Murderous Fantasies

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Reader’s Question

I have thoughts of killing people on a daily basis. I’ve tried pushing them aside, but they won’t go away — and I feel like one day I won’t be able to hold the monster inside anymore. What’s wrong with me?

Psychologist’s Reply

There is not enough information contained in your question to even hazard a wild guess as to what might be going on. It might be psychological, or it might be physical, and there are several possible causes within each of those two categories.

There have been cases of people having thoughts like these who had a physical problem that changed their brain structure and/or chemistry, so the first order of business is for you to get a complete physical. This must include a complete workup not only by your general physician but by a neurologist. If, when you try to schedule an appointment, you find that there is a waiting time of more than a few days, it may be helpful to explain to them why it is urgent that you get in as soon as possible and get yourself bumped to the top of the wait list. If you need to, you might even call every morning to see if there has been a cancellation you can have.

If this does not solve the mystery, a complete psychological evaluation is in order. Sometimes these thoughts are the product of a rage that can be worked out in therapy, or of a severe mental illness which might respond to the right medication. Either way, the mental health professionals working with you must know about these fantasies, because some treatments can inadvertently make them worse and your treatment team will want to avoid those. The same suggestion about scheduling applies here: this is an urgent matter, and you cannot go on a wait list or be scheduled weeks out.

Getting the results of these kinds of evaluations can take some time, so in the meantime it is vital that you monitor your thoughts for any changes. Even better, arrange to check in daily with a mental health professional. If you should observe that you are settling on any one of the following, you should present yourself immediately to the nearest emergency department: a time, a place, a victim or victim group, a weapon, recipients for your possessions, or the wording of a note to leave behind. Once any one of these goes beyond the fleeting thought or fantasy state and into the planning phases, you have a mental health emergency and should treat it as such.

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It is equally important that you remove any weapons that you have in your possession. If you own guns, for example, give them to a responsible adult to hold, or at least have a responsible adult lock them up where you can’t get to them. Get rid of anything in your home sharper than a dinner knife. Do it today.

If you are thinking of harming someone in your workplace or home, you would be well advised to take leave from work or accept a transfer to another location/position, and to live somewhere else until all this is resolved. You want to make it as difficult for yourself as possible, in other words, to act on impulse.

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