After the horrific events of Friday at the Sandy Hook Elementary School in Newtown, Connecticut, an understandable and frequent question has been, "What sort of person can shoot innocent children?"
The answer to that question, in short, is this: 1) Certainly, someone who has lost the capacity for human empathy--that God-given quality that allows us to resonate with the suffering of others, and 2) Probably, someone who is, probably unconsciously, making a statement about the random nature of destructiveness, about how innocence and youth confer no safety upon an individual, and about how his rage--likely unexamined and left to fester underground--knows no bounds.
The psychiatric diagnoses that can be connected to a lack of empathy are numerous. Someone can have fallen victim to schizophrenia and be suffering the delusion that others must die to save the earth. Hence, there is no grief for the people who must die. Someone can be drug dependent and inebriated to the point that his core empathy is suppressed, due to intoxication. Someone can be personality disordered--a "sociopath" who steals, cheats and commits violent acts without guilt.
Yet, these diagnoses still don't speak to the underlying cause of someone losing empathy. What about that? Regardless of what diagnosis we speak of, we still need to think about what causes those conditions marked by having little or no feeling for others.
Perhaps there is a genetic vulnerability in such individuals. Perhaps there is a defect in the serotonin (a calming brain chemical messenger) systems of such people. Perhaps head trauma can play a role in damaging the frontal lobes. Some will even claim symptoms of autism could be involved. But consider this: In every case I have ever treated in which empathy is in short supply or absent, it was eroded through suffering inflicted upon that person himself or herself, usually early in life. Psychological trauma--whether chronic or acute--has been present in every violent person I have ever evaluated during the past two decades.
In the case of the shooter in Connecticut, Adam Lanza, 20, now deceased, we must, sadly, imagine someone so devoid of empathy that he could shoot one child after another, seeing each go lifeless, ignoring the shock and terror on the faces of the victims, ignoring the grief being visited upon so many families. And such a person is, without question, an individual entirely without empathy, and, therefore, by definition, severely mentally ill.
I have not evaluated anyone in Adam Lanza's family. But the fact that he reportedly killed his mother by shooting her in the face, then left 18 dead children as his legacy, would make any psychiatrist with grounding in psychological reasoning wonder whether the 18 children represented what was "dead" inside him (psychologically or spiritually), and whether he believed--rationally or irrationally--that his mother was complicit in his demise. That terrible canvas of bloodshed would paint the picture of a tortured life. That would square with #2 above--namely a child killer's likely underlying, even entirely unconscious, belief (perhaps learned firsthand) that destruction is random, that innocence and youth is no protection and that rage knowing no bounds can, nonetheless, be denied by a force of will, or buried with substances, or kept under wraps through silence--which, ultimately, is the path to it exploding out of a person.
I am reminded tonight of Charles Manson who, upon considering that he might face the death penalty, said something very close to, "You can't kill me; I'm already dead."
The myth of vampires is instructive here--those living dead among us out for the blood of others, taking it with no remorse and no feeling for those who fall to the ground, lifeless, because they are lifeless, too.
Adam Lanza opened the door to a new kind of horror in America--the massacre of children. The likelihood that he was, for all intents and purposes, destroyed just as early on, is not 100 percent, but it is very high.
Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.