First, people taking psychiatric drugs rarely realize how much the drugs are impairing them mentally or emotionally. They often do not recognize that they’ve become irrational, depressed, angry, or even euphoric since beginning the medication.

Second, if they do realize that they are having painful emotional feelings, medication spellbinding causes them to blame their feelings on something other than the drug. They may get angry at their husbands, wives or children, and become abusive. Or they might blame themselves and become suicidal. Often they confuse the harmful drug effect with their emotional problems and attribute their emotional distress to “mental illness.”

Third, medication spellbinding makes some people feel that they are doing better than ever when in reality they are doing much worse than ever. In one case, a man who was high on a combination of an antidepressant and a tranquilizer happily went on a daylight robbery spree in his hometown wearing no disguise. Another otherwise ethical citizen happily embezzled money while documenting the details in easily accessible company computer files. Both men thought they were on top of the world.

Fourth, some people become so medication spellbound that they lose control of themselves and perpetrate horrendously destructive actions. My book opens with the story an otherwise kind and gentle man who became agitated on an antidepressant and drove his car into a policeman to knock him down to get his gun to try to kill himself. In another case, a ten-year-old boy with no history of depression hung himself after taking a prescription stimulant for ADHD. He documented the dreadful unfolding events while speaking in a robotic monotone into his computer.

According to journalist and author Robert Whitaker, after the failed suit against Breggin, Eli Lilly—one of NAMI’s largest corporate sponsors from the group’s inception— reputedly began making anonymous donations and guiding media attention to a very different type of organization, a then obscure California religious group called Scientology. Scientology, as the story goes, didn’t look the gift horse in the mouth and soon became the symbol of coercive pseudoscientific cults in the US—the “devil” which the drug industry needed in order to erect a good and evil binary and counterpart to the “angel” of its consumer front beneficiaries. Frau Koma only deals in black and white —except when shades of gray are needed to couch moral relativism. 

Scientology would not have been chosen as a target because it was the most dangerous alternative religion in that era of high profile violent and suicidal cults. But the group conveniently embodied “anti-psychiatry”: Scientology claimed to offer a form of therapy for mental suffering by way of earthly transcendence and seemed to view organized psychiatry as competition. Industry might also have noted that Scientology offered a drug-free reverse parallel for its own utopian marketing approach, promising the public a future paradise on earth free from disease, pain, suffering, violence and fear in exchange for uncritical faith in commercial science and the wonders of modern chemistry— while Scientology offered this through commitment to the church’s rites and practices. In any case, Lilly and Company likely recognized the potential to build up a straw-man target on which to project its own “sins” and as a means to silence critics like Breggin by generating associative cult smears in the media it sponsors.

Between 1988 and 2007, use of antidepressants in the US has risen by 400%, a fact which drug proponents claim is due to “increased recognition” of mental illness. But increased prescribing has not brought with it the expected improvement in mental health among Americans: instead, the rate of mental disability has increased nearly two and a half times between 1987 and 2007—from 1 in 184 Americans to 1 in 76. For children, the rise is far more staggering—the number of children so disabled by mental illness that they qualify for SSI and SSDI has risen 35-fold in the same two decades. Antidepressants are currently the third most common drugs prescribed to Americans 12 and older.

If there’s any basis to rumors of Eli Lilly’s straw-man-engineering, it was unquestionably a brilliant strategy. For twenty years—until the Zyprexa Papers Scandal in 2007 exposed Lilly’s fraud, spurred on Senator Grassley’s investigations, resulted in billions paid out in injury suits and took the wind out of the tactic—anyone who publicly criticized the safety or efficacy of mental health drugs or the integrity of industry, no matter how independent or credentialed, was instantly accused of being part of a cult and, for the purposes of public credibility, effectively censored. Frau Koma is clever. 

About the device: “Koma“ is “amok” spelled backwards; amok—as in “to run amok.” “Amoklaufen” is the German expression for “spree-killer.” After a mass shooting at the Johannes Gutenberg Gymnasium in Erfurt, Eastern Germany in 2002, police developed a new emergency code for school shootings—“Frau Koma kommt”—“Frau Koma is coming.” The code was activated again on March 13^th, 2009, the day that 17 year old student Tim Kretschmer rampaged through a school in Winnedon, Germany, killing 13 and then himself.

The term “amok” isn’t exactly new. After the Dutch East India Company began shipping 100 tons of opium a year to Indonesia in the 17^th century during the first and lesser-known Opium War to pacify the region, “amoklaufen”— derived from the Javan “amoak” or “kill”— was popularized by colonists who began observing random mass stabbings perpetrated by opium-crazed Malayans. Without making reference to opium or its source, Rudyard Kipling first used the term “run amok” in English to describe rampaging Malayans  who would senselessly hack through crowds with daggers until they were either subdued and killed or took their own lives according to historical accounts.

This type of crime— non-ideological mass killing, mostly performed outside a combat zone by an individual who is not acting as part of a militant group, who is motivated neither by specific sexual nor financial incentives, who most often has no extended history of criminality or serious mental disturbance and who uses no stealth in covering the evidence of their crimes which are frequently committed in public or broad daylight—also isn’t precisely new, though the explosive prevalence of it in developed countries is. Although the stated motive just prior to many mass killings has often been a bizarre generalized grudge or a contradictory hash of recently adopted political-sounding views, these individuals will attack strangers or groups of people with little relevance to their irrational complaints if any are even expressed. Though they may function enough to systematically and robotically plan an assault, the modern non-ideological “massacrist” doesn’t engage in the escape strategies expected of an addictively compulsive killer who wishes to remain free to kill again.

Even in certain mass killings committed by active duty members of the military, a breach in historical pattern has emerged. Because of consistent media misreporting on the history of the Mai Lai massacre and other atrocities during Vietnam, this might not seem the case. But, according to linguist and political media analyst Noam Chomsky,  Mai Lai was not a rogue act by servicemen going against orders as it’s been portrayed. Instead Chomsky refers to Mai Lai as simply a “footnote” of the Post-Tet “Accelerated Pacification” campaign which systematically and by design killed over 10,000 civilians in Vietnam in 1968. What happened in Mai Lai was intentional and approved and, in military history, it isn’t unusual.

But when Staff Sergeant Robert Bales killed seventeen Afghan civilian adults and children while they slept in their beds and set several on fire in March, 2012, he was not acting on even inferred orders at that moment but against them. There was no machinery in place to cover up or shift around responsibility for the horrific events as there has been for planned atrocities like Mai Lai or Abu Ghraib. He acted alone, not as part of classic “deindividuated violence” (Phillip Zimbardo, 1969) performed by mobs which are typically very attuned to “group think” and guided by ideological authority according to Canadian forensic psychologist Donald Dutton. Unlike serial murderers, Bales made no attempt to cover his tracks. And the media began investigating reports that Bales may have taken Lariam, the anti-malarial drug which Dan Olmstead and Mark Benjamin investigated in 2002 in association with a spate of domestic murder-suicides among members of the military. As Olmsted noted, the Lariam killers lacked histories of escalating violence typical in lethal domestic assaults.

Lariam and other medications commonly prescribed to military personnel have recently been the focus of Congressional inquiry due to the unprecedented one-a-day suicide rate among service people, a statistic which is all the more disconcerting since prospective recruits must pass screens for mental illness before enlisting. Obviously there’s been an enormous lag in undertaking the investigation by war machinery responsible for using its ranks as clinical guinea pigs by widely prescribing powerful medications to patch up battle-fatigued combatants rather than relieving them of duty. Peter Breggin, testifying this time before the Veterans Affair Committee in February, 2010, painted a chilling picture of suicidal and violent psychoactive drug reactions that have been covered up by pharmaceutical companies for decades.

If some believe the traumas of war alone explain Bales’ rampage and suicides among military personnel, it’s unclear why military suicide rates are currently so much higher than during Vietnam and 3-fold higher than during the American Civil War. Moreover, there’s very little evidence that psychiatric drugs help to heal traumatic response. In fact, as reported in journalist Robert Whitaker’s website, Mad in America, a recent study found that the drugs may be specifically counterproductive in the treatment of trauma:

Bruce McEwen and Joseph LeDoux, whose pioneering research in eliminating fear-related memories opened up new avenues for the potential treatment of post-traumatic stress disorder, show in research published in Biological Psychiatry on December 20, 2012 that chronic treatment with citalopram (selective serotonin inhibitor Celexa) or tianeptine (selective serotonin reuptake enhancer Stablon) impairs amygdala-dependent learning and consequently the ability to learn new responses to fear-related stimuli and to unlearn conditioned fear responses. 

And how would the extreme trauma of war explain the same upsurge in bizarre violence and suicide among civilians living far from combat zones? Like 19 year old Gutenberg killer Robert Steinhauser, teen shooter Tim Kretschmer of Winnedon had recently taken medication which contained black box warnings for violent behavior and suicide. Like Kretschmer, Steinhauser killed himself as police closed in.

Though Steinhauser’s post-mortem tox screen showed an absence of drugs or alcohol, just prior to his death he’d confessed in an interview to dabbling with the painkiller Tilidine and LSD, both of which can have lingering psychiatric effects after withdrawal.  Tilidine is associated with aggression and violent behavior in human and animal studies. In fact, researchers found the carcinogenic effects of Tilidine difficult to study because most male lab animals exposed to the drug would die from aggression and mutilation.  Police in Germany have found that an abnormal amount of force is often needed to subdue suspects under the influence of the drug due to an almost total lack of pain response. Pepper spray reportedly has no effect.

Because Tilidine is banned in the US, it might seem irrelevant to the rise in certain types of American violence. But like SSRI antidepressants and LSD, Tilidine is associated with lack of atonic paralysis in REM sleep: those under the influence may act out their dreams. Dreams experienced on these drugs are frequently reported to be violent and terrifying—another effect associated with Lariam.  Suspension of REM sleep atonia has been tied to inexplicably violent acts.

Following the Erfurt and Winnedon shootings, the media response in Germany ranged from calling for stricter gun controls, bans on violent video games, screening students for mental illness to throwback conjectures about Hoover Era Manchurian candidate schemes. This has always been the response. A list of prescription drug-associated murders and suicides (compiled from several online sources and the website SSRI Stories):

1. Huntsville, Alabama – February 5, 2012: 15-year-old Hammad Memon shot and killed another Discover Middle School student Todd Brown. Memon had a history for being treated for ADHD and depression. He was taking the antidepressant Zoloft and “other drugs for the conditions.”
2. Pittsburgh, Pennsylvania – March 8, 2012: 30-year-old John Shick, former patient of University of Pittsburgh Medical Center (UPMC) and former student at nearby Duquesne University, shot and killed one and injured six inside UPMC’s Western Psychiatrist Institute. Nine antidepressants were identified among the drugs police found in Shick’s apartment.
3. Seal Beach, California – October 12, 2011: Scott DeKraai, a harbor tugboat worker, entered the hair salon where his ex-wife worked, killing her and seven others and injuring one. At DeKraai’s initial hearing, his attorney indicated to the judge that DeKraai was prescribed the antidepressant Trazodone and the “mood stabilizer” Topamax.
4. Lakeland, Florida – May 3, 2009: Toxicology test results showed that 34-year-old Troy Bellar was on Tegretol, a drug prescribed for “bi-polar disorder,” when he shot and killed his wife and two of his three children in their home before killing himself.
5. Granberry Crossing, Alabama – April 26, 2009: 53-year-old Fred B. Davis shot and killed a police officer and wounded a sheriff’s deputy who had responded to a call that Davis had threatened a neighbor with a gun. Prescription drug bottles found at the scene showed that Davis was prescribed the antipsychotic drug Geodon.
6. Middletown, Maryland – April 17, 2009: Christopher Wood shot and killed his wife, three small children and himself inside their home. Toxicology test results verified that Wood had been taking the antidepressants Cymbalta and Paxil and the anti-anxiety drugs BuSpar and Xanax.
7. Concord, California – January 11, 2009: Jason Montes, 33, shot and killed his wife and then himself at home. Montes had earlier begun taking the antidepressant Prozac for depression in response to his impending divorce and a recent bankruptcy.
8. Little Rock, Arkansas – August 14, 2008: Less than 48 hours after Timothy Johnson shot and killed Arkansas Democratic Party Chairman Bill Gwatney, the Little Rock Police declared they were investigating shooter’s use of the antidepressant Effexor, which was found in Johnson’s house. A Little Rock city police report later stated that Johnson “was on an anti-depressant and that the drug may have played a part in his ‘irrational and violent behavior.’”
9. Kauhajoki, Finland – September 23, 2008: 22-year-old culinary student Matti Saari shot and killed 9 students and a teacher, and wounded another student, before killing himself. Saari was taking an SSRI and a benzodiazepine.
10. Dekalb, Illinois – February 14, 2008: 27-year-old Steven Kazmierczak shot and killed five people and wounded 21 others before killing himself in a Northern Illinois University auditorium. According to his girlfriend, he had recently been taking Prozac, Xanax and Ambien. Toxicology results showed that he still had trace amount of Xanax in his system.
11. Omaha, Nebraska—December 5th, 2007: 19-year-old Robert Hawkins had been taking antidepressants before he killed eight and then himself in an Omaha shopping mall. Hawkins had reportedly taken Zoloft and Ritalin since age five.
12. Jokela, Finland – November 7, 2007: 18-year-old Finnish gunman Pekka-Eric Auvinen had been taking antidepressants before he killed eight people and wounded a dozen more at Jokela High School in southern Finland, then committed suicide.
13. Cleveland, Ohio – October 10, 2007: 14-year-old Asa Coon stormed through his school with a gun in each hand, shooting and wounding four before taking his own life. Court records show Coon had been placed on the antidepressant Trazodone.
14. Blacksburg, Virginia—April 18, 2007: 23 year old Seung Hui Cho kills 32 and himself at Virginia Tech; according to The New York Times, “prescription medications related to the treatment of psychological problems had been found among Mr. Cho’s effects.” Cho had taken Paxil (Paroxetine) as a child. Cho’s medical records were sealed by court order against the protests of victims’ surviving family members.
15. Nickel Mines, Pennsylvania—October 2, 2006: Charles Carl Roberts murdered five Amish girls and then himself. His family reported that he took antidepressants.
16. Platte Canyon, Colorado— December 27, 2006: 53-year-old Duane Morrison claimed he had a bomb when he entered Platte Canyon High School. He held hostage and sexually assaulted six female students and killed one before killing himself. Antidepressants were found among his effects.
17. Red Lake, Minnesota – March 2005: 16-year-old Jeff Weise, on Prozac, shot and killed his grandparents, then went to his school on the Red Lake Indian Reservation where he shot dead 7 students and a teacher, then wounded 7 before killing himself.
18. Greenbush, New York – February 2004: 16-year-old Jon Romano walked into his high school in east Greenbush and opened fire with a shotgun. Special education teacher Michael Bennett was hit in the leg. Romano had been taking “medication for depression”.
19. North Meridian, Florida – July 8, 2003: Doug Williams killed five and wounded nine of his fellow Lockheed Martin employees before killing himself. Williams was reportedly taking the antidepressants Zoloft and Celexa for depression after a failed marriage.
20. El Cajon, California – March 22, 2001: 18-year-old Jason Hoffman, on the antidepressants Celexa and Effexor, opened fire on his classmates, wounding three students and two teachers at Granite Hills High School.
21. Williamsport, Pennsylvania – March 7, 2001: 14-year-old Elizabeth Bush was taking the antidepressant Prozac when she shot at fellow students, wounding one.
22. Wakefield, Massachusetts – December 26, 2000: 42-year-old computer technician Michael McDermott had been taking three antidepressants when he hunted down employees in the accounting and human resources offices where he worked, killing seven.
23. Honolulu, Hawaii—November 2, 1999: Gunman Bryan Uyesugi entered a Xerox Corporation building armed with a Glock, killing seven coworkers. Widows of the slain attempted to sue Kaiser Permanente for failing to monitor Uyesugi, who was reportedly treated with antidepressants by a psychiatrist at the medical center.
24. Conyers, Georgia – May 20, 1999: 15-year-old T.J. Solomon was being treated with antidepressants when he opened fire on and wounded six of his classmates.
25. Columbine, Colorado – April 20, 1999: 18-year-old Eric Harris and his accomplice, Dylan Klebold, killed 12 students and a teacher and wounded 26 others before killing themselves. Harris was on the antidepressant Luvox. Klebold’s medical records remain sealed.
26. Notus, Idaho – April 16, 1999: 15-year-old Shawn Cooper fired two shotgun rounds in his school, narrowly missing students. He was taking a prescribed SSRI antidepressant and Ritalin.
27. Fort Worth, Texas—September 15th, 1999: 47-year-old Larry Gene Ashbrook shot and killed eight, including children, and then himself at the Wedgewood Baptist Church. A prescription bottle for Prozac with Ashbrook’s name on it was found at the gunman’s home.
28. Springfield, Oregon – May 21, 1998: 15-year-old Kip Kinkel murdered his parents and then proceeded to school where he opened fire on students in the cafeteria, killing two and wounding 25. Kinkel had been taking the antidepressant Prozac.
29. Moses Lake, Washington—February 2nd, 1996: 14 year old Barry Dale Loukaitis entered Frontier Middle school, shooting an algebra teacher and two students. Loukaitis had reportedly been prescribed Ritalin for hyperactivity. Loukaitis is currently serving two life sentences and an additional 205 years.
30. Dunblane, Scotland—March 13, 1996: 43-year-old Thomas Hamilton entered the Dunblane Primary School armed with four handguns, shooting and killing 15 children, one adult and then himself. According to a local inquest, Hamilton had been prescribed Prozac.
31. Louisville, Kentucky– September 14, 1989: 47-year-old Joseph Wesbecker, pressman for the Standard Gravure Company, entered his place of work, killing eight and then himself. He had recently begun taking the antidepressant Prozac. Surviving families of several victims attempted to sue Eli Lilly.
32. Austin, Texas—August 1st, 1966: 25-year-old gunman Charles Whitman, addicted to amphetamines, suffering from a brain tumor and severe migraines for which he may have been prescribed one of the new MAOI inhibitors, killed his mother and wife, then climbed the tower at the University of Texas at Austin wounding 49, killing 14 and then himself.

In Japan, which has the most stringent gun control in the democratic world, Japanese bloggers and journalists have called for investigations into a spate of psychiatric drug-related knife attacks:

• 2001, Ikeda, Osaka, man kills eight children with small knife
• 2003, Uji City, Kyoto Prefecture, child stabs man twice
• 2005, Chiba Prefecture, man with knife enters high school, attacks officials
• 2005, Neyagawa City, Osaka Prefecture, boy with knife kills teacher, two officials, wounds several.

“Knife Rampage” is the new expression in Japan for an increasingly common category of crime. Frau Koma is cosmopolitan and doesn’t rely solely on firearms.

And then there was Aurora, Colorado. According the Goldwater Rule or Section 7.3 of the American Psychiatric Association’s ethics principles, psychiatrists are forbidden from commenting on individuals’ mental states without examining and being authorized by the individuals to diagnose them. But this hasn’t stopped a bevy of newscasters, print journalists, armchair experts and even psychiatric professionals from theorizing on 24 year-old shooter James Holmes’ mental status after he gunned down 12 and wounded 58 at the Century 16 movie theater on July 20th, 2012. Some blamed genetic psychosis coupled with access to guns or violent videos or have turned the Aurora massacre into a political football, conjecturing that Holmes was involved with the Tea Party or the Occupy Movement.  It’s not surprising that those populations which are being associatively smeared in the course of the diagnostic frenzy are then driven to defend themselves by reframing the dialogue.  Though none of it has gotten network coverage, psychiatric reform groups have not been shy in protesting that the investigation too quickly discounted psychiatric drugs with black box warnings for violence and suicide and, for the first time,  so have defenders of the right to bear arms.

The truth may never come out. Holmes’ files were sealed by court order, just as in the case of Virginia Tech’s Seung Ho Cho and Columbine’s Dylan Klebold.

An Arapahoe County Court judge has granted a request to seal the case against James Holmes, the 24-year-old shooter who killed 12 and wounded 50 during a screening last night of “The Dark Knight Rises.” The motion, filed in Arapahoe County court, asks for the records in the case to be sealed, including search warrants, affidavits, orders and the “case file.” The District Attorney’s affidavit says prosecutors are investigating first-degree murder charges against Holmes, but that disclosure of the court records would be “contrary to public interest” and “could jeopardize the ongoing investigation.”

The necessity of the seal could be argued as due to Holmes’ background, which, at least on the face of it, provides some good fodder for conspiracy theories. A cloak-and-dagger report states that Holmes interned at the Salk Institute just after the institute had partnered with the Defense Advance Research Projects Agency (DARPA) to investigate the use of an antioxidant found in cocoa as a blood flow increasing agent to prevent combat fatigue as part of a larger project to develop brain-machine interfaces for the battlefield. Holmes’ father, identified as statistician Dr. Robert Holmes, was also apparently professionally enmeshed with DARPA when a company he works for— HNC Software, Inc., now the Fair Isaac Corporation (FICO)— developed a “cortronic neural network” allowing machines to respond like the human brain to aural and visual stimuli. Holmes’ grandfather, Lt. Colonel Robert Holmes, was a language expert with the army and may have worked in intelligence.

But unless Holmes’ internship involved enrollment as a test subject for top secret military experiments, it seems unlikely that Holmes’ medical records had much to do with the 8 week summer program at Salk for college bound teens. One Salk scientist claimed Holmes should never have been admitted to the program since Holmes was merely an “average” student.

During the OJ Simpson trial, American media viewers were privy to Simpson’s every pill and pang in prison. These types of seals in capital murder cases are a new phenomenon and there’s another potential explanation for the lockdown on Holmes’ medical history:  despite claims that Holmes was not on drugs during his “sleepy” performance in trial,  reports emerged that Holmes took prescription Vicodin and that his psychiatrist, an assistant professor at Colorado University’s Anschutz Medical Campus in Aurora, Dr. Lynne Fenton, had been reprimanded by the state board in 2005 for illegally prescribing herself, her husband and an employee drugs such as Vicodin, Xanax, Ativan and Ambien, all of which are associated with REM sleep disturbance, violent dreams and sudden acts of extreme violence. As it turns out, up to three psychiatrists at the university may have treated Holmes prior to his crime. It’s interesting that the law firm which the university hired to shield Fenton and perhaps other mental health practitioners on staff,  Wells Anderson and Race, has professional ties to GlaxoSmithKline, maker of the antidepressants Paxil and Wellbutrin; and Bristol-Myers Squibb, maker of the atypical antipsychotic Abilify—all of which are also clinically associated with violent personality changes.

Torrence Brown, one of the victims of the Aurora shooting, filed suit  in July against three defendants: the Aurora Century 16 theater for leaving an exit door unguarded and without alarms; Warner Brothers for releasing a film so violent that theater goers could not immediately register that Holmes’ assault was not part of the movie; and Holmes’ prescribing doctors at Colorado University’s Anchultz Medical Center for not properly monitoring Holmes’ prescription drug use. Though Brown was uninjured, he claims extreme emotional trauma after his friend, 18-year-old A.J. Boik, was shot in the chest and killed in the attack.

It’s unclear how the seal on the case will effect injury suits. Could “contrary to public interest”— the justification for concealing Holmes’ medical records— be interpreted as: “people would stop taking their mental health drugs on hearing what Holmes was prescribed”? This was NAMI’s grounds for suing Breggin in the 1980’s and appears to be unwritten policy at the National Institute of Mental Health. The NIMH has remained mum on the association between violence and psychotropic drugs in the wake of every high profile mass killing, even in the many instances when prescription drug use of perpetrators was established fact.

Information blackouts tend to only fuel controversy. Behind a seal, anything is possible and, stemming from the Aurora tragedy, as in the German school shootings, there are continuing conjectures that Holmes was a hypnotized “Manchurian candidate,” on street drugs or that, like Bell Tower killer Charles Whitman, Holmes might suffer from a specific brain disease.

The drug link might not be immediately apparent from the Whitman Bell Tower case in 1966: Though the amphetamines which Whitman was reportedly addicted to had long been known to induce psychosis in adults, the synthetic form of ephedrine was discovered in 1887 and had been marketed in the US since 1933—yet Whitman set the general precedent for “school shootings” in the US. So it’s curious that no one has ever investigated whether Whitman had been prescribed other drugs by his psychiatrist (he was seeing one), such as the then-new beta-blockers which, by 1966, had become standard treatment for the “horrendous” migraines Whitman suffered due to an undiagnosed brain tumor. Beta-blockers can induce schizophrenia-like psychosis in some individuals and are contraindicated in combination with stimulants. In between killing his mother and wife and then committing the massacre at the University of Austin, Whitman left a note in his home requesting that money from his life insurance plan be donated to a mental health foundation to prevent “further tragedies of this type.” Whitman also requested that an autopsy be done after his death to investigate whether anything could explain his actions and worsening migraines.

All told, what’s especially disturbing about the Bell Tower case is that it may have taken a combination of older class prescription and illegal drugs, dysfunctional family history and brain tumor to generate an approximation of the rage, dementia and robotic planning involved in modern mass assaults which are frequently linked to only a single newer class prescription medication. This would lend to conjectures that a particularly modern type of prescription drug psychosis could be the common denominator in this type of relatively modern killing.

Although the seal on the Holmes case means the public won’t know the facts any time soon—or at all as in the case of the other crimes mentioned above— for the moment it appears that James Holmes, the formerly timid, “mediocre” student with no history of violence, fits a pattern.

Frau Koma is like the Statue of Liberty—always welcoming to the wretched refuse of our teeming shore:  the lonely, the tired, the sick, the shy, the toxically injured and the career-tracked grad student who doesn’t question the scientific establishment they aspire to. In an article entitled Gunman who massacred 12 at movie premiere used same drugs that killed Batman star Heath Ledger the Daily Mail straddles an uncomfortable fence between drug-induced Jekyll/Hyde transformation and genetic apologia:

Sumit Shah, a friend at Westview High School in San Diego, said: “Jimmy was pretty shy but once he got comfortable with you he was the funniest, smartest guy. The guy I knew was harmless.” Experts believe it is more likely that Holmes was suffering from a genetic psychotic illness which could have acted like a ‘time bomb’ set to go off any time between the ages of 15 and 25.

The killings in Aurora nearly overlapped a pre-election Heritage Foundation conference in which then-Romney administration hopefuls E. Fuller Torrey and former Bush appointee Sally Satel presented a thinly euphemized argument  for forced institutionalization and drugging of the mentally ill, mixing the message with a states’ rights platform. Frau Koma has a sense of humor.

E. Fuller Torrey, author of The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens, has long promoted mandated drugging for “at risk” populations. But it’s really Satel—the PR maven with the beltway flare—who’s particularly ominous. Satel is a science board alum (along with Paul Offit, Michael Fumento, Steven Novella, Breggin-nemesis Stephen Barrett of “Quackwatch,” and Skeptic Magazine editor Michael Shermer) for the corporate front group ACSH, the American Council on Science and Health. ACSH promotes and defends GMO’s, pesticides, drugs, food coloring, vaccines, military funding of academic science, etc., for corporate and institutional sponsors. On a “stopped clock” model—or like E. Fuller Torrey’s occasional ironic, credence-grubbing criticisms of psychiatry’s drug industry conflicts— ACSH decided to champion global warming warnings and to reverse its original Big Tobacco loyalty to an anti-tobacco message. Otherwise the group has never met an industrial agenda or product it didn’t like.

Satel was appointed by President Bush to the National Advisory Council (NAC) for the US Center for Mental Health Services (CMHS), presumably to carry out Bush’s vision for the Orwellian New Freedom Commission on Mental Health which sought to screen all Americans for mental illness. The New Freedom Commission championed the grossly corrupt Texas Medication Algorithm Program (TMAP), one of the model programs which increased child drugging in some states in which it was instituted by up to 100% in under a year. TMAP was funded by Janssen, Johnson & Johnson, Eli Lilly, Astrazeneca, Pfizer, Novartis, Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott, Bristol Myers Squibb, what was then called Wyeth-Ayerst (now part of Pfizer) and Forrest Laboratories. Satel also promoted Teenscreen, the Columbia University mental health screening program launched in public schools across the country in 2003 which boasted an 84% false positive rate in identifying teen “suicidality.”After 9 years of routing children to psychiatric treatment, the Teenscreen program finally met its demise in November, 2012.

Satel is also a “counterinsurgency” missionary– the go-to media mouthpiece for generating PR strategies to defeat and silence pharmaceutical critics. In 2002, Satel stated flatly that there was an “overemphasis” on patient “rights” that “people need to be protected from themselves” and that often “coercion” is essential. Advocates who attended the recent conference consistently reported that Satel made the aside that the mental health system needs a “strong dose of paternalism.”

When she was in power under Bush, Satel was considered one of the more chilling pharmaceutical operatives by consumer and reform advocates because of her skilled doublespeak in promoting mental health screening and drugging across political lines. All the same, the barely disguised racism in some of her published work and her record on ECT and mandated treatment tend to belie her equal opportunity cover. In PC, M.D.: How Political Correctness is Corrupting Medicine, Satel bitterly complains about the political pressure on medical and mental health practitioners to spout egalitarian open-mindedness. More recently, in a NYT’s opinion piece, Satel pretends a temperate approach that she has never once displayed when she formerly guided policy, though the real Satel  comes through: In the Times, her only remark about the new DSM autism category is that those with higher functioning forms of autism don’t like being lumped with the “intellectually impaired.” She fails to mention that a majority of individuals with autism, including low functioning, will lose the label under the new DSM recommendations and will be herded into newly devised diagnoses like Social Communication Disorder, a label which has already been intensely targeted for corresponding drugs with the usual deadly side effects.

Reading between the lines of the language used in the Heritage Foundation video presentation, when Satel talks about the 1% of the “severely mentally ill” who will be denied a say in their treatment under the proposed program, she is referring to a population which is exploding. And that’s not including the “tsunami” of children with autism aging into the adult mental health system. According to bastions of radicalism like the U.S. Census Bureau and Social Security, rates of disabled mental illness have risen 100 fold in 150 years, with huge leaps in prevalence corresponding to broadening use of various pharmaceutical products (From Robert Whitaker’s Anatomy of an Epidemic, table from page 25):

As Whitaker points out, the irony of the above statistics is that E. Fuller Torrey himself originally compiled them for his 2001 book The Invisible Plague— though Torrey does not blame pharmaceutical age practices for the mass decline of mental health in the US. Even so, Torrey himself is not Frau Koma.

And Satel, as much as she represents the corruption and fanaticism of organized psychiatry and commercial science, is not the sole ultimate embodiment of Frau Koma either. “Frau Koma” is non-partisan. Less than two months after the Columbine massacre, President and First Lady Clinton arranged the first Whitehouse Conference on Mental Health in which they trotted out Satel’s partisan psychiatric counterpart Harold Koplewicz who called for mandatory mental health screening and intervention on children and teens in response to the tragedy. Teenscreen was one of the programs that arose from this edict. Koplewicz was more recently the force behind the controversial NYU “ransom notes” billboard campaign, a fear-mongering dragnet to bring children in for treatment.

What Koplewicz intended by way of intervention and “treatment” was explicit: for decades, reform psychiatrists have identified Koplewicz as among the most radical proponents of drugging children, consistently claiming that mental disorders cannot be caused by rape, violence, trauma or abandonment unless the child has a “preexisting” genetic brain chemical imbalance that requires medication lest children prove “detriments” to themselves and society.  At the White House conference, Hilary Clinton—clearly under the influence of Koplewicz but also driven by her own faith in technological progress— vowed that these supposedly at-risk children would get treatment “whether or not they want it or are willing to accept it” (Breggin, Talking Back to Ritalin, pp. 18-19) and that the program would be enforced through public schools.

Koplewicz was a co-author of the infamous Paxil 329 study which was retracted when it emerged that authors minimized suicide-related adverse events by fivefold and grossly overstated the efficacy of GlaxoSmithKline’s blockbuster in the treatment of adolescents. This study also fell under the scrutiny of Iowa Republican Senator Charles Grassley in the course of his ongoing investigation for the US Senate Finance Committee. It was one of a slew of industry conflicted studies attempting to defend child prescribing practices against mounting evidence that these medication increase violence, suicide, alcohol and other drug abuse and were associated with worsening long term outcomes for patients as they reached adulthood. Grassley’s investigation focused on “millions in undisclosed payments” flowing between psychopharmaceutical makers and “key opinion leaders” in the field of child psychiatry.

Koplewicz remains a “key opinion leader” and continues to claim that Virginia Tech could have been prevented by forced treatment with the very drugs  repeatedly linked to these crimes. Advocacy attorney Jim Gottstein recently wrote about the impact of this brand of dogma on public views in an op-ed for Pharmalot:

I think it is important to understand a couple of pervasive public attitudes that shape the setting. One is that we need to lock up people diagnosed with mental illness and make sure they take their “medications” to keep them from going on killing rampages. The truth, however, is that both of these approaches, especially psychiatric drugs, increase rather than decrease violence. People diagnosed with serious mental illness are no more likely to be violent than is the general population, if one takes into account the impact of psychiatric drugs. They are far more likely to be victims of violence than to be perpetrators. For some research on this, click here. For a recent article on how neuroleptics (misnomered “antipsychotics”) might be causing this violence, click here.

To the extent that victims of Columbine, Virginia Tech and similar “inexplicable” modern mass killings back to the Bell Tower murders have been turned into logos to peddle a coercive treatment model, they remain publicly unhonored and undistinguished by the actual collective meaning of their deaths. For a very blunt example of this, the victims of drug-addled killers are never added up within the FDA’s Medwatch database list of drug deaths and injuries. The website SSRI Stories provides a database by which a death toll could be tallied, though the site is limited to the minority of accounts in which the antidepressant use of perpetrators (other classes of psychoactives aren’t included) actually made the news.

Enough time has passed for key facts to be confirmed regarding many civilian mass crimes. There are more and more victims every year, yet the nature of the acts is never officially acknowledged. From Berthold Brecht:

When evil-doing comes like falling rain, no body calls out ‘stop!’
When crimes begin to pile up they become invisible.
When sufferings become unendurable the cries are no longer heard.
The cries, too, fall like rain in summer.

Sadly the same may be true of those who died in Aurora in the summer of 2012.  Will anything emerge before their names are dropped from public memory? Jessica Ghawi, six year-old Veronica Moser-Sullivan, Alex Sullivan, Micayla Medek, Jesse Childress, Gordon W. Cowden, Rebecca Ann Wingo, Alexander J. Boik, Matt McQuinn, John Larimer, Alexander C. Teves, Jonathan T. Blunk.

The intense but carefully edited media attention on Aurora killer James Holmes’ persona, methods and possible motives has set off protests that the focus should rightfully be on those who were injured or killed. But at least four— McQuinn, Larimer, Teves and Blunk—  died defending others. There were probably more among the dead and injured who did the same.

Would those who risked or gave their lives for other people object to a search for interpretations that might prevent a repeat of the same tragedy? Survivors and the bereaved are also victims and might be traumatized by the discussion, but when those who are supposed to inquire in depth do not, it’s left to those left behind. This is often a reality in the wake of politicized tragedy.

For better or worse, there’s no question that non-ideological modern massacres, while they are not political, have been politicized. For worse, as illustrated earlier, the tragedies have become partisan footballs and industry selling points. But politicization may be unavoidable in attempting to understand the tragedies from an individual perspective, in terms of social response and within a framework for why they occur and continue.

Since so much modern psychological and social research on mass atrocity arises from epic events in the last century, in Hope and Memory, philosopher Tzvetan Todorov studies the social impact of a search for meaning among survivors of 20^th century crimes against humanity. Todarov questions whether victims should ever be forced to analyze their perpetrators because “Understanding relies on some degree of identification with the perpetrator (be it partial and temporary), and that could be highly damaging for a victim.” But the author also argues that, as bystanders to evil, we can’t equivocate “understanding” with “justifying” in order to avoid the task of comprehending the acts because “The whole modern apparatus of modern criminal justice is based on a quite different premise. Murderers, torturers, and rapists must pay for the crimes to be sure. But society does not only punish the criminals; it also seeks to understand why the crimes were committed and to take appropriate action to prevent their recurrence…No crime is ever the automatic consequence of a cause. Understanding evil is not to justify it.”

In the same book, Todorov also analyzes the ideological cults of science which gave rise to horrific events in the past century. In attempting to grasp the causes and consequences of more modern atrocities, there may be a very limited but still unavoidably politicized analogy to twentieth century totalitarian violence within a supposition that so many of the high profile killings could have involved drugs with black box warnings for radical personality change and violence: Those searching for answers 1) may be forced to contend with the “science” justifying a power apparatus which encouraged or even forced certain perpetrators to take particular actions which led to the destruction of lives; and 2) they may be forced to struggle with the relative guilt of those who might claim to have been “following orders”—though in the case of modern parallels, this could involve “doctor’s orders.”

Even though some Aurora survivors have called for forgiveness of the killer, the attempt to understand is not a bid for clemency for murderers, drug fueled or not. Breggin argued in his most recent book on drug-induced psychosis, Medication Madness, that as more information is available on side effects, fewer will be able to claim that they didn’t know the risks and there will come a day when adults who take the drugs—and especially those who prescribe them—will be liable for crimes committed under the influence. Of the 2009 Fort Hood massacre, the worst shooting on a domestic military base in history in which military psychiatrist Nidal Malik Hasan killed 13 and wounded 29, Breggin called the drug link the “elephant in the room” which the press and public would not discuss, though he also pointed out in an article for Huffington Post that Hasan would not have been an innocent victim of adverse effects:

Some in the media have expressed surprise that a man whose profession is about caring would turn to violence. According to one theory, Dr. Hasan was driven to the breaking point by the stress of counseling returning soldiers and having to listen to their horrific stories. Totally false. Psychiatrists are no longer trained to listen to or to counsel their patients. Nor do they care to.I’ve given seminars to the staff at both hospitals where Hasan was trained, Walter Reed in DC and the national military medical center in Bethesda, Maryland. The psychiatrists had no interest in anything except medicating their patients… being an ordinary [i.e., a psychiatric drug-dispensing] psychiatrist is deadly depressing. Psychiatrists routinely commit spiritual murder by disregarding and suppressing their patients’ feelings and even their cognitive functions, making it impossible for them to conquer their emotional struggles. It’s no wonder my colleagues have such high suicide and drug addiction rates.

At first glance, there are other twists and contradictions within the theory of substance-induced violence, though personal histories of perpetrators may only emphasize the difference between those who deliberately choose a mind-altering agent to amplify aggression or those without histories of violence who suddenly commit heinous acts on prescription drugs.

It was not always understood, for instance, that while alcoholism can increase violent tendencies, it may not be the cause of violence. When Carrie Nation led the campaign for the prohibition of alcohol in the 1920’s, she and her followers were fueled by then-prevalent medical theories that domestic abusers were driven to commit violence against women due to the “demon whiskey.”  More recent research argues that dissociative “battering” personality traits stem from repeat childhood humiliation and abuse by a same-sex role model and/or witnessing domestic violence against a parent— experiences which long precede the use of alcohol. This is also demonstrated by high rates of domestic violence in some cultures which traditionally prohibit alcohol consumption. Battering statistics don’t hinge on banning alcohol—they hinge on banning the act itself: domestic violence rates are highest where there’s the least enforcement against it.  Furthermore,  author, expert and clinical researcher Donald Dutton also noted that some chronic abusers who display both pathological and criminal tendencies will reportedly use substances in order to ramp up aggression and to manufacture an alibi for their actions.

Overlaps between drug-induced and deliberately drug-boosted violence in an era where more— and more dangerous—prescription drugs are available are admittedly confusing. Due to his long-standing ties to neo-Nazi and right-wing anti-Muslim organizations, Norwegian mass killer Anders Behring Breivik  fits the more traditional  profile of ideologically-motivated and militant mass-murderer. But even Breivik reportedly took a cocktail of ephedrine, steroids and caffeine “to be strong, efficient and awake” before he bombed government buildings, killing eight, and opened fire in a Utøya island camp linked with the Norwegian Labor Party, where he killed 69, mostly teenagers.

According to some reports, Anders took ephedrine and steroids for many years to combat a weight problem and he’d been “off” since anyone outside his militant circles remembered him. Whether or not long term substance abuse could account for long-standing psychopathology, Breivik attested that his use of “ECA Stack”—the combination of ephedrine, steroids, aspirin and caffeine— was chosen deliberately in order to increase aggressiveness in pre-attack journal entries:

Noticing that the testo[erone] withdrawal is contributing to increased aggressiveness. As I’m now continuing with 50mg it will most likely pass. I wish it would be possible to somehow manipulate this effect to my advantage later on when it is needed. Because the state seems to very efficiently suppress fear. I wonder if it is possible to acquire specialized “aggressiveness” pills on the market. It would probably be extremely useful in select military operations, especially when combined with steroids and ECA stack…! It would turn you into a superhuman one-man-army for 2 hours!

The degree to which any drug fueled killer may have had special access to information on clinical warnings and took the drugs anyway obviously reflects degrees of responsibility. It may not always imply—as it most likely does in Breivik’s case— that the drugs were taken either as a facilitator or as an alibi for intent to kill just as it’s unlikely most drunk drivers got behind the wheel with the aim of committing vehicular manslaughter. But drunk drivers are still held responsible. It’s also clear that anyone forcibly placed on drugs who lacks the capacity to give truly informed consent— such as minor children, those forced to take medications by court order or for life-threatening medical conditions (e.g.,  seizures) and the elderly suffering from dementia— are therefore not responsible for the effects, though their prescribers and industry are doubly so.

For some onlookers, any explanation for these crimes which casts killers as anything less than inherently, willfully, murderously evil is “politicized” in a negative sense, whether the search for mitigating factors is framed as a “bleeding heart” social posture or as motivated by an agenda towards pharmaceutical manufacturers or corporate power in general.  But this view ignores the fact that the “black and white” analysis of these crimes is politically guided in itself and, in the case that drugs play a role in certain cases of modern violence, this is incredibly dangerous. The degree to which “experts” refuse to educate themselves on the growing body of evidence that certain prescription medications alone can drive some individuals, particularly minors, to commit violence who might not have otherwise ensures that the trend continues.

Why would anyone want the trend to continue? If the trend is largely drug-fueled, even within the idea that it’s being allowed to continue solely for profit and related politicized reasons such as tort deflection and a good-money-after-bad defense of clinical and corporate reputations, a great deal is lost in a simplistic analysis of human motivation which ignores belief and ideology. It’s curious, on the one hand,  how easily some observers will ascribe a willful motive to take ultimate power over human life to individuals who explode in violence in public, make few attempts to conceal their identity and invariably end up dead or in prison. But, on the other hand, it can be difficult for the same observers to understand that certain authorities might not be exempt from a motive to take power over other human beings in a scenario that results not in death, imprisonment and infamy for those in control but nearly magical status in the realm of science and public health.

For example, organized psychiatry faced a conundrum in light of landmark legal cases which exposed conflicting drives: when held responsible for the actions of patients in Tarasoff, members of the American Psychiatric Association protested that psychiatrists are incapable of predicting future actions of patients. Psychiatrists, who had long claimed the ability to gauge the future course of patients’ conditions and their future actions, were suddenly scrambling to slough off responsibility when the threat of being held liable for crimes committed by these patients began to loom… although the profession continues to demand control over patients under their charge. And so psychiatry argues for the power to force high risk treatments on patients who’ve neither committed nor threatened violence as Satel and Torrey propose, based simply on a practitioner’s assessment that the individual is “seriously mentally ill” and therefore a potential danger to the public or themselves.

How does psychiatry maintain the precarious posture between disdaining responsibility and pleading that they have no crystal ball when things go wrong while still demanding the power to remove medical choice based on predictive prowess? Through fraud.  

In a  response to Torrey’s Heritage Foundation appearance entitled Heritage Foundation Presents Next Step in Evolution of Police State: Perjury,  The Guardian referred to Torrey as a “perjury proponent” in reference to Torrey's statements in several published works.

It would probably be difficult to find any American psychiatrist working with the mentally ill who has not, at a minimum, exaggerated the dangerousness of a mentally ill person’s behavior to obtain a judicial order for commitment.

Torrey also quotes psychiatrist Paul Applebaum in defense of this strategy,

Confronted with psychotic persons who might well benefit from treatment and might certainly suffer without it, mental health professionals and judges alike were reluctant to comply with the law…in the dominance of the commonsense model, the laws are sometimes simply disregarded.

Fabricating predictive powers in order to force treatment and ignoring the increased risk of violence from those proposed treatments all direct the attention to motives and incentives. An obvious incentive: one-fifth of the American Psychiatric Association’s funding comes from industry and that individual members are steeped in financial conflicts— from industry kickbacks for promoting and prescribing, to financial incentives in DSM panel policy, to hiding conflicts by hiring doctors through third parties to conduct industry funded continuing medical education forums.

But again, profit isn’t the only human motivation which science and medicine are subject to along with any other human undertaking.

Adriana Gamondes is a contributing editor to Age of Autism and a Facebook page administrator. She and her husband commute between Massachusetts and Florida and are the proud parents of recovering twins.

Disclaimer: Withdrawal from psychotropic drugs can often be more dangerous than continuing on a medication.  It is important to withdraw extremely slowly from these drugs under the supervision of a qualified speciaa.  Withdrawal symptoms are sometimes more severe than the original symptoms or problems.