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What Don't Shooters Feel That The Rest Of Us Do?

No explanation of who Adam Lanza was, what influences shaped him, what resentments drove him or what psychiatric diagnoses fit him will ever satisfactorily explain why he shot 27 children and women.

The FBI and others have profiled shooters. These profiles provide some common denominators, telling us something about who — but little about why. The "why" may lie in mass shooters' inability to connect to others.

The profiles say that shooters are almost always men, mostly young. They are very angry, usually about some injustice they believe they have suffered. They hold these grievances dear, so dear they have been called "grievance collectors." They incubate their resentment in a festering stew of self-righteous indignation until that stew explodes in a spasm of violence.

They are loners, awkward and socially unskilled, lacking the capacity to engage with others in the more productive ways that healthier people use to work their grievances out. They are paranoid and blaming, projecting their anger and resentments outward onto others.

Through a fantastic twist of thinking, they seem to believe that through their massive acts of destruction the world will come to appreciate how deeply wronged, injured and alienated they were. At the very least, they will leave their mark on a world that was otherwise unlikely to even notice them.

Many have qualified for the diagnosis of a severe mental illness, but even more have not.

Of course, they are also suicidal. These are almost all acts of suicide with intentionally massive collateral damage.

I suggest that other neglected elements in the profile are the interconnected concepts of "theory of mind" and mentalization. "Theory of mind" refers to the ability to imagine (theorize) and appreciate the mental states of others. Mentalization is the actual thought process through which we experience others as having thoughts and feelings that are separate from our own.

Theory of mind and mentalization are what allow us to experience others as real human beings with passions and sorrows, dreams and disappointments, and to empathize. These capacities shape our attachments, forge our connectedness and bind us together. They are the glue of the group, the building blocks of community. Without them, we see others as less real.

In the absence of theory of mind, we have solipsism, a stance that argues that our own thoughts and feelings are the only things that are real. In this extreme, others are merely the cardboard props that support our needs. They can be discarded at will. Without mentalization and empathy, we are morally disinhibited. The less real the life of another, the easier it is to take.

We can only speculate about the influences that shape the disconnected among us. There may well be some heritable genetic predisposition to mentalize and empathize. Undoubtedly that predisposition is enhanced by positive experience and diminished by trauma and neglect. The objectification of others in violent video games and movies, the social isolation and diminution of face-to-face time in our Internet and social media-driven world, and shortened attention spans and expectations of instant gratification may all play a role.

This is all speculation. For every paranoid, grievance-collecting loner who has spent an isolated youth lost on the Internet or in video games and who is capable of mass murder, there are thousands who could never pick up a gun.

Perhaps it is the sense of connectedness born of the capacity to mentalize and empathize with others that distinguishes those who might shoot from those who could not. The good news here is that we have workable hypotheses about how some people come to mentalize well while others do not.

Connectedness to others is something we can observe. The capacity to mentalize and empathize is something we can measure. We can encourage this capacity and even teach it, starting early in life.

Adam Lanza saw those terrified children and adults before him as mere cardboard targets for his rage. If he had been able to see them as real people with their own hopes and dreams, would he have been able to pull the trigger?

Harold I. (Hank) Schwartz, M.D., is psychiatrist-in-chief and vice president of behavioral health at the Institute of Living/Hartford Hospital.

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