Could Psychiatry Have Stopped the French Alps Crash?

Snapshot of Andreas Lubitz in running gear

From AFP and Newsmax.com 3/28/15:

The co-pilot who crashed a passenger jet into the French Alps, killing all 150 aboard, worried “health problems” would dash his dreams and vowed one day to do something to “change the whole system”, an ex-girlfriend told a German newspaper.

The 26-year-old woman, identified only as Maria W., recalled in an interview with the mass-circulation Bild daily how Andreas Lubitz told her: “One day I’m going to do something that will change the whole system, and everyone will know my name and remember.”

“I never knew what he meant by that but now it makes sense,” it quoted the “shocked” flight attendant as saying, adding the remark repeatedly ran through her head after hearing about Tuesday’s air disaster…

…She said he could be sweet and used to send flowers but got agitated when talking about work conditions, such as pay or the pressure of the job, and was plagued by nightmares. “At night he woke up and screamed ‘We’re going down!'” she recalled.

If Lubitz did deliberately crash the plane, it was “because he understood that because of his health problems, his big dream of a job at Lufthansa, of a job as captain and as a long-haul pilot was practically impossible,” she told Bild.

She split up with him because it became “increasingly clear that he had problems”, she said.

There are also reports that Lubitz sought psychiatric help for “a bout of serious depression” in 2009 and was still getting assistance from doctors, quoting documents from Germany’s air transport regulator.

Several German newspapers Saturday questioned whether doctor-patient confidentiality should always apply.

“The case of Andreas Lubitz has already sparked a debate on whether medical confidentiality for professions like pilots must be limited,” said the Sueddeutsche Zeitung newspaper.

In the United States, at least, mental health professionals are legally and ethically required to report any imminent danger posed by a patient to the appropriate authorities or persons. For example, if a client in psychotherapy or patient under psychiatric care makes a credible threat of intending physical harm to him- or herself or another, then the potential victim, or even the police, must be notified and warned.

There are two problems, however. One, human behavior is very hard to predict. People will bottle up emotions, even hiding them from confidants such as mental health professionals, and then “act out” impulsively. Most of the time the damage from the acting out is minimal or exclusively emotional; in a case like this, the damage is obviously catastrophic.

Two, we have to account for the criminal personality. The criminal personality actually hatches his plan and carries it around with him for months or years. The pilot’s reported comments to his ex-girlfriend are indicative of this. He was “smart” enough not to reveal his plan to his girlfriend, nor to any doctors or psychotherapists whom he may have seen for emotional problems. If so, this is likely because he knew all along what he was going to do, or at least had some vague idea, but because of his criminal mindset and intentions, he opted not to tell anyone.

Criminal personalities, as illustrated in great detail (and based on years of research) in Dr. Samenow’s Inside the Criminal Mind, feel a sense of victimhood and entitlement that others do not feel, at least not to this extent. Dr. Samenow also argues that the concept of an “out of character crime” is a myth. He documents that people who seem perfectly reasonable and normal — perhaps depressed or anxious, like a lot of people, but basically reasonable — who then later commit a crime were actual criminal personalities all along, and a detailed study of their lives and personalities usually reveals this fact.

Whatever was going on with this pilot, it must have been more than simply “depression.” Depression refers to a lack of energy, will, hope or purpose. To a non-depressed person, a depressed person seems apathetic, even lazy, not the kind who would hatch a deliberate plot to bring down an airplane, as Lubitz apparently did.

Assuming we have all the facts here, it’s much more likely that Lubitz was what psychiatry calls an “antisocial personality,” which is a diagnostic phrase for criminal personality. He did not merely wish to end his own life, as some depressed people do; he wanted to bring down hundreds of other lives as well. He must have felt a sense of entitlement, perhaps to have the job he wanted regardless of the requirements of his employers or even his own ability to properly do it. Such a disappointment would devastate anyone at first; but what makes a criminal different is this sense of entitlement and victimhood, taken to the ultimate extreme as in a murder-suicide. The vast majority of depressed people would never bring down an airplane.

As Dr. Samenow points out in his research, perfectly well-meaning and competent mental health professionals often miss the criminal personality traits evident in a person, and instead find more noticeable indications of problems like depression or anxiety. A criminal could even be faking or exaggerating some of these symptoms to cover up who he or she really is. Many mental health professionals buy the view of the patient-client that he or she has been “given a bum rap” in life and is entitled to take unspecified action in self-assertion and to right alleged wrongs.

It’s horrifying and chilling to think something like this could happen. Yet I’m not convinced that requiring mental health professionals to tell authorities of anyone they think might become a danger is the answer. This would probably result in lots of records and personal details about pilots (and others) getting released so that mental health professionals could limit lawsuits and protect themselves. I don’t know that it would save any lives.

A better approach might be for mental health professionals and physicians to get better training and understanding of what the criminal personality actually is. Criminals are very good at believing their own b.s. If psychotherapists and psychiatrists were better at challenging it, then you might have the beginning of a solution.

 

 

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