Saturday, January 15, 2011

I was interviewed for a story on parenting and the Arizona shooting this week in the Washington Post:
What are Jared Loughner's parents thinking today?

Do they blame themselves for the rampage allegedly committed by their son that killed six people and gravely injured U.S. Rep. Gabrielle Giffords (D) in Tucson on Saturday? Should we?

In a parenting climate that is fraught with mixed messages, conflicting studies and thousands of theories, mothers and fathers across America are taking a moment and perhaps shuddering at the thought of their children doing something horrific. Inside plenty of parental hearts this week is a probing self-evaluation of whether red flags are waving in their own homes. ....

"There are always warning signs. Nobody simply snaps," said Helen Smith, a forensic psychologist in Knoxville, Tenn., who has written books on school violenceand specializes in boys and young men.

She's got plenty of young men in her Knoxville practice who have violent thoughts. But they are getting help because their parents paid attention and pounced.

"It takes a lot of work to get them to open up. It's a matter of sheer time and effort. And it isn't easy," she said.

Let's hope all parents will learn to know when it's that time.

Well, I thought the Post did a good job with this story although to clarify, I have seen many young men over time in my practice but in recent years, I have cut back on my practice significantly.

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42 Comments:

Blogger Cham said...

I'm intrigued about this 23 year old man in California who hacked into Facebook profiles, found naked pictures and then sent them to the people's address book. He thought it was funny. Jared seems amused with his antics as well and is enjoying the attention.

I'm not a forensic psychologist but I would think this "snapping" isn't snapping at all, but much more of a reaction to parents/society that expect almost nothing from their children as they age. Some kids are never given the opportunity to take a leadership roll, complete a complex task or come up with an original idea and see it to fruition. Parents indulge their kids in a childhood of video games and TV, and don't expect them to socialize and participate. The kids enter college or the work world ill-prepared, unable to complete tasks and get along with others. In their early 20s they find themselves isolated, lonely and bored. No wonder their imagination takes them to such interesting places. These events, episodes, crimes or whatever you want to call them may be the first time they've gotten the attention, recognition and project-completion that they seek. These large-scale criminal outbursts seem to be heavily male. I suppose if a young woman wants to make a bit of a splash all she has to do is have a baby.

11:42 AM, January 15, 2011  
Blogger Michael said...

Schizophrenia is an inherited genetic disease of the brain. The actual pathology is not yet known but it has something to do with dopamine receptors and the complex web of associations between neurons. At about 16 to 17, there is a reorganizing of the brain in which many neurons are pruned from the system, possibly as redundant. This is the time that schizophrenia appears in males. Females tend to develop the disease a few years later, about 23. There is a study going on right now to see if full blown schizophrenia can be prevented. There are boys with certain characteristics that are seen, usually in retrospect, in schizophrenics before the disease is totally manifested.

The discovery of Haldol came about because World War II Japan used great amounts of amphetamines in their army. Recall that the Marines typically encountered Japanese night attacks when wars at that time were usually fought in daylight. After the war, large stocks of amphetamines still existed in Japan and abuse of that drug became a major problem. Attempts to treat amphetamine addiction led to the drug we call Haldol. It blocks some actions of amphetamines.

It was also discovered that it affected schizophrenics. The first clinical use was in Belgium (As I recall) in the son of a pharmacology professor who had very recently begun to show signs of schizophrenia. He was begun on the drug, which had previously bee tested on schizophrenics, and the initial dose was 10 times what would eventually be found to be the optimal dose.

His symptoms of schizophrenia cleared and he appeared perfectly normal. He was kept on the drug as he went to school to become an architect and eventually married and had two children. After ten years, no one knew if he was cured and if the drug could be withdrawn. Eventually, it was decided to taper him off the drug and, after a few weeks, his psychosis reappeared. He was put back on Haldol but he was never as free of symptoms as he had been for 10 years.

This is why it is extremely important for parents to report symptoms of psychosis as soon as possible. Not everyone gets better but there is a chance that someday this disease will be controllable.

3:56 PM, January 15, 2011  
Blogger Allison said...

One thing that matters so much, even (especially?) when the young people aren't as mentally disturbed as a schizophrenic with psychosis, say, is the person's subculture and peer group.

Kids that are exhibiting terrible behavior and starting to think violent thoughts are often around others who are too--and they quickly lose any sense that such thoughts or behaviors are abnormal or unacceptable to act upon.

This happens in the drug subculture too, but it happens anywhere you're isolated for too long--if all around you, you see violence, people behaving dangerously, and no one responding to it, you quite naturally think of this as a new-normal. And the more that weird behaviors cut you off from saner elements of society, the more you lose any way to gauge how far rom the norm you are.

Parents who can admit the distance between their child and the norm are at a great advantage, and their kids are too. Parents who deny it, constantly saying that "this is typical rebellion/just a little weird/not so strange" are the ones who keep letting their kids get farther and farther into the madness.

9:56 PM, January 15, 2011  
Blogger Anne B. said...

Well, we keep hearing (don't we?) that Loughner was getting up to stuff that would have got anyone else arrested - phoning death threats and all the rest of it - and because his mother worked for the Pima County Sheriff's office (was it?) the incidents kept getting covered up. I wonder if she wishes now that he'd been busted a little earlier.

I also wonder if the Loughner family has any other members with (ahem) mental health issues. When my daughter had a complete meltdown at 14 and spent a long weekend in a psychiatric hospital, the first question I was asked was "Have any other family members been hospitalized with mental problems?" - to which my answer was, "No, but there are several who should have been."

Her story has had a happy ending so far (the right psychiatrist and the right combination of meds - thank you, Big Pharma)- but basically because even at her worst she knew that "homicidal ideation" was crazy, and she was frightened enough to turn herself in and ask for help. I have to wonder whether Jared ever tried turning himself in (how old was he when it started?) and if anyone in the family took him seriously.

10:32 PM, January 15, 2011  
Blogger Der Hahn said...

When I read comments like the first one they remind me that not every one has been a parent, and they usually make me glad that the commenter isn't.

12:25 AM, January 16, 2011  
Blogger Cham said...

If this kid was black nobody would be coming up with the mental-illness excuse. People can rationalize anything.

7:39 AM, January 16, 2011  
Blogger campy said...

What are Jared Loughner's parents thinking today?

"Who should we sue?" would be my guess.

9:41 AM, January 16, 2011  
Blogger Larry J said...

It's all well and good to say something trite like "there are always warning signs" but it's meaningless unless people other than specialists know the signs of mental illness as opposed to the type of temporary that is adolescence.

1:04 PM, January 16, 2011  
Blogger Cham said...

Larry J: From this CNN article:

http://www.cnn.com/2011/CRIME/01/14/arizona.shooting.website/index.html

We learn:

"Loughner presented over-the-top assertions, posed random questions and made rambling comments that drew sympathy, scorn and confusion from others in his online forums.

He griped about losing job after job. Ranted about handicapped people and the educational system. And opened up about his round-the-clock struggle with aggression and difficulty in finding companionship."


That should describe about 50% of the population. If these are the new "signs" that something is amiss and we enact new laws that people can be detained without their consent, we are going to have to build many more psychiatric facilities. Perhaps we can use the same contractors that built all our new prisons. Ultimately, when we reach the nadir all the black males will be in jail and the white males will be safely tucked away in their looney bins, and the rest of us will be ordering up the specially designed sperm we need from a lab somewhere. ;)

2:00 PM, January 16, 2011  
Blogger Helen said...

Cham,

"If this kid was black nobody would be coming up with the mental-illness excuse. People can rationalize anything."

Actually, that's not true. Nicholas Elliot was a black 16 year old who was a school shooter and at trial, a psychiatrist testified that he was a "pressure cooker" who was unable to express his feelings and who exploded after being tortured by classmates. Was this correct? I don't know, but mental health issues are brought up in cases of both black and white defendants.

5:29 PM, January 16, 2011  
Blogger DRJ said...

Excellent article, Dr. Helen, and thank you for posting this. We all want to keep things like this from happening, mostly for the sake of the victims but also for the perpetrator and his family. It seems like the family is in the best position to realize something is wrong and take steps to address it.

I'm curious if drug use is a part of this picture. Are some people more susceptible to the effects of even casual drug use, or are at risk people more likely to try recreational drugs? Or is drug use a red herring?

5:49 PM, January 16, 2011  
Blogger Michael said...

Cham, those kids and the teacher who had been threatened or were sitting by the door so they could escape when Loughner blew his top recognized that something was seriously wrong with him. Many of them called the sheriff but got someone like that idiot Dupnik who told them not to pursue their complaints because he was "already in the mental health system." The problem was that was a lie. I am very interested in learning why they would lie. Had they acted appropriately, he would have been seen by someone who would recognize his illness.

5:52 PM, January 16, 2011  
Blogger Lola said...

I'm wondering if Jared Loughner fits the profile of a sociopath, or a psychopath, i which the tendency was there way before the shooting incident. From what I understand, there is no cure for a sociopath.

5:55 PM, January 16, 2011  
Blogger Brian said...

What interests me about Laughner is this: I always thought of what we colloquially call "neurotic" problems - e.g., anxiety and depression - as kind of continuous with normal experience, such that we can incrementally drift in and out of them over time. More radical disorders such as schizophrenia - including paranoid schizophrenia - I thought of as dis-continuous from normal experience. It's a radical alienation from reality, and I guess I imagined the break between mind and world typically happens quickly.

But the profiles of Laughner in the media seem to show an incremental descent from normalcy into madness spanning 3 or 4 years (or more.) So I guess and don't know what I thought I knew.

6:08 PM, January 16, 2011  
Blogger Wacky Hermit said...

Dr. Helen, could you tell us what the signs are that we should be watching for? I'm curious, as I have a newly-teenaged daughter and three younger sons. I'd like to know what events should trigger me to say "That's it, you're going to therapy!"

6:59 PM, January 16, 2011  
Blogger MB said...

"I'd like to know what events should trigger me to say "That's it, you're going to therapy!"

-----

Don't screw them up more than they are by sending them to "therapy". Seriously.

Point them towards information on controlling anxiety and depression (therapists and psychologists were like NoWheresVille for me, but there IS good information in the world) and give them a good moral and philosophical background.

Otherwise, the world is the world.

7:50 PM, January 16, 2011  
Blogger MB said...

Psychologists and therapists constitute a group of people who promise everything and deliver the least I have seen among any occupational groups - including used car salesmen.

7:51 PM, January 16, 2011  
Blogger MB said...

... and snake-oil salesmen, although they probably deliver more through the placebo effect.

8:10 PM, January 16, 2011  
Blogger JB said...

As a parent, I too would like to know what those warning signs are, and how does one get help if they believe their kid needs it?
I've got two step-sons that frighten the be-jeezus outta me. They seem to have no moral compass whatsoever. They take whatever they want to take, they are harsh and cruel to their peers, they have no compunction whatsoever for lying or cheating or stealing, they are physically cruel to their younger sister and to the family pets.
Is this normal for teen-age boys?
Or is this one of those cases where -- after they do something horrific -- everyone will point in hindsight at these "obvious" red flags?

8:11 PM, January 16, 2011  
Blogger Tether said...

This comment has been removed by the author.

8:15 PM, January 16, 2011  
Blogger Tether said...

This comment has been removed by the author.

8:16 PM, January 16, 2011  
Blogger Mike H. said...

DRJ, I have a nephew who is diagnosed with schizophrenia and currently taking medications. One of the questions that I had was about his heavy recreational drug use in school and whether it contributed to the severity of his problem (chemical short circuit.)

Perhaps a study is in order if it hasn't already been initiated.

10:07 PM, January 16, 2011  
Blogger rammer said...

Perhaps if Christians just had a concept of jihad, then people unable to meet society's minimum standards could simply opt out, and die while attacking the infidel. Actually, he sort of has done exactly that, except he missed out on the infidel part.

11:48 PM, January 16, 2011  
Blogger Helen said...

Wacky Hermit,

Therapy isn't a punishment and it is something that should be seen as a way to help, not as a "last resort" before a parent throws in the towel. Signs to look for are a sense of nihilism, coupled with depression or an anger that is out of control, or under the surface. Some kids are underly-controlled, that is, they are angry, lose control of their emotions and hurt or hit others or objects, while others are overly-controlled. They don't talk, seem depressed and bury their feelings. Trouble in school, drops in grades, and/or reports from teachers and others might be a sign that a kid needs help--maybe even help dealing with the school or their life that is causing the depression, anger, etc.

5:35 AM, January 17, 2011  
Blogger dr.alistair said...

MB, the therapist that i am delivers 100% of the time.

i have processes within my training that allow me to help my clients to profoundly change behaviours they want to change regarding anxiety, phobias, stop smoking, athletic performance, personal relationships etc.

i find your comments offensive and unfounded in fact.

regarding schizophrenia as an organic illness, there are certainly indications that it has organic origins, but recently a father on my wife`s caseload as a children`s aid worker had his wife leave him and return to germany to stay with family. she had been with this man, an exiled tribal king(!)from africa, for many years and had exhibited full-blown schizophrenia and had been medicated and institutionalised several times due to breakdowns.

the woman after several months of living in germany with family became so "normal" again that when she returned she was a healthy happy woman in her late 50s dressed well and looking after her appearance.

within a week or so of her return she had to be hospitalised again after being found walking shoeless in mid-winter yelling at cars.

i have seen many cases where psychosis and schizophrenia seemed to go into remission when a person was removed from a setting and contact with a person or persons was broken, but i have to say that the case of the german lady was profound to me because of the complete change in her, both forwards and then in reverse.

all three of her children are in the care of the province and all exhibit high functioning in math and physics, the oldest boy graduated honours at university and found placement at google.

9:08 AM, January 17, 2011  
Blogger TMink said...

There is a little part of the brain called the prefrontal orbital cortex (POC.) This part of the brain controls our ability to care for others, empathy, and it also impacts our ability to calm ourselves when emotionally riled up. So it is a crucual part of the brain and is crucial to interpersonal functioning.

That part of the brain develops from 20 weeks in utereo till about 9 months post partum. Then it is done developing for life. What it needs to develop well is a calm, happy pregnancy and attuned caregivers for the child for the first 9 months. If it does not get these things, it will never function properly. Never.

Not everyone with a compromised POC is a sociopath, but the current research seems to suggest that no sociopaths have a properly functioning POC. And they never will.

If the kids you worry about have had one secure, well bonded relationship, chances are they have some input from the POC. While it cannot be developed after 9 months, the pathways between it and the amygdala (the fright fight center of the brain) can be strengthened through practice. So there is hope for people whose POC works some.

For the people who missed the boat developmentally, they will remain dangerous when aroused until they are too old to be much of a threat.

Trey

10:51 AM, January 17, 2011  
Blogger DRJ said...

Following up on Wacky Hermit's question and your response, do you have any suggestions for how to find a good therapist?

11:45 AM, January 17, 2011  
Blogger TMink said...

DRJ, there has been research about this. First thing is you get word of mouth from people like you as to who they have heard of or gone to see.

Next, you give the therapist three sessions. The first does not count, too much paperwork and such. But after the second and third session you will know if you can work with the person. More session do not change that for the majority of people.

That is the research. Age, gender, approach, style, training modality, none of them are predictive of a good fit. You are the expert on who a good therapist is, just trust yourself, fire someone who does not work for you quickly, and you are there.

Trey

11:58 AM, January 17, 2011  
Blogger DRJ said...

Thanks, Trey.

3:27 PM, January 17, 2011  
Blogger Helen said...

DRJ,

Here is a post I wrote about how to find a therapist or how to tell if the one you have is not so good:

http://drhelen.blogspot.com/2005/12/how-to-tell-if-your-therapist-sucks.html

6:37 AM, January 18, 2011  
Blogger Alex said...

The kids enter college or the work world ill-prepared, unable to complete tasks and get along with others. In their early 20s they find themselves isolated, lonely and bored.

Cham - it's much worse for boys then for girls. It seems that the entire school system is set up with projects designed with feminine aspects rather then tough, masculine ones. So boys retreat into violent video games to get any sense of accomplishment. Also if a boy isn't mathematically gifted, what is his intellectual outlet for a college education? Engineering & hard sciences have always been male provinces and now 50% of those classes are female. The bottom line is the male ego has taken a shattering hit over the last 30 years and it's no surprise we get more head-cases.

3:00 PM, January 18, 2011  
Blogger fred said...

Some interesting comments here but alas I think it is a bit premature to know the full story as yet.
The one thing I would note:
When the young man applied for the army, he was turned down because of drug problem. But they did not test him! they asked if he used drugs and he readily admitted that he used them a lot...what sort of response is that from one who is trying to get accepted and is so straight forward?

3:19 PM, January 18, 2011  
Blogger Cham said...

Here is an interesting article about video gaming is tied to depression and anxiety in kids. We don't know if kids play video games because they are depressed or whether the games cause depression, but it is interesting enough to read:

http://www.nlm.nih.gov/medlineplus/news/fullstory_107754.html

3:27 PM, January 18, 2011  
Blogger Alex said...

Cham - most likely depression leads to video games. I've never heard of a happy, well socialized kid who turned into a Loughner from playing video games.

3:32 PM, January 18, 2011  
Blogger E. Steven Berkimer said...

JB,

I'm really surprised no one answered you. In this case, yes, those are serious red flags. You need to get them out of the home, or at least get them some serious help.

For your safety, as well as the sister and pets.

I don't recall where I read it, but animal torture, was a common item in most sociopathic individuals, and, if I remember correctly, most serial killers had in common.

6:19 PM, January 18, 2011  
Blogger DRJ said...

Thank you for the informative link, Dr. Helen.

12:20 AM, January 19, 2011  
Blogger DRJ said...

PS: I knew I'd read some good advice about finding a therapist -- and now I remember where it was. I commented on that thread!

12:24 AM, January 19, 2011  
Blogger dr.alistair said...

animal torture, bed-wetting and lighting fires are three early warnings in children of future psychological issues.

jefrey dahlmer had a graveyard of tortured and killed animals that his father discovered but ignored.

apparently those same three behaviours are now prerequisite for entering law school.

9:14 AM, January 19, 2011  
Blogger DRJ said...

Mike H.,

I'm sorry about your nephew but thanks for sharing that information. Apparently Peter Hitchens shares this concern.

12:41 PM, January 19, 2011  
Blogger Michael said...

There is some very interesting research on basic mechanisms that could be related. Some of this applies more to autism but may be related to schizophrenia, too. This is a pdf file but has a lot of info. http://www.columbia.edu/~dr2497/PUBLICATIONS_files/Blumstein%20et%20al.%202010,%20FNS.pdf

There are two species of ground squirrels, one that has a close family relationship raising pups and another that tends to be solitary and does not establish close groups. Differences have been found in neuro peptides like Vasopresin and oxytocin. The latter is the "milk hormone" that is related to maternal bonding with the baby. Some patients with social disorders have been treated with drugs related to these peptides.

If I were starting medical school now (instead of 50 years ago) I would give serious consideration to neuroscience It is going to be really exciting.

If you have a schizophrenic family member, you might want to follow this research.

7:50 PM, January 19, 2011  
Blogger JB said...

To E Steven Berkimer -- thank you very much for taking the time to respond. I realize that this is a public forum and the topic was actually someone else. I didn't intend to make it "all about me". But my question was genuine.
For me, it is extremely difficult to tell -- being in the middle of it and all -- if these kids really are outside the "norm", more than a couple of standard deviations from the mean, etc., or if this is just "the way boys are". I don't know how to check calibration in this case.
Their Dad (my DH) keeps assuring me that they are "fine" and I just don't "get boys". I only know that if my own brothers had behaved this way with me or my sisters growing up... my Dad would have taken them apart. Maybe nowadays that would be considered "abuse".
Thanks again for the data point. Much appreciated.

8:21 PM, January 19, 2011  
Blogger Allison said...

--I've got two step-sons that frighten the be-jeezus outta me. They seem to have no moral compass whatsoever. They take whatever they want to take, they are harsh and cruel to their peers, they have no compunction whatsoever for lying or cheating or stealing, they are physically cruel to their younger sister and to the family pets.
Is this normal for teen-age boys?

This is not normal. Not normal for teenage boys. Not normal for boys. Not normal for men. Not normal for girls. Not normal for anyone.

It is normal for younger teens to have a somewhat limited moral sense with respect to others as they are still developing out of their "my world is my self" development of childhood. But this does not mean they are cruel or lack empathy or never feel regret when they are put in touch with how their peer feels--usually it means you have to help them to see the situation from someone else's perspective, but once they identify with that person, they do feel regret, guilt, empathy as appropriate.

This level of cruelty and lack of any regret is abnormal and deeply unhealthy. Get them help, and if you can't, get yourself help to protect yourself and the rest of your family.

9:00 AM, January 20, 2011  

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