The media discussions around the horrific event that unfolded in Newtown, Connecticut just before Christmas once again focus the world’s attention on the nation’s gun control laws. Let’s hope that this time, the right actions for the right reasons will be taken to prevent these kinds of atrocities from occurring. This latest gun tragedy is also a topic of much debate in the mental health communities.
Discussion of what particular DSM mental health label Adam Lanza had, as with previous mass murders, is a red herring. That being said, our culture, our school system, the way we treat our family members has more and more adapted itself to psychiatric classification and labeling. The drugs used to treat these labels are more or less the same, thereby undermining these distinctions. Those of us in the more militant wing of the recovery movement believe that people have emotional problems in adjusting to living no matter what category they are deemed to fall under in the DSM. What I am about to say will not stop the kinds of tragedies we see in Newtown, but it may save some individuals like Adam Lanza from becoming mass murderers.
I’ve not read any media reports that indicate Adam Lanza was a violent person by nature, but he became violent. If prescription medications induce violence in some people, as a growing chorus of critics claim, then the public is long overdue for access to accurate information about the possible side effects of these drugs. If medication is not a factor in Lanza’s case (and will we ever know for sure if it was or wasn’t?), there is another ingredient that can push someone further and further into violence coupled with a full-blown break from reality: Being at the receiving end of daily stigma.
An Auburn University study found that stigma is increased if people think you have a mental illness caused by a biochemical imbalance as opposed to a mental illness resulting from understandable events in a person’s life. People treat you more harshly if they believe you have a biochemical imbalance of the brain, a “disease,” because they think they are doing it “for your own good.”
It is important to realize that people include families and parents, even the most well-intentioned and otherwise kind ones. Blame, impatience, embarrassment and frustration expressed within the family increases feelings of isolation and anxiety in family members. If the Auburn findings are correct, if we believe that our relative suffers from a biochemical brain imbalance, we are no doubt treating him or her more roughly, less kindly, than if we feel that they have been impacted by the environment they live in.
Even if we do not believe that our relative suffers from a mental illness, we are up against doctors who do. We are never sure if the psychiatrists are right about our relative and it is us who are delusional. We absorb their message of hopelessness, which breeds fear on our part. Fear is the usual starting point for stigmatization of others.
Where do we turn to understand how to create an atmosphere in the home that is less stigmatizing?
Access to information to find out about what we can do as a family to help is limited. Once the biochemical imbalance theory of mental illnesses began to reign supreme in the 1970s, not enough attention was devoted to teaching about how our social environment impacts our mental health. Doctors and our researchers tell us that mental illness is complex, and that it is thought that there is biochemical, genetic and environmental component to it, but lip service only has been paid to looking into the environmental component.
The environmental component has been largely captured by the scientific community to mean toxic chemicals, or fetal development issues stemming from chemicals in the environment or diseases the mother may have had while pregnant. Meaningful research and discussion of the social environment that drills down as far as the family has been largely off limits.
The social information that we need is hidden or hard to find because the biochemical model has encouraged the predominance of programs that are targeted to getting our relatives to take their medications. It strenuously avoids inviting examination of what goes on in day to day family life that may provoke feelings of isolation and anxiety. That is the way many parents prefer it. NAMI, the most prominent family support group in the nation, got started because parents felt they were being unfairly blamed for their child’s mental illness. NAMI members embraced the no-fault biochemical solution. Many of its members still resist recovery programs that teach that madness is part of the human experience and that critically examine the ways in which family members help or hinder their relative. They will continue along the path of least resistance unless we can do a better job of explaining how important the social environment is to recovery.
If we pay attention to what people with lived experience tell us (and we should), it is the social environment that has the biggest impact on our feelings, emotions and ultimate actions.
An insightful article in the Daily Beast, I Was Adam Lanza, written by an anonymous contributor, explains from his personal experience, what triggers some young men to inflict violence on a mass scale.
What was wrong with me, then? If I had a mental illness, it does not have a time. But the results can be described in very simple English: I was socially isolated, and I was smart. . . So what causes someone to be isolated and/or persecuted? This is where being smart comes in. As anyone who’s encountered a really smart person could tell you, eccentricity and intelligence are frequently close cousins. This is why you’ll hear that so many troubled kids, prior to their mass murdering careers, were engineering buffs, or entered college two years early, or could talk intelligently about subjects as diverse as Greek mythology and Einsteinian Physics at the age of 13.
And when you’re isolated from other people, your own mind – and its crazy ideas – becomes the only company you have… Moreover, this kind of solitary confinement inside your own head breeds paranoia and lack of empathy even where none existed before, because when you only live inside your own head, after a while you fail to notice that anyone else is really human. They become means to an end, an end like getting media attention for your suffering by shooting them.
What might exacerbate feelings of isolation and anxiety in an extremely intelligent but already socially marginalized young man like Adam Lanza, who had already faced daily stigma in the school system? A parental divorce and his mother’s decision to home school him are two possibilities that come to mind. It’s hard enough for any child or teenager dealing with a lone parent in a big, empty house, but with home schooling, now your mother is your teacher, too. Day after day after day. It’s not too difficult to imagine that mother and son got on each other’s nerves, a lot. I suspect, in this hothouse atmosphere, that the mother’s patience was worn thin and fear overwhelmed hope.
I have never owned a gun, nor would I ever choose to own one or use one, but I can understand what Nancy Lanza was trying to do by taking her son to the shooting range: To build his confidence. To give herself hope. To do anything that made him look more like the norm and less like the person that she was increasingly seeing.
On several occasions I drove my son out to the countryside and handed him the keys to the car when he was still heavily medicated and very withdrawn to prove to him, me, and the psychiatrist that he more capable than the psychiatrist gave him credit for. My son’s psychiatrist thought this was a bad move on my part and the driving lessons came to a grinding halt. I don’t think the driving lessons were a bad decision, but I’ll admit I didn’t have much of a clue then about what it takes to help someone recover. Anything I’ve learned since I had to cobble together on my own by reading about what works for other people. It shouldn’t have to be that way.
Adam Lanza needed social engagement skills and friends, not further isolation. His mother no doubt knew this, too, but perhaps couldn’t find the help she needed, rejected what was offered, or found the mainstream help that was available lacking in hope, as was my experience. Like me, she may have been forced to go it alone, to use her best judgment as she went along.
Unfortunately, we make mistakes. Nancy Lanza needed help learning how to engage with her son in ways that would not further isolate him. It is reported that she left him alone for a few days, returning just before the rampage. I once left my son alone for a week during a time when I thought he could handle it. I returned home in the middle of the day to find the blinds drawn, the lights out, and a frightened nocturnal creature backed into a corner that bore a strong resemblance to my son. Being isolated caused him to hallucinate.
I didn’t make that mistake twice. Families need informed coaching that will help us learn how to appreciate our relatives for their many gifts, to resist criticizing or feeling embarrassed about them, and how not to isolate them. If these kinds of courses are considered critical of parents, then as parents we ought to re-examine our commitment to wellness.
Undue faith in the biochemical model lets parents off the hook. There is no need to learn a new set of social interaction skills. More’s the pity, because what is missing from this picture is that while families may contribute to their relative’s difficulties, families also have big impact on how well their relative recovers.
People who have recovered and are doing well often attribute their recovery to their families never giving up on them, encouraging them at every step of the way, and being extremely loving and patient. Their families do not cast their problems in anything but human terms. For parents, whether or not we embrace or resist medications for our child, the supremacy of the biochemical model to explain in scientific terms minds that diverge from the norm, stifles growth in our learning to understand extreme mental distress in human terms.
Note: The Mother Bear Community Action Network is partnering with Family Outreach and Response program to offer an on-line Family Mental Health Education program beginning in 2013. For more information, contact Jennifer Maurer at [email protected]
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.