"terrorist" personality disorder? (detailed personal views)

[ClinPsycMasters]

Earlier I was reading about formulation of personality disorders in DSM-V. An hour ago I was looking at Michael Stone's 2006 book entitled "Personality-Disordered Patients" and I came across his grouping of personality disorders that are "beyond treatable" where he lists psychopathy, sadism, and oddly, "'fanatical paranoids' and terrorists."

There was no explanation so I kept searching and finally came across this in another section:

"In the realm of the untreatable are found the paranoid fanatics,

including political and religious fanatics (such as neo-Nazis, Ku Klux
Klansmen, Islamists), the vast majority of whom do not view themselves as disturbed or disordered, do not seek treatment, and, in all but a few instances, would not be amenable to change if remanded or forced into treatment."​

This got me thinking and here are my views on this very complicated and touchy subject, and I do appreicate your views/criticism:​

1. There is no single definition of "terrorism" nor "terrorist" personality, and subjectivity plays a major role in many definitions. The term "terrorist" has been used pejoratively to refer to various people, governments or countries over the years: Muslims/Islamists/Arab countries, Jews/Zionists/Israel, Americans and US government, "animal rights" groups*, nationalist groups (Tamil Tigers), anti-abortion groups, etc.​

2. Terrorism is not an identity but a tactic to achieve particular objective (political, economic, religious, etc); for instance, to end the military occupation**, to obtain more power and influence for one's group or in service of one's ideology, or good ol' financial gain. An example of religious objective would be the historical conflict between Jews and Muslims (and Christians to some extent) over "their" Holy Land in Israel/Palestine.​

Hence, as a tactic, terror attack can be perceived as rational. Akin to various tactics used during war, from propaganda all the way to dropping an atomic bomb, terror tactics are often cruel and inhumane. However, it does not follow that the ones committing the act are mentally ill. ​

3. I work with an international clientele in Canada and have written a number of papers on bigotry and intolerance, and I find Michael Stone's weak attempt at making a political statement under the guise of medical prescription quite improper. By pathologizing those who use terror tactics, and in reducing sociological, political, religious, or economical motive to individual psychopathology, he is rubbing us of the ability to see the bigger picture, where there may be many interventions (political freedom of expression, social programs, financial aid, etc) available to us in helping these individuals have their needs met in a nonviolent manner.​

4. This is not to say that none of these "terrorists" are mentally ill. Some can be. I can certainly imagine an exceptionally bright terror leader with ASPD and PPD who--for private financial gain or power--manipulates many (using fear tactics, appeal to patriotic and nationalistic sentiments, honor and pride, religion, etc) into buying into his ideology. Heck, history is replete with charismatic leaders who led nations to wars. Or imagine a simple-minded follower with PPD who feels very satisfied in projecting his "bad-self" outward to the group's object of hatred.​

However, one can argue for environmental factors influencing one's personality as well: poverty, health care, education, political freedom, safety, and physical environment, could all play a role in development of such personalities. So the "treatment" would be found in the environmental factors. For instance, I wonder if a higher than average percentage of children in proximity of Twin Towers in New York or many places in Iraq/Afghanistan, would be diagnosed/labeled with PPD in future. ​

5. Lastly, it is not the "terrorists" per se but all those who explicitly or implicitly approve of their actions that concerns me the most. We see this during war as well. Do these many millions of people also have personality disorders or some mental illness? Can we blame it on the media and intentional disinformation/misinformation of the public? Is compassion a thing of the past? How many of these people have had their most basic needs met? Is it a displacement of aggression...at a national level? Is it the archaic religious and political worldviews, or traditional values? Is globalization at fault? Clash of civilizations, all sides trying to retain power in this new game? Perhaps it all comes down to philosophy of causation.​

*Animal rights terrorists: what every neuroscientist should know. Kordower JH. J Neurosci. 2009;29(37):11419-20.​

**Pape, Robert A. (2003) "The Strategic Logic of Suicide Terrorism" American Political Science Review 97(3): 343-61.​

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[whopper]

I haven't read the book. The author may have addressed these issues.

Terrorism is a sticky subject. To quote Wolverine (yes the X-Men's Wolverine), a terrorist is simply what "The big army calls the little army." In some books on conducting a war, terrorist type tactics are recommended if the enemy you face is much larger than you.

The IRA is considered a terrorist group, but many would put it in a different category than the Al-Qaeda terrorists involved in the 9/11 attacks.

http://pn.psychiatryonline.org/content/42/10/2.full

When we psychiatrists start using our training, and adding it to the slings and arrows typically associated with politics, we only serve to cheapen our profession. We should try to adhere by the Goldwater rule whenever possible. The only legitimate exception, IMHO, is when a psychiatrist tries to assess someone, and that person refuses to cooperate, and the psychiatrist is in a position where he/she has to give an opinion. (e.g a murder suspect who may not be competent to stand trial. The law simply cannot forego a trial because the person refuses to cooperate with the psychiatrist).

I actually, for real, heard Peter Breggin on the radio a few months ago give a psychoanalysis on "liberals" calling them in general cowards, sycophants, etc. Hate liberals or conservatives as much as you want, the point is it was readily apparent his opinion was not within the standard you'd want someone in our profession to act. We, of course, are entitled to our own political opinions, but he, quite transparently, was trying to use his title as a psychiatrist to suggest his opinion was somehow scientific.

The fact that this guy has actually been called to be an expert witness in some big cases is embaressing to our profession and the lawyers foolish enough to hire him.

As for Michael Stone's opinions, again I haven't read the book, but I certainly hope he put in some objective analysis to back his opinions. E.g. some psychological testing, or studies involving some type of scientific method. Just because someone has an M.D. or Ph.D. after their name doesn't mean the opinion is valid and reliable. You only have to look to people like Dr. Phil, Judge Judy, or Dr. Laura to see my point. Otherwise, I hope Stone clearly points to the limitations of his opinion.

We should be open to bringing forth several of our opinions, but when they're only opinions, we need to present them as such and make the listener aware of our own limitations.

 

[st2205]

Terrorism is a sticky subject. To quote Wolverine (yes the X-Men's Wolverine), a terrorist is simply what "The big army calls the little army." In some books on conducting a war, terrorist type tactics are recommended if the enemy you face is much larger than you.

Is this a universality or does it stem from relativistic underpinnings that there is no moral objectivity? Both? Neither?

 

[ClinPsycMasters]

Is this a universality or does it stem from relativistic underpinnings that there is no moral objectivity? Both? Neither?

I know this question wasn't directed at me but I like to note that the idealist in me would like to believe that there are moral principles that transcend time and place. But they are frustratingly elusive. The sorts of justifications we have offered ourselves and others throughout history and the real reasons we have committed all sorts of questionable acts against people, animals, and environment, are all over the place.

I do like to respect a set of universal moral principles, but it is one thing for philosophers and theologians (and people) to agree on the universality of it, and another to put it into practice and enforce it fairly.

I have noticed that some psychiatrists like to stay clear of these issues and I respect that. It's very messy. However, mental health does not exist in vacuum and so various issues have a political component. History of psychiatry can attest to that, from antipsychiatry movement in general to gay rights and more recently, gender identity hullabaloo. Perhaps the next revision we hear from people who have various fetishes, though I don't think people define themselves by their fetish and consequently are not so hurt by stigmatization.

Psychiatry's authority and influence in society has made each DSM revision a true historical event.

 

[Therapist4Chnge]

One person's terrorism is another person's revolution.

 

[whopper]

Is this a universality or does it stem from relativistic underpinnings that there is no moral objectivity? Both? Neither?

That was actually kind of the point in the comic, which you haven't read, and perhaps was a bit egocentric on my part to bring it up. If you read it (Secret Wars), there's a lot more to his comment than what appears on the surface. The X-Men for example have been called terrorists, and we recognize them as the good guys.

I lived in the UK. There, at least most of the Brits I've known don't consider the IRA in the same vein as Al-Qaeda. Several of them see the IRA as someone you can actually negotiate with, hold a treaty with, and consider the IRA's movement extreme, but not on the order of fanatacism. Several of them saw Al-Qaeda as a type of group where there really was no room for negotiation....they just should be killed. Yet both groups are considered terrorists.

Again, I haven't read Stone's book, but in today's American vernacular, the use of the word terrorism often only refers to the latter extreme. I'm sure several loyalists during the American revolution considered George Washington and the Tea Party terrorists.

Let's take a specific example.
Here's the dictionary's definition of the word terrorist:

ter·ror·ism   /ˈtɛrəˌrɪzəm/ Show Spelled[ter-uh-riz-uhm] Show IPA
–noun
1. the use of violence and threats to intimidate or coerce, esp. for political purposes.
2. the state of fear and submission produced by terrorism or terrorization.
3. a terroristic method of governing or of resisting a government.

Now here's an article about that Texan pilot who crashed his plane into an IRS building.

http://www.foxnews.com/us/2010/02/18/pilot-crashes-texas-building-apparent-anti-irs-suicide/

The Department of Homeland Security said it did not believe the crash was an act of terrorism.

What? The pilot clearly committed an act of terror (crashed his plane), wrote a manifesto that he thought violence was justified against the government (now there's a political purpose) so by the dictionary definition, he IS A TERRORIST.

But no, according to the Dept of Homeland Security he is not. I don't quite understand that.

My point is, the use of the word terrorism is pretty warped because people aren't using it within it's definition, and that adds to the confusion on top of this issue which is already embedded with a lot of angry passion.

 

[jettavr6]

"When we psychiatrists start using our training, and adding it to the slings and arrows typically associated with politics, we only serve to cheapen our profession."

Sage words Whopper. Quite simply, we can psychopathologize everything and Psychiatrists/psychologists often attempt to do that.

Are terrorists anti-social personality disordered? Perhaps the leaders are, but I doubt that they are rushing to make an appointment with a therapist.

Are all those who engage in terrorism personality disordered? Maybe. However, a majority of them believe in their cause due to a lack of education, and knowing no other way of life. Moreover, many have no choice as they are subjected to bullying, threats, and torture.

Suicide bombers in particular may in fact be mentally ill, and this is a topic which would be interesting to research. From having worked in a prison, I have noticed that the "leaders/shot callers" in various prison gangs tend to exploit those who have less of an ability to defend themselves. Often times, these are people with dysthymia or psychosis who either want to please their leaders, gain notoriety/self esteem, or act on their personal delusions, etc.

Who knows.... I'll side with whopper on this one...

 

[whopper]

Caveat: this opinion is not scientific, but based on my observations.

Suicide bombers, from the cases I've seen either follow 2 general trends. They are either incredibly desperate, or they somehow believed the act was serving the greater good.

There's an old Steve McQueen movie, Hell is for Heroes, where he suicide bombs a nazi gunpost because it's either that or his fellow soldiers would be killed. I would've loved to have seen people's reactions to that movie in the weeks following 9/11. Many Americans were of a notion that no American would do such a "cowardly act." I didn't hear of an uproar to McQueen's movie.

 

[st2205]

That's because there's a pretty stark contrast between warfare and Nazi gunposts (military) and a large metropolis (civilians). Now, if the movie had centered around him walking into a German restaurant you may have a point. Otherwise... Not so much.

 

[Therapist4Chnge]

The pilot clearly committed an act of terror (crashed his plane), wrote a manifesto that he thought violence was justified against the government (now there's a political purpose) so by the dictionary definition, he IS A TERRORIST.

My point is, the use of the word terrorism is pretty warped because people aren't using it within it's definition, and that adds to the confusion on top of this issue which is already embedded with a lot of angry passion.

The label "terrorist" is a morally-based construct, which causes quite a bit of confusion. The application of the term to a person is further confused by an attempt to quantify the person's motivation and beliefs into a list of criteria, which are then translated into a disorder. Obviously this approach will lead to a great deal of variance because attempting to encapsulate a person based on specific data points assumes that the data will hold true across various scenarios. More simply, an evaluation of a person cannot be reduced down to singular acts, which are then quatified and the results measured against an existing set of scales. This also assumes that the scales/criteria actually measure what it states it measures, which in and of itself is shaky group within the psych. community.

To use the IRA as an example...their efforts are motivated by a doctrine they established in response to a perceived injustice. Some may quantify singular acts (bombings, arson, etc) as acts of terrorism, while other will look at those acts as steps towards liberation under an unjust government. To evaluate the individuals based on these acts, and attempt to quantify their motivations and beliefs is a misapplication of both the theory and science of psychopathology.

Obviously I disagree with attempting to quantify a "terrorist's" actions and beliefs and then compare them against DSM diagnostic criteria, though I am sure there are strains of characteristics that may be more common than not in these people. With that being said, how does a person explain the difference between a soldier falling on a grenade to save his company and an extremist who sacrafices himself/herself in a hail of gunfire so that his people can carry out their assigned mission? If we attempted to quantify both men without accounting for the confounding variables, they would come out with the same symptoms:

-Suicidal
-Impulsive
-Irrational
etc.

Yet...one is a hero....and the other is a terrorist. Does one may have a psychiatric disorder and the other have a "hero's mentality"? Did one make the ultimate sacrafice for his country, while the other died as a crazed extremist?

 

[whopper]

That's because there's a pretty stark contrast between warfare and Nazi gunposts (military) and a large metropolis (civilians).

I get your point, but if I'm interpreting you correctly, that's my point above.

There's a dictionary defition for terrorist and terrorism. The definition does not involve separating the civilians from the military as legitimate targets. It does however involve the use of using "terror" in the name of a political ideology.

Oh, and BTW, if killing civilians is terrorism, then America is the biggest offender. Ever hear of Hiroshima and Nagasaki?

IMHO, if people want to create a new type of meaning for the word terrorist and terrorism, they should just create a new word and leave the existing word alone.

It appears that the American vernacular has created a new meaning for the word terrorist according to this definition...

1) They have to be either brown skinned or Muslim. (This way we don't have to think of the IRA).
2) The person is open to targetting Americans (or it's allies), civilian or military.
3) The person's motivation is largely based on religious fervor.
4) The person is not committing their act of terror while identifying with a specific nation, but instead a group of people tied by an ideology.

With the above definition then the Dept. for Homeland Security was justified in claiming that the Texan who crashed his plan into the IRS building was not a terrorist.

The point of the Steve McQueen movie was that suicide bombing is not an act of cowardice unto itself. It depends on the rationale. If I, for example, had the opportunity to take out Hitler by suicide bombing him, IMHO that is a legitimate ethical action. (Yeah yeah yeah, the old and tired Hitler analogy). But in the weeks after 9/11, many Americans saw suicide bombing (the act in and of itself) as only the act of coward. Bill Maher got his show cancelled for making a similar comment while fully acknowledging the act was wrong because it was used to take out innocents. He said it was wrong, but it was not the act of a coward. A coward is not willing to sacrifice himself. I agree with him, though IMHO the person was not a coward, but a fundamentalist extremist (which is what I think he was getting at...)

 

[ClinPsycMasters]

Caveat: this opinion is not scientific, but based on my observations.

Suicide bombers, from the cases I've seen either follow 2 general trends. They are either incredibly desperate, or they somehow believed the act was serving the greater good.

There's an old Steve McQueen movie, Hell is for Heroes, where he suicide bombs a nazi gunpost because it's either that or his fellow soldiers would be killed. I would've loved to have seen people's reactions to that movie in the weeks following 9/11. Many Americans were of a notion that no American would do such a "cowardly act." I didn't hear of an uproar to McQueen's movie.

I agree! Also, I think sociological, economic, and political explanations need to be considered. Of course we can focus on the person only, make suicide bombers into villans and irrational brainwashed crazy people who want to destroy what is good and right. And we do that sometimes when we are very afraid or when certain people want the public to be very afraid. It doesn't matter who the enemy is, communists, Islamists, Zionists, Germans, Americans...fear makes us see things in black & white. Fear makes us regress. Love makes us grow.

When we look at other factors, povetry, human rights, freedom, crime, corruptions...when we are able to see people as the same deep down, we can have more compassion.

Of course that is not to say that young people who are willing to blow up their bodies and those of others are not different from others. However, I think the explanatory power of personality traits is limited. Particular personality traits may help explain why someone joined a terror group, or army, or a cult, but time and place matter too. A person with paranoid traits could be working for FBI or as part of a terror network. A narcissist could be a politician or terror leader.

I once read a paper about Israeli's reactions to Palestinian suicide bombings and the fear and the anger was very palpable. A researcher who interviewed Palestinian suicide bombers noted that surprisingly large number of them had felt humiliated by Israeli soldiers and had been exposed to suffering of fellow Palestinians as well. I couldn't make a black and white judgement. I can only think that out of fear and desperation we do scary things. So let's help people feel less fearful. Let's help them live better lives so instead of trying to survive and seeing the world in black and white, they can see colors.

 

[rmbsstock]

I once read a paper about Israeli's reactions to Palestinian suicide bombings and the fear and the anger was very palpable. A researcher who interviewed Palestinian suicide bombers noted that surprisingly large number of them had felt humiliated by Israeli soldiers and had been exposed to suffering of fellow Palestinians as well. I couldn't make a black and white judgement. I can only think that out of fear and desperation we do scary things. So let's help people feel less fearful. Let's help them live better lives so instead of trying to survive and seeing the world in black and white, they can see colors.

-When a person dies 100 times a day because of the suffering, anger, injustice, fear and hopelessness, then suicide bombings one time is MUCH MUCH easier.
-When death will make you join most of the people that you love who were murdered (some in front of you), why would you want to live. So at least do something to take some of the enemies with you.
- If you want to study major depression, and PTSD, go to Gaza and the occupied territories. 100% of the population fit the DSM IV of the signs and symptoms of major depression, and PTSD. When you see your 12 year old son, (and I saw but NOT my son) caught by soldiers, the youngest probably 35. These four soldiers hold your 12 year old son and with rocks break EVERY SINGLE BONE IN HIS BODY. And you are held there by other soldiers, and your son is screaming his head off. Do you think what you do after that is a terrorist action as a father or a mother!!!

 

[ClinPsycMasters]

That is a horrifying description. Are you speaking from personal experience, of living over there yourself and being witness to other cruelties?

 

[rmbsstock]

That is a horrifying description. Are you speaking from personal experience, of living over there yourself and being witness to other cruelties?

I lived there and my family still live there. On both sides its a terrifying experience. When a government turn a human into a killing machine that is willing to shoot a child while in his mom's arm....is terrifying.