Chapter 9

Toward a New Biology: Violent Stimuli against the Background of Human Psychological Development

The television commercial for an online video game begins with a man getting up to prepare for his drive to the office. He opens the cabinet to get his can of morning coffee, which falls out and spills all over the counter. He finally makes his steaming pot of coffee, but he spills it all over himself. Everything is going wrong. His jaw is clenched, and his eyes roll back in their sockets. The camera finally comes in for a close-up, and we see that not only are his eyes bright red, flaming in fury above his set, angry jaw, but his pupils are completely dilated. His face has an expression of menace as if he is the embodiment of an evil avenger. Now that he has lapsed into what looks like a psychotic fury, the promotion for the single-shooter game he is about to play comes up on the screen. That is the message. When you are so angry that you are completely bereft of all rational thought, that is the time to exorcise your inner demons by playing a violent video game. The man’s biology has merged with that of his avatar in a digital world in which there are no social restrictions against sadistic and cold-blooded murder and mayhem. It was a message Jared Loughner, James Holmes, Cho Seung-Hui, Anders Breivik, and Adam Lanza all embodied. They were all mentally ill young adults lapsed into a digital world of cruel and violent frenzy.

Click forward to 2013. President Obama made a stunningly bold announcement in early 2013 about his ambitious $100 million initiative to begin a study to map the human brain; $50 million would be funneled through the Defense Advanced Research Projects Agency (DARPA)—those same wonderful folks who brought us drones, nonlethal weapons, and the Internet—to support the brain-mapping project headed up by the National Institute of Mental Health. The president cited the program as vital to an understanding of the working brain and vital to finding solutions to PTSD, ASD, psychosis, and, one of the holy grails of neuropsychiatric research, Alzheimer’s disease. Although we can identify star systems millions of light years away from Earth and smash subatomic particles together in the large particle collider buried outside of Geneva, we “have not unlocked the mysteries of the three pounds of matter that sits between our ears,” President Obama said. This is an important undertaking that might make it through the federal budget approval process and open up new approaches to finding treatments and cures for mental illness by exploring the activity of neural networks inside the brain and ancillary structures, such as the neural activity lodged in the human heart.

The president’s announcement, one of the promises he made after the Sandy Hook Elementary School shooting to study mental illness, is important because as of early 2013, approximately two or more completed or attempted mass murders/suicides occur per week—sometimes one or more per day. These events include family violence, workplace and schoolhouse murders, and even random murders in which children and teenagers in playgrounds and in their own homes are hit by stray bullets. If this violence resulting from what we believe is mental illness and remedial behavioral disorders were an actual virus, it would receive one of the highest priorities to find a cure, because stopping the spread of viruses is one of the essential worldwide health endeavors to eliminate deadly illnesses. Think of the research into HIV, the frenzy over breakouts of Ebola and the Marburg virus, and the panic over the bird flu. Think of the search for the pathogens that cause these deadly viruses. Mental illness is no exception, but where is the search for its biological and psychosocial causalities? The epidemic of violence includes teenage and young adult perpetrators, military veterans, and enraged former employees seeking revenge on those who fired them. The violence continues unabated while lobbyists on all sides of the violence prevention and gun control issue battle over ideologies concerning the Second, Fourth, and Fifth Amendments. Yet the shooting continues, and more and more children are dying in playgrounds, in school classrooms, and even in their own front yards. It is as if the violence is not abating but leaving police and public safety agencies at their collective wits’ end. How did we get here? And now that we are here, how do we get out of this?

We believe there is a perfect storm of causality behind the landscape of violence that has America in its grip. The fascination with violence pervades the media. Images of graphic violence embed themselves in the neurocircuitry of at-risk, vulnerable individuals with a weak grip on reality and a low resiliency to trauma. This graphic media violence is reinforced by the wide marketing of violent, bloody, single-shooter online video games. The idea that individuals can indulge their most sadistic fantasies in violence online is pursuant to the rampant culture of guns in a modern society fed by fear promulgated by firearm manufacturers, who argue that even those at risk should arm themselves.

Family structure is also an issue in a situation in which the entire concept of family has evolved from the multigenerational farm families of the early twentieth century before the Great Depression to the latchkey, single-parent household of today. What we believe to be a new form of pathogen, a “psychopathogen,” is spreading virally through the media, including social media, just like an epidemic of the plague through modern society. The first element of this new pathogen is the culture of violence in the petri dish of the media, a culture that, for very legitimate entertainment reasons, extols the mythos of the hero fighting against overwhelming odds to bring about a victory. This is a tradition that goes back much farther than Wyatt Earp at the O.K. Corral, Gary Cooper facing down the bad guys at high noon, or John Rambo violently resisting the designs of a corrupt sheriff. In the “monomyth” of Western culture, as Joseph Campbell has written,100 we extol the virtues of the hero even when the hero has to employ extraordinary violence to combat evil. Think of Odysseus plunging the pointed spear into the single eye of the Cyclops. Think of Beowulf ripping Grendel’s arm from its socket during the bloody struggle at Heorot. And think of the slaughter at Thermopylae as Leonidas and his three hundred Spartans held off an onslaught from Xerxes’ Persian warriors to protect the Hellenic city-states. Two movies have already been made about this last story, one of which was made with advanced CGI and is more like a video game than a film with real human characters. This adoration of violence is not going to change, although there is a much greater number of at-risk viewers who fail to make a clean distinction between what is on the screen and what is real life.

There is fictional violence, and then there is violence as a form of reality, such as the viciousness of cage fighting or even the morality play of professional wrestling, where might almost always makes right. We know that this kind of television is having an effect on some viewers because of the stories of children and adolescents who try to mimic what they see in televised professional wrestling but without the safety net of pretense. Child psychiatrist Dr. Michael Rothenberg proved this theory nearly a half-century ago in his landmark University of Washington study of the effects of violent TV shows on children.101

Kids can and do get hurt when they carry out knee drops and punches to the throat in emulation of their favorite professional wrestling heroes. Essentially, violence, albeit fictional, has become a form of art, but an art without artifice, no longer mimetic but all too real for the most psychologically vulnerable. The fictional violence, particularly violence against women and threats to children, we see on television and in motion pictures is almost paradoxical to the lip service we pay to child victims of schoolyard shootings and to the political landscape that argues for the Violence Against Women Act, which affords female victims of violence greater protection under the law and greater access to legal remedies. Fictionalized violence is titillating, which is why films are becoming more graphically violent, but even though repeated violence on television may generate its own neural network among viewers, it is still designed to be a passive experience. Interactive digital video gaming is not and suggests a new type of neurobiology even though, as Johan Huizinga has written,102 play is not a product of culture; it precedes culture and defines it. Digital gaming is new, however, because it blurs the line between play, which is something one can leave, and interactive play, which becomes a part of consciousness.

What is fascinating about interactive digital gaming, particularly single-shooter, battle-oriented gaming, is that it satisfies at least two psychological motivations: first, it is an outlet, albeit a dangerous one, for aggression. A gamer can express feelings of frustration and anger by blowing away digital enemies, spattering their blood all over the screen, and convincing himself that he has saved the planet from its enemies. This healthy gamer can leave that fictional world and return to society as one would leave a dream. His score is saved in the “cloud” and not hanging in his consciousness as he navigates his way from his cubicle to the coffee machine. But what happens when the gamer is already in a waking dream state, his consciousness flooded by limbic music, a core dump of unpleasant memories from an overloaded and overwhelmed amygdala? What happens is that the game becomes reality, part of a waking dream of wreaking violence on proto-enemies that trains the gamer to eliminate foes, even if he projects those foes onto otherwise innocent people in their real lives, and even when it invites a psychotic and embittered child to navigate through the halls of school mowing down kids and teachers in the game School Shooter, which Adam Lanza had in his blackened computer room of horrors.

The second major factor affecting gamers is the reward mechanism. This makes perfect sense and explains part of the attraction for otherwise emotionally challenged gamers. Imagine the frustration of dealing with life’s adversities for those such as children with ADHD, prodromal schizophrenia, bipolar affective disorder, a variety of ASD, or Asperger’s. None of these children are actually mentally ill; they are behaviorally challenged or at risk for serious mental illness. Now imagine that for many of these individuals, the amassing of player points, the advancement from one level of gaming to another, and the accolades from other online gamers as the scores of successful players are posted are a form of reward or pleasure. We know that the pleasure center of the brain, the nucleus accumbens, is stimulated by the neurochemical dopamine, which is released from dopaminergic neurons in the ventral tegmental area of the brain. Therefore, in our model, the reward mechanism of video gaming is a stimulant, almost as addictive as methamphetamine, ringing the pleasure center bell of the nucleus accumbens, so that the gamer is attracted to the process of the game itself in the hopes of experiencing greater and greater pleasure from the rewards he receives from scoring points by blowing away the enemy. Remember those Parkinson’s patients treated with L-dopa to supplement their insufficient dopamine in the ventral tegmental region of the brain? They start gambling for the first time in their lives.

You do not have to be a psychiatrist to figure out how online single-shooter gaming can become a honey trap. For the at-risk individual, however, the honey trap can easily become more trap and less honey. The game becomes a dopamine-stimulating drug. Among the seriously mentally ill, it is a propsychotic that stimulates psychotic behavior by locking the gamer into a perpetual dream state in which he or she cannot separate the game from reality—hence, James Holmes playing the Joker to seek revenge upon all of society and the Joker’s enemies. The reward factor is even more important to gamers in light of how they can create characters and project their avatars into situations that can be death-defying if not just plain challenging in the game world. The more these avataristic projections succeed by eliminating enemies and avoiding catastrophic attacks upon themselves, the greater the reward mechanism that stimulates the pleasure centers. Therefore, the game can be a cycle of violence, success, and reward, all of it inside the chassis of a computer, a tablet, or even a smartphone, while the gamer himself has merged neurobiologically with the internal circuitry of the device and withdraws and morphs in isolation from reality.

Online gaming also relates directly to impulse control, particularly among the at-risk players. Because the player gets points for as many kills as he can achieve, the normal dampening function of the prefrontal cortex for impulse control and the logical restrictions of decision making are subsumed into the alternate fear and reward mechanism of the thrill of the hunt and the kill. More simply stated, the player finds a reward in not being forced to mediate decisions based on violence. Instead, the methodology of the game lies in the tactics and strategy of the hunt and the kill. For an at-risk player or one who is marginally at risk, this is a type of combat training but with a major difference. In a digital game, the player need only kill without facing the real-world consequences of taking a human life. Imagine if the lack of moral or legal consequence in a game were transferred to real life with real victims shedding real blood, as is the problem in real combat, whether in the Middle East or even on a street corner in downtown LA or in Times Square. This is one of the primary issues of online violent gaming for the at-risk or mentally ill player. The player loses the distinction between the digital world and the real world. In a depressed and delusional state where the player perceives the real world to be an antagonistic threat, the threat response transfers from the game to the real world. Importantly, for the decompensating young adult losing his core identity to the ravages of schizophrenia, gaming fills in the vacuum of chaotic signals and organizes them into a coherent construct for his cacophony of aggressive impulses. The gaming construct is better than the horrors of chaos of threatening signals and fragmentation of the young man’s “I,” his sense of identity or ego. Nature abhors a vacuum. So does a person whose identity is fragmenting into the black hole of psychosis. Game on. He is now in control. As we have seen, the control can be lethal to him and anyone else who happens to be in the wrong place at the wrong time, whether theater 9 in Aurora, Colorado, or a youth camp in Utøya, Norway.

Finally, two other mechanisms are at work in the world of online gaming that relate to real-world violence. First is the basic neuromuscular pattern of firing at what appear to be live targets. It normally takes many repetitions of point, aim, and fire to hit targets. The military and police training methodologies support the building of the neuromuscular network to enable officers to point and shoot to kill once after they have determined that a threat exists. For an at-risk player who is losing or has lost a grip on reality, this training can be extraordinarily dangerous to innocent victims because the neuromuscular pathways are trained to fire and kill even though the target may be a threat only in the shooter’s mind. Breivik reportedly learned military skills by solitary gaming after having been rejected for military service by Norway’s draft board.

What threat did a six-year-old first grader pose to Adam Lanza? None, except in his own delusional world of projecting upon those children all of his fear-driven anger. He saw these children as the representation of the child he never was nor could ever have been and by whom he had perceived himself, accurately or not, to have been relentlessly bullied. These were the children who shunned him when he was a first grader at Sandy Hook. These were the children from whose presence, even from whose casual touch, he withdrew as he slunk along the corridor walls of Sandy Hook Elementary, or in high school, clutching his computer, his back to the lockers, fearing human proximity. These were the children, according to friends who remembered Lanza’s elementary school years, who had made fun of him and likely bullied him to the point where Nancy Lanza had planned to file a lawsuit against the school. School officials did try to prevent bullying, going to the extreme of assigning a school nurse to him for his protection. But perception is everything for the decompensating psyche. Hence, in his delusion-driven fury, Lanza imagined that the children had become the enemy he had trained himself to kill via his obsessive immersion into violent video gaming.

The other factor at work in violent video gaming is the graphic nature of the explosion of body parts and blood spatter. Human beings have to be trained to overcome a natural and healthy abhorrence to violence and gore. However, repeated exposure to violence and gore and the training to create gore through the instrumentality of violence can inure the gamer to what he would shrink from naturally. For an at-risk player on the borderline of mental illness, repeated immersion in digital violence, with the consequent graphics of exploding gore and bloody victories that generate a reward to excite the pleasure mechanism in the brain, becomes a Pavlovian-type conditioning apparatus that also likely dumbs down the insula’s sensitivity to horrible sensations, thus creating the dehumanized adolescent, who is known to be a homicidal threat. Instead of salivating at the sound of a bell because of the expectation of food, the gamer is conditioned to feel pleasure or a release from pain at the successful elimination of a target—the gorier, the better. If thus inured to the abhorrence of violence and gore and rewarded for creating it, the at-risk delusional player, awash in the hopelessness of suicidal ideation, can, for the period of time immersed in the game, take himself right to the limit of threat and danger, turn those feelings into pleasure at confronting his fears, and then become addicted to those chemicals flooding his brain. How easy is it then to transfer those feelings to real life with real weapons at the ready? If you think that is far-fetched, look at the video gaming backgrounds of Adam Lanza, Cho Seung-Hui, James Holmes, Anders Breivik, and Jared Loughner, all of whom were seriously mentally ill and probably walking through their respective dream states. It would not be surprising to learn that the Brothers Tzarnaev conditioned themselves to dehumanize their American enemies by gaming. The older brother was a pugilist, but how did he dehumanize his younger brother? Was it through gaming or through the same type of conditioning that the Beltway Sniper John Allen Muhammad used with his accomplice, the seventeen-year-old Lee Boyd Malvo? To make things even worse, suicide is a reward in games, too, which might have been the point in Loughner’s babbling that words mean nothing, life is a scam, and a final “good-bye.”

The other side of the neurochemical-driven pleasure principle is the depression that follows when the neurochemical dopamine is not flowing. We have seen this type of bipolar reaction in methamphetamine addicts, whose behavior progressively deteriorates when they are not high on the drug. Methamphetamine operates on the brain by replacing dopamine on the neuronal reuptake pumps, then replacing it inside the neuron and flooding the synapses with the dopamine. The altered reuptake pumping of dopamine floods the brain with this activating neurochemical and arouses the brain’s pleasure sensors of the nucleus accumbens. Flooding the brain with dopamine conditions the neurocircuitry to expect that level of arousal and fall into the opposite of a reward state when the chemical is no longer present. Hence, insofar as violent video gaming may stimulate the flow of dopamine, the game itself, especially for an at-risk mentally ill population, could be as addictive as speed. Psychiatrists are becoming increasingly aware of patients with chronic schizophrenia who likely have too much dopamine in their limbic system and too little in their frontal lobes. In fact, this is the very dichotomy sought with designer drugs for schizophrenia—a dichotomy known as “atypical” or “novel” for the new generation of antipsychotics.

Those psychiatrists working with this population through the decades are well aware of the addiction to cigarettes, emblematically displayed by the yellowed fingers of their patients. Newer antipsychotic medications do not block dopamine and norepinephrine in the frontal lobes, as did the older generation of antipsychotics, such as Haldol, which blocked dopamine receptors throughout the brain. In fact, the newer generation of antipsychotics, such as Geodon (ziprasidone) may in fact increase dopamine in the frontal lobes while blocking it in the limbic system, for a win-win reduction of limbic music and reduction of patients’ cravings for nicotine.

Because gaming may act like a powerful drug, should the government, as a function of its powers to provide for public safety and the general welfare of its citizens, take steps to regulate it? Ideologically and legally, the attempt to regulate free expression runs right up against the First Amendment. If games and even some expressions of violence in the media act as pseudopharmaceuticals stimulating neurochemicals that can incite violence, does the exclusion of incitement speech from First Amendment protection act as a wedge for the federal government to set up communications restrictions? And if we discover that, in fact, violent games do act just like drugs in stimulating parts of the brain, might not the US Food and Drug Administration want to look at setting regulations for degrees of violence? In that case, the game is no longer a First Amendment–protected form of expression but an actual drug. Video gaming is not an isolated phenomenon limited to the at-risk population and the mentally ill. Is it not reasonable to argue that after the president and first lady personally expressed their deep sadness at four memorials of victims from suicidal mass murder, the time has come to use the bully pulpit at least to seek legislation to ban the game School Shooter in the wake of the SHES massacre?

According to the American Medical Association (AMA), about 75 percent of all households play video games.103 Those immersed in video gaming, especially online multiplayer games, play more than two hours per day. In 1983 US Surgeon General C. Everett Koop linked media violence, which includes video games and violent scenes and stories broadcast over traditional media and violence in feature films, to aggressively violent behavior on the part of viewers and players, especially insofar as it concerned family violence.104 For its part, although the AMA found that there are potential advantages to video gaming, such as improving hand-eye coordination, enhancement of logical thinking and decision making, benefits to victims of stroke, and teaching methodologies for students and even for the military, there are many potential detrimental health and behavioral effects.

In essence, the AMA suggested that there is evidence linking exposure to violent video games to antisocial behavior, aggressive affect, and what they describe as physiological arousal, which is the physical stimulation of fear/aggressive self-defense/flight stimulation in the autonomic nervous system. In other words, the violently aggressive stimulation of violent video game immersion bypasses the logical or meditative faculties of the frontal lobes and the limbic system’s regional uncus neurons, transmitting directly to our animal defense and attack instincts. The AMA said that even independent researchers found that the “preponderance of research from both sides of the debate does support, without controversy, the conclusion that exposure to violent media increases aggressive cognition, affect, and behavior, and decreases prosocial behavior in the short term.”105 Therefore, does it seem obvious that Holmes, Lanza, Cho, Breivik, and Loughner, all of whom were immersed in violent video games, might have been conditioned to the point of initiating the violence in real life that they participated in on their computers? That conclusion can be drawn from the AMA report, particularly if the players we cite here are mentally ill to the point where they are experiencing hallucinatory paranoid suicidal ideations and not motivated by social interactions of gaming, which is, more likely than not, the case with these rampage murderers.

The Spread of Mental Illness: A Psychosocial Phenomenon?

As more background is revealed about the mental health system encounters of James Holmes, Adam Lanza, Jared Loughner, Anders Breivik, and Cho Seung-Hui, the more one can see that mental illness progressively got worse within their minds and shaped their realities. One can look at other instances of suicidal or attempted suicidal mass murder to discover that every one of the perpetrators was in a state of hopelessness, a despondence without remedy, from their perspective, except for death, and filled with anger over the belief that happiness would always elude them. That kind of demoralized state breeds anger, not just against the self, but against others the individual perceives as the enemy. The question is, what is it about certain forms of psychosis that leads to violent behavior? Certainly, psychiatrists and medical researchers have found that hopelessness, the absolute despondency of dragging through each day as a victim of relentless depression, feeds a seething anger and irrational guilt that results in violence to oneself, even if not immediately to others. However, mental illness is progressive, with anger spreading like a toxin through water, permeating everything with which it comes into contact. In a world without rewards or success, even the smallest positive stimulus can have an extraordinary effect. Thus, when a mentally ill individual suffering from depression or extreme anxiety from losing his mind can reward himself through success in a violent video game, that level of stimulus can be transferred to other objects of the person’s anger: himself and those he believes are persecuting him. This is projective identification for paranoia that can scare you walking through the park when the homeless man shouts at you, but more ominously ticks like a time bomb of the well-organized, stealthy paranoid like Breivik. Thus, in the paranoid schizophrenic’s mind, the irrational thought process might be, “I am seething with homicidal rage. I find a person who seems offensive. I perceive that other person has homicidal rage towards me. I react aggressively.” Thus, both paranoid schizophrenics and those with borderline personality disorder project their rage onto another person, which, in their dysfunctional thought process, is a form of retaliation that justifies homicidal violence.

Mental illness also instills fear inside the decomposing mind of the sufferer. Fear also breeds anger at being afraid, anger at those who are perceived as causing fear in the individual, and anger at being at odds with society, even if being at odds is only in the mind of the individual. Every other person’s success, no matter how insubstantial, is a reminder to someone who is suicidally mentally ill that life may be good for others but not for him. That thought instills hostility to those on the outside, a hostility that grows until a mentally ill person with significantly reduced impulse control finally strikes out in a moment of self-destructive violence, taking as many with him as he can.

In these ways, psychosis can feed violence, particularly when that violence begins with an unrelenting desire for self-destruction. Delusions of persecution combined with feelings of hopelessness tend to generate rage or an urge to strike back. Even in a decomposed mind flooded with delusions, there is a pseudological assumption that the person has nothing else to lose. For example, Navy-Yard shooter Aaron Alexis wrote on his rifle butt that the massacre at the Navy Yard was the only way to stop the thought control from the microchip implanted in his brain, most likely, in his mind, implanted by the United States Navy. Therefore, why not lash out at the targets perceived as persecutors? Alexis finally did, after his more appropriate and rational attempts to obtain medical help for his despair failed. Hence, when depression is linked to even minor acts of violence, violence against inanimate objects, such as destroying one’s car with a sledge hammer, or cruelty to animals, can, among the mentally ill, be gross predictors of potential dangerousness that requires medical scrutiny. We have seen this with Holmes, Cho, Breivik, and Loughner, even though we still have seen neither Lanza’s nor Holmes’s complete medical records. What we can tell from anecdotal evidence about Lanza’s behavior is that when the delusion-bound mentally ill person feels threatened, the person strikes against the source of the threat. In Lanza’s case, that source was his mother, Nancy, and the evil child, whether helpless in the classroom or within himself.

Simply said, threats, whether real or illusory, generate anger. Anger generates rage, which can lead to violence among the mentally ill, whose minds are flooded with delusions not mediated by the logical functions of the brain. But why is there such an epidemic of suicidal mental illness? Is something going on beneath the surface of our collective awareness that has eluded the news media? We look at the landscape of our culture and can see that at the margins of American society are children, adolescents, and young adults who are at risk with various types of behavioral disorders, not limited to ADHD, ASD, or Asperger’s, which are not manifestations of a serious mental illness in themselves. However, because disorders can become progressive as the individual reacts with societal institutions around him, the behavioral disorders can wind up at odds with those institutions. The resulting friction may further exacerbate what began as a behavioral disorder into a full-fledged psychiatric disorder complete with delusional thinking, auditory hallucinations, and a paranoid delusion that society itself is the enemy. Consider the most recent attempted suicide/murder by Los Angeles Airport shooter Paul Ciancia, who carefully targeted TSA staff in the most brutal way. He wasn’t even a frequent flyer. But he wrote that he wanted to die after the kill of at least one.

We know that emotional issues in a child’s home life that arise can affect a child’s ability to perform in a classroom. Children from single-parent families have a difficult time relating to conventional subject matter in which traditional two-parent families represent the values of society. Worse, teachers found that when there is emotional turbulence at home from either divorce or separation or when the loss of a parent through death or disease compromises the child’s view of reality, that child can fall seriously behind his or her peers. If that child is subjected to bullying or disdain from other children, and personal or physical attacks are not remedied by intervention from teachers or school counselors, the child’s emotional stability, already compromised by learning difficulties resulting from problems at home, can become a behavioral disorder, which can then metastasize into antisocial psychological reactions. At the extreme, we have children from deeply disadvantaged neighborhoods exposed to actual threats to life every day from drive-by gang shooters. We speculate, therefore, that as society changes with respect to family structure, those changes can heavily impact what goes on in the classroom and schoolyard. And unless educational administrators are aware of these trends, not only could emotionally impacted students continue to struggle, but schoolyards themselves could become the new violent battlegrounds at the frontier of a changing culture. Even Maricopa County, Arizona, Sheriff Joe Arpaio has armed posses now riding the local schoolyards.

We know that certain populations are at risk for psychiatric impairment because of psychosocial risk factors. Poor, single-parent families with an adult son at home, for example, are at particularly high risk for having one of the 14 percent of patients who are afflicted with the most serious psychiatric disorders. In fact, R. Kessler’s Kentucky epidemiological studies of family analysis predicted future psychopathology in 82 percent of cases.106 These are lethal odds.

Among older members of society, particularly those who served in the military, perhaps in combat in Vietnam or the Middle East, there is another syndrome at work: PTSD, a progressive condition that impairs the sufferer’s resilience and his or her ability to react to stress in a healthy way. We find that individuals suffering from this disorder also experience friction with societal institutions and, unless treated, can wind up with a serious mental illness as memories of their past trauma flood their consciousness. This is also the case with young veterans, for whom cohort suicide rates are increasing. Politicians, now willing to chop pensions of civilians in the wake of the Detroit bankruptcy, have turned a blind eye to these combat veterans, now a million man and woman march to VA claims examiners for PTSD and traumatic brain injuries. These veterans suffering from varying degrees of PTSD and traumatic brain injury are a high-risk group for suicidal mass murder, like Navy Yard shooter Aaron Alexis and Eddie Ray Routh. This group is also at high risk for domestic violence.

Is our society inevitably and hopelessly degenerating into a violent generational conflict, or are there definable elements to the epidemic of self-destructive violence now rampant in our society? We believe that by looking at trends in the evolution of our society, as well as our own biological evolution, we can find some clues to what is happening and possible ways to halt the slide.

The Seismic Shift in Family, Economy, and Society

It seems clear that crimes of murder and suicide are more than a trend toward violence. Even as murder rates in general seem to have declined in most major cities, particularly in New York, incidences of suicidal mass murderers, depending upon how we define mass murder, have increased to an epidemic level. News of suicidal mass murderers breaks to the headlines on a regular basis, sometimes two or more times per week. We have to wonder whether these crimes have become a manifestation of something much deeper in American society, perhaps an outcropping of the clash of an ongoing seismic transformation in our society itself from the beginning of the twentieth century to the present. If that is the case, what are the pieces of evidence that point to such a societal transformation?

The evidence suggests, albeit oversimplistically, that human psychosocial biology has not evolved to where society itself has evolved over the past hundred years and is therefore locked in a conflict with the world itself. Our society is propelled by the forces of technology, mass population shifts, and a socioeconomy that has transformed so radically over the past century. Therefore, parts of America do not recognize the change or see it as threatening to their lifestyles. We have only to look at the policy arguments and resulting legislation over gay marriage to see the disparate ideological views regarding societal change. Even the Supreme Court, in oral arguments over the Defense of Marriage Act and California’s Proposition 8, which banned same-sex marriage in the state (which has now been overturned by the United States Supreme Court, along with the Defense of Marriage Act), was locked into an ideological conflict over what marriage means. When we look at the transformation of American society since just before World War I, what we see looks as if we as a species have been shoehorned into a world that has socially and technologically gone beyond us. Sure, there is a younger generation that has grown up with the Internet, interactive games, and social media. But as a species, we have not yet evolved to a point where we can fit into the society we have created, although that society was created by default as a byproduct of technological innovation. Thus, if we argue that the violence that we see is a form of turbulence on the edges as our species evolves, still constrained by biology and unable to fit into its new reality, how can we measure that? We argue that what we are not getting what we need as members of a society, and the result is violence against those around us whom we perceive to be mortal enemies. Like Pogo, we meet those enemies, but they are we.

However, there is an app for that: an explanation.

In a January 2012 article in Vanity Fair magazine, economist Joseph Stiglitz, in interpreting data supporting the real underlying causes for the Great Depression of the 1930s and comparing it to the Great Recession between 2007 and 2009, argues that transformation of the American economy from a rural agrarian one to an urban industrial one was the primary underlying reason for the decade-long Great Depression. As the economic structure of America evolved in the period after World War I, jobs moved to the cities and disappeared from the farms. People either had to move to the cities to get jobs in manufacturing, find jobs on the large farms and orchards in California, or stay out of work until the United States went to war, absorbing the huge unemployment into the military, and borrowing money to reinflate the economy for war materiel production. Similarly, Stiglitz said, the transformation of the American economy from product manufacturing to services, leaving manufacturing workers out in the cold, is part of the reason for the ongoing recession today. The jobs have gone to developing Third World countries where labor is cheap and the cost of manufacturing is lower than in the United States. We can gnash our teeth over the Great Recession and the loss of manufacturing jobs, but until we can lure manufacturing and the capital that supports it back to the United States, manufacturing and the jobs it supports will be gone until American manufacturers feel they can make money at home again.107

As a consequence of his economic argument, we believe that Stiglitz identified one of the major transformational events in our own evolution as individuals within a too-quickly evolving society during the twentieth century. Our premise here, which Stiglitz pointed out, is that American society itself evolved from agrarian and mainly rural to industrial and super-urban. We believe that such an evolution also involved the transformation of the American family structure within the home from a multigeneration farm family to a nuclear double- or even single-generation family living in an urban setting. In other words, we’ve gone from The Waltons to The Simpsons in just about seventy years: the speed of light in evolutionary terms. Why is this so crucial to our understanding of modern sociopathic and psychopathic behavior, the extreme and the ultimate forms of which are mass murder/suicide, whether in the form of psychotic murder and mayhem in cases of Adam Lanza, James Holmes, Cho Seung-Hui and Anders Breivik, or terrorism in the form of the Brothers Tzarnaev in the Boston Marathon bombings? We believe it is part of a social evolution, and we can see it in our schools and colleges. Look at it as an engineering problem in which you have to account for what kind of structure or structural architecture can handle load-bearing stress, in this case, load-bearing emotional stress on the child. We hypothesize that structure to be the multigeneration family unit, the basic farm family in which all generations from grandparents to children participated in a common family goal; it collapsed under economic pressure and the migration to cities and then to suburbs. A completely unanticipated sociobiological transformation took place as well. Jack Kerouac prophetically saw this and described it in his first novel The Town and the City.108 If one thinks of child development as partly an engineering case study in how the family handles the load-bearing stress on the developing child, one can see the valuable role a large multigeneration family plays in bearing that load and gradually leveraging it onto the growing child. Grandparents or even great-grandparents can intercede when tensions between parent and child exceed the ability of the parent/child relationship to bear them. Simplistic? Yes, but it makes a point. Parents who are under emotional stress in their own lives sometimes have little resiliency when it comes to dealing with the stresses of their growing children. That is when their parents, the children’s grandparents, play an important role.

But first a caveat about how television—and feature films, to a large extent—project a refraction of social ideals and values, whether negative or positive, onto an audience whose members, to a significant extent, share those ideals, hopes, and fears. We are contrasting two television series depicting life in two different societies, not as if they are documentaries but as if they are projections of social ideations that a viewing audience probably must share to understand the continuity of the stories.

On the old television series The Waltons, even during the tough times of the Great Depression, as the parents faced the stress of just putting another meal on the table and keeping the family farm from going bust, Grandpa and Grandma Walton eased the burden on their grandchildren by parenting their own son in times of difficulty and interceding with the grandchildren. As an engineering case study, to use our analogy, the load-bearing stress on the children was handled in large measure by grandparents, whose own egos and projection of their joint selves were not at stake in the parent/child interaction.

Sometimes, because parents see negative aspects of their own personalities manifesting in their children, they confront those aspects in their children’s personalities when they are unconsciously confronting those aspects in themselves. The result: intergenerational conflict. Not so much when it comes to the grandparents. Grandpa and Grandma Walton, a projected refraction of what we idealize as grandparents, kept tradition alive by functioning, among other things, as a family encyclopedia, because they were the link between earlier farmers on Walton’s Mountain and the children who were destined to inherit the family land. The Walton parents held up under the struggle because they were parented as they parented their children. Is ours now a cry for the good old days, tearing down the cities and heading back to the farms? No. It is simply an example of how society projects its own image of how it perceives the way things might have been or were supposed to be. It is a projection of perceived values. We do not see this in today’s society.

In today’s somewhat distorted projection of the comedy of an American family, as represented by The Simpsons, we see an entirely different picture: a father strangling his son or shaking him until his eyes bulge out, a father trashing his own father—depicted as a demented, physically challenged, and angry old man—while trying, but failing, to ease his way through life at his job at a leaking Three Mile Island–type nuclear power plant. The cartoon says a lot about how we recognize the foibles of a family as they fight over the last table scraps on pork chop night. Where is the multigenerational family when a grandparent with barely a grip on reality is relegated to a nursing home? It is nonexistent. And we have not even brought up the social values embodied in ABC’s Modern Family, whose tagline is “one big (straight, gay, multicultural, traditional) happy family.”

To our point, though, if we compare the agrarian, multigenerational family structure to what an urban child might face today in a single-parent environment or in a no-parent institution, we see that the child must shoulder the complete stress of growing up in society all by himself. That is hard enough. Even worse, what if growing children from single- or no-parent families find their family structure within the structure of a gang or a terrorist organization?

To make matters worse still, now add the additional stress of a dysfunctional parent taking out his or her frustrations on the child: an additional level of stress that a growing child must bear. A child of an alcoholic or violent substance abuser will most likely grow up dysfunctional, too, with little or no resiliency to stress and is at high risk of turning to violence as a first resort and winding up in the criminal justice system. This child will probably turn to violence as a first resort. We know from fifty years of research that children of abusers grow up to become potential abusers themselves. The abusive behavior they have learned feeds into whatever genetic predisposition may exist. If looked at from a transformative societal perspective, however, one can see the magnitude of the issue.

We presuppose a basic biological and developmental neuropsychological rationale for the inability of some of today’s young adult children to cope with and to shoulder the stresses of what society, domestic violence, endless wars, and economic hardship place upon them. And we aggregate this trend with the fact that the human being is one of a tiny number of species whose neurological system continues to develop postnatally. As the human brain specializes in its functions from birth through age five, neurological pathways develop and allow for the learning of predicative language—grammar, syntax, and vocabulary—and ultimately socialization brought about by the imposition of protological structures within the asymmetrical brain. Rewiring of the brain accelerates during adolescence into the early twenties, a particularly vulnerable time for the young to be traumatized by crime or combat.

Parent-Child Bonding in an Alienated Society

During the early years and in concert with the internal neurological development of the young child, the child faces its first Eriksonian crisis: the crisis of borders and trust in which the child must discriminate between self and non-self and develop a sense of trust in the non-self.109 This major developmental event, described by psychologist Erik Erikson, helps establish a healthy balance in the way a child looks at the outside world as it seeks to control its own bodily functions. In essence, from infancy through age four, the child’s confidence and germ of self-esteem gestates from his ability to develop trust in world that is outside of himself and his immediate physical control. This is a primary boundary issue—a control issue—the child’s primitive discovery that good biological fences make good neighbors and biological control builds self-esteem. Instilling in the child the distinction between self and other, “me and not me,” is the physical establishment of biological boundaries and the residing of trust in an entity that is a “not me” by skin contact with the parent. Research into ways parents can ease the emotional disturbance of children with ASD has revealed that autistic children respond to a sensation of pressure on their skin. Wrapping autistic children in a blanket, holding them close, or having them wear garments of a heavier weight so that they feel pressure on the skin helps the autistic child relax, feel secure, and not repeat some of the obsessively destructive behaviors that reinforce the need for physical contact. For example, Adam Lanza shrank from the touch of others when he was a student at Sandy Hook, but he pressed himself against the walls of school corridors. This might have served a double function as he reacted with visceral fear of contact with others while reassuring himself of a boundary by pressing his body against a wall.

The developing infant’s important skin contact is common among mammals. Ever watch a cat with her newborn kittens? She licks them, not only to clean away the afterbirth, but to stimulate the skin, the part of the body with the greatest amount of sensors. Watch a female dog with her newborn litter or a chimpanzee with its newborn. Watch the closest biological relatives to human beings groom their young, stroking and licking and constantly stimulating the outer skin. Our biology and their biology are not so different.

Because the human skin contains the greatest amount of sensors, it enables the child to experience the sensation of benevolent contact to nurture its developing neurological system, which is shedding nerve cells as it specializes to conform to its environment. It is referred to in postmodern parlance as “attachment parenting,” but it is a fundamental part of child-rearing from the dawn of human society. Parents must be in physical contact with their children in such a way that the sensors in the child’s skin are stimulated. That stimulation helps develop the child’s entire neurological sensory system while at the same time biologically demonstrating the distinction between what is the child and what is the outside world. Even more, it helps the child place his trust in the parent and thus reside trust in the presence of the outside world. Developing a native understanding of what is self and what is not self is vital. Failure to develop that understanding means that the individual will not distinguish between himself and others, not establish healthy boundaries, fail to integrate socially with peers, and wind up with some degree of psychosocial pathology in which the individual regards to some extent everything as his own. It does not mean that every child who fails the first Eriksonian crisis turns into a sociopathic killer like Ted Bundy or Jeffrey Dahmer. It does mean, however, that barring some form of external intervention from family sources or even school, the child may be at risk to develop antisocial criminal or asocial isolative tendencies. Now, if we place this child within the context of a modern two-career or single-parent family where a child is in day care and preschool and does not experience much physical contact with the parent, that child may find himself at odds with his peers and within the social system, especially when it comes time to demonstrate empathy or sharing.

We have found this out by observing very young children in day care or nursery school settings, wherein children assert their ownership of items by refusing to share. However, in conformity with classroom rules, older children from ages seven to ten do demonstrate the ability to share and to sympathize with other children. Unhealthy children do not demonstrate these things and from a very early age find themselves in conflict with the classroom rules of behavior. Does this mean that they will all grow up to be suicidal mass murderers? No, but it does mean that learning to share and participate with others in a social structure will be difficult for them. The prevalence of conduct disorder is 10 percent in males and 2 percent in females. Follow-up research on three hundred children who were referred to a child guidance clinic in St. Louis for antisocial behavior (conduct disorder) showed that in thirty-five years, 71 percent were arrested and 50 percent had multiple arrests and incarcerations. Nearly one-third in this group were diagnosed with antisocial personality disorder in adulthood, while almost all committed four offenses and went on to adult criminal careers. Only 16 percent were ultimately found to be free of psychiatric illness.

The severity and number of antisocial behaviors in childhood conduct disorder predict adult behavior better than any other variable, including social class and family background. And it is known that comorbidity between conduct disorder and ADHD is so high that the neurobiological linkage cries for large-scale research.

Time for another caveat: sociopathic behavior, like some forms of psychopathic behavior, exists along a spectrum. We can identify a Ted Bundy or a Gary Ridgway as extreme examples of sociopathology. They exerted the most extreme form of control over their victims, who they believed they possessed, by killing them, sometimes dismembering them, and thus making sacrosanct their burial places so that they could return to perform sexual acts upon their corpses. Necrophilia is the ultimate form of control over another’s body. But the pathological need to control and to dominate others and the playing field on which they operate can be seen in all aspects of society: from the brutal supervisor spewing toxic criticism on all of those hiding in their respective cubicles at work, to the teacher who demands more than just respect from students, to members of law enforcement agencies who use their authority to exploit others. Sociopathic behavior exists at all levels of society, from mildly disturbing social transactions to crimes of sexual abuse and murder.

Consider the at-risk child who has not established healthy borders as he or she emerges from the toddler years. Raise that child in a television and video game environment, especially one that demands that the child shift his attention instantly from thing to thing—called “smash cuts”—to watch violent images so that, in a “clockwork orange” type of scenario, the child may be inadvertently programmed toward violent reactions to the stress of repeated sudden psychological attention shifts. At the very least, a child will develop a natural tendency for ADHD and a resistance to what would be the natural abhorrence to violence in such a way that violence becomes a first, rather than an ultimate, resort. As an example, just take any wartime video game or even professional wrestling, which many children imitate without regard to the injuries it can cause. For an already at-risk child, inculcation to violence can be a lethal psychological mix. Absent the nurturing and mitigating presence of older family members, grandparents, or parents, there is nothing to bear the load of the stress the child is experiencing.

As we have described it, generations of children after World War II and the subsequent generations of children they bore were simply not biologically or developmentally ready for this shift in the family structure. The family in which Theodore “The Beaver” Cleaver thrived is no longer. As our troops, the children and grandchildren of the post–World War II cohort, return from the Middle East, the problem we describe threatens to escalate to gargantuan proportions.

The Psychopathogens of an Epidemic

If we are in an epidemic and we are calling suicidal mass murder a syndrome, how is the syndrome spreading? Diseases are contracted because pathogens enter our bodies. The great Black Death that spread across Europe from the fourteenth through the seventeenth centuries was spread by infected fleas that fed on the blood of rats. The bacteria was transported in the bloodstreams of the rats and carried by fleas into the human population. It could not be stopped in England, until the reign of Charles II, when the great fire of London destroyed the population of disease-bearing rats. The pneumonic plague, another form of the disease, was spread in the air from infected person to infected person. We believe we know, and have entire organizations to study this process and intervene medically when necessary, how disease spreads and how to try and control it. But what about the disease of suicidal and homicidal mental illness?

From the records that have been pieced together about the life of Adam Lanza, investigators learned that he was an avid follower of the Anders Breivik case. For his part, Anders Breivik was an avid follower of the Unabomber, Ted Kaczynski, whose manifesto and other writings inspired much of the “rage against the machine” movement. If Lanza followed Breivik and Breivik followed Kaczynski, we can see how violently antisocial messages can spread—and that certainly comports with the First Amendment—and influence at-risk individuals who cannot partition an anger-driven rant from a homicide. Similarly, from what investigators learned about Cho Seung-Hui, he wrote a high school essay after the Columbine shooting in which he expressed his admiration for shooters Klebold and Harris and said that was exactly what he wanted to do. Even in high school, Cho was articulating his suicidal and homicidal ideations but objectifying them in the Columbine High School massacre. In the latest case of a mass attack in Texas by Lone Star College student Dylan Quick, who went on a stabbing rampage against students, we learned not only that had Quick been planning the attack for years, according to the Harris County, Texas, sheriff’s office, but that Quick had studied books about serial killers and mass murderers. He was a student of psychopathic and sociopathic behavior.

Psychopathogens are spread by media. Within the context of video games, violent entertainment, and graphic news coverage of mass shootings, the pathogens are spreading among the most vulnerable and at-risk individuals. The suicidal mass murderers, while certainly not being extolled in the media, are objects of fascination and wonder. Photos of wide-eyed Adam Lanza, smirking Jared Loughner, and dazed James Holmes with flaming red hair are indeed media-catching. These horrendous suicidal mass murders are happening with too much frequency, are grouped too closely together, and share too many commonalities to be occurring coincidentally. We believe that violence does breed violence, but the way it is bred and spread has coalesced into a perfect storm among the most vulnerable and the most preconditioned to violence. One can combine the influences of media-borne psychopathogens, the influence of violent video games and media, and the growing population of undiagnosed, untreated, and unmanaged seriously mentally ill people and look at it within the context of the transformational societal shift. We can then see that there is an evolutional inability to catch up to that societal shift, and the problem of an epidemic of murder suicide becomes more dire. This perfect storm of suicidality is one of the root causes of the problems of apocalyptic and episodic rampage violence we face today. It is violence that threatens to engulf the very public agencies we rely on to protect us, and if not ameliorated, this violence will result in a draconian governmental reaction that will make anyone born before the twenty-first century wonder where the good old days went.

100 Campbell, Joseph. The Hero with a Thousand Faces. New York: Pantheon Books, 1949.

101 Rothenberg, MD, Michael B. “Effect of Television Violence on Children and Youth.” Journal of the American Medical Association, Vol. 234, No. 10 (1975): 1043–46.

102 Huizinga, Johan. Homo Ludens: A Study of the Play-Element in Culture. New York: Roy Publishers, 1950.

103 Elliot, Victoria Stagg. “AMA Meeting: AMA Concerned about Video Games’ Impact on Youth.” American Medical News, July 16, 2007. http://www.amednews.com/article/20070716/profession/307169962/7/ (accessed December 11, 2013).

104 Brown v. Entertainment Merchants Association, 564 US 08-1448 (2011).

105 Elliot, Victoria Stagg. “AMA Meeting: AMA Concerned about Video Games’ Impact on Youth.” American Medical News, July 16, 2007. http://www.amednews.com/article/20070716/profession/307169962/7/ (accessed December 11, 2013).

106 Kessler, R., et al. “Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States Results from the National Comorbidity Survey.” Archives of General Psychiatry, Vol. 51, No. 1 (January 1994).

107 Stiglitz, Joseph E. “The Book of Jobs.” Vanity Fair, January 2012. http://www.vanityfair.com/politics/2012/01/stiglitz-depression-201201.

108 Kerouac, Jack. The Town and the City. San Diego: Harcourt Brace Jovanovich, 1950.

109 Erikson, Erik H. Childhood and Society. 1950. Reprint, New York: Norton, 1993.