Mind of a Rampage Killer

PBS Airdate: February 20, 2013

MILES O'BRIEN (NOVA Correspondent): The images flash across our screens, and we wonder what compels a human being …to commit the most inhuman of crimes?

911 CALL: The school is in lockdown.

MILES O'BRIEN: In the wake of Newtown, NOVA investigates the roots of violence. Are killers born or made? Are mass murders driven by an urge to kill or a wish to die?

He was really going through hell?

JEFF WILLIAMS (Father of Andy Williams): Yes, he was being tormented by his friends. He was a new kid at a big school.

KATHERINE NEWMAN (Johns Hopkins University): This sense of frustration and hopelessness grows in them.

MILES O'BRIEN: Neuroscience examines of the causes of violent behavior and the key ingredients in creating a killer.

PAUL FRICK (University of New Orleans): We know the factors that can put a child at risk for acting aggressive and violently. And the kids who typically do these rampages show many of the same factors.

KARLEN LYONS–RUTH (Harvard Medical School): These were very important behaviors. They are telling us something. These were kids who are going to go on to have serious hostile and aggressive behaviors towards their classmates, even though they don't look that way in infancy.

MILES O'BRIEN: On the front lines, working with the most violent teens,…

GREGORY VAN RYBROEK (Mendota Mental Health Institute): Their way to survive, their way to be safe is to be aggressive.

MILES O'BRIEN: …in rare interviews with families living the daily nightmare of mental illness,…

LIZA LONG (Mother of Michael): Hammers, knives, scissors.

MILES O'BRIEN: Why did you do that?

LIZA LONG: Because he pulled a knife on me. You feel like you're in a warzone, right down to the constant anxiety.

MILES O'BRIEN: …can we uncover clues to help unravel the mystery of the violent mind and help find ways to stop the next massacre before it happens?

The question on everyone's mind is how do we prevent the next Newtown?

Inside the Mind of a Rampage Killer, right now on NOVA.

JEFF WILLIAMS: (On home video) Hi, Andy!

ANDY WILLIAMS: (On home video) Hi, Daddy.

JEFF WILLIAMS: Andy was always real playful.

ANDY WILLIAMS: (On home video) The movie that you're going to see is going to have me in it, and a couple of other friends.

JEFF WILLIAMS: He was a real kind kid. He was the clown of the classroom.

Andy was like my best friend.

MILES O'BRIEN: But on March 5th, 2001, Jeff Williams' only child shattered that image.

NEWSCASTER: About 9:30 this morning, shots rang out at a suburban San Diego high school.

MILES O'BRIEN: Andy Williams had packed a revolver in his backpack and opened fire when he got to school, killing two and injuring 13.

JEFF WILLIAMS: You don't expect the class clown would be the class killer.

MILES O'BRIEN: How did the sweet kid in the home movies become a rampage killer?

On behalf of Andy Williams, who is present, in custody, before the court.

MILES O'BRIEN: And why does it keep happening?

NEWSCASTER: Eyewitnesses say the two gunmen, wearing black trench coats and black masks, came in shooting and began working their way through the school.

MILES O'BRIEN: From Columbine, where two seniors plotted to blow up their school,…

NEWSCASTER: A gunman appeared at the front of one of the theaters. 14 confirmed dead...

Victim: It seemed very methodical.

MILES O'BRIEN: …to Aurora, where a graduate student in neuroscience took aim on a crowded theatre,...

Dispatcher: Caller's indicating she thinks someone is shooting in the building.

MILES O'BRIEN: …to Newtown, and the slaughter of 20 first graders and seven adults,…

NEWS FOOTAGE (ABC News/Film Clip): State and local police are on the scene.

MILES O'BRIEN: …the images are all too familiar, and the questions are always the same.

NEWS FOOTAGE (ABC News/Film Clip): …why that young man was set off? Why the attack on the children at the school? Are there warning signs for people like this?

MILES O'BRIEN: We all want to know what was going on inside the mind of the killer.

Unfortunately there is no easy answer.

JOSHUA BUCKHOLTZ (Harvard University): One of the most infuriating things, as a scientist and as a person, is this attempt to try and find some diagnostic label, some neat diagnostic box to put this person into and, and thus explain why they did this terrible, terrible thing.

MILES O'BRIEN: But that has not stopped researchers from trying. And their hunt for an explanation is taking them closer to some answers.

Little did they know, when the work began many decades ago.

NEWS FOOTAGE (1966/Film Clip): And a human rampage spreads death and terror across the University of Texas campus. Twenty-four-year old student Charles Whitman goes berserk…

MILES O'BRIEN: In 1966, ex-marine Charles Whitman killed his mother and wife, then climbed to the top of a bell tower at the University of Texas, and started shooting.

NEWS FOOTAGE (1966/Film Clip): One afternoon's tragic total: 16 dead, 33 wounded.

MILES O'BRIEN: Whitman knew something was wrong with his brain.

Before he set off on his rampage, he left behind writings asking for an autopsy, hoping that it might reveal the source of his violent thoughts.

After he was gunned down by police, Whitman's brain was analyzed, revealing a nickel-size abnormality close to the amygdala, one of the brain's primary emotion centers.

JOSH BUCKHOLTZ: And so the thought was, "Ah ha! This was it. This amygdala lesion in Charles Whitman can explain his behavior."

MILES O'BRIEN: In the decades since Charles Whitman's rampage, one thing has become clear: the human brain is not that simple.

Today, CT scans and M.R.I.s allow researchers to peer deep inside the brains of violent criminals, revealing detailed anatomy and function. And using sophisticated analysis of many brains, they find some patterns.

Josh Buckholtz is a Harvard neuroscientist searching for the biological roots of violent behavior.

JOSH BUCKHOLTZ: When we compare people who commit violent acts against people who don't commit violent acts, some brain differences begin to emerge: differences in brain circuitry that's involved in emotional arousal and emotion regulation.

MILES O'BRIEN: One of these circuits connects the prefrontal cortex, responsible for higher level thinking, to the amygdala, an emotion center, which goes into overdrive whenever a threat is perceived. If the threat is not real, the prefrontal cortex will send a message to the amygdala to calm down, but if the wiring is faulty, that calming message may not get through.

JOSH BUCKHOLTZ: And in those folks, it seems like this circuit is broken in such a way that they're more likely to respond with greater amygdala activity and greater emotional arousal, when they think that they're being faced with some kind of threat.

MILES O'BRIEN: So what can break or damage this crucial circuit? At least part of the answer lies in the genes we inherit from our parents. Buckholtz and others have found that certain genes can compromise this wiring. But here's the tricky part: even if people have those genes and their wiring appears weak, there's no guarantee they will end up violent.

JOSH BUCKHOLTZ: There's no one single gene, there's not even 10 single genes that, on their own, predispose people to become violent. What we know about complex behaviors generally and violence specifically is that the genetic architecture is very complicated.

MILES O'BRIEN: When it comes to the brain and people's behavior, evidence points to a complex dance between genes and the environment: nature and nurture.

PAUL FRICK: Everything we talk about in psychology is both nature and nurture. So the trick is to find out, how do they both operate? It's never one or the other, never.

MILES O'BRIEN: Key clues to how nature and nurture might operate to shape the brain are emerging from studying families.

And some of the best evidence is coming from these families: rats. Remarkably, researchers discovered that baby rats who were licked frequently by their mothers grew up to be calmer and gentler adults. But if the mother was standoffish, when the babies grew up, their biology and behavior was different.

MICHAEL MEANEY (McGill University): What we were particularly interested in is the way in which these animals might respond to stressful events. And we found the offspring of low-licking mothers, during periods of stress, show greater increases in blood pressure and greater increases in stress hormone production.

MOSHE SZYF (McGill University): They will scream. They will try to bite you. Just walking into their cage, those rats will respond differently.

MILES O'BRIEN: Moshe Szyf and Michael Meaney, of McGill University, knew this violent behavior was not strictly inherited, because it happened even when the caretaker was unrelated and long after the rats were grown. Could it be that nurture was trumping nature, somehow changing the way the genes worked?

MOSHE SZYF: The behavior of the mother has an impact on the offspring, years after the mother is already gone. And we reasoned that there must be some mark in genes that marks that memory.

MILES O'BRIEN: Studying the brain cells of the calm and stressed out rats, they found that different genes were getting turned on or off in the babies, depending on how they were treated.

When a baby was licked and cuddled, cells in the rat's hippocampus, a part of the brain that helps regulate emotion, turned on a gene that reduces stress hormones. But if the baby was neglected, a chemical chain reaction began that effectively shut down the gene, causing stress hormones to soar. And, amazingly, these changes would stick, long after the baby grew up.

KARLEN LYONS-RUTH: What we've learned from animal models, which was pretty astounding, is that the quality of maternal care in the first week of the rat baby's life, sets up the stress response system in the baby.

MILES O'BRIEN: Harvard researcher Karlen Lyons-Ruth doesn't study rats. She studies people.

Of course, there are differences between rats and humans, but she's finding we might have a lot in common, particularly when it comes to the relationship between parent and child and how it can impact the way the child will respond to stress throughout his or her life.

It started with a simple, yet revealing experiment called "the strange situation."

Here's how it works: the baby is placed in a room with some toys; the parent leaves; the baby, predictably, gets upset. Next, a stranger comes in and tries to provide some comfort. No luck. The baby just wants his mom. So in comes the parent. What happens next is what Lyons-Ruth finds fascinating.

KARLEN LYONS-RUTH: We're interested in how the baby responds to stress and then how the parent is able to help the baby regulate that stress.

MILES O'BRIEN: Most of the time, it is a happy ending, like this one, but things don't always go so well.

The Lyons-Ruth research videos, now 30 years old, have never been shown outside a narrow circle of scientists. To protect the identities of the participants, we obscured them digitally.

KARLEN LYONS-RUTH: You see the mother come in, so, you hear the mom enter silently. It's a threatening approach. We usually signal it that we're friends: wear a smile, we talk.

MILES O'BRIEN: Arms open, whatever.

KARLEN LYONS-RUTH: To approach silently is threatening. The lab assistant leaves. So she then goes to mother, and then…see the mom step back? And the baby is now going to stop.

MILES O'BRIEN: She's just comforting herself on the rug.

KARLEN LYONS-RUTH: She gets up, she looks to Mom, and she's not quite comfortable just scooping her up, and she hesitates, and she does that and then she picks her up.

We call this the hot potato: pick up, put down. Quickly, the mom puts her down again in the middle of all the toys.

MILES O'BRIEN: Though this behavior would never qualify as abuse, some of the moms found it harder to comfort their distressed babies.

KARLEN LYONS-RUTH: As an observer, you see that there's a bigger picture emerging. There's the silent entry. There's the not moving to the baby. There's the hesitating when the baby moves to her. There's the awkward pickup. There's the quick put down. There's the silent interaction from there on. So, as these accumulate, you begin to get much more pattern of the emptiness and what the baby is not getting in terms of regulating their own state.

MILES O'BRIEN: The research team has followed about 60 families over 30 years. Although there is not just one way to build attachment, certain patterns became clear. They found that the babies who had trouble calming down were more likely to grow up with behavioral problems once they go to school.

TODDLER BOY: Go away!

KARLEN LYONS–RUTH: They're predicting that these were kids who are going to go on to have serious hostile and aggressive behaviors toward their classmates, even though they don't look that way in infancy.

MILES O'BRIEN: And when they became adults, the same group was twice as likely to be anti-social or suicidal.

MOM WITH BOY: (Reading) And the pirate captain was...

MILES O'BRIEN: It's not just the relationship with mothers that can count, but other caring relationships as well. And it's not just the infant brain that can be altered by stress. Throughout childhood and adolescence, the growing brain is extremely sensitive to threatening situations.

MARTIN TEICHER (Harvard Medical School): When you're exposed to stress, you program your body to have a more elaborate, greater stress response, and that can help you survive.

MILES O'BRIEN: Martin Teicher studies the effects of neglect, abuse and stressful environments on brain anatomy and function. He's found that as a child grows up, different areas of the brain are more vulnerable, depending on age. And one of the most sensitive periods of all is the teenage years.

MARTIN TEICHER: It's a period of very rapid transition. In that, that period between the onset of puberty and what we define, arbitrarily, as adulthood, say 18 or so, there's a tremendous amount of brain change. There's more brain change taking place in that period than will occur for the rest of your life.

MILES O'BRIEN: And a quickly changing brain is more likely to be altered and shaped by stress, potentially making it more prone to anxiety, depression, antisocial behavior and even violence. For example, the prefrontal cortex, responsible for higher-level thinking, can be stunted by stress and abuse during this period, making it even harder for teens to control their emotions.

So, could the pressures and strain prove too much to bear for those few teenagers who go on to become rampage killers? Like Andy Williams?

Is that him?

JEFFREY WILLIAMS: Yes. And there he is.

MILES O'BRIEN: Oh, yeah.

JEFFREY WILLIAMS: Making the goofy faces.

MILES O'BRIEN: It was March 5th, 2001, when the cute kid in Jeff Williams' photo albums became the murder suspect on the six o'clock news.

NEWSCASTER: About 9:30 this morning, shots rang out at a suburban San Diego high school.

MILES O'BRIEN: Andy walked into the boys' room at Santana High School, in Santee California, and opened fire. He killed two fellow students and injured 13 others.

POLICE OFICER: The suspect shot two people in the bathroom at first. Then opened the door to the bathroom and started shooting randomly anybody who was passing him by.

MILES O'BRIEN: More than a decade after the shootings, Jeff is still perplexed.

So, he wasn't a kid that was infatuated with violence?

JEFF WILLIAMS: No, not at all. You have the silly clown, that's the thing. You don't expect the silly clown to do something like this, to go kill people.

MILES O'BRIEN: The class clown.

JEFF WILLIAMS: The class clown to be the class killer.

NEWS FOOTAGE (Newsclip): When we heard the shots, I thought it was fake, but my teacher said it was real.

MILES O'BRIEN: The gun was a .22 caliber revolver, like this one. Andy took it from Jeff's locked gun cabinet—ironically, a gun that had brought father and son together.

JEFF WILLIAMS: I feel bad that he used my gun, but it was the gun, one of the guns that I taught him how to shoot with.

NEWS FOOTAGE (Newsclip): The first two counts charge the defendant with murder, the remaining counts are 13 counts of premeditated attempted murder.

MILES O'BRIEN: Facing life without parole, Andy pleaded guilty.

At his sentencing hearing, a year and a half after the shootings, he faced the families of his victims.

NEWS FOOTAGE (Newsclip): All I ask is that you look at the horrors Andy committed and not to be lenient because of his age. He was old enough to know what was right and what was wrong. And he knew that what he was doing was terribly wrong.

MILES O'BRIEN: Do you love your son?

JEFF WILLIAMS: Yes, I love my son very much. Ironically, first time I told him I loved him, that I can remember, was when I saw him for the first time at Juvenile Hall, on March 8th. And you know, I, yes, I love him now. I loved him then and I'm going to support him. He's my son. I do not condone what he did. I did not condone the way he went about trying to resolve his issues whatsoever. He made a very bad choice. I can't change that.

MILES O'BRIEN: So what were Andy's issues?

After the shootings, the truth began to emerge. For Jeff, the revelations were a complete surprise. He knew that Andy was the new kid at school. He and his son had recently moved to a San Diego suburb from Maryland, leaving his ex-wife, Andy's mom, a continent away.

But what Jeff didn't know was that Andy had sunk into a state of deep despair.

ANDY WILLIAMS (Home Video): About to go down to the skate park, meet everybody, because they're already down there.

MILES O'BRIEN: He didn't fit in at Santana High, and even his so-called friends bullied him unmercifully.

ANDY WILLIAMS' FRIEND (Home Video): Beat him up, like you did Trevor that one day.

MILES O'BRIEN: He'd started drinking, smoking pot and taking prescription painkillers.

ANDY WILLIAMS' FRIEND (Home Video): He's high. Yeah, we're all high.

ANDY WILLIAMS' FRIEND (Home Video): Turn it off.

REPORTER: Santana students say the suspected shooter had a reputation for being picked on, and even though he made threats, no one thought he would carry out such an act.

MILES O'BRIEN: Andy is now 27 and has served 12 years of his 50-year-to-life sentence.

We spoke on a monitored line from inside the Ironwood Prison, in the middle of the southern California desert.

PHONE RECORDING: This call is from an inmate at a California correctional facility.

MILES O'BRIEN: Can you still hear me?

ANDY WILLIAMS: Yes.

MILES O'BRIEN: Take us back to that moment, and if you can, tell us what was going on in your mind at the time. That would really help us.

ANDY WILLIAMS: To me, it was just like a numbness, at the time, you know what I mean? And like I couldn't really, like, at fifteen, I didn't really think, like, all that stuff through. I didn't think two boys were going to die. I didn't think 13 people were going to get shot. I just thought I was going to make a lot of noise and that the, and that the cops were going to show up.

MILES O'BRIEN: Did you feel suicidal?

ANDY WILLIAMS: Absolutely. It was like an eight-month constant like, like, "I wonder if things would be better if, if I wasn't, if I wasn't like in this, in this city, in this state, like or even, even on this earth?" So my grand scheme, like, my grand plan was "suicide by cop."

MILES O'BRIEN: Andy says he wanted to die, if not by his own hand, then suicide by cop–getting gunned down by authorities. At the last moment, he changed his mind and turned himself into police on the scene.

As it turns out, about 60 percent of rampage killers end up killing themselves. Some experts believe understanding and spotting the suicidal mind is a key piece of the puzzle.

KATHERINE NEWMAN: The sense of frustration and hopelessness grows in them, often to the point that they are suicidal.

MILES O'BRIEN: Katherine Newman is a sociologist at Johns Hopkins University. She's studied school rampages, looking for the particular set of circumstances that can turn a child into a murderer.

KATHERINE NEWMAN: These are kids who are desperate to be accepted. They are not loners; they are people who are trying to join groups all of the time, but their experience every day is friction.

MILES O'BRIEN: She found that many of these shootings take place in smaller, tight-knit communities, where acceptance is crucial, and not fitting in becomes all the more unbearable.

Tight-knit is great, as long as you're part of the knit?

KATHERINE NEWMAN: Yeah. So if you're on the outs, you've got nowhere to go.

ERIC HARRIS AND DYLAN KLEBOLD (Columbine High School Shooters): Imagine that in someone's f----ng brain.

MILES O'BRIEN: Depression, suicide and exclusion proved to be volatile factors in one of the most infamous rampage shootings of all: Columbine.

In April, 1999, seniors Eric Harris and Dylan Klebold arrived at Columbine High School with an arsenal of homemade bombs and weapons, hoping to kill hundreds.

FEMALE COLUMBINE HIGH SCHOOL STUDENT (Newsclip): These kids have guns! These kids have guns!

MILES O'BRIEN: Their bombs failed to explode, but they still shot up the school, killing 13, before turning the guns on themselves.

We now know Dylan Klebold was severely depressed and suicidal, but his parents, evidently attentive and loving, had no idea.

ANDREW SOLOMON (Author, Far From the Tree): He was incredibly good at keeping his inner life secret from everyone who was around him, as many adolescents, in fact, are.

MILES O'BRIEN: Author Andrew Solomon, who has written eloquently about his own depression, spent weeks with the Klebold family, trying to get to the roots of what had happened to Dylan.

He found disturbing clues in the teenager's secret diaries.

ANDREW SOLOMON: In his writings, he talks endlessly about wanting to die. He talks about feeling incredibly sad. He talks about being in love with a girl who doesn't even know his name. He talks about the feeling of invisibility. And in all of that, there's a lying through of profound depression and finding this life a terrible life and wanting to be out of it.

MILES O'BRIEN: So is the brain of a suicidal person like Dylan Klebold different? Psychologist John Keilp is trying to find out.

JOHN KEILP (Columbia University): We're looking at what's different about those people. One of the things I think we feel confident about is that there is something different about those people, that it's not just a feature of depression.

Take your three fingers and put it on the buttons. And one, two and three stand for the response red, blue or green.

MILES O'BRIEN: Keilp believes one fundamental difference may show up in a deceptively simple test, which he let me try. It is called a Stroop test, invented by psychologist John Ridley Stroop in the 1930s. All I had to do is identify the color I saw on the screen.

JOHN KEILP: Go through the set as quickly as you can.

MILES O'BRIEN: But when the color and the word do not match, it gets a more interesting.

JOHN KEILP: The thing to do is just respond to the color.

MILES O'BRIEN: Yeah, okay. Got it. Got it. Okay, I get it.

Gosh. This is harder than you would think.

JOHN KEILP: But you noticed right away how you slow down.

MILES O'BRIEN: Yeah. I don't know why this…this shouldn't be that hard. Why is that?

JOHN KEILP: That was Stroop's big discovery.

MILES O'BRIEN: Keilp had two groups of people complete Stroop tests, while their brains were being scanned in an M.R.I.

JOHN KEILP: Lie still and relax okay?

MILES O'BRIEN: One group was depressed, and some had attempted suicide; the other was healthy. He noticed a surprising difference in their brain scans.

These are healthy brains doing a Stroop test, when the color and the word don't match. The red areas denote increased blood flow, and thus, brain activity, in the frontal cortex region, the cingulate, which resolves conflicting perceptions, and the visual regions as well.

Now, look at the brains of depressed and suicidal people doing the same test.

That's very dramatic. Look at that.

JOHN KEILP: What it's telling us is that they're not activating regions that are necessary in order to process the task as efficiently.

MILES O'BRIEN: Keilp has found depressed, suicidal people are just not as good at the Stroop test. Their brains seem inclined to focus on one thing—in this case, the word, not the color—and are less flexible.

It may mean their brains are wired in a way that makes them fixate on suicidal thoughts.

Research like this may take scientists closer to a means of screening for suicidal tendencies, especially in adolescents who would never admit to it, like Dylan Klebold or Andy Williams.

But the question remains: why does someone who wants to end his own life decide to take so many others with him? One answer is the desire for fame.

STEVEN PINKER (Harvard University): If you decided that your life is worth nothing, you are nobody, you haven't made a difference, and you want to do something that guarantees that your name will be on the lips of everyone in the country, what are your options? There's only one, and that is kill a lot of innocent people.

MILES O'BRIEN: According to many experts, rampage killers are often trying to remake their images, and they say boys are more likely than girls to use violence to change the way the world perceives them.

STEVEN PINKER: Violence, in general, is a guy thing. Testosterone is responsible for all kinds of violence, but it, it does seem to be involved in the response to a challenge to dominance.

MILES O'BRIEN: The link between violence in the media and real world violence is still being debated, but it is clear rampage shooters sometimes cast themselves as Hollywood villains, the antiheroes. Aurora shooter, James Holmes, was infatuated with the Joker in the Batman movies.

HEATH LEDGER (As Joker in The Dark Knight, 2008): Good evening, ladies and gentlemen. We are your entertainment this evening…Where is Harvey Dent?

KATHERINE NEWMAN: What young people see is power. They see power. They see people who inspire fear in others or respect. The antihero is a respected character.

MILES O'BRIEN: Better to be infamous than irrelevant?

KATHERINE NEWMAN: Better to be infamous than invisible.

MILES O'BRIEN: Andrew Solomon found evidence in Dylan Klebold's diaries that the Columbine shooter was, in a sad, twisted way, trying to redeem his reputation.

Unfortunately, Dylan was very good at keeping both his despair and plans for redemption secret from the adults around him.

ANDREW SOLOMON: What's clear, in reading Dylan's diaries, is that he was in agony. He was in terrible distress for a long period of time. If someone had only known that, and if someone had only been able to help assuage it a little bit sooner, perhaps this wouldn't have happened.

MILES O'BRIEN: Like Dylan Klebold, Andy Williams never said anything to his father about his suicidal thoughts or his plans to bring a gun to school. In fact, he lied about the bruises and cuts from the bullying, said he fell off his skateboard.

Was there anything that you wish you did? You wished your dad did?

ANDY WILLIAMS: No. I wish, I wish I was brave enough to, to tell someone what was going on with me. I wish I was like, courageous enough to confront, you know what I mean, everything that was happening to me.

MILES O'BRIEN: So, why were you holding back from your father, though?

ANDY WILLIAMS: I don't know, man. I think I, like, I think I was just ashamed of, like …confront, like, my failure.

MILES O'BRIEN: Is it possible to help kids confront their problems, before they escalate into violence?

Psychologist Paul Frick has spent his career trying to understand what causes violent behavior, so he can try to stop it. I met him on a windy, cold day at the University of New Orleans. I asked him if there is any way to spot a rampage killer in the making.

PAUL FRICK: The analogy I use is like a hurricane. We're kind of good at predicting what conditions make hurricanes most likely to develop: low pressure, the warmth of the water, wind shear, things like that. We're not always perfectly correct. You might have the perfect conditions, and somehow, the hurricanes don't develop, and it is the same thing with violence.

We know the factors that can put a child at risk for acting aggressive and violently. And the kids who typically do these rampages show many of the same factors. The thing we're not too good at is determining, "When does the perfect confluence of influences lead to a Category 5 hurricane?"

MILES O'BRIEN: So the rampage would be Category 5.

PAUL FRICK: Rampage would be Category 5.

MILES O'BRIEN: Like Category 5 hurricanes, rampage killings may get the banner headlines, but they are extremely rare. Since Columbine, about 90 people have died in school rampages in the US. For every single person killed this way, about 2,000 died in less infamous homicides.

When it comes to violence overall, scientists have a slightly better track record predicting who will become an offender. For that, they turn, not to brain scans or psychiatrists, but to statistics called "actuarials."

JOSH BUCKHOLTZ: Instead of turning to neuroscience, we can turn back to some, perhaps less sexy, but still very useful techniques that are derived, of all places, from, from insurance companies.

PAUL APPELBAUM (Columbia University): There are characteristics that, when they occur together, markedly increase the risk of violent behavior: youth, male gender, substance abuse, a paranoid view of the world, hostility and difficulty controlling anger, preoccupation with weapons.

MILES O'BRIEN: These are the factors that greatly increase the risk that a person will turn to violence. But there's a hitch.

PAUL APPELBAUM: The problem is that there are tens of thousands of people who fall into that category, and the majority of them will never commit a violent act, and that's the limit of our predictive abilities today.

MILES O'BRIEN: Without good predictions, what can we do to reshape young minds before they become too entrenched in violent thoughts?

PAUL FRICK: The adolescents who are committing serious crimes, the adolescents who are doing very serious aggressive and violent acts, typically have started with milder conduct problems early in development. They've had problems in school, maybe even in preschool, and so the key, the number one thing is to do early intervention, early mental health programs, because we know what are the early signs, it's behavioral problems early on.

MILES O'BRIEN: But when, if ever, is it too hard or too late to change a violent mind?

This is the Mendota Juvenile Treatment Center, in Madison, Wisconsin. And these are some of the most violent teenagers in the state: the worst of the worst, too hard to handle in the traditional juvenile prison. That's why they are here.

The typical teen at Mendota has been arrested between six and nine times, starting at about age 11. Their crimes are violent felonies: armed robbery, assault, rape and even murder. Many of them are callous and unemotional: psychopaths in the making.

Greg Van Rybroek is the director.

GREG VAN RYBROEK: We have kids who basically came from hell. They came from hell and don't understand what the world is all about that is of benefit to them. They're not interested in playing by the rules of the game.

MILES O'BRIEN: And so, here, they have changed the rules.

GREG VAN RYBROEK: So, what we're trying to do here is have a little bit of time for you guys to talk about your lives. And I'm asking for you to do that, but I'm really talking to your heart. I want to hear about what went on in your life before you got to this point and what you're thinking about for your future. Deal?

MENDOTA JUVENILE TREATMENT CENTER RESIDENTS: Okay.

MILES O'BRIEN: Despite the locks and chains, Mendota is no prison. It is a mental health facility. And Greg is no warden; he is a psychologist.

GREG VAN RYBROEK: Do you remember the first time you got in trouble with the law?

MENDOTA PATIENT ONE (Mendota Juvenile Treatment Center Resident): Yeah.

GREG VAN RYBROEK: How old were you?

MENDOTA PATIENT ONE: Eleven. I was a new kid, right? Here I was, like, they will mess with him, see what he about. So I felt like, well, at first I used to let people bully me and mess with me; at the end I just said, "Enough is enough." That's when I started fighting.

GREG VAN RYBROEK: It wasn't a school playground fight then, if you've got caught? It was worse than that?

MENDOTA PATIENT ONE: I kind of like, I won't stop fighting until I've seen blood, like, until he was badly hurt.

GREG VAN RYBROEK: And then?

MENDOTA PATIENT ONE: Then guns came.

GREG VAN RYBROEK: Guns came? How did guns get there?

MENDOTA PATIENT ONE: I just started playing with guns.

GREG VAN RYBROEK: Well, I couldn't get a gun if my life depended on it, probably. How do you get a gun?

MENDOTA PATIENT ONE: It ain't that hard.

GREG VAN RYBROEK: What do mean "it ain't that hard?"

MENDOTA PATIENT ONE: You could find a gun, like, in the alley somewhere, there, under, like, somebody's car, on the side, or somebody's wheel. I bought a gun from this dude for $60.

GREG VAN RYBROEK: And how did you live?

MENDOTA PATIENT ONE: Selling crack.

GREG VAN RYBROEK: This guy's been sitting quiet, but I can tell he wants to talk.

Something must have got you here.

MENDOTA PATIENT TWO (Mendota Juvenile Treatment Center Resident): Yeah, I was tired of being picked on, you know? I was tired, tired of losing fights, tired of struggling, you know what I mean? So I got me a little crew and start getting cool with people.

GREG VAN RYBROEK: So, I, I don't got me a crew, so I don't really know, when you "got me a crew." What is a crew? How does that work?

MENDOTA PATIENT TWO: Like we had others. We stand up with each other and stuff like that.

MILES O'BRIEN: There aren't any school rampage shooters here, but the same storm brews inside, a storm fed by a lack of hope, loneliness, fear, access to guns and a deep desire to prove themselves. Only, for these boys, the venue for violence is not school, it is the streets.

What kind of trouble did you get in that put you here?

MENDOTA PATIENT TWO: Robbing people and fighting.

MILES O'BRIEN: Tell me about what kind of robbery. With a gun?

MENDOTA PATIENT TWO: Yeah. I would pull a gun on you in broad daylight.

MILES O'BRIEN: What's it like when you pull out a gun on somebody and point it at them? What's that like?

MENDOTA PATIENT TWO: It's like you are in control, like you tell them what to do, like your word is higher, no matter what.

MILES O'BRIEN: The usual approach is to lock these kids up, so what is different about Mendota?

CYNTHIA "CINDY" EBSEN (Mendota Juvenile Treatment Center): I have been on this unit for a year and a half, but I've worked out here at Mendota…I'm working on my 14th year.

MILES O'BRIEN: When I walked the halls with operations director Cindy Ebsen, I started to understand. The razor wire, remotely locked doors and restraints coexist with boys walking to class or therapy sessions, past birthday greetings, award certificates and motivational posters.

CINDY EBSEN: Ken here made honor roll in school, and so he put that up.

MILES O'BRIEN: The place runs on a mix of punishment and positive reinforcement.

CATHY: These guys, they do good in school, if he make honor roll, at the end of the semester you get a McDonald's® meal.

MILES O'BRIEN: There is a direct and immediate connection between conduct today and privileges, or not, tomorrow. All of it is tracked in meticulous detail.

GREG VAN RYBROEK: So what did you think coming here would be about for you?

MENDOTA PATIENT ONE: You know, it was like, it's all based on my behavior, to go home.

MENDOTA PATIENT TWO: Yeah, like, it's all depending on me. The fate is in my hands. My freedom is in my hands. Either I can grab it or I can let it go by fights with somebody else.

GREG VAN RYBROEK: So, what's hard about grabbing it instead of fighting?

MENDOTA PATIENT TWO: Like, like I'm so used to fighting.

GREG VAN RYBROEK: It's a habit?

MENDOTA PATIENT TWO: Yeah. It's the only option we know.

GREG VAN RYBROEK: We want to believe you just open the steel door and give them a big hug and some cookies and say, "Get over it." But it's nowhere close to that, in reality.

We can't go back to the womb and play Beethoven, and we can't get the attachment that they maybe, ideally, should have received. But we can, by constantly, consistently creating a fair system for them to interact in behaviorally, start to work with them, once they trust that we're not anything but people who are firm and fair and then, most of all, caring.

MILES O'BRIEN: The sound bite statement would be you're being soft on crime, soft on criminals.

GREG VAN RYBROEK: I would amend that to saying we're being smart about people.

MILES O'BRIEN: And it appears to be smart when it comes to reducing the number of repeat offenders. Graduates here are half as likely to commit a violent felony, as teens who are incarcerated in a traditional prison.

Mendota is a unique crucible for the idea that it is possible to stop the storm. If it works here, with some of these callous, unemotional felons, perhaps intervention can stop the clouds from building inside a potential rampage shooter.

Are there kids that are beyond that, just kind of lost causes?

PAUL FRICK: No. And I will say that, and I think people will disagree, and I will, I will say the younger that kid is, the more sure I am of that statement. The only time a kid is a lost cause is when we're not willing to put the resources to give him what he or she needs.

MILES O'BRIEN: Frick is preaching to the choir for people like Liza Long. Liza is trying to bring a national discussion about mental health care to a crescendo.

LIZA LONG: Everybody wants to help these kids, but we don't have the information, we don't have the resources. Too often, there just isn't enough.

MILES O'BRIEN: She knows firsthand how unavailable and unaffordable mental health care can be in the U.S. After all, she is trying stop the storm from building inside her own son.

When Adam Lanza went on his rampage, in Newtown Connecticut, Liza watched with a strong sense of foreboding: might this be a vision of her future? Her son, we'll call him Michael, is a bright normal 13-year-old, most of the time, but he is prone to violent, uncontrollable blind rages. All of this roiled in her mind as she wrote a blog post about her son that went viral.

NEWSCASTER: Circulating across social media today is a blog, titled "I Am Adam Lanza's Mother."

MILES O'BRIEN: It launched a national conversation on the link between mental illness and violence.

LIZA LONG: I had no idea that I wasn't alone. Really, I thought I must be the only person in America who's struggling with this. And, boy, I heard from so many people who said, "You just told my story."

MILES O'BRIEN: Liza Long lives in fear every time she leaves the house.

LIZA LONG: You feel like you're in a warzone, right down to the constant anxiety. I'm always checking my phone. I'm panicked. What if something goes wrong? I never know.

MILES O'BRIEN: Her son has been different since he was born.

LIZA LONG: As a parent, you don't always know what's normal, but then, looking back, I think that there were signs early on that he just wasn't the same as other children his age.

He did things like bang his head against the wall a lot. I remember asking a pediatrician about that, like, "Why is this kid banging his head against the wall all the time?" "Oh, just some kids do that." Or repetitive sounds, made a lot of repetitive sounds. Again, we just didn't know any better.

MILES O'BRIEN: I met Michael on a good day.

MICHAEL: And it really was kind of fun, because you really have nothing to do in the loony bin.

LIZA LONG: Don't call it the loony bin.

MICHAEL: That's what it is.

MILES O'BRIEN: But in her car, Liza carries evidence that he can change into something very frightening.

So what's this?

LIZA LONG: This is the Tupperware container.

MILES O'BRIEN: What's in it?

LIZA LONG: I'll show you: hammers, knives, scissors, anything sharp.

MILES O'BRIEN: Now, why did you do that?

LIZA LONG: Because he pulled a knife on me. So the knives travel with me. I don't have to worry about that.

MILES O'BRIEN: Not surprisingly, Liza does not have a gun in the house and doesn't think anyone with a child like Michael should.

MICHAEL'S BROTHER: I'm not doing anything.

MICHAEL: You put your foot down on the pedal. Please go away!

MICHAEL'S BROTHER: I moved this piano out of the way and moved this bench and sat down on it, and then he came over here and...

MICHAEL: No, I was playing it before you sat down.

MILES O'BRIEN: Brothers bickering: the usual stuff in most households. But here, everyone is on eggshells.

MICHAEL: Thanks a lot.

MILES O'BRIEN: Because every now and then, for no apparent reason, Michael flips into a wild rage.

What happens when you have a rage?

MICHAEL: Your mind goes blank. You think about nothing but getting revenge on the people that have hurt you, you lash out and do violent things. It's very hurtful, and afterwards you may be incredibly tired and basically depressed. You feel really bad about it, but you know that there's not really anything you can do to them to make up to the people you hurt during those incidents. You can't control yourself when you're like that and no one else can. When you get like that, you just want to get the heck away from anyone in the area. It's kind of like a werewolf. When a werewolf turns into a werewolf, it doesn't know who he is, it doesn't know where he is, it's just wants to hurt and fight people.

MILES O'BRIEN: Wow, so you feel like there's another person inside, almost?

MICHAEL: Basically.

MILES O'BRIEN: Scary.

MICHAEL: Yes.

LIZA LONG: The first time he pulled a knife on me, he was 10. That's a really frightening thing. It's just a really frightening thing, but again, as a mom, I love this child. I just love this child, but it's exhausting. It's painful for him, too. He's not the type of child who wants to get to that space where he's that angry or that violent. He doesn't want to be there. He doesn't have the coping strategies or the ability to stay in a safe space for him. It's frustrating for him and scary. He's scared of himself when he gets like that.

MILES O'BRIEN: Is it hard to love him?

LIZA LONG: It's never hard to love your child. It's hard to wonder how to help your child and to feel helpless. That's what's hard.

MILES O'BRIEN: The frustration is compounded by this simple yet frightening fact: medical science cannot even settle on a diagnosis, much less a cure.

LIZA LONG: By the time he was 10 years old, we'd looked at autism spectrum, we had looked at intermittent explosive disorder, oppositional defiance. We hadn't considered A.D.H.D. at that point, but that got thrown into the mix. Basically, people are just looking at your child saying, "Well, it's something. Let's throw some medication at it, see if it sticks."

MILES O'BRIEN: So what do we have here?

LIZA LONG: Some of these are some of his older meds. I just kept them in case they change his dosage or in case they say, "Oh, we're going back to that drug."

MILES O'BRIEN: When I met Michael, he was on a drug that is used to treat A.D.H.D. and anxiety.

LIZA LONG: He's done really well on it.

MILES O'BRIEN: So, since he's been on this, has he had a real escalating episode or anything?

LIZA LONG: We did have to call the police one time since he's been on this medication, but he deescalated when the police came, which is huge. It's really great.

Here you go; it's time.

MILES O'BRIEN: But Liza Long is still on eggshells, wondering when the next rage may be.

LIZA LONG: Hey, Bug. I just need you to take your meds. You can stay asleep, I need you to take them, okay?

MILES O'BRIEN: In December, a minor argument in the car escalated. Michael tried to throw himself into traffic. Two days later, while he was still hospitalized, Liza saw the horrible images from Newtown.

DISPATCHER: Caller's indicating she thinks there's someone shooting in the building.

NEWSCASTER (Newsclip): Until today, Adam Lanza was known mostly in his neighborhood as someone who did not play well with others.

LIZA LONG: My first thought was, "What if my son grows up to do something like this?" I sat down and I wrote that piece right there.

MILES O'BRIEN: She took a lot of heat by speaking out, many criticized her for stigmatizing her own son.

But Liza feels it is important to stop avoiding this taboo issue for her son and for anyone who may struggle with mental illness.

LIZA LONG: We're seeing children like this, who need help, everywhere.

MILES O'BRIEN: They're everywhere, and yet, they're of kind of silent, until we have a Newtown.

LIZA LONG: Yes, and that's the tragedy. And that's why I'm talking with you, because, in the aftermath of all of this, I decided that, as hard as it's been personally for me—it's been hard and for my family—this is a conversation that's got to continue.

MILES O'BRIEN: And so will the research. While it may never give us an easy way to identify a future rampage killer, it has made it crystal clear it is never too early or too late to make a difference in a child's life.