Violence And The Mentally Ill

Violence And The Mentally Ill

Many people believe that all violent, sadistic and dangerous people in our society are mentally ill, thus coming to the conclusion that mentally ill people are dangerous.

The truth is, people with mental illnesses are no more likely to be violent than anyone else. Only about 3% to 5% of violent acts can be attributed to individuals with a serious mental illness.

Many movies depict violent characters as being mentally ill and often the news continuously replays stories of the rare occurrences when someone with a mental illness acted out in violence. We start to associate mental illness with violence.

One of society’s biggest fears are acts of violence that are senseless, random, unprovoked and unpredictable and thanks to the media, we often associate this with mental illness. We somehow take more comfort in knowing a man was stabbed to death walking down the street during a robbery than if he was stabbed to death walking down the street for no apparent reason.

This stigmatization is just one of many things people with a mental illness face. I have often heard people say they were afraid of a suicidal individual or someone who self-injured themselves: “If they would do that to themselves, what do you think they would do to me?” The fact is, most suicidal and self-harming individuals would rather hurt themselves before they would hurt anyone else.

While it is rare, people with mental illnesses, just like anyone else in the general population, can act out in violence. Individuals who have a substance abuse disorder alone are much more likely to become violent than the general public, including those individuals who have a mental illness alone or an associated substance abuse disorder.

However, when it comes to dealing with mental illness, individuals who abuse substances, have a co-occurring mental disorder and are non-compliant with their medication are at higher risk of committing violence.

Even with the combination of substance abuse and non-medication compliance, the general public are not at high risk of being attacked by someone with a mental illness. People who are in close relationship with these individuals such as family and friends, especially if they have troubled relationships and/or are financial dependence are more likely to become victims of violence.

Some of the most predictive variables for violence untreated psychotic symptoms to include suspicion/paranoia, hostility, severe hallucinations and poor insight into their delusions and the overall mental illness.

A Tragic Example

I recently spoke to a young man who appears to have had his first psychotic episode, at-least as far as he knows. He’s in his early twenties and at the prime age for the onset of many psychiatric disorders including schizophrenia.

One day last week he was home watching YouTube videos and became paranoid that someone was going to come and rape his mother. Alarmed and frightened, he armed himself, first with a shotgun, but discovering the shot gun was not operational, he armed himself with a handgun. He proceeded to guard the house from what he thought were real threats to his mother, some mysterious intruder/rapist. What happened next rocked the whole community.

At some point, his mother came downstairs and he shot her twice in the head. He then shot their dog twice in the head as well before setting the house on fire and rowing a boat across a lake. According to the people who were at that house, he came out of the boat shirtless, walking slowly and looking like Jason from Friday the 13th.  He was chased away by the homeowner and ran off into the woods. Soon after he turned himself into authorities and the totality of his behavior was brought to light. When the authorities went to his burned down home they found the charred body of his mother and their dog.

I have worked with a lot of individuals who were experiencing their first psychotic episodes, but I have never spoken to someone so young that went from apparently “normal” to acting out so violently in response to paranoid delusions and hallucinations.

Most individuals, who develop a psychotic disorder or any mental illness for the most part, start off with small signs and symptoms that if left untreated, can lead to worsening symptoms and rarely horrible things like suicide or violence. Usually this takes several months to years to decompensate to this level. It’s very rare for someone’s first psychotic episode to turn out so violent, causing death and destruction.

Thankfully, situations like that are extremely rare.

Warning Signs

Some warning signs to look out for when dealing with anyone, not just someone with a mental illness include:

  • Pacing
  • Psychomotor Agitation (i.e., leg bouncing rapidly)
  • Combative posturing (i.e., fist balled up)
  • Paranoid or threatening remarks
  • Irritability
  • Talking to self in language that includes violence or paranoia

If you see these behaviors, it may or may not mean that the person has a mental illness, but these are signs that someone is possibly in a volatile state. Stay calm, give them space, avoid intimidating eye contact.

If you have to deal with the person because they are a friend, family member or even a customer in your place of business, use a calm/soothing voice, helpful attitude, avoid loud noises, remove potentially dangerous objects and attempt to give positive reinforcement until you can either get help or get out of the situation.

We all probably know someone with a mental health problem and many of us don’t even know it because most individuals with mental health problems are productive members of our community.

When we destigmatize the violence associated with being mentally ill, we make it easier for those individuals to seek treatment and to talk about it with their family and friends instead of hiding it out of fear or shame.

Overcoming Suffering While Incarcerated

Overcoming Suffering While Incarcerated

Working in a correctional setting, I often find myself reciting my favorite quote by Viktor Frankl; “To live is to suffer. To survive is to find meaning in the suffering.” The reason this quote appears to have such relevance when dealing with incarcerated people is that many of them see themselves as suffering. They are imprisoned, away from their families and often facing uncertain futures. Many become depressed, anxious, hopeless and unfortunately, suicidal.

When  I speak with inmates who see themselves and their situation as depressing and bleak, I remind them that yes, they may feel like they are suffering, but that is life. A large part of life for most people includes a great deal of suffering. There is joy, and there is pain. I remind them that they are not the only ones suffering. They are incarcerated with hundreds of other individuals going through similar situations and millions of people around the world who are going through their own struggles.

I encourage them to accept the reality of it. Learn from it. Figure out how to use this suffering to become a better, stronger person instead of dwelling on it and allowing it to punish you even more.

There is a popular saying in prisons that goes, “Do time, don’t let time do you”, which means to use your time incarcerated to better yourself, to live life even in the bleakest circumstances and to not just be miserable and unhappy counting down the months, years or even decades until you are released (if ever). Have something to look forward to and remember that suffering doesn’t have to last forever. This situation doesn’t have to be permanent. People find ways to live good, happy lives even while imprisoned for life.

I ask every inmate I evaluate, “What do you have to live for? What are you looking forward to?”  I want to know what will motivate them to not only survive the stressful environment of being in incarcerated, but also what will give them something to hold on to when they start struggling with depressing and negative thoughts.

Many will say they have kids to live for, or they’re young and have their whole lives ahead of them, or their family or goals they want to accomplish. These individuals tend to be much less likely to both get in more trouble while incarcerated as well as are less likely to attempt suicide compared to those who struggle with or can’t find a reason to live.

Lastly, I also try to help inmates to stop seeing themselves as victims. Many inmates think that they are being punished unjustly, or they keep getting arrested because they have bad luck. They blame the system, their friends, society. These inmates are more likely to deal with depression, suicidal thoughts and to become repeat offenders.

Instead, I try to help them see that things happen for them, not to them. Yes they got arrested and it sucks, but maybe this is going to save their lives by getting them off drugs, stop them from associated with that criminal element, teach them that they really do need anger management classes or that they really need to take their psychotropic medications. Hopefully this experience will help them reexamine their lives and make better choices.

When people see things as happening for them, instead of to them, they do time better, easier and even happier. They become inmate workers, earn GEDs and even college degrees while incarcerated. They tend not to look like the typical depressed, angry, bitter inmates that I encounter far to often.

The things I try to teach these inmates are invaluable to helping them survive being incarcerated and they can use it when they are released to hopefully live better lives and to not come back. It can also help all of us understand that we’re not special, things happen, life sometimes sucks, don’t take it personal, don’t dwell on it, learn from it and grow from it. It’s when we get stuck feeling down, victimized, hopeless, worthless and negative that we stop fully living life and start suffering though life. That’s when we start living in a prison of our own construction regardless of if we are incarcerated or not.

Get In To The Habit Of Asking Yourself: “Does This Support The Life I’m Trying To Create?”

Get In To The Habit Of Asking Yourself: “Does This Support The Life I’m Trying To Create?”

We create the lives we want by the things we think, the things we do, how we spend our time and the people we spend our time with.

The problem is, many of us mindlessly do things and spend time with people that do not support the life we are trying to create. We say we want to raise our standards and make positive changes in our lives, but our habits show otherwise.

This is a very common theme with the inmates I work with in the jail. I see some of the same inmates re-incarcerated over and over again. Many of them are generally good, caring and intelligent individuals who could do anything they set their minds to.

They have goals and dreams that don’t include being behind bars, yet when they get released from jail they tend to go back to the same neighborhood, hang around the same people and end up doing the same things that landed them in jail to begin with.

They are holding themselves back, just as many of us are holding ourselves back by wasting time and energy doing things and associating with people who are not going to get us to the lives we want for ourselves.

We may be in relationships with partners who don’t believe in us, don’t support our goals and dreams or worst, attempt to sabotage our goals rather it be weight-loss goals, financial goals or our happiness.

We may be at jobs that don’t offer room to grow, that doesn’t offer training courses for professional improvement and career advancement or simply requires so much of our time and energy that at the end of the day we have none left for much of anything else, let alone to pursue our passions and talents.

There are countless ways we can be in situations that are not supportive of what we are trying to create for ourselves. It’s real easy to get stuck situations and habits without thinking much about it, which is why I think it’s important for us to take a step back from time to time and become mindful about what we are doing and to remember what is it we really want.

So get into the habit of asking yourself, especially when you get that gut feeling or you know deep down you shouldn’t be doing something (i.e., going out drinking when you should be home studying): “Does this support the life I’m trying to create”.

At least once a week, get into the habit of taking a quick inventory of your life. It doesn’t have to take a long time or be complicated, but check in with yourself:

  1. How is my life going? (take a quick look at all the important areas of your life and how satisfied you are in those areas)
  2. Make a note of the areas that need adjustment (areas where you are not so satisfied) and then commit to making changes in those areas.
  3.  Get to work making changes in those areas and repeat this check in again in a week or so. Little adjustments add up to big changes and you will realize you’ll start living more mindfully and intentional in creating the life you want and deserve.

Parenting Your Inner Child

Parenting Your Inner Child

Most of us think we are adults because we have reach a certain chronological age, but psychologically , we are often pseudo adults. We are children in adult bodies, trying to do adult things. I think this may in part be where the term “adulting” comes from. We may be 35 physically, but deep inside of us is a five year old trying to navigate through adult life, attempting to maintain relationships and cope with adult stress. Every now and then the pressure becomes too much and our inner child is forced to make their needs and fears known.

What Is An Inner Child?

Inside of all of us there is a part that is frozen in time, stuck in the past. As therapists, especially those of us who deal with trauma, we call that part of us our inner child. Everyone has an inner child (at least one), but we experience our inner child in different ways.

Some of us have an inner child that is relatively well-behaved and quiet. He or she may be barely noticeable and only make their needs, concerns and fears known subtly and infrequently. It could be the anxiety we feel whenever we are talking to our boss, or the explainable way we suddenly feel small and unsure of ourselves when we have to give a presentation.

Others have an inner child that is more boisterous. He or she may make themselves known often and show up as a temper tantrum when we are frustrated with our partner (sometimes complete with yelling and throwing things), shutting down when we can’t find the words to express ourselves or a panic attack at the thought of being alone if our relationship fails.

Many of the destructive behaviors we have in our adult lives from infantile neediness, fear of abandonment and dependency to self-sabotaging behaviors, impulsivity and irresponsibility can be attributed to our inner child.

Why We Ignore Our Inner Child

Society tells us that when we become adults, we put away childish things. We are forced to ignore our inner child, the good and the bad. Our inner child not only holds our childhood hurts, traumas, fears and angers, but it also holds our innocence, awe, playfulness, sensitivity and wonder.

Remember the things you loved in childhood, the things that made you happy? When adults would ask you what you wanted to grow up to be maybe you said a pilot or an artist. As we grow up, most of us end up going into jobs and careers that have nothing to do with what made us happy or what we wanted to do as children, in large part because many of us were told that those dreams were childish and we needed realistic, more “adult” goals.

One way or another, we were taught to ignore our inner child almost completely which is why most adults are unaware of this unconscious part of them that sometimes throws their lives off balance seemingly out of the blue.

Because most adults are unaware of this inner child, they do not know how to meet his or her needs. This unawareness is what allows the inner child to take over and sometimes ruin relationships or cause us to act in ways that as adults, we know we shouldn’t.

In order to address our inner child and meet their needs appropriately, we have to first acknowledge and accept that he or she exist, and then take responsibility for parenting and loving our inner child.

When we are inattentive or neglectful to our inner child, we may find ourselves in situations where we are unconsciously looking to fill his or her needs through other people. We are basically asking someone else to parent our inner child and that can come in the form of dependency, toxic relationships and even substance abuse.

Our inner child most likely is looking for something he or she felt neglected of when we were children and as adults we can’t expect our parents or anyone else to go back and fix that. We have to do it. We have to attend to the needs of our inner child through love and support as well as set up boundaries and structure just like a parent would with a physical child.

Having a symbiotic relationship with our inner child will allow us to meet their needs in ways that are mutually beneficial to our adult side as well, instead of meeting their needs through ways that are inappropriate, impulsive and childish.

Explore your inner-child. Get to know them. Listen to them and find out what he or she needs.

Don’t Be Afraid of Being a Beginner

Don’t Be Afraid of Being a Beginner

Many people I know allow the fear of looking awkward or silly prevent them from trying something new. It could be anything from karaoke to going to their first yoga class. Just the thought of failing or looking like they have no clue what they are doing is enough to prevent them from ever trying things they have dreamt about doing.

Remember when you first learned to walk or ride a bike? You probably don’t because it’s quite natural to you now, but if you see any old videos of yourself you would see how unbalanced you were and how many times you fell, but never gave up. That’s what it is like trying something new. We can’t let the fear of looking stupid, like we don’t know what we are doing or even failing, rob us of the joy mastering (or at least being competent) in that area will bring.

Recently I started training in Brazilian Jiu Jitsu and one of the hardest things I have done so far was to walk through that door and start my first class. I had so much anxiety about it and most of my anxieties revolved around how silly I would look attempting to perform exercises and maneuvers I had never performed In my life.

I was worried about my conditioning because while I consider myself to be in somewhat decent shape, I knew I was not in the type of shape I thought I needed to be in for Jiu Jitsu. I was mostly worried about my conditioning (or lack thereof). I go to the gym often and lift weights, but I rarely do aerobic activity. I also knew that I could find a thousand excuses to keep putting off starting the class if I didn’t push myself to go despite those anxieties.

During my first few classes, I was really self-conscious and compared myself to the rest of the class. Most of the other guys were in better shape, quicker and more coordinated. I did feel like an awkward gorilla when we did many of the warm up exercises that required flexibility I didn’t have and left me sucking in air before the class even really begun. All of that started pushing doubt and excuses in my mind. “You’re too out of shape”, my inner critic said, “You’re too old, too tired, too busy” it added.

I live in my head, which isn’t always a good thing if you can’t master it. I had to quickly get out of my head. I did this by reminding myself that I was a beginner and it was okay to look and feel like a beginner.

I had to tell myself that it was okay if I looked and felt awkward during the exercises, if I couldn’t perform some moves right, if at all. I told myself that it was okay if I got gassed during class and had to take a break. I was a beginner, and if there is ever a time to look awkward while trying your best, it’s when you’re a beginner.

Instead of being worried about being a beginner take advantage of it, embrace it.

When I started focusing more on myself and not on the other people in class things became easier. I had taken the pressure off of myself to be better than I reasonably could be. I pushed myself of course, but took breaks when I needed to and learned to be unapologetic about it (by the way, no one ever made me feel bad about having to take a breather). I modified moves I couldn’t do until I could do them instead of getting upset, hurting myself or giving up out of frustration.

I worked on not caring about other people’s opinions.

So what if other guys in the class made fun of me or snickered about how this middle aged, muscular but uncoordinated guy flopped around class like a fish out of water. They weren’t paying for my classes, I was. They weren’t in my shoes. We all have different lives and different goals. While some guys were there to someday compete for medals, I was there to get in shape and learn a martial art I had been curious about for over a decade. While some guys live to train, I have a full-time, stressful job, commute 144 miles to and from work each day and have a family to divide my time with. Our goals and drives are completely different, and that’s okay.

Once I got out of my own head, allowed myself to be a beginner and stopped being concerned about what other people may think about me, things became fun! It helps that most people who train Jiu Jitsu seem to be non-judgmental and encouraging. You’ll hear them say, “We all started at the same point, don’t give up, just keep showing up”.

I don’t think anyone ever looked at me and thought about how awkward I looked or how much my conditioning sucked. It was all in my head. Once I got out of my head and really focused on being mindful and present in the moment, I quickly realized I very rarely even thought about my weight, my clumsiness or my fitness level that much. As a matter of fact, Jiu Jitsu class became one of the few places I didn’t think too much about those things or other life problems at all. It became a stress reliever.

I’m still extremely new in Brazilian Jiu Jitsu and in every class I am learning something new and attempting to perform it for the first time. I am still a beginner and I allow myself to be a beginner, unapologetic ally.

We’re Conditioned to Stay

We’re Conditioned to Stay

The idea for this post came from a client who wanted to understand why it was so hard for her to leave both a bad relationship and a job she nearly hated. As we discussed her family history, I learned that her mother stayed in bad relationships with no good boyfriend after boyfriend.  Her grandmother stayed in a bad marriage for decades.  The answer became clear. It was simple, powerful and complex at the same time. She was conditioned to stay.

Many of us find it painfully hard to leave situations we know are not healthy for us. We find ourselves in relationships for years sometimes with people we should have left a long time ago, or friendships that should have been let go of a long time ago. Unfortunately, many of us are conditioned to stay in these situations that aren’t the best for us and we don’t even realize it which makes it that much harder.

This conditioning could be as subtle as watching or parents stay in a loveless marriage so we stay in an unhappy marriage because we learned that we don’t leave a relationship just because we’re no longer happy, or we stay for the kids or we stay because we vowed “til death do us part”.

Many of us witnessed our parents have terrible fights, sometimes even getting physical, but they always stayed together so subconsciously we learned that even in an abusive relationship, we stay. It can even be that we witnessed our parents blissfully happy and in love for 30 years and we want that same relationship so we stay in our terrible marriage because we don’t want to not have what our parents did or are afraid of disappointing them.

Conditioning comes from many directions. Many families, religions and cultures do not believe in divorce so we may be even more obligated to settle and stay where we are not happy.

Beyond relationships, that conditioning can spill over into the work environment. We tend to copy what we do in personal relationships with what we do on the job. We stay in unsatisfying romantic relationships and end up staying in unsatisfying jobs. We want more, but somehow, somewhere were conditioned to settle.

Just like relationships, different cultures have different views on work. Many cultures believe that a man’s job defines him and that he must do the same type of work his father did, or work on the family form despite his own dreams and aspirations.

Maybe our father taught us that we show up to work every day for 30 years, keep your nose clean, head down and then retire, so even though we are unhappy, that’s what we do.

My mom went to work every day, she retired from two jobs and I never heard her complain so subconsciously I learned to go to work every day and not complain. I also learned to be loyal to a company, sometimes to a fault.

The same things can be said about relationships. I watched my parents stay in a troubled relationship for many years and that helped condition me to stay in toxic relationships longer than most people would.

We are all conditioned in good, bad and neutral ways of thinking, behaving and relating to the world and ourselves. It’s only when we start to examine this conditioning can we break away from what may be holding us back without us realizing it.

Psychopaths Most Dangerous Trait: “He Seems So Normal”  

Psychopaths Most Dangerous Trait: “He Seems So Normal”  

Every day I work with some of the worst of mankind; killers, rapists, molesters, etc. Most of these individuals easily fit into the category of psychopaths or sociopaths. Although these terms are often used interchangeably, the difference mostly comes down to nature versus nurture.  

Psychopaths are thought to be born that way. Their traits are more innate and often have underdeveloped parts of the brain that influence emotions such as empathy. Sociopaths on the other hand tend to be the result of their upbringing and environment. Both are covered in the Diagnostic and Statistical Manual of Mental Disorders under Antisocial Personality Disorder.  

Not everyone with Antisocial Personality Disorder ends up being a criminal. Studies show that many leaders, CEOs and medical doctors have Antisocial Personality Disorder. In some ways, it is what makes them able to do their jobs so well. However, many career criminals, especially does engaged in some of the most violent and heinous crimes, do fall under the constructs of psychopaths or sociopaths.  

A common and what I consider to be the most dangerous trait that most of these individuals possess is the ability to appear perfectly “normal”.

They are not the creepy, easily recognizable monsters we would like to believe they are. They don’t look scary. They don’t cause us to cross the street when we come across them on the sidewalk.

They are the guy next door we see every day and says hello, yet he’s got death bodies hidden in his apartment (Jeffrey Dahmer). They are the charismatic friend we never could imagine is going out raping and killing women (Ted Bundy). They are the neighbor who dresses up like a clown and entertains the kids, yet is killing and torturing young boys (John Wayne Gacy).  

They are the people you could never imagine had such violent tendencies and could carry out such devious acts because they act so “normal” and blend in with the rest of society so well. Many not only appear harmless, but also appear weak.  

Watching a documentary on Jeffery Dahmer, one person interviewed commented that when he first met Dahmer, he found him unassuming and thought to himself that his seventeen-year-old son could easily beat him up, yet Dahmer successful drugged, sexually assaulted and killed seventeen males.  

Ted Bundy often put his arm in a sling and put on a facade making himself appear harmless and handicap, that’s as if his relatively good looks and charm weren’t enough to lower his victims defenses.  

I’ve spoken to a man who attacked two women with an axe, brutally killing one, yet he portrayed himself to me and others as barely able to walk and incapable of moving as fast as the blitz attack he was later convicted of committing called for.  

Another man I spoke to killed his wife, dismembered and discarded her body, yet during our interview who portrayed himself as being fragile and sick with mobility issues. Many of the healthcare staff who came in contact with him commented on how they felt sorry for him, that he was so weak and needy that they couldn’t imagine him hurting a fly.

And that’s how psychopaths and sociopaths get you. You think they are harmless, your guard is down and then they hit you in the back of the head and stuff you in the trunk of their car, or the back of their van. 

I recently spoke to a serial rapist who, once again presented himself to me as being emotionally weak, compliant and an overall nice guy, yet he has attacked, abducted, beat and raped women in his van. He is a good-looking young man, that with his charm and apparent mild-mannered disposition allowed him to meet women who had no idea they were putting their lives in the hands of a monster. 

I’m not saying you can’t trust people, but what I am saying is to listen to your gut. Society has slowly been pushing us as to ignore our natural instincts that say “something isn’t right here”, and that ignoring our natural instincts can make us easy targets for people to victimize us and not just rapist and killers, but those who are less deviant such con-artist and scammers.  

The person who could have ended up being Jeffrey Dahmer’s next victim, felt like something wasn’t right when Dahmer had him back at his apartment and wanted to take pictures of him handcuffed and lying face down on the bed. This person found an opportunity to leave and this saved his life and ended Dahmer’s killing streak. How many other of his 17 victims also felt like something wasn’t right, but overrode their innate warning system and told themselves nothing bad was going to happen.

Not that this totally summarizes my point nor do I necessarily agree with everything said in this clip, but  listen to what Saundra Bullocks character says in this clip from the movie Crash about ignoring her gut.  Some things can not be avoided, but from my research, individuals like psychopaths and sociopaths are counting on us to ignore our innate instincts in order to become their next victims.