James Holmes | Mental Health & Personality | What is Schizotypal Personality?

welcome to my scientifically informed insider look at mental health topics if you find this video to be interesting or helpful please like it and subscribe to my channel hello this is dr grande today's question asks if i can take a look at the mental health and personality factors that may be at work in the james holmes case holmes was responsible for killing 12 people at a movie theater in aurora colorado in 2012. just a reminder i'm not diagnosing anybody in this video only speculating about what could be happening in a situation like this so first i'll take a look at the background for homes then the timeline of the crimes and then the mental health and personality factors so starting with the background james holmes was born in san diego california on december 13 1987. from the age of 10 holmes became introverted and he struggled with finding purpose and meaning in his life not the kind of problem we would typically expect in somebody that young around the same time he developed an obsession to kill he had an interest in biological agents nuclear weapons knives and then eventually firearms he contemplated becoming a serial killer but then he tended to focus on the idea that he could kill everyone in the world right so now we get into an area where he's deviated quite a bit from what would be considered normal for that age or any age he spent a good deal of his childhood playing video games which he preferred to any type of socializing he would later say that he enjoyed them because they were an escape from reality where you could live the life of a hero he also liked the ability to chat with people online as opposed to talking with them interestingly in high school he appeared happier and he maintained four to five close friends he did well in school and he had no behavioral problems teachers noted that holmes did well on assignments to avoid attracting attention to himself so it wasn't really necessarily a drive for academic achievement he just didn't want to be the center of attention he didn't want to have to interact with other people reports indicate that he was awkward in social settings he had an unusual spaced out stare and he was thought of as a loner holmes had no history of being mistreated when he was young after high school holmes earned a bachelor's degree in neuroscience then he spent a lot of time at home sleeping all day and watching television eventually his parents convinced him to go to graduate school which seems like an unusual way to address those behaviors he applied to a number of graduate programs but they found him to be bizarre disconnected aloof and they said he demonstrated a lack of affect they said he was an excellent candidate except for those characteristics eventually he was accepted at the university of colorado at denver he struggled academically and socially there classmates reported that he lacked motivation and he told jokes that were off or ill-timed he was disappointed because what he learned there did not help him decrease homicidal thinking or improve his communication skills kind of unusual goal to set for taking a college class what i hope to learn in this class is how to have less homicidal thinking doesn't really seem like that lines up with the curriculum too well that you would see in college march 2012 holmes receives treatment from mental health professionals at the university student health center his main treatment provider becomes a psychiatrist named dr fenton he sought treatment because he had anxiety and difficulty with public speaking during may and july 2012 holmes purchased two glock 22 pistols this is a pistol chambered for 40 caliber smith wesson he also purchased a remington 870 shotgun and a smith wesson m p 15 which is a lot like an ar-15 he also purchased over 6 000 rounds of ammunition with over half of it being 223 caliber for the m p 15. all the firearms were obtained in separate purchases so as to avoid arousing suspicion holmes went to practice at a shooting range he selected one where he could be unsupervised he visited that range five times in june and july the range was two and a half hours away from where he lived even after consuming half of his ammunition and target practice holmes reported that he was still a really bad shot but he thought that didn't matter to the nature of the crime that he was planning holmes went to the century 16 theater in aurora colorado several times to scout out a location for his crime he selected theater number nine as being an environment where he could kill the most people with his plan he purchased multiple tickets for the movie dark knight rises hoping to get a ticket for theater 9 but he ended up getting a number of tickets for theater 8. in mid-june holmes dyed his hair red he said it had nothing to do with trying to imitate the joker as featured in that movie rather he just wanted to differentiate himself from who he normally was so now moving to the timeline of his crimes july 20 2012 aurora colorado century 16 theater using a ticket he had purchased in advance he entered that business and made his way to theater number nine even though his ticket was for theater eight he said he was able to do that because no one was checking tickets after sitting down in a theater seat he made his way to the exit pretending that he was making a phone call he then exited and propped the door open with a tablecloth holder at 12 30 am he went inside his vehicle which was parked right outside the exit he called the student mental health emergency hotline at the university of colorado where he had received treatment before he didn't say anything on that call holm said he called them just because he wanted a last chance to turn back after he put on a ballistic jacket which is like a bulletproof vest a gas mask a helmet and arming himself he then put on headphones and turned on techno music to the maximum volume he said he did this because he didn't want any type of connection to be established between himself and the victims he wanted to think of them as a crowd and not as individuals he then entered theater 9 through the exit door he didn't make eye contact with anybody or say anything he then threw gas grenades and opened fire he started by firing six rounds out of the shotgun he switched to the m p 15 it malfunctioned after 65 rounds and after this he fired five more rounds from a glock 22. he murdered 12 people and injured about 70 others in this attack holmes attempted to clear the action of the m p 15 but he didn't know how to do it so he walked out of the exit door to his car and waited for the police as he sat there and watched the police move closer to him he said that he had a complete lack of feelings as officers approached him he told them about the explosives in his apartment he was arrested without incident he was eventually found guilty for over 160 felonies and given 12 life sentences without the possibility of parole he was also given an additional 3318 years which probably means he's exempt from the planning for life after release classes offered at the prison now moving to the mental health and personality factors with the case of james holmes there's a lot of information about his mental health available we see over 200 pages of reports on his mental health we see some from before his arrest and quite a few that were generated after his arrest so i'm going to look at both here i'm going to look at the time before he was arrested when he went to that clinic at the university and then look at what the professional said about him after he was arrested but before he went to trial so starting with the time before he was arrested when he went to the student health clinic his first mental health professional contact was with a social worker that social worker writes this is the most anxious guy i've ever seen and he has symptoms of ocd but most concerning is that he has thoughts of killing people though i don't think he's dangerous so clearly the wrong assessment there they also said that it was hard to interview him because he would just stare and take a long time to answer holmes told them that he never hurt anybody and he never would they noted he had a number of odd mannerisms for instance when he left appointments he would not say thank you goodbye or any other remark on his way out they also thought that he may be having a psychotic break a psychiatrist there named dr fenton know that she was worried about homicidal ideation she activated a threat assessment team to help her formulate a plan for holmes she listed specific concerns his long-standing fantasies about killing as many people as possible his reluctance to discuss any details about his plans his refusal to allow them to talk to anyone else like they couldn't talk to family members he wouldn't sign a release for that and the unclear timeline she didn't know if he was always that way or if this was a new behavior so if the behavior was new that would suggest possibly a psychotic break given the information available about homes at this time what it came down to in this situation with the clinic was that homes simply didn't reveal enough information to be assessed as an imminent threat holmes was fully aware that because he failed to tell them his plan they really couldn't act to stop him as much as if he revealed some information about specifics even though the center offered to treat him if he lost his insurance he left treatment there his final diagnosis there was schizoid personality disorder with two rule outs so these are diagnoses that are given for the next clinician ostensibly the next person that reads it just to let them know they need to rule out those conditions so it's not a diagnosis but essentially it's saying there could be something here like that and those two rule outs were schizophreniform disorder and what we would now refer to as autism spectrum disorder interestingly there's no mention of depression ocd or trichotillomania but it's important to know that holmes did not reveal a number of symptoms including catatonic episodes that he had that would last from three to five hours in the middle of the day holmes was assessed after he was arrested now of course at this point there was no mystery about the seriousness of his homicidal ideation and his level of cooperation was higher we learned a number of interesting things from these assessments holmes had a good memory but he would frequently space out during interviews with the mental health professionals his thinking was surprisingly concrete for example he could not interpret the proverb people in glass houses should not throw stones if somebody could think abstractly they would realize that that proverb means that if somebody's going to accuse somebody else they have to make sure that they aren't doing the same thing but with holmes concrete thinking he may have thought that literally people who live in glass houses would be ill-advised to project stones right so taking that term and just looking at it as literal holmes believed that the numerous letters that he was receiving from women who were romantically interested in him were the result of a dating profile that he had put up before his crimes so he didn't realize that that was totally connected to the fact that he was in prison for a high profile crime he had numerous mental health symptoms disorganized thinking paranoia delusions hallucinations catatonic behavior diminished emotional expression a volition which is a lack of motivation diminished speech output a sociality depression anxiety obsessive compulsive behaviors and chronic homicidal and suicidal ideation so his diagnosis according to this first report that was done after he was arrested we see three diagnoses here schizoaffective disorder first episode bipolar type with a history of catatonia trichotillomania that's a hair pulling disorder and social anxiety disorder as far as the cause of the crimes it was determined that but not for his mental illness he would not have committed these crimes even still he did know the difference between right and wrong now whenever we see high profile criminal cases it really shouldn't be surprising that the mental health professionals will disagree on what the defendant has and we see that here in the case of holmes this first report as i mentioned had schizoaffective disorder which is really like a combination of schizophrenia and bipolar disorder but we see another report generated after that where the diagnosis was schizotypal personality disorder and delusional disorder unspecified type continuous course so we go from a report that has three diagnoses to a report that has two and they're quite different what they're suggesting between those reports is drastically different so what's going on here with holmes well there's no way to be certain but we can examine some options here if we look at the nine symptoms for schizotypal there does seem to be quite a bit of alignment with those symptoms here we see ideas of reference odd beliefs and magical thinking unusual perceptual disturbances odd thinking and speech paranoia inappropriate or constricted affect behavior or appearance that is odd eccentric or peculiar a lack of close friends and excessive social anxiety that tends to be associated with paranoid fears rather than negative self-judgment so one could argue that his behavior really aligns with all nine of those symptoms i think it really comes down to this was he psychotic or not if the psychosis was somehow removed would his underlying personality still align with schizotypal i can appreciate the argument that the visual experiences before the crime were not hallucinations rather they were just the characteristic visual disturbances we would expect to see which gets a tipple and that the planning and execution of the crime required a lot of attention to detail and follow through and disorganized thinking would certainly make that difficult at the same time though a diagnostic profile that includes schizotypal personality disorder and delusional disorder is extremely unlikely in almost every instance where we would see this arrangement of symptoms the diagnosis would be something like schizophrenia schizophrenia has five symptom criteria delusions hallucinations disorganized speech grossly disorganized or catatonic behavior and negative symptoms like diminished emotional expression or a volition two or more of those symptoms is required for the diagnosis and one of them has to be either delusions or hallucinations so everything seems to pivot on that same question was holmes delusional if a diagnosis of delusional disorder is going to be given that appears to answer that question this is why i think it's so hard to understand a diagnosis that would include both schizotypal and delusional disorder in essence if both those are together isn't that really like saying someone has schizophrenia how can one differentiate between comorbid schizotypal and delusional disorder and schizophrenia i think the best argument can be made for schizotypal personality disorder premorbid and schizophrenia meaning he had schizotypal personality disorder for years and then developed schizophrenia sometime near when he committed the crime the last item i want to cover here is the motive for homes to commit these crimes holmes was never consistent when he discussed his potential motives there are two that he mentioned one he was frustrated by the question why do people need to be alive in the first place so that was a question he asked himself he always wanted the answer to that question but he could not figure it out he reasoned that if he killed everybody he could put an end to that question so in essence it was not about answering the question it was about removing any need for the question to exist this really seems to have some relationship to existential obsessions that we might see in ocd but again that diagnosis did not appear in the final two reports now the second motive was that killing people would make him feel not worthless because people did not have any purpose or meaning why did it matter if they lived or died so this is a reason that he gave for the crimes but it doesn't really make a lot of sense it's not really clear how other people not having any purpose or meaning in their life would mean that he would feel not worthless if he killed them so i guess to him that somehow made sense and that was part of his motivation so in stepping back and looking at james holmes we see he really does have a frightening mental health and personality profile he has enough delusional or just illogical thinking to become dangerous but he's organized enough to plan and follow through with sophisticated attacks with all the knowledge we have about holmes we still don't know what made him into a killer was it genetics was it the environment or a combination he didn't have any history of trauma so we're just left with kind of a mystery in this case now i know whenever i talk about controversial cases there will be a variety of opinions please put any opinions and thoughts in the comments section they always generate an interesting dialogue as always i hope you found my analysis of this topic to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 512,486

Keywords: james holmes, schizotypal personality disorder, schizophrenia, schizoid personality disorder, delusions, hallucination, disorganized speech, catatonia, negative symptoms, anhedonia, avolition, ideas of reference, paranoia, eccentric, loner, aloof, bizarre, trichotillomania, social anxiety disorder, obsessive-compulsive disorder, mental health, counseling

Id: Fb1Rn5ZQfS8

Length: 17min 51sec (1071 seconds)

Published: Mon Jun 08 2020

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