Philip Markoff, the 22-year-old accused Craigslist killer of model Julissa Brisman, may seem like the least likely of killers.  But when all the facts are known, Markoff’s story (if he is convicted) will start to make sense.  Granted, he’s a reasonably affable medical student without a criminal record ― but Scott Peterson was a friendly fellow and seemingly good neighbor before murdering his wife Laci and their unborn son, Conner.  Dr. Richard Sharpe,  the Harvard dermatologist (and cross-dresser, it turns out) was a respected physician prior to shooting his wife to death in front of their children.  Dr. Jonathan Kappler, a California anesthesiologist who murdered my friend and colleague Paul Mendelson back in 1990, had worked for decades as an anesthesiologist prior to accelerating to 60 mph in his car and intentionally mowing Paul down as he jogged. 
 
Psychiatric instability is often invisible until we look for it, in retrospect, after a terrible event triggers the inquiry.  But the evidence of that instability and the causes of it are never absent once we start digging. 
 
In the case of Philip Markoff, we could start excavating the roots of his violence by looking at his gambling habit.  If it is true that he owed gambling debts that motivated him to rob women-for-hire in hotel rooms, then he may have been someone deeply moved by the wheels of fate — by risk or ruin being determined by the alchemy of skill and the luck of the draw at a poker table.  In my experience treating gamblers, their connection to fate often comes from having little or no control over their lives as much younger people.  Sometimes, that adds up to having had parents who could have cared less about their feelings or desires. Sometimes, it adds up to not knowing when the next beating was going to come. And sometimes, it adds up to too many sudden losses. 
 
But it always adds up. When someone shoots a woman, then calmly walks to his car sending off text messages, he is unmoved by the cruelest roulette life can serve up.  Somewhere deep inside him, he is used to destruction because he has been destroyed.  He is without feelings because he has tried desperately to wall off his own — whether fear or grief or rage.
 
If I were with Markoff right now, I’d want to know why gambling spoke to him.  Why was Foxwoods the kind of place he felt at home?  Why was it the place he reportedly planned to marry his fiancé? 
 
Markoff also allegedly preyed upon women.  He didn’t pistol whip drug dealers and make off with their cash.  Maybe, if he’s guilty, he’s had it in for women.  Maybe he harbors deep feelings that his life was “stolen” from him with the dissolution of his parents’ marriage and its aftermath.  Maybe he thinks they’re all prostitutes when it really comes down to it.  Maybe he thinks they’re dangerous enough to him emotionally ― or even physically ― that they need to be tied up.  We don’t know — yet.  We never know, until we ask the relevant psychological questions.
 
I’ve been a forensic psychiatrist now for many years.  And I’ve learned one thing for sure:  No killer comes out of the blue.  No child is born into this world evil.  Every act of destructiveness can be explained.  And no one, not even a medical student whose fiancé loves him very much, is ultimately much of a mystery once you decide to burrow beneath the surface.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

Resist the behaviors that keep the pain buried

None of us want to feel pain.

 That’s why we are all very adept at finding habits and behaviors that keep our minds from focusing on it. These habits and behaviors are called because we hide behind them, and use them as barriers against sadness, anger, disappointment or painful memories.

Some shield strategies are very obvious. Some are much more subtle. Some of the most common shield strategies include:

– Overspending
– Constantly arguing with your husband, wife, or partner
– Obsessive dieting or exercise
– Sexual indiscretions or sexual addiction
– Pornography addiction
– Gambling
– Overeating
– Obsessing over romantic relationships
– Alcohol, drugs and/or cigarettes

     The common denominator of all these shield strategies is that they cover up the truth. They soothe us, and let us feel that for now, everything is OK. But once their intoxicating or anesthetizing effects have worn off, we are left with the same pain we sought to mask.

Step Three is about finally breaking that cycle. It is about telling yourself that the temporary pleasure, thrills, and boosts in self-esteem that you get from shield strategies are no longer enough for you. It is about clearing away temporary balms and short-sighted feel-good strategies so you can prepare for real growth. It is about recognizing that you are stronger than you believed, and knowing you don’t need to hide from your truths.

It might help to imagine that beyond the shield you’re holding up is a mirror. You can’t see the mirror because the shield is in the way. But the mirror is capable of reflecting who you are and where you’ve been, going all the way back to your earliest years.

Now envision that in order to start seeing in the mirror, you have to start putting down the shield. You don’t have to drop it all at once, but you have to begin to lower it, slowly.
As long as you’re holding a shield, you are living in fear. When you put the shield down, you’re starting to live the truth.

The first thing you want to do is to identify your shield. It might be very obvious, perhaps something from the list above, and it may be the reason you were motivated to visit LivingtheTruth.com in the first place.

Having trouble identifying your shield strategies? Think about anything you do repeatedly that tends to powerfully shift your focus away from yourself and what you truly value and care about. Maybe office or family gossip has you on the phone late into the night or interferes with your daily activities. Perhaps you’ve taken to obsessing about the clutter in your house as a way of forgetting about the clutter in your head. Perhaps it is yo-yo dieting or a tumultuous relationship or the cigarette in your hand (all shield strategies) that distracts you from the underlying, emotional questions you could be answering right now. And answering them would free you to live a much more powerful future.

You may want to write down a few ideas about what your shield is, and come back to the question a few times over the course of a day. Whenever you find yourself thinking about something you don’t want to do, or a challenge that you don’t want to face, make a note of what you reach for. It may be a drink or a cigarette or the controls to a video game. It might even be a behavior that seems “healthy” – like a vow to climb every peak on the eastern seaboard before age

Be sure to record your shield strategies on your MyTruth page size: Once you identify a shield strategy, it’s time to oppose it. It would be wonderful if a two-pack-a-day smoker or an alcoholic were to quit right now. But that isn’t realistic for most people. Living the truth starts with simply paying attention to your shield strategies more than before, noticing how often you use them, and beginning to resist them. If you’re too hard on yourself – I’m so heavy that I just can’t even begin to diet; I’m so heartbroken that I will never stop thinking about him; I’m so far behind in my career that I have to work day and night or I’ll never catch up – you run the risk of giving yourself reasons to stop before you begin.

Make your changes small and manageable. Even simple changes, like throwing out one type of food you tend to binge on, taking a walk instead of reading an old lover’s email again, or changing one section of your resume instead of playing another computer game, are steps in the right direction of self-discipline, self-esteem and genuine self-improvement.

Remember that it isn’t supposed to feel good when you start using anti-shield strategies. The fact that you feel anxious or depressed or irritable when you leave an obsessive relationship, or stop binging on sweets is a sign that you’re detoxing. You’re discovering the art of spending time with yourself. The more you can put down your shield, the harder it gets for your mind’s defense mechanisms to muster forces against the truth.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com.