I don't think schizoid or terrorist is an either or proposition. He was a murderer. That's that.

Once you go about labeling all people who commit crimes as severely mentally ill, all people who are labeled as severely mentally ill become guilty a la Fuller Torrey. As we know well over 99% of violent crimes are committed by people not previously labeled as mentally ill and the vast majority of people labeled as mentally ill do not commit violent crimes. This dude was clearly not considered mentally ill by an entire staff of psychiatrists and thus it would be absurd to go back and say they missed it and that if only he had taken loads of risperdal he would have been a flag waving gun totin patriot.

It's not just irrational to look at humanity this way, it's immoral. Most people who commit violent crimes appear normal before committing them, not mentally aberrant. The guy was trapped in a military fighting a war he didn't agree with. His contact with al Qaeda indicates he was a traitor, not a schizophrenic.

I can understand why you and Breggin lean towards the terrorist thing. The guy was Muslim and did sympathize with al Qaeda but I won't think terrorist unless I hear that he was part of an organized political conspiracy and not just an angry trapped man who committed a horrible act of violence.

I am thrilled to see that the administration is considering not sending more troops to Afghanistan. We need less troops to prevent more death and more terrorism.

Getting our troops out of Afghanistan will save more lives than fear mongering about a traitor who is caught, contained and will be punished. Though I can see how a law forbidding psychiatrists from carrying guns might be a good thing.

There is a vast distinction in our willingness to label someone a terrorist vs labeling them mentally ill. To call someone a terrorist, you have to cross a highly politicized threshold -- often, however errantly, involving race, religion, geography and certainly politics. That makes some people uncomfortable. To call someone mentally ill -- that's easy. We've been doing it for ages, far longer than terrorism has even been in the American lexicon. It's so well engrained in our minds that we accept it without question as a legitimate label that you can use to dismiss an entire person without really having to take a stand against their professed beliefs, motives or people. You never have to answer for it. That becomes very convenient. Maybe it's partly because collectively the "mentally ill" will never have something we want while groups based on other commonalities do or may in the future.

Philip,

You did it again! You are confusing two issues - as you did with the Anthrax murderer and some of the school shooters.

The REASON they were psychotic was because they were on antidepressants. The reason Hasan, if he was on antidepressants and he probably self-prescribed them since 9/11, was psychotic was because of his antidepressant use. Naturally, being a Muslim, his target would be anyone who was opposed to Muslims. A person who is psychotic on the antidepressants naturally chooses as his target those people who he thinks are oppressing his beliefs or desires.

Sure, Hasan was a terrorist of the worse kind but why was he psychotic?

I amazed that people pretend to KNOW Hasan. If any of you has actually met the man then do tell. If you've actually met ANY murderers then do tell. Now a gentle reminder-this is Philips blog-he can say what ever he likes.

Now as to mental illness-yes it does exist. The end.

As to the definition of terrorism-pick one and run with whatever makes you comfortable.

As far as "labeling" all murderers mentally ill-why not? Because it makes YOU uncomfortable? Go hug your pillow because life is hard. People will look at humanity any way they please irrational or immoral and guess what? There is no way to stop it. Has anyone stopped anyone from murdering someone with an argument? No? Then check your own heads. People do not conform merely because you want them to or because you think they "should".

An insane person killed people. It's happened, it's going to continue to happen, and there is zero that you can do to stop it.

The end.

We don't know he was psychotic and we certainly don't know what, if any, contribution psychotropic drugs played in this. It is possible, but I believe the possibility of this as the cause to be very remote.

All I see is another unremarkable instance of islamic extremism. How is this guy any different than any of the other examples? Is it that he was a military officer, a psychiatrist, what exactly? I tend to think of terrorist as ideologically based people/groups that choose to ignore societal norms to achieve their goals (one man's terrorist is another's freedom fighter...) - typically through violence. He's most likely just another extremist who was coddled rather than confronted by his chain of command. What action was taken on his fitness reports? They pushed him off on Fort Hood where he would be less visible and swept it under the rug. Too bad this guy meant what he said.

He may be a "me-too al qaeda wannabe". He's also not the only one with an advanced western education to commit such an act - look up the profiles on the 9/11 assassins. I see no evidence of mental illness, unless one considers islamic extremism to be a form of mental illness? I don't don't. I believe these people are rational and have been exceedingly honest and clear about their intentions. Are Hasan's actions all that surprising? His colleagues aren't gobsmacked. So, why are we????

Sorry, I don't see psychosis here, just another committed muslim willing to act on the teachings of his belief system.

I have no idea what to say.
All I know is that it's sad to have a murder that involves terrorism + mental illness + psychiatry + army + Al Qaeda + muslin + psychotropics at the same news.

Not this time Rosie

Rosie said "The REASON they were psychotic was because they were on antidepressants."

I do believe in psychotic reactions as an adverse effect of anti depressants, BUT this man's culture and religion supercedes that.

He is a terrorist who might happen to take psych meds, that's it plain and simple. Unfortunate that the Army didn't pay attention to his rantings, look what happened as a result.

Hasan's still alive. Let's see what he has to say for himself. If he intended to gun down a bunch of people to make a political point, I'm sure he'll be happy to talk about it.

Not that I can resist my two cents, which is to point out that in Iran, people protesting the stolen election shouted "Allahu Akbar" - "God is Great" - during the anti-government marches. I'm sure the governing mullahs were intoning the same thing as they railed against the protesters. This is part of Muslim culture; that this phrase was on Hasan's business card signifies nothing.

"...BUT this man's culture and religion supercedes that."

I just want to remember that islamic culture and religion is complex and terrorism is not the rule for all the billions of people.
Bush has made many speeches using the word "God" and we don't suppose that all Americans are following some of the religious that support the government.

Ana,

Obviously, the man doesn't represent the average American citizen who signs up to defend the country during war times.

Sigh...Of the first three listed below which HAVEN'T had radicals in the name of their religion? Does their "extremism" make them sane? Because they think God told them to do it does it make it right or serve as a reason or make them LESS mental?

# Christianity: 2.1 billion
# Islam: 1.5 billion
# Secular/Nonreligious/Agnostic/Atheist: 1.1 billion
# Hinduism: 900 million
# Chinese traditional religion: 394 million
# Buddhism: 376 million
# primal-indigenous: 300 million
# African Traditional & Diasporic: 100 million
# Sikhism: 23 million
# Juche: 19 million
# Spiritism: 15 million
# Judaism: 14 million
# Baha'i: 7 million
# Jainism: 4.2 million
# Shinto: 4 million
# Cao Dai: 4 million
# Zoroastrianism: 2.6 million
# Tenrikyo: 2 million
# Neo-Paganism: 1 million
# Unitarian-Universalism: 800 thousand
# Rastafarianism: 600 thousand
# Scientology: 500 thousand

Philip,
You know I'm crazy so I decided to use the madness prerogative and created an award.
This is the second award the first was a Life Achievement Award to Robin Willians: the Hella Heaven LAA
This is what I did for you:

http://hellaheaven-ana.blogspot.com/2009/11/philip-dawdy-independent-journalism.html

You deserve something much better but this is what I can do, always using the prerogative, of course.

I would like to invite all the nutties that admire Philip Dawdy's work to leave a comment at this post in order to promote Philip's blog and tell others about this wonderful person.

Normal people are welcome too.

:)

"The REASON they were psychotic was because they were on antidepressants. The reason Hasan, if he was on antidepressants and he probably self-prescribed them since 9/11, was psychotic was because of his antidepressant use."

1. Antidepressants don't cause psychosis.
2. You have literally just *made up* the fact that Hasan took antidepressants, right?
3. In the light of 1) and 2), you have two clearly delusional beliefs, so I decree that you are psychotic.

As for the "crazy or terrorist" question - why couldn't be both?

Has biological psychiatry wiped clean the idea that people can be driven mad? I cannot see terrorist attacks in any other light, and quite frankly, I see the US involvement in the Mideast as the catalyst of that madness. An old number, maybe two years old, estimated the number of Iraqi civilians killed in the war at one million—this in a war that is supposed to be freeing the people. It reminds me of the scene in Mars Attacks where the aliens are screaming “we come in peace” as they’re obliterating cities.
Anyone who truly believes the propaganda that we are in Iraq or Afghanistan for humanitarian motives—to free people from extremism or terror—should read some history about what our military-industrial complex has been doing in the Mideast for the since the 50s. Oh, I forgot. We are a nation without memory.
Was Hasan mentally ill? How much of a difference, if any, do we now recognize between those who “have” a mental illness, a diagnosis, on the one hand, and those who have been driven to desperate acts of violence on the other? In other words, in our biological account of mental illness, have we completely lost sight of the fact that social conditions can drive people mad? Or are we satisfied to take for granted that the cause of deviant behavior is “brain chemistry” and the cure is meds? So the problem becomes that either Hasan went crazy because he was on meds or should have been on meds, or because he was a sane but evil man, a terrorist, senselessly killing from a deluded sense of righteousness.
From what I can see, the actions of our military, which goaded Muslim extremism by upholding the despotic Shah of Iran, to name just one action, are now goading terrorism by fighting wars for bogus reasons, which a largely uninformed and brainwashed America take on faith. Even if those reasons are revealed to be bogus, the vast majority of Americans hardly object. After all, terrorist acts show us that “those people” are crazy and thus we have a right to root them out by any means the military sees fit. What rot. If you believe such bullshit, you need a lot more than meds.

Neuroskeptic, it is not true that antidepressants don't cause psychosis. Jay Cohen, a psychiatrist who is not antimeds, say this about one of his first patients on Prozac.


http://medicationsense.com/articles/july_sept_04/black_box_warnings.html


"Since the advent of Prozac in 1988, it was obvious that in some people, antidepressant medications could trigger extreme anxiety, physical agitation (akathisia), impaired thought and concentration, impaired judgment, reduced impulse control, and increased suicidal thinking and behavior. Almost as soon as Prozac was introduced, reports of these problems were swift and compelling.1-10 Although thought and memory impairment could occur with earlier antidepressants such as Elavil and Tofranil, the problems with Prozac seemed far different, far more worrisome, and more frequent. One of my first patients became psychotic after just three doses of Prozac"


Joseph Glenmullen, another psychiatrist who is not antimeds, talks about a someone in his book, the antidepressant solution, who became psychotic due to horrific reactions to SSRIS.


Here is a link to an article in a psych journal that says it definitely can occur.


http://psychrights.org/Research/Digest/AntiDepressants/DrJackson/Preda2001.pdf.


Neuroskeptic, I am curious why you keep denying that psych meds have serious side effects in spite of the evidence. Reasonable people can disagree on the frequency but your positions on this board regarding side effects are beyond comprehension. I just find it shocking that someone who calls himself a scientist would write posts like that.


By the way, to get back to the main topic, I don't feel that if the shooter was on psych meds, that was the reason for him going on s shooting spree. If he was and we don't know that for a fact, it might have pushed him over the edge but it sounds like he was bad news for many years.

I thought long and hard about leaving another comment on this subject. I asked myself whether I really cared about coming to any kind of resolution about it, one way or the other. And I found that I didn't.

This is how I see it:
1) Hasan took a gun and killed a bunch of his colleagues;
2) Erm...
3) That's it.

Yep. That's all I know. And even that's secondhand information. Everything else is conjecture, and conjecture that says more about those engaged in said speculation than it does about either Hasan, or his dead colleagues.

Based on this, all I can say is that Hasan deemed it appropriate, for whatever fucked up reason that he had, to kill a bunch of people. Put another way, he could perceive no other course than to kill a bunch of his colleagues.

If you wish to speculate, then speculate on what he was trying to achieve. I doubt very much that he killed them solely for the sake of killing them; such a lack of self-awareness must be nearly impossible. Mustn't it?

Matt

"I asked myself whether I really cared about coming to any kind of resolution about it, one way or the other. And I found that I didn't."-Matthew Holford

There has never been a requirement to mediate, except to counsel one's self.

"I asked myself whether I really cared about coming to any kind of resolution about it, one way or the other. And I found that I didn't."

Mediating one's self is the goal, then.

AA: You provide two anecdotes about SSRI-associated psychosis - anecdotes don't mean anything.

The paper is about people who presented with mania or psychosis after starting antidepressants. This does not mean the antidepressants caused them - for example "Case 3" is about a woman who developed "low mood and anxiety", was started on venlafaxine, and then became psychotic. It's entirely possible that the "low mood and anxiety" was actually the incipient psychosis and the venlafaxine had nothing to do with it... I will accept that SSRIs cause psychosis when randomized clinical trial data show that they do. They don't.

"Neuroskeptic, I am curious why you keep denying that psych meds have serious side effects in spite of the evidence."

I've never denied that psych meds have serious side effects. Chlorpromazine, for example, does. Obviously. Antipsychotics have nasty side effects in most people, I have never denied that. SSRIs however are completely different. From what many people on this board say you'd think there was no difference and all psych meds were equally bad. They're not. If you can't handle SSRIs, don't take them but SSRIs have mild or no side effects in the vast majority of people and withdrawal effects are likewise. That's why tens of millions of people take them without being forced to, as opposed to other drugs, where you have to hold people down and inject with depot preparations to get them to comply.

Please leave a comment to this post:

http://hellaheaven-ana.blogspot.com/2009/11/philip-dawdy-independent-journalism.html
there are people visiting without leaving a comment.
Please leave a comment

I think we should try to make Furious Seasons the Top 1 in all mental health or health blog's directory.
I did a review at Blogged because they have rated Furious Seasons 7,9.
Not fair. My blog is rated 7,8... not fair.

They change the grade if many people make a review and grade it 10,0

this is a call for action.
Please let's do it.
If you have any idea let us know.
I'm not very good using social networking.
I'll try anyway.
thank you.

Anonymous wrote:
"Mediating one's self is the goal, then."

Is that a statement, or a question?

In any case, you are correct: there is no requirement to mediate, which is why the world's as fucked as it is - everybody stands by, and watches powerful parties steamroller those who have neither the resources, nor confidence, to defend themselves. The standard behaviour is that people place themselves on one or other side of the argument, and a conflict ensues. As a consequence nobody appears to recognize genuine mediation for what it is (ie, it is not sufficiently "normal" behaviour to mediate for people to be familiar with it).

Back to the case in hand... Given the extreme absence of anything like a "full story," I'll paint you a picture of the environment in which Hasan was required to operate.

He was a relatively senior guy, with some authority. He belonged to two "clubs": he was an American citizen, and he was a Muslim - a difficult balancing act, in the current climate. He was required to work with men who had fought against members of one of his clubs. No doubt he was familiar with his fellow Muslims being referred to as "rag-heads," and worse. He would certainly have been aware of sexual humiliation, and so on, dealt out to prisoners at Abu G'hraib, by American (and now British, it seems), soldiers.

He may have suspected how he was viewed by those fighting men, as a consequence of his membership of the Muslim club. He may have perceived that he was viewed as "less". He may have perceived that he was viewed with suspicion. He may have been treated as less and with suspicion. Who knows? This may have gone on for some time. There was Hasan, a virtual outcast (although possibly only in his own mind), still trying to behave normally, trying to help the men who belonged to his other club. Except he perceived that they didn't want his help, because they couldn't trust him.

All conjecture, of course, and even if it's completely accurate guesswork, it was still probably going on, for the most part, in Hasan's head. And yet, given the piddling amount of information at my disposal, do you see what a compelling case I can make for Hasan? If you've ever been in a position such as the one that he was in (ie, where one's authority is completely undermined by others perception), then it's easy to see why he became violent, in the end: his own sense of self would have been completely destroyed by the experience.

Matt

The Sunday New York Times has a very good front page story on this exact topic and essentially comes to the conclusion that he was both. It implies that the descent into madness/psychosis went hand in hand with descending into a terrorist mentality. Makes sense to me. No evidence yet of psych meds.

"I've never denied that psych meds have serious side effects. Chlorpromazine, for example, does."

I checked on www.dailystrength.org/treatments and 80% of the responders liked chlorpromazine or said it was helpful.

For the SSRI Prozac, 64% said the same and for the SSRI Paxil only 55% agreed it was helpful. The SSRI Zoloft also came in at 64% but trifluoperazine., a phenothiazine like chlorpromazine, came in at 92%. Just thought you might be interested.

Sara wrote:
"...It implies that the descent into madness/psychosis went hand in hand with descending into a terrorist mentality..."

Hmmmm. These are just labels, not facts, and we would need to understand what a person must do to acquire them, before they have any kind of meaning. As such, at the very most, it is Philip's/Breggin's/The NYT's *opinion* that Hasan was a terrorist/mentally ill/whatever.

This may sound like nitpicking (and it may be), but I think it's dangerous to treat opinion as fact, and to then base further judgments and decisions on those opinions. For example, a racist may be of the opinion that a black person is inferior, which is unimportant, until the racist believes that is acceptable to hang an inferior person from a tree.

Matt

Neuroskeptic, surely you believe that SSRIs can cause mania?

Matthew Holford, I actually don't understand your point. I think both sides of this argument are using substantial pieces of evidence from his behavior to make their case. In fact I have been quite amazed at just how many details we have about this fellow from his whole life and especially his past few years. It's much more complete than the portraits we usually get of rampage shooters when we often really are stretching things to come to our conclusions. The only thing we don't know and probably never will is whether he was taking psych meds or ever, took them. I have no doubt that even taking antidepressants and God knows what else several years ago, say when his parents died and 9/11 happened, could easily have started him on a path to mental deterioration, even if he stopped some time prior to this horrific event.

Beth wrote:

"Has biological psychiatry wiped clean the idea that people can be driven mad? "

It does seem that biological psychiatry has replaced reasoned and rational thought in many places often including this thread.

Thanks Beth for bringing a bit of reason into this mostly nonsensical, politically correct, label based thread.

There's no real objective medical meaning to the term psychotic and the term terrorist is without meaning here.

The word mad implies so angry one is out of control. I think that would seem to apply to this murderer.

Sara wrote:
"Matthew Holford, I actually don't understand your point..."

I'm not making one, and neither is anybody else, as far as I can tell. I'm just playing Devil's Advocate, because Hasan isn't here to speak for himself, and because the argument is very definitely slanted in one direction, as dictated by, dare I say it, a degree of prejudice on the part of commenters (clearly I do dare say it).

You mentioned that a large number of details about Hasan's life are available for scrutiny(?). I know nothing of those, and I don't see that they would help us, anyway, unless we knew to what extent they had impacted Hasan.

Look, if you want to understand why Hasan did what he did, putting a label on him won't help you. If you don't wish to understand, then put a label on him, and then file him away in the drawer marked "evil," or whatever. I don't really care, one way or the other, as I mentioned. I'm just bored, and that's the only reason I'm commenting, now.

But I have one question for you (in my role as Devil's Advocate, of course): if America's societal system is so fucking perfect, why is it hated by so many people - surely if it was that excellent, its excellence would be apparent to one and all, and would be replicated, the world over?

Matt

NS,

How do you envisage the proper design of an RCT to elucidate whether SSRIs induce psychosis? Do you expect such a trial to pass IRB/IEC scrutiny? Which pharma company or academic group will be the first to delve into this question?

Matthew lol: "I don't really care, one way or the other, as I mentioned. I'm just bored, and that's the only reason I'm commenting, now."

Hey at least he's truthful.

I still think nuts is nuts. Arguing the definition of nuts isn't going to stop people from killing each other. Or people like Matt here from participating merely out of boredom.

Matt has not real caring about the issue -just the need to argue. He is America. Needing an attention feed and not giving a crap about the killer or the deceased. Honest. I like it.

lili wrote:
"...Matt has not real caring about the issue -just the need to argue. He is America. Needing an attention feed and not giving a crap about the killer or the deceased. Honest. I like it."

Thank you for the compliment, backhanded, as it may be! I'm not sure I actually "need" attention, though (perhaps that's a matter of opinion). It is true to say that I'll only comment for as long as somebody responds - I've reached my own point of understanding, and my choice would be to understand why he did it, except that I'm never likely to meet him, and his word is the only one that's worth anything, on that subject.

Anyway, I may have no real feelings for either "victim" or "perp" in this incident, but perhaps that leaves me better-placed. Taking sides has to be the very antithesis of mediation, after all. As is laying blame.

Matt

"Neuroskeptic, surely you believe that SSRIs can cause mania?"

Probably, in people predisposed to it, most antidepressants do. That is not the same as psychosis.

"How do you envisage the proper design of an RCT to elucidate whether SSRIs induce psychosis?"

There's no need for a trial looking at that specifically. You'd do a clinical trial of an SSRI and see if people go psychotic during treatment which would be recorded as an Adverse Event. They don't. At least not to my knowledge. They develop suicidal ideation, maybe they even have a tiny increased chance of actual suicide if you believe David Healy, but I have never seen any data suggesting people go psychotic.

FS: "Neuroskeptic, surely you believe that SSRIs can cause mania?"

NS: "Probably, in people predisposed to it, most antidepressants do. That is not the same as psychosis."

Neuroskeptic, why the assumption that people must have been "predisposed"? I'm talking about SSRIs actually causing (creating) mania where it has never been a symptom before. And wouldn't you agree that the top end of mania overlaps with psychosis just as very serious depression can become psychotis?

That was supposed to be "psychosis" at the end there.