As North America and the rest of the world try to answer the question 'why' when it comes to the murder of innocent school children, current psychiatric research uncovers patterns to apparently random and motiveless 'mass' killings, which might reveal clues as to their impetus.
In a paper just published in the academic journal Psychiatric Clinics of North America, entitled 'Mass Murder: Causes, Classification, and Prevention', Dr James Knoll from the Division of Forensic Psychiatry, SUNY Upstate Medical University, New York, reports the most up to date current psychiatric understanding of mass killers.
There appear many widely held public myths around mass murder - for example, that this is a new phenomenon.
In fact Knoll cites evidence such killings have existed for decades into the past; whether it's increasing in frequency is still an open question. But he does wonder if the way the media reports these incidents might be shaping how they are carried out.
He cites the case of the Bath School disaster of 1927. This, and other historical cases, demonstrate psychological themes emerging from forensic analysis of modern tragedies, are indeed perennial. Andrew Kehoe's financial problems and a gravely ill wife led to anger and despair, which he appears to have mentally 'displaced' on to the local Michigan community.
Eventually overwhelmed with bitter resentment, Kehoe murdered his wife, set his farm ablaze, and killed 45 others with a bomb. Kehoe committed suicide in the explosion. Like many modern-day mass murderers, he left a final communication. Inscribed on a plaque outside his property, his message read 'criminals are made, not born'. Today he might have been disseminated his note via social or news media. Dr Knoll interprets this statement as suggestive of the recurrent psychological drive underpinning many modern mass murders - 'externalisation' of blame combined with a long-held grievance.
Dr Knoll points to an important study by Dr Paul Mullen, a forensic psychiatrist based at Thomas Embling Hospital, Victoria, Australia, published in the academic journal Behavioural Sciences and the Law - a detailed investigation of five mass murderers. Dr Mullen's research - entitled 'The Autogenic (Self-Generated) Massacre' - uncovered several common traits.
All the subjects had been bullied or isolated as children, loners who despaired over social exclusion. They were all suspicious, resentful, grudge holders, obsessional or rigid. Narcissistic and grandiose, they constantly located the source of their problems as outside of themselves. The community around them were perceived as rejecting and uncaring, not that the perpetrators were difficult or self-centred. This generated resentment and obsessive rumination on past humiliations, evolving into fantasies of vicious vengeance. They eventually came to 'welcome death' as bringing fame and power, the ultimate revenge and putting right of past wrongs.
Knoll contends that examples of this kind of psychopathology include Atlanta day trader Mark Barton, who shot and killed nine people and injured 13 more in 1999. Barton had become depressed and angry following financial and marital crises. He developed a resentful, hopeless attitude - his suicide note stating, "I don't plan to live very much longer, just long enough to kill as many of the people that greedily sought my destruction". He stormed two Atlanta day trading firms, stating, "I hope this doesn't ruin your trading day" before initiating the shootings, then killing himself.
Murderous anger might be targeted on former employees or school mates, but if the resentment is against a community, it can be arbitrarily manifest in some public place. Knoll cites the example of James Huberty, who killed 22 and injured 19 others at the San Diego McDonald's shooting of 1984. Huberty explained to his wife immediately before that 'society had their chance' and he was 'hunting humans'. He appeared to have chosen the McDonald's out of familiarity and knowledge large numbers of potential victims were likely to be there.
Seung-Hui Cho, a student at Virginia Tech, in 2007 shot to death 33 students and faculty, wounding 24 more and then killed himself, and Knoll contends the pattern repeats here again. It's expressed in the killer's 'manifesto', when he rebuked other students as a result of his perception that they possessed 'everything' they ever wanted, such as 'Mercedes... golden necklaces... trust funds... vodka and cognac.' Yet, Knoll argues, the killer also reveals dark envy, stating: 'Oh the happiness I could have had mingling among you hedonists, being counted as one of you, if only you didn't ***** the living ***** out of me.'
Knoll's summary is the message communicated by these mass killers is: "I carry profound hurt - I'll go ballistic and transfer it onto you".
Knoll concludes his important paper by examining what can be done to prevent these tragedies in the future. He cites an Australian study comparing mass murders before and after 1996, the year of a notorious 'spree killing' in Tasmania. Gun law reforms were rapidly enacted, including removing semiautomatic firearms, pump-action shotguns, and rifles from civilian possession. In the 18 years before the gun laws, there were 13 mass shootings in Australia, while during the 10.5 years after the gun law reforms, some claim there were none.
The reason this claim is controversial is the possibility of one multiple murder in Australia in 2007, but there is controversy as to whether it meets the definition of mass murder (four or more fatalities in one incident) as 'only' three people were killed. Also, the shooting appears to have followed an argument with the victims.
Knoll wonders if the true solution to mass murder might involve a three pronged approach - better media responsibility over reporting these incidents, tighter gun regulation and improved mental health services.
He reports Seung Hui Cho, the Virginia Tech mass killer, was evaluated by a social work clinician in 2005, leading to temporary detention in a behavioural health unit. The following day, Cho was evaluated by a psychologist diagnosing him mentally ill, but not an imminent danger to self or others. Several hours later, he was released with an appointment for a counselling centre later that day.
Whether or not Cho actually kept that appointment remains unclear. There seems to have been no further mental health follow up until the shootings on April 16, 2007. Who knows how the future might have been different, if better resources meant mental health services 'follow up' was more meticulous?
Dr Knoll believes we cannot hold a proper debate on this issue until we grasp the killings that could have happened, but never did.
He has little doubt that over the years, unsung mental health heroes have averted many possible mass murder tragedies.