Mental Health, Mental Illness, Shooters

I’ve watched and read a lot of the conversation related to ‘mental illness’ and gun violence and so far have stayed on the sidelines. However as I sense increasing polarization and confusion around this issue I thought, as a mental health healer with more than 30 years of experience in the field, I’d add my two cents. With my ramblings and a couple of bucks you can buy a cup of coffee.

First, I understand that people with mental suffering face a great deal of prejudice and stigma in our society and they quite naturally don’t want any more crap dumped on them as they see themselves, as part of a group, being ‘blamed’ for our mass shooting problem. Such stigma and prejudice needs to be fought against and rejected.

Secondly, I also understand the somewhat natural reaction by people who say that someone who decides to kill large numbers of people, seemingly out of the blue, is suffering from some sort of ‘mental’ problem. Such a conclusion does appear, at face value, very logical.

Part of the challenge with our conversation lies in our definition and model of mental suffering. While mental suffering is a universal human phenomenon, the models we use to explain and describe this suffering are varied and quite different. Some see mental suffering as a spiritual issue, some as a social issue, some as a disorder of thought or feeling, and, most recently, the medicalized countries of the US and Europe have increasingly adopted the medical disease model to explain such suffering.

Most people are not aware that the advance of the medical model of mental illness has largely been driven not by evidence or data or even because it’s the best model, but rather by the pharmaceutical companies which have reaped billions of dollars in profit from the adoption of this point of view. One of the most blatant examples of such advocacy is that in Japan there was no word for ‘mild depression’ until a drug company invented one so that they could sell more anti-depressants. Suddenly, out of the blue, the Japanese were being told they had an ‘illness’ that didn’t exist a few months earlier.

The medical model of illness has certainly been very helpful to us in many ways. Identifying the biological underpinnings of distinct disorders have allowed us to mitigate much suffering. However we are also finding that this model has many limitations. Nowhere are these limitations more clear than in the realm of mental suffering: because mental suffering simply doesn’t function and behave in the same way that the flu does.

For the VAST majority of mental disturbance, diagnosis of an ‘illness’ is a very vague process that is done by matching a group of symptoms and behaviors with a category of disturbance found in the DSM (the diagnostic manual for mental illness). Such a process is fraught with numerous complications of bias, inaccuracy, the desire to label and control, and is often of little value to anyone other than, again, the drug companies who are making billions from this process while we have little to show for it in terms of greater mental health.

I would suggest that it is our adherence to this problematic model of mental suffering that is causing us such difficulty when we discuss something like a mass shooter. From the diagnostic point of view, there actually are categories of diagnosis for which the symptoms are anger and violence. Numerous, mostly male, teenagers are diagnosed with ‘conduct disorders’ every day. Anger, violence, and the refusal to obey social norms of behavior are some of the key diagnostic features of such an ‘illness.’ PTSD, Schizophrenia, and major depression, just to name a few more, are also ‘illnesses’ that have anger and violence as possible symptomatic manifestations.

Yet one of the biggest problems with the medical model of illness when it comes to mental suffering is that it leaves out all of the very important issues and arenas that we know effect our mental health. Moral issues, spiritual issues, socialization and family behavior, culture and social history are all basically left out of the equation when it comes to ‘mental illness.’ If we cannot address these questions when it comes to a person’s suffering and behaviors then we are stuck with, for example, the two poles of ‘mentally ill’ or ‘not ill but angry’ which I’ve seen splashed across my FB feed.

In my life and healing practice I basically reject the medical model of mental illness. That doesn’t mean I’m not up on my brain biochemistry! (I am) But what it does mean is that I have a much more holistic view of mental suffering that draws from a myriad of teachings and models that seek to explain human suffering and behavior. From this vantage point it seems obvious to me that anyone who uses humans as their own personal shooting gallery is in the grip of deep suffering and delusion. And it seems equally obvious that most people who experience anxiety or depression or any other number of states of suffering are NOT going to grab a gun and kill a lot of people.

I hope that we can broaden our discussion horizon on this very vital issue.