The debate about gun control will undoubtedly be fueled by this latest shooting in California. But the dialogue that needs to happen is about recognizing the problem. The question we need to ask is “What do you do when you think someone is dangerous to others?”

For the parents of Elliott Rodger, and a psychiatrist who treated Denver shooter James Holmes, they did recognize something was wrong. In the case of Rodgers the parents tried to contact law enforcement, who, when they checked on Rodger, found him to be okay. The parents knew that not to be the case, so now we have to ask “What more could they have been done?”

The simple fact is that all of us have blind spots because some truths are too much to bear. This is especially true when we feel that a person is getting out of control. Rage, anger, violence and abuse are very frightening things to experience for all of us, and, as a result, we shy away from confrontation. We get scared and hope it passes. We try to rationalize away irrational rage. When we are frightened our judgment gets clouded and decisions we make are often made to allay our own discomfort.

Reporting about a family member or friend also brings all sorts of anxiety. First, we might fear becoming a target of the destructive rage if we confront the person or suggest intervention. Second, we don’t want to make the whole thing worse. We might picture a physical altercation where we become the victim. Thus, the whole subject evokes a good deal of anxiety.

As a psychiatrist, I have even seen this anxiety in professionals who work in the field, too. Unconsciously, professionals can also become scared dealing with a patient who talks about mass shootings and murder. In these cases, the therapist might unconsciously change the subject to suicide rather than talking about killing others. In these instances, because of the anxiety created around the discussion the therapist may give shallow advice such as suggesting increased exercise to calm someone down. Sadly, I have even seen angry patients dismissed from care because of therapist anxiety. The dismissal is usually rationalized in some way. At the very least, I have seen people with overt red flags who are not probed enough or who are sent on their way because the professional is reluctant to become more deeply involved in discussing the details of their fantasies for fear of going to an uncomfortable place. This is why continued clinical practice and training and peer support remain such necessary tools. There are also professional violence screening tools which help in the consultation room.

Professionals and lay people alike should always ask for help when confronted with such anxiety-inducing situations. We are all human and prone to anxiety. There is no shame in being anxious. Reaching out can sometimes save a life. We will never be able to predict and prevent all violence, but there is a room for improvement.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.