Advertisement

Psychiatry’s Collusion with Anesthetic Culture

  • Brent Dean Robbins
Chapter
First Online:

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.

This is a preview of subscription content, log in to check access.

References

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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.
  8. 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
  9. 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
  10. 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
  11. 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/.
  12. 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
  13. 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
  14. 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
  15. 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/.
  16. 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
  17. Elkins, D. N. (2007). The medical model in psychotherapy: Its limitations and failures. Journal of Humanistic Psychology, 49(1), 66–84.CrossRefGoogle Scholar
  18. 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
  19. 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
  20. Fischer, W. F. (2000). The psychology of anxiety: A phenomenological description. The Humanistic Psychologist, 19(3), 289–300.CrossRefGoogle Scholar
  21. 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
  22. 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
  23. Fromm, E. (1944). Individual and social origins of neurosis. American Sociological Review, 9(4), 380–384.CrossRefGoogle Scholar
  24. 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
  25. 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/.
  26. 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
  27. 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.
  28. 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
  29. 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/.
  30. 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/.
  31. 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
  32. 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
  33. 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
  34. 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
  35. 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
  36. 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
  37. Kasser, T., & Ahuvia, A. (2002). Materialistic values and well-being in business students. European Journal of Social Psychology, 32(1), 137–146.CrossRefGoogle Scholar
  38. 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
  39. 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
  40. Khantzian, E. J. (1997). The self-medication hypothesis: A reconsideration and recent application. Harvard Review of Psychiatry, 4(5), 231–244.CrossRefPubMedGoogle Scholar
  41. 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
  42. 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
  43. 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
  44. Madioni, F., & Mammana, L. A. (2001). Toronto Alexithymia Scale in outpatients with sexual disorders. Psychopathology, 34(2), 95–98.CrossRefPubMedGoogle Scholar
  45. 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
  46. 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
  47. McInerney, R. G. (2015). A phenomenological account of the shooting spree. Janus Head, 13(2), 45–60.Google Scholar
  48. 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
  49. Michael, R. (1990). A preliminary investigation of alexithymia in men with psychoactive substance dependence. American Journal of Psychiatry, 147(9), 1228–1230.CrossRefGoogle Scholar
  50. 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/.
  51. 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
  52. 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.
  53. 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
  54. Papastylianou, A., Kaila, M., & Polychronopoulos, M. (2009). Teachers’ burnout, depression, role ambiguity and conflict. Social Psychology of Education, 12(3), 295–314.CrossRefGoogle Scholar
  55. 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
  56. 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
  57. 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
  58. 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
  59. 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
  60. 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
  61. 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
  62. 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.
  63. 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
  64. 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
  65. 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
  66. Schmidt, U., Jiwany, A., & Treasure, J. (1993). A controlled study of alexithymia in eating disorders. Comprehensive Psychiatry, 34(1), 54–58.CrossRefPubMedGoogle Scholar
  67. 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
  68. 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
  69. Taylor, G. J. (2000). Recent developments in alexithymia theory and research. Canadian Journal of Psychiatry, 45, 134–142.CrossRefPubMedGoogle Scholar
  70. 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
  71. 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
  72. 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
  73. 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
  74. 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
  75. 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
  76. 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.
  77. 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
  78. 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
  79. 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
  80. 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.

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Department of PsychologyPoint Park UniversityPittsburghUSA

Personalised recommendations

Cite chapter

Buy options