Is anyone still surprised that mass shootings continue to occur? Sure, we're still horrified at the loss of life and the sheer depravity of the act, but let's not kid ourselves. Mass shootings have become a part of the American experience. We have come to expect them. We don't know when they'll happen or where, but we now have a reasonable expectation that somewhere in America, at some time in the not too distant future, someone will walk into a school, a mall, or a church and open fire. People will die, families will grieve, and those with the power to do something about it will continue to do nothing. Yes... we will all be outraged, demand action, and go for the throat on Twitter and Facebook... for a while. After a short time, we all ease back into the complacency of our lives and hope it's over... but we know it isn't. Here we dwell, in this place of denial and fear, until we are again forced to watch the horror... and we are again momentarily outraged... momentarily.

The senseless loss of life this past week in Charleston, SC has brought untold pain and misery to a community. My heart goes out to these families. The strength and resolve they have shown in the face of absolute horror is nothing short of humbling. I recognize them as my betters and as people from whom I could gain much wisdom. I know I would not have their resolve... just thinking about losing my daughters or my wife makes me want to burn down the world. I can recognize my own sickness, however, in that I find myself wishing they would do just that... burn down the world and take revenge upon those who have taken so much from them. But they won't. For this, I stand in awe of their bravery.

Over the coming weeks and months, we will no doubt hear a plethora of lofty ideas seeking to answer the "why" of this latest mass murder. Even now the theories are starting to roll in... one by one... each as irrational and unfounded as the next. Predictably, the self-appointed leader of paranoid America, Alex Jones, says the shooting is "a government plot to start a race war and persecute conservatives". Rick Perry weighs in with that age-old chestnut, prescription drugs caused the shooting. Not to be outdone by anyone, Fox News throws in their two cents to say it was caused by living in a multi-cultural society or, as an alternate theory, the whole thing was actually an attack on Christians... of course.

As a therapist and someone professionally trained in the assessment of risk for near-future violence, these excuses would be laughable were it not for the fact that they're using an unimaginable tragedy to further their own political ideology. At the very least, they're simply regurgitating the library of complete bullshit that masquerades as right-wing "science". The simple truth is this: there is not now, nor has there ever been a single cause for mass murder. There is not a single personality profile associated with those who are going to commit acts of unspeakable violence. It's not medicine... it's not multiculturalism... and it sure as hell isn't some conspiracy theory cooked up in the sad and lonely world concocted and inhabited by Alex Jones.

Of all the research-based factors for which I assess during a formal threat assessment, only one is highly correlated to those who HAVE acted out violently. Mass murderers such as Cho Hui Seung, Eric Harris, Jared Loughner (although not technically a mass murderer), and others all developed what noted forensic psychologist Dr. Reid Meloy has termed a "paranoid pseudo-community". A paranoid pseudo-community is formed by the soon-to-be murderer when they begin to tie individuals or groups of people together in their mind as the root cause for their own suffering. The subject begins to see these groups or individuals as their oppressors or as the cause for their life not being what they want. In the case of Cho Hui Seung, this paranoid pseudo-community was comprised of people Cho perceived as having money, coming from wealthy families, whom he described as "snobs". These people were not hallucinations, they were real people. But they were not linked together in reality. Their conspiracy and oppression of Cho existed only in his mind. We can see this pattern of thinking repeat itself in the case of Loughner, in the case of Harris, and in the case of many other mass murderers. But, while this delusional system is found within the cognitive schema of many mass murderers, it's not found in all. Again, there is no single factor, symptom, or red-flag that is solely diagnostic of imminent violence.

It would not be a stretch to say that, if someone is exhibiting signs of developing a paranoid pseudo-community, they should not have a gun... and should not have easy access to a gun. It also makes sense that mental health treatment and assessment needs to be well-funded, accessible, and immediately available. Clinicians need to be trained in the assessment of those research-based factors which ARE indicative of a higher likelihood for violence. To be clear, these factors are not predictive of violence itself. They are indicative of a HIGHER LIKELIHOOD for violence. While it makes sense to address the etiology of mass murder and to make efforts to stop it, instead we have an ongoing and brutal evisceration of mental health programs and treatment funding as well as a seemingly endless slew of legislation making it easier for anyone and everyone to get a gun... and then to take that gun wherever they please.

But... even if guns continue to infest our communities in record numbers and mental health treatment and assessment is never adequately funded, those in positions of influence such as the those in the right-wing media or vocal Tea Party/GOP politicians, could make a single change that would have a profound impact on the number of mass murders in America. They could stop providing people who may be at risk to commit acts of violence with ready-made, pre-packaged, paranoid pseudo-communities. They could simply stop offering up the poor, immigrants, minorities, gay people, liberals, democrats, muslims, non-Christians, and others as the cause for the misery the next mass murderer may be experiencing at this very moment. As it stands though, the new blood spilled by a right-wing racist in Charleston, is on the hands of those in the media and politics who continue to use hate, fear, and division to motivate their party.