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Noted forensic psychiatrist, Dr. Michael Welner, on NBC’s approach this week in the Virginia Tech shooting, and the correct approach in understanding schizophrenia.

Friday, April 20, 2007
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HH: I want to welcome now to the Hugh Hewitt Show Dr. Michael Welner. Dr, welcome, it’s good to have you here.

MW: A pleasure to be with you. Thank you for inviting me.

HH: You’ve been very busy this week of tragedy. ABC News, in fact, has put your forward as their person of the week, and I know you’ve been doing a lot of media. I appreciate you’re making the time for us today. Dr, would you run through for us a little bit of your education? I know you are board certified in psychiatry, and forensic psychiatry, and clinical psychopharmacology, and in disaster medicine. Where did you do your medical training?

MW: I went to the University of Miami in Florida, and trained at Beth Israel Medical Center in Psychiatry here in New York, and did a fellowship in forensic psychiatry at the University of Pennsylvania. And when I began practice, took on a full-time practice, and then worked in correction psychiatry at Bellevue Hospital in Manhattan, and have since graduated, I suppose, to being chairman of the Forensic Panel, which is a national forensic science practice in psychiatry, toxicology, pathology, and other medical specialties.

HH: You have also helped pioneer, and have adopted The Depravity Scale, which is an evidence-driven forensic instrument that is attempting to standardize certain definitions in the law. Has that gotten widespread acceptance, Dr, among professionals who are prosecutors?

MW: Well, the professional community has been very supportive of the research effort, but I would urge your audience to be familiar with this as research in progress that your audience should be participating in. We have a dedicated web destination at www.depravityscale.org, that includes surveys that take in public input that helps to define the worst of crimes based on their intent, actions, attitudes, and the victims chosen. The reason this is important is because we’re using forensic science, legal standards, both from, both with the input of attorneys, defense attorneys and prosecutors, as well as judges, but including the general public, because in my professional opinion, the idea of defining evil crimes is so dependent on a variety of different perspectives, that we want to make sure that public opinion drives this the same way the best of representative democracy can do, because the public is affected by sentencing decisions, and because the public has to wrestle with criminal sentencing at trial. And the depravity scale is also pertinent to the case that we’ve been talking about this week, the Cho matter, and how it needs to be represented to the public, whether there are standards for what is off limits relating to the intent, and actions, and attitudes of a criminal. And so this is a very delicate undertaking, but I would absolutely urge your audience to participate in this research, because everybody’s input counts equally.

HH: I’ll be sure to link the site for the opinion surveys at Hughhewitt.com. Now Dr. Welner, how much experience do you have with killers like Cho?

MW: I’ve worked on a number of multiple homicides. As a forensic psychiatrist, just to acquaint you with how it works, we might be called in, in a criminal setting, or a civil setting, a criminal setting in which somebody is charged for embarking on a homicide, may raise a particular defense, or there may be sentencing, pre-sentencing issues. It’s not always the insanity defense, it may be a whole host of issues that arise that affect how the courts deal with that individual. Many, and perhaps most in the United States, rampage shooters end up killing themselves, or being killed by police. But there are a number of rampage shooters who do survive, and I’ve been privileged to work on some of the most sensitive cases in the United States, four of which are done, and have had an opportunity to interview four such multiple shooters, but have also interviewed those who wanted to embark on multiple shootings, but were stopped.

HH: Can you tell us which of the multiple shooters you have spoken with who in fact committed the crimes?

MW: Ronald Crumpley, who carried out a multiple shooting in the West Village in New York, targeting homosexuals, Byron Uesugi, who carried out a multiple shooting in Honolulu, Hawaii, at the Xerox, Ronald Taylor, who carried out a mass shooting in Pittsburgh, targeting whites, Richard Baumhammers, who carried out a mass shooting in Pittsburg, targeting blacks and other ethnic groups.

HH: And how many would have been rampage shooters who were stopped before they did have you spoken with?

MW: Well you know, ironically, and I see that both you and I have had some similar views on this, and NBC having released what they released…

HH: Yes.

MW: The most visible of those cases was William Tager, who went to the NBC Today Show studios in 1996, intending to carry out a rampage shooting. The stage hand, his name’s Theron Montgomery, rest in peace, was quick-witted enough to try to shield him from the door. But Tager shot him, and killed him, and then police closed in. Of course, this being in the middle of Rockefeller Center, police were not too far away. And Tager was psychotic and became disorganized once the shooting started. But he walked in there with a full jacket, and was ready to destroy the place. So it’s…I found it a phenomenal irony, either that or perhaps everybody at NBC who works there now didn’t work there back in 1996, to see that that indeed would be the network that was most insensitive to something that they might be particularly sensitive to, given their history.

HH: And I do want to get to that, but I’m laying the foundation first for your opinions on the NBC action, so that the audience understands you’re not a late arriver to this stage. You’ve been working this field for a long time.

MW: I have, and…I have, and have…it’s a privilege and a curse, and you do encounter the kinds of things that you don’t expect. You know what it’s like to sit with the parents of the shooter, and walk through the feelings that they have, you know what it’s like to hear the stories and the attitudes of the shooters, and the kinds of things and the explanations that they give, and their righteous indignation and railing against others who were the cause of what they believe to be their misfortune. And these are familiar experiences, the flavor of paranoia, the flavor of contempt, and how it expresses itself, and also, the familiar aroma of psychosis as it expresses itself in writing and other kinds of creative expression.

HH: How often have you been under oath on a stand in a proceeding involving a rampage shooter, either one who unfortunately carried out and had victims, or one that was stopped?

MW: Well, I’m proud to say that most of my cases go away, and never go to trial. I think that that’s probably one of the best compliments that people can say about me, is how invisible I am. I think that when you consult and you’re asked by one particular attorney, your objective should be to come up with something that’s as straightforward and close to the bottom line, so that both sides can look at it and say well, you know, yeah, that’s what it is. There’s really nothing to fight over, let’s go work this case out.

HH: Is that a diagnosis? Is that what you come up with?

MW: Actually, it may be one of many issues. It may be to what degree was a person criminally responsible? To what degree does a person reflect an abuse in his background? Or is that significant? What were the antecedents to the crime? How severe is a diagnosis, actually, particular to rampage shooting? Something that I’ve found to be a fascinating dilemma, which you really can’t get into unless you do understand the fine points of any case, and Cho’s would be no exception, is even if a person has a specific diagnosis, to what degree did that diagnosis actually relate to his decision to kill? Example, Richard Baumhammers in Pittsburgh had [delusional disorder]. And he suffered from it. It took a toll on his function and his development and his progress. He was a lawyer, but he never went anywhere. He just aimlessly tailed downward, and ultimately carried out a rampage shooting. But Richard Baumhammers was a racist, and long before he carried out a rampage shooting, he was burning a cross on a neighbor’s lawn who was African-American. And he identified with Nazi ideology, and had politically anti-immigration beliefs. So I had no doubt in my mind that he had [delusional disorder], and yet at the same time, looking at his decisions and his behavior, at the same time, and around the same time that he made the decision to embark on a mass shooting, the decisions that he made were driven by factors that didn’t reflect delusional thinking, or irrational, fixed false ideas, because his hatred was separate from his irrational ideas. On the other hand, Byron Uesugi, the Xerox shooter, killed seven people, and one of those people, and again, I had to explore his feelings about each of the people that he specifically targeted, he delusionally believed that this person had tampered with and destroyed his private fish collection. Now putting aside the idea of whether we believe that somebody should be killed for doing that, I just want to illustrate perhaps a distinction for your audience, about how a person may have a condition, and it may be relevant to it, or they may have other sides of their personality that may be driving an hostility from the condition, maybe feeding into that decision.

HH: Now…I’m talking with Dr. Michael Welner, an expert in rampage killing. And Dr. Welner, I’ve gotten a lot of anguished e-mails this week from parents and close friends of people suffering from schizophrenia, urging me to alert an audience like this, that not all schizophrenics are walking time bombs, and that in fact, not many of them are. Do you concur with that?

MW: Well, I really appreciate those e-mails, and I would refer you to an article that’s probably going to get posted this afternoon about bringing schizophrenia out of the closet. The timing or your saying that couldn’t be better. I just finished writing it about ten minutes ago. These folks are absolutely correct, but the problem with schizophrenia is far more complex than just assuring people that schizophrenics are almost invariably not violent, with a number of exceptions. The fact of the matter is, occasionally, there are schizophrenics who are violent, because of their schizophrenia. And you’re not going to make people feel any more warm and fuzzy just because that number happens to be miniscule. I mean, you could make the same assertion about Muslims, that the overwhelming majority of Muslims are not violent. But as long as you have terror, that is the exclusive province of Muslims, people will be nervous. And so with schizophrenia, in my professional opinion, we’ve got to advance beyond that. And what I see the problem with schizophrenia is, from a physician’s and medical perspective is, there is so much stigma attached to the diagnosis, that people are even afraid to engage it. And that kind of thinking is outdated. I see colleagues who are, and I’m not saying this righteously, I can understand how difficult it can be to deal with stigma, but who are reticent, who are cautious, overly cautious about telling somebody who’s a young male in his early 20’s or late teens, which is a typical time of onset, you know, we’ve got to talk. You have this condition. And you can mange it, or it will manage you, which is an absolutely must discussion that you have to have with a patient. Now again, I would refer to this piece that’ll be posted soon on ABCnews.com, to get more of an insight about why, and the different qualities of schizophrenia that are so staggering for a person to have to come to terms with. But consider someone who is a young man, and I say man because schizophrenia occurs in women, but there seems to be a much greater difficulty in men embracing a relatively new diagnosis of schizophrenia, tremendous denial, and especially with the expectations of function and wage earning and that sort of thing. And you’re just finding your way in the world, and now you’re being told that you’re saddled with the diagnosis that you’re going to be with for the rest of your life. And you don’t necessarily have to think about it unless you’re around parents who want you to get help because they care, people who tell you you’re weird, or your doctor who tells you you’re sick and you need to take drugs. So it takes a real strength to accept this kind of burden, and indeed responsibility. But I would say this, we now live in an age where medications have been refined at least to the point that their impact on symptoms, and the morbidity of schizophrenia is such that the medicines are far easier to take, and they…

HH: Dr. Welner, can I ask you a very…I didn’t intend to bring this up, but I do would love to get a minute or two out of this. What are the warning signs of schizophrenia, and what should people look for who are not themselves burdened with it, but might suspect it in someone else?

MW: That you know, the earliest stages of schizophrenia are so subtle, but…and I don’t at all want to cause panic, because the early symptoms of schizophrenia are so similar to depression, and that’s why many psychiatrists will call someone depression until it’s overwhelmingly obvious that the person has schizophrenia, because depression is so much easier to treat, and because depression has already come out of the closet. And this is why I believe we have to bring schizophrenia out as well, so that psychiatrists don’t lie to themselves, either, and patients do not, and the appropriate treatments are then given. And in the interest of answering your question, I think that parents need to become concerned with someone they love is just too peculiar, pervasively, that there’s something about the way they relate, that is just a little too withdrawn and odd, and strange, and the things that a person is absorbed in are just a little bit too strange to be bohemian or off the beaten path for an adolescent, and a person changes in a way that they’re increasingly withdrawn, but not seemingly depressed, and is clearly not using drugs. Those are some of the first things that one sees, and yet they’re so subtle, if you sit back and think about it, it’s very easy to attribute those to just what somebody might be going through as an adolescent. I’m bringing this up in the context of Cho, because look, when you’re talking about someone who’s sitting in a classroom with his hat pulled down, and his sunglasses on, when a teacher’s talking to him, and speaking inaudibly, and taking photographs of people on his cell phone, and having, taking 20 seconds in order to answer a question, come on, now. That case, in that case, it cannot be ignored. People who are depressed, and may be anxious, and maybe with withdrawn, and may not integrate, people who are peculiar to a pathological degree, they set themselves off, and others find them alarming.

HH: All right, on that note, let me go back to the rampage killer, Dr. I know I’ve got about a half hour of your time. I don’t want to take too much of your time. What triggers a rampage killer? And if there are multiples of those, which are the most common?

MW: Well, in my professional opinion, it’s a confluence, it’s a coming together of several factors. It’s very important for your audience to appreciate this, because everybody is sensitive to identifying folks who are at risk, and yet I want to assure everybody that it’s just not so simple to presume that someone is necessarily at risk. These are the kinds of things that would worry me, were I to be asked to assess a patient who had never been violent before, and many are not, keeping in mind the very sad history of people who go on rampage shootings are people with terrible difficulty expressing their anger. And that is part of the problem. They’re ineffectual, they express themselves poorly, they are suspicious, but suspicious to a point that they have contempt and resentment for others. But what happens to make them more of a risk is that they’re blaming of others, that they have repeatedly fallen into a pattern of, graduates into a sense that the people who were responsible for their failures need to be punished. Even that in and of itself wouldn’t be enough. But when you combine this with an individual, and exclusively a man who derives a sense of identity and purpose in being somebody from the capacity to destroy, and in particular using weaponry, and identifying with people who have, then you have someone who is a ticking time bomb.

HH: And do they, do they often give the poker tell of that definition of themselves as violent? Is that commonly observed prior to their rampage?

MW: Sometimes, sometimes. It depends on the person. Look, Ronald Taylor in Pittsburgh gave no indication, and he wrote a manifesto just like we’ve seen here, and that’s not an extremely unusual circumstance, but everybody was surprised, and he wasn’t one of these people who went out and stole a gun, or bought a gun, he stole it from his mother.

HH: In your opinion, why did Cho produce the video and the still photographs, in addition to his rambling manifesto?

MW: Oh, in my professional opinion, a mass shooting is a crime of immortality. It’s a crime of people seeking immortality. It is a crime that is committed by someone who is, who experiences himself as a failure, who is extremely disappointed in that failure because he had much higher expectations for himself, has blamed and dehumanized others, feels that they deserve to be punished, and is ready to go, because he comes to the conclusion that it’s just not going to get any better. Some of these individuals are suicidal, some of them are passively suicidal in the sense that they are ready to accept whatever it is that happens to them. Their planning reflects that, and that mass shootings invariably plan…the mass shooters invariably plan the shootings, but they don’t plan what happens afterward. And they may kill themselves, they may happen to be killed, or they may just simple wander off without a plan. So this is another reason why the notion of a mass shooter escaping and running off and going on some elaborate pathway of escape afterward, it’s just not something that’s seen in this kind of population.

HH: Those who have survived, do they ever develop or exhibit remorse or compassion for the carnage they have visited on people?

MW: No, no. It’s really quite, it’s really quite stunning. In fact, one of the things that I like to do as a forensic psychiatrist when I deal with a homicide case is to actually ask the person I’m interviewing if such and such were alive today, what would you say to them. And if you’re looking for some sense of humanity in their response, you’re not going to find it. It’s a very familiar quality, very cold, very hostile, very much with the attitude, in one way or the other, expressed of you got what you deserved, of some expletive.

HH: Now Dr. Welner, I’m talking with Dr. Michael Welner, on the faculty of NYU [Medical] School, also founder and chairman of the Forensic Panel, had Steve Capus, president of NBC News called you yesterday, or two days ago, and asked you what to do with these video and photos, what would you have told him?

MW: I would have told him about the Tager story, and I would have told him, you know, you can inspire someone who is seeking fame and immorality from NBC, but keep in mind, there’s no greater way to find fame and immortality than somebody who comes after you, because you are the network. And how soon you forget a lesson like that. Don’t forget the lesson of Tager.

HH: Would you advise him not to broadcast them?

MW: Oh, absolutely. But not just the tapes, the pictures.

HH: Right.

MW: And for reasons, for other reasons. The notion of parents and loved ones who contemplate what the last thing somebody that they cared about might have been going through, or the last image that that person might have seen, opening up their computer to see Cho Seung Hui pointing a gun at them is unfathomable, and I’m saying this as someone who has board certification in disaster medicine. I’m saying this as a clinician. You cannot do that to people who have been exposed to an emotional trauma, to essentially stick it in their face in the fashion of flooding without any kind of emotional resources to provide them with sanctuary, that it, emotionally, nobody can stomach that.

HH: But what kind of an impact can that have on parents or siblings or spouses or…we saw today buried a professor with three children, 11, 12, and 13, who will forever have these images around. What does that do to them?

MW: I think it traumatizes them. I mean, I don’t want to, I want to be very careful about this, because I don’t want to encourage litigation. And frankly, I think from having worked within the system, and I want to point out to your listeners this is also in civil litigation matters as well, I completely respect the need for many people to sue and to charge emotional distress, and all of this thing, but I do not know that that necessarily, necessarily is the answer, if people need help, they get them the help they need. That said, and financial compensation doesn’t solve the world’s problems necessarily. But that said, it’s traumatic, and I can understand how something like that would be traumatizing.

HH: Can you talk about the effect of NBC’s decision on other borderline cases of people who have not yet gone over to violence, but are, well, where Cho was two years ago?

MW: Well, why don’t we take a look at the number of copycat incidents that have just happened this week, but they happened after this was released. They didn’t happen after this crime hit the news. They happened after he turned into a badass action hero. It’s so disappointing. And I would distinguish some of these incidents as possibly motivated by individuals just trying to get attention for themselves, because of the amount of attention, and the nature of the attention afforded this pervert. And I think pervert is the appropriate word that has to be distinguished for this kind of behavior. It’s a perversion. But what I’m particularly concerned about are those people who just with repeated exposure, their sense of perhaps compassion and understanding for him, because he’s humanized, degenerates into something that is more of an identification with him. And then, when you combine that with a person who is failing and gets to a place where he feels that he’s had enough, and has all of these other ingredients that I’ve noted, then look out next April 20th, because it is a sort of, it is a perverted anniversary that not only attaches itself to the Columbine case, but Hitler’s birthday as well.

HH: Now Dr. Welner, if I was defending NBC, and I’m not. I’m sure that you if you’ve read anything I’ve written, you know I’m just completely astonished and disgusted by their decision, but I would say those people who have been pushed into copycat, and those in the future who will push to actual rampages, would have been the same because of what they had seen Monday through Wednesday afternoon, and that what followed on Wednesday night on NBC, and then on all the networks shortly thereafter, really wouldn’t have had any difference. What’s your professional response to that argument, that the cumulative effect was in fact inconsequential?

MW: My professional response is different for the two groups. For people who had poorly formed plans…mass shooting is not about the victims. It’s not inspired by seeing people suffer. It’s carried out by a person seeking immortality. It’s all about a person and what he wants to achieve for himself. That person so dehumanizes the others around him that that’s what makes it easy for him to kill strangers. But it’s a person who kills just as he would kill an ant or a bug, or destroy something needed to make an implement. And so essentially, he destroys the soul of a number of folks in order to essentially ingest it, and become that much more significant and inflated. So just the dynamics of what’s involved in a mass shooting, if we operate it under that kind of mentality, we’d be thinking that shootings would follow news of big car accidents, and big fires, because traumas would inspire people to go out and shoot. Well no, that’s just preposterous, of course. The only thing that was exposed to us in the early days after the shooting was the grief and suffering of people who lost loved ones. It was only once Cho Seung Hui was exposed as a figure of intimidation and menace, and done so with such spectacular exposure, that…in intrigue and interest, that we want to know about him, that these kinds of attacks have followed.

HH: So would the next time someone mails a DVD of themselves, or still photos, or uploads of You Tube video, will you trace that back to Wednesday night?

MW: Oh, absolutely. Absolutely. How can I not?

HH: My last question for you, Dr, and take some time to answer this if you would. What should the media do following one of these…I have not played a second of his audio. I hesitate to say his name. I only use it when I have to. And my view is, as we said, as Moses said strike their name from the tablets, what would you advise the media generally, and perhaps the Forensic Panel can come up with something, to do concerning rampage killers and their desire to be known in the aftermath of their violence.

MW: You know what? I appreciate your attitude in not even mentioning his name, or if perhaps you can adopt my suggestion of encouraging people to refer to this as perverted…and first of all, I think that this kind of crime, and the people who carry it out, have to be referred to as perverts specifically because it’s a copycat crime. No one copies a pervert. Nobody copies a sex offender or a rapist. And this is why it sends out a message that even if people feel disaffected, they would be ashamed to entertain these notions, because society reacts to these kinds of crimes the way it would a rape or other kind of sexual assault. I would liken what NBC did to the release of a toxic cloud. Once you release it, if you continue to release it, it compounds the problem. If you allow it to spread and to be accessible, it compounds the problem in access to it. And so what you have to do once the mistake has been made is to simply shut it off in order to contain fallout. And so the answer to a news organization receiving a package is, I would say well, what would you do if somebody mailed you anthrax? Would you open it because of the media’s right to know? Or would you send it to law enforcement authorities, because they have appropriately skilled people who can handle these things. Well, the answer is fairly obvious. This is exactly what this is. It is a psychological warfare that has societal, catastrophic ramifications of some kind of biological agent or radioactive agent. And responsible individuals should recognize what their skills are, and what their skills aren’t.

HH: Dr. Michael Welner, I appreciate the abundance of time you’ve given us, and we will be linking to both The Depravity Scale and your new article at ABCNews.com, and any story about you as well. And I appreciate very much the time.

MW: Well, I appreciate your interest, and the opportunity to explain this, and I just want to conclude by saying that for anyone of your listeners who expressed concern about schizophrenia, I would encourage you to be resolved in your support, and if you want to e-mail me with any kind of particular questions, obviously I’m not in a treating capacity, but if there’s any help that I can offer, I want to be able to be a resource, because you’re challenged, and you deserve the support of others.

HH: Do you have an e-mail address, Dr?

MW: My e-mail address is drwelner@forensicpanel.com.

HH: Dr, thank you very much.

MW: Quite all right. Have a good weekend.

End of interview.

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