COMMENTARY

Mass Shootings and the Ethic of the Open Heart

James Knoll IV, MD

Disclosures

December 20, 2012

In This Article

Mass Murder: What Is It?

Mass murder, strictly defined, is the killing of 4 or more victims at 1 location within 1 event.[33] It is both a rare and catastrophic event that is usually carried out by a single individual. Mass murder is distinguished from both spree and serial murder. In the case of serial murder, there are at least 2 victims, the victims are killed in a noncontinuous fashion (ie, there is an emotional "cooling off" period between murders), and the murders usually involve a sexual component.[34,35] In contrast, a spree murder involves killings at 2 or more locations with very little time in between murders and no cooling-off period.[34,36] The type of mass murder discussed here involves that carried out by a single, heavily armed individual who is very likely to expect to die as a result of the event. This further distinguishes it from gang-related mass murder, in which the perpetrators do not typically expect to die, and their motive involves various forms of profit, drug trade, or territorial disputes.[37]

At the present time, it is typically the high-profile cases that are most heavily covered by the media, yet these are the least representative. In many cases, the precise number of victims may be arbitrary. Research has been slow in the area of mass murder, and there is not yet an officially accepted typology. However, it is clear that not all mass murderers are alike in their motivations and psychology. Some may be driven by strong feelings of revenge born of social alienation or a perceived injustice. Others may also suffer from severe depression or, rarely, psychosis. Still others may resemble terrorists with idiosyncratic political beliefs. Such was the case with a Polish chemistry professor who was recently arrested before he could blow up a parliament building. Dr. Brunon Kwiecien openly supported Breivik and wished to carry out a similar attack, but on a larger scale.[38] His wife alerted authorities after he asked her how he could make a biological "dirty bomb." When he was apprehended, he was found to be in possession of high-powered, military-grade explosives, bomb-making equipment, several hundred rounds of ammunition, a bulletproof vest, and a pistol.

The majority of research indicates that there are factors common to mass murderers, such as extreme feelings of anger and revenge, the lack of an accomplice (in adult mass murder), feelings of social alienation, and planning/organizing the offense. In a detailed case study of 5mass murderers who were caught before they were killed, a number of common traits and historical factors were found.[39] The subjects had all been bullied or isolated as children, turning into loners who felt despair over being socially excluded. They were described as suspicious, resentful, grudge-holders who demonstrated obsessive and inflexible thinking.

Not surprisingly, they were also narcissistic and coped with personal problems by blaming others. Their worldview was characterized by seeing most others as rejecting and uncaring. As a result, they spent a great deal of time nurturing their resentment and ruminating on past humiliations. The ruminations evolved into fantasies of violent revenge. They did not see their own violent death as a deterrent, particularly because they perceived it as bringing them fame with an aura of power.

Careful study of individual cases of mass murder often reveals that the offender felt compelled to leave some type of final message.[40,41] These messages may be written, videotaped, or posted on the Internet or social media networks.[42] Very often, these messages are rich sources of forensic psychiatric data that help us get a deeper understanding of the perpetrator's motive, mental state, and psychological disturbances.[43] These communications often have great meaning to the perpetrator, or he would not have bothered to record them. He often realizes that they will be the only "living" testament to his motivations and inner struggle.[44]

In sum, the factors associated with and contributing to mass murder are complex and multidetermined. Biological factors may include possible brain pathology, as well as psychiatric illnesses. Psychological factors include a negative or fragile self-image, a strong sense of entitlement, and vulnerability to humiliation. Social factors include social isolation/alienation, being bullied, and marital or financial loss.

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