What happened at Fort Hood? Why would a psychiatrist, a physician trained in the treatment of “mental and nervous” disorders, go on a rampage against his own comrades? I suspect we will be reading about the following in the days ahead:

1. Did Major Nidal Malik Hasan, the accused murderer, have proper supervision of his work and his own fitness for duty? Did he suffer from a psychiatric disorder of his own and was he being treated? News accounts suggest that he was terrified in anticipation of an expected deployment to Iraq or Afghanistan.

2. To what extent did he feel marginalized within the Armed Services? He is said to be a man born in the USA, the son of immigrant parents. It is also reported that he had become increasingly devoted to his Muslim faith and might have experienced some harassment from other soldiers because of his religion.

3. Was the Major marginalized in other ways? He is described as a 39-year-old bachelor who had been looking unsuccessfully for a mate.

4. Major Hasan is believed to have treated numerous veterans suffering from PTSD (Post Traumatic Stress Disorder) returning from the Middle East. Is it possible that he suffered a form of vicarious trauma from hearing the disturbing, if not tragic stories of these young people?

5. To what degree have the Armed Services been able to reform an organizational culture that discourages soldiers from showing emotional vulnerability and seeking treatment before they become dysfunctional? It is one thing for the returning wounded veterans to get psychiatric services; it is another for them to believe, early on, that their anxiety, worry, and depression will not be seen as a weakness by their comrades, make it harder to perform their duties in war-time, and cause them to be ridiculed? Did Major Hasan, who apparently had not experienced combat himself, believe that his own inner-turmoil was acceptable and would have received support from his superiors?

6. Did Dr. Hasan have a history of having received treatment prior to his entrance into the military? If Dr. Hasan did seek treatment at any time, what was the result? Is their any routine assessment of the psychological status of both the soldiers and those who are given the task of treating them? Does the military realize that the nature of their work puts virtually all personnel at psychological risk?

7. What security procedures exist in military installations such as Fort Hood?

8. Is the military sensitive to cultural conflicts that are experienced by its uniformed personnel?

Most of us assume that mental health professionals have their own personal lives well under control. Unfortunately, such is not always the case. For more on this subject, please read my recent blog: “When Helping Hurts: Therapists Who Need Therapy.”