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Guest Commentary
Dubious promises of our mental health system: Lessons from Virginia Tech
By Lewis P. Lipsitt, Ph.D., Founding Editor
Adults around him thought he was badly in need of counsel-
T
he graduation rituals at Virginia Tech this spring, absent the
victims, were accompanied by measured but serious con- ing, clinical care and, at least once, hospitalization. One profes-
cerns across the nation about violence in a free society and sor considered him to be hazardous to her class. Indeed, at least
on open campuses. While we await the full psychological one mental health professional thought he was potentially dan-
autopsy on the Virginia killer, it is becoming clear that there is no gerous to himself, and a judge regarded him as greatly needy of
shortage of mental health professionals willing to do a lot of even involuntary treatment. It belittles the sensitivity of these
Monday-morning-quarterbacking on Cho, and they are coming “first responders” when the media’s mental health professionals
up with unsubstantiated diagnoses of what “ailed” the perpetra- eagerly provide simplistic, poorly documented diagnoses with-
tor of the massacre. out any professional contact with the perpetrator.
The one thing these retroactive diagnosticians are unques- The search for an understanding of aberrant and criminal
tionably correct about is that there were numerous “signs” of behavior can get confused and misled by the rush to diagnose.
dangerous-looking behavior and, apparently, alarming fantasies, The term “autistic” has now been used to characterize Cho, this
which many people in Cho’s community recognized. While many having been offered by Cho’s family along with a public apology.
individuals outside the mental health field reacted to them and Whether or not Cho was a child with autism, such a public mes-
sought relief from his behavior and from the shooter himself, the
culture of helping professions, including psychiatric care institu-
tions and some protective elements of the legal system, ulti- To give Cho a diagnostic name and suppose that
mately failed.
The rush toward explaining Cho’s day at Virginia Tech in a
that is a definitive statement as to why this tragedy
word or two, like “paranoid schizophrenic,” giving the whole occurred is a horrendous misuse of the helping
affair the seeming dignity of professional understanding, is
regrettable. It provides a false impression of the extent to which
systems we are supposed to have in place in this
his behavior is in fact understood, and it suggests that merely country. Let us not buy into the false explanatory
naming something is explanation enough.
Even the young science of human development is beyond
power of diagnostic terms.
explaining events by naming them. Physicists no longer explain
the fall of a dropped rock to the ground by saying it is in the sage has the unfortunate effect of implying that Cho’s behavior
nature of rocks to do that. Child psychologists likewise do not stemmed from some inherent characteristic like those generally
any more say that toddlers behave the way they do just because of people with autism. The fact, however, is that most – not just
they are two years old. There are developmental processes and most, but almost all – individuals with autism do not share the
mechanisms to be discovered which result in some two-year- aggressive deviancy of behavior and murderous impulses mani-
olds behaving negatively and with resistance to authority. fested by Cho.
Understanding how people get to be the way they are takes hard To give Cho a diagnostic name and suppose that that is a
investigative work. Mere naming does not help. definitive statement as to why this tragedy occurred is a horren-
Whether one subscribes to all of his theory or not, Sigmund dous misuse of the helping systems we are supposed to have in
Freud insisted that behavior develops, and all complex behaviors place in this country. Let us not buy into the false explanatory
must be understood in terms of multiple factors existing togeth- power of diagnostic terms. They often stifle the investigatory tal-
er or cumulatively. This view of the supremacy of individuals’ ent we need to mobilize at times like this. Recall that many peo-
histories requires that we know something about genetic factors, ple declared “case closed” when it was announced in the media
birth circumstances, early interactions with significant others, that John F. Kennedy’s assassin was “epileptic.” This is still dis-
traumatic experiences, conditions of emotional excitation and puted by experts, but the declaration probably eclipsed other
inhibition, previous ways of coping with stress (or not), and how aspects of Oswald’s personal history which were relevant.
the environment has been reacting to the individual’s behavior. We need more humility with respect to what we know and
Do we know anything, really, about Cho’s personal history, don’t know, and fewer attempts to explain by naming.
such as whether he was a wanted child, or whether he upset peo-
ple early in life by his appearance, his voice, his isolation? At the Lewis P Lipsitt is professor emeritus of psychology, medical science
.
time of this writing, we do not. We have begun to learn from his and human development at Brown University. A child develop-
family’s media contacts that there was grave concern about him ment researcher, he studied self-regulatory and risk-taking
as a child. Also, by the time he got to college, people were laugh- behavior as a visiting scientist at the National Institute of Mental
ing at him, mocking him, and avoiding him. Health and is the Founding Editor of CABL.
The Brown University Child and Adolescent Behavior Letter July 2007