COMMENTARY

Are Terrorists, By Definition, Psychotic?

Ronald W. Pies, MD

Disclosures

December 16, 2015

Introduction

When people behave in an extreme and violent manner, it is tempting to assume that they must be "crazy" or "mentally ill." So when we view the violent atrocities of groups like the Islamic State ("ISIS"), we may imagine that the perpetrators are "psychotic" or severely disturbed. But there is little evidence to support this notion, and most research on terrorism doesn't point to severe mental illness as a significant causal factor.

Of course, the definitions of "terrorism" and "terrorist" are highly contested. Indeed, psychiatrist Jeff Victoroff, MD, associate professor of clinical neurology and psychiatry at the University of Southern California Keck School of Medicine in Torrance, California, suggests[1] that "there are roughly as many available definitions as there are published experts in the field." Furthermore, as Victoroff notes, any effort to uncover the "terrorist mind" will more likely result in uncovering "a spectrum of terrorist minds." Nevertheless, if we can agree that most terrorists are persons who use violence against noncombatants in order to advance a particular political, psychological, or ideologic goal, we can then begin to explore the mindset of specific types of terrorists. For example, terrorism expert Jerrold Post, MD, professor of psychiatry, political psychology, and international affairs at the Elliott School of International Affairs in Washington, DC, distinguishes between "nationalist-separatist terrorism" (eg, that of the Irish Republican Army) and "religious-extremist terrorism"—a subset of which is "suicide terrorism" of the sort we witnessed recently in Paris.[2]

In his book, The Mind of the Terrorist,[2] Post notes that, in recent years, most religious-extremist terrorists have grown up in "a culture of martyrdom." By the time volunteers enter a terrorist cell, Post notes that "they require very little indoctrination, only technical training." In effect, religious leaders in some Arab countries have reframed suicide bombings as "martyrdom operations," which these authorities praise as the highest level of jihad. This is a powerful inducement to carrying out terrorist acts. We might consider this a kind of cultural "sickness," but it is not a manifestation of mental illness.

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