Words & underlying concepts; Stump the Shrink on individualized treatment; Pressing buttons
Enduring principles as healthcare changes; Customer & team values; Marchers’ messages
Dr. Vince Felitti and the roots of the ACE Study; Expressive writing; Interactive Journaling; Pen, pencil and paper planners
The ACE Study; the 3 E’s, 3R’s plus 4 th R; 5 components; Attraction, not promotion
Upcoming conference; 14 minutes at Longwood University; Stump the Shrink
Borneo, Malaysia; Nature nuggets; Addiction in SE Asia; Travel tips; Culture
Lifestyle, Sick-care; MI training; Acceptance
Best Practices; Alterations; Jim Gaffigan
Guns and violence; A rant; A new resource
In This Issue
I am no gun expert – either in handling a gun or in the research on guns and violence. However it is hard to keep silent in the wake of two shocking gun violence killings within three days of each other – December 11 Clakamas Mall shooting in Orgeon with two deaths in addition to the shooter’s life (and there would have been many more death had his gun not jammed) – and the December 14 school shooting in Newtown, Connecticut leaving 20 schoolchildren, 6 teachers and staff members, the gunman and his mother dead.
On December 18 in my local “big city” newspaper, The Sacramento Bee, Will Oremus, a staff writer for SLATE shared his viewpoint on the gun control lessons the USA might learn from a mass shooting in Australia.
I remember being shocked in April of 1996, when hearing about the gunman who had opened fire on tourists in a seaside resort in Port Arthur, Tasmania, the quiet island state off the southeast tip of the big island country of Australia. It was the kind of event you couldn’t imagine happening there in that tiny community, just like Newtown, Connecticut. By the time the gunman was finished, “he had killed 35 people and wounded 23 more. It was the worst mass murder in Australia’s history.”
I will extract from Will Oremus’ article that you can read in full at http://www.sacbee.com/2012/12/18/5060929/mass-shooting-in-australia-provides.html
It is worth pondering what the Australian government did just twelve days after the April 28 shooting. I understand Australia’s population of about 23 million is just 60% of California’s population, let alone the whole USA. But even California, which has the toughest gun-control laws in the USA, couldn’t mobilize support for the range of changes Australia made less than 2 weeks after their mass murders.
Consider this list of gun-control measures. Could they work in all parts of the USA?
The Australian government in 1996 was able to craft a bipartisan deal with state and local governments to enact sweeping gun-control measures:
- Massive buyback of more than 600,000 semi-automatic shotguns and rifles, or about one-fifth of all firearms in circulation in Australia.
- Prohibition of private sales.
- Requirement that all weapons be individually registered to their owners.
- Requirement that gun buyers present a “genuine reason” for needing each weapon at the time of the purchase. Self-defense did not count.
In 1989, California became the first state to ban the manufacture, transport, import or sale of assault weapons.
Other key gun-control laws in California as listed in The Sacramento Bee, December 19, 2012, p.A18:
- Require gun buyers to undergo background checks and mandate that handgun buyers obtain safety training and certificates.
- Require gun sales to go through licensed gun dealers, and mandate a 10-day waiting period and criminal background check.
- Ban gun sales to felons, drug addicts and various other people deemed potentially dangerous, including those suffering from certain mental disorders or covered by a restraining order for domestic violence.
- Prohibit possession of concealed weapons without a permit. County sheriffs have discretion to approve or reject such applications.
- Outlaw high-capacity magazines that house more than 10 rounds.
Banned the carrying of a firearm within 1,000 feet of public or private schools.
- Prohibit consumers from buying more than one gun per month.
- Require people who move to California to register their firearms.
- Ban the sale of various cheap guns commonly used for crime.
- Bar possession of armor-penetrating bullets.
By now, if you are an avid gun-owner, you are probably fuming and it is questionable whether the same policies would work as well in all parts of the United States.
I am Australian-born living in California, so my culture shaped by my upbringing is not highly invested in protecting the US Constitution’s Second Amendment protecting the rights of the people to keep and bear arms. (The only “bear arms” I’m focused on as I prepare to spend the holidays in Hawaii, are “bare arms” on the beach….sorry).
Ponder how to balance individual rights for guns with a public health perspective and the greater good.
Here’s what happened next in the sixteen years after the sweeping gun control measures in Australia. I am listing and quoting from Oremus’ article:
- Homicides by firearm plunged 59 percent between 1995 and 2006, with no corresponding increase in non-firearm-related homicides.
- Drop in suicides by gun was even steeper: 65 percent.
- Studies found a close correlation between the sharp declines and the gun buybacks.
- Robberies involving a firearm also dropped significantly.
- Meanwhile, home invasions did not increase, contrary to fears that firearm ownership is needed to deter such crimes.
- “But here’s the most stunning statistic. In the decade before the Port Arthur massacre, there had been 11 mass shootings in the country. There hasn’t been a single one in Australia since.”
“There have been some contrarian studies about the decrease in gun violence in Australia.” Again I am listing and quoting from Oremus’ article:
- A 2006 paper that argued the decline in gun-related homicides was simply a continuation of trends already under way.
- But that paper’s methodology has been discredited and its authors were affiliated with pro-gun groups
- Other reports from gun advocates have “cherry-picked” anecdotal evidence or presented outright fabrications to make the case that Australia’s more restrictive laws didn’t work.
- “Those are effectively refuted by findings from peer-reviewed papers, which note that the rate of decrease in gun-related deaths more than doubled following the gun buyback, and that states with the highest buyback rates showed the steepest declines.”
- A 2011 Harvard summary of the research concluded that, at the time the laws were passed in 1996, “it would have been difficult to imagine more compelling future evidence of a beneficial effect.”
As Will Oremus says: “I wonder if Americans are still so sure that we have nothing to learn from Australia’s example.”
When it comes to gun control, addiction and mental health, personal, interpersonal or cultural issues, H.L. Menken’s wisdom is worth remembering:
For every complex problem, there is a solution that is simple, neat, and wrong.
George Engel, M.D. championed the Biopsychosocial model, a holistic alternative to the prevailing biomedical model that had dominated industrialized societies since the mid-20th century. (Engel GL (1977): “The need for a new medical model: a challenge for biomedicine”. Science 196:129-136.)
A biopsychosocial view is a useful construct to appreciate that guns and violence is a complex problem for which you may think there is a simple solution….and it would be wrong!
Take a broad perspective on what is involved in a biopsychosocial view of guns and violence.
Here are some issues that have surfaced in the proliferation of reports, articles and blogs since the Newtown, Connecticut shootings:
→ “Connecticut’s chief medical examiner said he hopes Adam Lanza’s biology will help explain why the Sandy Hook shooter went on a deadly rampage. The Hartford Courant reports that Dr. H. Wayne Carver has asked a geneticist at the University of Connecticut to join in his investigation of the killings.
→ “I’m exploring with the department of genetics what might be possible, if anything is possible,” Carver told the paper on Tuesday. “Is there any identifiable disease associated with this behavior?”
→ Carver is also awaiting toxicology testing results for the gunman.
→ Fox News reported Nancy Lanza, Adam’s mother, was in the process of having her son committed to a psychiatric facility when he went on the mass shooting spree, according to a lifelong family acquaintance. Connecticut police have said a motive for the shooting remains unclear, Newtown Patch reports.
→ A senior law enforcement official confirmed that Adam Lanza’s anger over his mother’s plan is being investigated as a possible motive for the massacre.
→ According to Psychiatric News (December 19), a publication of the American Psychiatric Association, reacting to speculation that the shooter behind the Newtown, Connecticut tragedy, Adam Lanza, “might have had Asperger’s syndrome or some other autism spectrum disorder,” some “national autism groups were quick to point out that, although that may have been true, such diagnoses would have had nothing to do with his violent acts.” On its website, the group Autism Rights Watch “noted that autistic individuals are more likely to be victims, rather than perpetrators of violence, and urged the public and media outlets not to stigmatize these individuals and their families.”
→ “Poor social skills, trouble communicating and repetitive behaviors are all hallmarks of autism, but there’s no correlation with violence, says pediatric neuropsychologist Michelle Dunn, director of Montefiore Medical Center’s Neurology and Autism Center in the Bronx.”
There is the influence of the shooter’s immediate family social network:
→ “A federal law enforcement official said the Bureau of Alcohol, Tobacco, Firearms and Explosives had determined that Lanza and his mother, Nancy Lanza, visited firing ranges together and separately in recent years, with one known occasion of their going together. It was not clear whether they had both fired weapons on that visit.”
And then there’s the influence of the greater culture and social context:
→ “So deeply embedded is the gun culture of the United States that millions of law-abiding Americans truly believe that it is safer to own a gun. This is based on the chilling logic that because there are so many guns in circulation, one’s own weapon is needed for self-protection. To put it another way, the situation is so far gone there can be no turning back.”
For each of the personal tragedies that have involved guns and violence, the configuration of the unique biopsychosoclal factors in each case, reminds us that there is no simple solution.
For the larger issue for society on what to do about guns and violence, it is also multidimensional and complicated.
But complexity need not justify procrastination; nor bipartisan paralysis need not justify inaction.
I am reminded often of the importance of cultural competence. Whenever I start getting worked up and angry over the obvious (to me) stupidity and narrow-mindedness of others, I try to remember cultural sensitivity.Here’s my rant about guns and violence and individual rights versus the greater good:
Sort of like Piers Morgan on CNN, I yell: How many more children have to be slaughtered; how many more cinema goers and mall shoppers have to be terrorized and killed; how many more murders, crimes of passion and suicides have to splash on the front pages and feature in “Breaking News” before we wake up and do something real about guns and violence?
How much longer can the USA ignore the huge disparity in gun deaths compared with Japan, Europe, Canada and Australia all the while advocating for more guns; concealed weapons permission; and no change in gun laws already so diluted compared with the rest of similar societies?
When will we Americans find some balance in our fierce defense of individual rights that reveres personal freedom over the greater good (Live free or die)?” “Nobody is going to make me buy health insurance, but I sure want someone to do something and take care of me if I end up in the Emergency Department!” “I’ve got my health coverage.
I don’t want the government to do anything about the 30-40 million who don’t have coverage, especially if I have to help contribute to the cost of expanding access to care. But I sure want someone to extend my unemployment benefits and cover me if I lose my job and health benefits.
Ah, it feels good to rant. But then there’s that cultural competence thing again.
I don’t want to diminish any of the passion about this and other “rantable” issues. But yelling across the great divide won’t solve much either.
Somehow I have to feel the pain of the National Rifle Association members which anchors their staunch opposition to gun controls. Somehow I must develop a better sensitivity to the fierce defense of the right to keep and bear arms, and the historical cultural roots that fuel such steadfastness.
Maybe if I become more culturally competent, I can help solve these complex issues, not just rant about them. Maybe….but now I can feel myself getting worked up again.
Now available:Motivational Interviewing authors, Miller, Moyers and Rollnick have developed a two-part DVD set. It provides descriptions and demonstrations of the new four-process method of Motivational Interviewing. Watch a video explaining what resources are now available from The Change Companies with the new edition of Motivational Interviewing just published.
Thanks for reading and Happy New Year for 2013. See you late January next year!
In This Issue
SAVVY – Alternate terms for “Relapse”; ASAM’s definition of relapse
SKILLS – How to deal with substance use in residential treatment settings
SOUL – When not being chosen was good!
Welcome to the November edition of Tips and Topics. I hope you have been able to balance some family and friends time with the commercial push to have you shop till you drop.
Senior Vice President
of The Change Companies®
In This Issue
SAVVY – “Relapse” revisited and reconsidered
SKILLS – Dealing with substance use in treatment and Deleting “resistance”?
SOUL – Who has influenced you and how did they get there?
SUCCESS STORY and SHARING SOLUTIONS: How one program is moving to individualized services
Welcome to the many new readers this month. Thank-you all for joining us for the October edition of Tips and Topics.
Senior Vice President
of The Change Companies®