Behind Loughner's million-mile stare

This version of Behind Loughners Million Mile Stare Flna1c9467741 - Health and Medicine | NBC News Clone was adapted by NBC News Clone to help readers digest key facts more efficiently.

Jared Loughner’s former friend, Zane Gutierrez, says he has the look of a “monster.” U.S. Marshal for Arizona David Gonzales told the Daily Beast that Loughner has as a “paranoid headlights” stare. But is there a medical or psychiatric term for that disturbing million-mile stare we’ve seen in the eyes of accused killers like Loughner and Charles Manson?

Yes and no, says Dr. Alan Hirsch, a Chicago-based neurologist and psychiatrist.

"There is something called reverse ptosis, which is when the eyelids are up higher than normal,” says Hirsch. “You can see the whites of the eyes both above and below the iris. It’s been associated with diseases like hyperthyroidism and with psychiatric diseases such as paranoid or acute psychosis.”

But the fact that we’ve come to associate that look with monstrous acts has more to do with Hollywood than psychiatry. “In movies, the person who’s psychologically deranged will have bulging eyes,” he says. “That’s how they portray the evil person. Look at Peter Lorre — he played a variety of wicked characters.”

But what’s really going on when we make judgments about someone’s character based on their looks is something called “metoposcopy,” Hirsch says. “That’s the idea or concept that you can tell a person’s character based on the way their face looks,” he explains. “And we can misinterpret things. We’ll see someone whose eyes are bulging, but they’ll have hyperthyroidism.”

Dr. Dan Iosifescu, associate professor of psychiatry and neuroscience at Mount Sinai School of Medicine, says Loughner’s fixed, piercing stare could simply be purposeful.

“I don’t think you can make too much out a single photograph,” he says. “It could be bravado, someone who’s trying to play a game. In most animals, including humans, this kind of fixed-eye contact is a sign of aggression. But it could also be the attitude of someone who feels cornered in the police department but is trying to appear otherwise. It could be a show that he’s putting on.”

Hirsch says there are also theories that people who are paranoid or in some way delusional will subconsciously signal others to stay away by adapting certain characteristics.

“It could be through the way they dress or how they smell or the facial expressions they give,” he says. “They’ll give a signal for others to stay away, to allow them the space they need. That’s one of the hypotheses behind some of the behaviors we see amongst acutely paranoid, delusional individuals, like among the homeless or certain people in psychiatric hospitals.”

The bottom line? Both doctors say it’s impossible to determine someone’s mental state just from a certain look in their eye.

“There could be a number of different factors,” says Iosifescu. “You could see that look in someone who’s perfectly sane. You could see it a prisoner of war. A lot of it just depends on the circumstances.”

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