Section: PHYCHOLOGY IS THE COLORADO SHOOTER DEPRESSED, INSANE, OR PSYCHOTIC? ANATOMY OF A DOWNWARD SPIRAL. FROM THE moment news broke of another shooting in Colorado, the question reverberated: why? As the tragedies continue, our collective national frustration has boiled over: Aurora, Columbine, Tucson, Virginia Tech … Why does this keep happening? Why can't someone explain? In the 80 interminable hours it took to get a glimpse at the suspect, a second question emerged: what was a look at James Holmes going to reveal? When he walked into court Monday morning, one thing was immediately obvious. Something was wrong with this guy. Which was weirder, the dazed expression he wore most of the 11 minutes of the hearing, or the sudden bursts of wild eyes, matching his ridiculous orange hair? The obvious explanation, which many viewers and commentators embraced, was that he was out of his mind or, medically speaking, undergoing some sort of psychotic break. But a minority view pushed back, and hard: the hair, the eyes, the sensational getup tor the attack were a little too cute: a coldblooded killer, playing crazy. You will never understand this man if you leap to either of these conclusions. Do not look for a unified theory of mass murder, a single coherent drive. It doesn't exist. Examining all the mass murderers together yields a hopeless mass of contradictions. Forensic psychiatrists are not baffled by these tragedies. One drive will never explain them. Instead, experts have sorted them into types, which bring the crimes into remarkably clear relief. These researchers find that aside from terrorism, most of these mass murders are committed by criminals who fall into three groups: psychopaths, the delusionally insane, and the suicidally depressed. Look through these lenses, accept the differences, and some of our worst recent tragedies make more sense: SeungHui Cho, who shot up Virginia Tech, was delusionally insane; Dylan Klebold, at Columbine, was deeply depressed; and Eric Harris, his co-conspirator, was the psychopath. Occasionally, there are combinations, or rare exceptions, involving brain tumors or substance abuse. The substance danger has made a resurgence with the abuse of bath salts, recently implicated in many violent crimes. Mass murderers do share a few common traits. The best meta-study on the subject is an exhaustive report by the Secret Service in 2002, which studied all school shooters for a 26-year period. In this cohort, all the shooters were male, 81 percent warned someone overtly that they were going to do it, and a staggering 98 percent had recently experienced what they considered a significant failure or loss. Despite this last fact, the ubiquitous question "what made him snap?" leads us astray. The Secret Service found that 93 percent planned the attack in advance. Hardly spontaneous combustion. A long, slow, chilling spiral down. Early evidence in the Aurora case suggests it fits this pattern. James Holmes apparently spent months acquiring the guns and ammunition he used, and it's likely his descent began much earlier. What set him off down that path? PSYCHOPATHS ARE the easiest to explain. They seem to be born with no capacity for empathy, a complete disregard for the suffering of others. The sadistic psychopath, a rarity, makes a cold-blooded calculation to enjoy the pain he inflicts. Killing meant nothing to Eric Harris at Columbine-humans were as disposable as fungus in a petri dish. "Just all nature, chemistry, and math," he wrote. Harris was witty, charming, and endearing-like most psychopaths-but he artfully masked his hate. "I hate the f-king world," his journal begins, a year before the attack. Hate roars from every page, but it is contempt that really comes through. "You know what I hate?" he posted on his website. "People who mispronounce words, like 'acrost,' and 'pacific' for 'specific.' You know what I hate? The WB network!!!! Oh Jesus, Mary Mother of God Almighty, I hate that channel with all my heart and soul." What an ordeal for him to tolerate all us inferior beings. Harris's burning desire was a command performance to show us how powerful he really was: "I have a goal to destroy as much as possible," he wrote in his journal. "I want to burn the world. KILL MANKIND, no one should survive." For those bandying about terms like "evil," "bad seed," or "born bad," this is who you have in mind. Sadistic psychopaths are callous, vicious creatures, probably born that way, with cruelty to animals and a fascination with fire typically showing up by grade school. There is no known effective treatment or cure. It is what the otherwise eloquent Colorado Gov. John Hickenlooper was describing when he went briefly astray and called the Aurora killer "delusional," "diabolical," and "demonic." Can we spot these killers? Of the three types of mass killers, psychopaths leave the fewest warning signs. They are master manipulators who delight in deceit. People see them as kind, trustworthy, and endearing. But it is an elaborate ruse. Harris bragged that he deserved an Oscar for duping his parents. Families who met with Wayne and Kathy Harris told me the Harrises realized in retrospect their boy was a psychopath, but were oblivious to that danger at the time. They knew he had anger issues, and legal run-ins; they were punishing him sternly, restricting his freedom (the surest way to infuriate a psychopath). They thought if he could find an interest or vocation in which to immerse himself, his idle hands would be out of the devil's playground. How were they to know he was flexing his creative muscles, staging an elaborate death ritual? Those who saw Holmes's bizarre courtroom behavior as a calculated ploy to appear insane are describing a psychopath, also called a "sociopath" by clinicians. Psychopaths are not crazy in the sense that they don't know what they are doing. They are hyperrational-they just don't care about our pain. Psychopaths are remarkably like Heath Ledger's Joker in The Dark Knight, if you strip away the costume and theatrics. But psychopathic killers have one Achilles' heel: they revel in glory and like to brag. Look for clues as James Holmes's history comes to light. WHILE PSYCHOPATHS kill for their own amusement, severe psychotics-a very different category of sufferers-are driven to slaughter to extinguish their torment. Their agony is typically apparent to everyone. The official report on the Virginia Tech killings documented Seung-Hui Cho's steady disintegration, beginning in third grade and reaching homicidal ideation by eighth. It listed a dozen pages of "aberrant behavior," from "pathological shyness and isolation" to stalking women in the dorm. Cho wrote weird, angry plays for creative-writing class, which he refused to discuss. He sat silently, spurning eye contact, with his ballcap pulled down to shield his eyes. Since the tragedy, Cho was widely diagnosed as psychotic-the clinical term for a broad spectrum of deep mental illnesses including schizophrenia and paranoia. Psychotic killers are, most commonly, suffering from schizophrenia, a disease marked by delusions, hallucinations, and loss of emotion, speech, or motivation. Schizophrenia seems genetically predetermined but generally lies dormant until the late teens or early 20s. Alleged Tucson killer Jared Lee Loughner, 22, and Reagan would-be assassin John Hinckley, 25, were both diagnosed as schizophrenics. Severe psychotics like Cho are delusional, way out of touch with reality. And yet most who suffer from these mental illnesses, even some severely, pose no threat to anyone but themselves. So how does a mentally ill man like Cho make that awful journey to the trigger of a gun? Slowly. Days or months of planning are preceded by years of mental unraveling. As the disease sets in, the victim is typically perplexed and then distraught by the alarming thoughts ricocheting around his brain. Occasional flutters build to a chorus of angry chatter. "Schizophrenic delusions are usually grandiose and persecutory," noted psychiatrist Dr. Frank Ochberg explains. "There can be terror as a teen or young adult feels he is losing his mind." Cho was a red-flag assembly line. Everyone around him could see. Cho even checked himself in for a psych evaluation. What we fail to grasp about killers descending into this kind of illness is the fear. Picture yourself waking up this morning, coherent enough to see that yesterday you were off your rocker. Likewise, three days ago. And two days last week. In and out, but drifting deeper into what you see quite clearly as the crazy pit. Could you get help? That would require confessing. Too dangerous. If you shared what you were up to yesterday, you'd land in a padded cell, electrodes attached to your head, medications administered to obliterate your personality. No way. Most schizophrenics survive the internal terror, but for future killers, the delusion can be a coping mechanism: I'm not losing my grasp, you people are just out to get me. Arm yourself. Oh God. Which way to point it? Me? Them? For most mass murderers, it will end up being both. "Do you know what it feels to be spit on your face and to have trash shoved down your throat?" Cho railed in his manifesto before killing at Virginia Tech. "You have vandalized my heart, raped my soul, and torched my conscience. You thought it was one pathetic boy's life you were extinguishing. Thanks to you, I die like Jesus Christ, to inspire generations of the weak and defenseless people." Cho found a way to help everyone. He would be the hero of this tragedy. "There was pleasure in planning such a grand demonstration of 'justice,'" wrote Roger Depue, former chief of the FBI's Behavioral Sciences Unit, in the official report of the Virginia Tech Review Panel. "His thought processes were so distorted that he began arguing to himself that his evil plan was actually doing good." These tortured minds can lurch momentarily from one extreme to the next, an exhausting ride. Ochberg explains that the flat affect tends to be rather constant, while the bizarre impulses and behavior tend to come and go in bursts. It can puzzle the untrained observer. Psychiatrists who consider Holmes, the alleged Aurora killer, psychotic, would not have been surprised to see him looking catatonic for most of his court appearance, with fits of crazy eyes. It's unclear whether Holmes is schizophrenic, but his behavior would fit neatly with the profile if he is. THE THIRD type of killer is the hardest to fathom. Depression, for mass murder? We've all tasted depression, or some version of it, so we think. But it's not even close. Dylan Klebold, before his rampage at Columbine, felt his soul dying. Hopeless. Helpless. Unrelenting despair. He documented it in a private journal for two years. He also left telling school essays and notorious videotapes. The wealth of information provides one of the most enlightening portraits of the depressive descent to a killing spree. "Such a sad, desolate, lonely unsalvageable I feel I am," Klebold confided to his journal, "not fair, NOT FAIR!!! I wanted happiness!! I never got it!!! Let's sum up my life, the most miserable existence in the history of time." Other days, Klebold's spirit soared. He dreamed of a blissful world, with himself vaguely superhuman, "this tranciever of the everything." It's glorious. Tranquil. Radiating with love. Klebold fills entire pages with elaborate hearts. "OH MY GOD," he gushes between suicidal gasps, "I am almost sure I am in love. Hehehe." The despair returns. His writing grows erratic, fevered all-caps: "F--KIN DUM-ASS SHITHEAD…F-- K!" He grows quiet, returns to his tidy penmanship to close out the entry: "No emotions, not caring. Yet another stage in this shit life. Suicide." A startling wake-up call came three years after Columbine. The Secret Service found that 78 percent of shooters had a history of suicide attempts or suicidal thoughts. Sixty-one percent had a documented history of extreme depression or desperation. The difficulty is not in recognizing a problem, but its severity. An angry, moping teenage boy? That describes much of the high-school population. Dylan's mother, Sue Klebold, wrote movingly about her experience in an essay for O Magazine in 2009: "I believed that if I loved someone as deeply as I loved him, I would know if he were in trouble." She saw only sadness. "He did not speak of death, give away possessions, or say that the world would be better off without him." Sue Klebold used the piece as a plea to other moms to take what appears like recurring sadness seriously. Good advice. The U.S. Preventive Services Task Force estimates that 6 percent of American adolescents-2 million kids-suffer clinical depression. Most go undiagnosed. With one quick skim of Klebold's journal, suicide is easy to understand. But why take others with you? Murder instead of suicide comes down to whom you blame. Through much of his journal, Klebold blames himself (he talks about suicide on the very first page). Sometimes God. But slowly, gradually, he focuses the blame outward. Most vengeful depressives blame their girlfriend, boss, or schoolmates. Some just aim to kill those targets. But the eventual mass murderer sees it differently: it wasn't one or two mean people who drove him down, it was all of us. Society was brutal, the whole teeming world is mean. We all need to understand what we did to him; we all need to pay. "In 26.5 hours ill be dead, & in happiness," Klebold finally wrote. "The little zombie human fags will know their errors & be forever suffering & mournful. HAH AH A." Two months before Columbine, he wrote a chilling short story for a creative- writing class-after Harris had already assembled the guns and some of the explosives. The story involved a single killer very much like Harris shooting down random "preps" in cold blood, with many of the same atmospherics planned for Columbine. The first-person narrator, apparently a stand-in for Klebold, is just an observer. He watches the gunman intently, and in the final moments, gets a good look and sees right into him. "I not only saw in his face, but also felt emanating from him power, complacence, closure, and godliness." Sounds pretty appealing. Especially compared to "the most miserable existence in the history of time." These seem strikingly similar to Cho's rants, but Klebold understood what he was doing. Cho had lost the ability to discern reality from fantasy. In his reality, he was helping the world. Klebold knew he wasn't. He was just getting even. Most mass murderers intend to die in the act. And most do. James Holmes was an exception, meaning a trial, a psychological evaluation, and answers about why it happened this time. If Holmes is a psychopath, he probably had a ball Friday. He would have been gleeful through the months from conception to planning and attack. If he's not a psychopath, he may have spent months or years descending into his own private hell. But which hell? Insanity or suicidal depression? Anyone who claims they : can answer these questions this early is ignorant or irresponsible. But we will learn, NW + ON THE IPAD Watch Interviews with survivors of the 2011 Tucson shooting. PHOTO (COLOR): VA TECH: 32 KILLED, 17 INJURED: SEUNG-HUI CHO DELUSIONAL PHOTO (COLOR): COLUMBINE: 13 KILLED, 24 INJURED: ERIC HARRIS PSYCHOPATHIC PHOTO (COLOR): COLUMBINE: 13 KILLED, 24 INJURED: DYLAN KLEBOLD SUICIDALLY DEPRESSED PHOTO (COLOR): A long, slow spiral down probably led to the killings in Aurora, where this memorial stands. PHOTO (COLOR) ~~~~~~~~ By DAVE CULLEN I L L U S T R A T I O N B Y G L U E K