The American Spectator

English teachers were disturbed by his angry writings and oddness. According to the New York Times, “Lucinda Roy, then head of the English Department at Virginia Tech, began to tutor him privately. She, too, was unnerved. She brought him to the attention of the counseling service and the campus police because she thought he was so miserable he might kill himself.”

Even his classmates sensed his underlying psychosis. One of them said that after he finished reading one of Cho’s weird plays one night, he turned to his roommate and said, “This is the kind of guy who is going to walk into a classroom and start shooting people.”

Late in 2005 he became fixated on several real female students. Two of them complained to the police that he was calling them, showing up at their rooms, and bombarding them with instant messages. After the second complaint against him in December 2005, the police came by and told him to stop.

A few hours after they left, the New York Times reports, “…he sent an instant message to one of his roommates suggesting he might as well kill himself.”

ALL OF THIS ADDED UP to an individual who was significantly out of touch with reality. Like most psychotic people he was a quiet “loner” who avoided social relations, afraid of other people finding out how fantastic his thoughts were. The point is that he should have been under psychiatric care and close observation at least from December of 2005. That he was not is partly the result of the dominant attitude at Virginia Tech and most other schools — the therapeutic culture’s requirement that bizarrely behaving students be “tolerated,” handled with kid gloves, and that the offending behavior be treated as though it does not exist — pretending that there is no elephant in the room. Unfortunately, the laws enacted since the seventies protect this state of things. A school may not suspend or expel a student with mental illness who is or becomes psychotic — more absence of common sense. And further, the school may not share any information about the student and his aberrant behavior with anyone, even if such information might be helpful in the patient’s treatment.

This is what happened in Cho’s case. After he threatened suicide the campus police were called, and Mr. Cho was sent to an off-campus mental health facility. After a counselor recommended involuntary commitment, a judge signed an order deeming him a danger and he was sent for evaluation to Carilion St. Albans Psychiatric Hospital in Radford, Virginia. A doctor there wrote a cursory report: “Oriented X4. Affect is flat. Mood is depressed. He denies suicidal ideation. He does not acknowledge symptoms of a thought disorder. His insight and judgment are normal.” The doctor who wrote that Cho had normal judgment and insight — insight in this case meaning the capacity to understand how sick he was — was either quite inexperienced or incompetent if he could not see what so many of Cho’s classmates and teachers could see. In any case, if the examining psychiatrist had been informed that Cho had been behaving in ways that suggested that his reality testing and judgment were impaired, he might have required that the patient spend a couple of weeks being observed on an inpatient unit. While there, the degree of his psychopathology would have been ascertained and realistic treatment plans might have been formulated.

But the system failed Cho and the University. And although the judge ordered him to undergo outpatient treatment, as far as we know he never even tried and thirty-three people died.

The forces that can be unleashed in severe mental illness — psychosis — are very powerful. And of course it is a mistake to focus on Cho’s guns. As his videos show, he could have killed with a hammer, or a hunting knife, and he could have become a serial killer with these. The gun was only more effective and dramatic. Psychotic killers can use anything as a weapon. A distraught mother can kill her five children by drowning them in a river or the bathtub. Or he could have become a “Unabomber” like Theodore Kaczynski, another psychotic loner whose final score was 3 killed and 23 mutilated.

The most important thing is to see aberrant behavior realistically as a sign of a possible psychosis and deal with it realistically — not tolerate it as an aspect of the individual’s “creativity” or politely ascribe it to simple shyness, in accord with the attitudes of the therapeutic culture.

The attitudes and techniques of the therapeutic culture — non-judgmental toward behavior (moral neutrality), empathic, understanding — have only one useful and proper place — a treatment venue: a consulting room or hospital. There is no place for these in schools or in any other life situations. Their use outside of clinical situations can only result in a perversion of normal guidelines for social behavior, confusion for teachers and students, and ultimately resentment and mischief.

These attitudes and the clinical techniques based on them emerged out of the practice of psychoanalysis in the early part of the century to deal with clinical problems unique to analysis but with no other application outside of analytic therapy. This came to be misunderstood by those who fell under the influence of psychoanalysis either as patients or students in schools of education and social work. Aping their analysts or teachers, they came to believe that these attitudes were in and of themselves therapeutic. And over the years these misunderstandings have gained ground and replaced reality — and common sense — as the guiding principles of education and social work.

It would be highly desirable to change the laws that stress the “civil rights” of the mentally ill in schools and that encourage the view that the privacy of the mentally ill individual trumps his health and well-being to laws that support early recognition of severe mental illness so that he may be helped to treatment and management of his psychosis in a timely way, and prevented from doing serious harm to the innocent.