Cain murdered Abel. In fact, we could be even more confused. We have lost the vocabulary to talk about evil and rely on psychological clichés. We search for the cause, not the motive. Our explanations are mechanical, not spiritual.

The news stories about the shooting at Fort Hood follows a familiar multiple shootings template. First, the perpetrator explodes in a sudden spasm of violent rage. Second, the rage is due to simmering but severe mental disturbance and stress. Finally, the tragedy could have been avoided if only we had paid attention to the warning signs of mental illness.

Every element of this template is wrong, not only in the case of Major Nidal Hasan but also in most of these other atrocities.

According to the New York Times, "Every man has his breaking point."

The mad gunman tale always begins with the "snap." The mass murderer comes to a point when he breaks down and explodes. The so called "rampage" alludes to an uncontrolled, frenzy of destruction. Three days after the shooting, in an article titled, "Painful Stories Take a Toll on Military Therapist", the Times transformed Hasan into one more victim of the war, a fellow traumatised soldier whose stress was manifested in a different way. The meek psychiatrist was now a confused Rambo.

But Hasan didn’t snap. All evidence indicates that he had been contemplating this attack for several months. According to the Times, security experts stated that the use of two civilian guns (bought soon after arriving at Fort Hood) and acquiring enough ammunition to shoot 43 people suggested premeditation. He told his neighbours goodbye and gave away his possessions.

His ambush also wasn’t a wild rampage. The Times also reported that during the attack he "methodically moved around the room" sparing some and shooting others. Rather than Rambo, Hasan’s cool demeanour during the attack was closer to another, fictional, killer and psychiatrist, Dr Hannibal Lector.

Nor were Hasan’s preparations and discipline unusual. In the recent shootings at the upstate New York immigration centre and the Virginia Tech massacre two years ago, both assailants concocted a scheme to trap and ambush their victims. In New York, Jiverly Voong, blocked the back door with his car and went into the front door. The Virginia Tech shooter, Seung-Hui Cho, chained the exit doors shut. Both Voong and Cho prepared messages for media. About three weeks before the assault, Voong wrote a rambling letter that was delivered to a local television station on the day of the shootings. Cho had made a video that he mailed to NBC during his attack.

Instead of being a rabid werewolf, the mad gunman is more a sly fox. The violence is not an eruption but a culmination.

The next element of the mad gunman tale is the madness, a mixture of mental illness and stress. In the case of the Fort Hood killer, the press invented a new illness, Pre-Traumatic Stress Disorder, first floated on the Larry King Show by television psychologist Dr Phil. Dr Phil stated that Hasan must have "snapped" and was far "out of touch with reality" and had suffered a "major mental event".

The media hasn’t been able to let go of the crazybone. Last Friday on the CBS Early Show, the head muppet, Harry Smith, pressed Hasan’s attorney, "Is he competent? Is he coherent?"

Surprisingly, the lawyer admitted that Hasan wasn’t babbling or checking for devices implanted by aliens.

In another article, building on the same stress/snap theme, the Times states that Major Hasan "acted out under a welter of emotional, ideological and religious pressures." Despite being born and raised in a country where men can chose their faith and politics, the Times treats his religion and politics as afflictions, no more chosen or controllable than emotions.

Since the shooting, all reports indicate that Hasan was able to work and engage with other people without any evidence of significant psychological disturbance. So far, no one has reported any history of psychiatric treatment. Rather than being a miserable, paranoid psycho, Hasan’s neighbours said that he was the "nicest guy you’d want to meet."

Even if Hasan suffered from mental illness, studies do not show any significant relationship between most mental disorders and violence. Psychosis and substance abuse are the two diagnoses that have some relationship to violent behaviour. However, psychosis contributes very little to overall violence.

The other psychological culprit in our tale is stress. People used to laughingly say, "the devil made me do it". Stress is the new demon. Twisting logic to fit the facts, we’ve been told that hearing about combat is more stressful than being in combat.

Recent evidence shows that Hasan wasn’t driven to violence but drawn. Hasan sought both glory and vengeance. He had praised suicide bombers. Investigators also found that Hasan had business cards identifying himself as Soldier of Allah.

The sad endings to our mad gunman stories are as fanciful as the rest of the story. Like meteorologists checking radars and air pressure, the media searches for warning signs as if these events were simply the hurricanes of society, accidents of nature. Any warnings signs are always clearer in retrospect. Although military life requires moving and saying goodbye, the New York Times reports that Hasan’s goodbye to his neighbours was a signal. Major Hasan did voice some opinions not consistent with serving in the military, but nothing observed in the Major’s behaviour indicated that he was planning a mass murder. Moreover, none of the signals were a sign of mental illness. People who commit premeditated murder are shockingly secretive.

Like other mass shootings, Hasan’s assault on Fort Hood was a planned massacre. Labelling these events as sudden eruptions of mental angst is more comforting than worrying about classmates, co-workers, strangers or the nice neighbour who may be harbouring murderous fantasies and waiting for the right moment. I find these half-baked psychological theories and excuses cold comfort. Thorazine and therapy won’t save us from these twisted souls.

Theron Bowers MD is a Texas psychiatrist.

From here.

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