Terrorism, suicide bombing, fear and mental health.

This paper is based on the Bruce Burns Memorial Trust Lecture, Terrorism and Mental Health, presented in October 2005, in Birmingham. In addition to written sources, it is informed by the author's experience and contact with military and police experts in this arena over 28 years as a member of the British Army. The diagnosis and treatment of post traumatic mental disorders are not addressed in this paper. The author explores the general phenomenon of terrorism, in an endeavour to inform understanding of terrorist acts. He stresses the need for contextualisation of acts of terror, their perpetrators, their effects on populations and individuals, and attention to the psychology of groups. The author aims to invite and inform further thought and debate on the subject by raising a wide range of issues which do not sit comfortably within a strict psychiatric, research-based paradigm. The author covers a brief history of terrorism; organisational requirements of terror groups and the process of recruiting personnel to them; the means, motives and opportunities terrorists exploit in their work; the need for communication with terror groups; sacrificial death; governmental responses to terrorist acts and fear and mental health. The author proposes that terrorist organisations perform some of the functions of a family; that acts of terror are 'propaganda by deed'; that terrorism, or more precisely the media's treatment of it, breeds 'formless fears' which may directly lead to the development of fear-based symptoms and illness within societies. He notes that terrorism is an enterprise from which many players ('experts', media, politicians, etc.) benefit; that terrorism has its shadow in counter-terrorism, which may range from benign to malignant and that psychiatry could, in this context, acknowledge its bias towards individual psychologies and rectify its lack of understanding of groups and the behaviours of individuals within them.