Luigi Mangione: the Diagnosis

The only thing missing from the Luigi Mangione saga is-- a diagnosis. How did it happen that we have not yet called on our mental health professionals to explain it all away.

Note that I see Mangione’s action within the saga that it has provoked. People are not treating the spoiled Marylander as an everyday garden variety criminal. They are studying his action as a commentary on our health care system. Which is not the same thing.

It is fair to say that psychiatric diagnosis is fraught with peril. Once upon a time the profession decided that its diagnostic categories were not sufficiently scientific. Then it produced a book called the Diagnostic and Statistical Manual of Mental Disorders, leading to an extended debate about whether its methods were really science. As of now the DSM has gone into six editions. Apparently, the science was not settled.

But now the New York Post has tried to shed some psychiatric wisdom on the killer, by interviewing some of New York’s leading psycho therapists.

The first one says that Mangione must be a grandiose narcissist, someone who saw himself as a hero and who disregarded some of society’s basic laws. The therapist said that Mangione was obviously deranged because he had “this sense of permission to take a man’s life into his own hands.”

I quote the last phrase because it is so basically illiterate.

We are not surprised to hear Mangione being labelled a narcissist. To today’s psycho therapists, everything is narcissistic. At which point the concept is drained of meaning.

Freud invented the concept over a century ago, to honor the lovelorn youth of legend who became so enamored of his reflection in a pond that he tried to get hold of it and drowned.

Later iterations have given us pathological narcissism and malignant narcissism. Still and all, comparing Luigi Mangione to the Greek youth seems to be a stretch. 

True enough, the young man wanted to be famous. He wanted to be part of a debate, even a public critique of the health insurance industry, but that does not mean that he was in love with himself. 

It seems more accurate to say that he was sacrificing himself in order to save others. That does not make him a narcissist.

Another therapist dug deep and declared that Mangione was a sociopath, that he was suffering from “antisocial personality disorder.”

She compared him to serial killer Ted Bundy and to Charles Manson. The latter is more cogent since Manson ordered murders that were designed to make a political and cultural point. Bundy was merely a sexual predator who murdered his victims.

Of course, you might say that Mangione committed a crime and therefore deserves to be labeled a criminal. Assuming that the courts do their job. And yet, how do you socialize someone who is anti-social. After all, the young man had an excellent eduction and good jobs. And, why do they call him a sociopath and not a psychopath?

One thing will not surprise anyone, The therapists insist that it’s all about empathy, or, lack of same. And yet, have you noticed that Mangione’s apologists have expressed great empathy for the people who had had treatments denied by insurance companies. Perhaps Mangione was thinking of them.

As one therapist put it: 

 I don’t think that someone who feels deeply on an emotional level would be okay with shooting someone in the head.

Dare I say, as you have doubtless noticed, that we are not in a world of deep or even minimally competent thinkers. 

As it happened Mangione did not shoot Brian Thompson in the head. He shot him in the back, a sign of cowardice.

As for the mental drool about feeling deeply on an emotional level, that is just code for-- woman. I would agree that women are far less likely to commit such crimes, but that does not a diagnosis make.

Said therapist offered this qualification:

Clearly this is someone who was planning on going out and conquering the world. So does he have some grandiosity? Yes. But I do not think he was a sociopath…. Instead, “he felt like time was running out for him to accomplish his dreams, which is why chose to murder Brian Thompson.”

Which dreams might those have been? Did he want to conquer the world? Did he think that the way to conquer the world was to spend the rest of his life in prison? Or did he want to be written up in the history books, for having fired the shot heard round the world, the shot that provoked a rebellion, 

Finally, the psycho therapists all agree that he is not schizophrenic. At least they got that one right.

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