Essayist Theodore Dalrymple is also psychiatrist Dr. Anthony Daniels. I've been to a couple of conference cocktails parties where he's stepped to the side to take calls from patients or loved ones of patients, and his long distance bedside manner is superb. I made sure to stay far enough away where I couldn't listen in to exactly what he was saying, but close enough to pay attention to his tone, and I couldn't have been more impressed with the concern with which he responds to his callers. He's a superior individual.

From City Journal:

THEODORE DALRYMPLE

Newtown’s Unanswerable Questions

It is not likely that psychiatrists could have prevented the massacre.

21 December 2012

The horrific massacre of the innocents in Newtown was bound to result in a search for preventive action so that nothing like it could ever happen again, and hence also for its real or final cause. To ward off fatalism, we tell ourselves that the massacre could, and therefore that it should, have been prevented; or alternatively, that it should, and therefore that it could, have been prevented. But as the cacophony of opinion demonstrates, the world is an irreducibly complex place. Agreement about what ought to have been done has all too predictably not been reached. ...

First, he was of age (20) to refuse to see a doctor if he so wished, and he might very well have so wished. By all accounts, there were no grounds on which psychiatric attention could have been forced upon him. He was strange, he was socially isolated, his mother worried about him; but he was a good student and had committed no acts that would have justified compulsory treatment, as would have been the case if (for example) he had attacked someone under the influence of delusion.

I've pointed this out before, but the number of people who are in some fashion mentally unbalanced at some point in their lives is a lot higher than most people would think. It's definitely higher than I assumed when I was young.

Second, even if he had agreed to consult a psychiatrist, there is no certainty that the psychiatrist could have done anything for him and thus averted the disaster. Nor would the psychiatrist necessarily have had any reason to suspect a mass killing as a possible outcome in this case; the best predictor of future behavior is, after all, past behavior, and the killer had (as far as has been revealed) no history of violence. Further, the psychiatrist would probably have seen several, perhaps many, similar cases that did not end in mass killing—an outcome that after all remains rare. The Newtown killing might have taken a psychiatrist by surprise as much as anyone else.

In fact, psychiatrists are no better than others at predicting violence by disturbed people, except possibly among the psychotic. ...

Not long ago, I was asked to participate in an inquiry into a spate of murders committed by psychiatric patients. The killings seemed to be statistically abnormal (recalculation showed that they were not). We were asked to determine whether there was a single type of act, or omission, by the psychiatric services common to all the murders which might help explain them.  ...

Yet, except in one case, I found no evidence that the low standard of practice had actually resulted in a preventable killing, despite the immense power of the retrospectoscope—the medical instrument that provides us with wisdom after the event and that sometimes does lead to improvements in practice that saves lives, though at other times it provides us only with scapegoats. In this instance, I should have been provided with, say, 20 medical records, among them those of the killers, without knowing the outcome of the cases, and asked to decide blindly which resulted in murder, and why. ...

The behavioral expression of a psychiatric condition takes place in a social and cultural context.

This context is perhaps propitious to young mass killers (quite apart from the effect of imitation or emulation). In an article in Le Monde, a professor of sociology at Strasbourg University, David Le Breton, quotes a German schoolboy who killed 15 people in a school in Winnenden in 2009: “I’m fed up, I’ve had enough of this meaningless life which is always the same. Everyone ignores me, no one recognises my potential.” This reeks of resentful, narcissistic grandiosity, the result of an imperative to be an individual at a time when individuation is more difficult than ever.

Here's a new theory: maybe it's Wikipedia's fault. You can now look up every goddam mass shooting you want these days in Wikipedia. I wasn't familiar with the Winnenden massacre in German, but now, having read up on it in Wikipedia, I am.

In particular, I wonder if there's an urge to Up the Ante due to people being able to study up on what did and did not grab the media's attention in the past, and allow potential shooters to test out their creative brainstorms against the historical record on Wikipedia. Shoot people at a nursing school? Boring. It's been done. Dress up as the Joker and shoot people at a Batman movie? Now we're talking. That should get attention.

The more you can check up on Wikipedia, the more you can make yourself exceptional. How many people do I have to shoot to be assured of going national? How many people do I have to be a cause celebre? Who are the best kinds of people to shoot? All this is researchable on Wikipedia.

Lots of people 10 to 15 years ago shot up high schools, so that got dull. Then, college shooting got big, but they've been kind of boring lately, too. So, shooting little children is exactly the kind of thing that is so rare that it will cause a vast crisis and get you lots of attention. Sure, there will by copycats, but that will get boring too.

But, in retrospect, the Joker guy should have waited until after the election. Before the votes are counted the Democrats/media don't want to make a big deal about gun control because they want to keep white gun fans bored with the election. Afterwards, however, as with Arizona in January 2011, the media is on tenterhooks for a good shooting they can use.

But don't implicate the media too directly, like with the The Dark Knight Rises shooting, because the media protects the media. The best is to be enough of a blank screen for the media to project its latest obsession, but not so blank that you are too boring.

So, what should be done about this? Ban Wikipedia? No.

It makes sense to look at gun control as a way to slow down and discourage the more disorganized lunatics. Obviously, with 300 million guns out there it's impossible to stop the most indefatigable. The worst shooting in this decade took place in the richest Scandinavian country, Norway, for example. Nor can you stop fully people who have rational reasons for acquiring guns for their criminal enterprises, a vastly larger cause of homicide than mass shooters. But, a lot of the few people who are that evil are also lazy, so putting bureaucratic hurdles in their way might discourage some.

Throwing people in the loony bin can also work, but in both cases it makes sense to test out proposed policies using Dalrymple's idea of giving experts like him ten cases of guys who went on to be killers and ten who didn't and seeing how accurate they are and guessing what works and what doesn't.

Finally, do we have to give so much publicity to this little bastard? How many others are getting jealous and thinking about how to top him?