On July 20, 2012, as the audience in a sold-out theater anticipated the beginning of The Dark Knight Rises on the movie screen before them, a lone gunman dressed in ballistic armor and armed with multiple firearms and smoke bombs entered the theater to execute the largest mass shooting in U.S. history. James Eagan Holmes, who surrendered to police minutes later, has been charged with the deaths of 12 people and injuries to 58 others. Background information on James Eagan Holmes was obtained in order to generate a hypothetical five-axis diagnosis and treatment/intervention plan. Consideration was also given to related psychosocial and family issues, related career and vocational issues, and potential legal and ethical issues. Note: This is a projective assessment based on background data, research, and publicly available records. James Eagan Holmes was NOT directly evaluated by this author.
Hailed as one of the most anticipated movies of 2012, The Dark Knight Rises – the third installment of the DC Comics based trilogy starring Christian Bale – opened on July 20, 2012, with $30.6 million in tickets sold for the midnight premiere screening and $85 million in tickets sold for the opening day across the nation. Those numbers earned the movie second in history for both figures, falling behind The Twilight Saga: Breaking Dawn – Part 1’s midnight record of $30.2 million and Harry Potter and the Deathly Hallows – Part 2 opening day record of $91 million (Gallagher, 2012). News of the box office records would be delayed and overshadowed, however, by an isolated event at the midnight opening at an AMC Theater in Aurora, Colorado.
On July 20, 2012, at approximately 12:38 a.m. an individual entered the Aurora theater’s opening of The Dark Knight Rises through an emergency exit as previews drew the attention of the packed audience in the sold-out theater. Dressed fully in black ballistic armor and armed with a .223 caliber semi-automatic AR-15 assault rifle, a 12-gauge Remington shotgun, and a .40 caliber Glock handgun, the man dispersed what was found to be a smoke bomb before indiscriminately opening fire into the audience. Twelve people were killed and 58 others were wounded as dozens of police officers arrived at the scene within minutes of the first shots being fired. The suspect, later identified as James Eagan Holmes, did not resist police officers and was apprehended in the parking lot next to his white Hyundai. At approximately the same time as the shooting, loud electronic music on an endless loop began blaring from Holmes’ apartment and prompted at least one noise disturbance call to the police department. Based on information provided by Holmes during initial interrogations, police evacuated the residents of the apartment complex, executed a search warrant at Holmes’ apartment, and found what appeared to be tripwires, ammunition, and explosives (Bustillo, Banjo, & Audi, 2012).
Mass shootings, while statistically rare events, have a tendency to create significant emotional responses from the general public and are a needed subject of further psychological research. Forensic psychological assessment of mass shooting suspects, while salient to the discovery and understanding of any patterns of underlying psychopathology, is impeded by the low survival rate of individuals involved in U.S. mass shootings over the past 50 years. On August 1, 1966, Charles Joseph Whitman killed his mother and wife before climbing to the top of a University of Texas tower to kill 16 and wound 30 others before being shot and killed by police. On September 25, 1982, George Banks shot and killed 13 people in Pennsylvania before being apprehended and sentenced to death. On July 18, 1984, James Huberty shot and killed 21 people at a McDonald’s in California before being killed by a police sniper. On October 16, 1991, George Hennard drove a pickup through the wall of a Luby’s cafeteria in Texas and shot and killed 23 people before committing suicide. On April 20, 1999, Dylan Klebold and Eric Harris opened fire inside a Colorado high school, killing 13 and wounding 23 others before committing suicide. On April 16, 2007, Seung-Hui Cho killed 32 students and wounded dozens of others before committing suicide at Virginia Tech. On March 10, 2009, Michael McLendon shot and killed 10 people before committing suicide. On April 3, 2009, a shooter killed 13 and wounded 4 before killing himself at an immigrant community center in New York. On November 5, 2009, Nidal Malik Hassan reportedly killed 13 and wounded 32 at the U.S. Army’s Ford Hood in Texas (CNN, 2012). On July 20, 2012, James Eagan Holmes reportedly killed 12 and wounded 58 in a movie theater in Colorado, the largest mass shooting in U.S. history (Bustillo, Banjo, & Audi, 2012; Sandell, Dolak, & Curry, 2012). Of those (n = 11) who reportedly shot and killed 10 or more people in the United States during a single criminal episode in the past 50 years, only 3 (27%) subjects survived their involved incident to be available for psychological evaluation through methods other than forensic autopsy. As the number of mass shooters is limited and thus hinders empirical analysis, the greatest weight of empirical evidence will likely be obtained from forensic case study analysis.
This researcher set out to review the body of available information on James Eagan Holmes less than a month after his abrupt entrance into national attention in order to develop a hypothesized forensic psychological assessment and treatment plan. All background information on the subject was obtained through credible news media sources and is thus appropriately referenced. Data collection methods are proposed and informed from current and empirically validated forensic psychological research. The resulting five-axis diagnosis, related psychosocial and family issues, related career and vocational issues, proposed treatment and intervention options, continuing assessment and follow-up, and potential legal and ethical issues sections, while informed from the referenced background information, are hypothetical in nature and are not derived from any actual direct interview or assessment of James Eagan Holmes. All sources for background information were considered to be reliable; however, facts contained within the sources were not further verified.
James Eagan Holmes is a 24 year-old Caucasian male who is currently being held without a set bond in the Arapahoe County Sheriff’s Office Detention Facility in Centennial, Colorado. Sheriff’s office officials elected to hold Holmes in solitary confinement for his safety after other inmates began talking about killing him in the jail facility. Holmes was born on December 13, 1987, in San Diego County, California. His mother, Arlene Rosemary Holmes, has been a Registered Nurse for over thirty years (Gembrowski, Bello, & Hughes, 2012). His father, Robert M. Holmes, Sr., holds degrees from Stanford University, the University of California at Los Angeles, as well as the University of California at Berkeley and develops statistical models for financial services for FICO with an emphasis on fraud detection (Rowe & Wilkens, 2012). He has a younger sister who is involved in musical performance. The family continues to live in the home that he grew up in, located in an upper-middle-class neighborhood in San Diego (Bustillo, Banjo, & Audi, 2012).
James Holmes attended Westview High School and graduated in 2006 (Bustillo, Banjo, & Audi, 2012). He excelled academically and was involved in extracurricular activities that included cross-country track and soccer (Rowe & Wilkens, 2012). A former teacher described him as a neat, well-dressed student who liked to read, excelled in all academic areas, and was good with computers (Quigley, 2012). Classmates described him as having been extremely quiet, really shy, and a really sweet person who lacked self-confidence. His time in high school did not involve significant dating relationships and he spent much of his social time with a video gaming group (Leonnig & Achenbach, 2012). Holmes spent one summer between high school years working as a counselor at Camp Max Straus, a summer camp for younger kids with activities designed to teach compassion, empathy, and good citizenship (Simon & Whitcomb, 2012).
After graduating from Westview High School, Holmes participated in a biotechnology summer internship hosted by Miramar College and the Salk Institute. A fellow intern described him as a distant smart aleck who preferred working alone as opposed to working with other participants on projects (Rowe & Wilkens, 2012). His internship supervisor described him as oddly stubborn and extremely shy. Holmes gave his final presentation during his internship while smiling shyly and speaking with some, but not much, confidence (Simon & Whitcomb, 2012).
James Holmes completed undergraduate studies in neuroscience with honors at the University of California at Riverside. He attended on a merit-based scholarship and was never the subject of any disciplinary action (Gembrowski, Bello, & Hughes, 2012; Leonnig & Achenbach, 2012). He was listed as a Dean’s Fellow, Regent’s Scholar, and member of the Phi Beta Kappa Society (Holmes, 2012). “Academically, he was at the top of the top,” said Timothy White, chancellor of the university, “he had the capability to do anything he wanted academically” (Bustillo, Banjo, & Audi, 2012). Fellow students described him as smart, shy, and a loner who fit in with other neuroscience students and took regular snowboarding trips with fellow students (Rowe & Wilkens, 2012).
Holmes had a difficult time finding a job after graduating from the University of California at Riverside. Neighbors said that he was very shy and engaged with few friends during this time period (Rowe & Wilkens, 2012). After he was only able to obtain part-time work at a nearby McDonald’s fast food restaurant, his mother encouraged him to apply to graduate schools for additional studies (BBC News, 2012).
James Holmes began doctoral studies in neuroscience at the University of Colorado at Denver – Anschutz Medical Campus in Aurora, Colorado, in 2011 (Bustillo, Banjo, & Audi, 2012). He was one of six neuroscience students at the campus to receive a grant partially funded by the National Institute of Health that provided him with a $26,000 per year living expense stipend (Simon & Whitcomb, 2012). During his first year, Holmes gave presentations with titles including “Micro DNA Biomarkers” and “Biological Basis of Psychiatric and Neurological Disorders” (Rowe & Wilkens, 2012). Fellow graduate students described Holmes as very quiet, introverted, and pleasant. One faculty member noted that he seemed socially off (Leonnig & Achenbach, 2012). Another fellow student described Holmes as a “typical studious introvert” (Simon & Whitcomb, 2012). A research assistant in the laboratory where Holmes worked described him as socially awkward and noted that Holmes spoke of playing online role-playing games through his computer (BBC News, 2012). Neighbors described him as a geeky, intelligent person who lived alone and kept to himself (Rowe & Wilkens, 2012).
Holmes’ level of functioning began to take a downward turn in the spring of 2012 while completing his second term of graduate studies. His test scores began to suffer, causing faculty members to discuss remedial instruction and academic probation (Leonnig & Achenbach, 2012). Holmes began seeing Dr. Lynne Fenton, a psychiatrist for the university, for psychiatric treatment that included prescription medications (BBC News, 2012). He began the process of voluntarily withdrawing from the school in June, three days after failing a key oral examination (Harris, 2012).
James Holmes began acquiring the materials he would use on July 20th sometime in March of 2012 with deliveries of equipment and chemicals having been delivered both to his apartment and the lab where he worked (Simon & Whitcomb, 2012). He purchased a ballistic helmet, ballistic vest, ballistic leggings, gas mask, throat protector, groin protector and tactical gloves – all in black (Leonnig & Achenbach, 2012). He purchased a .40 caliber Glock handgun from the Gander Mountain gun store in Aurora in May, a 12-gauge Remington shotgun and a second .40 caliber Glock handgun from the Bass Pro Shop in Denver in June, and a .223 caliber Smith & Wesson M&P AR-15 style semi-automatic assault rifle with a high capacity drum magazine from the Gander Mountain gun store in Thornton in July (Gembrowski, Bello, & Hughes, 2012; Winter, 2012). The assault rifle was purchased a few hours after Holmes failed the oral examination that precipitated his withdrawal from graduate school. All of the firearms were obtained legally (Sandell, Dolak, & Curry, 2012). Holmes additionally ordered 3,000 rounds of .223 caliber ammunition for the assault rifle, 3,000 rounds of .40 caliber ammunition for the handguns, and 300 rounds of 12-gauge ammunition for the shotgun from Internet-based suppliers (BBC News, 2012).
James Holmes activity was off the radar until the days before the movie theater massacre. He dyed his normally dark hair brown a bright, orange-red color (Gembrowski, Bello, & Hughes, 2012) before taking photographs and updating his profile on the popular dating service website Match.com (TMZ Staff, 2012). He continued grooming and self-care, shaving his face between the time that he took the updated photographs for Match.com and when he was arrested outside of the movie theater. Holmes also mailed a spiral-bound notebook to Dr. Lynne Fenton that would not arrive in the university mail room until three days after the shooting. The notebook contained hand-written details about how he was planning to kill people as well as stick figures wielding firearms and shooting other stick figures (Winter, 2012). Two nights before the shooting, Holmes had a few beers with a friend at a local bar, talking idly about football (Rowe & Wilkens, 2012).
Holmes’ reported attack in the movie theater on July 20th appears to have been well planned and meticulously executed. His white Hyundai was found parked behind the AMC Theater and near the emergency exit doors leading out of the exact theater where The Dark Knight Rises would premier at midnight (CBS News, 2012). Dressed in unremarkable clothing, he purchased his movie ticket, entered the theater, exited through the emergency exit, prevented the door from locking behind him, donned the ballistic and protective equipment he had purchased, and re-entered the theater through the emergency exit doors minutes later (Sandell, Dolak, & Curry, 2012). Surviving witnesses described Holmes’ movements as methodical and his targeting of victims as random and indiscriminate (Sandell, Dolak, & Curry, 2012). Holmes steadily fired rounds from the firearms, pausing only when he had to reload (CBS News, 2012). He abandoned the assault rifle after its firing mechanism jammed and exited the theater through the same emergency exit doors (Winter, 2012). As he exited, Holmes used other firearms to shoot victims who were attempting to escape through the emergency exit doors (Sandell, Dolak, & Curry, 2012). Holmes then approached his vehicle and was removing his body armor when police officers arrived. Officers observed that Holmes appeared surprised that they had arrived so quickly (Winter, 2012). Holmes then surrendered without resisting police efforts or further incident (Leonnig & Achenbach, 2012).
At precisely midnight, techno music set to an automatic timer began blaring from Holmes’ unoccupied apartment, prompting at least one resident in the building to call in a noise complaint to the Aurora Police Department (Bustillo, Banjo, & Audi, 2012). The music continued blaring and stopped on its own at exactly 1:00 a.m. (Gembrowski, Bello, & Hughes, 2012). The music may have been programmed with the intent to lure an unsuspecting neighbor or police officer into the apartment that had been rigged with trip wires attached to chemical and incendiary devices (Leonnig & Achenbach, 2012). Law enforcement officials later described the booby traps as sophisticated, elaborate, and capable of destroying the apartment building as well as damaging nearby buildings (Rowe & Wilkens, 2012; Sandell, Dolak, & Curry, 2012).
The first reported indications of potential mental illness were seen after Holmes was arrested by police. Holmes first identified himself to arrest officers as “the Joker”, a character who was the nemesis of Batman in the previous episode of the current film trilogy (Sandell, Dolak, & Curry, 2012). When investigators placed paper bags over his hands to preserve gunshot residue (GSR) evidence, Holmes pretended the bags were puppets and began to play with them (Harris, 2012). During the initial hours after arrest, Holmes spent much of the time starring at the wall in front of him while his eyebrows twitched (Harris, 2012). He has reportedly spit at jail personnel on a number of occasions (McLaughlin, 2012). During his first court appearance the following week, Holmes appeared to be dazed, alternating his facial expressions between being bug-eyed and having his eyes closed while nodding (Harris, 2012).
Up until the events of July 20th, James Holmes’ online interactions and criminal history were unremarkable. With the exception of a speeding ticket in 2011, Holmes had never been arrested or otherwise encountered law enforcement (Bustillo, Banjo, & Audi, 2012). Federal investigators were unable to find any ties to terrorist organizations (Sandell, Dolak, & Curry, 2012). The Pentagon reported that Holmes had no record of ever serving in the military or armed forces (CBS News, 2012). No records of Holmes ever having social media accounts on Facebook or Twitter could be found (Rowe & Wilkens, 2012). His profile on the popular dating website Match.com described him as an agnostic with “soul penetrating eyes” who’s political views were “middle of the road”, a non-smoker who drank socially, definitely wanted kids someday, and was seeking women between the ages of 19 and 38 for “flings, foodies, activity partners or whatevs”. He had been actively logged into the Match.com site within three days but not within 24 hours and had recently posted pictures with his hair dyed red. He had also changed his headline to say “Will you visit me in prison?” (TMZ Staff, 2012).
The resume that James Holmes (2012) reportedly submitted as part of his graduate school application to the University of Illinois was available for review. He described himself as an “aspiring scientist” who was a “problem solver” and “adaptable” to various work environments. His personal statement included:
“Rational people act based on incentives for self-fulfillment, including fulfilling needs of self-development and needs of feeling useful and helpful to others. […] I have always been fascinated by the complexities of a long lost thought seemingly arising out of nowhere into a stream of awareness. […] I have an unquenchable curiosity, a strong desire to know and explore the unknown, and a need to persist against the odds. […] Although I don’t plan on curing cancer in graduate school I believe this research experience is worthwhile and relevant to my goals of contributing to neuroscience. […] Due to the seemingly infinite vastness of indefinite knowledge we must be selective in our pursuits of knowledge. This is why I have chosen to study the primary source of all things, our own minds. […] My life-long goal is to increase the efficiency of how human beings learn and remember.” (Holmes, 2012, 2-3)
James Holmes transitioned from a brilliant doctoral student in neuroscience to an academically unremarkable mass murderer in a few short months. As such, it would be prudent for full medical and neurological evaluations to identify or rule out physiological abnormalities that may have contributed to his apparently acute psychosocial decline. The medical evaluations should be followed by neuropsychological evaluations to establish measurements of intellectual functioning, language processing, visuospatial processing, attention and concentration, executive functions, processing speed, and sensory-perceptual functions. The sum of the medical and neuropsychological assessments may be highly informative for continuing psychological assessment.
From a psychological perspective, James Holmes should initially be assessed through a structured interview that has documented reliability and validity for greatest future admissibility in court. Informed consent should be obtained with an understanding of the limits of confidentiality in light of the pending criminal court inquiries (American Psychology-Law Society, 1991). A potential structured interview for consideration would be the Interview Guide for Evaluating DSM-IV Psychiatric Disorders and the Mental Status Examination (Zimmerman, 1994). An emphasis should be placed on assessing for the delusions and/or hallucinations that are the hallmarks of schizophrenia and other psychotic disorders. A battery of personality assessments would also be indicated both clinically and forensically and should instrumentally include the Minnesota Multiphasic Personality Inventory-2, Restructured Form (MMPI-2-RF), Million Clinical Multiaxial Inventory-III (MCMI-III), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) as well projective assessments such as the Rorschach Test (Butcher, Mineka, & Hooley, 2010). Given the heinous nature of the accused criminal activity, screenings for psychopathology would also be warranted using the Psychopathy Checklist – Revised (PCL-R) (Hare, 2003).
Additional assessments should be made to assess for, or rule out, the possibility that James Holmes’ present psychological symptoms are due to malingering. The Minnesota Multiphasic Personality Inventory-2, Restructured Form (MMPI-2-RF) is a reasonable screening measure for malingering (Butcher, Mineka, & Hooley, 2010). The Negative Impression scale (NIM) of the Personality Assessment Inventory (PAI) has also been established as a reasonable tool for detecting malingering (Boccaccini, Murrie, & Duncan, 2006).
In order to complete the hypothetical diagnosis, treatment and intervention options, continuing assessment, and potential issues certain assumptions were made. It was assumed that there were no clinical indications for an Axis I diagnosis and that the sudden onset of psychological symptomology was due to malingering so as to avoid criminal culpability. Further, it was assumed that Holmes continued to display a lack of remorse and empathy displayed after his arrest and the grandiose sense of self-worth seen in his resume. The criminal act in question without question involves antisocial, impulsive, and socially deviant behavior. These combined with an assumed rating on the PCL-R resulted in provisional considerations of antisocial personality disorder (APD) and psychopathy. Given that Holmes had no reported history of onset of symptomology required for APD, a finding for psychopathy was assumed (Butcher, Mineka, & Hooley, 2010).
Five-Axis Diagnosis (Projected)
Axis I: V65.2 Malingering
V.71.01 Adult Antisocial Behavior
Axis II: Psychopathy (primary)
Axis III: Deferred to Medical Evaluation
Axis IV: Academic Problems
Problems Related to Interaction with the Legal System/Crime
Axis IV: GAF 20
(American Psychiatric Association, 2000)
Related Psychosocial and Family Issues
By all indications, James Holmes’ Meyers-Briggs personality type is an introversive, intuitive, thinking, judging (INTJ) subtype. The available background information is consistent with the descriptors of an INTJ provided by the Myers & Briggs Foundation (2012). His introverted nature and thinking-over-feeling tendencies may have made antisocial, impulsive, and socially deviant, maladaptive behaviors difficult to detect by peers and family members. Family issues do not become apparent from the body of background information; however, Holmes may have been affected by a distant, workaholic father and an enmeshed mother. There is no indication of any significant dating relationships and his Match.com profile indicates potential interest in quick, meaningless encounters that could be indicative of psychosexual difficulty and frustrations, reducing his self-perception of his masculinity that could predicate psychopathic behaviors.
Related Career and Vocational Issues
The only vocational activity that could be found in the background information on James Eagan Holmes was a part-time job at McDonalds’ obtained after the completion of his undergraduate degree and prior to his entrance into graduate school. Intra-familial stress from Holmes’ difficulty finding a job related to his academic pursuits and interests would appear to have been present given that his mother encouraged, if not forced, him to apply to graduate schools.
James Holmes’ success in life appears to have been related to academic pursuits. The sudden decline in academic performance in the months prior to his arrest may have had significant impact on his emotional state and psychological functioning. It is also possible that changes in his emotional state and psychological functioning were causal to his decline in academic performance.
Proposed Treatment and Intervention Options
The meticulous nature of the efforts involved over a several month period of time would not support a finding that James Holmes was incompetent to stand trial (18 USC § 4241). Therefore, the treatment and intervention plan would focus on the findings of psychopathy and recent episode involving adult antisocial behavior. Individualized Cognitive Behavioral Therapy would be indicated with treatment goals of increasing self-control, increasing victim awareness, changing antisocial attitudes, and modifying self-defeating, maladaptive behaviors. As Holmes’ psychopathy does not appear to be a lifelong occurrence, a positive treatment outcome is possible (Butcher, Mineka, & Hooley, 2010).
Continuing Assessment and Follow-Up
During treatment, it would be important to monitor for changes in psychopathic behavior. Regular use of psychopathy measuring instruments, such as the PCL-R, and instruments that have been shown to further assess levels of dangerousness such as the Violence Risk Appraisal Guide (VRAG) and the HCR-20 would also be indicated to make informed recommendations regarding custody level during incarceration.
Potential Legal and Ethical Issues
The avoidance of multiple relationships is paramount to working with James Eagan Holmes. The Ethical Principles & Code of Conduct defines a multiple relationship as including having more than one professional role with the same person (American Psychological Association, 2010). The Specialty Guidelines for Forensic Psychologists recommends that practitioners avoid the provision of both evaluation and treatment services to a party in a legal proceeding (American Psychology-Law Society, 1991). As such, the forensic psychologist who conducts the evaluation and assessment of James Holmes should not be the same psychologist who provides the treatment and intervention options. This would also be consistent with the forensic psychologist remaining within the boundaries of professional competence (American Psychological Association, 2010).
Informed consent is another area of potential ethical issue, especially if the practitioner is working both as evaluator and therapist. The forensic psychologist should obtain informed consent from James Holmes and/or his attorney prior to initiation of services unless ordered to conduct the evaluation by the court (American Psychology-Law Society, 1991). Regardless of the origin of informed consent, the forensic psychologist should take effort to ensure that James Holmes is aware of the limits of confidentiality given the pending criminal court inquiries (American Psychology-Law Society, 1991).
While these are the most apparent ethical issues attached to psychological professional association with James Eagan Holmes, forensic psychologists should remember to adhere to all aspects of the Ethical Principles and Code of Conduct (American Psychological Association, 2010) and the Specialty Guidelines for Forensic Psychologists (American Psychology-Law Society, 1991).
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