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17 April 2007

Psychosocial aspects of the Beslan Massacre

Prof Michael Simpson, Health 24's Cybershrink and an internationally recognised trauma expert, comments on the tragic events in Russia.

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The siege of the large school in Beslan, North Ossetia, Russia, by terrorists always seemed likely to have a tragic ending, but its mishandling by the Russian authorities may lead to more serious consequences for the victims of this barbarism.

The botched interventions
Early on, it at first seemed almost refreshing that the media were being allowed access to the scene, when we remembered the decades in which Russia tried to deny the reality of plane crashes and other disasters and to exercise total control over the reporting of such events. But when the killing started on Friday, September 3, it rapidly became clear that the situation represented something much nearer to sheer chaos than any conceivably planned response or intervention. One might even ask the radical question, as to whether the outcome might have been better for the children and citizens of Ossetia if the authorities had totally ignored the emergency and had not intervened at all.

There was, as we watched live on satellite TV, an astounding degree of absolute pandemonium, with unidentifiable persons rushing about. No proper perimeter was controlled, enabling people from the community to intervene at random, and making it easier for any terrorist who had thought to bring civilian or Russian military clothing, to simply merge with the crowd and fade away. Indeed, one wonders how many casualties were caused by what is, in that macabre term, called "friendly fire".

It requires a rather profound misunderstanding of such a situation to produce a result worse than complete non-intervention.

Hostage negotiation
There was, for instance, what appeared to be an unwisely uncritical acceptance of the idea that normal hostage negotiations could succeed in bringing about a peaceful conclusion to the events. But several absolutely basic aspects of the situation were being ignored. Though our ability to negotiate in hostage situations may have improved significantly over recent years as a result of our studies of the nature and normal developmental course of such events, it seems to have been forgotten that the sort of groups devoted to the active creation of fear and disorder by such acts of terrorism, have also been studying us. If they are good at their grisly business, they should know what the negotiators will do and expect, and how to counter likely moves to wrest control of the situation from them.

"Hostage negotiation" techniques such as were eloquently described by a parade of pundits during the Beslan siege, are indeed generally effective when used when hostage taking is a private activity, conducted by psychologically disturbed private citizens under extreme and muddled stress, or by ordinary self-serving criminals seeking to maximise the personal benefits for themselves. But it is far from clear whether these are likely to be useful interventions when the motivations are so different, as they were in Beslan.

With suicide bombers and terrorists who not only do not fear death for themselves, but actively seek it with fervour, believing that it will bring them political and religious glory, there is no valid threat in a death penalty, as they have no wish to avoid their own destruction. Offering safe passage is unappealing to a jihadist wanting confrontation and an accelerated admission to paradise. In private and criminal hostage situations, the hostage-takers generally want to survive and to gain certain explicit and possible goals - be it immunity from prosecution, child custody, the return of an errant spouse, a helicopter and a million dollars. All this could be promised and even provided.

But when as in Beslan they make no demands, or only utopian and grandiose demands which they know absolutely cannot and will not be agreed to by the government concerned, when they do not want to be satisfied, the negotiator is severely limited. There are various ways in which the negotiators try to establish warmer relations with hostage-takers: but this group insistently refused to accept food, water or medical supplies. They were not planning to survive the episode, nor did they want their hostages to be safer or more comfortable.

Targeting the innocent
While the ordinary hostage-taker wants something which might be given, the terrorist wants terror, and does not want the horror to be ameliorated or limited. We complain about their abuse of "innocent victims" without recognising that the more innocent the victims, the greater our degree of outrage and horror, the more satisfied is the terrorist. Guilty or unappealing victims would be useless to them. Perhaps the assembly least likely to be taken hostage by terrorists would be a convention of politicians and lawyers!

Terrorism is a technique of instrumental violence, in which A threatens horrible damage or death to B, in order to influence C. C may be a government, or the public at large, hoping that we might influence the government in such a way as to suit the purposes of A, the authors of the violence. But there is an evolving pattern that is even more nearly hopeless to confront, and exemplified by al-Qaeda and its ilk. They have never had any really coherent political agenda, and that which has been sketchily described by them is wildly unrealistic, grandiose and messianic. Their main aims appear to be several, including the intoxicating sense of power they gain by frightening and appalling others, and their sheer delight in chaos and disorder. To a degree they are seeking publicity, but they're like the drunk who grabs the microphone at a meeting, then can't think of anything to say.

At one level, some of their actions may be announced to be about such goals as "the freedom of Chechnya" or "the freedom of the Palestinian people", but absolutely none of their actions have ever brought such aims any closer to being achieved, indeed they have generally made them much less likely to be accomplished. In fact, they hijack such causes for their own ends, to provide a surface gloss of a possibly worthy cause. Their activities are not about the needs they mention in their garbled manifestos and declarations.

The likely impact on survivors
What is the likely impact of the Beslan massacre on the survivors? We are much more aware nowadays of the likely psychological damage which usually outlasts most of the physical damage caused by such atrocities. All the children were exposed to the threat and in many cases the reality of direct physical violence towards themselves, as well as witnessing acts of appalling violence towards others. In addition, they were deliberately stressed with fear, hunger, thirst, uncertainty, and degradation - all elements typically used in "brain-washing" methods, in order to induce intended significant psychological trauma.

In addition, the complete chaos and disorganisation into which the victims emerged from the school, will probably add to the harm. Much of the damage caused by such traumatic events can be reduced if the victims emerge into a calm and comforting community, in an atmosphere of composure and confidence; but not if the community they re-join has itself become disorganised and needy. Their families and community were themselves severely traumatised by the experience and what we saw to be only extremely limited information and an absence of support. This will limit the ability of family and community caregivers themselves to be as helpful to returning victims as is needed.

Fortunately, children can also show surprising reserves of resilience and hardiness, and although all will have been deeply upset, many may recover to a degree that may surprise their caregivers. Sadly, we have heard and seen nothing of any possible gathering of Russian psychologists and others with experience in dealing with trauma, to help the children and adult survivors, and to advise the parents and communities. I am not aware of any such group within Russia which could provide such help, though the need for creating such a facility has been obvious for many years. There are a considerable number of skilled trauma specialists around the world who would be able to help, though with the language barriers, they would need to do so through training and supervising local psychological personnel.

In South Africa, where I and others have strongly urged the Ministry of Health to develop plans and facilities to deal with such events, the advice has been ignored so far. Maybe this is an opportunity for that failure to be reconsidered. Like Russia, we need to be capable of a coherent and practical response to the psychological and social components of major disasters, whether natural or man-made, not only in a strictly military sense, but also so that prompt and expert psychosocial interventions might limit the damage caused. - (Prof Michael Simpson, psychiatrist)

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