After 31 more deaths, IT’S PAST TIME TO ACT
Take it from a shrink: America needs better gun control
The body count is rising. As of this writing, there have been 255 deaths from mass murders in America in 2019.
Nobody expects this number to remain stable. As we recover from the tragedies of El Paso and Dayton, we are once again subjected to pallid explanations from politicians beholden to the gun lobby, all designed to detract from the real issue — gun control.
(Former U.S. Sen.) Rick Santorum tells us that the El Paso shooter picked “soft targets” at a shopping mall. If the citizens shopping for school supplies were carrying guns, he argues, the shooter would probably have chosen to stay away. The most powerful Republican U.S. Representative, Kevin McCarthy, argues that video games are to blame. And finally, (President) Donald Trump drags out the tired gun rights mantra; i.e., that shooters are mentally unstable, ergo we need better mental health services.
As a psychiatrist who has been practicing for over 48 years, I heartily welcome public commitment to more mental health services. However, I resent, as should professional societies like the American Psychiatric Association and the American Psychological Association, the use of our patients as a shield for the National Rifle Association and the politicians on its payroll.
It is obviously true that mass murderers are unstable mentally. A few, though not as many as some people may think, are people who could meet diagnostic criteria for a major psychiatric disorder like schizophrenia or serious mood disorder with psychosis. However, the thread that connects all killers like the (alleged) Dayton and El Paso shooters is not psychosis, but pathological narcissism.
Narcissism is a normal part of psychological development. All 2-yearolds are narcissists; good parenting tames it. It takes some degree of normal narcissism to rise to the top of corporations and government entities. But pathological narcissism is a severe, potentially dangerous, lack of empathy. Who is more devoid of empathy than a person walking through a department store randomly shooting strangers? An unhinged pathological narcissist is not swayed by the prospect of death, as Santorum argues. He is looking for his 15 minutes of fame. He usually expects to be dead by the end of the day. A parking lot full of gun-toting Texans would not dissuade him.
There are a few mental health professionals who believe that severe narcissism is treatable. I am not one of them. To submit to mental health treatment one must have the ability to see one’s vulnerabilities and commit to change. This is antithetical to pathological narcissism. If one looks at the histories of shooters like those (suspects) in El Paso and Dayton, it is rare to see someone who was referred for mental health services; even rarer to see someone who stayed in treatment if referred.
The professional societies mentioned above tell us that it is not possible to predict violence. The only remotely reliable predictor of violence is past violent behavior. Nearly all, if not all, mass murders were (the perpetrators’) first violent acts in public.
To point out the obvious, mental illnesses are worldwide phenomena. Mass shootings do occur in other countries, like Norway and New Zealand, but they are isolated, rare events. Is this because other countries have better mental health services? No, they have better gun control laws. They also watch video games.
And finally, there is one “culprit” not identified in our public discourse: the American voter. Polls consistently tell us that over 70% of Americans favor tougher gun laws. But when we go to voting booths we just as consistently vote for politicians with A+ ratings from the NRA. We are not helpless. We just choose to be.