I felt it was time to share my thoughts on the mass shootings phenomenon that has been occurring to the dismay and horror of all of us over the last several years. My memory on this is somewhat longer than most people’s because of my profession as a psychiatrist and because I have been following this issue for now over twenty years when the first “modern” shootings started and the first was of school shootings by minors starting nearly two decades. This does not mean mass shooting have not occurred before in history as any internet search engine entry of “history of mass shootings” will give new reports and articles on shootings going back many many decades, eclipsing by far all our current lifespans.

I have seen as a psychiatrists people who have done isolated shootings very early in my training and early in my career after residency training. All of them were shootings in the singular or in pairs or more family members or persons known and close to the shooter/murderer. The first was an estranged young high school student who shot a supposed girlfriend he had an imaginary of delusional fixation on, and who finally jilted him at school, which was the trigger for his shooting her outside of school fortunately. He fit the now current profile we hear about in many of these cases, a younger, white loner male who is known by almost no one, a marginal student, on the fringes of almost all social circles in school and who suffers a traumatic loss and which constitutes the apparent motivating “last straw” or trigger for the murderous act which seems to come out of nowhere. As with at least some of the recent young white male shooters, he had had no contact with any sphere of mental health services and his family was certainly not aware of what was going on with him. Which leads to one of the central issues with many of these shooters, they convey their intentions usually to no one clearly though some of them display very disturbed, aberrant, angry, paranoid views toward one or more social groups they rant about and blame for various and sundry personal or national ills. Since the youths who become these murderous shooters, they have lived less long and have consequently displayed or entertained these issues for shorter periods of time, though in some of them by the time they reach their later teen or young adult years, it may have really been going on in their thoughts for several years. In the cases of the adult shooters, it seems to fall into two time frames, some for many years, in some for most of their adulthood with only hints conveyed to others rarely in the form of racial or ethnic group hatreds or “odd” ideas, that they do not expand upon long or often enough to raise alarm in their work colleagues or families if they are not total loners. The other class is the impulse shooter who usually is confined to giving way and losing control of murderous anger suddenly in reaction to a sudden loss, such as a job, rejection by a spouse with separation (usually a wife who leaves). These men then stalk their estranged wives, develop or increase their previous paranoid ideas that they wives are and have been cheating on them, though many or most of them have surveilled their wives so closely for so long with such sophistication, nowadays even planting secretly GDS directional instruments in the wives’ cars to track their driving patterns and destination, being convinced they will surely catch them in an affair. Also they typically, record  their wives’ cars’ mileage constantly, often follow them in their own cars, or do not permit them to drive as part of the over the top irrational jealousy and controlling behaviors toward their wives, in effect, keeping them captive, perhaps a milder subset that is related to though milder than the serial killers who capture women, torture them, but keep them in captivity as the case in Cleveland with the fellow who kept three women hostage for 10 years or so. Those men usually kill their spouses, and sometime qualify as mass shooters, which now is defined variously as killing two or three persons at once, though most authorities and experts still hold to the older threshold of at least three persons. An example would be the man in Minnesota who accosted his estranged wife in the beauty shop across from the large mall, shot and killed her, and killed one or more other women before turning his gun on himself. His shooting shows how indiscriminant the murderous rage can be as after he shot his wife which one would assume was his primary motive, intention and target, he shot, wounded and killed other women who just happened to be in shop at the time. Others of these men will not only shoot their estranged wives, but also their children, their own parents,-aut and/or their wives’ parents and thus qualify as “mass shooters.”

But still there is a profound difference between these “family targeting” mass shooters [my own clumsy made-up phrase for these mass shooters, and the totally in-discriminant mass shooters that we have seen more and more of in the last 2 decades or so. These person, again almost always males, are far more disturbing to us all, as they go somewhere public whether it is a school or a public gathering place and just open up with one or more weapons, nowadays often semi-automatic rifles or semi-automatic pistols and fire randomly at anyone and everyone, and often it is learned after their acts through investigations, that they had indeed planned to try to achieve high “body counts.”

My first actual professional encounter with mass shooters was second hand. While practicing in Phoenix for nearly five years, after I had left Duke to go the Southwest to be closer to my then ailing parents, I underwent training to be on a hostage or mass shooting mobile crisis team. My practice partner had there had long been a part of this group as Phoenix by then had had some hostage situations, often perpetrated by jilted jealous husbands intent on murdering their estranged wives and would take them and other employees hostage at the wife’s place of work. I recall one situation involving a famous upscale department store which closed down an entire mall and was a true mass mobilization on the part of law enforcement, first reponders, and mental health providers to counsel and debrief the traumatized hostages and others who were trapped in the shut down interior of the mall for hours and hours. But the worst was one of the post office mass shootings that were then plaguing the country and Phoenix experienced one in which a male employee with long nurtured angry jealous grievances over the bureaucracy of the post office then, entrenched beliefs that he was being passed over for promotions he deserved in favor of minorities. He brought his AR-15 type rifle to work in the trunk of his car, came into the building and opened fire killing several employees but targeting in particular a supervisor he was convinced had wronged him. This and the other post shootings in that era showed the general lack of security measures at governmental facilities whether local or state or federal. As more shooting occurred in the years since, each kind of public institution, that deals with persons with self perceived wrongs, or who are the agents of the now well known triggers for mass shooters, such as courts, especially family or divorce courts have had to institute the security measures we take for granted nowadays, body scans, emptying our pockets of all objects, scanning of briefcases or bag lunches, purses and anything that might hide a weapon. Many can recall vaguely instances of persons shooting attorneys or even judges in court or outside courthouses now in our era of constant 24 hour news channels in which these incidents are often capture on film from security cameras and are replayed many times over periods of days or more while the story is “hot.”

It is not possible to cover in one piece to address in a responsible manner the many questions that continue to be raised in the now front burner debate over the factors involved in the generation, triggering of, identification of, or even prevention of mass shooting incidents. Many responsible steps have been taken in certain quarters, banning firearms of any any sort at various types of workplaces, increased security and practice of evacuation of schools, locked entrance doors and courthouse like querying and identification of visitors to schools, etc.

So in coming posts I will try to address these and other questions regarding the troublesome phenomenon of mass shootings:

Are there any, and if there are, connections between certain types of mental illnesses or personality types (personality disorders) and mass shootings?

Are the identifiable or alerting signs/behaviors/triggers that should be part of the increased awareness it appears we all must have in monitoring for individuals who may be at risk for acting out their issues in extreme fashion?

Are mass shootings increasing in frequency?

What interventions may be helpful or obligatory in situations with persons clearly headed toward acting out violently, such as stalking husband, threatening in escalating patterns their estranged spouses?

Is there a need for more stringent and concerted legal interventions by courts in the application and enforcement of orders of protections by threatened, abused, estranged spouses who have repeated experiences with pre-homicidal acting spouses?

What should we all know about the various legal pleas that indicted or convicted mass shooters can utilize, especially the pleas of “not guilty by reason” of insanity?

What is the value of the relatively new method of evaluation of “risk” in captured, incarcerated violent offenders, even those who fall far short of committing mass shootings but who nonetheless may have committed one violent of murderous act with a long escalating pattern of communicated threats to commit more acts? What is “risk assessment of dangerousness” and what is its proper place, value and use?

So stay tuned and these and other issues stemming from the welling up phenomenon of mass shootings and the “science of violence” and perhaps the emerging science of identification and brain science of psychopathy in general, somewhat allied to this subject, will be examined in a number of coming posts with references to relevant materials for the interested reader.