Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

Reflections on school violence: a psychodynamic perspective

Jonathan Berent, LCSW
Conditions
April 15, 2018
Share
Tweet
Share

The mental health community must increase its clinical acumen regarding complex psycho-pathology consisting of the avoidant personality, social impotence, and related rage. School violence has taken on epidemic proportions since two disturbed adolescents masterminded Columbine and became role models for the mentally ill young men who drive the new culture of school shootings.

While the profile of the school shooter has evolved over the last couple of decades, it’s worth considering the behavioral patterns and psychodynamics significantly present in school shootings. For the mental health profession to increase its clinical efficacy with this very at-risk group, this consideration is imperative. The following can hopefully provide insight into this pathological scourge.

Shortly after Columbine, several of my young adult male patients with social anxiety said to me, in various ways, “I understand why those kids shot up schools.” I want to stress that these individuals did not have the DNA for such behavior, but the reason why they said what they did is important.

This reason is that these patients had experienced the painful experience of bullying and peer rejection, the emotional trauma of which created unresolved anger and rage. My patients were communicating their understanding of revenge for bullying, which at the time was considered to be the primary motivation. The Columbine assassins epitomized hatred for the social pecking order. Columbine represented the epitome of explosion and the power of revenge.

Research into the school shooter profile varies from articles claiming a “consistent profile” to a “differing profile from one another, in numerous ways.” However, there is a very strong correlation between aggression and the socially damaged who extract their revenge on peer groups.

Examples include the Sandy Hook shooter, who epitomizes a special needs- driven social disorder concurrent with sick parenting. The shooter at Virginia Tech displayed an obvious concern with his anti-social behavior and selective mutism. The shooter at Marjory Stoneman Douglas High School personifies a socially and emotionally broken individual and a broken system.

Despite educational campaigns that teach the positive power of introversion, human beings are social animals. When individuals are handicapped with social skills, social anxiety, and relationship development challenges, the result is often a void of pleasure and happiness. The sufferer may or may not be conscious of this void. The more this void of pleasure accrues, the more potential there is for anger and rage that creates a myriad of physical and mental symptoms when recycled in the human psyche.

The brilliant work of the late John Sarno, MD provides profound insight into the clinical realities of anger and rage. His thesis states that repressed anger and rage is so powerful that it inhibits the flow of oxygen into the bloodstream. This creates a condition known as Tension Myositis Syndrome, which is the etiology for physical symptoms not caused by biological organicity.

While the mainstream medical community questions this thesis, my clinical experience with thousands of social anxiety sufferers using Sarno’s treatment architecture has proven to be extremely productive. Bringing a patient’s rage to a conscious level and teaching channeling strategies have proved to be a primary dynamic for clinical success.

To further complicate things: while it is the responsibility of the media to report the news, focusing so much attention on the criminal reinforces the narcissistic pathology of the shooter. They know they will become infamous for their evil. Their revenge gives them the power they never had. Many are driven by the compulsion to score the most kills. Just like in many video games, the individual with the most kills becomes the winner. This often becomes a compulsion and core activity within the alternate universe in which many socially challenged individuals exist.

It appears that pathology homeostasis has been achieved with school shootings, given the intensity of societal forces working against one another. These forces include the void of mental health background checks, the superabundance of assault weapons, and the lack of clinical acumen by the mental health community regarding the rage-filled socially impotent.

As society searches for answers to this epidemic, the mental health community must step up to the plate and productively treat rage and the socially impotent, while working to increase awareness about the implications of the elusive avoidant personality.

Jonathan Berent is a psychotherapist and the author of Beyond Shyness, Work Makes Me Nervous, and Social Anxiety: The Untold Story. He can be reached at SocialAnxiety.

Prev

Emergency physicians are glorified secretaries with medical degrees

April 15, 2018 Kevin 15
…
Next

Physicians: What are your endpoints in personal finance?

April 16, 2018 Kevin 0
…

Tagged as: Psychiatry

< Previous Post
Emergency physicians are glorified secretaries with medical degrees
Next Post >
Physicians: What are your endpoints in personal finance?

ADVERTISEMENT

More by Jonathan Berent, LCSW

  • When high achievers and isolated adults share a common enemy: social anxiety

    Jonathan Berent, LCSW

Related Posts

  • Reflections after finishing the first year of medical school

    Batoul Harissa
  • Medical ethics and medical school: a student’s perspective

    Jacob Riegler
  • End medical school grades

    Adam Lieber
  • School vaccine exemptions must be for medical conditions only

    Shetal Shah, MD
  • The medical school personal statement struggle

    Sheindel Ifrah
  • Why medical school is like playing defense

    Jamie Katuna

More in Conditions

  • The continuum of fertility care: Why IVF is not the only option

    Scott Morin
  • Why heart failure care requires spaced repetition for doctors

    Vimal George, MD
  • Therapeutic alliance in psychiatry matters more than ever

    Timothy Lesaca, MD
  • Why doctors struggle to listen to your body after an injury

    Diane Alexander, MD
  • IVF insurance coverage depends on your ZIP code

    Laurel A. Coons, PhD
  • The deadly reality of eclampsia and maternal mortality in Nigeria

    Dr. Mansur Auwal Sani
  • Most Popular

  • Past Week

    • When shared decision making gives way to medical paternalism

      DeAnna Pollock, MD | Physician
    • How xenotransplantation could finally solve organ shortages

      Rafael S. Garcia-Cortes, MD | Conditions
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why early detection technology and precision medicine are failing patients

      Julie Chen, MD | Physician
    • The silent patient experience in the exam room

      Michele Luckenbaugh | Conditions
    • Closing the execution reliability gap in health care systems

      Katherine Owen, RN | Conditions
  • Past 6 Months

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Rethinking the role of family physicians vs. specialists

      Ronald L. Lindsay, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • The cost of time constraints in primary care: Why doctors feel rushed

      Ann Lebeck, MD | Physician
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Why Florida physician background checks are driving doctors away

      Tamzin A. Rosenwasser, MD | Physician
  • Recent Posts

    • Why early detection technology and precision medicine are failing patients

      Julie Chen, MD | Physician
    • Gradually, then suddenly: Dr. Robert Wachter on health care’s giant AI leap [PODCAST]

      The Podcast by KevinMD | Podcast
    • The continuum of fertility care: Why IVF is not the only option

      Scott Morin | Conditions
    • Physician autonomy is not separate from patient care

      Corinne Sundar Rao, MD | Physician
    • Why heart failure care requires spaced repetition for doctors

      Vimal George, MD | Conditions
    • 51 cases that reframe methylene blue serotonin syndrome

      Steven E. Warren, MD, DPA | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • When shared decision making gives way to medical paternalism

      DeAnna Pollock, MD | Physician
    • How xenotransplantation could finally solve organ shortages

      Rafael S. Garcia-Cortes, MD | Conditions
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why early detection technology and precision medicine are failing patients

      Julie Chen, MD | Physician
    • The silent patient experience in the exam room

      Michele Luckenbaugh | Conditions
    • Closing the execution reliability gap in health care systems

      Katherine Owen, RN | Conditions
  • Past 6 Months

    • Why clinicians fail at writing expert reports

      Tracy Liberatore, Esq, PA | Conditions
    • Rethinking the role of family physicians vs. specialists

      Ronald L. Lindsay, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • The cost of time constraints in primary care: Why doctors feel rushed

      Ann Lebeck, MD | Physician
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Why Florida physician background checks are driving doctors away

      Tamzin A. Rosenwasser, MD | Physician
  • Recent Posts

    • Why early detection technology and precision medicine are failing patients

      Julie Chen, MD | Physician
    • Gradually, then suddenly: Dr. Robert Wachter on health care’s giant AI leap [PODCAST]

      The Podcast by KevinMD | Podcast
    • The continuum of fertility care: Why IVF is not the only option

      Scott Morin | Conditions
    • Physician autonomy is not separate from patient care

      Corinne Sundar Rao, MD | Physician
    • Why heart failure care requires spaced repetition for doctors

      Vimal George, MD | Conditions
    • 51 cases that reframe methylene blue serotonin syndrome

      Steven E. Warren, MD, DPA | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Reflections on school violence: a psychodynamic perspective
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...