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Thursday, April 19, 2007





(CHICAGO)(April 19, 2007) A mass murder, seemingly unprovoked; a cryptic package of photographs and irrational claims sent to a news organization; bizarre babbling by Virginia Tech college student Cho Seung Hui to NBC News.
Does any of this make sense?
I believe I can offer a coherent connection that will survive peer review by mental health experts once more information is known. Obviously my analysis and conclusions are drawn from incomplete facts. But that's my specialty. Profiling the pattern before the puzzle is complete.
I have dealt with schizophrenic patients for more than 25 years. Some were helpless veterans, others were criminals who had been misdiagnosed. Mr. Cho does not look all that different from patients who endured illness and were treated before they committed calumny. Only he was never properly diagnosed and treated.
Just what is schizophrenia and how is it significant as a starting point in the Virginia Tech tragedy? Schizophrenia can strike at any age, but it particularly strikes young adults. Thus Mr. Cho was in the danger zone.
While we know that schizophrenia is a biochemical disease, and not the result of moral fault or infection, we don’t really have any understanding of how and why the condition strikes some and not others. Is it triggered? Does it descend on an individual and become the trigger itself? These questions remain open for medical science.
What makes schizophrenia such a terrible illness is that the condition does not strike all at once. A person may start acting "strange." Then "stranger." Strange behavior is attributed initially to personal "problems," not mental illness. It takes a while to close the circle and realize schizophrenia has struck.
But "schizophrenia" or psychosis is not the complete answer. It is only part of the solution. The disease exists in the mind and body; but it is the external, environmental factors that cause the disease to become treatable, or an explosive danger to public safety.
What I have to say is controversial, but I believe that time and further analysis will prove me correct.
We can observe the silence of the Cho family for, so far, three days. Nothing has been heard from his relatives. Here is a classic case of the "dog that didn’t bark." My hypothesis: the family observed Cho's deterioration but could not understand it, because they could no longer understand him. And they were too busy working, as many immigrants often are, to direct attention at what they mistakenly perceived as an increasingly "difficult" and demanding child.
Mr. Cho's rage in the NBC materials is ostensibly directed at someone or something. Superficially he seems to be attacking "rich people." I believe that in reality he is attacking his own family. Because most of us find it too difficult and too painful to attack our own relatives, we compensate by attacking external factors in lieu of root causes. Family as the target of Cho's wrath is the only explanation that makes sense.
I further suggest that it was "immigrant displacement syndrome," a term I have evolved based on my own clinical observations, that created the explosive cocktail that erupted on Monday.
Cho's family came to the U.S. as immigrants. They were hard working, perhaps in retrospect too hard working. They retained Korean traditions and a Korean state of mind despite adapting successfully to the economic challenges of their new homeland. And they could not understand a confused child as he grew apart from his immigrant roots and became an assimilated American.
The onset of schizophrenia provided the incendiary stimulus for him to separate from his family and to separate from society. In other words, it took the explosive combination of a person undergoing immigrant displacement stress and the onset of schizophrenia to create the ideation of a mass murderer.
Here is where society failed Mr. Cho. People do not take the unstable behavior of college students very seriously. Many "mental health" problems are ascribed to college adjustment, to parental separation. "Lovesick" students are not taken seriously. And we don't really pay much attention to the way immigrants undergo pain as their lives are disrupted in their new environment.
In Mr. Cho's case the displacement was internalized because his family was too busy to cope with his emotional needs. Once he began to act in what they thought was an "irrational" manner they probably shut down and he shut down and the result was a widening gap.
That is why the family is so silent, and why it is likely to remain silent. No one suggested or suspected that the gradual changes in Cho's personality were due to schizophrenia.
Recently, a young actress, Adrienne Shelly, was murdered in Greenwich Village. How did her 19 year-old immigrant killer become a cold-blooded murderer instantly, without any history of violence? The killer was potentially unstable and that instability was exacerbated by immigrant displacement. He acted irrationally, explosively. Ms. Shelly was murdered in a moment. The killer then created an elaborate improvised crime scene, again instantly. He was thinking and unthinking at the same time.
In Mr. Cho's case his disorientation and displacement may have become internally intolerable as he decompensated, i.e. became delusional and lapsed in and out of reality. He seems to have lived in a general funk. He received no mental health counseling, no medication, nothing. Because of inattention and ineffective supervision (read: lawsuit) he became a time bomb.
In retrospect, his explosion is no surprise. We cannot
predict when a psychotic person will explode, but unless treated with medicine and counseling they are volatile and can become irrational at any time. Cho received no treatment and eventually he exploded.
So here is the theory, summarized: Cho was disoriented and displaced as a result of his hard-working immigrant family's focus on economic survival and success; he felt stress from his own psychological separation both as an adult and as someone leaving behind his Korean heritage and becoming an ordinary American college kid. What in reality was the slow onset of schizophrenia was mistakenly perceived by school and family as "difficulty." Eventually his alienation turned to anger.
College can be very stressful even for healthy young adults. It can be disastrous in cases such as Mr. Cho's where a mental illness such as schizophrenia descends slowly and initially is not properly diagnosed. And when schizophrenia struck Cho, and he was either misdiagnosed or not diagnosed at all, he became the monster that committed mass murder on April 16th.
What does Cho's odyssey tell us? Here some thoughts. It is terribly unfortunate that a school with over 20,000 students had such inadequate mental health treatment options. Immigrants, especially, need extra mental health resources to cope with the changes in their lives. Cho should either been diagnosed or disenrolled from school.
When Cho encountered the stingy Virginia court system, court personnel were interested in closing his case, not in analyzing him for treatment. The same appears to have been the case at the treatment facility where he was evaluated and released. There was no follow-up, no peer review of his misdiagnosis. He was not taken seriously; his illness casually ignored.
In our modern society we have identified one species of mass murder, "going postal," that is strikingly similar. Often the explosion comes because someone who is feeling the onset of psychosis/schizophrenia responds to stress with violence and anger.
We treat mental health insurance as a stepchild of the
medical profession. Congress and the states need to do more; we can help prevent tragedies such as a massacre at Virginia Tech only if we realize and accept that our understanding of mental illness is still very incomplete.
We must treat mental health problems with the same attention and seriousness that we apply to other traditional illnesses. Had Cho been diagnosed and treated with one of the several drugs available, he might have never exploded, and dozens of people would be alive today.
Family-immigration alienation and displacement-schizophrenia. Analyzed in context, Cho's garbled message in the package sent to NBC News seems strikingly coherent and preordained. The signs were there before April 19th and we ignored them; and even after April 19th, when the NBC envelope arrived, we failed to understand how a series of unconnected facts can be tied together to simply and directly explain Mr. Cho's tragic actions at Virginia Tech. Profile: Completed.
Chicago-based Internet journalist, broadcaster and media critic Andy Martin is the Executive Editor and publisher of © Copyright by Andy Martin 2007. Martin covers regional, national and world politics with forty years of personal experience. Columns also posted at; Comments? E-mail: Media contact: (866) 706-2639 Web sites:;


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