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I am a psychiatrist. I have spent most of my career studying people who kill other people.Not long ago I evaluated an adolescent who, like the Newtown shooter, first killed a parent, then shot up his school, wounding and killing many of his classmates.Could this massacre have been prevented? I think so. The adolescent I saw had much in common with the Newtown shooter.
1)He was a loner and was considered peculiar by his classmates because of his preoccupation with violence.
2)When obsessed with violence he wore black or camouflage, signalling his state of mind.
3)He was fascinated with weapons and prevailed on his parents to buy him a glock.
4)He went target shooting with his father (a passtime encouraged by his therapist as a means of bonding.)
5) He made his preoccupation with shooting known by speaking of it to classmates and writing about it in school assignments. It was no secret.
Unfortunately, of all who later told of the boy's fascination with violence, none took him seriously.
6) He had psychotic symptoms which were obvious (e.g.auditory hallucinations) which were observed by his teacher but ignored and/or punished.
Do the above similarities between the adolescent I saw and the Newtown shooter matter? You bet they do!
There are others in our schools and in society at large whose recurrent violent ruminations and preoccupations are signals that they are struggling with impulses to act on these preoccupations. They go out of their way to make their demons known.
We tend to look away. We leave it to others to respond.Believe it or not, several of the murderers I have evaluated were turned away from mental hospitals just prior to their committing murder. Psychiatrists hate violent patients.
Teachers, friends and acquaintances are reluctant to call attention to their peer's violent proclivities lest they be seen as over-concerned or  intrusive. Others worry about being sued.
I would suggest that adolescents and adults be made aware of the numerous clues available that  friend or acquaintance may be preoccupied with violence and may be about to "blow." They must also be taught to share their misgivings with a responsible adult.
Will mistakes be made? Of course.
On the other hand, some potential shooters might get the help they are seeking and thus be prevented from acting on their darkest urges and fantasies.


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