Madness After Virginia Tech from Psychiatric Risk to Institutional Vulnerability

Madness after Virginia Tech From Psychiatric Risk to Institutional Vulnerability

Benjamin Reiss

Perhaps no contemporary creative writer has had a greater impact on American colleges and universities recently than Seung-Hui Cho, the perpetrator of the Virginia Tech massacre of 16 April 2007, which left thirty-three people dead (including him). As virtually everyone knows, Cho was a troubled English major whose writing and bizarre behaviors set off alarms for his fellow students and professors, several of whom tried to intervene in his life well before the gruesome violence erupted. According to the New York Times, "as many as eight of his teachers in the [previous] 18 months had formed what one called a 'task force' to discuss how to handle him," and this group made at least two pleas to university officials to take action.' In the wake of Cho's violence, college campuses across the country have enacted strategies and created policies to detect violent impulses in their students before they become manifest. The tacit assumption behind these directives is that the university's counseling center, security team, administrators, and faculty can work together to predict violent behavior and intervene before violent acts are committed, and monitoring students' academic and creative work is one important element in that preventive intervention. Many of these strategies include issuing guidelines to faculty about how to scrutinize students' writing, when and to whom to report troublesome signals, and how to balance the competing values of free creative expression, students' right to privacy, and campus security. Many of these directives minimize the first two values and emphasize the last. The University of Illinois, for instance, casts a very wide net for potentially violent student writers: "Previously, a piece of violent fiction passed on to the counseling center by a teacher would be followed up only if

Social Text 105 • Vol. 28, No. 4 • Winter 2010 DOI 10.1215/01642472-2010-009 © 2010 Duke University Press 2 5 it included a named target.... This policy changed when it became apparent that they never would have had the chance to evaluate Mr. Cho. . . . Now a student who writes anything focused on killing should be called in."^ At my own university, such blanket policies have never been broached, and faculty are encouraged to remember that often "weird doesn't mean dangerous; it just means weird," in the words of the director of Emory's counseling center. Such compassion, however, is counterbalanced by administrative discussions about setting up security cameras in dorms with live feeds to the campus police (a policy that never came to fruition), and the distribution to all faculty members of a video urging them not to hesitate in contacting the counseling center with concerns about student behavior, including writing that is "angry, tnorose, strange." As for legal concerns, the paramount one should be the university's liability for not intervening, since "the legal risk—and the human risk—is not taking action and not doing something we should have." Faculty have been told that concerns about student privacy in this context are misplaced, given that "there are no rules, regulations, or statutes that prohibit a faculty member from sharing information about the student with other appropriate individuals at the university."^ Similar attitudes prevail on a wide range of campuses, both private and public, and they have been reinforced by a federal task force report on the aftermath of Virginia Tech—written by the secretaries of Health and Human Services and Education and the attorney general—and a review panel commissioned by Virginia governor Tim Kaine."' Media discussions of such developments do raise some objections. A writer for the New York Times, for instance, wondered about the effects on literary culture—in particular, that "intervening could squelch a young writer's voice."^ The Daily News mused about how one could tell whether "dark writing foreshadows the next Unabomber or the next Stephen King."'' Academe Online ran an imaginary debate between two professors, one con- cerned with security and one with academic freedom and openness. This second professor recoils at the idea of expanding "the use of writing as a surveillance system." He describes the chilling effect of such surveillance on students and the nightmarish, Kafkaesque webs in which one might be trapped. He also protests that even violent imaginings might have a kind of therapeutic effect: "Dozens of studies have shown that writing acts therapeutically, for traumatized veterans and nursing home residents and prisoners and troubled kids."^ The debates staged here are not about whether students' creative writing and other academic efforts should be subject to quasi-psychiatric scrutiny but about which type of scrutiny: a caring, therapeutic one or a forensic one that uses writing as a case to be made for intervention. But those who propose a therapeutic rather than a surveillance orientation toward the classroom tend not to consider that the therapeutic task might bleed over into the domain of intervention, leading

26 Reiss • Madness after Virginia Tech at one end of the spectrum to possibly unwanted counseling sessions and at the other to removal from the classroom, expulsion, or even involuntary hospitalization. Lest this seem an extreme scenario, remember that this is precisely what was at issue in the Virginia Tech case: shouldn't the authorities have recognized that the testimony and evidence provided by Cho's creative writing teachers was enough to lock him up, or at least ban him from campus, before he acted? (Lawsuits and civil rights complaints directed at other universities also make clear that administrators do sometimes act to remove the mentally ill from campus and run legal risks in doing so. I return to this phenomenon in my conclusion.) Perhaps not surprisingly, such protests against—or really, musings about—psychiatric scrutiny of students' writing have generally been lim- ited to assessing the trade-offs of negative effects on the psyches or creative lives of individual students who come under surveillance versus the needs of the institution to provide security.* What I would like to call into question is the structure of relations emerging post-Virginia Tech among faculty, students, administrators, and counselors around the problems of mental illness and the risk of violence. My contention is that the classroom — and most intensely the literature and creative writing classroom — is in danger of becoming a barely acknowledged zone of quasi-psychiatric surveillance, risk assessment, and preventive intervention. While the mitigation of violence—including suicidal behavior, which is a far more prevalent phenomenon than homicide—is a self-evidently worthy goal to be addressed by the campus community, the "risk" thinking that leads to identifying students before they act has not been sufficiently analyzed by those who are asked to play a role in identifying those students. While this development has become increasingly visible and urgent in the wake of Virginia Tech (and, in different ways, the Columbine High School shootings of 1999), it does have a history, one that reaches back at least into the nineteenth century. In order to frame what I think is a necessary conversation about the use of the classroom to detect psychiatric abnormality and the risk of violence, I would like to lay out some elements of that history so that we may wrench ourselves free of the panicky responses that immediately follow such events. And in my conclusion, I propose an alternative framework for thinking about the situation of those students living under the description of mental illness, one that moves beyond identification and isolation of risky populations to a more thorough examination of individual and institutional vulnerabilities.' While identifying risk springs from a top-down concern to protect institutions from the possible behaviors of individuals who pass through them, "vulnerability" provides a framework for thinking fiexibly about how institutions might exacerbate individuals' susceptibility to harm, and vice versa—and how actors within institutions might strive to promote resilience rather than to predict and prevent future harm.'"

Social Text 105 • Winter 2010 27 Pangraphic Panopticism One might ask three basic questions about the emergence of psychiatric surveillance of creative writing in the classroom: How did creative writing come to constitute evidence of mental illness? How was the detection of deranged (or degenerate or psychotic) writing made consequential for its authors? How did this operation come to be detached from the field of psychiatry proper and moved into the educational system? Psychiatric interest in the aesthetic productions of the mentally ill goes back to the late-eighteenth-century origins of the psychiatric pro- fession, with Philippe Pinel in France and Benjamin Rush in the United States. Through the romantic period, this interest often served to human- ize the mad rather than to justify stigmatization and/or incarceration. The insane. Rush believed, had an uncommon capacity for artistic expression, a belief shared by American asylum superintendent Pliny Earle in his 1845 tract, "The Poetry of Insanity."" At a time when romantic poets embraced childlike intuition as the route to inspiration, Earle wrote that his patients, "in their attachments and antipathies, their sources of pleasure and of pain, their feelings, motives, all their secret springs of action . . . appear to have returned again into childhood. But childhood and early life are emphatically the poetical age of man, when hope is unclouded and care is but a name, when affection is disinterested, the heart unsullied, and imagination untrammeled by the serious duties of a working world."'-^ During Earle's time, psychiatry was institutional psychiatry, and the only form of medical treatment was removal to an asylum. (There was no agreed-upon name for the medical practice that oversaw these institutions: "asylum medicine" was perhaps the most frequently used; but most histories of madness refer to asylum superintendents as early psychiatrists.) Inside such asylums, writing flourished: as Earle wrote, "The urge to write poetry rages, if possible, to a greater extent within the walls of an Asylum for the insane, than in the community at large. Extemporaneous oral cou- plets, and stanzas written upon scraps of paper, or the fly-leaf of a book, are things of almost daily occurrence." But such effusions were subject to the first methodical scrutiny. Despite Earle's appreciation of his wards' natural abilities, he ultimately recoiled from his quasi-Wordsworthian valorization of the childlike poetic genius of the insane. In the end, madness is a "disease," a "deformity," a "horror," and understanding patients' writing should only be a means to combat their madness.'^ Accordingly, writing in the asylum was bent into a diagnostic and therapeutic tool. Mid-nineteenth-century asylums often held schools, debating societies, and literary workshops, and they even published journals; in each of these scenes, writing and declamation were to be practiced under the watchful eye of the medical superintendent. Appropriate writing might find its

28 Reiss • Madness after Virginia Tech way into asylum-sponsored rituals of public oratory or even into print, but inappropriate writing could be held against one. Any offerings that openly criticized the authorities, of course, were scrutinized for evidence of pathology; even several exposés of abusive asylum practices published by former patients were read as evidence of relapse. The work published within the asylums records well the sense of scrutiny and surveillance to which all writing was subjected.'" But how did psychiatric scrutiny of patients' writing make it out of the nineteenth-century asylum and into the twenty-first-century creative writing classroom? In his Collège de France lectures of the mid-1970s (recently published in English as Abnormal and Psychiatric Power), Michel Foucault wrote that the deep significance of the nineteenth-century asylum for his own age was that the "tactics" of power developed within them ultimately migrated into other institutional settings. Although modern therapists may be surprised to hear this, Foucault implied that psychiatry had become the master-discipline in the world of modern power: it performs what he calls "a permanent doubling of the functioning of every institution," ranging from the administration of colonial justice to the running of a modern army to the disciplining and moral pedagogy of children at schools and the evaluation of corporate employees.'^ Consider, for instance, the role of psychiatry in the modern judicial system. "The individual never appears in court," Foucault says in Abnormal, "with just his crime. He arrives with the psychiatric expert's report and comes before the court burdened with both his crime and this report.""" A key aspect of psychiatric knowledge that migrated into legal, educational, and other realms was the kind of literary surveillance that had been practiced in asylums. What the asylum brought into being was a mode of writing that "becomes an instrument of control, of the permanent and overall taking charge of the individual's body.'"'' It was essential in nineteenth-century asylums for records to be made of the patient's initial interview with the asylum superintendent and for this record to be followed up with frequent reports of the patient's progress. This entailed a thorough accounting of the administration of drugs, punishments, activi- ties, behaviors, and conversations.'^ Sometimes patients were compelled to narrate their own autobiographies; the doctors used these memoirs not simply as evidence of progress or relapse, but as a storehouse of ammuni- tion to be used against patients—to put psychological pressure on them, to shame them, to trap them in their logical inconsistencies. The patient, Foucault reports, was forced to narrate the story of his or her life until it coincided with the "official" version—so that refusal to accept the doctor's narration was a refusal to accept the reality of psychiatry and its power of normalization." In fact, Foucault saw the asylum as a laboratory for a new kind of

Social Text 105 • Winter 2010 29 modern writing, one with new functions. He saw the products of this laboratory operation in "the army as in schools, in centers of apprenticeship as in the police or judicial system" — all modern disciplinary apparatuses where "people's bodies, behavior, and discourse are gradually besieged by a tissue of writing, by a sort of graphic plasma which records them, codifies them, and passes them up through the hierarchy to a centralized point." The name he gives for this "direct and continuous relationship of writing to the body" is "pangraphic panopticism": a mode of writing that does not so much represent anything as it performs a kind of discipline. In the asylum, it enacted a "constant punitive pressure" on the body, weaving webs of discourse that could entrap the patients with their own words.^° In the contemporary world, we can all feel the pressure of pangraphic panopticism whenever we feel most entrapped by a cold disciplinary system that puts a kind of "punitive pressure" on our behaviors through discursive or even digital means. Credit reports, internet browsing cookies, records of library checkouts: all can serve as fodder for pangraphic panopticism, and all can—perhaps will—be used to generate psychological profiles of us when our behavior is judged abnormal.^' The "doubling of psychiatry," or what Foucault calls the "psy- function" of so many modern institutions, is generally a submerged feature of contemporary life; but incidents like the Virginia Tech shooting show clearly how psychiatric authority has bled out of the institutions in which it was created and migrated to new spaces. As Cho's professor, Lucinda Roy, put it: "I kept saying, 'please go to counseling; I will take you to counseling,' because he was so depressed . . . [but] I was told [by counselors] that you can't force anybody to go over ... so their hands were tied, too."^^ While I applaud the sensitivity and courage of Professor Roy and her colleagues, their story has fed into a troubling call for the doubling of pedagogy and psychiatric scrutiny. Psychiatric power in this frightening moment was shown to be incomplete—it could not compel Cho to go into counseling, to leave the class, to check into a mental hospital. (An earlier incident had, however, led to this result in 2005.) But the force of media reports in the wake of the shootings was to suggest that a student's creative writing should have led to his identification as psychotic and from there to intervention. Professors, acting in the name of security, should have been able to instigate a process in which a student—who had at this point done nothing violent—would be isolated from others on grounds of his psychiatric abnormality. The media accepted as entirely natural the notion that English professors should have this double role as the first line of psychiatric preventive intervention. Universities now seem to have followed suit, openly recruiting faculty in their detection of students who are dangerous to themselves or others. While one certainly wants to make counseling and care more accessible to troubled students, this mechanism

30 Reiss • Madness after Virginia Tech needs to be questioned, for it has the potential to turn difficult pedagogical encounters into situations leaving both sides more vulnerable than when they began. I sketch out several such scenarios in my conclusion.

Monstrosity, Social Hygiene, and Psychiatric Risk How has the image of the mentally ill student fared in the wake of Virginia Tech? And how has a new campus environment been created around this image? It is easy to argue that Cho represents a new kind of psychiatric monster in the mainstream media: the psycho killer ready to stand up in the middle of class and spray the room with bullets. In her forthcoming book Mad at School: Rhetorics of Mental Illness and Academic Life, Mar- garet Price argues that a focus on the mental illness of school shooters functions as "a mechanism through which the shooters are placed in a space of unrecoverable deviance."" Indeed, several patient advocacy groups have expressed this fear. Active Minds, a student-run mental health organization with sixty-five chapters on American college and university campuses, worries that media focus on figures like Cho will further stigmatize students living under the description of mental illness, and reminds the public that statistically speaking, "people with mental illness are no more violent than people without mental illness."^" The National Alliance on Mental Illness has been urging state legislators to block changes that would dilute students' privacy rights out of concern that such reforms would heighten the perception of the mentally ill as a threat to society. ^^ Campus administrators and counseling staff paint their efforts at preventive intervention as a means of caring for students; no doubt their concern is genuine, even if they are also driven by fear of lawsuits. But some aspects of the new programs seem likely to increase stigmatization of mentally ill students. In the view of many administrators and counselors, the spike in campus violence has been caused by an increase in the number of students with psychiatric illnesses. The New England Journal of Medicine sums up such thinking, which has also made its way into print in forums like USA Today: "Not so long ago, people with [serious mental disorders] would have been unlikely to stay in college, but the availability of new psychotropic medications has enabled more mentally ill students to pursue higher education, and the courts have made it clear that mental illness and suicidal behavior and ideation aren't grounds for dismissal."^* If psychiatric medication and legal protections for the mentally ill have created a new kind of liberation for the psychiatrically disabled, this comes with new kinds of dangers: drugs allow students who previously would have been unable to attend college to matriculate in large numbers. Once on campus, they are subject to extraordinary new pressures and granted

Social Text 105 • Winter 2010 31 personal liberties that may allow them to slip out of the counseling and medication routines that have enabled them to function. Thus the need arises for new strictures—now in place on several campuses — such that students can be expected to get mental health evaluations if their behavior has been identified as troubling by faculty, coaches, and/or residence advisers.^^ Further, the Virginia governor's review of the Virginia Tech incident suggests that "students should be required to submit records of emotional or mental disturbance . . . after they have been admitted but before they enroll at a college or university." The review goes on to recommend the loosening of Family Educational Rights and Privacy Act (FERPA) regulations on the sharing of information about troubled students because "information privacy laws that block information sharing may make intervention ineffective."^* The goal of such information gathering and sharing, sometimes stated, sometimes not, is to catch violent or suicidal students before they act. In a way, such social hygiene is reminiscent of a previous era's rationales for eugenic treatment of the mentally ill. In the middle of the nineteenth century, the "nioral treatment" paradigm governed care for the mentally ill: Pliny Earle and his generation believed that insanity was nearly univer- sally curable if treated by medical authorities in a sanative environment— with appropriate measures for socialization, creative expression, moral pedagogy, and medical interventions. But as this paradigm collapsed under the weight of its own Utopian designs, the following generation of alienists and neurologists came to believe that such humanistic measures merely coddled the insane. Reñecting the inñuence of social Darwinism, they argued that much insanity was a biological, hereditary condition that should be neutralized before it corrupted the race. Darwin himself never advocated closing asylums, but he did write, in The Descent of Man (1871) that "civilized men" built "asylums for the imbecile, the maimed, and the sick" while "our medical men exert their utmost skill to save the life of every one to the last moment. . . . Thus the weak members of civilized societies propagate their kind."^' As Ian Dowbiggin has shown, the eugenic measures for sterilizing the insane were presented as the logical alternative to this history of failed "reform" of madness. By coddling the insane. Western societies were planting the seeds of their own destruction; therefore, rather than trying to reintegrate the mad into the normal world, society should instead see that insanity be eliminated.^° By arguing that post-Virginia Tech psychiatric monitoring on campus resembles the eugenics movement's attempts to solve the problem of madness by eliminating the mad, I am not suggesting that Cho's story and the new campus prevention policies signal newly fertile ground for eugenics thinking. After all, few would argue today that the mentally ill—violent or not—should be sterilized; eugenics, as many scholars of disability have

32 Reiss • Madness after Virginia Tech argued, has moved away from sterilization and euthanasia and into the realm of prenatal screening—the ultimate risk-aversion technique for a society that wants to eradicate disability but disapproves of overt eugenics measures." And yet, like the ideas of eugenicists, the new administrative and legislative initiatives to monitor students rest on a conception of mental illness that highlights identification, prediction, and intervention that may bleed into a kind of purging. Additionally, such security measures implicitly stand as correctives to a previous generation's perhaps misplaced lenience toward the insane. By erecting legal barriers to the monitoring of students with psychiatric illnesses, legislators and administrators have made possible the integration of the mentally ill into campus life, but they have also weakened campus defenses. As with Darwin's slapping down of a previous era's softhearted responses to madness, this argument implies that Cho is a by-product of a society that has—with the best of intentions — gone soft in its response to mental illness. The fear remains, though, that we simply won't know who is mad until they do something awful. And so the idea of a dragnet is broached, no matter how sensitively. Conducted in the name of preventive intervention, these forays into detection of madness may also be viewed as exercises in risk management, as the statements by politicians and administrators attest. And the fear is not unfounded: within the past few years, families of students who have committed suicide have sued MIT, Hunter College, and other institutions for failing to follow up on warning signs that might have led them to prevent the students' deaths. In 2009, a similar suit was filed at Virginia Tech for a suicide of a student who was distraught because he thought he looked like Cho; in the same year, parents of two students killed by Cho filed suit as well. When murders and suicides take place, it is easy to connect the dots and assign blame. But how to predict—and forestall—such incidents? The presidential report on Virginia Tech recommends that state and local agencies "increase information sharing and collaboration among state and local communities, educators, mental health officials, and law enforcement to better provide care and detect, intervene, and respond to potential incidents of violence in schools and other venues."^-^ The curious logic of this passage suggests an unspoken subtext. How can one "respond" to a "potential incident"? A response comes after an action, not before it. Along these lines, campus directives adopt a contorted syntax in addressing this future—technically the conditional perfect progressive: "The legal risk—and the human risk—is not taking action and not doing something we should have." While the sentence appears to address the present, it really addresses the future, a point after which our terrible suspicions about someone will have already been born out. The risk isn't "not doing something we should do," which would make perfect sense. Rather, it is not

Social Text 105 • Winter 2010 33 doing what we will later imagine we "should have" done : this imperative is knowable only in retrospect, and so the directive suggests that our actions should be fashioned as if the present were already the past, as if we already knew what is to happen. The only way to do this is to assume that violence is a latent possibility in any "odd" situation. What has shifted is the relationship of the forensic aspects of psychiatry to the treatment. Whereas previous generations identified violent people first and then determined whether their acts were the result of mental illness, we now are asked to assume that the threat is simply there, out there, and that by sorting through all of our students' behaviors, we might identify the ones who are in need of intervention. All students write; some will write angrily or bizarrely; some ofthat anger and bizarreness will seem undermotivated; some of this inappropriate writing will come attached to strange or inappropriate behaviors. From this broad array of behaviors, we are to sort through each case and determine which ones indicate madness, and those that might be violent. Or at least—in the interests of protecting the university—we adopt policies that make it impossible for anyone to say "they should have done something; they should have known." Foucault's late work can help us to see—broadly—how one's pedagogy might serve a kind of psychiatric function; but what about this notion of madness as a steady, constantly present risk across the population of students? How has the detection of violent madness in which we are implicitly asked to participate become a matter of throwing a broad net out over all of our students? The events of Virginia Tech — as well as the earlier shooting at Columbine High School—made some of these processes visible and newly urgent, but again there is a deeper history at play. An important essay by French sociologist Robert Castel, "From Dangerousness to Risk," tells a part of the story. In late-nineteenth-century theories of degeneracy, the category of "dangerousness" was both an "affir- mation of a quality immanent to the subject. . . and a mere probability . . . given that the proof of the danger can only be provided after the fact." Given the felt need to identify individuals with latent degeneracy before they committed crimes, Benedict Morel and other physicians developed tech- niques of surveillance and preventive intervention aimed at special problem groups (which today would be called "populations at risk"). The lament of one nineteenth-century French alienist about a sensational act of violence reported in the press signaled the need for broader preventive measures: "If we did not wait until lunatics committed some serious crime before we committed them, we would not have to deplore such accidents every day."^^ The seeds of psychiatric risk management were planted: the focus shifted from the present to the future, from the individual subject to broad flows of population. When one imagines future harm, some may be at high risk, some at medium risk, some at low risk; virtually none at no risk.

34 Reiss • Madness after Virginia Tech Especially as eugenics fell out of favor in the second half of the twentieth century, such drastic measures as sterilization and permanent confinement were no longer appropriate, so the problem became how to "prevent without being forced to confine." The solution was to widen the zone for intervention of the psychiatrist. As Gerald Caplan, an advocate of preventive psychiatry, wrote in 1960, "The mental health specialist offers consultation to legislators and administrators and collaborates with other citizens in influencing governmental agencies to change laws and regulations. Social action includes efforts to modify general attitudes and behavior of community members by communication through the educational system, the mass media and through interaction between the professional and lay communities."^'' Virginia Tech provided an impetus for this social action, particularly on college campuses and in state leg- islatures, where new security measures gained traction. But the advent of the psychiatrist as risk assessor and manager of institutional risks was already well under way.

According to British sociologist Nikolas Rose, for the past few decades, psychiatry has increasingly come to function as a tool to protect public safety rather than as a discipline devoted to protecting the mentally ill. Part of this shift has entailed a transition in the use of forensic psychiatry. From the late nineteenth century through roughly the 1970s, psychiatrists were called to determine questions of criminal culpability for past actions; in recent decades, "forensic expertise is deployed in assessing psychiatric patients' risk of future violence." Security, rather than culpability, has become the key concept in forensic psychiatry, and the justification for incarceration is not cure or care but "containment of risk."'^ In the Tarasoff case of 1976, the California Supreme Court held mental health professionals responsible for warning third parties against patients' prospective violence.^' This case, which set legal precedent followed in many states, presumes that therapists will be able to foretell a violent action and separate real threats from idle fantasies. According to Rose, in addition to putting professionals on the hook for predicting what their patients will do, "this professional obligation to manage risk trans- forms the act of diagnosis"; it folds forensic psychiatry into a network of risk assessors including "police, social workers, doctors" — and I would add, teachers and professors—who create "circuits of surveillance and communication designed to minimize the riskiness of the most risky."" Rose identifies some of the problems raised by this new constellation of mental health risk assessment. First is the consistent overprediction of dangerousness — a problem both minimized and brought into clear view in the Supreme Court's Barefoot case. This was a death penalty appeals case that hinged on whether the state of Texas could reasonably use psychiat-

Social Text 105 • Winter 2010 35 rie witnesses to prove that a convicted murderer posed a threat of future dangerousness. In answering in the affirmative, the majority explained that although the accuracy of psychiatrists' predictions of the future dangerousness of mental patients was no higher than that of laypersons (both groups were accurate about one-third of the time), the jury only had to consider whether there was a significant probability of future violence rather than a likelihood beyond reasonable doubt.'* Of equal concern, however, is whether this new mode of what Rose calls "governing through madness" targets the mad for new kinds of control rather than care. Paradoxically, argues Rose, while risk thinking appears to blur the distinctions between the mad and the rest by viewing everyone on a continuum of risk, it may actually sharpen the distinctions by identifying those in need of intervention and labeling them as dangerous to the public. Thus, the public perception of madness comes to be dominated by a sense that it is "a wholly negative focal point of risk. Madness comes to be emblematic of the threat posed to 'the community' by a permanently marginal, excluded, outcast, and largely unreformable sector who require enduring management."^' Seung-Hui Cho fell through the net cast by Virginia Tech's loose network of instructors, security personnel, and counselors that comprised the ad hoc risk-aversion team. As a junior in the fall of 2005, he had come under some suspicion for his silent and aloof manner, his strange behavior, and his violent, psychologically disturbing writings. Responding to complaints of Cho's threatening behavior lodged by female students who had received unwanted e-mail and instant messages, campus police vis- ited Cho twice; after a suitemate reported Cho's suicide threat, the police asked Cho to speak with a counselor. He went voluntarily and spoke to an "emergency evaluator" from the state Department of Mental Health, who had him admitted to the psychiatric hospital in Radford, but the next day a judge discharged him and ordered him to seek outpatient treatment. When Cho returned to campus, there was no mechanism in place to require follow-ups. According to the inspector general's report of the incident, the school's counseling center did not accept "involuntary or ordered referrals for treatment from any source.'""^ Eighteen months later, in the aftermath of Cho's horrific violence, it is understandable that his English professors' attempts to get him into counseling, and perhaps to remove him from campus, were viewed as tragi- cally unsuccessful, and that the breakdown of Virginia Tech's surveillance network was a warning to other campuses across the country about the need to shore up defenses. Within the context of our current formation of psychiatry as risk management, I have no argument with either of these conclusions. But I do believe that the context needs to be questioned. First, it depends on the statistically unlikely notion that Cho could have been identified as a potential mass murderer before the event. The mounting

36 Reiss • Madness after Virginia Tech alarm over his behavior and his writings in the months leading up to his rampage certainly bears out the concerns of professors and other students that he was dangerously troubled; but policies constructed to enable or even mandate this sort of intervention confuse both the specific case and the general, and the future with the past. They work, in other words, only in the contorted syntax of the conditional perfect progressive tense. More likely is the scenario Rose imagines: the "detention of many individuals who would otherwise be capable of leading lives that might be troublingly different but would pose no dangers to others.""" Or, as an editorial in Toronto's Globe and Mail put it, "In a nation that had grounds to detain a Mr. Cho, how wide would the net be cast? How many thousands of others with mental-health or personal troubles might also be detained or monitored? ""2 Beyond this concern for civil liberties, I worry about the transfor- mation of college campuses into spaces pervaded by suspicion, fear of the strange, and the blurring of the line between pedagogy and surveillance. Since 9/11, intellectuals have been raising their voices to protest the erosion of civil liberties, the surveillance and security measures, the xenophobia and suspicion of otherness that have constituted the federal response to national security threats. The "Report to the President" on the Virginia Tech incident reads as a somewhat more chilling document when viewed in the context of national security more broadly: while it cautiously recommends that administrators and legislators strive to maintain "the proper balance between providing for . . . safety and security . . . while protecting privacy and liberty," the balance of its recommendations falls toward creating a more expansive surveillance system for the mentally ill on campus and beyond in order "to conduct a reliable assessment of the degree, type, and immediacy of safety risk the individual poses.""' As Amy I. Brandzel and Jigna Desai recently argued, Cho's racial difference and foreign background may well have added to the chain of links between the national security apparatus and campus screening of the mentally ill, both in media reportage of the incident and in the minds of authorities tasked with responding to the event."" In a time when psychologists have increasingly been employed in overseeing the interrogation of suspected terror- ists,"^ perhaps it is not surprising that the "Report to the President" on Virginia Tech was co-authored by Attorney General Alberto Gonzales. Finally, I worry about how this incident (and related ones, such as the recent shootings at the University of Alabama, Huntsville) may blur the functions of pedagogy and the management of the mad. While I have no quarrel with campus outreach policies that use faculty and others to spread the word about available counseling services, and while I certainly think that in extreme and clear-cut cases it is appropriate for faculty to recommend that their students visit psychological counselors, I do not find

Social Text 105 • Winter 2010 37 it appropriate to turn all encounters with students whose writing and/or behavior may seem "angry, morose, strange" into preludes to the counselor's office. I generally want to extend a hand to suffering or struggling students and point them to those who can help, but I resist the intrusion of psychiatric risk assessment and intervention into my classroom or advising sessions.

Conclusion: From Risk to Vulnerability The issues raised by Seung-Hui Cho's rampage deserve to be taken seri- ously, for they expose the fear and insecurity that any campus community faces when the combustible forces of mental illness, widely available weapons, open classrooms, and even copycat impulses come into conjunction. Foolish indeed would be the campus administrator or even faculty member or student who did not refiect on the incident, emotionally, intellectu- ally, and strategically. Improving communication across faculty, student, and administrative units is certainly an appropriate element of this, as is developing preventive or anticipatory measures that would try to address the underlying exposure of the community to potential violence.''* But what should be the frame for these discussions and actions? Assessing and managing "risk," as I have tried to show, has the effect of iso- lating certain classes of persons as potential threats and prejudges them for actions they have not yet committed. Additionally, when humans—rather than natural forces or the possibility of accidents — are mapped on the grid of risk, they are objectified and dehumanized.'" Additionally, viewing the problem of mental illness through the frame of potential security risk can turn students with psychiatric histories into objects of fear who may come to view their teachers and counselors as inquisitors. And even for the administrators who push such strategies, avoiding risk by intervening in a predictive way might open one up to the risk of having intervened too precipitously. Indeed, a former student at George Washington University recently sued the university for suspending him after he sought treatment for severe depression at the university hospital. Several other students nationwide have filed complaints with the Department of Education's Office of Civil Rights for similar actions."* As such, the new risk thinking brings to bear the full weight of institutional scrutiny and even suspicion on individuals in ways that seem as likely to increase fear and insecurity—for all involved — as to mitigate them. The problem lies with individuals; the solution rests with the institution. It is not an even match. A potentially more useful frame than risk is suggested by new work in critical and legal theory on the concept of "vulnerability." In legal scholar Martha Albertson Fineman's conception, the "vulnerable subject" is a construct with more utility for social justice and equality than the liberal

38 Reiss • Madness after Virginia Tech "autonomous and independent subject" of the liberal tradition. Because vulnerability is a universal and constant human condition, a vulnerability approach to social justice and security would not focus on identifying on the one hand individuals or groups who pose risks and on the other those who are threatened. Fineman imagines moving beyond equal protection laws that focus on discriminatory treatment of individuals and clearly identified groups and toward an understanding of how "inequalities are produced and reproduced by society and institutions.""' The model can, however, be applied beyond the realm of discrimination law to the kind of risk thinking that so profoundly affects the treatment of those living under the description of mental illness, on campus and elsewhere. For both discrimination law and the risk-aversion strategies I have been discussing depend on identifying individuals—those who have been harmed in one case, and those who might do harm in the other—as a proxy for thinking about broader institutional and societal problems. Like risk, the concept of vulnerability highlights a universal susceptibility to harm, a susceptibility whose intensity or likelihood of yielding actual harm compels varying degrees of precaution, preparation, and even intervention. But there are crucial differences. As Francois Ewald has shown, risk is a statistical category invented by the insurance industry and adopted by institutions as a mechanism for self-preservation.^" When campus administrators speak of "the risk of doing nothing," they primarily attempt to minimize risk to the institution—the institution that "should have done something"—rather than the risk of actual violence. In other words, as in the Tarasoff case, lawsuits, as much as lives, are at stake. In contrast, vulnerability is not necessarily assessed or managed from the top down. Institutions can assess the vulnerability of individuals who pass through them, but those individuals can also identify points at which the institution itself is vulnerable, and at which they are made vulnerable by the institution. Some sources of Virginia Tech's vulnerability seem to have been poor outreach and counseling for troubled students, poor information sharing across various units, possibly class and racial tensions on campus (given Cho's apparent animosity toward wealthy white students in his writings)—and, perhaps above all, lax gun control laws. But Cho was vulnerable because of his mental illness, his feeling of racial stigmatization, and his apparently unsuccessful previous encounters with psychiatry. An institution's attempt to identify and quarantine or neutralize a particular "risky" student before he or she becomes violent seems a proposition far less likely to reduce violence and fear than addressing some of these broader vulnerabilities. Additionally, whereas "risk" rationalizes and objectifies problems, the concept of vulnerability is relational and flexible. In the wake of the Virginia Tech shootings, mentally ill students have been viewed as risks to institutions, but it is somewhat absurd to see the institution as pos-

Social Text 105 • Winter 2010 39 ing a risk to Cho. If Cho were instead viewed as a "vulnerable subject"—to use Fineman's term—rather than a risky psychiatric case, then the vulnerabilities of Virginia Tech could be seen to compound his problems—and vice versa. Exploring the nature of this relationship might yield campus policies that integrate the thinking of administrators, counselors, students, faculty, and security forces rather than segmenting their fears and liabilities and imposing top-down strategies for controlling them. The semantic distinction between risk and vulnerability may seem to be just that, but perhaps sharpening the language we use to frame such problems may be a first step toward reimagining responses. When we trace from beginning to end the line of causation behind campus strategies for intervention in the affairs of those living under the description of mental illness, we find at one pole the specter of violence (directed by an individual either to him- or herself or to others) and at the other a legal culture that relies on the lawsuit to apportion responsibility and redress harm. Tarasoff and Barefoot hover over these policies and underscore that the university—even the private one — is constructed by and answerable to the state. (As Fineman puts it, "the state is always a residual player in so-called private arrangements, having fashioned both the background rules that shape those agreements and maintaining the background institutions upon which parties ultimately rely."") In between the state and the scrutinized student are the administrators, counselors, faculty, coaches, residence advisers, and even friends who struggle to behave in a humane way while considering one another on the grid of risk. A first step in moving beyond this risky thinking is to examine the legal structure that demands it. Moving beyond Tarasoff might allow some breathing room for risk-averse administrators to think about mental illness as a problem that can be disentangled from lawsuits. On a more local level, though, we might begin by discussing how we manage vulnerability—both our own and that of our students — in our classrooms. If I read a student's writing through the lens of risk, I may find myself in the position of inquisitor, but if I read through the lens of vulnerability, I am as likely to inquire how the institution may pose potential harm to the student as how the student threatens the institution or to me. A student whose writing seems "angry, morose, and strange" may well benefit from campus counseling services, may have a troubling psychiatric history, and may well pose a threat to self or others. But he or she may not. Guiding such a student toward counseling may be of benefit to the student, but it also may be experienced as a form of pressure and judgment and may break the student's trust in me. I imagine that this potential breach of trust could be even more severe if the student in question does indeed have a psychiatric record. Over the years, I have referred

40 Reiss • Madness after Virginia Tech numerous students to counseling, but only when the students themselves have brought up their psychological and emotional troubles. In other cases, I am very careful not to stray from my pedagogical duties and turn my response to their work into psychological scrutiny. I can imagine exceptions to the rule, Seung-Hui Cho being one of them. But I resist extrapolating from that one-in-a-hundred-million case a logic of risk assessment that would frame my teaching and advising. Reading through the lens of vulnerability might help us to refine our pedagogy and our policies in ways that promote resilience within students who are struggling to navigate the pressures of college life; it might also help us to bolster the resilience of institutions trying to navigate a toxic brew of litigious society, sensational media culture, and a stressed-out, possibly overmedicated student body. At any rate, it seems a better proposition than trying to catch a risky student before he or she acts.

Notes An early version of this essay was first delivered at the Humanities Institute of the University at Buffalo for the conference "The Other Side of Reason: The History of Madness Today" (31 October-1 November 2008). I thank Tim Dean, Carrie Tirado Bramen, and the other conference presenters for their excellent feedback. I have also benefited enormously from my participation in the Vulnerability Studies project at Emory University led by Martha Albertson Fineman—who, along with Rosemarie Garland-Thomson, Eunjung Kim, and Ani Satz—offered sustained feedback as I developed this essay. 1. Marc Santora and Christine Häuser, "Students Knew Killer's Demons by His Writings," New York Times, 20 April 2007. 2. Elizabeth Stone, "The Expanding Safety Net," New York Times, 20 April 2008. 3. Steven Erandzel, "Battling the Demons: Students, Mental Health, and the Specter of Violence on Campus," Academic Exchange: A Place for Scholarly Conversa- tion at Emory 10 (2008): 2, 3. Frandzelis citing Emory University's associate general counsel, Amy Adelman. 4. U.S. Department of Health and Human Services, "Report to the Presi- dent on Issues Raised by the Virginia Tech Tragedy," 13 June 2007, www.hhs.gov/ vtreport.html; Virginia Tech Review Panel, "Mass Shootings at Virginia Tech: Report of the Review Panel," August 2007, www.governor.virginia.gov/TempContent/ techpanelreport.cfm. 5. Joseph Berger, "Deciding When Student Writing Crosses the Line," New York Times, 2 May 2007. 6. David Hinckley, "Creative vs. Crazy: Grim Material Doesn't Always Tell the Whole Story," New York Daily News, 18 April 2007, 38. Stephen King himself, perhaps feeling defensive over such comparisons of Cho's writing to his own, seemed to suggest that one could pick out violent students on the basis of writing that fea- tures "violence unenlivened by any real talent." King's essay originally appeared in Entertainment Weekly and is excerpted in "Creative Writing and the Virginia Tech Massacre," Chronicle of Higher Education 53 (2007): 60.

Social Text 105 • Winter 2010 41 7. Chris M. Anson, "What's Writing Got to Do with Campus Terrorism?" Academe Online 93 (2007), www.aaup.org/AAUP/pubsres/academe/2007/ND/Feat/ anso.htm. 8. See Tyson Lewis, "The Surveillance Economy of Post-Columbine Schools," Review of Education, Pedagogy, and Cultural Studies 25 (2003): 335-55. 9. The phrase "living under the description of mental illness" comes from Emily Martin's powerful book. Bipolar Expeditions: Mania and Depression in American Culture (Princeton, NJ: Princeton University Press, 2007). 10. I owe this formulation to Martha Albertson Fineman, "The Vulnerable Subject: Anchoring Equality in the Human Condition," Yale Journal of Law and Feminism 20 (200S): 1-23. 11. Sander L. Gilman, "The Mad as Artists," in Difference and Pathology: Stereotypes of Sexuality, Race, and Madness (Ithaca, NY: Cornell University Press, 1985), 220. 12. Pliny Earle, "The Poetry of Insanity," American Journal of Insanity (Janu- ary 1845): 193-224. 13. Ibid., 194. 14. See Benjamin Reiss, Theaters of Madness: Insane Asylums and Nineteenth- Century American Culture (Chicago: University of Chicago Press, 2008), esp. chaps. 1 and 6. 15. Michel Foucault, Psychiatric Power: Lectures at the Collège de France, 1973-1974, trans. Graham Burchell (London: Palgrave Macmillan, 2006), 191. 16. Michel Foucault, Abnormal: Lectures at the Collège de France, 1974-1975, ed. Arnold I. Davidson, trans. Graham Burchell (New York: Picador, 2003), 41. 17. Foucault, Psychiatric Power, 48. 18. My own research suggests that the ideal of complete records and case studies was most often honored in the breach. 19. Foucault, Psychiatric Power, 158-59. 20. Ibid., 49, 55. 21. See David Lyon, The Electronic Eye: The Rise of Surveillance Society (Min- neapolis: University of Minnesota Press, 1994). 22. Alex Johnson, "College Gunman Disturbed Teachers, Classmates," MSNBC, 17 April 2007, www.msnbc.msn.com/id/18148802/. 23. Margaret Price, Mad at School: Rhetorics of Mental Illness and Academic Life (Ann Arbor: University of Michigan Press, 2010), chap. 4. 24. Kathleen Vail, "Mental Health Issues at the Forefront of Virginia Tech Tragedy," American School Board Journal 194 (2007): 35. Even the notion that increased surveillance would protect mentally ill students from themselves has been questioned, as recent findings have shown that the suicide rate among students is actually far lower than for people of the same age group who do not attend college. See Philip W. Meilman and Janice A. Pattis, "Suicide Attempts and Threats on One College Campus: Policy and Viacúce.," Journal of American College Health 42 (1994): 147-54. 25. Michael J. Stoil, "Virginia Tech's Implications," Behavioral Healthcare 27 (2007): 11. 26. Miriam Shuchman, "Falling through the Cracks—Virginia Tech and the Restructuring of College Mental Health Service," New England Journal of Medicine 157, no. 2 (2007): 105-10. 27. See Marilyn Elias, "Colleges Put Out Safety Nets," USA Today, 16 April 2008.

42 Reiss • Madness after Virginia Tech 28. Virginia Tech Review Panel, "Mass Shootings at Virginia Tech," www .vtreviewpanel.org/report/index.html. 29. Charles Darwin, The Descent of Man (London: Murray, 1871), 168. On the movement from moral treatment to a more deterministic neurology, see also Charles E. Rosenberg, Trial of the Assassin Guiteau: Psychiatry and the Law in the Gilded Age (Chicago: University of Chicago Press, 1968). 30. Ian Robert Dowbiggin, Keeping America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940 (Ithaca, NY: Cornell University Press, 1997). 31. See Marsha Saxton, "Disability Rights and Selective Abortion," in The Disability Studies Reader, 2nd ed., ed. Lennard J. Davis (New York: Routledge, 2007), 105-16. See also Ulrich Beck, "Eugenics of the Future," in Ecological Enlight- enment: Essays on the Politics of the Risk Society (Atlantic Highlands, NJ: Humanities Press, 1995), chap. 7. 32. U.S. Department of Health and Human Services, "Report to the Presi- dent," 8. 33. Robert Castel, "From Dangerousness to Risk," in The Foucault Effect: Studies in Governmentality, ed. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: University of Chicago Press, 1991), 281-98. 34. Ibid., 286. 35. Nikolas Rose, "At Risk of Madness," in Embracing Risk: The Changing Culture of Insurance and Responsibility, ed. Tom Baker and Jonathan Simon (Chicago: University of Chicago Press, 2002), 209-37. 36. Tarasoff V. Regents of University of California (Cal. 1976), biotech.law .lsu.edu/cases/privacy/tarasoff.htm (accessed 29 June 2010). For a synopsis, see www.emotrics.com/people/milton/practice/privacy/tarasoff.html (accessed 29 June 2010). 37. Rose, "At Risk of Madness," 220, 227-28. 38. Barefoot v. Estelle, 463 U.S. 880 (1983). See biotech.law.lsu.edu/cphl/ articles/hastings/hastings-3_-2.htm (accessed 29 June 2010). 39. Rose, "At Risk of Madness," 232. 40. Shuchman, "Falling through the Cracks," 106-7. 41. Rose, "At Risk of Madness," 231. 42. "To Deter the Next Cho Seung-Hui," Globe and Mail, 19 April 2007. 43. U.S. Department of Health and Human Services, "Report to the Presi- dent," 1. 44. Amy L Brandzel and Jigna Desai, "Race, Violence, and Terror: The Cul- tural Defensibility of Heteromasculine Citizenship in the Virginia Tech Massacre and the Don Imus Mî&h," Journal of Asian American Studies 11 (2008): 61-85. 45. See essays in Ron Roberts, ed.. Just War: Psychology and Terrorism (Ross-on- Wye, UK: PCCS Books, 2007). 46. The weapons issue has not been addressed here, but in some ways the ease with which the perpetrators in the Virginia Tech and Huntsville incidents acquired weapons makes the media, administrative, and governmental focus on mental illness something of a red herring; one could argue that the energy spent in setting up risk assessment measures to identify the violently mad before they act could be better spent ridding our campuses of guns. However, public discourse on the issue seems to be moving in the opposite direction. It used to be that advocates of looser gun control laws—like the NRA—would fall silent for a few weeks after mass shootings. But in recent years, many have seized on such incidents to strengthen their arguments. Now,

Social Text 105 • Winter 2010 43 the argument goes, if all students and faculty could carry weapons to campus, then crazed shooters would quickly be gunned down. 47. On the objectification of risk, see Mitchell Dean, "Risk, Calculable and Incalculable," in Risk and Sociocultural Theory: New Directions and Perspectives, ed. Deborah Lupton (Cambridge: Cambridge University Press, 1999), 131-59. 48. Inside Higher Ed, "Counseling Crisis," 13 March 2006, www.insidehigh ered.com/news/2006/03/13/counseling. 49. Fineman, "The Vulnerable Subject," 5. 50. Francois Ewald, "Insurance and Risk," in The Foucault Effect: Studies in Governmentality, ed. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: University of Chicago Press, 1991), 197-210. 51. Fineman, "The Vulnerable Subject," 7.

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