Your piece is far more sympathetic - and I don’t mean that as faint praise (I’ve scooped things out of cat litter that were more sympathetic than Ted Nugent). But if one chooses to look for psychopathology or madness in this story, however one defines psychopathology or madness, one should be very cautious about any conclusions. If indeed this is the fault of culture, it remains unanswered why this one person should have responded so extraordinarily to what so many millions are exposed to. Surely, at some point, we must agree to move beyond the polemically convenient binary of “the biomedical” and “the social” - especially since there are very few people, very few indeed, who think that there is an either/or choice.

I fear we’ll hear calls for compulsory treatment on the pretext of pre-emptive war against America’s psychiatric enemy combatants. I fear we’ll see a an unthinking reinforcement of the biomedical model of mental disorder in the hope that “Virginia Tech Syndrome” can be identified in rogue genes and frontal cortex deficits.

Well, one might in turn respond, “I fear unthinking reinforcement of the chic notion that broad generalizations about American culture and digs at the myspace generation will be explanatory.”

Do you think that those people who would like to consider what might have been going on in Cho’s brain, and how his neurophysiology might have been affected by those social and cultural dimensions you mentioned, ought to stop doing so, lest they “unthinkingly” reinforce a model you consider insufficient? In short - given that I entirely agree with your assessment of the cultural and social milieu in which this happened, why do you appear to think that I should also entirely abandon a biomedical model, one that is at times complementary, at times contradictory, and at times - well, at times, we just don’t know?

What I fear we won’t see is a deep reassessment of the painfully isolated form of selfhood so ingrained in the American psyche, the paradigm of consciousness which runs according to Gore Vidal’s sardonic and illuminating remark that “it is not enough to succeed. Others must fail.”

I fear you are correct. Although perhaps Americans ought not look across the Atlantic for a more loving and communal form of psyche, where “we hate it when our friends become successful”. And if they’re Northern? “That’s even worse.”

I’m not sure, though, what explanatory power “individualism run amok” has in this context either; as S points out, one would need to explain why the vast majority of citizens, presumably all likewise suffering from “individualism” (what is it, exactly?), do not actually commit mass murder. Apparently some pundits have found it explanatory that Cho once played Counter-Strike, but that runs into the same problem: millions of other non-murderers have too.

I don’t object to anybody considering how Cho’s mental state might have contributed to his actions: his psychology is profoundly relevant, and I didn’t mean to imply that exploring a societal account entails an absolute repudiation of a biomedical one. This is not an either/or situation, and if my post suggests otherwise, then perhaps I was “unthinkingly” carried away by the rhetorical momentum of my advocacy for the societal component. Ultimately, it’s presumably a “perfect storm” of personal, psycopathological and social factors that interacted with such devastating consequences in Cho’s case, with no single factor per se explanatory.

That said, in terms of “individualism” (to answer Steve’s query), what I was trying to articulate here is the Hobbesian war of all-against-all in postmodern laissez faire capitalist guise amidst which I detect the American underclass increasingly finding itself forcibly engaged. In other words, what sort of level of social responsibility can we reasonably expect from the economically and ethnically marginalized? Yes, large numbers of the American poor don’t commit mass murder, but you only need to look at, say, the rate of gunshot wounds treated at San Francisco General Hospital (increased by more than 100 percent to over 200 from 2003 to 2006) and the related demographics of those involved (primarily low-income black and Latino) to note that a high level of gun violence is endemic to the US economic underclass, with biology surely only marginal as a causal factor. The American poor increasingly settle their conflicts by killing each other: this, I guess, is what I meant by my vaguely formulated “individualism run amok.” I should add that we’re dealing here with statistical propensities, rather than an explanatory criterion that would have a predictive effect at the level of every individual (Cho’s profile, for instance, isn’t entirely consistent with the underclass I’m describing), but I sense it’s the poverty-attenuated scope of the American social contract — the parameters of the self as constituted for the “losers” in a starkly polarized winner/loser capitalist culture — which, through interaction with a vulnerable mind, ends up producing Cho. When reductive, neither biomedical nor sociological explanations explain the killings sufficiently; both factors were critical drivers at Viriginia Tech, and determining how they interrelated will likely tell the story of that fateful day.

to be fair, I don’t see much risk of that occurring in the current political and cultural landscape, where the debate appears primarily driven by talk of Cho’s mental state, motive, and ready access to Glock 9mms.

Right, but to be really fair, it is surely understandable that the debate is primarily driven by talk of Cho’s mental state, motive, and ready access to Glock 9mms. If you were to wake up and discover that the debtate was about fundamental, structural causes of Cho’s actions, you would think you had been transported to another planet. Perhaps the newly discovered superearth.

Nevertheless, let me take a step back and thank you for your effort to introduce these issues; I suppose it’s unfair of me to ask you not to throw the baby out with the bathwater, when most people don’t even notice that the baby is in a bath in the first place.

How do we make sense of “American individualism”? I was sullenly listening to some people talk admiringly about the “fatalism” apparently found in “other cultures”; the chatterboxes disparaged what they called the American sense of individual responsibility - that is, vain Americans thinking they were in individual control over their lives. My argument with them was not so much their glib assessment of other cultures, to which they had varying degrees of access and intimacy - cumulatively, not much. Rather, I was annoyed by their foolhardy insistence on American individualism and lack of fatalism in the midst of a society where The Rapture looms, where nationalism is rampant, where one can talk about “minorities” and know what one means (by which I mean to invoke the centrality of race and ethnicity to American consciousness, which, at least in part, challenges simple individualism).

How can you then unpack American Individualism? Well, one must notice that much American “individualism” is a myth, one designed to mask or elide the very real presence of social structures which allowed the “individual” to achieve what he or she achieved - hence, it’s not got anything to do with you that I’m a successful capitalist with loads of money, and it has nothing to do with me that you’re living dirt-poor. The relationship between such myths and statistics is a complicated one.

what sort of level of social responsibility can we reasonably expect from the economically and ethnically marginalized?

A brave question.

the poverty-attenuated scope of the American social contract — the parameters of the self as constituted for the “losers” in a starkly polarized winner/loser capitalist culture

You are surely on to something.

Weird relevant news today: a student gets arrested for “disorderly conduct” after writing a “violent” essay for an English creative-writing assignment. Should the school officials really have called the police? Couldn’t they have got him a contract writing for 24 instead?

That logic proceeds as follows: a prisoner, believed to be too dangerous to inhabit the “general population,” moves into solitary confinement. This prisoner has made “bad choices,” which must be “corrected” through tougher conditions. The prisoner, in many cases suffering from a mental illness, reacts to the isolation of solitary confinement by becoming more enraged or experiencing a psychotic break. The guards, observing this reaction (the prisoner has made another “bad choice”) then believe that their original fears of the prisoner’s supposed danger are now fully vindicated. At the next, more violent outburst, the prisoner risks transportation to even more severe conditions. And so on. Some prisoners never leave the “control units” of these extreme facilities for decades, steadily deteriorating into chronic psychosis and rage, their only means of self-validation to hurl their own feces at the guards.

Now, in this grimly dehumanizing situation, what level of rational agency is it accurate to impute to a prisoner? Is he, perhaps facing a choice between either life imprisonment in the “general population” or intensified punishment in a “control unit,” realistically empowered to “choose” the “better” option? Or, by contrast, might there in fact for the prisoner lie some faint residue of existential strength in raging against the prison machine all the way to the very worst conditions imposable? Might the latter “choice” even feel less degrading?

Perhaps Cho, in his lifelong social alienation, had attained some such no longer tolerable limit of psychic incarceration, within which his final “choices” were nihilistically circumscribed; the killings would in this sense virtually be chosen for him…

The reason there’s so much give and take about whether Cho was ill or not, and whether he was culpable or not, has to do with what psychiatry actually is: the pressure valve of society.

Our society does not have a good mechanism for dealing with poverty, frustration, and anger. I’m not judging it, I’m not a left wing nut, I’m simply stating a fact; ours is not a custodial society, and it does little to “take care of” (different than help) these people.

So it has psychiatry, it fosters psychiatry, and it creates a psychiatric model in which these SOCIAL ills can be contained.

The inner city mom who smokes daily THC to unwind, with three kids who are disruptive, chaotic in school, etc– society has really nothing to offer her. But it can’t leave her be, because eventually there will be a full scale revolution. So it funnels her and her kids into psychiatry.

More here on my blog (when I write it)…

http://thelastpsychiatrist.com/2007/05/why_we_are_so_obsessend_with_c.html