I recently watched the program from Nova entitled, "The Mind of a Rampage Killer," with Director/Producer/Interviewer Miles O'Brien that sought to shed light on the mind of rampage killers including Andy Williams, Charles Whitman, Eric Harris and Dylan Klebold and Adam Lanza.

The interviews with researchers on early and later teenage experiences combined with studies of brain and and innovative treatment approaches for incarcerated were interesting.

But what struck me was how common it was for apparently caring parents to not know the dark thoughts and feelings and violent urges that lived within their teenage sons (nearly all the rampage killers have been male).

Having been a clinical psychiatrist for more than thirty years with a special focus on and and people with violent tendencies, I have sought to gather together some of the reasons why teens don't tell their parents what is going on.

For purpose of explanation I'll separate them into two main categories. First, a belief that doing so will not help and second, that doing so will actually make their torment and angst worse.

Doing so will not help

1. "I don't know how talking about feeling so awful will make me feel better"

2. "I can't imagine what they'd tell me that would make me feel better"

3. "They will just reassure me or give me advice or solutions and I can't imagine how any of these will help me"

Doing so will make me feel worse

4. "I will just scare one or both of my parents and make them more worried and and then I'll feel guilty or feel like I have to reassure them I'm okay to make them feel better when I don't"

5. "I will just cause one or both of my parents to give me advice or solutions and when I don't try any of them, they'll just get frustrated and I'll feel even more guilty"

6. "When I tell my parents how or what I am feeling, I will feel more exposed, ashamed and then when I see that they can't do anything, I'll feel even more alone and worse"

So if you are a teenager who is feeling the above or a parent and is worried about your teenager being in a dark place, what can you do?

Share the following with your teenager or parent and then see what speaks to them:

How Hatred Develops

1. Perceived injustice mixed with - Whether it's real or imagined these individuals often perceive the world saying to them: "You're stupid," "You're ugly," "You're weak," "You're nobody," etc.

2. Isolation - As these individuals pull away they become greater prey to their imaginations and the thoughts above.

3. Agitation - These individuals then proceed to have observation (they look out at the world as if it is saying all these things to him) and then (this further justifies the vengeful and beginning of plans or even acting on prior such events that were not stopped or taken as a full risk).

4. Last straw - Often we will discover some event, sometimes even small or trivial from our point of view, but given the foundation created by the above 3 steps, it essentially causes a moral lobotomy. At that point these individuals act by reflex and with an eye for an eye, for perceived injustice and to the degree that they have felt that the world has put them down and pushed them away, they will find a way to get in and get even.

5. Lowered impulse control - When drugs or or are involved it further makes it difficult for these individuals to tap into their senses, their brain and their pre-frontal cortex which might put some last ditch brakes on acting on the impulses that are increasing.

Letter to Mom and Dad (shorter version):

Dear Mom and Dad,

I'm writing you this letter, because I'm afraid if I tell you how unhappy I am, you'll become angry or frightened, or even worse, you'll tell me I'm just trying to make excuses or trying to get . Then I'll have to take it back and reassure you that it's nothing and I'm okay-- when I'm really not. I really don't know what's wrong, and I know I don't deserve to feel as bad as I do because other people have it much worse. But I can't help it. I do feel as bad as I do. I feel very alone and that nobody in the world knows me-- and I'm so confused, that I couldn't even tell anyone what I want them to know about me. I'm really sorry if I'm a big disappointment to you. Please don't be angry at me for being so ashamed of me. Can you please help me?

Love,

Letter to Mom and Dad (longer version):

Dear Mom and Dad,

Given all the things I'm doing that have disappointed you, I'm hoping you won't just see this as another excuse or a way of manipulating you, both of which I'm very capable of doing and during other times have even been a master at.

In fact I've been so good at doing both of those, I'm afraid to tell you what I'm about to and have you think I'm just being dramatic and only trying to get attention or get out of taking responsibility for my actions and paying the consequences for them.

Today, I have a little bigger fish to fry.

I'm losing it. I'm losing my mind, my sense of who I am, of where I belong, and I'm spending more and more time wondering if life is worth living.

I know I don't have any reason to feel like ending it, I know that so many people have it worse than me, I even know that I have all the reasons to live. I just don't feel any of them.

I have felt alone for some time now. It hasn't been a few days or even a few weeks. It's been at least months.

Also the intensity of that I feel not only chills you -- which I know is why you back off when it gets really ugly between us -- it chills me.

I hate hating you more than I hate you. When I hate you at the level I'm capable of hating you I feel like destroying things. That has escalated and finally shifted to thinking of just destroying me.

But in reality, I don't want to destroy anything, I just want to destroy the pain I feel and make it go away. But it won't go away and I can't make it.

The reasons I drink, do drugs and cut on myself -- all of which scare the shit out of you -- are because they all relieve me. When I'm stone-cold sober and drug free and the pain and the craziness intensifies, all I can think about is numbing myself. I don't do alcohol and drugs to get high, I do them to get by.

And when I cut on myself, which terrorizes you, I feel like I'm out the pain or at the very least that I'm feeling something. And that gives me relief from the pain of feeling nothing.

Assuming you won't rub my face in this -- which might actually wake me up or push me over the edge, but I don't think you want to play Russian roulette with me -- you'll probably ask me what you can do to help.

And I wish I had an answer to tell you.

Actually the answer I'd like to tell you, I am telling you by telling you this message and hoping you'll "just listen."

I think the hole in my being and the missingness at my core needs warmth from you, Mom -- occasional kindness from pathetic, rational, lecturing, clueless Dad is not the same -- which I either think you can't get to because all of us -- including Dad -- fight you or because you no longer have any warmth, either because you didn't get it from grandma or because it got worn out by all of us.

Dad, you're not off the hook in this. I think you run interference between Mom and me and try to keep the peace and then I think you find your home away from home when you get away to go to work or travel for work or play sports with your buddies.

Maybe a start would be if I saw each of you making the effort to understand me especially when you have no chance of really achieving it.

There is a good chance that neither of you will be able to understand me because I am as different from you as you are from each other, but it might help if I saw you continuing to try and continuing to ask or say things to me like:

Tell me what's happening and how you feel in another way, because I see that I'm not getting it and I want to get it. And then tell me at its worst, what that's like.

And if I push you away, you might do well to stand firm and say, 'We can't go away because as your parents we can't allow you to feel so alone in hell and we've got to do whatever we can to get you out. Sorry to tick you off, it's in the parents rule book which you'll figure out when you become one.' One of my friend's parents actually sleeps outside her room on the floor which my friend both resents and feels safer with.

More importantly I think it might help if I saw you not getting so frustrated and throwing your hands up, because I keep pushing back and won't agree to what you think should make me feel better. Going along with it to get you off my back hasn't worked and actually makes me feel worse.

I think I can live with the pain, I just can't live with suffering. I think the suffering happens when I feel alone in my pain for a long period of time and it doesn't let up.

I think if I could feel less alone from the inside out, I could listen to what you and the world are telling me from the outside it.

Feeling alone is feeling that I am unpaired with what everyone seems to have.

Being unpaired with a future worth living causes me to feel hopeless; being unpaired with any help that I or others can provide causes me to feel helpless; being unpaired with a reason to go on causes me to feel that everything is both pointless and meaningless; and being unpaired with doing or accomplishing all the things I'm supposedly capable of causes me to feel worthless.

And feeling unpaired with all of those things causes me to feel despair.

I feel like I am trapped in a deep dark cold mine shaft, have run out of food and water and am running out of oxygen and time.

I keep hearing people digging to find me. I hear them thinking they have found me and are all excited. But what I know that they don't know is that they're digging in the wrong direction because one of them got a glimpse of a doll in a different mine shaft that I left there many years ago and everyone thinks it's me.

Love,

What Your Teenager Who Won't Talk to You Wants You to Know

Watch the following and if it applies to you as a teenager share it with your parents and explain why it fits. Or if you're a parent, share it with your teenager and ask them if it fits for them and then to tell you how and why.

ALSO: About Teenage Violence - It's the Rage