COMMENTARY

Mass Shootings and the Ethic of the Open Heart

James Knoll IV, MD

Disclosures

December 20, 2012

In This Article

Why?

The answer to "why" is: It depends. It depends upon the mind of the individual perpetrator and of the accumulated bio-psycho-social factors that affected him. And then, after all of that is considered (no simple endeavor), layer on top the fluid vicissitudes of an extremely distraught and nihilistic individual who has access to firearms and ammunition. When all of this is truly considered, one begins to see that the answer to "why" is a highly unsatisfying "it depends" and "it is complex." I can analyze a case in minute detail and proceed to give you the complex answer. Your eyes will invariably glaze over.

It is possible to study individual cases in great detail and gain a better understanding of that individual, his motivations and mental anguish. A well-trained, experienced forensic psychiatrist, who has access to all the evidence, will be very likely to give you a reasonably reliable answer to the question of "why" for a single case. But then, how does this translate into prediction or prevention on a large scale? It often doesn't. Still, there are lessons to be learned in a broad sense. But these lessons cannot be expected to make a material difference because we have not yet understood the deeper lesson that these events are pointing us to. We are not listening carefully enough. This has become ritual. A ritual of sacrifice. These recurring tragedies are solemn appeals begging us "to expose to the light of reason the role played by violence in human society."[31] Rituals have meaning beyond the act itself, and they communicate a message. The message communicated here is:

"I carry profound hurt. I'll go ballistic and transfer it onto you."

A few psychiatrists in this day and age will recognize the formula. It has a name. It used to be called "projective identification" at a time when psychiatrists were able to do psychotherapy with their patients. It is the process by which humans do unto the other that which they cannot stand within themselves. If you are mathematically minded, try instead: X experiences feelings that belong to Y that Y is unable to process. Thus, Y projects them onto X. Let Y represent the mass murderer. Let X stand for victims, families, and much of society.

Is this psychobabble? The name may be, but the process is quite real and has been observed for centuries: "The notion that we can transfer our guilt and sufferings to some other being who will bear them for us is familiar to the savage mind."[32] He seeks to "shift the burden of his pains and sorrows to another, who will suffer them in his stead."[32] Understand these dynamics and you will begin to have a clearer and more satisfying answer to "why."

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