As details begin to emerge from the Fort Hood shootings (you can read the CNN article here), it appears that the shooter, Dr. Hasan, was in fact, a Psychiatrist. Not only that, but he was considered an excellent clinician who had been treating military trauma victims. More information about this should come out over the next few days (some are calling this an act of terrorism, in part due to the fact that his name appears to be Muslim), but I wanted to share some initial thoughts.
I’ve made no secret of the fact that I view mental health professionals as just as quirky, neurotic and idiosyncratic as the general population. Perhaps even more so. I’ve discussed Dr. Gail’s OCD, Dr. Pete’s Social Phobia, and Dr. Steve’s raging narcissism. And if you’re fairly new here, do note that I’ve never spared myself while doing so (feel free to comb through the Archives to read about my own…problems). But I’ve usually painted these people in at least a somewhat humorous and light-hearted manner, with the goal of showing that all of us are flawed and fragile in our own way. It’s part of the human condition. I’ve never discussed more serious mental illness as it relates to my peers, so I’d like to touch on that subject now.
I agree with the professional in the CNN article who points out that most people who work with trauma can experience a vicarious, depressive and anxious state, but that such extreme action like Dr. Hasan’s is not part of the process. This doctor must have had much, much more going on with him. Perhaps he suffered from a psychotic disorder, although that in and of itself doesn’t greatly increase the risk of violence in people. Psychotic conditions such as Schizophrenia and Delusional Disorder paired with substance abuse do, however, greatly increase the risk of harm to others, so these are factors worth considering. If this man perhaps suffered from PTSD, along with a possible psychosis and/or a substance abuse issue, why was he not getting treatment himself? In fact, why not treatment if he experienced just one of these issues? The reality is that we don’t always know who, if anyone, has a mental illness, and we rarely look at the healers as those with the disease.
I’ve met a few mental health clinicians with severe mental illness. One suffered from extreme paranoia, believing the government was plotting to arrest him for no viable reason. He took strong anti-psychotic medications to remain functional and stable at work. Another had suffered an assault and was so traumatized by it that she would often approach and scream at strangers who reminded her of the perpetrator, truly believing she needed to protect herself from them. And yet another had a history of violence and substance abuse, to the point that he needed to be supervised nearly every minute of the work day just to keep his license.
Cardiologists get heart problems, vascular surgeons experience strokes and shrinks suffer from mental illness. If you don’t view what Major Hasan did as a symptom of a psychiatric disorder and just an act of terrorism or hate, then this post will fall flat for you. But for the rest of us we have to realize that no one is immune from mental illness. You can believe as much as you’d like that your brain is strong, but that doesn’t mean it can’t possibly crash and burn on you.
Did Dr. Hasan have a greater responsibility to seek help, given his job description and training? Yes. But sometimes the illness itself prevents people from getting treatment. If he suffered from a psychotic disorder, perhaps he believed that he would be persecuted if he disclosed any violent thoughts. This would be an even greater possibility if he considered how people might respond to his last name. And, sadly, there are still plenty in my field who still see help-seeking as only for the “weak and crazy,” even as they tell their patients to believe the opposite. Dr. Steve holds that view and he’d need to be standing on the edge of a building before even considering an admission of mental distress.
This post was written early on in the investigation of what went on at Fort Hood so many elements may change over the next few days. But the fact that severe psychiatric illness is present in the mental health community does not. These providers need to dig deep, acknowledge the reality of sickness and get the help they need. Until then, we’re not really putting the dent in the world of mental disorders that we claim we are.