Seeing the media coverage of the devastation and misery caused by the earthquakes in Haiti has gotten me thinking about the media and the impact of second-hand trauma. I remember after the 911 attacks that many of us had the tendency to sit glued to the repetitive images of the jets crashing into the twin towers on our televisions. The stations replayed the tape so many times that I imagined that every human on the planet had seen it dozens of times. As technology advances, worldwide communications are more connected and lightning fast. A video of a traumatic event halfway around the world is on the evening news here in Cleveland, along with all the coverage of local traumatic events. This is so different from what our ancestors experienced. Certainly they had plenty of traumatic events to deal with; life is just like that. But they were not bombarded with images of traumatic events from all the other villages around the world. After 911, I started advising patients to monitor and limit their exposure to trauma coverage in the media, especially video coverage. There is something very neurologically compelling about visual images of trauma. It is important to know what is going on but compulsively taking in these images can be very disturbing. We do not have power over the enormous events in our world, but we have power over how we handle them. For physical health we should watch what we eat and drink, attending to what we put in our bodies. For mental health we have to attend to what we put in our minds, making healthy thought choices like we would make healthy menu choices. It is not the mission of the media to present us with a balanced diet of positive and negative images. We have to take control of how much of what news we allow in.
Archive for the ‘Violence’ Category
Haiti and Media Coverage of Traumatic Events
Friday, January 22nd, 2010What Makes a Murderer?
Tuesday, December 8th, 2009One of my loyal blog readers asked me to write about serial killers. This is a timely topic here in Cleveland where the remains of eleven women have been found in the Imperial Avenue house of Anthony Sowell. What is evil and what is mental illness? These are philosophical and spiritual questions as well as psychiatric ones. When faced with an account of murder, people sometimes think that only someone who is insane could perform such an act. It’s not so simple. Psychiatrists would limit the definition of insanity to situations in which the person had a major mental illness like schizophrenia and the murder was a direct result of the illness. Clearest example of that would be a murder committed at the command of hallucinations and delusions. A mother might have heard the voice of Satan for months threatening to take her children to hell before she kills them to save them by sending them to heaven. Murders like this are rare and don’t help us understand the more common occurrences.
Researchers study those who murder by looking for genetic traits, patterns of brain malfunction and life histories, hoping to find clues to what make a murderer. Some genetic markers are more common in violent individuals but no one marker identifies a murderer. On brain scans, there is evidence for decreased activity in the areas of the brain responsible for judgment and behavioral control. But again, this pattern of brain function does not mean a person is violent or a murderer. In life histories, the combination of violent individuals in the family tree and abuse or mistreatment as a child seems to produce violent behavior. It’s as though the genetic components are activated by early life trauma.
Dr. James Fallon at the University of California at Irvine is a psychiatrist interested in violent behavior and whose own family tree includes multiple murderers. He studied the DNA of family members and found that he himself carries the violence markers. He also has some patterns on brain scans typical of violent individuals. He has no history of violence and explains that his childhood was nurturing and safe and perhaps that is what overrides the genes. There is a video about this work on the Wall Street Journal site. Caution: there are some pictures of murder victims and of brain dissection. Not for the squeamish.
What makes a murderer or a serial killer remains mysterious,. Psychiatrists do not have all the answers to this question. In fact, we have very few.
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Ft. Hood Attacker is a Psychiatrist!
Friday, November 13th, 2009I am accustomed to questions about whether psychiatric patients are dangerous (see my blog from 4/7/09). I am not accustomed to questions about whether psychiatrists are dangerous. I was shocked to hear that the attacker in the Ft. Hood shootings was a psychiatrist. As I thought about this more (as I procrastinated on writing this blog), I realized I had fallen into the trap of somehow believing that doctors and psychiatrists are not like other people. I know better than this. I know that psychiatrists have a high incidence of divorce, depression and suicide. Doctors in other specialties are also not immune from mental disorders and family dysfunction. I have been a vocal critic of narcissistic doctors who act like they are God and I strive to work with my patients in a collaborative partnership. I also know that there are doctors who do criminal acts. Ohio’s Medical Board mails all physicians a quarterly newsletter, part of which details all the docs in the state who are in trouble with the Board. Many of these are in trouble because of criminal activities outside the realm of their practice of medicine. Doctors are not superior human beings, just highly trained professionals. So after some thought, I am shocked that I was shocked that the shooter was a psychiatrist. I should know better that that.
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Violence and Mental Illness
Tuesday, April 7th, 2009Recent shootings in the news bring up the recurring question of what leads people to commit these dramatic acts of violence. Surveys show that about 75% of the public believe that mental illness causes violence. A national study of the relationship between mental illness and violence has been done to examine whether this is true. The study tried to separate out the factors of mental illness alone, mental illness with drug or alcohol abuse, and mental illness with a prior history of violent acts. There was no elevated level of violence in people suffering with major depression, bipolar disorder or schizophrenia alone. The risk was elevated if they were also abusing drugs and alcohol and/or if they had a pre-existing history of violence. If all three of these elements were present the risk of dangerousness was elevated by a factor of ten! What are other factors that contribute to risk of violence? Childhood physical abuse, humiliation, losses such as divorce and unemployment, and parents with criminal behavior are some examples.
As a psychiatrist, one of the most difficult things I have to do is to attempt to determine whether someone is dangerous to others. Outside of my professional role, like other members of society, I have to struggle with the media reports of these horrific shootings and to wonder what leads people to these desperate and destructive acts. It is seems simple to attribute violence to mental illness but the reality is far from simple. The vast majority of people who have been my patients over the years have not been violent. My patients have suffered from stigma because they are depressed or anxious or just in need of some therapy to talk through difficult times. They have felt that society sees them as “crazy” and maybe dangerous. What is really dangerous in my opinion is if stigma prevents people who need therapy or medication from coming in for treatment.
