The photograph of a bald, grinning, seemingly defiant Jared Loughner is the face that launched a thousand diagnoses.
Psychiatrists, psychologists, news anchors, and others have shown little reluctance to diagnose Loughner, whether or not they know anything about psychiatry, and in the face of what might seem to be a rather large impediment: None of them have examined the patient.
From the Arizona Daily Star, we learn that Loughner “appears to fit the criteria” for court-ordered care for someone “persistently and acutely disabled.” That evaluation comes from Charles “Chick” Arnold, “a leading Arizona expert on mental health and the law.” As reporters Carol Ann Alaimo, Tim Steller and M. Scot Skinner point out, Arnold is a lawyer, not a psychiatrist.
John Cloud at Time opens his story with this: “It seems clear that Jared Loughner was developing a mental illness in the two years or so before the Tucson killings…” Clear to whom? Did Cloud go to school with this guy? Cloud does note that it’s difficult to tell exactly what mental illness Loughner has. But then he goes on to talk about Loughner’s reported fascination with lucid dreaming. How does Cloud know this? He read it in Mother Jones, which heard it from Bryce Tierney, who says Loughner told him about a dream journal he (Loughner) was keeping. This it a little bit too much like one of those exercises in which a story is passed around the campfire from one person to another until it becomes unrecognizable. I’ll look forward to reading a story about the dream journal if someone in the press gets access to it, but, in the meantime, maybe we shouldn’t repeat this tale.
From Diane Mapes at msnbc.com, we get these evaluations, also borrowed from other people’s reporting: “Jared Loughner’s former friend, Zane Gutierrez, says he has the look of a “monster.”U.S. Marshal for Arizona David Gonzales told the Daily Beast that Loughner has as a “paranoid headlights” stare.”
From Benedict Carey at The New York Times, we get this: ““I’d say the chances are 99 percent that he has schizophrenia,” said Dr. E. Fuller Torrey, the founder of the Treatment Advocacy Center in Arlington, Va…”
I’m being a little unfair, because these stories included more discussion than I’m showing here, but I’m trying to make a point: Diagnosing illness by way of news reports is a questionable practice.
Some stories took what I thought was a careful and intelligent look at the issue of diagnosis. Peter McKnight of the Vancouver Sun wrote, “Indeed, the most popular ‘explanation’ for shooter Jared Lee Loughner’s behaviour is that he is mentally ill. That no psychiatrist has made such a diagnosis hasn’t stopped media commentators, who are certain that Loughner is mentally ill and that his putative illness offers a full and final explanation for the events in Arizona.” The last part of that is worth repeating. A diagnosis of mental illness is not enough to explain violent behavior. Some people with mental illness become violent; most do not.
Daniel Carlat, a psychiatrist and the author of the Carlat Psychiatry Blog, wrote a short piece on AOL Health in which he discussed the possibility that Loughner might suffer from schizophrenia, while resisting the temptation to make the diagnosis. “We do not know if Loughner has schizophrenia, but if he does, I would guess that there is a complex and elaborate web of delusions festering in his mind — with Gabrielle Giffords at the center of them,” Carlat wrote.
Douglas Fox at Wired Science wrote an interesting piece on a Secret Service study of U.S. assassinations. Most assassins, the study’s authors concluded, were not delusional:
Contrary to popular assumptions about public killings, the attackers didn’t conform to any particular demographic profile. But when Fein [one of the authors] reconstructed their patterns of thinking, he was able to distill them into a handful of recurring motives for killing a public person — motives that seemed consistent regardless of whether a given individual was delusional or not (and three quarters of those who pulled the trigger were not).
It’s always tempting to reach for the easy explanation. We’d like to think that those who commit acts like the Tucson shooting are different from us–aberrant, ill, deranged–anything that will help to reassure us that we are not capable of such a thing.
Mental illness isn’t enough to explain assassination or mass murder. And in many cases, it appears, it isn’t part of the explanation at all.
We should remind ourselves that Rep. Gabrielle Giffords and the others killed or wounded in the Tucson attack were shot by a person–not by a diagnosis.
– Paul Raeburn
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