Ideological Terrorism As a Mental Health Issue

This is probably the strangest bit of random philosophizing I've ever done. But I had this idea about terrorism and I thought I'd write it down.

In the US and in many countries around the world, there are laws that allow people to be committed involuntarily as the result of mental illness. In the United States, there are many kinds of safeguards against false or unnecessary imprisonment, which can be summed up as the following basic principles:

• The person must be found to be mentally incapable by a psychiatrist or panel of psychiatrists.
• Because of their mental status, the person must be a danger to himself or herself, or to other people.
• The danger to self or others must be such that only institutionalization can prevent harm.
• While in the institution, the individual must receive treatment for their disorder.
• While in the institution, the individual's status must be reviewed frequently (e.g., every six months).

I believe that terrorism--the deliberate slaughtering of innocents--is the product of the worst kind of conduct disorder and delusional mental status. There is currently no "official" diagnosis in the APA manual for "Ideological Terrorism Disorder" (ITD), but I think that one could be well-motivated and clearly defined. Even in the absence of a separate diagnosis, there are components of existing disorders that can be identified with terrorism: delusions of various sorts, paranoia, depression, conduct disorder, and obsessive-compulsion. But the core disorder, it seems to me, is that the individual terrorist has been infected, so to speak, with an ideology that cancels out normal standards of social awareness, and that promotes terrorism, even self-destructive terrorism, by the individual. There have been many such ideologies; this is by no means an attack on the currently most frequent one in cases of terrorism, so-called Islamism.

The question has often been asked, why so few Islamist terrorists? If the ideology intrinsically promotes violence, why is it that only a few individuals actually commit terrorist acts? I believe that this state of affairs is strong evidence for the terrorism-as-mental-illness hypothesis that I am promoting here. That is, as the ideology itself becomes prevalent throughout the community, ITD is triggered only in susceptible individuals, not universally.

If this hypothesis is accepted--and I'll return to an important reason why it will be difficult for this to happen--then it follows that ITD individuals are not responsible for their actions, any more than other mentally deranged individuals are for theirs. Therefore, the issues of guilt and punishment do not apply to them. Instead, the important question is whether those individuals present a danger to themselves or to others that cannot be controlled without institutionalization. If an individual presents with ITD, they are almost by definition a danger without institutionalization, and so in most cases, an ITD diagnosis would lead directly to long-term institutionalization, until periodic review indicates that the person no longer has ITD.

I believe that this approach is highly satisfactory compared to the military or criminal approaches that we now apply, for two reasons. I think that this approach will be more effective at preventing harm to the individual or to society, and I think that it offers the possibility of treatment and possibly a return to normal or near-normal life for the ITD individual, through out-patient monitoring or eventual remission and release.

Why isn't this approach already in place? In the face of the horrible acts perpetuated by ITD individuals, why hasn't the mental health community and the government responded in the manner outline above?

There is an existing problem with the diagnosis of delusional disorders: many delusions are so widespread that they cannot be considered abnormal. I may offend many here, but the prime example of this is religious delusions. There are many psychiatric patients whose delusional systems involve religious aspects. Millions of "normal" people accept as true the reports that Jesus, Moses, Muhammed, or Joseph Smith conversed with God or with angels, and that God, angels, or other supernatural entities affect their daily life. Society can accept this kind of delusion as long as it is benign, that is, that it doesn't cause antisocial acts. This fact interferes with the diagnosis of some individuals, such as many schizophrenics, whose delusions tend to run along conventional religious tracks. For example, we accept that people somehow hear God telling them what to do, as long as their actions are not harmful to themselves or others, or are not outside the conventions of normal behavior.

This can also be true of non-religious ideologies. People can become "true believers" in such things as racial or national superiority, or that certain social systems are inherently bad or even evil, as long as they do not harm others or themselves, or become too eccentric in their personal behavior.

This makes the task of diagnosing standard disorders such as schizophrenia more difficult, not to mention a disorder like ITD where the defining symptom, outside an ideology that is shared by millions of "normal" individuals, is the commission, planning, or substantive support of acts of terror. Yet, there seems little doubt that in susceptible individuals, certain ideologies have been demonstrated to trigger antisocial acts, including terrorism.

I do not think that simply because ITD individuals may share the same ideology as people who do not commit antisocial or terrorist acts, that we should fail to recognize the fact of the disorder; that the disorder, with proper study, may have brain correlates and may eventually be treatable. If we are to combat terrorism, and if terrorism is the product of a mental disorder, as I believe the facts indicate, then the failure to involve the mental health community, and the system of laws, procedures, and safeguards that exist for them to use, is like fighting with one arm behind our back.

The US government has imprisoned hundreds of individuals, and our leadership has basically spun a web of legalalistic rationalizations to support their continued imprisonment, in ways that go against our legal tradition and our constitution. However, if ITD were recognized, along with peer-reviewed, tested standards of diagnosis and treatment, it is my contention that the individuals we have imprisoned could have been treated much more justly using the mechanisms of our mental health system mentioned above. Their rights would have been protected, but also their safety and the safety of society, in an open and compassionate way.

One final thought. What about people like Osama bin-Laden? He personally, as far as I know, has committed no terrorist act; certainly no act of suicidal terrorism. Where does he fit into this picture?

I think that bin-Laden is a sociopath. He understands very well the processes of ITD, and he works to trigger it in as many susceptible individuals as he can, and he assists them in manifesting their disorder by carrying out ideologically motivated terrorist acts. This kind of malevolent parasitism has been seen from time to time in the past, where a sociopath has manipulated mentally ill individuals to carry out acts of violence, but because of the very nature of ITD, it is possible for al-Qaeda to work on a much wider scale, and for a much more focused purpose, than in the historical examples of the deliberate manipulation of schizophrenics.

In summary, I suggest that there is a mental disorder that I have labeled Ideological Terrorism Disorder, ITD, that is at the root of the vast wave of terrorism we are currently witnessing; that ITD individuals should be handled via the mental health system rather than solely by the military and criminal justice systems; that this approach would be more effective in protecting society as well in protecting the ITD individuals themselves.