“I hate you people for leaving me out of so many fun things.”

Those words were not written by Adam Lanza, but another school shooter, Eric Harris, whose life was also wrought with themes of alienation and social awkwardness. Eric Harris, a Columbine shooter, compiled journal entries that pulsate with narcissistic rage and reveal a tendency to rely upon the psychological strategy of splitting: separating the world into black or white, weak or strong, good or bad, me or them.

Splitting can be seen in certain personality disorders and might also be used by some to justify bullying someone, starting a militia or cult, deciding to home-school a child, maintaining a survivalist mentality or even getting a divorce. Extreme cases of splitting can even contribute to rationalizing suicide or murder.

Partitioning and compartmentalization are not just becoming more prominent patterns in our ever more paranoid collective psychology, or politics for that matter, but may actually be a consequence of increased fragmentation and isolation found in Westernized societies and family structures.

I remember the first time I saw the movie “Kramer vs. Kramer” and thinking how crazy the idea of another naked lady other than my mom sleeping with my dad seemed. Aside from winning prestigious accolades, “Kramer vs. Kramer” reflected a cultural shift in the ’70s, further normalizing baby boomer ideals of individuation and rejection of traditional values.

While we embrace the technological and capitalistic gains made by the baby boomer culture, I wonder if we are in denial of the insidious social ills that have resulted from unrelenting individualism that sometimes manifests in shared custody situations, decreased social connectedness, or even an unwillingness to relinquish the right to own a gun.

While “Kramer vs. Kramer” was fictional, Roe v. Wade was very real. Some academicians have theorized that the drop in crime in the U.S. in the 1990s is related to the impact of legalizing abortion in 1973. In other words, fewer unwanted pregnancies beginning in 1973 might have something to do with a drop in crime approximately 18 to 20 years later.

Movies can act as a time capsule, reflecting societal attitudes or events for a particular point in time. The United States saw a sharp increase in divorce rates from the 1970’s to the 1980s. If “Kramer vs. Kramer,” released in 1979, reflects a culture that was beginning to accept and normalize divorce, and subsequent fragmentation of family, is it just a coincidence that the U.S. saw a sharp increase in school shootings in the late 1980s and early 1990s? Is it also a coincidence that the early 1990s also saw an increase in disruptive behavioral disorders — which include ADHD, oppositional defiant and conduct disorder?

In the essay, “I am Adam Lanza’s mother,” Liza Long wrote about her perspective on living with a son with mental illness. She mentions ADHD, oppositional defiant disorder and intermittent explosive disorder and advocates for the need to address mental health issues. Even as a child psychiatrist who understands the great need to destigmatize and advocate for mental health, I have concerns with her projecting such extraordinary violence onto her own son and would caution anyone from taking any child psychiatry case at face value. Just because a patient is identified doesn’t mean the problem is an individual rather than a dysfunctional system.

As I read Liza’s descriptions of physically restraining, hospitalizing and receiving verbal abuse from her son, I couldn’t help but wonder where the boy’s father was in all of this. She doesn’t mention another parent helping her at any point and it reminds me of my experience during my child psychiatry fellowship.

When I began to compile a caseload of young boys with behavioral problems, I also began to make a connection between their acting out and a physically or emotionally absent father. By no means am I invalidating the challenges faced by single parents or suggesting that all children with behavioral problems are linked to family dysfunction, but I think we’re kidding ourselves if we keep pretending it’s not a significant factor.

Some might look to the increase in school attacks in China to point out that this problem transcends American society. I would argue that the school attack timeline in China parallels a time of tremendous economic growth that has similarly contributed to social fragmentation and isolation. The difference in China is that knives are most often used in the school attacks and most do not result in mass fatalities. It’s the guns that make our problem uniquely American.

No one will ever know what really was going on in the head of Adam Lanza, and each school shooting case is different in some way. Anger borne out of narcissistic wounds, however, seems to be a common psychological factor in United States school shootings and this dynamic is more likely to arise in an individual who has not developed healthy ego functioning.

A loving, secure and consistent family and social environment can be conducive to healthy ego development. I wonder if America’s biggest problem is our continued refusal to acknowledge the social impact of our increasing difficulty in providing this for our children.

School Shootings: Symptoms of an American Disease