The recent massacre at Marjory Stoneman Douglas High School in Parkland, Florida has brought up the expected responses of both anguish and fear we have sadly grown accustomed to over the last seven years. Traditionally these fall into two camps. On the one hand, a failure to uphold the law: people are furious that this “evil monster,” this “sick” person was able to acquire a gun. The second camp insists that “only between 1% and 4% of mass shooters are mentally ill” and that “guns are the problem,” not the individual. Putting gun laws aside for the purpose of this article, let’s focus on these two contrasting sentiments and how they affect our understanding of the discourse surrounding what it takes to create a mass shooter. On the one hand we don’t wish to stigmatize mental health; after all, the vast majority of people with mental health issues are more likely to hurt themselves, if anyone, rather than others. On the other hand, however, how can anyone of sound mind and positive well-being commit such a monstrous act?
It would be convenient to simply declare mass shooters as “evil,” because like with everything complicated, it soothes our anxiety about the world when we can put things into nice little neat boxes. However, this does nothing to advance our understanding of mass shootings, and thus of how to prevent such atrocities in the future. The conversation requires tabling knee-jerk emotions of disgust or outrage, and instead using nuance to make sense of the seemingly intolerable nightmare scenario. Clearly, walking into some school and murdering children is monstrous, and no amount of post hoc analysis or justification will change that. In this I want to be clear: any formal mental health diagnosis reached, if that ever comes to be, is not tantamount to justifying or excusing the deeds committed.
With that in mind, let’s first tackle the 4% statistic. In all likelihood, that number is conflating all violent gun crime with mass shootings specifically. Isolating mass shootings from other gun crime would likely result in a higher number of shooters who fit a DSM diagnosis, or a partial diagnosis. It seems almost axiomatic to suggest that an individual who carries out a mass shooting is likely suffering from a personality disorder, a mood disorder, a thought disorder, or symptoms that together don’t yet fit an existing mental health diagnosis, but are nonetheless clinically significant. Clinicians utilize the Diagnostic and Statistical Manual of Mental Health Disorder 5th edition (DSM-V), our handbook, in order to make formal diagnoses of individuals meeting the clinical threshold for a mental health disorder. This essay is focused specifically on mass shootings: distinguishing them from acts of terrorism allows me to bracket questions about the mentality of someone drawn to ideologically-driven suicide attacks.
Often, mass shooters have suffered some tragedy, trauma, or prolonged suffering to such an extent that their minds can no longer function healthily enough to express their sadness, frustration, and anger. Perhaps they never had this ability in the first place, as can be the case with conditions like Narcissism, Psychopathy, and Anti-Social Personality Disorder (ASPD). These are people you would want to avoid having in your life, unless your plan is world domination at the expense of others, including yourself. They are manipulative, deceitful; they don’t feel empathy in the traditional sense; they are at the top of the food chain: a social predator that will destroy you, exploit you, and discard you, and that’s all before breakfast. A Narcissist, for example, may not need to suffer from depression in order to act out their revenge. The smallest slight from you – even just bringing up something that counters their version of reality – could make them decide to totally destroy you. Narcissism and Psychopathy are not in themselves indicative of a predisposition to murder, but put into place the right sequence of events, say an abusive childhood, neglect, and bullying, and you can create a monster that will see killing as an option to deal with the pain or slight, as we see with serial killers.
There is of course the possibility that some of these traits may be created or acquired due to prolonged suffering throughout development. Although we don’t fully know the extent of the genetic and environmental influences for personality disorders, we do know that the brain is always adapting. Thus, if you put a child into an abusive environment and they have these genetic predispositions, they will adapt to that environment. Naturally the brain’s perception of reality becomes highly dysfunctional, and the individual begins to attempt to make sense of the world in such a way that it’s no longer in touch with reality. They may have highly distorted cognition, very poor emotional regulation, and the inability to see beyond their own pain. The pain could begin to define their existence; they are unable to handle it and as a consequence they search for something to end it. I have not included Borderline Personality Disorder sufferers in this description for the simple reason that their desire to manipulate and deceive does not often come from a place of malevolence, they are more likely to be in treatment compared to those who suffer from other personality disorder, and they are far more likely to harm themselves than others.
Indeed, overwhelmingly individuals that fit this description of suffering and pain would likely choose suicide or self-mutilation over hurting someone else. This is why there is so much fear of stigmatizing mental health by discussing mass shooters: it would be completely inappropriate to assume that someone with a mental health issue is “likely” to become a mass shooter. However, the desire to express that pain outward and to hurt others is where we begin to define an individual with the potential to become a mass shooter. This obsession with revenge-suicide can be thought of as a desire to see others hurt the way they hurt. Bearing this in mind, it would be difficult not to consider this person deeply depressed, for why else would they be focused on negative thoughts attached to low self-worth and frustration at the outside world? Taken a step further, we can follow a seemingly logical path of thought to see why a person might arrive at the conclusion to hurt others as well as themselves. A recent conversation with a close friend, who had been, as they described “right at the abyss of suicide” reminded me of how the mind can go to very dark places.
It begins by feeling shunned by society, totally isolated, deeply hurt, with non-existent self-esteem, and in pain from just wanting to be accepted. An idea, which begins as a seed, festers until it’s all they think about. “You are the reason I am in pain; why should you get away with me leaving this world without getting some pain back?” This thought becomes insidious, an obsession, their task at hand righteous: “I’m going to watch this hurtful world burn.” They become obsessed with weaponizing their pain. Of course revenge fantasies are to a certain extent “normal,” in that most of us think about causing harm to those that chose to hurt us. However, the vast majority of us don’t act out that fantasy. The problem is when it becomes an obsession and when that obsession becomes tangled into a twisted and distorted web of righteousness and justice.
Then there is of course the small matter of the word “psychotic.” This word is used colloquially in the media and elsewhere to make sense of people who commit these acts: they are suffering from a form of sudden psychosis. Judging by the typical prolonged planning phase, it is unlikely these people were suffering a sudden psychotic break from reality, where they dissociate and can no longer separate right from wrong, or reality from fantasy. It appears instead that these people are so obsessed with causing pain to others that they are blinded from simply caring about right and wrong. Other psychotic disorders might provide some insight. For example, Schizophrenia has been thought to explain, at least partially, the psychological makeup of some mass shooters. This makes sense when considering the prolonged nature of the psychosis, their actions based on what they consider a normal reaction to unreasonable outside events. Combining elements of both Depression and Schizophrenia, Schizoaffective Disorder includes hallucinations, paranoid delusions, and disorganized speech and thinking. The advantage of considering this diagnosis is the difficulty in emotional regulation and associated cognitive distortions that come with depression that combined with paranoia might lead to mass shootings. Once again, the percentage of individuals meeting this diagnosis likely to commit violent acts is so low, it would be difficult to justify the restriction of gun ownership on the basis they may be more “dangerous to others.”
Finding this all too complicated and nuanced, conversation has begun to shift towards placing masculinity as the root of the problem. The theory blames toxic masculinity: i.e., characteristics that hurt both men and others by upholding archaic beliefs about what it means to be a man. Supposedly the shift to equality in society is making it difficult for men to work out what being a “man” means in the 21st century. It appears the implication is that since the vast majority of mass shootings are done by men, there must be something wrong with how men are making sense of their masculinity. This ranges anywhere from an inability to express themselves emotionally without bullying to being indoctrinated into believing that violence is manly. This focus on masculinity to understand mass shooters is about as useful and productive as looking at hair colour and mass shooters. The simple fact of the matter is that men are much more likely to engage in violent and aggressive acts relative to women. It’s a trait that has evolved over a substantial period of time as a survival mechanism, and it’s not going away any time soon. Of course, socialization plays a role in masculinity and how we understand the gender construction of being male, and naturally there are some archaic concepts of what being a man is meant to be, which can cause significant issues with well-being and expressing one’s emotions. But if people think they can simply “un-train” boys at school to not be aggressive, with gender neutral Lego, then I’m afraid I’m going to have to be the bearer of bad news: you are deluding yourself. More likely this focus on attempting to change thousands of years of evolution, as classical feminist Christina Hoff Sommers and Dr. Debra Soh have suggested, is going to simply leave society with increased polarization and some angry, confused boys, who will one day be angry and confused men.
When the perfect storm of pain, suffering, and personality clash together, we see a very rare case of a man choosing to pick up a gun and kill innocent people. How do we screen for individuals likely to commit these acts before we give them a gun? The short answer is, right now, it’s very, very difficult. Just being depressed is not going to do it; after all, depressed individuals, at the very high end of the scale, are far more likely to take their own lives. There are very comprehensive personality and mood disorder screeners that can be used in assessments, but taking into account the nature of the required interview, the time taken to write up the assessment, and the ability to defend this assessment, conducting them would require a highly trained, likely a forensic or clinical forensic psychologist/psychiatrist. The specialization is required in part to screen out people who are simply trying to “fake” the test, as well as the need to defend their assessments in court, because make no mistake, refusing gun permits is likely to make some people quite unhappy. The costs would be high, and potentially price people out of the opportunity to have a weapon. In an ideal world, a grassroots diagnosis would exist, in which teachers, parents, and police departments would work in harmony to perform an early screening and intervention, and enforce restrictions on gun use for someone who is going to end up as a mass shooter. However, if the vast majority of mentally ill people don’t kill, and personality disorders alone are not a useful predictor, what exactly are we screening for? Will question 7 ask: “Do you have the desire to shoot up a night club?” The profile of mass shooters is a perfect storm, and right now it falls through the cracks.
This essay does not offer a Disney ending. I don’t have any sweeping conclusions to make about gun culture, laws, or a new DSM diagnosis. It’s messy, and that’s an uncomfortable truth. As it stands, profiling a mass shooter requires nuanced difficult discussions, which deserve to be discussed outside of the realm of politics or used as an ideological weapon. This is all we can do until we better understand what it takes to make someone willing to commit an act that can surely only be defined as evil.