Centennial, Colorado (CNN) -- Colorado movie shooting suspect James Holmes was charged Monday with 24 counts of first-degree murder -- two counts for each of the 12 people killed in the shooting.
Twelve of the murder counts cite "deliberation," and 12 cite "extreme indifference" to the value of human life.
The 24-year-old former doctoral student also was charged with 116 counts of attempted murder -- two for each of the 58 moviegoers wounded in the attack. Finally, he was charged with one count of felony possession of explosive devices and one count related to the use of an assault weapon, a shotgun and a handgun during the incident.
The 142 counts are all in connection with the July 20 massacre in the Century Aurora 16 multiplex minutes into a midnight screening of "The Dark Knight Rises."
Shackled around his wrists and ankles, Holmes was escorted into Arapahoe County Courthouse by two sheriffs deputies. Five other sheriffs deputies were standing in the courtroom.
In his first court appearance last week, Holmes appeared dazed and did not speak. During Monday's hearing, meanwhile, he seemed calm and frail, sitting at the right edge of the defense table with his dyed-orange hair matted on top, its roots dark.
For a while, he stared blankly at the judge's bench but appeared to be aware of what was going on. When the judge asked him whether he understood why his attorneys were asking for more time before a hearing, he said softly, "Yes."
About half of the approximately 120 seats in the courtroom were filled with victims or their family members; more watched on video in an overflow room.
One young man in the front row of the courtroom leaned forward and stared at Holmes without averting his gaze throughout the 45-minute proceeding.
Another observer, her left arm and leg in bandages, sat slumped in her seat. Around her wrist was a hospital wristband.
"It was very important to come today to see him as who he was," MaryEllen Hansen told reporters outside the courthouse. "I really wanted an opportunity to watch his gestures (and) study him as much as I could."
Her niece's 6-year-old daughter, Veronica Moser-Sullivan, was the youngest person killed in the rampage. Hansen's niece, Ashley Moser, faces a long recovery after being paralyzed in her lower half and miscarrying after the shooting.
"I got a sense that he was very aware of what was going on," Hansen said of Holmes. "He had an expression and kind of a persona of evilness to him. But he looked very sane to me, he really did."
Asked if she favors the death penalty, the retired school principal said, "I'm a Christian and I do believe that he should probably be locked away and live with what he did every day of his life."
Arapahoe County District Attorney Carol Chambers said last Monday that it will take time for prosecutors to decide whether or not they will pursue the death penalty, since they'd first want to get input from victims and their relatives.
Authorities have remained silent about a possible motive in the case.
A court document filed Friday revealed that Holmes was a patient of a University of Colorado psychiatrist before the attack.
The disclosure was made in a filing by Holmes' public defenders requesting that authorities hand over a package he sent to Dr. Lynne Fenton at the university's Anschutz Medical Campus, where he had been studying neuroscience before announcing earlier this month that he was withdrawing from the program.
The package seized by authorities under a July 23 search warrant should remain confidential, protected by the doctor-patient relationship because "Holmes was a psychiatric patient of Fenton," the request said.
In response, prosecutors asked Arapahoe County District Judge William Sylvester to deny Holmes' request, saying it contained inaccuracies including claims of media leaks by government officials that in reality may have been fabricated by news organizations.
The package is expected to be the focus of a status hearing set for August 9.
Prosecutors say they will begin turning over thousands of pages of discovery in the next couple of days. The defense says they need this information to prepare for the hearing.
During the week of November 12, attorneys expect a preliminary hearing and an evidence hearing that will include several days of testimony.
As Monday's hearing unfolded, 10 survivors remained hospitalized, three of them in critical condition. But there was some progress: The day began at the University of Colorado Hospital at Aurora, for instance, with three in critical, one in serious and one in fair condition and ended with two in critical and three in fair condition.
Meanwhile, those affected continued to come to grips with the horror. On Saturday alone, memorial services were held for four people killed in the massacre including two men -- Matt McQuinn from Ohio and Alex Teves from Arizona -- who died shielding their girlfriends from gunfire.
Closer to Aurora, which is just east of Denver, people worked to make sense of what happened and support one another. For some, that includes making sure the shooting suspect knows that they are stronger, better and united.
"The man was a coward. We're here to show that we have strength and that we're willing to fight back," said Don Lader, after attending Monday's court hearing.
"He looked defeated," Lader added about Holmes, "and he knows that he's not the one with power anymore -- that's us."
CNN's Ed Lavandera contributed to this report