Nancy Lanza part 3

James Coplan, MD, continues his review of the OCA report on the shootings at Sandy Hook Elementary School, focusing on Nancy Lanza’s mental health.

Previous articles on this topic:

Shooting At Sandy Hook Elementary School – Report Of The Office Of The Child Advocate.

Who’s Story Is It, Anyway?

Unfounded Claims Of Illness

Now we enter the realm of informed speculation.

We know that Nancy Lanza represented herself to others as having a variety of medical disorders (Multiple Sclerosis, seizures, an immunologic disorder). What we don’t know is whether she actually believed it herself. If she truly believed that she was suffering from a crippling, terminal illness, despite repeated normal exams and test results, that would point us in the direction of Illness Anxiety Disorder, Somatic Symptoms Disorder (SSD), and Conversion Disorder (Functional Neurological Symptoms Disorder). If she was experiencing symptoms (albeit psychogenic in origin), then SSD or Conversion Disorder rise to the top of the list. If she were consciously “making it all up,” then malingering would need to be considered, but given the totality of what we know, this option seems unlikely. If she were inventing illness in herself in a “driven” way, stemming from unconscious, deeply rooted psychiatric need, then Factitious Illness Disorder becomes a leading contender, diagnostically. Regardless of exactly how the cards fall, “Mrs. Lanza’s statements regarding her medical condition…[raise] important questions regarding the parents’ mutual understanding of the trajectory of [Adam]’s educational and mental health treatment, much of which was guided by Mrs. Lanza’s interpretation of unfolding events.” (OCA p 31) Read the rest of this entry »

Whose story is it, anyway?

James Coplan, MD, continues his review of the Office of the Child Advocate report on the Newtown shootings, and concludes that although the report centers on Adam Lanza, his mother Nancy was actually the protagonist.

Adam Lanza killed his mother, 20 elementary school children, six staff, and himself. It would appear, on the surface anyway, that the story of the Newtown massacre is “about” him. But is it really?

Think back to High School English class. There, you were introduced to the concept of the “protagonist.” The word comes down to us from Ancient Greece, and means – roughly speaking – “the one who drives the action forward.” The actions of the protagonist set the plot in motion and keep the story moving – like the mainspring of a wristwatch.

Home Alone, Jurassic Park, and Peter Pan are examples of the genre of “child hero” tales, in which children are cast as protagonists. In each instance, the child (or children) are more clever than the bumbling adults, and save the day: Kevin defeats the burglars, Lex and Tim figure out how to bring the computer grid back on line, saving everyone from being devoured by dinosaurs, and of course Peter Pan defeats Captain Hook. That’s what makes such stories so appealing, but that’s also what puts them into the category of fantasy. The mirror image of the “child hero” genre is the child protagonist with evil or supernatural powers (for example: The Sixth Sense, The Shining, and Rosemary’s Baby).

In real life, however, infants and young children do not drive the course of events. Rather, they are acted upon by adults. Whether lovingly cared for or neglected and abused, children are dependent upon adults for their very survival until well into their teen years. For the bulk of the Newtown narrative, Adam Lanza was a child. A troubled child, to be sure. But a child nonetheless. So, although the story is nominally about Adam Lanza, he cannot have been the protagonist. Who, then, was driving events – the person without whom there would have been no story? Read the rest of this entry »