Saturday, December 26, 2015

We All Pull The Trigger

Here's my most recent article published in the Huffington Post:

http://www.huffingtonpost.com/mary-walker-baron/we-all-pull-the-trigger_b_8787898.html

When confronted with terrifying and inexplicable events we experience extremely uncomfortable and seemingly unbearable individual and collective chaos. We are thrown into crisis. Nothing makes sense. Everything seems out of control. Life becomes terrifying. Our very survival appears to demand an immediate return to the perceived safety and certainty of life before the chaos of crisis.
Surviving a crisis can sometimes be as clear as finding the most direct path to safety: Leave a burning building through the closest exit. Seek a storm cellar before the tornado arrives. Go to high ground during a flood. These safety strategies are historically effective and may help us survive such moments of danger. We further understand that fires are extinguished, winds end, and waters recede. Most of us don't live in constant fear of these dangers and those who do seldom thrive. We also generally understand the root causes of these dangers. When these understandable crises end, their dangers for the most part also end. We clean up the debris, we bandage the wounded, we bury the dead and then we turn once again toward balance and life.
Common wisdom indicates that the mass shootings of the past decade have devastated our necessary sense of equilibrium and left us in a different type of crisis state. As we reel from the violence we demand explanation. As life becomes increasingly scary we seek accountability. Unfortunately, this is no simple crisis and, despite our yearnings for one, there is no clear, direct path to safety. There is no single source of our current danger. Nevertheless, flailing, we grasp at anything that might steady us. We cling to the simple solution and the named culprit. With a culprit and a solution we feel safer and more in control.
This human need to quickly resolve a crisis and regain safety and control is innate and understandable. As a strategy for resolving our current crisis of mass shootings this 'quick-find- the-culprit-and-implement-the-solution' approach holds the potential for doing more harm than good. All too quickly and all too frequently we point our fingers at already disenfranchised minorities and proudly proclaim that we've found the bad guys. We then feel compelled to 'do something about' those to whom our fingers point.
After each tragic mass shooting we are called upon, for example, to 'do something about' mental illness. The majority of the 'mental-illness-is-the-culprit' strategies are sadly rooted in misunderstanding and misinformation.
Any strategy designed to target those among us receiving mental health services will likely violate the Health Insurance Portability and Accountability Act (HIPAA) privacy rule. Federal law protects the privacy of our medical information. If you don't want your recent treatment for that STD made public then don't demand that your neighbor's recent treatment for depression be made public either.
It must be further noted that when we point our fingers of blame at the mentally ill in this country we are pointing at over 50 million people. Each year one in four adults experience a mental disorder. (Martinelli, Laurie R., Binney, June S. & Kaye, Rebecca.2014."Separating Myth from Fact: Unlinking Mental Illness and Violence and Implications for Gun Control Legislation and Public Policy." New England Journal on Criminal and Civil Confinement. 40. 359-357.) Seeing a woman odorous and disheveled jumping up and down while shouting at someone invisible to us can be unsettling. It is very different behavior. Unfortunately our national mythology equates different with dangerous and so we fear difference.
Between 2001 and 2010 people with mental illness perpetrated fewer than 5% of the 120,000 gun-related killings in this country. (Metl, Jonathan M.2015."Gun violence, stigma, and mental illness: Clinical implications". Psychiatric Times. 32.3. 54.) Different does not necessarily mean dangerous. Is it possible for a person suffering from mental illness to become violent? Of course it is. Is it possible for a person who has never experienced any symptoms of mental illness to also become violent? Absolutely. Predicting violent behavior is potentially possible. However relying on mental health providers to make such predictions is not practical. Definitions of mental illness are fluid. Even the bible of psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, publishes regular revisions.
Seeking our quick exit from crisis by identifying and pointing fingers at potential culprits also increases the stigma of already stigmatized minorities. Research tells us that public stigma robs the mentally ill of work, independent living and other important life opportunities and further negatively impacts their own self-esteem and self-efficacy. (Corrigan, Patrick W. & Watson, Amy C.2002."The Paradox of Self-Stigma and Mental Illness". American Psychological Association. D12. 35-53.)
In his address to the Institute of Medicine's (IOM's) Forum on Global Violence Prevention, Dr. Mark Rosenberg stated that, "Mental illness plays only a small role in violence, but that intersection is clouded by misconceptions and disinformation in the public's mind." (Levin, A.2014."Experts Refute Myths Linking Mental Illness, Violence". Psychiatric News. March 31.)
There is no denying that we are in the middle of a national crisis. However, by claiming the quick explanations and solutions we so desperately crave we risk not only missing the root causes of the crisis but also, in fact, making it worse. Our problem is systemic. Each of us is part of the problem and in our hands each of us holds part of the solution.
In a crisis it is extremely difficult to take time for analysis and consideration. We desperately want to take the quickest path to safety. This crisis, however, demands deliberation and careful attention. Our quick solutions based on knee-jerk blaming may feel good in the moment. In the long run, however, they will worsen our already terrible reality.
People don't like having fingers pointed at them. It doesn't feel good. However, to appropriately examine our current crisis it is absolutely necessary to first point our fingers at ourselves. It won't feel good but it may help us navigate through this crisis to a place of safety.

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