Violence in America

or The Injuries are not Life Threatening or He's Expected to Make a Complete Recovery

We often speak in the media about "gun violence" but gun violence is but one form of violence, a subset really. We could talk about "knife violence" or "fist violence" but we don't. We will address gun violence later but first we need to look at just plain old violence as it is portrayed in America. Like most portrayals on TV or in the movies, there is often a disconnect with reality. Most fights on TV or in movies are as realistic as a Saturday morning cartoon. A real punch would likely break the puncher's hand and surely shatter the cheekbone or nose of the recipient. The fight then would last mere seconds before the combatants were too injured to go on. Instead, we see punch after punch for minutes with no significant or lasting injury. This is but one instance where violence is portrayed in a way that diminishes the actual damage and its consequence. There are many others.

In thinking about a title, I have always bristled at the newscaster describing injuries as "not being life threatening" as though never being able to walk again or think a clear thought was inconsequential. The other report that bothered me was that the injured person was "expected to make a full recovery". Really? You've been shot or stabbed or bludgeoned into unconsciousness but you're expected to make a full recovery. What about the emotional damage even if the physical damage heals (which it probably will not)? Violence is always chaotic and frenetic and almost always traumatic. Traumas don't just go away so you make a full recovery. The tennis player, Naomi Osaka, was celebrated for acknowledging the emotional toll of playing professional tennis and deciding not to play in some events as a result. Good for her but a gunshot or stabbing victim is A-OK. No, their lives are probably irrevocably changed and not for the better and yet all we're told is that their injuries are not life threatening and their recovery will be complete. Consistently, we discount the real consequences of violence, the reality of violence. And when we do, we make it less scary and more normal, more acceptable.

Freud first postulated a force in life called Eros which was the driver for sex, love, growth, creativity, etc. It is thought by some that, after World War I, Freud was rocked by the atrocities of that conflict and concluded that there was a second force in nature, Thanatos. Thanatos is a destructive force that in the end results in death. I am always startled at the popularity worldwide of professional boxing, especially heavyweight boxing. Routinely, tens if not hundreds of millions of people watch championship fights where the object of the fight is to injure the opponent. The Muhammad Ali - George Foreman fight, Rumble in the Jungle, is said to have been watched by one billion people. We are all abuzz about concussions in the NFL, as we should be, but we condone a "sport" in which the object is to hurt the opponent. The proliferation of the "cage" events is further testament of our fascination with, if not propensity to, violence. Seems that Freud was on to something.

From the beginning of time through the second world war, soldiers would not confront their enemy directly and, in the case of guns, would not fire at the enemy. It is said that through World War II only about 15% of soldiers would ever fire their gun at the enemy. The job of the second lieutenant was to get his men to fire at the enemy soldiers. In the aftermath of the battle at Gettysburg, 6,000 muskets were found with their muzzles loaded with three to ten rounds in the barrel. The soldiers would just load their weapons but never fire them. In other battles and wars in that era, at 30 yards, infantryman should have killed hundreds of the enemy in the first ten minutes. Instead, one to two were killed per minute with encounters lasting hours. Soldiers would just not shoot at another human. In a rather famous incident from the Viet Nam War, it is said that an American solder and Viet Cong soldier encountered each other in a tunnel. Without words, both looked at each other and then retreated. These and other stories are recounted in a fascinating book entitled On Killing by military psychologist, Lt. Col. David Grossman. Later on, we'll look at how that situation has changed.

So to recap, there is a destructive force in nature, Thanatos, and a fascination with violence but also a sturdy resistance to actually inflict harm on another person. How then have we found ourselves in our current situation in which violence in America seems as commonplace and routine as the sun rising each morning. The lead story, it seems, on the morning news is almost always one of death and it is no longer confined to the inner cities of Chicago, LA or New York. What has changed so that harming another person seems no longer to be a problem-- at least for some people.

One of the findings recounted in David Grossman's book was that the further away the combatants were from each other, the easier it was to assault them. Bomber pilots or artilleryman do not suffer from PTSD, even though the magnitude of the casualties is enormous compared to the infantryman. Remember the 20% firing rate that was in place from the beginning of gun warfare through WWII. That changed to 95% in Viet Nam due in large part to changes in training in which soldiers were taught to fire at images of people rather than bullseye targets and to do so without thought, just reaction. Essentially, the training stripped any sense of shooting at another person and substituted shooting at an image. Without any sense of humanity, the inherent resistance to killing another person vanishes. How does the change in military training that raised the firing rate from 20% in WWII to 95% in Viet Nam relate to violence in America in 2023? Let's take a look.

Probably more than at any other point in history, people in America are isolated from one another. At one time, people knew their neighbors. Today, relatively few do. Confounding this situation is social media and texting. A tweet is like shouting across a street. A reply is just another shout. There is no real communication and certainly no exchange with emotion and context. Texts have no inflection or volume. The reader understands the message like a projective test i.e. the reader sees or hears what they want to see or hear. Unlike an in-person conversation or even a phone call, there is little opportunity for feedback or clarification. As a clinician, I advise my patients not to discuss anything important through texts because of the danger for misinterpretation, distortion and misunderstanding. Young people (anyone under 40) seems to use texting as their exclusive way to communicate. And in so doing, deprive themselves of the opportunity to experience the other person, in other words to experience a relationship in which there is an awareness of the other person, complete with emotion. Due to the pandemic, healthcare has changed dramatically from in office visits to telehealth. While telehealth provides more information than a text, email or phone call, it is still a two dimensional image. There is almost no opportunity to read non-verbal cues other than facial. This lack of basic information limits our understanding of the other person and therefore increases the emotional distance between us. Texting, tweeting and the like lead to emotional distance, lack of true awareness/relationship and social isolation. The young woman who was convicted in Massachusetts of encouraging her boyfriend to commit suicide had met in person five times in two years. Their entire "relationship" was conducted almost exclusively with texting. And yet, the news reports always described them as boyfriend and girlfriend as though they were fixtures in each other's homes. I think it is an example of how devoid we are of true interaction in today's cyberworld. Most of you probably know of an online "relationship" which flourished until the lovers actually met each other, at which point it crashed and burned. Testament, I think, to the self-fulfilling distortion inherent in online encounters, especially ones without video.

Just like the bomber pilot, the reality of violence is reduced and obscured by distance, both physical and psychological/emotional. It is easier to shoot at an image than it is a real person. It is also easier to assault or kill if the victim is not considered to be an individual but rather a member of hated or vilified group. So to a radical jihadist, people on a subway are infidels, not people like themselves. To the Nazis, Jews were not people, they were "Jews". So even in situations where there is no hesitance to harm or kill, the victims cannot be real people. The exception are crimes of passion where the victim is definitely a person and the clear object of rage, usually fueled by rejection or some other hurt feeling. These killings are easier to identify and to understand precisely because the context is an actual relationship. Sometimes the "relationship" is one-sided and may even be psychotic, like Chapman and Jodie Foster in the murder of John Lennon.

I indicated that the military changed their training of soldiers in an effort to increase the firing rate. They did so by taking thought out of the decision to fire and to replace it with reaction. And by taking the reality of killing another person out of it. I've described how our modern cyber-obsessed, texting-obsessed and social media-obsessed culture reduces actual human contact. The result is a kind of narcissistic exercise in which the user's own picture and understanding of the cyber-interactions becomes their reality. Like the online lovers who do so well until they actually meet each other.

To this end, video games both create a distorted view of reality for some people and also dehumanize violence. To succeed at a video game, speed of reaction, not thought and awareness, is critical. What is needed in a video game is exactly what the military was after in changing the training of soldiers. The video games I am familiar with use guns and so the "training" provided by them is most easily transferred to gun violence which we'll discuss next.

As I indicated earlier, gun violence is a subset of violence. It is an implement of violence just like a knife or fist or a bow and arrow. It poses special problems because guns are readily available and they are most often used at a distance which makes hurting or killing another person easier psychologically. To kill someone with a knife requires more emotional/psychological acceptance and is therefore more difficult except in the case of crimes of passion as mentioned earlier. A bow and arrow has the advantages of the gun but is not readily available and requires skill. An implement of violence is not a cause of violence . To think so would be like blaming the chair because we bumped into it. On the other hand, how a gun or knife looks can, in my view, suggest or connote violence. Such is the case with so-called assault weapons even though the reality is that those weapons are not as lethal as many others and in fact are referred to as "wounding" weapons along with the 9mm handgun because of their relatively low caliber bullets. They seem to be the weapon of choice for mass shooters, mainly in my view because of the way they look. As an implement of violence, guns have become a political issue and, as is the case with most political issues e.g. abortion, the real issue becomes clouded.

We have looked at the issue of violence and have some understanding of its origins and complexities. And we have discussed the implements of violence. What is missing and what is arguably most important in our discussion is identifying the perpetrators of violence so that we might intervene before it occurs and prevent it from ever happening. To my mind, there are three distinct groups that are relevant to our discussion. The first group are regular, normal people and is by far the largest. The second is criminals who use violence in the commission of crimes and the third, the one I think we are most interested in, are disturbed people. In this last group are misfits and social isolates, psychopaths, psychotics and narcissists/true believers who are prone to violence targeted at a specific person or group.

We know that criminals will use violence as a means to an end and that psychopaths will use violence for sick gratification. The groups we need to understand better are the alienated, disaffected one and the narcissistic/true believers. The first group lacks the human connection, the affect or feeling, that explained the reluctance for centuries on the part of soldiers to actually fire their weapons at the enemy. The second group does not lack feeling and in fact it is the intensity of their feeling that fuels and directs the violence. An example is the jilted lover who kills his beloved and then takes his own life or the postal worker who shoots his coworkers in response to his being fired. Both of these examples involve a narcissistic insult in which the perpetrator is unable to accept rejection and so lashes out at the perceived rejecters. Religious or political true believers see their opponents as evil which in effect dehumanizes them in the perpetrator's eyes. The feelings that underlie the violence in these groups are internal, not interactional. In that way, they take a different emotional/psychological route to end up in the same place as the disaffected/alienated group.

Columbine, if not the first, is probably the most famous of the mass shootings that have since plagued us over the past few decades. After the shock and horror, the first question most people asked was "why"? The answer seemed to lie in the perpetrators themselves. We learned that Dylan Klebold and Eric Harris were socially isolated, socially inadequate teenagers who were likely seeking revenge against their classmates who they held responsible for their lack of success/social inclusion that they desperately sought. Adam Lanza who killed 20 children at Sandy Hook Elementary School had a long history of social isolation and mental illness. Like the Columbine shooters, he spent untold hour playing violent video games, in effect training to be a mass shooter. Though no one will ever know, there is at least speculation that Lanza was delusional and thought he was playing a video game in real life. Both of these horrific incidents were carried out by what has become a stereotype of the mass shooter, a socially inadequate and isolated white male whose reality was a mixture of video gaming and online activity. The recent murders in Idaho where the implement of violence was a knife were carried out by a man who largely fits the profile of the socially inadequate and isolated white male. The difference seems to be that he developed a fantasy relationship with one of his victims and so targeted her for some as yet unknown reason in what appears to be a crime of passion. Another mass shooting of note occurred in Las Vegas in which the shooter, Stephen Paddock, literally massacred 60 people from his hotel window and wounded 413 while they attended a concert below. The motive has never been determined which leads the clinician in me to conclude that he was psychotic and that the episode was the result of a delusion. Like Columbine and Sandy Hook, Paddock took his own life which speaks of their inadequacy in my opinion. 32 people were killed in a mass shooting at Virginia Tech in 2007. The shooter fit the loner, vengeful profile, targeting no one in particular and ended in suicide.

What these horrific mass killings have in common is a socially-isolated, inadequate and often mentally ill perpetrator who is taking revenge for real or perceived harm, usually rejection or non-acceptance. The victims are most often unknown to the perpetrator and may as well have been images of people on a video screen. The perpetrators have little experience in real relationships with an awareness of and exchange of feelings. There is no sympathy or empathy in a video game, a text or a tweet. When the perpetrator of these acts is described by family or neighbors or coworkers as "quiet and kept to himself", these are red flags when seen in the larger context of a life without social connections. Modern society promotes social isolation and self-absorption by reducing opportunities for person to person interaction when texting is the primary form of communication. Remote learning/working as we have seen in the pandemic further exacerbates social isolation. To the vulnerable individual, the Dylan Klebolds, the Adam Lanzas, social isolation is the condition, the circumstance, that sows the seeds of violence.

My belief is that feelings always drive violence and that when the feelings are internal, narcissistic and almost schizoid-like, they are most dangerous and likely result in the carnage described above. My hope is that we can have an open dialogue about violence in America, its causes and contributing conditions, with a focus, not solely on the implements of violence, but on its perpetrators.