Houses Built on Sand

Reflections of a country doctor on the problem of school violence
by John R. Lee, M.D.

Houses built on sand do not fare well in the face of storms. Hurricanes and tornadoes that demolish poorly-built homes leave the well-built homes relatively unscathed. So it is with health. One's health is not merely a matter of an assault by bacteria or viruses, or the trauma of an accidental fall, or the rigors of a perilous journey. Health is also a matter of one's immune system, nutrition, and resistance to stresses of all sorts. Health, then, is the ratio or balance of the sum total of all those factors favorable to health and the sum total of all those factors deleterious to health, as the simple equation below expresses.

Examples are all around us. Hip fractures occur not merely because one trips and falls; they occur because the bones have become fragile. Strep throat infections are not due merely to an exposure to Strep bacteria but also to a weak immune system. Measles pneumonia (50% fatality) occurs primarily in children deficient in vitamin A. Hypertension occurs more often in people deficient in magnesium and potassium. Weight gain, water retention, and fibrocystic breasts occur in women deficient in progesterone. The belief that infections can be controlled simply by the use of antibiotics is an illusion: the time is short before pathogens learn resistance to all antibiotics, and survival from infections will depend solely on our inherent resistance to them.

The same equation can be used for the health of society. The rising incidence of youngsters assaulting other youngsters with guns is a case in point. Most analysts are looking for external causes (guns, mental illness, drugs, etc.) and failing to look at underlying causes. Guns have been available for several generations and school shootings were rare. Mental illness treatment focuses on drugs such as tranquilizers and antidepressants to control symptoms but not in treating underlying causes. Neither gun control nor mood-altering drugs will solve the problem. The gun assault epidemic is a symptom of an underlying societal problem. Find the problem and we can stop the epidemic.

From the descriptions of the shooters, it is clear that poverty or job discrimination or a broken home is not the problem. One shooter, for instance, drives his BMW to high school. They all came from what seems like "normal" homes and family life. Lack of intelligence is not the problem: these kids were all bright.

One way to start finding the problem is to ask the children themselves. They report that they did the shooting because they were jilted by a girlfriend, or taunted by schoolmates, or given a poor grade in school, or failed to become a cheerleader. The reasons are so mundane that we adults disregard them. We say that we all experienced similar problems and we did not resort to gun assaults or bombings.

But let us accept these reasons and re-state the question as: Why are these same disappointments apparently sufficient to cause children to act out in this manner now and not before? Why are so many children not resistant to such common rebuffs? Consider some of the following factors.

1. Instant gratification of impulse-driven desires
In an affluent society such as we now enjoy, parents indulge their children far more than ever before. Their children must have the latest Beanie Baby, the latest (and most expensive) sports shoes, and their own TV. Modern family homes are littered with discarded toys bought on impulse and used for a nanosecond. The narcissism common to three-year olds is allowed to extend into teenage, untempered by guidance that would have taught them that the world does not orbit around them nor exist merely for their own gratification. Having recently attended a Bar Mitzvah, I was pleased to observe that its primary focus was the confirmation that the 13-year old boy had achieved adult understanding of his place in society, that the days of a child's impulse-driven actions had changed to a recognition of adult responsibilities. The lack of this understanding, perpetuated by the constant gratification of impulse-driven desires long past childhood, is a factor deleterious to a healthy society.

2. Failure to set limits on behavior
This is the other side of the same coin. A child's world is different than an adult's world. The child's world is one of fantasy not yet balanced by reality. When our children are very young we indulge them their belief in Santa Claus, but we expect them to grow out of it. Their fantasy is that life is full of goodies and never troubled by disappointment. It is the parents' obligation to set limits on behavior. In less well-off societies, food may be scarce or requires hard work to obtain. In those societies, children observe that sharing is a desirable behavior since, without sharing, they may be the ones who go hungry. Children in a well-off society rarely experience that dose of reality.

Living in a world of no limits on behavior is troubling and fearful for most children. They are constantly testing the limits in an attempt to make sense of an otherwise chaotic world. Their outlandish behavior and bizarre hair-does are often a tip-off that they are testing the limits. In healthy families, mothers and fathers provide unconditional love and both must cooperate in setting consistent, reasonable limits. It is difficult for a mother (or a father) to fill both roles alone. And 50% of our US families lack the presence of a father. Being a good father does not mean merely attending a son's Little League game; it means setting standards of behavior that reflect respect of others throughout all venues of life.

Even with both parents, setting limits on behavior is not easily accomplished when parents are away at work during the day. We worry about poor "latch-key" kids who must fend for themselves when coming home from school. Their nutrition suffers and so does their emotional development. An affluent family with two working parents is no different than a poor family when no one is home for the kids.

3. Lack of opportunity to develop the sense of responsibility
Responsibility is not the same as obedience. Obedience refers simply to obeying commands regardless of how arbitrary they are. For example, being told to make your bed is an arbitrary command. You make your bed only to unmake it when you go to bed. Obeying the order is merely obedience, not an exercise of responsibility. Responsibility refers to consequences of one's actions. If you fail to close the pasture gate and the horse gets out, you are responsible getting the horse back in the pasture. Failing to do that, you lose your horse. Failing to weed the garden means you have less to eat. Fouling the well means you have no water. Two or three generations ago, the majority of US children grew up on farms. Farms are family projects. Children growing up on farms had many responsibilities. Children learn that they are important to the running of the farm. That is how one learns responsibility.

Urban life is a different matter. Less than 5% of US children now grow up on farms. Urban children have no necessary role in urban life. Water, food, housing, all the necessities of life are devoid of children's input. The "good" child learns obedience, his folks think he is fine, but he has little opportunity to develop any sense of responsibility. His folks are busy with their jobs and other commitments. The urban child constantly feels useless; he needs something to do, something that nurtures his/her sense of responsibility. Gardens are good. The child observes that soil preparation, weeding and tending the garden, and waiting until the fruit or vegetables ripen are all important to enjoy the "fruit of their labors." He/she learns the value of work and the benefits to be gained from delayed, rather than instant gratification. Meaningful chores, of all kinds, are beneficial to the development of one's character. Raising pets can be meaningful. If the child fails to feed them, they die. The child does not have to be taught that actions have consequences, they follow directly from the action or inaction.

4. The fear of damaging a child's "self-esteem"
Many of our children are insecure and are thought to lack self-esteem. Self-esteem is not damaged by hardship and is not maintained by indulgence in dysfunctional behavior. Both the home and school environment are important here. Abusive unreasonable behavior at home leads to the same behavior outside the home. Schools afraid of damaging a child's "self-esteem" reward substandard effort. There is something wrong with school systems in which over half of the students are given high grades. Over the past 10 years, the scholastic level of study books has been downgraded by two years to help the mediocre student to graduate to the next level. Kids are quick to recognize hypocrisy and condescension, acts that breed contempt. Children are amazingly good learners. They are sponges for learning and they respond admirably to challenge. If they observe that poor study effort is rewarded with good grades, they disparage the attempt to perform well in school. If they observe that cheating and outlandish behavior go unpunished, they learn that honesty and good behavior are not worthy goals. If home life does not include an atmosphere of love and respect between father and mother, and between parents and children, the children will be less likely to respect others. Self-esteem comes from affirmation of good effort and attainment of properly set goals. Failure to make good effort should not be met with ridicule, of course, but with graded meaningful incentives to do better.

Fear of damaging a child's self-esteem should not prevent the parent from exercising some control over their child's activities and associations. When we read that the parents were not aware of their children's web site communications, or their stockpiling of guns and explosives in their bedrooms, we must realize that this is not good parenting. This is a neglected child. A strong family life includes an understanding of parental authority.

5. Lack of accountability
Accountability has lost its meaning. In auto accidents due to prescription drugs (e.g. Valium), the driver is generally not held accountable. If you leave your keys in the car and it is stolen, you are at fault and the car thief is not held accountable. If it can be proved that someone was raised in an abusive home, his/her abuse of others is excused. If "everyone" is doing something destructive, the individual is seldom held accountable. If there is no shame or accountability in verbal abuse, or bullying, or rape, what lessons do the children learn? Accountability means that if you do a wrong, you suffer the consequences. Our court system also has something to do with the loss of accountability. If you are without sufficient funds for a responsible defense and you know that the rich are rarely found guilty, why should you respect the legal system?

6. Desensitization to violence
Violence in the home is fearsome to children. How do they cope with it? They are drawn to fantasies of violence where the consequences are dissipated. They see it on the TV, in computer "games", and in movies. Violence becomes an art form for vicarious thrills. In these media, there is little feeling of remorse or pain. Military recruits are subjected to dramatizations of violence to desensitize them to the act of committing violence. If they repeatedly see buildings being blown up, or caricatured people being gunned down, the act of setting off the bomb or pulling the trigger becomes merely a reflex. It is no accident that abusive relationships are more common among military families than among non-military families.

Violence as a method of conflict resolution seems to have become the method of choice. Four decades ago, the hero in the movie, Shane, avoided violence except in extreme emergency. Violence is not negated by refined art. In Clockwork Orange, the villains performed their violence to the music of classical composers. Even Dirty Harry used his gun only when conventional police work failed. Now, however, movies, TV, and computer games portray violence as a senseless thrill devoid of personal feelings. Often the violence is wrought by robots or by long distance (e.g., bombs and rockets from planes too far away to see their victims), acts that remove the last vestige of personal feeling. When the victim is depersonalized, the moral and ethical consequences of violence disappear.

7. Desensitization to death
Very few children ever see anyone die except in movies or TV. Real people with serious illness or accidents are removed to hospitals where death occurs behind closed doors. A generation of so ago, people with lingering illnesses or serious accidents more often died at home where children could see the loss of life first-hand. A child will cry if he witnesses the death of a favorite pet. The child rarely cries if he sees a death on TV or in a computer game. And the hero is almost never killed. Lacking any real exposure to the death of a known friend or loved one, death has a way of becoming depersonalized. On TV, the permanence of death is lacking because the child sees the same actor in other later shows. In video games, the tape can be run again. Killing is a transitory thrill without serious consequences. Even suicide falls into this category. Playing Russian Roulette with a loaded revolver is merely something to do when bored.

The concept of personal death is relatively meaningless to children. They, themselves, feel immortal. If a group of very young soldiers are told that their next battle will result in 90% casualties, each of them feels sorry for the nine men around him. If the soldiers are 30 years old, they will all seriously question the rationale for the up-coming operation. Only the very immature feel that warfare is fun.

Among statesmen and politicians, remote deaths or deaths of multitudes lose relevance. As Stalin once remarked, "The death of a friend is a tragedy; the death of 10,000 men is a statistic."

8. The biologic factor
Conscience and respect for the rights of others are influenced by brain function. Brain functions are influenced by a variety of biologic factors. Let me give you a few examples.

a. There are people who are sociopaths; i.e. they truly lack any feeling or compassion for others. The have learned that violence and murder are "wrong" but they lack the feeling of doing wrong when they commit violence or murder. It is said that they lack a "conscience". But, at present, we do not know where conscience comes from. It is quite possible that some brain defect is responsible.

b. Two excellent studies using laboratory rodents found that pre- or early postnatal exposure to fluoride resulted in specific brain damage that effected behavioral responses later in life in the exposed rodents. If the exposure were prenatal, the brain damage caused an inability to solve problems (e.g., "street" people). If the exposure were early post-natal, the rodents showed clear signs of attention deficit disorder.

c. A recent study of teen-age violence in a large number of US cities found wide variation in incidence between cities. The factor that correlated most strongly with teen violence was fluoridation of city water. It is quite likely that the brain damage wrought by prenatal exposure to fluoride also includes a predisposition to violence.

d. Highly glycemic diets in children results in poor problem solving, high frustration levels, and prompt resorting to violence in conflict resolution situations. In these children, dietary change to whole foods and good nutrition were highly effective in clearing these behavioral disorders.

e. Premature puberty causes a disjunction of sexual drives with the ability to make adult choices. At the turn of the century, puberty age was approximately 15-16 years. A decade ago, puberty age fell to 12 years or so. Now, 30% of female schoolchildren show breast development and pubic hair by age 8, and menarche by age 10-11. These early changes obviously reflect hormone levels. These changes within the past generation mean that children will experience sexual drives while they are still impulse driven and lack the ability to act on reason and recognition of consequences. The age of responsibility is still 13 years. Our schools know of this change in the biology of students but we still have no clear idea of how to deal with it.

f. Estrogen dominance leads to an imbalance of copper and zinc blood levels. This, in turn, effects neurotransmitters with the result that mild irritation is turned into rage. When a mother repeatedly exhibits inappropriate rage, her children become confused, demoralized, and angry. They act out their anger in relationships with others. I recall a sign I saw in the kitchen of one such family that said, "When momma's not happy, no one's happy."

g. When families living along Lake Michigan are tested for polychlorinated biphenyls (PCBs) exposure from pollutant contaminated fish, those children born of women with the higher exposures to PCBs during pregnancy are found to suffer from intellectual and emotional impairments. They grow up frustrated and angry. Toxic petrochemicals from industrial pollution contaminate much of the food supply throughout the US.

9. Rx Drugs
Children showing signs of aberrant behavior and moods are frequently treated by tranquilizers and antidepressants. The antidepressants used are frequently of the serotonin uptake inhibitor variety such as fluoxetine (Prozac) and similar compounds. There is considerable concern that such drugs may contribute to the absence of behavioral restraint, and that the discontinuation of the drug may predispose one to violence. It should be obvious that such treatment is merely directed at symptom control and does not address or treat the cause of the behavior or mood problem. In addition, the treatment appears to exacerbate the risk of violence. This is a problem yet to be resolved.

10. Alcohol abuse
Alcohol abuse by the children is rarely the issue. Alcohol abuse by parents is a huge problem. The alcoholic parent can not be a good parent. Bad parenting is not good for the emotional development of children. Alcohol abuse is thus related to the problem of school violence as well as to automobile accidents and other social problems. Conventional treatment of alcoholism is not particularly effective. However, this problem is far too complex for me to presume to offer a treatment in this instance.

11. Decay of societal morals
At no time in our countries' history has there been more news coverage of moral lapses in society. Schoolteachers are found to be pornography collectors, religious leaders are convicted of seducing children, loaning institutions and investment counselors misappropriate (steal) money from clients, police abet drug dealing and shakedowns, political leaders lie about their sexual dalliances, rap musicians become millionaires singing about sex and killings, movie stars openly use drugs and are sexually indulgent, minor crimes often receive harsh sentences while major crimes by the rich receive only a slap on the hand. Our news media are awash with lurid reports of such goings on. It is not surprising the children see moral standards as hypocritical. Where are the role models for moral behavior? They exist, of course, but do not make the news that sells. What lessons are being taught here?

12. Loss of spiritual values
In a world lacking spiritual values, the meaning of shame and guilt is also lacking. In a society that glorifies abundance of goods and monetary achievement, with families too busy to attend church regularly, or with organized churches not meeting the spiritual needs of people, spiritual growth and values decay. It is ironic and certainly confusing to many people including children that wars are being fought in the name of specific organized religions. Children who are taught that spiritual values are arbitrary or irrelevant to life will more likely not recognize the sanctity and holiness of their own or another person's life.

The subject of gun control is peripheral to the resolution of the problem of school violence. No one is against devices to prevent accidental discharge of a loaded weapon or against keeping guns out the hands of children. But not even the most ardent gun safety proponent believes laws and regulations will prevent the availability of guns to those who are intent on obtaining them. Until we recognize the underlying dysfunctions as described above, it is unlikely that any successful programs will be mounted to solve the school violence problem we are facing. The children committing school violence are certainly cause for concern, but they are symptoms, not the cause, of a larger societal problem. The solution will come when we understand that our house (society) is built on sand and is in for prolonged and severe battering until we get our foundations back in order.

John R. Lee, MD

June 1999