The recent murder cases of Annie Le at Yale, possibly by 24-year-old Yale lab technician Raymond Clark, and of Trisha Leffler by accused Craigslist killer Philip Markoff obviously took the lives of two young women and shattered the lives of their families.  I have treated parents of murdered children, as well as their siblings, and know that the surface scars may fade over time, but that the internal emotional bleeding—the complicated grief—never seems to end. 
 
Less attention is paid to the other victims of such horrific crimes—the families, girlfriends and friends of the killers.  Both Raymond Clark and Philip Markoff were not only the sons of mothers and fathers, but both men were engaged to be married.  In both cases, if convictions are obtained, their fiancés are left to pick up the pieces of their psyches, battered by the knowledge that they had loved and committed themselves to men who were pathologically violent.
 
When one’s son or daughter, husband or wife, or fiancé turns out to be a stranger full of darkness, it is a reckoning with reality like few others.  I have counseled such individuals and seen the tears in their eyes and the stress in their faces as they tried to make sense of how someone seemingly so close to them could have been, in fact, infinitely far removed. If people who profess their love can keep their darkest truths under wraps, who and what can be trusted in the world?
 
Many, many people know something about the challenges that face the “survivors” of intimate connections with murderers.  After all, my practice has long been populated by those who were injured by assailants who played the role of parents, teachers and mentors. Their ability to trust is often long in being reborn, relying not a little bit on how trustworthy and reliable I can be as a clinician.  Such is the miracle of human empathy:  the example of a decent, caring relationship can mend some of the damage done by a harmful one, even a predatory one.
 
Yet to have lived with or loved a killer is a special case.  The journey back from that kind of terror and self-doubt has several ingredients.  First, it has to be said that there are among us men (and women) who can indeed wear what the great psychiatrist Hervey Cleckley called a mask of sanity.  Having buried their destructiveness and rage deep inside them (until it explodes) they become people imitating people, doing those things that seem kind and respectful, without feeling kind or respectful.  They are playacting, and they can be better at it than the best actor in any movie.  Scott Peterson, who killed his wife Laci and their unborn son Conner, was such a man—likeable, with good manners, able to win women over with one-liners harvested from movies and chilled champagne tucked in a backpack for a romantic hike.
 
So those who share their lives with killers can take some solace in the fact that many pass themselves off as normal, even to law enforcement officials and psychiatrists. That’s the easy part.
 
The harder part is understanding that there can be a reason why those who turn out to have loved killers find themselves in that rare psychological territory.  And often that relates to their own willingness to distance themselves from core feelings of anger and anxiety and accept the surface of things. Very often the lovers and best friends and even parents of killers have had traumatic life experiences that paved the way for them turning a blind eye to their emotions and instincts, making them the ideal partners for predators. 
 
Predators can sense when they are in the presence of others who will take them at their word. 
 
Like most of our emotional challenges in life, the biggest hurdle to healing for those with a killer in the family is looking inside themselves, at the very things they have tried to avoid seeing.
 
Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

The murders of Arturo Gatti, possibly by his 23-year-old ex-stripper wife, and of Steve McNair by his 20-year-old lover, may reflect yet another sign that more Americans than we know —especially younger Americans — are losing their sense of self and, with it, their psychological and moral bearings.  

Certainly, crimes of passion are nothing new.  As has always been true, the killers of Gatti and McNair had to have had extreme life stories with major psychological fault lines reaching back, quite possibly, to childhood.  But in both cases, the victims were famous men who may well have offered the women in their lives temporary and fragile shelter from deep, unresolved questions about whether they could exist independently or would crumble into nothingness without their connections to fame and fortune. It is often those who feel dead themselves who take the lives of others.

Some may think it’s too big a leap to draw any connection between a lack of respect for life and the artificial, Internet-based, technology-fueled existences that too many of today’s teens and twenty-somethings have lived, but I’m not so sure.  I think that the kind of existential panic — the panic of having nothing real at one’s core — that can lead a young woman to murder her famous lover, rather than lose him, is a distant cousin of posting videos on YouTube of staged beatings and the deconstruction of real lives and relationships into profiles, IMs and tweets.

In a world that worships reality TV parents who turn their children into entertainment automatons and a psychologically disturbed pop star whose celebrity was initially forged through enslavement to his sadistic father, respect for one’s own life and that of others can start to erode.  Gaining fame and saving face on Facebook is what matters, and the loss of image can feel like the loss of everything.  I hope I’m wrong.  I hope that cases of extreme violence are now just the same as they always were — outlying cases that are no predictor of anything about the rest of us.  

But as a psychiatrist who has made it part of my life’s work to resist dismissing my instincts, I now sense something ominous about our culture reflected in the worst deeds of the most violent among us.  I fear we are at risk for losing respect for one another and for human life.  I fear our fragile God-given capacity for empathy is under siege. I fear that in obsessing over “Blanket” Jackson (and I feel a little disturbed by even writing his preposterous name), who was dangled over a railing by a father who may not have fathered him at all, we open the door to outlandish acts of dramatic violence that would make for decent psychological thrillers, but are now the stuff of what we call “real” life.

When Drew Peterson was brought into court on charges that he murdered his third wife Kathleen Savio, he was in a good mood.  He yelled jokes to reporters about how “spiffy” his red prison jumpsuit was and called his shackles “bling.” 

Peterson is, of course, also a suspect in the 2007 disappearance of Stacy Peterson, his fourth wife.  He insists he is an innocent man.

Think of how you’d respond to being dragged into court on murder charges, especially if you were wrongly accused.  You might be terrified or confused or enraged at the injustice of your plight, but you wouldn’t be all smiles, spewing one-liners.

So how can Drew Peterson do it?

To have any hope of understanding Drew Peterson, one first has to understand human empathy.   Empathy is the ability to resonate with the feelings of others to such an extent that one actually experiences some of their joy or grief or anxiety.  It is a remarkable and inexplicable quality that we too often take for granted.  The fact that a friend can be brought to tears by a loss of yours, that you can intuit and share the worries or hopes or pride of your partner in life, or that the hunger of children thousands of miles away could spur you to action on their behalf is a tribute to this miraculous force.

Empathy does even more, though.  It helps us contain our anger and our destructive impulses, because we can imagine how it might feel to be the object of that rage.  It also helps us gauge what is appropriate language and behavior in various situations, again because we can imagine how others are likely to respond to us.  We can put ourselves in the shoes of our friends or neighbors or loved ones. 

I believe empathy is an essential ingredient in experiencing guilt, as well.  If you can’t imagine the injuries you may have done another person—can’t feel their pain in any measure—then you aren’t likely to worry over any harm you’ve done them.  The absence of empathy is the growing place for antisocial and narcissistic traits that set a person adrift from the interpersonal ties and sense of personal responsibility that bind the rest of us.

Drew Peterson may be largely devoid of empathy.  That’s why he just doesn’t get the fact that lobbing jokes to reporters while being dragged into court on charges he murdered a young woman is bizarre and macabre.  It’s why he believed he’d come across as credible on television during the media tour he orchestrated after the disappearance of Stacy Peterson.  It’s why he probably is confident a jury will acquit him (which, of course, it could).  Peterson may not be able to put himself in the place of others—at all.

One of the most toxic manifestations of having no empathy, of course, is that it leaves those without it free to inflict suffering on others.  There’s no wincing at causing them pain, even death.  In the forest of pure narcissistic and antisocial traits that grow in soil without roots of empathy, only self-preservation and one’s own needs matter.  No one and nothing else really does.

If Drew Peterson killed Kathleen Savio or is responsible for the disappearance of Stacy Peterson or both, he isn’t worried about any of that.  He’s busy with the opportunity to showcase what he believes is his extraordinary charm and intelligence and wit.  And he thinks you and I and every reporter and every judge and every juror will be mesmerized.

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 Web site at livingthetruth.com.

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.

The tragedies are coming one after another.  In Binghamton, NY, Jiverly Voong kills13 at the American Civic Association.  In Pittsburgh, Richard Poplawski guns down three police officers.  In Graham, Washington, James Harrison kills his five children and then shoots himself.  All told, 57 people have died in multiple killings in the last month alone. 

What’s behind the carnage?  Could our troubled economy, with rampant job loss and the specter of home foreclosure weighing on our collective psyche, be pushing people over the edge?  Or is the answer to be found in the minds of a small number of people who have been quietly gathering rage and losing control for many months or years.

I think the answer is both.

Mass murderers have one thing in common:  They have lost the capacity for empathy.  They no longer see others as fully human, so they don’t worry over causing them to suffer.  They no longer see the life stories of others as sacred, so they don’t worry over bringing them to a violent end.  I believe this chasm of inhumanity opens because mass murderers have stopped valuing their own lives.  They are dehumanized to the extent that depression or paranoia or rage — or all three combined — have displaced everything else inside them—including love, whether for themselves or for others.

The road to becoming a murderer may have its roots in childhood, when abuse and neglect begin to make a child shut down his or her emotions, in order to stop feeling so much pain.  That dark psychological process can cast a long shadow, preventing the future killer from resonating with the pain of others.  Unrestrained by empathy, it leaves that person freer, in a terrible way, to be violent. 

It might well be the case that those who shut down emotionally and begin storing paranoia and rage inside them have less “hearty” or resilient nervous systems.  Maybe they have lower levels of serotonin than others among us who would preserve our humanity in the face of equally traumatic events.  Maybe they have absolutely no one who is obviously proud of them or shows concern for them or at least shares kind words with them.  Maybe they are unlucky enough to have head injuries that erode their capacity to control their emotions and leave them with shorter fuses.

But while the roots of the paranoia and rage that fuel mass killings may run bone deep, today’s stresses can set ablaze the deepest cauldrons of emotion.  We have among us many, many people who are on the edge psychologically.  They do not have reservoirs of self-esteem to carry them through job losses that make them feel like failures — as workers or fathers or husbands.  They cannot draw on stores of optimism to believe that things will turn out alright in the end, because things were not alright for them, often from the very beginning.  They may already be suffering with depression that can, in some of its forms, lead not only to anxiety and irritability, but also to paranoia and thoughts that life is not worth living.  Perhaps they have already turned to bankrupt strategies to keep their emotions at bay, including alcohol or illicit drugs, substances that lower self-control and are involved in the majority of violent crimes.

These are the people who are at risk to become the next Jiverly Voong, Richard Poplawski or James Harrison.  They are a job loss, a divorce or a repossession away from utter hopelessness that can tap their underlying stores of self-hatred and hatred for others and lead them to project it outside themselves, in an explosion of violence. 

There are many such people in the world.  They are victims of life events beyond their control who then victimize others, exponentially.  Psychological arithmetic is sometimes cruel:  The suffering of one person can multiply itself into the suffering of many.

This economy and these times are dangerous potential triggers.  Anyone who says otherwise should sit with me in my office and listen to some of the good and decent people, many from fine families, many with histories of great success, with wonderful potential futures, who can’t see any future for themselves, anymore. 

Anyone who says otherwise should listen to these “lucky” people, now down on their luck, who irrationally see themselves as permanent failures — not just economically, but personally.  Then imagine if you were the product of trauma, with only the most fragile sense of self, thinking the world was already against you.  Imagine how a pink slip hits you then.  Imagine if it comes with news that your wife is leaving you or cheating on you — with a real man.  Imagine if you stop thinking you’re a man at all, not even a human being, that everyone is laughing at you, that you’re powerless and forgotten and destined for nothing but emptiness.  Imagine trying to contain all that. 

Some people don’t.  Instead of containing it and processing it, they project it.  Economic chaos makes that outcome more likely.  The sooner we stop denying that fact, the sooner we can begin putting in place the needed resources to reach out in a real way to those who think — wrongly — that they are beyond help, and prevent the deaths we can.

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.

Police in St. Johns, Ariz., allege that an 8-year-old boy gunned down his father, Vincent Romero, and his father’s co-worker, Timothy Romans, using a .22-calibre rifle.  They say the crime was planned and methodically carried out.  Prosecutors have not yet announced whether they will seek to try the 8-year-old as an adult.

First things first:  Without access to the information that police have at this time, the public should withhold judgment about the veracity of the 8-year-old boy’s confession. False confessions are common enough in traumatized, eager-to-comply adults, let alone kids.  Three other children between the ages of 7 and 8 have confessed to murder since 1958; none of them committed the killings.

Assuming that the boy in Arizona is indeed the perpetrator, mental health professionals will have the task of trying to ascertain why he committed two murders.  Already, neighbors and friends and school officials have commented that the boy seemed perfectly normal, seemed to have a good relationship with his dad and had no history of violence.

As a forensic psychiatrist I have evaluated many killers and testified about them in court, not to mention treating dozens of very violent people.  And I promise you that, if responsible for these murders, there is indeed a psychological explanation why the boy committed them. 

Possible explanations include the boy suffering an underlying mental illness causing a delusion (a fixed and false psychotic belief) or hallucinations.  Conditions like bipolar disorder, for example, can (in a great minority of cases) trigger paranoia and even voices commanding one to carry out actions that would normally be abhorrent to the afflicted individual.   No one has suggested that Romero’s son suffered such a condition, but clinicians will need to rule out the possibility.

If the boy has been under treatment for any psychiatric symptoms with medications, the possibility of a medication side effect has to be explored.  Some psychoactive medications can, in rare cases, prompt violence against oneself or others.  The same is true, by the way, for some medicines used to treat medical conditions, like asthma.

Even in an 8-year-old, the remote chance that a mind-altering substance could be involved — perhaps belonging to someone else who was present at his school or in his home — has to be excluded.  That should be relatively easy to do by taking a detailed history from the boy and testing his blood and urine. 

Neurological explanations have to be entertained.  An MRI or CT scan of the alleged killer’s brain can tell investigators whether or not pathology like a brain tumor could be responsible.  The possibility is small, but can’t be dismissed out of hand.  Even an infection of the 8-year-old’s cerebrospinal fluid — the fluid that bathes the spinal cord and the brain—has to be formally eliminated as a possibility.

Chances are, however, that the why for these killings would reside in the emotional pathology of the alleged killer, not his brain pathology.  Some trauma or series of traumas, near or far in time, has to have occurred, in order to make this child either desperate enough to kill or cold-blooded enough to kill.  In sixteen years practicing psychiatry, I have never met a murderer who was born evil.  In every case, I eventually learned the circumstances that extinguished that person’s empathy.

So if this 8-year-old boy is indeed a murderer, the search will be for the roots of his violence.  We have only a hint which questions to ask from the news coverage to date.  But here are a few:  Why was the boy’s father awarded sole custody of him?  Why is his mother residing in Mississippi, rather than closer to him?  What are the details of the boy’s living arrangement, including the fact that his father had rented out a room in the house to his co-worker?

The truth of this 8-year-old and his alleged violence is knowable.  The key to finding it is in asking enough questions and never buying into the myth that killers are born.  They are made.  And when one is made by age 8, enough bad has happened in eight years to make the unthinkable actually occur.

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.