A Tragedy on Too Many Levels

The appalling news from Connecticut, USA has sent a huge wave of shock and disbelief around the globe. No fewer than 28 victims died in a gun attack, 27 of them at Sandy Hook Elementary School and 20 of those, little children who had barely had chance to live yet.

Of course there is necessarily a great deal of speculation and supposition in these early news reports as people try to comprehend what might have driven a human being to commit such an atrocity. What could his motive possibly have been?

I don’t (as part of my own speculation and supposition) believe there was one as such, in the rational and logical sense of the word anyway. That is because there have been several (early and anonymous) reports that the alleged killer, Adam Lanza, had been diagnosed with a personality disorder. 

Personality disorders are psychological disorders of the mind, often arising from prolonged trauma during childhood and adolescence. The most commonly diagnosed of these disorders used to be called Borderline Personality Disorder (BPD). It was called ‘borderline’ not because it is borderline as to whether or not it is a disorder at all, but because it sits on the border between being neurological and psychological in nature. In other words, it is partly 'wired' into the brain.

We all have an ancient response to perceived danger, commonly called ‘fight or flee.’ To this day, we will either run from threats, or fight them. Sometimes we might ‘freeze’ too. In people who are unfortunate enough to suffer from personality disorders, this response is often exaggerated. They also have a particular ‘black-and-white’ perception whereby people or events seem either ‘all good’ or ‘all bad’ – a rather dangerous combination.

And what might turn a dangerous combination into a catastrophic one is the phenomenon of ‘dissociation.’ This is where reality switches off for a while and the individual drops back into instinctive and impulsive behaviour, sometimes with high-level thinking and perception.

When they flee, especially if they dissociate, they might literally run, putting themselves into dangerous or difficult situations. Or they may run to alcohol or drugs or the pain of self-harm, or they may commit suicide. When they are dissociated and fight...well, we are just watching on the news reports what might happen then.

That is why I noted above that there were 28 victims in total. Of course that is no comfort to the parents and friends of the dead and injured, or, of course, to the injured themselves. Theirs is a pain beyond comprehension. Nor is it an excuse.

That is not to say that those who have disordered personalities are likely to be dangerous. They are much more likely to hurt or kill themselves than others. But there are people with emotionally unstable personality disorders of the impulsive type, who under certain circumstances can be very dangerous indeed.

Unfortunately, mental health service providers around the world often neglect the treatment of personality disorders. They are seen as persistent and difficult or expensive to treat despite the fact that they cause misery for millions. In the UK, many believe that psychiatrists deliberately do not diagnose personality disorders because that will then lead to the right of patients to access treatments (Dialectical Behaviour Therapies, or DBT) which are expensive to provide.

It really is an outrage.

In THE EIGHTH CIRCLE OF HELL, the main character is tormented by personality disorders arising from adolescent sexual abuse. It happened to hundreds of thousands like her during the Defloration Mania of Victorian times. But then there was little psychiatry and no DBT.