Category Archives: Dissociation

Mental Health Issues and the Security Clearance Process—Questions Raised after the U.S. Navy Yard Active Shooter

The recent Navy Yard shooting in which active shooter Aaron Alexis entered the Washington, D.C. Navy facility with a gun that he used to kill twelve and injure many more–before being shot and killed himself, raises some important national security issues regarding the clearance process and granting of access to military facilities. 

Edward Snowden, Chelsea Manning (at the time Bradley Manning), Nidal Hassan, and Aaron Alexis all carried clearances.  Snowden and Manning betrayed their clearance by releasing classified documents into the hands of others.  Nidal Hassan, a military psychiatrist who had been treating wounded veterans returning from war and who was about to deploy into Afghanistan and Aaron Alexis were both active shooters.  They took weapons into a military facility and opened fire upon their colleagues ending in their own anticipated suicide. 

Today over five million U.S. security clearances are issued–one third of them to “contractors”–that is individuals who work for companies that hold government contracts.  Snowden and Alexis were both contractors.  Snowden, working for Booz Allen amazingly maneuvered himself into a position with access to innumerable classified and highly important government documents that he was able to surreptitiously remove from his workplace and then release to media contacts. 

How were these persons holding security clearances and with access to government facilities able to penetrate a system to do it terrible damage without the system having some idea of the impending danger?  Is our security clearance system broken? 

If one goes back over these cases it’s clear there were some warnings in nearly every case.  In the case of Nidal Hassan, he was becoming increasingly agitated over the wars in Afghanistan and Iraq and about being a Muslim serving in a military conflict against a Muslim country.  He expressed his concerns to his colleagues in a fashion that caused them to be disturbed–but nothing was done about it. He also asked the military not to send him to Afghanistan.

Likewise Hassan, a Palestinian by descent, would by anyone’s estimation likely have been aware of the campaign of suicide terrorism-glorified as “martyrdom” being carried out by Palestinians during the Second Intifida.  That campaign and its ideology may or may not have infected his own way of thinking about suicide rampages in behalf of what he might have felt was a good cause.  And if authorities had tracked his Internet and personal records they would have found him worshipping at the same Northern VA mosque in which Anwar al-Awlaki served and that Awlaki–then living in Yemen and highly radicalized–had become a mentor to Hassan discussing his concerns about serving as a Muslim in the U.S. military.  Before his active shooter campaign, Hassan packed up his belongings, settled his debts and bid goodbye to his landlady–although leaving her with the impression he was going off to war.  It was just a different type of war he was engaging in and no one picked up the warning signs.  

If Hassan had been subject to a more frequent security review process, if his colleagues had engaged more with him about his very real concerns, if the military had considered his expressed reservations about being sent as Muslim military member to Afghanistan, and if he had been subject to a data base review of his Internet contacts, he might have been flagged and successfully treated or discharged from the military before he went on his murderous rampage.  His acts depended upon his access to the base and trust that had been placed in him by a government that failed to realize how mentally unstable he had become. 

Chelsea Manning also gave clear signs of distress to colleagues and the medical system prior to her betrayal of U.S. secrets.  Her dilemma was quite different than Nidal Hassan’s but every bit as personally distressing.  As a serving transgender individual in the U.S. military which still does not accept and more disturbingly does not reassure it’s well serving transgender service members that they can continue to serve if they disclose their status or seek treatment along existing standards of care–she faced automatic discharge if her “secret” became known. 

As is often the case with many transgender service members, Manning had likely entered the service without having come to grips with her transgender issues.  At the time when she could no longer ignore it, she was already committed to her military career and caught in the don’t ask/don’t tell dilemma that continues to this day for transgender service members.  She was literally harboring a painful personal secret that was bursting to be addressed at the same time when she was becoming increasingly disturbed by U.S. military practices in Iraq.  Unable to disclose her secret or to get adequate treatment for it without losing her military career, she instead addressed her other concerns about U.S. military practices making a decision to become what she believed was a whistleblower–a decision that involved disclosing state secrets, betraying her country and her security clearance. 

Aaron Alexis also gave out serious warning signals.  Prior to being accepted into the Navy reserves he had been arrested, but not charged in 2004, when he shot out the tires of a car in what he explained to police afterward was an anger induced rage–a signal that he might have a serious dissociative tendency and anger management issues.  Then while in the military in 2008 he was thrown out of a bar after destroying furniture in it.  In that incident he was arrested and spent two nights in jail.  Then in 2010 he had intimidated a neighbor over his complaints about her being noisy, in an ongoing altercation that culminated in him “accidently” discharging his gun, shooting through her apartment’s floor.  The Navy was alerted of all three incidents.  

Likewise despite being discharged from the Navy and their knowing from his parents that they were also concerned about their son’s “anger management” issues, the Navy allowed him to continue to carry his security clearance that allowed him to be later hired by a contractor and gain access to multiple military facilities.  And in the past month Alexis had been seeking emergency treatment more than once at the VA for multiple nights of insomnia–another flag that he might have been deeply psychologically distressed.

Perhaps most disturbingly in his long record of signaling possible impairment to those who gave him his clearance and access to the bases, Alexis had also called the police in August of 2013 while in Rhode Island complaining that he was being microwaved and that there were persecuting voices in his head–potential signals of a schizophrenic episode.  The Rhode Island police alerted the Navy police who somehow failed to take action.  Clearly with all these signals of a troubled mind, the Navy had some obligation to re-review his security clearance and access privileges but it appears that given numerous warnings they failed to do so.  And now twelve people are dead and many more are wounded, bereaved and psychologically traumatized by his actions. 

The security clearance process in the U.S. does not require a person never to have sought mental health treatment or even not to have mental health issues and that is probably correct given that many people serve their country well despite psychological challenges and there are many treatments available to stabilize mental conditions. What the clearance process does require is an assessment of whether a psychological condition and its treatment would impair that person’s judgment and behavior in regard to classified materials and access.  This includes an assessment as to whether or not they are faithfully following their treatment.  So carrying a diagnosis and receiving treatment is not a definitive block to carrying a security clearance.

Despite this, I have personally been asked over the years many times to treat military and diplomatic personnel outside their medical system because they were seriously enough concerned over their security clearance status should they seek treatment for anxiety, addictions, PTSD, dissociative disorders, marriage stressors and even suicidal family members that they wished to do so paying cash rather than having any entry of their treatment logged into their medical system.  In each case that I was involved as a treating clinician, I was given no reasons to doubt the cleared individual’s ability to carry out their duty to their country.  And it seemed wise to me that they did seek treatment as the issues they were facing were serious ones that could impair their ability to perform without treatment.  But had they been compromised, I as an outside clinician would have also faced a dilemma–would this constitute an instance of duty to warn, or would I be obliged to not break their confidentiality? 

While we certainly don’t want to discourage those carrying clearances from seeking and receiving help for psychological challenges they may inevitably as members of the human family face, we also must consider some way of flagging those who should not for mental health reasons be carrying a clearance or having access to military or government facilities, personnel and data bases.  That is a difficult issue to maneuver as penalizing security clearance holders for needing and responsibly seeking treatment can also mean they simply won’t seek treatment–which can also have disastrous consequences.

More frequent review of clearances seems to be a likely solution.  When a military pilot project on security clearance reform was carried out looking only at social media traces of a group holding security clearances it revealed that twenty percent showed demonstrable reasons for review of their security clearance status–including threats to a president, history of arrest and charges, and suicidal intentions. Perhaps the most important things we can do immediately as a country is to enact some kind of security clearance reform that requires continuous evaluation of those who hold clearances without penalizing those who are legitimately addressing any mental health issues they may have.

We could also encourage more police reporting of those they arrest and interact with, who carry security clearances–to flag the appropriate agencies.  These days with big data applications we could easily track those who carry security clearances to be, at a minimum, alerted of their arrest histories.  While medical records likely should not be the subject of privacy invasions, it certainly could be possible to collect all arrest records and have them analyzed to spit out those like Aaron Alexis who we now see in hindsight, gave us many warnings of his psychic unraveling. 

 Sadly he was not flagged for a diagnostic workup and comprehensive treatment and continued on with a clearance and access status while falling apart, a failure of the system that allowed him to hurt not only himself but many others in the process.  Clearly we need to and can find a better way to address these issues.

The Jodi Arias Trial & Dissociative Amnesia for Sex – the Intersection of PTSD & Dissociation with Child Abuse, Rape and the Carrying out of Crimes

The Jodi Arias murder case in which she claims prior abuse and failure to remember crucial aspects of her crime have brought the issues of posttraumatic stress disorder (PTSD) and dissociation—concepts that are confusing to many—into national attention leaving many bewildered about how traumas, dissociation and crime may all be linked together.  

Oftentimes PTSD is thought of as a disorder in which one cannot forget a trauma.  And in many cases of PTSD, the trauma—having been burned deeply into memory—is constantly relived in intensely detailed and disturbing traumatic flashbacks.  This is the most common manifestation of PTSD and what we have become accustomed to seeing portrayed in movies of trauma victims such as veterans perhaps suffering flashbacks of combat for instance.

There is however, also another side to PTSD and that is when a dissociative amnesia occurs in response to a trauma that is too horrible to make its way into the normal conscious narrative. This often happens for rape victims or others whose bodies were literally penetrated in an assault, accident or crime——they were so overwhelmed in every sense that their mind failed to record all the details of what happened to them, or locked it away so deeply that they are unlikely to get it back except in the safety of treatment—thus they suffer from a dissociative amnesia.  They cannot remember everything that happened—the trauma is completely blocked from consciousness and locked away in the mind—in what psychologists label a dissociative amnesia.  This is less common than recurring flashbacks but also occurs in those who have been deeply traumatized and suffer from PTSD.

A case of such an effect that comes to mind is Lorena Bobbit whose defense team I served on.  After separating from her violently abusive husband who had threatened to continue raping her —into perpetuity—after their divorce she was again raped by him one last time.  So horrified by the traumatic experience of rape and the fact that he apparently believed he could do as he liked with her, she stood up from the rape and suddenly experienced a flood of all the other abuse he had subjected her to over a long period of time—all episodes that she normally kept locked up in her mind.  And during that overwhelming episode of traumatic recall—seeing a knife on the counter—she took it and removed “his weapon” ensuring he would never rape her again.  In those moments she moved into a dissociative amnesia—and drove away from their home in such a state—only gradually “coming to” as she regained safety at which time she recalled both the rape and the crime.  In this case a brutal sexual assault—following many others that had happened before it—caused a brief dissociative amnesia in which a chronic abuse victim enacted a crime and fled from it.

In addition to these responses to trauma there is yet another type of dissociation—dissociative identity disorder—that occurs in childhood victims of repetitive and inescapable traumas such as chronic sexual or violent abuse during early development.  In these cases the child may create an entire sequestered personality—or personalities—that hold the traumas, with complete or partial amnesias occurring between the personalities.  This used to be referred to as multiple personality disorder and is now referred to as dissociative identity disorder, and is believed to be rare. 

I witnessed dissociative identity disorder in Annette Morales Rodriguez (and later wrote a book about it—Fetal Abduction) who admitted to me while in jail that she was both a rape and sexual abuse victim and that she had managed until just before her crime to keep all the memories of her rape and sexual abuse separated from her conscious awareness by having two personalities.  However later in life when severely triggered by stressful events, her second personality “Lara” emerged with a vengeance and enacted a murder for which she had no conscious recall.  Tragically the abuse had gone full circle and an abuse victim had in a severely dissociative state also become a victimizer.

So, is it possible to have a sexual episode engender dissociative responses and amnesia as Jody Arias’ defense team is claiming?  Yes—I have seen this many times but only in those who endured rape or chronic sexual abuse. 

Once, for instance a victim of childhood sodomy told me that she had complete amnesia and could not believe it had occurred, even when her mother presented her with hospital records of the event.  Likewise when I questioned her further she was horrified to realize that she “disappeared” and had no record whatsoever of any sexual act that she had ever taken part in.  She could, for instance tell me that she had sex (with her loving husband) a week previously and she could tell me where it started and what happened before and afterward but she was terrified to realize, with my questioning, that she was at a complete loss to recall anything that had happened during the actual sexual encounter.  And this was true throughout her life.

Whether Jodi Arias is one of these cases I will refrain from commenting as I have only followed her case peripherally.  But is it hypothetically possible that the threat of abuse following chronic abuse, or the act of sex following the experience of abuse or rape, or killing in the act of self-defense could engender a dissociative amnesia? Yes.  Is this the case with Jodi Arias?  I don’t know but I would comment that her seemingly need to over-kill her claimed abuser disturbs me—it’s almost as if she didn’t believe she could stop his life—and that makes me wonder.  

That said I would add that with the societally denied—but sadly true ubiquity of child sexual abuse, rape and violence occurring in our culture—I am never totally surprised to run into persons who have rather severe PTSD, dissociative amnesias and dissociative disorders.  Rape and sexual abuse are very terrifying experiences and victims are often silenced by threats and continued abuse.  As a result some repeatedly re-experience their traumas as painful flashbacks and bodily arousal with triggers to recalling the trauma; others bury such traumas deeply in their mind with dissociative amnesias that they take many measures to keep buried until they are safe enough to work through them—if that ever occurs—and still others bury childhood traumatic experiences by splitting their consciousness into personality fragments that have strong dissociative and amnestic barriers between them.

What the Jody Arias case should make us all realize is that when rape and child abuse do occur—and they do often occur—the victims can be plagued with traumatic flashbacks, dissociative amnesias and even fragmented personalities and like Lorena Bobbit, Annette Morales Rodriguez and many others—they may commit crimes.  Indeed I have even seen the same issues occurring also in individuals who volunteer as terrorists for suicide missions (see Talking to Terrorists).  We should all be working to stop rape and child abuse because not only does it create victims but sometimes those victims turn around and commit crimes making our society less safe for all of us.

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry in the Georgetown University Medical School and author of Fetal Abduction: The True Story of Multiple Personalities and Murder and Talking to Terrorists: Understanding the Psycho-Social Motivations of Militant Jihadi Terrorists, Mass Hostage Takers, Suicide Bombers & “Martyrs”