A Lament for a Disturbed Mind

PSYCHIATRIC VIEWS ON THE NEWS

Following the death of A Beautiful Mind’s John Nash, we are hearing more news-this time about the trial of the alleged Colorado shooter. Perhaps most would say that his mind was not such a beautiful one, even if he turns out to have the same diagnosis as Mr Nash.

What is clear is that he had a disturbed mind. In its second month, his trial reveals more of his long-standing troubled thoughts before he allegedly killed 12 people in a Colorado movie theater in October 2012.

[[{"type":"media","view_mode":"media_crop","fid":"38109","attributes":{"alt":"schizophrenia","class":"media-image","id":"media_crop_8416510108243","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3826","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 182px; width: 160px; float:right","title":"©JohnSmithDesign/Shutterstock","typeof":"foaf:Image"}}]]We await much more testimony, analysis, and verdict to better understand his mind and perhaps why it was not helped enough in time. What does seem reasonably clear is that his mind is working better since he was put on antipsychotic medication some months after the murders in 2012.

In the meantime, there is much to lament that relates to other psychiatrically related news we have discussed, from the death of Mr Nash and his wife to the APA Annual Meeting sessions on Schizophrenia and the tragic Germanwings Flight 9525. Let us collectively lament the following:

• the lives lost, injuries suffered, and secondary trauma to loved ones of all involved in the Colorado shooting

• the anguish of the psychiatrist who tried to treat the alleged shooter before the murders; she faces a lawsuit against her, which is on hold until this trial ends

• that the alleged perpetrator did not get much treatment earlier in life; in light of the new RAISE study by NIMH which substantiates that state-of-the-art treatment of early psychosis can be effective

• the shrinking duration psychiatrists have to evaluate a new patient, often 1 hour or less; this pales in comparison with 22 hours of live interviews and 300 hours of preparation of the court-ordered examination recently reported by William Reid, MD

• the increased fear and stigma about mentally illness resulting from this and other cases

• that psychiatrists deemed expert witnesses tend to disagree depending on which side they represent, throwing doubt on our expertise

• the virtual impossibility of the legal quest to ensure that some people, like the alleged shooter, can distinguish the difference between right and wrong precisely at the moment of violence

Memorial Day gives us a national time to mourn those in the military who died while serving our country. Yet, we have many other tragic and well-known deaths that affect our collective grieving process. How should they be mourned over time?

The hope for the future must be that we will learn some things from this case that will soothe the grief that has persisted after those killings, and that will benefit others with disturbed minds.

Time will tell whether he will have chance for any sort of redemption, if indeed that is even possible, or whether he will be executed, a punishment that many psychiatrists oppose.