Topic Expert Roundup: Therapists Seek Solutions in Aftermath of Newtown

The tragedy last month in Newtown, Connecticut, has predictably thrust the issue of mental illness into the national spotlight.

Is this a good thing? Bad? Unfair? And how so? We’ve heard from the media—perhaps more than we wanted to. Now it’s time to turn our attention to those who are trained to identify and treat mental issues. With that in mind, we posed these very questions to our panel of Topic Experts. We also asked what, if anything, they would want their clients to know about mental illness as it may (or may not) relate to what happened at Sandy Hook Elementary School.

Not surprisingly, many had strong feelings about what happened and how it should be addressed, both in the mental health community and beyond. From cultural and institutional change to stricter gun laws to empathy for people affected by mental issues, our Topic Experts are calling for a wide range of responses. Which ones we act on may determine not only whether future instances of violence occur, but also whether awareness and understanding increase for the millions of people who peacefully live and struggle with mental health issues every day.

A sampling of their responses follows:

• Shannon McQuade (addictions and compulsions): “We’re headed in the right direction when we address causes rather than get distracted by the symptoms. As a society, we’ve become increasingly distracted and isolated from one another. Asking for help has always been considered a weakness, especially in a culture that strongly values independence. We’ve gone from locking people up in mental institutions to releasing them into the world without a real plan. While we have made some progress, there continues to be a cultural denial of mental illness and a punitive response to the consequences, with many people going in and out of our ‘correctional’ system. Out of sight, out of mind … until tragedies like the one in Newtown occur.  We need to look beyond the guns, drugs, homelessness, and poverty to see the primary cause—an overall lack of genuine concern for helping the most vulnerable people in our society. We’re too distracted with our television shows, computers, smart phones, food, clothes, sports, and celebrities. We lack social skills as a society, even with all of our ‘social’ networking. We learn to socialize by mimicking, and if you can’t do a good job fitting in, you’re left to isolate. Differences are seen as threats. I want my clients to know that they are not alone. It’s OK to ask for help. Connecting with others is a basic human need and is nothing to be ashamed of. I want them to learn to accept themselves as they are while, at the same time, they seek to heal and grow as individuals.”
• Andrea Schneider (postpartum depression / learning difficulties): “It is extremely dangerous to assume that special needs children/adults with developmental delays are capable of doing the unthinkable and mowing down 20 innocent first-graders. True, Adam Lanza, the troubled 20-year-old responsible for last week’s massacre, was said to possibly have had autism spectrum (maybe Asperger’s or high-functioning autism); however, autism alone does not create an individual with premeditated violence. Some of the most loving, generous, caring people I have met struggle with autism and other developmental challenges.” For more from Andrea Schneider, click here.
• John Sovec (LGBT issues: lesbian, gay, bisexual, transgender): “Mental illness has come to the forefront of media attention due to a national tragedy that has caused pain and heartache for many. The pain will remain present for a lifetime, yet in a few short weeks, the importance of providing accessible care for those living every day with mental illness will disappear out of the national spotlight. It is important that this conversation continues on so that we as a nation can provide the resources necessary to address the needs of those with mental illness. If a person has a cancer diagnosis, we don’t deny them care, but when it comes to meeting the needs of those with a mental illness, it often comes with strict limitations and many accessibility issues. Now is the opportunity to make a change in this philosophy and the policy choices that support it.”
• Roni Weisberg-Ross (abuse / survivors of abuse): “What I would want my clients to know about Sandy Hook is that neither mental illness nor guns can individually be held responsible for this tragedy. Rather, it was an unfortunate combination of the two. The lack of adequate gun control laws and the tyranny of the National Rifle Association in this country is appalling. But the government has not only failed us on that front. Since the early 1980s, when the Reagan administration cut off funding for mental health facilities and literally drove this population out onto the streets, we as a nation have been ignoring and minimizing a dangerous social—as well as humanitarian—issue. It is an issue that goes hand-in-hand with our lack of action on all health care issues, but I would say that the insensitivity toward the mentally ill is even greater than to those who are physically ill. Many of us separate mental and physical illness as if they are two, distinct entities. We do not fully appreciate the interaction of mind and body. Unlike physical illness, many view mental illness as an aberration—something to keep at arm’s length. If we don’t believe that it can happen to us, we don’t have to care or take care of it. However, in the end, we are all interconnected, and our lack of empathy as a society will be the basis of our decline.”
• Erika Myers (family therapy): “While the issue of mental health OUGHT to be in the spotlight for so many reasons, I am concerned that looking at it solely through the lens of the tragedy at Sandy Hook may breed fear and misunderstanding. It is so tempting to try to find a cause for incomprehensible events. We want to explain it away. Unfortunately, there is no simple answer to what led an extremely troubled young man to commit such an unspeakable act. His mental health may likely be a factor, but I worry that without a deep understanding of mental illness guiding the conversation, it will be too tempting to extrapolate his actions and perpetuate the fear that all people with mental illness could/would do the same thing.”
• Andra Brosh (divorce / divorce adjustment): “The Newtown tragedy is a strong reminder of how many things need to change in our country even beyond the mental health system and gun control. As a psychologist, I strongly feel that a great contributor to this and past horrific events is a lack of psycho-education. While we have become extremely advanced in areas like technology, the archaic attitudes and stigma around mental health remains. Until we can give people, especially parents, the education and tools they need to recognize and address the signs and symptoms of both transient and chronic mental disorders, we will continue to see more and more individuals slip through the cracks of our mental health system. I believe it is our responsibility as mental health providers to not only prevent and treat mental illness, but to educate society so earlier intervention can take place.”
• Judith Barr (power: Healing to the root): “Sandy Hook Elementary school is seven and a half miles from where I practice. The tragic events that occurred there on December 14 have had an impact on all of us, near and far. People are having intense feelings, including fear and anger. With all these feelings, which, believe it or not, most people cannot face feeling, many are looking for someone or something to blame. Guns. Media. Movies and video games. And the lack of adequate care for the mentally ill. But even this inability to feel is part of what needs to be healed ‘in the mental health system.’ Even the search for someone to blame is an indication of issues with mental health. And doesn’t this mean we all have issues we need help with? For many, mental health is now in the spotlight. To me, this holds great positive possibility. But it also holds great concern. Too often in our world, something with great possibility is misused or abused for someone’s advantage, to satisfy someone’s greed—whether that someone is an individual or an organization. Since there has already been abuse of power related to mental health in our country, this is where I have deep qualms about ‘mental health’ being in the spotlight now. It is up to each of us—those of us in the mental health professions, those of us who work with mental health professionals, and everyday citizens, as well. It is up to each of us to do our part in preventing this abuse of power. We can’t just leave it to some anonymous authority, some anonymous ‘them,’ to take care of this. If ever there were a time to get involved and help, this is one of those times.”  For more from Judith Barr, click here.
• Athena Phillips (posttraumatic stress / trauma): “The Newtown tragedy has fostered a new interest in mental health, likely in our hopes to prevent such a horrific event from occurring again. Tragedies like this are an emotional upheaval and can highlight an unspoken truth; that perhaps our cultural ambivalence around supporting the mentally ill interferes with our ability to maintain safety. We want to live our lives with the belief that we are safe, that most people are also healthy and safe, and those struggling internally are somehow responsible for that. Additionally, acknowledging that mental health issues are real requires us to acknowledge two things: 1) that bad things happen to people that contribute to their struggles (and we have a responsibility to protect each other and respond), and 2) sometimes mental illness occurs organically and thus could strike us or our loved ones. Both propositions are difficult, frightening, and can render feelings of helplessness. That being said, it is important to note that most people with mental illness are not dangerous and very rarely have the capacity to perform such an atrocity. Most of the time, we needn’t be frightened and alongside that oughtn’t judge or place those who we don’t understand on the social periphery. Simultaneously, it is both our duty and in our best interest to act when we notice something isn’t right, to acknowledge that sometimes children and adults alike are in horrible circumstances that they are incapable of escaping on their own. In working with trauma survivors, one of the most painful aspects of what happened to them is that people knew what was happening and no one responded; no one helped them. Further, they are blamed for their own symptoms and often do not have access to appropriate treatment, which feels like a replication of the initial injury. From my perspective, any attention given to mental health is welcome, although it is my hope that part of the spotlight highlights what stigma can do. In a certain way, it could be that isolation (sometimes as a result of stigma) associated with mental health issues supports (versus causes) Newtown tragedies. It would theoretically be more difficult to commit crimes like what happened in Newtown if one is connected to other human beings; in other words is known and understood. When we abandon each other, we lose touch with our own humanity and simultaneously the connection with other human beings. Possibly, this disconnect is what opens the door to human atrocity. In sum, our response to the suffering of others, our noticing when something isn’t right, and taking appropriate action may be a small contribution to preventing another Newtown.”
• Kimberly Young (Internet addiction): “As I learn more about Adam Lanza, I understand that the shooter possibly had Asperger’s and also played violent video games. My research on Internet addiction shows these two variables can lead to aggressive and violent behavior. I have seen how Asperger’s syndrome is a significant risk factor in developing online gaming addiction and work with parents on prevention. Asperger’s syndrome does not cause violent behavior, although it is common that Asperger’s children have a loss of impulse control, making them unpredictable, and they have trouble processing and expressing feelings. My research has found that these same children are attracted to violent video games as a way to overcome their social difficulties by talking through the computer, plus they become addicted to the mental and intellectual stimulation. We should not underestimate the role of violent games in the events of the Sandy Hook school shootings. These games allow players to practice killing and to get into the mind-set to shoot and to kill. Given that Asperger’s children have difficulties expressing emotion, these games can feed underlying feelings of rage or aggression. These games dehumanize people. Adam Lanza may have harbored so much rage and anger that he killed children without thinking of them as human beings.”
• Beverly Amsel (individuation): “When violent tragedy occurs, as it did at Sandy Hook Elementary School, we become overcome with sadness, disbelief, outrage, and fear (among other feelings). These violent acts raise serious issues about guns, but the spotlight also swoops onto mental illness. While there is no question that we need better mental health services and care, I think it is important to ask what comes to the minds of the public when the term ‘mental illness’ is thrust onto center stage. I worry about this because I am a psychotherapist who works with people who have troubles in their lives. Many are anxious and depressed. They may have relationship problems, work issues, or have issues with self-esteem. But do we need to label them as mentally ill? I know the insurance companies want a diagnosis, and so I must find the right label for my clients in order that they get reimbursed. But I don’t want my clients to believe they are mentally ill. I like to try and help the people I work with understand that they have problems in living so they don’t have to accept or feel the stigma of the ‘mental illness’ label.”
• Deb Hirschhorn (relationships and marriage): “I happen to have very strong feelings about this terrible tragedy and the role of the mental health system. Here they are: News reports mentioned that in high school, security guards were to keep an eye on Adam Lanza, the killer of 20 innocent children and six good adults, because they had concerns about his potential behavior. Not only that, as far back as when he was 5 years old, observers felt that he needed some kind of special treatment because, again, his behavior seemed ‘off.’ The issue, then, is what was done for him when he was 5? And 15? Did anyone talk to this boy? While some classmates tried to extend themselves to him, it was too little and not directed toward a therapeutic goal by trained professionals. Now a young man who was a former friend in high school feels—mistakenly—guilty because he did not do enough. But it is not his place to take under his wing a disturbed individual. This is a burden he should not have to carry. Rather, there should be in place a means for counselors at schools to reach out to children who might need someone to talk to. While it is true that, in our society, we object to such things as ‘teen screen’ because it is invasive, this is different. Teen screen was meant to fish out of every teenager potential depression through the use of leading questions and then have psychiatrists prescribe medication to them. My recommendation is quite the opposite and includes these points: 1) Start in elementary school, not high school. 2) Don’t waste time with children who seem to be getting along fine. 3) Don’t prescribe medications at all; don’t refer for medications until you have met many, many times with the child and the family to really make a difference. 4) Focus on the children who give you a queasy feeling, and just talk to them. This should be the counselor’s job. Make them feel like the counselor cares and wants to see them happy and healthy. The counselor must be patient before rushing to decide that the child has a mental illness or that it is inborn. Circumstances can bring out the worst in us all. 5) Government funding should be available for this at all grade levels.”
• Lynn Somerstein (object relations): “Mental illness is scary to everyone, especially the people living with it who are usually not violent but frightened and confused. One of the teachers at Newtown told her students, ‘I love you,’ thinking that might be the last thing they would hear and hoping that would help them be less afraid. I hope that as a society the tragedy at Newtown doesn’t make us more frightened of people with mental illness who need our help and protection. We look away from the mentally ill, make believe they aren’t there, pretend that everything’s OK, especially when it isn’t. Psychologists call this ‘denial,’ and we all do it. Look around. People sometimes need help—talk therapy, medication, even hospitalization sometimes, for individuals who are dangerous to themselves and others. It is not a sin to be in need, but to ignore the needs of others.”
• Sarah Swenson (Asperger’s / autism): “In the rush to make sense of an inherently incomprehensible event, many members of the press reached into the realm of psychology. Since they are typically not experts in this area, their efforts added more confusion than clarity. The term Asperger’s syndrome, for example, has been thrown around frequently in relation to the shooter at Sandy Hook Elementary School. Those of us who practice in the field of psychology and psychotherapy cringe when we see such causality attributions, not only because it is impossible to make a clinical diagnosis in such a facile manner, but also because Asperger’s itself, for example, in no way explains what made this man enter this school on this day and shoot children and adults, after first having killed his own mother. If this incident serves to point out the weaknesses in our mental health care delivery system in this country, then we have a tremendous silver lining to this heinous cloud. We must take steps to remove the stigma attached to mental illness and increase our efforts to make access to care possible for anyone who needs it. But careless journalism with unwarranted connections, such as the speculations that surround the Sandy Hook killings, can also do a tremendous amount of harm in the minds and lives of readers who do not question the validity of such assertions and then develop a notion that individuals with Asperger’s, for example, are all capable of hideous violence. This is just not true.”
• Moushumi Ghose (sexuality / sex therapy): “As a mental health practitioner for many years, I’ve always believed that mental health care is not just for people with ‘issues’ but can be beneficial for everyone. As a society, many people associate mental health care with the severest of cases only, saying, ‘I don’t need therapy,’ as if therapy or counseling is something we need only if something is ‘wrong.’ (Even right or wrong is subjective.) If we change our views on whom mental health care is beneficial for, and see it as preventative care as opposed to a tool used to fix something after the fact, then more people would be willing to get mental health care for themselves and for their kids along the way. There are many things kids do learn and many things kids don’t learn at home, in school, and from family and friends that are not addressed. Kids are often floundering to discern right from wrong. Often, parents don’t know what is going on at school and teachers don’t know what’s going on at home, and kids aren’t the best communicators. Mental health professionals are often the gateway in many kids’ lives that know about what is happening in both the home and in school and can provide some extra guidance. Kids today are exposed to a lot of things parents aren’t equipped to handle. Why shouldn’t every kid, parent, and adult get a little extra help?”
• Gail Post (women’s issues): “While the horrific shooting in Newtown has placed a spotlight on the role of mental illness in violent crime, it is important to keep the following in mind: 1) The vast majority of individuals with mental illness are NOT violent or dangerous; and 2) most gun-related deaths in this country are not committed by individuals classified as mentally ill. Nevertheless, this tragic event may raise public awareness about the shortage of psychological treatment available in this country. Financial limitations, marginal insurance coverage, public misinformation, a shortage of appropriate treatment options, legal constraints, and even denial among family or friends can all contribute to inadequate care.  Hopefully, a meaningful dialogue will ensue, one devoid of stigmatization and stereotyping, but ripe with ideas and potential solutions to this multifaceted dilemma.”

What do you think about what happened at Sandy Hook? Where do we go from here? How can the issue of mental health be most effectively addressed? Do you agree or disagree with our Topic Experts? Please share your thoughts below.

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