Wednesday, January 16, 2013

The Violence of Assumed Violence: A Reflection on Reports of Adam Lanza’s Possible Autism

By Guest Contributor Jennifer C. Sarrett, MEd, MA
Doctoral Candidate, Graduate Institute of Liberal Arts
Emory University


On Friday, December 14th 2012, the country learned of the mass shooting of 5- and 6-year-old children and several adults in Newtown, CT. By the end of the day, we learned that Adam Lanza, the perpetrator of the heinous act, may be autistic. Although we now know that this is not the case, it has spurred conversations about the link between autism and violence. This mental illness guessing-game has become the norm in the wake of such tragedies. Jared Loughner and James Holmes may have been schizophrenic; Sueng-Hi Cho may have been depressed, anxious, and also possibly autistic; Eric Harris and Dylan Klebold may have been depressed and/or psychopathic. These speculations are understandable – the public yearns to understand the motives behind such acts and recognizes that good mental health and mass shootings are never coupled–however, the way these representations are presented to the community create stigma and blames others with similar disabilities. 

Adam Lanza
In Media Madness: Public Images of Mental Illness, psychologist Otto Walh explains that the public does not get its information about mental illness from evidenced-based, professional sources, rather, “[i]t is far more likely that the public’s knowledge of mental illness comes from sources closer to home, sources to which we are all exposed on a daily basis–namely, the mass media.” [1] The media (i.e. news, television, movies, video games, popular literature) often provides these links casually but carefully. Reports may mention Adam Lanza had autism, but don’t make the causal link between this diagnosis and his crimes. Yet in the minds of readers, the association is made.

The link between mental illness and violence has a long history. [2] In addition to the news, popular movies and TV shows contribute by featuring violent characters with a history of mental illness. Films such as Psycho,  the Halloween seriesMisery Silence of the Lambs,  and Natural Born Killers center on violent characters with some kind of mental illness. [4-7] The Law & Order  and Criminal Minds  series both frequently implicate a mentally ill person in some violent and incomprehensible crime. [8-10]  The majority of these representations are of individuals with some sort of undefined psychosis, however, as the country wonders over Adam Lanza’s possible autism diagnosis it is fair to expect autism as the next violent scapegoat.

Autistic individuals are represented in the media as aloof, shy, detached, rigid, and unpredictable – a seeming recipe for apathy. [11] The first popular portrayal of autism in America, Rain Man (1988), portrays Raymond Babbit (Dustin Hoffman), an autistic man who, in one memorable scene, screams and hits is own head at the prospect of getting on an airplane and refuses to connect with his brother, Charlie (Tom Cruise). [12] He is detached and unpredictable. Mercury Rising (1998) features a young autistic boy who does not communicate verbally and who relates more to numbers than to people, a skill that eventually saves his and FBI agent Art Jefferies’ (Bruce Willis) lives. [13]

Charles Babbit getting angry
Beyond these fictional portrayals, autism is usually portrayed one of two ways in popular news stories: (1) stories of amazing abilities or unexpected outcomes – most of which are entirely unremarkable events for non-disabled people (such as this well known story or this recent story), or (2) the immense difficulty of life with autism (with sometimes fatal consequences). While these stories are written with an underlying sense of hope or struggle, they all serve to set up distinct separations in the mind of the public between us (i.e. the non-autistics) and them (i.e. the autistics). [14] The recent reports, however, come dangerously close to creating a new category of representation – the violent autistic.

Though reports that Adam Lanza did not, in fact, have autism or Asperger’s syndrome came out days after the shooting, the damage has been done. [15] Blogs, articles, and op-eds quickly denounced the relationship between autism and violence, but this was simply triage and not nearly as interesting, memorable, or comforting as the original reports of psychiatric difference. What is needed is more responsible reporting of psychiatric and cognitive differences from the very first mention in place of later, cursory amendments.

For example, did any initial reports of Adam Lanza, Sueng-Hui Cho, James Loughner, James Holmes, or Eric Harris and Dylan Klebold’s possible mental illnesses mention the fact that people with mental illness are much more likely to be the victims, rather than the perpetrators, of violent crime? [16] Does news of a crime perpetrated by a person with a severe mental illness, such as schizophrenia, also report the extremely high levels of comorbidity between mental illness and substance abuse in instances of violent crimes? [17] The lack of a connection between mental illness and violence has been reported by the Surgeon General (in this 1999 report) and the National Institute of Mental Health, who, in this 2006 report, stated that “...the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia,” yet “by comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period…” [18]

I am not claiming that people who commit the atrocities like those at Sandy Hook Elementary are not mentally ill or that their psychiatric state should be ignored. What I am proposing is that when these reports come out, they should come out alongside accurate information about the stated mental illness or disability and its actual relationship to violence. People on the autism spectrum are not and have never been clinically associated with premeditated violence, yet I fear that when Adam Lanza and Sueng-Hi Cho are linked with autism, this is an implicit suggestion that autism is the cause of their violent behavior.[19] Yes, autism may be part of the profile of a perpetrator, but it is usually no more a cause of violence than if they had, for instance, been diagnosed with heart disease. When a diagnosis is recklessly implicated in the reporting of violent crimes, the public tends to remember this association much more so than follow-up reports of no diagnosis or actual levels of violence among diagnosed individuals. In respect for the majority of the population of people with psychiatric or cognitive difference, this context needs to be presented at the very beginning.

The WHO reports that stigma is the biggest barrier to overcome for individuals with mental illness  and an association with violence is among the most common and damaging representations. [20] In all the talk of mental health reform, a top priority must be a reduction of the stigma of violence. This stigma leads effortlessly into hate crimes, injustices, and poor care for people with cognitive and psychiatric differences.

I’d like to close with a quote from the Autistic Self Advocacy Network’s statement on the Newtown, CT shootings that highlights the faulty logic and stigma that follows these assumptions: “Should the shooter in today’s shooting prove to in fact be diagnosed on the autism spectrum or with another disability, the millions of Americans with disabilities should be no more implicated in his actions than the non-disabled population is responsible for those of non-disabled shooters.”

To learn more about autism and related issues, I recommend the following resources:

Books
Frith, Uta, ed., Autism and Asperger Syndrome. Cambridge: Cambridge University Press, 1991.

Grandin, Temple. Different...Not Less: Inspiring Stories of Achievement and Successful
Employment, Arlington, TX: Future Horizons, Inc., 2012.

Grinker, Roy R., Unstrange Minds: Remapping the World of Autism. New York: Basic Books, 2008.

Murray, Stuart, Autism. New York: Routledge, 2012.

Offit, Paul. Autism’s False Prophets: Bad Science, Risky Medicine, and The Search for a Cure. New York: Columbia University Press, 2010.

Online

Autistic Self Advocacy Network, http://autisticadvocacy.org/

National Institutes of Health: Neurological Disorders and Stroke, “Autism Fact Sheet,” http://www.ninds.nih.gov/disorders/autism/detail_autism.htm



Want to Cite this Post?
Sarrett, J. (2012) The Violence of Assumed Violence: A Reflection on Reports of Adam Lanza’s Possible Autism. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2013/01/the-violence-of-assumed-violence_16.html



Author Bio

Jennifer C. Sarrett started working with people on the autism spectrum in 1999 in Athens, GA while getting her B.S. in Psychology. In 2005, she completed her M.Ed. in Early Childhood Special Education with a focus on autism from Vanderbilt University. She is currently a fifth year doctoral student in Emory University’s Graduate Institute of Liberal Arts working on her dissertation which compares parental and professional experiences of autism in Atlanta, GA and Kerala, India as well as the ethical issues the arise when engaging in international, autism-related work.

Jennifer Sarrett is the co-organizer for Critical Juncture–an upcoming conference aimed at exploring the ways multiple social identities (i.e. race, sexuality, disability, gender, ethnicity) influence experiences of difference and inequality in communities, science, medicine, and public spaces. This interdisciplinary conference will be held at Emory University on March 22-23, 2013 and aims to highlight the work of emerging scholars. Please visit the website for additional information, including registration: www.criticaljunctureconference.wordpress.com.  

References

[1] Walh, Otto. Media Madness: Public Images of Mental Illness. (New Brunswick: Rutgers
University Press, 2005), 2.

[2] JC Phelan & BG Link, “The growing belief that people with  mental illnesses are violent: The role of the dangerousness criterion for civil commitment,” Social Psychiatry and Psychiatric Epidemiology, 33 (1998): S7-S12; Wahl, Media Madness.
 
[3] Psycho, directed by Alfred Hitchock (1960; Universal City, CA: Universal Pictures, 1998), DVD.

[4] Halloween, directed by John Carpenter (1978; Los Angeles, CA: Compass International Pictures, 1978), video.
[5] Misery, directed by Rob Reiner (1990; Los Angeles, CA: Columbia Pictures, 1990), video.
 
[6] Silence of the Lambs, directed by Jonathan Demme (1991; Los Angeles, CA: Orion Pictures, 1991), video.

[7] Natural Born Killers, directed by Oliver Stone (1994; Los Angeles, CA: Warner Brothers, 1994), video.
 
[8] Law & Order (franchise), created by Dick Wolf (1990; New York, NY: NBC, 1990), television.
 
[9] Criminal Minds, created by Jeff Davis (2005; Los Angeles, CA: The Mark Gordon Company, 2005), television.

[10] Patricia Owens, “Portrayals of schizophrenia by entertainment media: A content analysis of contemporary movies,” Psychiatric Services, 63, no. 7 (2012): 655-659.; Wahl, Media Madness.

[11] There is a conversation over the use of the phrase “autistic person” or “person with autism.” While the latter follows “person first” language, often used in disability advocacy to represent that a person is more important and, thus, comes first than a disability, autistic self-advocates are increasingly promoting the former phrase. Not only is a person’s autism often viewed as an integral component into who they are, but some argue that the phrase “person with autism” seems to suggest the need to remind others that autistic people are, in fact, people. (Steven Kapp, personal communication). I choose which phrase to use based on the representation I am referring to; in other words, I use “autistic person” when advocating and “person with autism” when referring to non-advocacy based positions.

[12] Rain Man, directed by Barry Levinson (1988; Los Angeles, CA: United Artists, 1988), video.

[13] Mercury Rising,directed by Harold Becker (1998; Universal City, CA: Universal Pictures, 1998), video.

[14] For more on this see: Rosemarie Garland-Thomas, “Seeing the disabled: Visual rhetorics of disability in popular photography,” The New Disability History: American Perspectives, ed. Paul K. Longmore and L. Umansky (New York: New York University Press, 2001), 335 and Stuart Murray, Representing Autism: Culture, Narrative, Fascination. (Liverpool: Liverpool University Press, 2008).

[15] Asperger’s syndrome is a diagnosis under the autism spectrum that is characterized primarily by differences in social interaction preferences and styles.

[16] KA Hughes, MA Bellis, L Jones, S Wood, G Bates, L Eckley, E McCoy, C Mikton, T Shakespeare & A Officer, “Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies,” Lancet, 379, no 9826(2012): 1621-9, doi:10.1016/S0140-6736(11)61851-5; Patricia Owens, “Portrayals of schizophrenia by entertainment media: A content analysis of contemporary movies,” Psychiatric Services, 63, no. 7 (2012): 655-659; Katherine Quarmby, Scapegoat: Why We are Failing Disabled People, (London: Portobello Books, 2011); LA Teflon, GM McClelland, KM Abram, et al., “Crime victimization in adults with severe mental illness: Comparison with the National Crime Victimization Survey,” Archives of General Psychiatry, 62 (2005): 911-931.

[17] Seena Fazel, Guam Gulati, Louise Linsell, John R. Geddes, & Martin Grann, “Schizophrenia and violence: Systematic review and meta-analysis.” PLoS Medicine, 6, no. 8 (2009): e1000120. doi: 10.1371/journal.pmed.1000120; U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.

[18] JW Swanson, MS Swartz, RA Van Dorn, EB Elbogen, HR Wagner, RA Rosenheck, TS Stroup, JP McCoy, JA Lieberman, “A national study of violent behavior in persons with schizophrenia,” Archives of General Psychiatry, 63, no 5 (2006): 490-9; U.S. Department of Health and Human Services, Mental Health.

[19] Judy Endow, “No linkage between autism and planned violence.” Special-Ism. retrieved January 9, 2012 http://special-ism.com/no-linkage-between-autism-and-planned-violence/; Though there is little research on the subject, the following article concludes: “...a potential risk for aggression (but not necessarily for criminal behavior) in this populations and that, when violence does occur, it is often in distinct ways relevant to the symptomatology of HFASDs [High-Functioning Autism Spectrum Disorders]”; Matthew D. Lerner, Omar Sultan Haque, Eli C. Northrop, Lindsay Lawer, & Harold J. Bursztajn, “Emerging perspectives on adolescents and young adults with high-functioning autism spectrum disorders, violence, and criminal law,” American Academy of Psychiatry and the Law, 40, no. 2 (2012): 187.

[20] World Health Organization, “The World Health Report 2001: Mental Health: New Understanding, New Hope.” Geneva: World Health Organization, 2009.

1 comment:

Julia Haas said...

Thanks for your post, Jennifer! Very shortly after I read it, I came across an episode of L&O SVU that drew precisely the kind of relationship between mental illness and violence that you describe. I'm ashamed to say that I had never really considered the frequency with which that connection is made, or why it is so deeply problematic. Thanks to your post, I have a feeling I'm going to be noticing it everywhere.