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Cartoon by Tom Tomorrow - Gun talk
The latest issue of The Journal of the American Medical Association has again produced several articles about reforming our gun laws, and the different state and federal approaches to addressing reform in regard to mental illness.

A third article from a psychiatrist with personal experience, both with the NRA and its gun safety programs and with the trauma of gun violence, has my attention today. In it, the author, Dr. Paul Kettl, compares the message of using guns "safely and responsibly" that he remembers from a youth hunting course with the NRA to its present campaign of fear, misinformation and threats, and finds it wanting.

Part of this article is behind a paywall, but fortunately someone provided me with a hard-copy of the magazine. Let's take a look.

Here's how Dr. Kettl begins his article in JAMA, with a story from his scouting days that I think many of us can empathize with.

Ok, perhaps I'm not that empathetic
I was 15 years old, and after firing the shot, I could feel the kick of the rifle against my shoulder. Hearing the “pop” of the shot also gave me a thrill that echoed through my adolescent frontal lobe. I looked up, and the representative of the National Rifle Association who was running the session told us, “We are going to have some fun today, and we’ll do some more target practice, but we also are going to learn how to use that weapon safely and responsibly.”
I understand that these days, it can be difficult to get this point across that shooting and target practice can be fun. Although the psychiatrist relates gun use as part of the American way -- I have my doubts about that -- it's still prevalent enough that this aspect of it shouldn't be ignored. I've shot a gun once myself, and it wasn't particularly horrifying. Being taught enough to deal with the recoil to not get a headache from it was a plus. It's not that kind of shooting that worries me; it's the popping noise of gunfire in my neighborhood at night, and the noise of helicopters overhead, reminding me that no, that was no backfiring truck.

Dr. Kettl takes on the idea of gun ownership for security -- a means to feel better, really, as he puts it. Unfortunately, the data he presents suggests that guns in the home create far more suffering than they alleviate.

If you have a gun to "protect" your home, the person most likely to die from that gun is you. For every case of self-protection death with a firearm in the home, there are 37 suicides involving a gun in the home. The second most likely person to die from that gun is a homicide victim -- at your hands, four times most likely than a self-protection shooting. Way down the list is stopping that intruder breaking into your house, the imagined reason you bought the gun in the first place. In the United States, 32,000 people a year are killed by guns, and another 32,000 people a year are shot and injured. Firearms are an efficient and common way to kill people. You don't have to think much about it. Firearm-related homicide is more than twice as common as all other means of homicide put together.
Having heard all of the gun lobby's objections to this data, I can already imagine them being repeated here in response. There may be other 'self-protection' instances where no one was shot and killed. Suicide is just "a choice," some inevitable, unstoppable outcome. As if people at risk of committing suicide are some sort of cyborg self-terminators that absolutely will not stop, ever, until they are dead. The gun enthusiasts will seek to dismiss the suicides altogether, as if they somehow don't count -- which reminds me of a program I heard on NPR yesterday. On Talk of the Nation, they discussed the racial disparity of gun violence -- that gun deaths among whites tend toward suicide as much as gun deaths among blacks tend toward homicide, and what that does to their respective opinions.
KEATING: Well, it's kind of interesting, because then what really drove my story was not just the disparity in the rates, but how that applies to guns and access to guns. So the people that suffer homicide among relatives, family, friends, tend to have a very anti-gun attitude. And so that's prevalent in the city across all races and in the African-American in both cities and African-American community of predominately homicide for gun deaths, and there's a strong urge for gun control both in the urban environment and in the African-American community.

But then as you move out of the city, suburbs and then rural, where the gun deaths shift to suicide, you also shift to a much lower desire for gun control, much more support for gun rights. And so what really is interesting to me about that is that when people die in a gun homicide, the gun is vilified. The gun is blamed, and people want to stop the guns.

But in gun suicide, the gun is not blamed. The gun is actually considered, you know, not the problem, and it's that, you know, they tend to more put a stigma on the person, oh there was something wrong with him. So in the reporting on this, it was - you know, and in talking to the experts, when you go to the academic experts and those kind of people, they have a very strong conviction, and they look at the data about access to guns and suicide, and how much more suicide there is in places where there are a lot of guns.

I've seen this exact same difference of opinion here. Even though guns are a documented risk factor in suicide. Even after explaining how the gun facilitates the suicide when the impulsive thought strikes. How taking the gun away will save lives. About how many people attempt suicide but go on to live normal lives, versus the ones who pick up a gun -- nearly all of whom become part of that statistic, 32,000 dead in a year, because guns are so effective at killing people. Even after explaining all of this, the blinkered mindset of they will find a way continues to persist. In spite of the evidence, in denial of it.

Even Dr. Kettl in the JAMA article mentions this particular quality of guns -- their ease of use, how handy they are when that impulse strikes, how irreversible their effects are. And more.

Guns make it too easy to take a life. Impulsive thoughts or threats of violence against oneself or others become fatal if a handy means of implementing those thoughts is all too easily accessible. Firearms provide those ready means. But we also have semiautomatic weapons with large ammunition clips designed for maximum killing. Handguns are sold without checks at gun shows, or on the streets. Those who are overtly psychotic can purchase them without a worry on the street or at those large gun shows.
...or from websites like ArmsList, as I've found. The ultimate expression -- and utter failure -- of the honor system in obeying the law, which we're told is a valid alternative to more credibly founded record-keeping for background checks. ThinkProgress investigated the particular problem of online gun dealers back in February. Dr. Kettl doesn't mention that part of the gun trade. But he does mention the common-sense policies promoted by the President and Democrats in Congress, to make background checks for guns as routine as they already are for taking an airplane flight or even just for voting. Policies like taking away access to guns from people who suffer from dangerous mental illness. Where is the NRA to be found here, the NRA that supposedly is interested in using guns "safely and responsibly"?
But it doesn't look like many of these safety measures will be put into place. The reason is not that they wouldn't save lives, or prevent trauma pouring into our emergency departments, or assuage grief seen in our mental health offices. The reason is fear and misinformation propagated by a public discussion dominated by fear and threats. The National Rifle Association let me down. What it taught me as a teen was to use guns "safely and responsibly." I believe that the NRA is not teaching that now nor following the tenets of safety or responsible gun use in its public policy stance. Instead, it uses fear and condemnation to avoid even the most sensible, obvious changes needed in our gun laws. In Florida, a law threatened physicians if they even asked about guns present at home with the family. And then, after that law was struck down, the NRA appealed that decision in federal court.
So, as it turns out, the NRA youth programs about gun safety? Not so much, once you've grown up. And since the proliferation of guns and gun violence has been treated like a public health crisis in recent issues of JAMA, which I've written about here, perhaps this message, this evident fakery from the NRA should be viewed as the hook. Much like the deceptive advertising from cigarette companies targeting young people to get them hooked on smoking. I suspect that Dr. Kettl wouldn't go that far with it, though. There is value in promoting safe and responsible use of guns, when they're going to be used. But I see the NRA as tainted. A poisoned well, and they've polluted it themselves.

The desire for security is in one sense the freedom from danger, from fear. And I can cite again the example of Charlton Heston, addressing the National Press Club on behalf of the NRA:

Sign at the 2011 Rally to Restore Sanity in Washington DC that reads
It is America's First Freedom, the one right that protects all of the others. Among freedom of speech, of the press, of religion, of assembly, of redress of grievances, it is the first among equals. It alone offers the absolute capacity to live without fear.
In spite of their protests otherwise, gun enthusiasts fighting for unfettered access to guns and gun proliferation exhibit this fear in their desire for security. The NRA's conspiracy theories and scare tactics about government tyranny and gun confiscation exude this fear; they create it, they nurture it. The NRA cultivates fear, and their harvest can be seen in the frantic gun enthusiasts buying everything off the shelves at gun stores, putting guns on back order, guaranteeing months or years of continued profit for gun manufacturers. They are being farmed, harvested for profit.

It is a sad contrast, to compare this fear-mongering to the story from Dr. Kettl's youth, of target practice and safety lessons and, yes, fun with guns. In advocating gun safety and responsible, progressive change in gun laws, I'm with the researchers, the scientists. Our emphasis is on saving lives -- whether it's gun violence and homicide by gun, which the rural folk seem to dismiss as some particular urban blight that they can safely ignore; or cases of suicide, which actually hit hard in rural areas, hard enough to make them deny the gun as a risk factor.

That denial doesn't resemble courage; that would mean confronting, overcoming fear. It smacks of cowardice instead. It's a shame to see that, thanks to the NRA, cowardice may win the day and prevent change for the better.

Originally posted to The Tytalan Way on Wed Mar 27, 2013 at 11:06 AM PDT.

Also republished by Shut Down the NRA.

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Comment Preferences

  •  I've started on a , guns and suicide diary , (3+ / 0-)

    trying to push back against some of the BS published by some on this site . Some things have been posted and recommended that are the very opposite of truth .

    Drop the name-calling MB 2/4/11 + Please try to use ratings properly! Kos 9/9/11

    by indycam on Wed Mar 27, 2013 at 11:51:58 AM PDT

  •  Although I seldom vouch for this, I will today (5+ / 0-)
    Recommended by:
    SoCalSal, tytalus, a2nite, viral, Joy of Fishes
    I understand that these days, it can be difficult to get this point across that shooting and target practice can be fun.
    Target shooting includes the same sense of accomplishment that any other endeavor does, when you are striving for mastery, and when you are measuring yourself against your own personal best.

    E.g. runners know what their average pace is, and know without measuring when they are at the top of their game.

    And yogis, likewise, know when an asana that has challenged them finally gives way to determined and patient practice and they breakthrough to achieve perfect form and balance.

    Imagine this - being extremely comfortable and calm in your focus as you hold a rifle with your nose resting on a part of it, right behind the sites, which are the little posts or loop you look through to aim. On the M16, it's called the charging handle. You place your nose on the charging handle when you look through the sites. Your cheek is resting on the stock. The butt is firmly pressed back against your shoulder.

    In order to put 3 consecutive shots inside a quarter you need to do all of the following:
    1) aim,
    2) exhale and then pause your breathing for a moment,
    and then
    3) squeeze the trigger in such a way that the explosion surprises you.
    and you need to do them in such a way that your nose never leaves the charging handle.

    If you do you will be able to put 3 consecutive bullets inside a quarter. With practice a sharpshooter develops muscle memory for the precise way that they, specifically, hold the weapon and how they aim and does so consistently, that they know how to adjust in order to hit their target in different conditions.

    If that's still seems weird, think of the way a golfer gets to know their own grip and how to adjust their swing in different conditions.

    "They did not succeed in taking away our voice" - Angelique Kidjo - Opening the Lightning In a Bottle concert at Radio City Music Hall in New York City - 2003

    by LilithGardener on Wed Mar 27, 2013 at 12:03:17 PM PDT

    •  I thought it worth mentioning (6+ / 0-)

      while not making it the focus of the diary. On a day full of gun violence, pretty much every day,'s hard for me to be very sympathetic, when my pastimes don't contribute to the suffering and death the way gun enthusiasm and the NRA does.

      I'm aware of the objections, I expect them. But my freedom to tell stories and play games doesn't result in people dying in the way that unfettered gun rights and proliferation do.

      We demanded a plan to reduce gun violence. Now it's time to demand a vote.

      by tytalus on Wed Mar 27, 2013 at 12:22:17 PM PDT

      [ Parent ]

      •  I'm trying to find (at least occasionally) (3+ / 0-)
        Recommended by:
        tytalus, viral, Joy of Fishes

        common language to demystify what was second nature to me, since I grew up with it.

        Fear is the barrier, and where I can translate, I sometimes try to do so.

        But don't mistake me, I'm fast on my way to becoming a gun safety advocate. For all the reasons that are so abundantly clear long term change is needed and is going to come.

        I have shifted since Newtown.

        One thing that horrified me was when I read about unlicensed shooting ranges in, of all places, Newtown, and how the town had tried to pass some ordinances and couldn't come to agreement (in part because only the gun rights folks showed up).

        I have wondered why no one heard 4 gunshots about 9 AM in a quiet residential neighborhood. Or if someone had heard them why they weren't reported to the police. Was it because the sound of gunfire in a residential area wasn't that out of the ordinary?

        Gunfire in a residential zone should never become "normalized." It should remain a signal that people recognize - time to call the police.

        "They did not succeed in taking away our voice" - Angelique Kidjo - Opening the Lightning In a Bottle concert at Radio City Music Hall in New York City - 2003

        by LilithGardener on Wed Mar 27, 2013 at 12:46:55 PM PDT

        [ Parent ]

  •  Does the article include any breakdown of (2+ / 0-)
    Recommended by:
    tytalus, Joy of Fishes

    how many suicides are just suicides, and how many suicides are murder-suicides?

    Or do you know of any data sources that break out how many murders are committed by a killer who then shoots themselves or is killed in a shoot out with police?

    "They did not succeed in taking away our voice" - Angelique Kidjo - Opening the Lightning In a Bottle concert at Radio City Music Hall in New York City - 2003

    by LilithGardener on Wed Mar 27, 2013 at 12:19:06 PM PDT

    •  The articles in JAMA this month (4+ / 0-)

      don't contain data of that sort, and from what I can find there is no comprehensive effort to track murder-suicide. The Violence Policy Center is studying it by gathering news reports; but they acknowledge their data is likely to be incomplete.

      In a research specifically related to murder–suicide, Milton Rosenbaum (1990) discovered the murder–suicide perpetrators to be vastly different from perpetrators of homicide alone. Whereas murderer–suicides were found to be highly depressed and overwhelmingly men, other murderers were not generally depressed and more likely to include women in their ranks.[2] In the U.S. the overwhelming number of cases are male-on-female and involve guns.[3] Around one-third of partner homicides end in the suicide of the perpetrator. From national and international data and interviews with family members of murder–suicide perpetrators, the following are the key predictors of murder–suicide: access to a gun, a history of substance abuse, the male partner some years older than the female partner, a break-up or pending break-up, a history of battering, and suicidal ideation by the perpetrator.

      Though there is no national tracking system for murder–suicides in the United States, medical studies into the phenomenon estimate between 1,000 to 1,500 deaths per year in the US,[4] with the majority occurring between spouses or intimate partners, males were the vast majority of the perpetrators, and over 90% of murder suicides involved a firearm. Depression, marital or/and financial problems, and other problems are generally motivators.

      We demanded a plan to reduce gun violence. Now it's time to demand a vote.

      by tytalus on Wed Mar 27, 2013 at 12:28:47 PM PDT

      [ Parent ]

    •  asdf (3+ / 0-)
      Recommended by:
      tytalus, LilithGardener, allergywoman
      At least 691 Americans died in 313 murder-suicides during the first six months of 2011 with the vast majority (89.5 percent) involving a firearm, according to the fourth edition of the Violence Policy Center’s (VPC) study "American Roulette: Murder-Suicide in the United States"

      There's a link to a pdf with the full study.

      "No one life is more important than another. No one voice is more valid than another. Each life is a treasure. Each voice deserves to be heard." Patriot Daily News Clearinghouse & Onomastic

      by Catte Nappe on Wed Mar 27, 2013 at 12:30:50 PM PDT

      [ Parent ]

  •  The relative sense of safety/control discussed (4+ / 0-)

    in the article, as opposed to statistical risk of harm, reminds me of the way people feel about driving vs. flying.

    Most people who are afraid of flying are very comfortable with driving, even though their risk of injury and death is so much greater in a car than in an airplane.

    There's something about committing 100% of your body to an airplane, that sneaks past rational thought. I think it's more than just being the driver, but I'm not sure how to make sense of it.

    "They did not succeed in taking away our voice" - Angelique Kidjo - Opening the Lightning In a Bottle concert at Radio City Music Hall in New York City - 2003

    by LilithGardener on Wed Mar 27, 2013 at 12:26:56 PM PDT

    •  Fear of flying, now that... (3+ / 0-)
      Recommended by:
      LilithGardener, a2nite, Joy of Fishes

      I can empathize with. I don't like flying much, and it is for reasons like that, although I know they're not very rational ones. It's not a huge panicky deal for me, though. I just don't enjoy it. Then again, the entire flying experience (airports security etc.) makes it even less fun.

      We demanded a plan to reduce gun violence. Now it's time to demand a vote.

      by tytalus on Wed Mar 27, 2013 at 12:36:50 PM PDT

      [ Parent ]

    •  Perhaps it's control? (2+ / 0-)
      Recommended by:
      tytalus, LilithGardener

      I don't drive, due to disability, but I do travel a lot, and I suspect that one thing that's different for the fearful person is a lack of control.  I love flying and I've only been scared once (a very, very rough landing at Midway - I didn't think we were going to crash but I did think we might come down hard enough to aggravate my scoliosis-related pain and perhaps ruin my trip).  However, in an airplane, you don't look forward, in the direction of travel and you don't always know what's going on.  The fearful person might constantly doubt their surroundings - "Was that bump minor turbulence?  Beginning of a descent?  Or did an engine fall off?"

      I dunno, just theorizing.

      "The first drawback of anger is that it destroys your inner peace; the second is that it distorts your view of reality. If you come to understand that anger is really unhelpful, you can begin to distance yourself from anger." - The Dalai Lama

      by auron renouille on Wed Mar 27, 2013 at 09:50:02 PM PDT

      [ Parent ]

  •  Simple Plan (0+ / 0-)

    The plan of the National Rifle manufacturers' Association is simple and working well.  The more paranoia they can create, the more guns and ammunition their sponsors can sell.  Follow the money.

  •  I've been trying to find any kind of reliable data (1+ / 0-)
    Recommended by:

    on "defensive gun use" and having not much luck. There seem to be wild disagreements over the very sparse data, ranging from 700 instances/year to 2.5 million!
    The best documented estimates are around 62000/year but the researchers believe (unable to confirm) that this is an inflated data set because many of the claimed defensive uses have been armed confrontations between equally armed antagonists and most likely illegal incidents, so not technically self-defense in the sense of home defense.

    If I ran this circus, things would be DIFFERENT!

    by CwV on Wed Mar 27, 2013 at 01:49:03 PM PDT

    •  Another of those things (1+ / 0-)
      Recommended by:

      that has no comprehensive effort at data collection behind it, although I doubt there's even a settled definition for what constitutes a 'defensive gun use'. Deaths, now, those get tracked...that I suppose is why Dr. Kettl has the statistics to compare it to suicides and homicides.

      We demanded a plan to reduce gun violence. Now it's time to demand a vote.

      by tytalus on Wed Mar 27, 2013 at 02:01:09 PM PDT

      [ Parent ]

    •  As I recall, the NRA via Congress has made (1+ / 0-)
      Recommended by:

      those kinds of studies very difficult, through blocks on funding etc.  Does that block extend to the aggregation of data by municipal/county and state LEOs?

      "The first drawback of anger is that it destroys your inner peace; the second is that it distorts your view of reality. If you come to understand that anger is really unhelpful, you can begin to distance yourself from anger." - The Dalai Lama

      by auron renouille on Wed Mar 27, 2013 at 09:52:08 PM PDT

      [ Parent ]

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