17 July 2009

Why terrorists choose soft targets

Nine people were killed in bomb blasts at posh hotels in central Jakarta. Health24’s Cybershrink takes a look at the psychosocial aspects of terror attacks.

Nine people were killed in nearly simultaneous bomb blasts at the JW Marriott and the Ritz-Carlton hotels in central Jakarta.

It is the second time in six years the Marriott has been targeted, after a car bomb killed 12 people in 2003.

Health24’s Cybershrink takes a look at the psychosocial aspects of terror attacks.

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 acts of terrorism 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.

The survivors of acts of terror are normally 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 may be 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.

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.

Fortunately, people can show surprising reserves of resilience and hardiness, and many may recover to a degree that may surprise their caregivers.

Post Traumatic Stress Disorder (PTSD) arises as a delayed response to a traumatic or stressful event of an exceptionally threatening or catastrophic nature, such as acts of terrorism, hijackings, physical assault or natural disasters.

Signs to look out for
According to the Diagnostic and Statistical Manual of Mental Disorders, people who have PTSD are those who:

  • Have experienced, witnessed or were confronted with a traumatic event that involved the threat of death or serious injury to themselves or others, causing them to respond with intense fear, helplessness or horror.
  • Persistently re-experience the event through intrusive thoughts, dreams, acting or feeling as if the event were reoccurring, and/or intense distress and emotion when exposed to cues that symbolise or resemble the event.
  • Avoid stimuli associated with the event and attempt to numb their general responsiveness by avoiding thoughts, feelings, conversation, activities, places or people associated with the trauma.
  • Are unable to recall important aspects of the trauma and loss of interest in participating in activities.
  • Feel detached from others, have a restricted range of emotions and are often unable to have loving relationships.
  • Feel little hope for their future.
  • Experience symptoms of increased emotional stimulation such as difficulty sleeping, irritability or angry outbursts, difficulty concentrating and exaggerated or startled responses.

For a diagnosis to be made, these disturbances must continue for at least a month and cause significant distress or impairment in social, occupational or other important areas of functioning. Should traumatic stress symptoms persist beyond four to six weeks, therapy is indicated and medication may be necessary.

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. As a country, 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)

(Health24, Updated July 2009)


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