The Medicalized Body and Anesthetic Culture pp 275-300 | Cite as
Psychiatry’s Collusion with Anesthetic Culture
Abstract
The lone mass shooter is among one of many examples of pathological behavior that can be linked to anesthetic culture. An in-depth case study of Las Vegas shooter Stephen Paddock will illustrate how anesthetic consciousness likely played a key role in Paddock’s violent behavior. Anesthetic consciousness can be linked to Paddock’s case, including his sociopathic father, pathological gambling, aloof social behavior, materialistic values, conformity to toxic masculine norms, and violent behavior—all associated with hypoactivity in the insula of the brain and severely impoverished empathy and sympathy for others. When Paddock’s physician prescribed him a benzodiazepine drug to treat his anxiety, this likely pushed him over the edge into violent behavior. Paddock’s case is a microcosm of a larger, problematic cultural pattern in which psychiatry tends to collude with anesthetic consciousness.
References
- Albrecht, B., Staiger, P. K., Hall, K., Miller, P., Best, D., & Lubman, D. I. (2014). Benzodiazepine use and aggressive behavior: A systematic review. Australian and New Zealand Journal of Psychiatry, 48(12), 1096–1114.CrossRefPubMedGoogle Scholar
- Albrecht, B., Staiger, P. K., Best, D., Hall, K., Nielson, S., Lubman, D. I., & Miller, P. (2017). Benzodiazepine use of community-based violent offenders: A preliminary investigation. Journal of Substance Use, 22(3), 295–303.Google Scholar
- Aupperle, R. L., Ravindran, L., Tankersley, D., Flagan, T., Stein, N. R., Simmons, A. N., …, Paulus, M. P. (2011). Pregabalin influences insula and amygdala activation during anticipation of emotional images. Neuropsychopharmacology, 36, 1466–1477.Google Scholar
- Balodis, I. M., Kober, H., Worhunsky, P. D., Stevens, M. C., Pearlson, G. D., & Potenza, M. N. (2012). Diminished frontostriatal activity during processing of monetary rewards and losses in pathological gambling. Biological Psychiatry, 71(8), 149–757.CrossRefGoogle Scholar
- Beaver, K. M., Schwartz, J. A., & Gajos, J. M. (2014). A review of the genetic and gene-environment interplay contributors to antisocial phenotypes. In J. Morizot & L. Kazemia (Eds.), The development of criminal and antisocial behavior (pp. 109–122). Berlin, Germany: Springer.Google Scholar
- Berthoz, S., Consoli, S., Perez-Diaz, F., & Jouvent, R. (1999). Alexithymia and anxiety: Compounded relationships? A psychometric study. European Psychiatry, 14(7), 372–278.Google Scholar
- Beydoun, K. (2017, October 2). America’s stunning double standard when it comes to race and religion. The Washington Post. https://www.washingtonpost.com/news/acts-of-faith/wp/2017/10/02/lone-wolf-our-stunning-double-standard-when-it-comes-to-race-and-religion/?utm_term=.ea29e8c1d70b.
- Bird, G., Silani, G., Brindley, R., White, S., Frith, U., & Singer, T. (2010). Empathic brain responses in insula are modulated by levels of alexithymia but not autism. Brain, 133, 1515–1525.CrossRefPubMedPubMedCentralGoogle Scholar
- Blair, R. J. R., & Curran, H. V. (1999). Selective impairment in the recognition of anger induced by diazepam. Psychopharmacology, 147(3), 335–338.CrossRefPubMedGoogle Scholar
- Buckley, P. F. (2006). Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness. The Journal of Clinical Psychiatry, 67(7), 5–9.CrossRefPubMedGoogle Scholar
- CBS News (2007, October 5). Stephen Paddock: Motive of Las Vegan gunman may lie in his gambling habits. CBS News. https://www.cbsnews.com/news/stephen-paddock-motive-las-vegas-gunman-gambling-habits/.
- Cox, B. J., Swinson, R. P., Shulma, I. D., & Bourdeau, D. (1995). Alexithymia in panic disorder and social phobia. Comprehensive Psychiatry, 36(3), 195–198.CrossRefPubMedGoogle Scholar
- Del-Ben, C. M., Ferreira, C. A. Q., Sanchez, T. A., Alves-Neto, W. C., Guapo, V. G., de Aravjo, D. B., & Graeff, F. G. (2010). Effects of diazepam on BOLD activation during the processing of aversive faces. Journal of Psychopharmacology, 26(4), 443–451.Google Scholar
- Delaveau, P., Jabourian, M., Lemongne, C., Guiannet, S., Bergavignan, L., & Fossati, P. (2011). Brain effects of antidepressants in major depression: A meta-analysis of emotional processing studies. Journal of Affective Disorders, 130(1–2), 66–74.CrossRefPubMedGoogle Scholar
- DeVega, C. (2017, October 2). America’s white man problem: After Las Vegas, a familiar script unfolds. Salon. https://www.salon.com/2017/10/02/americas-white-man-problem-after-las-vegas-a-familiar-script-unfolds/.
- Droutman, V., Read, S. J., & Bechara, A. (2015). Revisiting the role of the insula in addiction. Trends in Cognitive Science, 19(7), 414–420.CrossRefGoogle Scholar
- Elkins, D. N. (2007). The medical model in psychotherapy: Its limitations and failures. Journal of Humanistic Psychology, 49(1), 66–84.CrossRefGoogle Scholar
- Ernst, J., Boker, H., Hattenschwiler, J., Schupbach, D., Northoff, G., Seifritz, E., & Grimm, S. (2014). The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. Social Cognitive and Affective Neuroscience, 9, 857–863.Google Scholar
- Evren, C., Evren, B., Dalbudak, E., Ozcelik, B., & Oncu, F. (2009). Childhood abuse and neglect as a risk factor for alexithymia in adult male substance dependent inpatients. Journal of Psychoactive Drugs, 41(1), 85–92.CrossRefPubMedGoogle Scholar
- Fischer, W. F. (2000). The psychology of anxiety: A phenomenological description. The Humanistic Psychologist, 19(3), 289–300.CrossRefGoogle Scholar
- Forsyth, J. P., Parker, J. D., & Finlay, C. G. (2003). Anxiety sensitivity, controllability, and experiential avoidance and their relation to drug of choice and addiction severity in a residential sample of substance-abusing veterans. Addictive Behaviors, 28(5), 851–870.CrossRefPubMedGoogle Scholar
- Frewen, P. A., Dozois, D. J., Neufeld, R. W. J., & Lanius, R. A. (2008). Meta-analysis of alexithymia in post-traumatic stress disorder. Journal of Traumatic Stress, 21(2), 243–246.CrossRefPubMedGoogle Scholar
- Fromm, E. (1944). Individual and social origins of neurosis. American Sociological Review, 9(4), 380–384.CrossRefGoogle Scholar
- Fukunishi, I., Kikuchi, M., Wogan, J., & Takubo, M. (1997). Secondary alexithymia as a state reaction in panic disorder and social phobia. Comprehensive Psychiatry, 38(3), 166–170.CrossRefPubMedGoogle Scholar
- Gafni, M. (2017, October 7). Where Las Vegas shooter Stephen Paddock bought his guns; it was all legal. The Mercury News. http://www.mercurynews.com/2017/10/07/where-las-vegas-shooter-stephen-paddock-bought-his-guns-it-was-all-legal/.
- Goerlich-Dobre, K. S., Bruce, L., Martens, S., Aleman, A., & Hooker, C. I. (2014). Distinct association of insula and cingulate volume with cognitive and affective dimensions of alexithymia. Neuropsychologia, 53, 284–292.CrossRefPubMedGoogle Scholar
- Grinberg, E. (2017, October 2). Nothing stood out about Stephen Paddock before Las Vegas shooting, people who knew him say. CNN. http://daily.hgd.hu/news/nothing-stood-out-about-stephen-paddock-before-las-vegas-shooting-people-who-knew-him-say.
- Handelsman, L., Stein, J. A., Bernstein, D. P., Oppenheim, S. E., Rosenblum, A., & Magura, S. (2000). A latent variable analysis of coexisting emotional deficits in substance abusers: Alexithymia, hostility, and PTSD. Addictive Behaviors, 25(3), 423–428.CrossRefPubMedGoogle Scholar
- Harasim, P. (2017a, October 3). Las Vegas strip shooter prescribed anti-anxiety drug in June. Las Vegas Review-Journal. https://www.reviewjournal.com/local/the-strip/las-vegas-strip-shooter-prescribed-anti-anxiety-drug-in-june/.
- Harasim, P. (2017b, October 4). Drug given to Paddock calms some, provokes others, experts say. Las Vegas Review-Journal. https://www.reviewjournal.com/local/the-strip/drug-given-to-paddock-calms-some-provokes-others-experts-say/.
- Haviland, M. G., Shaw, D.G., MacMurray, J. P., & Cummings, M. A. (1988). Validation of the Toronto Alexithymia Scale with substance abusers. Psychotherapy & Psychosomatics, 50, 81–87.Google Scholar
- Hendryx, M. S., Haviland, M. G., & Shaw, D. G. (1991). Dimensions of alexithymia and their relationships to anxiety and depression. Journal of Personality Assessment, 56(7), 227–237.CrossRefPubMedGoogle Scholar
- Hogeveen, J., Bird, G., Chau, A., Krueger, F., & Grafman, J. (2016). Acquired alexithymia following damage to the anterior insula. Neuropsychologia, 82, 142–148.CrossRefPubMedPubMedCentralGoogle Scholar
- Honkalampi, K., Hintikka, J., Laukkanen, E., Lehtonen, J., & Vinamaki, H. (2001). Alexithymia and depression: A prospective study of patients with major depressive disorder. Psychosomatics, 42(3), 229–234.CrossRefPubMedGoogle Scholar
- Honkalampi, K., Hintikka, J., Tanskanen, A., Lehtonen, J., & Vinamaki, H. (2000). Depression is strongly associated with alexithymia in the general population. Journal of Psychosomatic Research, 48(1), 99–104.CrossRefPubMedGoogle Scholar
- Jonason, P. K., & Krause, L. (2013). The emotional deficits associated with the Dark Triad traits: Cognitive empathy, affective empathy, and alexithymia. Personality and Individual Differences, 55(5), 532–537.CrossRefGoogle Scholar
- Kasser, T., & Ahuvia, A. (2002). Materialistic values and well-being in business students. European Journal of Social Psychology, 32(1), 137–146.CrossRefGoogle Scholar
- Kasser, T., Cohn, S., Kanner, A. D., & Ryan, R. M. (2007). Some costs of American corporate capitalism: A psychological exploration of value and goal conflicts. Psychological Inquiry, 18(1), 1–22.CrossRefGoogle Scholar
- Kelly, R. E., Mansell, W., & Wood, A. M. (2011). Goal conflict and ambivalence interact to predict depression. Personality and Individual Differences, 50(4), 531–534.CrossRefGoogle Scholar
- Khantzian, E. J. (1997). The self-medication hypothesis: A reconsideration and recent application. Harvard Review of Psychiatry, 4(5), 231–244.CrossRefPubMedGoogle Scholar
- Kupers, T. A. (2005). Toxic masculinity as a barrier to mental health treatment in prison. Journal of Clinical Psychology, 61(6), 713–724.CrossRefPubMedGoogle Scholar
- Levant, R. F., Hall, R. J., Williams, C. M., & Hasan, N. T. (2009). Gender differences in alexithymia. Psychology of Men and Masculinity, 10(3), 190–203.CrossRefGoogle Scholar
- Levant, R. F., Richmond, K., Majors, R. G., Inclan, J. E., Rosello, J. M., Heesacker, M., …, Sellers, A. (2003). A multicultural investigation of masculine ideology and alexithymia. Psychology of Men and Masculinity, 4(2), 91–99.Google Scholar
- Madioni, F., & Mammana, L. A. (2001). Toronto Alexithymia Scale in outpatients with sexual disorders. Psychopathology, 34(2), 95–98.CrossRefPubMedGoogle Scholar
- Mahalik, J. R., Locke, B. D., Ludlow, L. H., Diemer, M. A., Scott, R. P. J., Gottfriend, M., & Freitas, G. (2003). Development of the Conformity to Masculine Norms Inventory. Psychology of Men and Masculinity, 4(1), 3–25.Google Scholar
- Mann, L. S., Wise, T. N., Trinidad, A., & Kohanski, R. (1995). Alexithymia, affect regulation, and five factors of personality in substance abusers. Perceptual and Motor Skills, 81(1), 35–40.CrossRefPubMedGoogle Scholar
- McInerney, R. G. (2015). A phenomenological account of the shooting spree. Janus Head, 13(2), 45–60.Google Scholar
- Meyer-Lindenberg, A., Buckholtz, J. W., Kolachana, B., Hariri, A. R., Pezawas, L., Blasi, G., …, Weinberger, D. R. (2006). Neural mechanisms of genetic risk for impulsivity and violence in humans. Proceedings of the National Academy of Sciences, 103(6), 6269–6274.Google Scholar
- Michael, R. (1990). A preliminary investigation of alexithymia in men with psychoactive substance dependence. American Journal of Psychiatry, 147(9), 1228–1230.CrossRefGoogle Scholar
- Moons, M. (2017, October 7). Undersheriff confident no second shooter in room with Las Vegas attacker Stephen Paddock. Breitbart. http://www.breitbart.com/big-government/2017/10/07/undersheriff-confident-no-second-shooter-room-las-vegas-attacker-paddock/.
- Niccolo, G., Semerari, A., Lysaker, P. H., Dimaggio, G., Conti, L., D’Angerio, S., …, Carcione, A. (2011). Alexithymia in personality disorders: Correlations with symptoms and interpersonal functioning. Psychiatry Research, 190(1), 37–42.Google Scholar
- O’Neill, A., & Ortega, B. (2007, October 7). The unknowable Stephen Paddock and the ultimate mystery: Why? CNN. http://www.cnn.com/2017/10/06/us/unknowable-stephen-paddock-and-the-mystery-motive/index.html.
- Panayiotou, G., Leonidou, C., Constantinou, E., Hart, J., Rinehart, K. L., Sy, J. T., & Bjorgvinsson, T. (2015). Do alexithymic idividividuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample. Comprehensive Psychiatry, 56, 206–216.Google Scholar
- Papastylianou, A., Kaila, M., & Polychronopoulos, M. (2009). Teachers’ burnout, depression, role ambiguity and conflict. Social Psychology of Education, 12(3), 295–314.CrossRefGoogle Scholar
- Parker, J. D. A., Bagby, R. M., & Taylor, G. J. (1991). Alexithymia and depression: Distinct or overlapping constructs? Comprehensive Psychiatry, 32(5), 387–394.CrossRefPubMedGoogle Scholar
- Paulus, M. P., Feinstein, J. S., Castillo, G., Simmons, A. N., & Stein, M. B. (2005). Dose-dependent decrease of activation in bilateral amygdala and insula by Lorazepam during emotion processing. Archives of General Psychiatry, 62(3), 282–288.CrossRefPubMedGoogle Scholar
- Peralta, R. L. (2007). College alcohol use and embodiment of hegemonic masculinity among European American men. Sex Roles, 56(11–12), 741–756.CrossRefGoogle Scholar
- Ribeiro, A. P., Mendes, I., Stiles, W. B., Angus, L., Sousa, I., & Goncalves, M. M. (2014). Ambivalence in emotion-focused therapy for depression: The maintenance of problematically dominant self-narratives. Psychotherapy Research, 6, 702–710.CrossRefGoogle Scholar
- Robinson, J., Sareen, J., Cox, B. J., & Bolton, J. (2009). Self-medication of anxiety disorders with alcohol and drugs: Results from a nationally representative sample. Journal of Anxiety Disorders, 23(1), 38–45.CrossRefPubMedGoogle Scholar
- Robinson, L. J., & Freeston, M. H. (2014). Emotion and internal experience in obsessive compulsive disorder: Reviewing the role of alexithymia, anxiety sensitivity, and distress tolerance. Clinical Psychology Review, 34(3), 256–271.CrossRefPubMedGoogle Scholar
- Rosenstrom, T., Ystrom, E., Torvik, F. A., Czajkowski, N. O., Gillespie, N. A., Aggen, S. H., …, Reichborn-Kjennerud, T. (2017). Genetic and environmental structure of DSM-IV criteria for antisocial personality disorder: A twin study. Behavior Genetics, 47(3), 265–277.Google Scholar
- Ryan, S. (2017, October 2). Interview with two neighbors of Stephen Paddock, the Las Vegas shooter. Paste Magazine. https://www.pastemagazine.com/articles/2017/10/interview-with-two-neighbors-of-stephen-paddock-th.html.
- Sayar, K., Ebrine, S., & Ak, I. (2001). Alexithymia in patients with antisocial personality disorder in a military hospital setting. The Israel Journal of Psychiatry and Related Sciences, 38(2), 81–87.PubMedGoogle Scholar
- Scher, D., & Twaite, J. A. (1999). The relationship between child sexual abuse and alexithymic symptoms in a population of recovering adult substance abusers. Journal of Child Sexual Abuse, 8(2), 25–40.CrossRefPubMedGoogle Scholar
- Schmidt, S., Roesler, U., Kusserow, T., & Rau, R. (2012). Uncertainty in the workplace: Examining role ambiguity and role conflict, and their link to depression—A meta-analysis. European Journal of Work and Organizational Psychology, 23(1), 91–106.CrossRefGoogle Scholar
- Schmidt, U., Jiwany, A., & Treasure, J. (1993). A controlled study of alexithymia in eating disorders. Comprehensive Psychiatry, 34(1), 54–58.CrossRefPubMedGoogle Scholar
- Shirtcliff, E. A., Vitacco, M. J., Graf, A. R., Gostisha, A. J., Merz, J. L., & Zahn-Waxler, C. (2009). Neurobiology of empathy and callousness: Implications for the development of antisocial behavior. Behavioral Sciences & Law, 27(2), 137–171.CrossRefGoogle Scholar
- Stewart, S. H., Zvolensky, M. J., & Eifert, G. H. (2002). The relations of anxiety sensitivity, experiential avoidance, and alexithymic coping to young adults’ motivations for drinking. Behavior Modification, 26(2), 274–296.CrossRefPubMedGoogle Scholar
- Taylor, G. J. (2000). Recent developments in alexithymia theory and research. Canadian Journal of Psychiatry, 45, 134–142.CrossRefPubMedGoogle Scholar
- Tiihonen, J., Lehti, M., Aaltonen, M., Kivivouri, J. Kautiainen, H., Virta, L. J., …, Korhonen, P. (2015). Psychotropic drugs and homicide: A prospective cohort study from Finland. World Psychiatry, 14(2), 245–247.Google Scholar
- Tull, M. T., Gratz, K. L., Salters, K., & Roemer, L. (2004). The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety and somatization. The Journal of Nervous and Mental Disease, 192(11), 754–761.CrossRefPubMedGoogle Scholar
- Vansteenkiste, M., Duriez, B., Simons, T., & Soenens, B. (2006). Materialitsic values and well-being among business students: Further evidence of their detrimental effect. Journal of Applied Social Psychology, 36(12), 2892–2908.CrossRefGoogle Scholar
- Veit, R., Flor, H., Erb, M., Hermann, C., Lotze, M., Grodd, W., & Birbaumer, N. (2002). Brain circuits involved in emotional learning in antisocial behavior and social phobia in humans. Neuroscience Letters, 328(3), 233–236.Google Scholar
- Wang, Y., Xu, C., Cao, X., Gao, Q., Li, J., Liu, Z., …, Zhang, K. (2012). Effects of an antidepressant on neural correlated of emotional processing in patients with major depression. Neuroscience Letters, 527(1), 55–59.Google Scholar
- Weiss, R. D., Griffin, M. L., & Mirin, S. M. (1992). Drug abuse as self-medication for depression: An empirical study. The American Journal of Drug and Alcohol Abuse, 2, 121–129.CrossRefGoogle Scholar
- Winsor, M., Jacobo, J., & Margolin, J. (2017, October 5). Las Vegas shooter booked hotel overlooking Lollapalooza, seen with mystery woman. ABC News. http://abcnews.go.com/US/las-vegas-shooter-booked-hotel-overlooking-lollapalooza-visited/story?id=50273390.
- Wong, Y. J., Moon-Ho, R. H., Wang, S. Y., & Miller, I. S. K. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology, 64(1), 80–93.CrossRefPubMedGoogle Scholar
- Xue, G., Lu, Z., Levins, I. P., & Bechara, A. (2010). The impact of prior risk experience on subsequent risky decision-making: The role of the insula. NeuroImage, 50(2), 709–716.CrossRefPubMedPubMedCentralGoogle Scholar
- Zeitlan, S. B., & McNally, R. J. (1993). Alexithymia and anxiety sensitivity in panic disorder and obsessive-compulsive disorder. The American Journal of Psychiatry, 150(4), 658–660.CrossRefGoogle Scholar
- Zwirz, E. (2017, October 6). Las Vegas killer Stephen Paddock was lone shooter, police say. Fox News. http://www.foxnews.com/us/2017/10/06/las-vegas-killer-stephen-paddock-was-lone-shooter-police-say.html.