Then A Great Silence

Posted on September 23, 2007 in Conservatives Psychosis Stigma Therapy Violence

Five months after the [[Virginia_Tech_massacre|Virginia Tech shootings]], you don’t see or hear much about them. One person who tried to do this from the very beginning was Dr. Aradhana “Bela” Sood who had the task of examining just why a quiet, shy man went ballistic without anyone noticing that he was on his way to mass murder. Last week Dr. Sood blasted the state of Virginia for going cheap on its mental health services and described the process she used to unveil the mystery of Cho’s past:

Sood spent three hours sequestered with Cho’s mother, father and sister, a time she used to piece together Cho’s life “from his mother’s pregnancy until the day he died.”

“The person they saw described on television and in the newspapers was not the person they knew,” Sood said, recalling how the discovery of a pocket knife in her son’s dresser drawer was enough to frighten Cho’s mother.

She said she is most often asked why the Cho family did not seem to move to intervene as Cho’s state of mind spiraled downward.

“People ask why they sat back, why they seemed to do nothing.”

But she likened the situation to that of thousands of other families with troubled children who take assurances from good grades, an acceptance to a college, or pending graduation, all the while knowing there are deep problems.

As a parent, “you are constantly walking on eggshells [asking] when are they . . . going to bottom out? You are so grateful that nothing has happened.

“It is like you don’t want to upset the apple cart. You want to leave well enough alone,” Sood said.

Cho called home, as he always did on Sunday nights, the night before the shootings. He expressed no concerns.

Cho’s family, especially his older sister, a brilliant and accomplished student and now a federal government employee, “did everything they could to nurture this young man,” Sood said.

Contrary to initial speculations, Cho received good care for his mental illness during his high school years. “Cho’s family, teachers and doctors struggled to understand his quiet ways, diagnosed a form of mutism, prescribed medications and reacted with alarm to Cho’s dark writings. He made remarkable progress, Sood said.” This standard of care disintegrated, as it all too often does, when Cho turned 18 and matriculated at [[Virginia Tech]]. One could call this period — which is common to many young adults who are expected to make their way in the world without insurance for a few years — the Pit. You can’t pay for the psychiatrists you need to monitor you or the medicines you need to stay well. It becomes a cruel joke when people say “Well, it’s all your fault because you didn’t take your meds” as if your meds were handed out to you for free.

Not only did Cho struggle unshielded with his disease, but counselors at Virginia Tech ignored findings that he was destabilizing:

“Erring on the side of caution instead of making basic overtures in trying to get information,” counselors and administrators too strictly interpreted privacy laws and chose to withhold information from Cho’s family and from among one another, Sood said.

There was no push for information about Cho beyond the little that he chose to present, she said.

“You can become hostage to the information [a patient] is giving you,” Sood said, contrasting Cho’s college experience to his high school years.

She likened the failure of Virginia Tech counselors and other clinicians to pursue information about Cho to a doctor who limits a diagnosis of a patient to simply asking, “How do you feel?”

Cho felt like hell but nobody did anything. Readers of this blog may recall the time I suffered an especially scary episode while in college:

I developed the belief that the world wasn’t real, that I could predict the next thing someone would say. Now I suspect that my brain had neatly bifurcated so that one part lagged behind the other. When I sought help at the school counseling center, the therapist did not even for a moment suspect psychosis but suggested that I get more to eat.

Like me Cho sought help for his condition at his school counseling center. That the Virginia Tech counseling center never called Cho, never invited him for a follow-up appointment does not surprise me. It was almost as if they were trying to ensure a necessary attrition at the college, created by students dropping out. So Cho was going it alone when two events upset his already upset life:

First came a rejection letter from a publisher, dashing Cho’s distorted view of himself as a budding, creative author. He had shifted his major to English from business information technology, which was better-suited to his cognitive skills.

“This is a young man with a really inadequate personality. He has this niche area,” Sood said. “But he sees this won’t come to fruition” because of the rejection.

From that point late in his sophomore year, Cho began to regress. In the fall of 2005, his junior year, Cho began showing behaviors that were the first signals of a new obsession with death and culture-bashing.

Cho’s conduct was quasi-threatening; he took pictures of classmates; he refused to cooperate and became more isolated. Unlike in high school, where Cho had written approvingly of the [[Columbine_High_School_massacre|Columbine killings]], no one followed up on the signals despite many opportunities and recognitions of Cho’s decline.

Then came the second episode, ironically one that was designed to usher in a system of help.

Cho had made bothersome contacts with female students in December 2005 and in an offhanded way threatened suicide. “I might as well kill myself,” he told a student.

Cho was taken into custody and underwent a commitment hearing that found him mentally ill and a danger to himself.

Sood believes that the brief hearing, during which Cho was barely audible, crushed any perception harbored by Cho that society would accept him.

Cho’s life story gives lie to the conservative insistance that he was at fault because he did not take his meds. Those of us who have suffered through episodes know, first, that when you are in mental illness, the thought that medications might help you through the rough spots either does not occur to you or seems dangerous to your ability to concentrate; and, second, that even if you want to take the meds, the cost of seeing a psychiatrist plus the cost of many of the medications which may be the right ones for you can be prohibitive. So you tough it out. And if you believe that no one cares about you, you may be driven towards violence — either towards your self or towards others.

Cho was a product of a conservative’s world where nobody cares for the mentally ill. His is an extreme case where 21 other people happened to die. Sure there were calls for mental health care reform, for mandatory incarceration in asylums, but five months later I have not seen a single conservative call for mental health reform. So far, things continue as they have gone. There was a hue and cry, villifications of the shooter, and then the great silence. The Right cares nothing about us, but the Middle and, maybe, the Left cannot be counted on either. Not until the mass of people can be made to understand and care about the situation of those who suffer from mental illness.