Tag Archives: PTSD

Waterboarding, Sarah Palin and Our Image Abroad as the “Great Satan”

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“Waterboarding is how we baptize terrorists,” Sarah Palin told an audience at the National Rifle Association’s Stand and Fight rally last weekend. She would reinstitute the practice, she told listeners, calling it a valuable technique.

What Sarah Palin perhaps doesn’t know is that when al Qaeda was being formed, the middle eastern extremists who were using terrorism to fight their own corrupt governments had finally given up fighting inside their own governments in the face of overwhelming force. Realizing that they couldn’t stop their own governments they began to look for who was on the outside—funding and propping up torturous and unjust regimes. And that led them to begin to question foreign policies carried out by the U.S. and the EU.   Ideologically it led to the budding AQ terrorists labeling the west as the “Great Satan” and to their new initiatives of attacking us. They called that an attack on the “the head of the snake.”

Sarah Palin, like all of us wants that to stop. But is she right about how to go about it?

Waterboarding, a technique in which water is poured over the angled face of a prisoner—so as to fill his nose, mouth and lungs—terrifyingly creates the feeling of drowning. “When performed on an unsuspecting prisoner, waterboarding is a torture technique—without a doubt,” Malcolm Nance, former master instructor and chief of training at the U.S. Navy Survival, Evasion, Resistance and Escape School (SERE) in San Diego states. “There is no way to sugarcoat it,” he writes, referring to that he personally witnessed and supervised the waterboarding of hundreds of U.S. military trainees who were drilling to resist torture.

“It does not simulate drowing,” Nance states, “as the lungs are actually filling with water. There is no way to simulate that. The victim is drowning … “Unless you have been strapped down to the board, have endured the agonizing feeling of the water overpowering your gag reflex, and then feel your throat open and allow pint after pint of water to involuntarily fill your lungs, you will not know the meaning of the word.”

“Waterboarding is slow-motion suffocation with enough time to contemplate the inevitability of blackout and expiration” Nance continues. “Usually the person goes into hysterics on the board. For the uninitiated, it is horrifying to watch. If it goes wrong, it can lead straight to terminal hypoxia – meaning, the loss of all oxygen to the cells.”

And horrifyingly, the lack of physical scarring allows the victim to recover and be threatened with its use again and again.

Waterboarding was on the CIA’s list of approved “enhanced interrogation technique’s” for use against high-value terror suspects in 2005, and was included in a 2009 U.S. Department of Justice memo released in April 2009 as an approved torture technique. Waterboarding was carried out under the Bush administration but has now been condemned by President Obama as “torture”.

According to journalist Julia Layton, when waterboarding was used in counter-interrogation training for CIA operatives and Navy SEALs, the trainees could not survive it without breaking. According to her sources, CIA members have lasted an average of fourteen seconds before begging to be released.

Being subjected to drowning and feeling that one is imminently about to die is a powerful psychological torture method and it breaks down both our guys, as well as our enemies. Khalid Sheik Mohammed, the mastermind of 9/11 was water boarded and reportedly managed to last an impressive two minutes. Perhaps his faith kept him steady in the face of overwhelming terror. Yet he too broke and began confessing.

No doubt water boarding works to create terror and an overwhelming sensation of imminent death by drowning. Yet while Palin believes that water boarding is a useful interrogation technique, those who have had it in their arsenal of “torture” tools disagree. CIA officials according to Layton, stated that it is a poor interrogation tool because it scares the prisoner so much you can’t trust anything they tell you as a result.

When Jesse Ventura, the colorful, former Minnesota governor recalls how he was waterboarded as part of his Navy SEAL training to resist torture techniques he states, “It’s drowning. It’s torture,” and that it can kill you. Trying to make the point of how serious waterboarding is and that one will say anything to make it stop, he declared to Larry King, “You give me a waterboard, Dick Cheney and one hour and I’ll have him confess to the Sharon Tate murders!”

In September 2006, Senator John McCain, who had been tortured as a prisoner of war in Vietnam stood up to his party and tried to outlaw torture techniques against all U.S. held prisoners. In 2006, the U.S. military also made it illegal for the any members of the military to use this technique. Shamefully, it took longer for the CIA to catch up.

“The lack of physical scarring allows the victim to recover and be threatened with its use again and again,” Nance writes adding that whoever carries out waterboarding has to move from humanity to hatred and overcome basic human decency to endure causing its torturous effects.

And our use of such methods has now opened Pandora’s box for what may be considered by terrorists as acceptable to be used against our soldiers. Just as now dead, Chechen terrorist leader Shamil Basaev stated that he justified the terrorist use of weapons of mass destruction, because poisons had been used by the Russian government to kill his cadres—terrorists often attempt to justify their acts on the basis of our own.

Nance writes, “Our own missteps have already created a cadre of highly experienced lecturers for Al Qaeda’s own virtual school for terrorists” Indeed, even when we try to keep torture methods classified, convicted AQ members and released captives broadcast widely over the Internet what they were subjected to and how they endured.

While Sarah Palin may believe “soft” torture that leaves no physical marks of harm done is useful, waterboarding is nevertheless psychologically devastating. And that it is a useful tool for interrogating is also not a strongly supported position among those in the know. Just as I learned when I was helping build what became the Detainee Rehabilitation Program for our 20,000 detainees in Iraq, the best approaches to interrogation are to find common ground, rapport and build a relationship where the detainee begins to trust and open up. Terror and pain may make a person “talk” but what they say in order to escape from torture often doesn’t add up.

And the anger in that person over being mistreated and in others—including family members and friends—who learn of it often creates more of a threat than elicits any useful information.

Indeed when the pictures from Abu Ghraib circled the world via the Internet, and now, when burned up corpses of children killed in drone attacks are sent around via YouTube—these powerful images of what the West is all about to those who haven’t yet decided if what the militant jihadi terrorists claim in their anti-Western ideology is correct. And it only takes one or two of these—like the Tsarnaev brothers for example, to jump into the terrorist camp and wreak havoc for all of us.

Images and stories about torture and acts that cross the bounds of human decency can easily be used to push fence sitters into the enemy’s camp ideologically and also to then move them along the terrorist trajectory into finally enacting terrorism.

While Sarah Palin may consider herself a patriot, all we need are more Americans publicly espousing waterboarding, and other unacceptable terror methods, to push even more potential enemies into believing that indeed the West is serving, or is itself, the Great Satan. 

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry at Georgetown University in the Medical School and author of Talking to Terrorists. She conducted psychological autopsies of over half of the one hundred and twelve Chechen suicide terrorists, interviewed hostages from Beslan and Nord Ost and has interviewed over four hundred terrorists, their family members and supporters in various parts of the world. 

Honoring Civilian Service in Danger Zones

Today, April 24th, 2014, Dr. Jerry Umanos, a Chicago pediatrician who moved to Afghanistan to treat children and train Afghan physicians was gunned down at a Kabul hospital—killed by an Afghan police guard. While we have become sickeningly accustomed to hearing about “green on blue” attacks on our soldiers as the Afghan people become more and more disenchanted with foreign troops operating on their soil—this was a cold blooded attack on a civilian non-military worker.

A fact that is often overlooked these days, is that our wars are fought not only with soldiers, but with a great number of civilian workers going out alongside of them—military contractors who perform a myriad of tasks supporting military operations; government agency workers representing in the case of the U.S.—the Departments of State, Energy, Labor, Health & Human Services, etc.; journalists; and nongovernmental (NGO) workers performing all kinds of missions—many of them humanitarian.

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Most people don’t realize that in 2007 there were actually more civilian contractors in Iraq than combat troops and that in 2009 contractor deaths exceeded military deaths in Iraq. According to a 2013 report of the Special Inspector General for Iraq Reconstruction (SIGIR): “In September 2007, the United States had more than 170,000 combat personnel in Iraq as part of the counterinsurgency operation, with more than 171,000 contractors supporting the mission.” These contractors are credited in the report for supporting “the counterinsurgency mission in unstable, yet strategically significant, areas such as Baghdad, Anbar, and Babylon provinces.”

And when contractors, NGO workers and civilians serve in high threat security zones they are often not working with the same pre-deployment training or the same support during and after their deployments that military and government workers receive. Yet they too get injured and killed—like Dr. Umanos—who was trying to train up an Afghan medical force. And even when they return home safely—mission completed—they, and their families can still suffer considerable psychological strain in the months and even years to come. But there is no Veterans Health Administration for civilian workers to turn to for support. And sadly we as a society are still slow to recognize our hundreds of thousands of civilians who have or are now serving abroad in high threat and danger zones.

The dangers for civilians are greater now that the military outsources many of its jobs to civilian contractors just as the dynamics of war have also drastically changed. These days, with guerilla and terrorist adversaries attacking anywhere at anytime, the battlefront “rear” and “front” no longer are clearly delineated. The enemy attacks any and everywhere, placing civilians who assist military operations in the same dangers as the uniformed warriors and often injuring and killing civilian workers who would have in the past been operating in the “rear”.

While our military serviceman returning from Iraq and Afghanistan have faced shameful delays and nonresponsive replies from the Veterans Health Administration to get their claims covered—civilian contractors who return from the battle space with similar injuries—including limbs blown off, traumatic brain injury, PTSD, depression, traumatic bereavement and the like—have found they too have had to battle with the insurance coverage provided under the Defense Base Act (DBA)—a law requiring insurance coverage for those contracting with any agency of the U.S. government for work outside the U.S.

At present the recording of civilian contractor deaths in conflict zones is thought by many to be underreported and sadly many of these civilians die unheralded. Likewise those who are wounded are finding it difficult to get their needs met.

In terms of psychological well being, a 2013 RAND study, aptly titled “Out of the Shadows: The Health and Well-Being of Private Contractors Working in Conflict Zones” found evidence for posttraumatic stress disorder (PTSD) in twenty-five percent of their sample, depression in eighteen percent, and alcohol misuse in over half the sample. And longer deployments and increased combat exposure was associated with higher rates of distress. In our 2007 study of resilience in civilians deployed in Iraq, our research team found similar findings.

Serving in a combat zone, high threat or danger zone is just that—dangerous—and it’s time we recognized the hundreds of thousands of civilians who are doing just that. A new organization We Served Too (WS2) has been formed with the mission to raise awareness; conduct research; develop education materials; support resilience, health and well-being; and create a web-based community, support network and information resource for those who are serving or have served in conflict and high threat security zones. Currently an oral history project collecting lessons learned from civilians who deployed into conflict and high threat/danger zones is underway. Volunteers and civilians who served are welcome to join.

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Today colleagues of Jerry Umanos told CNN that Jerry “loved the Afghan people, loved the country, and loved to teach”. We need to honor his service and ultimate sacrifice just as we do for our military soldiers, and support all those, like him, who are risking it all to try to make our world a better place.

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry at Georgetown University in the Medical School and author of Talking to Terrorists. She conducted psychological autopsies of over half of the Chechen suicide terrorists, interviewed hostages from Beslan and Nord Ost and has interviewed over four hundred terrorists, their family members and supporters in various parts of the world. She is Co-Director, with Martha Hudson, at We Served Too.

Childhood Cancer and Posttraumatic Stress Disorder

“Your child has cancer.” These are words no parent ever wants to hear.

“You have cancer,” is often a meaningless sentence to a child, but the fear and horror the child sees in his parents’ faces and hears in their voices is unmistakable.

For parent and child, a cancer diagnosis is a mental shock. And the physical shocks that follow that diagnosis—invasive treatments, surgeries, radiation and chemotherapy are also difficult to bear, also potentially traumatizing.

Cancer is a life threatening disease. And the threat to life—including the treatments to save life—can be traumatizing to those who witness their child or sibling going through cancer treatment. Death of course makes it even harder. Treatment is also potentially traumatizing to the child with cancer, potentially leaving psychic scars lasting well after a hopeful recovery.

Facing a series of repeated life threatening events puts each of this group (parents, siblings, and the childhood cancer patient as well) at risk for developing posttraumatic stress disorder (PTSD). PTSD is a disorder that is commonly associated with exposure to combat, natural disasters, or bodily assault.

PTSD in those who experience cancer, usually presents in response to feeling one’s life or one’s child/or sibling’s life is under serious and/or repeated threat.

The symptoms of PTSD include:

  • Reexperiencing the cancer treatment in nightmares, intrusive thoughts or flashbacks—scenes that are often reported to be much like full sensory movies playing unbidden in one’s mind.
  • Avoiding places, people and reminders of the cancer experience including shutting down sharing with others what one has been through.
  • Negative changes in beliefs and feelings including feelings of guilt, fear, shame or losing interest in previously enjoyed activities and feeling alienated from others.
  • Bodily hyper-arousal experienced as agitation, inability to fall or stay asleep, being easily startled, irritable, having difficulty concentrating and so on.

To qualify for a diagnosis of PTSD these symptoms must last for longer than a month and must significantly interfere with life functioning in relationships, work, education or other important areas of life.

In some cases delayed responses occur and in others only some of the features of PTSD occur. Or other related disorders arise such as anxiety disorder or panic, phobias or depression. Those who are suffer from PTSD are also at increased risk for substance abuse—as alcohol or drug abuse arises out of attempts to self medicate flashbacks and nightmares away.

Children who have PTSD often manifest their symptoms in ways that are unique to their developmental stage. For instance traumatized children may revert to wanting to sleep with their parents or go backwards on skills they previously mastered. They also often display a need to play and replay the cancer experience in attempts to master it. Or hyper-arousal may come across as aggression or misbehavior, especially in boys. Girls often go dissociative following a traumatic event—meaning their minds compartmentalize the event. They may say “everything is fine” and show no emotion but if someone where to measure their pulse when cancer is being discussed, they would see that their bodies are showing agitation. More loving touch, sleeping near to parents, and loving interactions with pets can help both adults and children to self soothe in the face of hyperarousal and posttraumatic re-experiencing.

When it comes to trauma children also often take their cues from their protectors. Parents who stay calm and who modulate their emotions well model to their children about how to cry over sad news, stay strong in the face of fear and self comfort, as well as seek comfort for overwhelming emotions. Parents who get hysterical or who shut down emotionally provide little support for children who have to navigate their own emotions and need help doing so.

The risk factors for developing PTSD in response to cancer include longer hospital stays, recurring cancers, invasive procedures such as bone marrow transplants, greater experiences of pain, previous traumas, previous psychological problems or high levels of stress in general. The protective factors against developing PTSD include a strong support network; help regulating emotions, and a good relationship with the medical staff.

PTSD following cancer should be treated sensitively. A child who is for instance triggered into fear states by the smell of a hospital or medical setting, or white lab coats needs help working through their present day anxiety while separating it from the pain or distress that went before. Children and parents may need help reframing present day thoughts that lead to anxieties and slow exposure to triggers to understand they are different (and safe) now, and help learning to calm.

The child patient as well as his or her siblings may develop more behavior problems than before the cancer treatment, become clingy or need help expressing anger versus acting it out. They may also want to avoid reminders of anything to do with cancer and even the medical system. In some case avoidance works to a certain point, but too much avoidance creates a cycle of trying to shut down only to have the painful re-experiencing start up again with another exposure to triggering reminders.

Families are strained when cancer is part of the picture. And each family member has their own way of responding to traumas—withdrawing, acting out, etc. adding an even heavier stress load on the marriage and family system. It can be hard for parents to meet the needs of everyone equally. Often the sick child gets all the attention and the siblings suffer and learn to withdraw or meet their needs outside the family creating complications later on.

Marriages are also at risk when one partner develops PTSD. For instance Stacey, a mother deeply traumatized by her young son’s cancer diagnosis and treatment found that after a hopeful resolution of his cancer she could no longer sleep well and was plagued with nightmares, flashbacks of hospital procedures and flash-forwards of imagining a dire future—including the return of cancer and death of her son.

To cope with her psychological agitation Stacey started avoiding activities she previously enjoyed. She stopped going to her son’s school or sports activities, didn’t want to have sex with her husband or go out to dinner with their friends—responses that Jim, her husband found inexplicably painful. And when Jim became angry over not understanding that posttraumatic triggers were causing Stacey to “shut down” they would have painful arguments that resolved nothing.

Children and adults with PTSD do best to work slowly with help if needed, through their traumas by facing it in small steps and creating a narrative of sorts that works for them. One of the most painful parts of PTSD is dealing with a trauma that makes no sense and for which one has no cognitive frame—“You have cancer,” is often too horrific a statement to accept. Or the suffering of a child in treatment is also too horrific to accept—at first. But over time, cognitive frames must be created in which one finds peace and accepts into one’s life story that indeed this trauma occurred and now needs to be accepted as real.

Running away from it and living with the painfulness of cycling through flashbacks, avoidance and hyperarousal is no way to live. Medications in serious cases may be useful, and relaxation training is also helpful. Simply understanding what one has been through and that posttraumatic responses—even to cancer—are normal can help to work through it.

Most PTSD sufferers feel a sense of foreshortened future—that their lives will not be as long as previously expected or as fully lived. In some case that is the sad reality, but in others it is simply fear that needs, like the cancer, to be excised from the mind.

In the end, both the trauma and the cancer need to be accommodated and the sufferer must find peace in mind and soul with both—no matter the outcome.

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry at Georgetown University Medical School and author of several books. Her latest children’s book is Timothy Tottle’s Terrific Dream.

We Served Too—Remembering Civilian Sacrifices made in Behalf of our Country—Honoring those who Served alongside the Military in Conflict Zones and High Threat Security Environments

This Memorial Day all Americans send a heartfelt salute to all those warriors who fought and died so gallantly in recent and far off wars in behalf of our freedoms and safety.  In behalf of those who died, we can never thank them or their families enough for the ultimate sacrifice they made for our country.

Alongside that salute we now also need to begin to honor the oft forgotten civilians who also serve in war and high threat security environments alongside the military, supporting their efforts and working in concert with them—especially all those civilians who served in the two recent U.S. wars in Iraq and Afghanistan—as many civilian workers have also lost their lives while serving our country.

While we don’t often remember the sacrifices of civilian workers in conflict zones, or have a holiday to commemorate their service, we do need to honor that they too serve their country. 

A little known fact is that in September 2007 there were more contractors in Iraq than combat troops.  According to a 2013 report of the Special Inspector General for Iraq Reconstruction (SIGIR) reports that, “In September 2007, the United States had more than 170,000 combat personnel in Iraq as part of the counterinsurgency operation, with more than 171,000 contractors supporting the mission.”  These contractors are credited in the report for supporting “the counterinsurgency mission in unstable, yet strategically significant, areas such as Baghdad, Anbar, and Babylon provinces.” (Emphasis added)

Civilian contractor casualties it turns out may be one of the least known aspects of our recent wars. For instance, the Defense Base Act case summary report lists three hundred defense base act death claims filed for 2012 and since September 2001 it lists three thousand, three hundred and two civilian contractor deaths and ninety-one thousand civilian contractors injured in that time frame.  While not all of these deaths occurred in combat zones, the majority did.  Likewise not all of the civilian deaths are Americans—the Department of Labor does not release the names of the claimants or their nationalities so it is difficult to parse.  Many different nationalities—from Americans, Europeans and third world countries—serve our military and civilian efforts in conflict zones, with deaths and injuries spread across all.

As traditionally held military jobs have increasingly shifted to the private sector, including mess hall cooks, guards, drivers, interpreters, analysts, culture experts, trainers, etc. the risks to civilians serving inside conflict zones has also risen.  The New York Times reported in February 11, 2012 that, “More civilian contractors working for American companies than American soldiers died in Afghanistan last year for the first time during the war,” reporting that “at least 430 employees of American contractors were reported killed in Afghanistan: 386 working for the Defense Department, 43 for the United States Agency for International Development and one for the State Department”. 

Contractor deaths exceeded military deaths in Iraq in 2009 also and were nearly equal last year—fifty-four soldiers compared to forty-one contractor deaths according to the U.S. Department of Labor statistics.  Clearly civilians are just as likely to make the ultimate sacrifice as soldiers in Iraq and Afghanistan—yet so few know about or recognize civilian service to our nation.

When, Major General Arnie Fields was asked to comment for our newly formed organization We Served Too—an organization that supports and honors American and international civilian service in conflict zones and high threat security environments—he had a lot to say on how the shift to asymmetrical warfare now places civilian workers in the same danger that front line soldiers traditionally faced.  He states:

The dynamics of war have considerably changed in recent years.  The past ten years have been most significant.  The parameters that have heretofore defined the battlefield—or battle space—have been dramatically altered.  Military commanders in Iraq and Afghanistan have learned early on that the conventional ‘front’ and ‘rear”, which in earlier wars defined the most dangerous areas of the battlefield and the safest, respectively, do not exist.  The enemy’s threat is virtually omnipresent.  Soldiers not in direct pursuit of the enemy are in almost as much danger as those who are.  This new paradigm, often referred to as asymmetrical warfare, places civilians assisting in the war effort in about as much imminent danger as the traditional uniformed warrior…For example, as a civilian department of State employee in Iraq and as the U.S. Special Inspector General for Afghanistan Reconstruction, I wore my military flak jacket and helmet with more consistency while conducting my work than I did on active military duty in the Marine Corps.”  (Emphasis added).

Commenting on the medical aspects of service to our nation in conflict zones, Lt General Dr. Paul K. Carlton, Jr. also states “Military medicine has served as the tip of the spear in this conflict!
Our civilian medical system has been a superb partner to us and has to be
considered the shaft of the spear! They are integral to our entire effort!”
 

Indeed it is no longer only our military that are serving and sacrificing their lives in conflict zones.  As the Special Inspector General in Iraq pointed out in his 2013 report, government contractors, government civilian workers, nongovernment workers and even journalists are serving alongside our military and as Major General Arnie Fields states—while serving in asymmetrical warfare they may serve in equal danger to those previously considered to be in the “front” lines. 

While our military serviceman returning from Iraq and Afghanistan have faced shameful delays and nonresponsive replies from the Veterans Health Administration to get their claims covered—civilian contractors who return from the battle space with similar injuries—including limbs blown off, traumatic brain injury, PTSD, depression, traumatic bereavement and the like—have found they too have had to battle with the insurance coverage provided under the Defense Base Act (DBA)—a law requiring insurance coverage for those contracting with any agency of the U.S. government for work outside the U.S.

At present the recording of civilian contractor deaths in conflict zones is tought by many to be underreported and clearly these civilians die unheralded.  Likewise those who are wounded are finding it difficult to get their needs met. 

My wish today is for all service persons—civilian and military veterans alike—who return from our recent wars in Iraq and Afghanistan and from serving our great nation in other high threat security posts, to be honored—for their needs and those of their family members to be well taken care of, and for none of us to ever forget all those who served our country—civilian and military alike. 

In behalf of that, I and some other colleagues have begun an organization entitled We Served Too (www.WeServedToo.org) in order to honor and support civilian veterans of conflict zones and high threat security environments.  We are only on our first steps in that initiative, but invite you to join us in giving a hearty and respectful salute on this Memorial Day to all the civilians who also serve alongside their military counterparts and especially to those who gave the ultimate sacrifice.  May they be honored and never forgotten.

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry in the Georgetown University Medical School and author of Talking to Terrorists: Understanding the Psycho-Social Motivations of Militant Jihadi Terrorists, Mass Hostage Takers, Suicide Bombers & “Martyrs” In the last decade she interviewed over four hundred terrorists, suicide bombers, terrorist supporters, family members, close associates and hostages.

Post Abortion Distress—The Politically Incorrect Trauma

The recent trial and guilty verdict of Philadelphia Dr. Gosnell for murdering three children delivered alive after late term abortions has raised the controversial issue of U.S. abortion rights once again. It also reminds me of years of research I conducted documenting high stress reactions to abortion and the inability of many to discuss this issue in a rational and caring manner.  Having interviewed and treated women with high stress responses—including posttraumatic stress disorders and traumatic bereavement—as a result of abortion, I found myself deeply embroiled in the politics of abortion versus a genuine concern with whether or not all women do well with, and find abortion a useful coping mechanism for a problematic pregnancy. 

As my research carefully documented what a high stress reaction to abortion looked like, I found myself facing such career blocks thrown in my path as having the head of the National Planned Parenthood office write a letter to Harper & Row asking them to not publish my book on the subject—and to have the contract I was about to be offered suddenly rescinded—what seemed to me to be a clear violation of my First Amendment rights.  As a result, I found myself presenting my research in academic circles in a defensive manner so much so that I began to talk about post-abortion traumatic stress responses as “the politically incorrect trauma”. 

Unfortunately the politics of arguing over abortion rights has made many blind to the fact that women fall all over the spectrum of potential psychological responses to abortion—and while some find it a useful coping mechanism, experiencing it with minimal distress—others are deeply distressed by it.  And among academics and activists there are those who for decades now have refused to admit that there are a group of women who do not do well with abortion—and are even psychologically harmed by it.  Yet the fact remains that some women are harmed by the “politically incorrect trauma”.

The potential traumatic stressors involved in abortion are many.  For most they involve perceiving the pregnancy as a human being and the abortion being experienced as a traumatic death event.  This is worsened if they have formed an attachment to the embryo or fetal child in that they likewise experience a traumatic severing of the maternal attachment bond and deep questions about what severing this bond then says about them as women and mothers. 

While many women feel none of this—others are deeply disturbed by abortions that they go through for various reasons.  And let us not forget that many women—particularly young women and victims of domestic abuse (by parents or spouses) are forced into abortions they do not want.   Far more women are forced into abortions than anyone likes to admit.

Abortions are also physically intrusive and frightening for some.  The cramping and suction or viewing of fetal remains can be terrifying for some.  And in some cases the traumatic nature of abortion is a result of the doctor who performs it—his or her abusive nature or failure to perform the procedure in a medically sound manner.

While we would hope that Dr. Gosnell—if he can even properly be referred to as a doctor—is the rare case, I have unfortunately heard too many first person stories of similar although lesser horrors. 

Many women have told me of pregnancies that were not properly dated as the doctor only did their examination once they had already paid for and were fully committed to their abortions—as in up in stirrups and fully prepped for it.  And as pregnancy by physical examination and recall of last menstruation is not as accurate as ultrasound, one woman I worked with found herself with an incomplete abortion—she left the clinic thinking she had been given a first term abortion—when in fact she went home with the head and shoulder of an aborted seventeen week fetal child still left inside. Likewise a nurse told me of a hysterectomy done on a woman in which a live fetus was removed along with her uterus—the doctor never bothering to tell his patient that he had mistaken a tumor for a live fetus that he had then removed under anesthesia along with her uterus.  One abortion clinic doctor in Wisconsin admitted performing an abortion on a woman who was so distraught that she had moved into a dissociated state during her abortion and was talking baby talk during the procedure.  That doctor apparently never thought to stop the procedure and deal with the distress of her patient.

Likewise I have argued for years that most U.S. based abortion clinics fail to obtain a true informed consent.  When a distressed woman shows up at their door she is in many cases asked to fill out paper work including signing an informed consent and to pay for her procedure prior to meeting with any health care provider.  And the abortion procedure is often explained in many clinics in group settings (in a mill like format) often by a non-medically educated informant who explains the procedure without explaining all the options, nor insuring that each group member understands how pregnant she is, and what the procedure entails. 

Most women at U.S. abortion clinics only meet their doctors once they are up on the table in stirrups—hardly a time to carry out a careful informed consent procedure—to have time to respond with any careful deliberation to accurate dating of her gestational stage, etc. Women also leave such clinics often with little understanding of what to expect in terms of possible negative outcomes—particularly psychological ones such as traumatic grief, acute stress responses, overwhelming guilt, etc.  And if they do feel traumatized by their abortions they often don’t want to return to the source of the trauma and don’t know where to turn.  These issues of course are compounded for underage minors who may be acting in an acute state of fear without the protective guidance of an adult that truly cares for their well-being.

Some years ago I attended a U.S. medical panel over which Dr. Nada Stotland presided—a psychiatrist who has for years denied that women can be traumatized by the actual experience of abortion.  She and the other panelists bemoaned the fact that medical schools could no longer force unwilling doctors to learn to perform abortions, and that young American doctors were increasingly finding providing abortions unsavory and that increasingly, ill-reputed doctors who were forced out of their practices by lawsuits and the like were becoming abortion providers—with all the attendant scandals that same with them.  Apparently Dr. Gosnell was of this ilk.

Today we see a doctor convicted of murder for taking the lives of fetuses he had just taken from the womb.  I’ve always wondered about the teenagers who get similar convictions for denying to themselves or possibly even dissociating the fact of their pregnancies—until they deliver—often in inconvenient circumstances—such as at a high school dance or party.  Totally in shock at the delivery of a full term infant they toss the child aside and when the evidence of the “trash can baby” catches up to them they also receive convictions for manslaughter.  Yet if they had gone for a late term abortion and the doctor had managed to end the fetal child’s life while still inside the teen’s body it would have been a medical procedure.  There’s something highly schizophrenic about that—hardly something we can expect a young troubled teen in a high state of distress to fully comprehend.

Likewise we must admit that abortion is often also used against women.  Women all over the world have been forced into abortions they didn’t want—in China because of the one child policy.  Likewise female fetuses have been the subject of massive gendercide in both China and India.  Here in the states, some women are forced and coerced into abortions they don’t want by family members and many women feel ill equipped to stand up to a partner who believes paying for an abortion absolves him of his duty to pay child support if the woman opts to carry the pregnancy to term.  When it comes to abortion far more women than we care to admit, face choice-less choices.

The truth is every abortion represents a crisis of sorts—a failure of some kind—birth control, relationship, timing, one’s ability to provide for self and baby, etc.  And every abortion says something about the society we live in—where parents don’t have access to good day care and may not have health insurance or the wherewithal to provide for their children.  Whether one sees abortion as a life option, tragic necessity or as violence, we need as a society to find useful ways to discuss abortion, the way it’s provided and its effect on women and society. 

Dr. Gosnell was a sick doctor.  But there is also something wrong with a public health system that received numerous complaints about him and seemingly for political concerns did nothing to stop him.

Politics have also stood in the way of good research being conducted to examine psychological responses in a nationally representative sample to all pregnancy outcomes: live birth, miscarriage, induced abortion, and still birth (and perhaps even including adoption).  I offered in 1987 to our National Center for Health Statistics a simple mechanism for collecting such data via a short interview to be attached to an already existing survey—but fear of the answers—on both sides of the issue staunchly squelched the idea.

The politics of abortion and our inability to objectively seek the truth on these matters in a rational manner have for years thwarted my attempts to collect objective, nationally representative data on postpartum pregnancy outcomes.  And feminist researchers like myself—who have tried for years to painstakingly document and truthfully address the fact that not all women do well with abortion, have been all but silenced. 

The truth is not all, but some women having abortions—are traumatized, have anxiety responses, panic disorders, depression, acute and posttraumatic stress responses, psychosis, traumatic bereavement, etc.  There is an entire spectrum of psychological responses to abortion and when some women don’t do well with it, or are even abused by their provider, and become traumatized—that trauma should not be one more statistic under the rubric of  “the politically incorrect trauma” just because we wish to keep all options open for all women.  We must be able to talk rationally about these issues and to conduct good research on the subject.

And we must acknowledge that some women don’t do well with abortion—and sometimes—rarely so—but sometimes—it’s because the person who provided it was a butcher.

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” She is also currently serving as the co-chair of the American Psychological Association, Division 48, Presidential Task Force on “Research Agenda on Abortion from a Peace Psychology Perspective”.

 

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”

 

Zero Dark Thirty – And the Real World of Torture, Enhanced Interrogation, Rendition and Prolonged Detention

The disturbing torture scenes depicted in the recent film Zero Dark Thirty along with President Obama’s signing of the National Defense Authorization Act allowing for Americans on U.S. soil to be subject to indefinite detention and torture have once again brought the questions relating to the usefulness of rendition, indefinite imprisonments and torture (both lite and hard) back into the public consciousness.  With media depictions increasingly glorifying the roles of military and civilian intelligence officers—even those who rely on torture—surveys of U.S. citizens have shown an alarming increase of Americans who embrace the idea of torture.   Of course one must understand that people—on both sides of the “war on terrorism” —are increasingly likely to embrace violent and extremist measures in direct proportion to the more they feel threatened.

That being said, however, the thoughtful individual needs to examine some core questions—the first being—does torture in any of it’s forms, including “torture lite” work?  The answer appears to be a resounding no.  Torture for the most part fails as a tactic because it does not leads to credible information, is problematic later for anyone we wish to prosecute, and may actually contribute far more to terrorism recruitment rather than to curbing terrorism.  When dealing with al Qaeda for instance we must understand that most hardened terrorists who have blood on their hands have committed themselves to the idea of “martyrdom” and may be adept at misleading us when we believe they have cracked under torture. And when we resort to anything that is morally bankrupt they will later use it against us to show their constituents and potential recruits our “true colors”.

By contrast, interrogation that relies on rapport building has shown itself to yield positive results.  When I worked in Iraq helping to build the Detainee Rehabilitation Program for the 20,000+ detainees held there at that time by U.S. forces, three high value AQ operatives had been turned to our side as a result of a skilled and kind interrogator.  The simple act of sensitively inquiring about a head wound that needed treatment versus days of holding a person in stress positions, while denying him the ability to use the toilet as needed, and other abuses was much more effective in getting one of these operatives to switch sides, talk and to offer to assist us in our efforts to fight AQ in Iraq. Former FBI agent Jack Cloonan agrees, stating that we have been very successful in getting even hardened terrorists with blood on their hands to talk by using old fashioned methods of building rapport.  Interrogation and building rapport are actually acutely honed skills that rely on a high level of emotional intelligence and that should be carefully taught and used in place of brute force.

I also found in Iraq that many of the lower value detainees expressed genuine amazement that they had been humanely treated and not tortured while in U.S. detention facilities.  They as a result also became much more positive about the U.S. and had little to go home to tell their families and tribes against us.

Whereas when pictures of our misdeeds in Abu Ghraib circulated, they became a powerful propaganda tool for AQ recruitment, fueling claims we are not who we say we are.  Indeed when I interviewed an Iraqi sheik who had been held in Abu Ghraib he was three years onward still suffering from the shame and humiliation of the way he had been forced to strip naked and be photographed while his genitals were mocked in the presence of female soldiers in the room.  And this Sheik’s outrage did not end with him—it extended to his entire family and tribe who are all responsible to revenge for him.

 And if we combine his outrage with that of our already too high collateral damage tolls from drone attacks, the fear and anger in civilian populations engendered by our drones, our renditions, prolonged detentions and our use of hooding, darkness, cold, loud and disturbing music, small cells, solitary confinement, stress positions, water boarding and all the other permutations of “torture lite” that we have recently resorted to—our actions become profound and powerful recruiting tools for al Qaeda.  And whatever gains made are severely outweighed by the loss of the moral high ground that occurs when we are lowered to the level of our enemies and we ourselves make a mockery of our once highly cherished principles of human rights.

That power corrupts is a well-known adage.  The famous Zimbardo prison experiments demonstrated how role-playing students when placed in positions of prison authority over others quickly transformed into cruel guards.  In real life the UK learned this lesson as well.  When their forces were allowed to use highly coercive interrogation techniques against IRA prisoners they found that it quickly advanced to cruel threats and the actual use of violence.  The progression in Abu Ghraib similarly moved quickly from prisoner physical to sexual abuse. When oversight and limits are missing in prison situations, cruelty can quickly abound with serious repercussions for all. 

And neither the UK or the U.S. claimed any significant actionable Intel as a result of these two shameful situations.

While “torture lite” may leave no lasting physical scars, the psychological scars of arrest, prolonged detention without due process, rendition and “torture lite” all leave long lasting psychological scars.  Indeed, imprisonment itself can be traumatic when it occurs without due process.  Who among us would do well with being put in a cage with little to no outside contact whilst having their records and computers suddenly and completely impounded? Relationships, employment, businesses, marriage plans—entire lives go off track in such instances.

When I made interviews of Palestinians during the second Intifada who had been put in administrative detention I found many youth who emerged from not knowing why or how long they would be held were deeply traumatized.  Even hardened terrorist leader Zakaria Zubeidi, leader of the Al Aqsa Martyrs’ Brigade in Jenin and sender of suicide terrorists, told me he’d rather “martyr” himself than ever again return to a prison cell.  Chechens who faced serious torture echoed similar sentiments. This tells me that our use of administrative detention and “torture lite” may actually contribute to the hardening of many terrorists who fear imprisonment more than “martyrdom”.

So as we debate once again our methods of choice in the fight against terrorism I suggest we back off of secretive decisions in behalf of proxy torture, secret detentions, coercive interrogations and the use of torture of any type.  Instead we should once again become a society that publically debates these issues and wisely decides to uphold the fundamental human rights of all persons—even those of unlawful enemy combatants.  And when those times come when we have no choice but to detain terrorism suspects we must learn from our mistakes and know that mistreating them nearly always carries too high a price and leads to less positive results than treating humans with the dignity and care that is necessary to build real rapport that can yield real results.

Anne Speckhard, Ph.D. is the author of Talking to Terrorists: Understanding the Psycho-Social Motivations of Militant Jihadi Terrorists, Mass Hostage Takers, Suicide Bombers & “Martyrs”

Death from the Skies—Targeted International Assassinations via U.S. Drones

With John Brennan—considered by many to be the mastermind behind U.S. drone policy—nominated to be the next head of the CIA, we are hearing a lot about drones. And unlike those upon who drones reign down terror—it’s not the high pitch of an overhead motor that we are hearing.  Instead the discussion is all about kill rates, kill versus capture, terrorizing innocents and an absence of transparency about policy—particularly when Americans and minors are considered eligible targets.

Surgically precise and effective—drone strikes are argued by many to be useful in decapitating known terrorist leadership. However the truth is that noncombatants are also being effected and the human toll of that fact may be causing as much threat to our national security as live terrorist leaders also pose. 

Much of the damage caused by U.S. drone strikes is clouded in secrecy and the U.S. government rarely acknowledges the full extent of civilian casualties.  And how civilians are categorized is also arguable—for instance all adult males in the strike vicinity are often named as militants.  Data reported by the New American Foundation, informs that in Pakistan alone drones have killed between 1,953 to 3,279 persons since 2004—with between eighteen and twenty-three percent of these being civilians.  (In 2012, the hit rate on militants got better and the civilian kill rate went down to ten percent.)  The New American Foundation also estimates that of the 646 to 928 people killed in Yemen (in a combination of air and drone strikes) four to eight percent were civilians.

In addition to the civilian kills, researchers are finding that armed drones hovering over Pakistani communities day and night and suddenly striking homes, vehicles and public spaces without warning also causes considerable anxiety and psychological trauma in the daily lives of ordinary civilians—most notably children.  When families fear gathering for funerals; tribal leaders shun gathering in groups—even for tribal dispute resolution; children are kept indoors and community members dread public assemblies, a breakdown in society occurs and anti-American sentiment is greatly fostered.  Likewise when the U.S. becomes known for striking an area multiple times killing those who gather around the first strike—a behavior that unfortunately mirrors al Qaeda type strikes—and rescue and even humanitarian workers fear aiding injured victims—both societies—theirs and ours is gravely injured  in multiple ways (see the Stanford/NYU Living Under Drones Report http://livingunderdrones.org for more on this).

Indeed as the arguments of today are made in behalf of drone strikes we forget that it was not long ago—only twelve years back, in July, 2001—just before 9-11, that Martin Indyk our then American Ambassador to Israel, denounced Israel’s use of targeted killing against Palestinian terrorists stating, “The United States government is very clearly on record as against targeted assassinations. . . . They are extrajudicial killings, and we do not support that.”  Likewise, George Tenet, the then CIA’s agency director argued the week before 9-11 that it would be “a terrible mistake” for “the Director of Central Intelligence to fire a weapon like this.”

Times appear to have changed. 

 That we are winning the so-called “war on terror” by heavy reliance on drone strikes is not necessarily true.  For one thing killing militants versus capturing them means that valuable Intel that might have been collected from prisoners is never gathered.  And as YouTube videos of burnt drone victims—including pictures of child victims—circulate over the Internet and ideologues cry out for more recruits to protect the innocent Muslim ummah against “death from the skies” we may be unwittingly contributing more to global militant jihadi terrorism recruitment than we are gaining by terrorist decapitation. Researchers have long known that when a feeling of personal threat from an outside force increases, so to does social support and endorsement for terrorism among the civilian population thereby increasing the pool of potential recruits.

Moreover when there is a lack of public transparency over U.S. drone strike policies, failure to follow international laws regarding who can and cannot be targeted by lethal force—especially force administered by CIA operatives versus our uniformed military—and repeat strikes kill rescue workers aiding the victims of the first strike—we may be playing with real fire.  Soon other nations will also have drones and all will likely deem whatever practices we follow justifiable.  If all of these concerns are not addressed thoughtfully in the coming months they may conspire to create circumstance in which our government’s moral stance is considered so questionable that in relying on drone strikes we may be doing more—rather than less—to increase the dangers from terrorism.

 Anne Speckhard, Ph.D. is author of Talking to Terrorists: Understanding the Psycho-Social Motivations of Militant Jihadi Terrorists, Mass Hostage Takers, Suicide Bombers & “Martyrs” available on Amazon at http://www.amazon.com/Talking-Terrorists-Understanding-Psycho-Social-Rehabilitation/dp/1935866532/ref=tmm_pap_title_0

Christopher Dorner & The Murder/Martyrdom Mentality of Terrorists

As hundreds of investigators are trying to catch former LAPD police officer Christopher Dorner in one of the hugest man hunts in South California, the country is puzzling over his manifesto and recently declared war on the Los Angeles police.  His actions remind me of the psychological framework of terrorists who adapt a murder/martyrdom mindset to address either a real or perceived grievance.

Christopher Dorner may not be a true terrorist, and if he is one—he is a lone wolf—as he is not working with any terror group and he has not signed on to any terrorist ideology.  However, he has in common with terrorists that he is a non-state actor and attacking civilians (including law enforcement officers and their family members) to create terror in the community—in this case using extreme violence, attacks on civilians and a public manifesto and using the predictable media spotlight—to try to shape public opinion and to force the LAPD to address his claimed grievances regarding what he sees as racism.  And his stance of willing to murder others knowing it will likely end in his suicide, probably in “death by cop” are all hallmarks of terrorists that follow a murder/martyrdom mentality in behalf of their cause.

Christopher Dorner’s manifesto while narsiccisitic and grandiose is largely rational versus the rantings of the insane—and reflects the thoughts of a person who perhaps due to his own lifetime of painful experiences sensitized him, maybe over-sensitized him, to the issue of racism.  Like many terrorists who go down the terrorist trajectory, Christopher Dorner appears to have an individual vulnerability—as his self reports and those of others who interacted with him on the issue of racism evidence.  He appears to have a great deal of anger, even violent responses, to encountering what he claims was racism inside the LAPD.  The LAPD deny his charges although we do know that what happened to Rodney King is not an imagined event and that “whistle blowers” often do get silenced and pay a price without justice being done.  In this case, Christopher Dorner’s perceptions of events and his grievance over them—whether real or not—when not addressed by the LAPD in a manner that worked for him—was the trigger that moved him into the martyrdom/murder mentality in which he is now willing to kill and die for his cause. 

In my research over the past decade, I interviewed over four hundred terrorists, their close associates, supporters and hostages from around the world and I found over and over again that those who were willing to kill and die for their cause had gotten into this same type of mindset that allowed them to glorify murder/suicide.  According to their perceptions, and often of the group they became involved with (via the terrorist’s ideology) they came to believe that by using violence against civilians that they were bringing justice, being heroic, standing up for a cause, becoming a religious “martyr” and bending the political process to their will by their own self sacrificing death and murder.  Of course murder/suicide is never heroic but if one becomes convinced that it is, then those beliefs may begin to move that person into a grandiose state that is truly intoxicating.

Furthermore, psychologists know that the most likely predictor of suicide is that the person is experiencing overwhelming psychological pain—sometimes referred to as psychache—that drives him to chose suicide as an escape .  And we know that when deadly serious in their suicidal intentions, individuals often go “dissociative” before they kill themselves—that is normal cognitive functions drop out, they become detached from their normal way of thinking and feeling and the horror of what they are about to do—take their own lives and perhaps the lives of others as well. And in this dissociative state they also often spontaneously enter into a state of euphoria. 

That is why family members of suiciders often recall that the depressed loved one suddenly became “happy” or seemed “at peace” just before he took his own life. Indeed the psychological reprieve of making a definite plan that will afford an escape from overwhelming psychic pain coupled with what probably is a deeply ingrained psychological defense to overcoming the self preservation instinct likely delivers an opiod response in the brain that for many is experienced as pure euphoria.  

Similarly suicide bombers often claim that when contemplating their own death and the murder of others delivers a sense of euphoria. As they step totally away from the pain, they step into a dissociative bliss that accompanies taking one’s own life.  It seems that this euphoric state empowers a suicide/murderer to go forward to die while killing others, and if the cause is religious, to also believe that he or she is “on the path of God” and doing the right thing.

Of course media involvement is crucial to those who take on the murder/suicide or “martyrdom” ideology in their attempt to bend the political will of those they terrorize by using violence to call full media attention to their cause.  And receiving attention can also contribute to a sense of grandiosity.  This is problematic for the media who have the duty to report the news but also must struggle not to become mouthpieces for terrorists.

The answer to this murder/martyrdom mindset is complex, but one issue that should be addressed  in terms of prevention is to investigate, and when possible, correct real grievances of those who become so in pain and so enraged that they are willing to murder and die for their cause.  It becomes for them a sick passion whereby they come to believe that by using violence they can bend others to address issues as they see fit.  And once on their killing path, they are—as we are seeing in the case of Christopher Dorner—extremely lethal and difficult to stop.