Is War a Psychosis?

In 1967, the Scottish psychiatrist R. D. Laing wrote, “Insanity is a perfectly rational adjustment to an insane world. Normal men have killed 100 million of their fellow men in the past 50 years.” Wartime behavior deviates markedly from crosscultural social norms and values. The irrationality and emotionality of war is a radical departure from accepted normal behavior. In the heat of battle, killing becomes the norm and is reinforced, even rewarded. Wartime behavior of and by itself meets current diagnostic criteria for a severe mental disorder.

The United States was founded in war, the American Revolution, and has had wars in every generation from that time to World Wars I and II, Korea, Vietnam, the Persian Gulf, and now the Afghan and Iraq wars. That is not unique to the United States. Every world region has had a war. In the context of world history, it seems war is inevitable, and as philosopher George Santayana sadly observed in 1905, “Those who cannot remember the past are condemned to repeat it.

“Why war? Of all the personality theorists, Freud came closest to explaining the psychological roots of war. He speculated that war is an outlet for the thanatos libido, the “death instinct,” a basic instinctive drive that is the polar opposite to eros libido, prosocial and life supportive. Applying Freud’s insight, under the right circumstances the thanatos libido can rise to a level that overcomes reason and logic. It also emerges in a quest for power and the impulse to win or dominate. This tendency is evident in business, government, and competitive sports.

Situations and circumstances allow this primitive and predatory drive to surface, such as in the racist paranoia of lynchings in the U.S. South and the Indian wars in America’s West, à la Custer’s infamous last stand. The thanatos libido emerged in the holocaust in Nazi Germany and more recently in the ethnic cleansing of Bosnia, Darfur, and Rwanda. It was economic in Japan’s need for oil and the country’s attack on the U.S. at Pearl Harbor that began World War II for America. The death instinct has been political and nationalistic, in the colonialism of European nations in the seventeenth to nineteenth centuries and the quest for power and dominance from Napoleon to Hitler and Stalin into the twentieth century. It can be territorial, like tribal wars in ancient societies. And it can be religious, such as the Crusades and today’s extremist Muslims reinforcing millennia-old, seemingly irreconcilable differences.

There have been attempts at neutralizing this powerful instinctive drive and nonviolently resolving differences. Gandhi’s “salt march” opposing British rule in India led to India’s independence. But Gandhi was assassinated, and differences between Muslims and Hindus led to the establishment of Pakistan as an independent nation. Their armies still face each other in the continuing dispute over the Kashmir. Both have nuclear weapons.

The norm has been tens of thousands dying in religious wars, but nonviolent accommodation of religious differences does occur. Theravada and Mahayana Buddhists peacefully co-exist in many nations. They have had no religious wars.

But it is in war where the death instinct is most obvious. Atrocities–”crimes against humanity”–occur in every war. Ironically, we award medals to and hail as heroes or martyrs those who kill more of the enemy. One nation’s freedom fighter is another’s terrorist, even though it may be the same behavior. To Islamic terrorists, death in battle or a suicide attack is martyrdom; reward with a harem of virgins is said to be guaranteed. Suicide is especially attractive when many enemies are killed with the martyr. This was true for the 9/11 terrorists who flew hijacked airliners into the World Trade Center and Pentagon, inspiring others to follow their examples in Afghanistan, Iraq, and Israel.

World history offers many examples of extreme wartime behaviors, including Attila, Genghis Khan, and Alexander the Great. More recently, leaders such as Hitler, Stalin, and others in Africa, Asia, and Latin America have motivated thousands to take up arms and vent their aggression against targeted enemies. Extremist behavior is not limited just to charismatic leaders. Kamikaze pilots in World War II and today’s suicide bombers were recruited from the rank and file. Suicide as a chosen alternative has historical roots (e.g., Japanese hara-kiri).

These behaviors meet current criteria for mental disorder. For example, the diagnostic standard, the DSM-IV-TR (American Psychiatric Association, 2000) defines a dissociative disorder as “disruption in usually integrated functions of consciousness, memory, identity, or perception of the environment and impairment in social, occupational, or other important areas of functioning” (p. 239). Derealization (”Can this be really happening?) and depersonalization (”Is this me?”) are listed as typical symptoms. Victims are dehumanized into objects, and robot-like violence depersonalizes the aggressor in the process.

In 1957, psychologist Leon Festinger described the state of “cognitive dissonance,” which preserves “internal harmony, consistency, or congruity among opinions, attitudes, knowledge, and values” (p. 260). Waldinger defined delusion as “a false belief firmly held despite incontrovertible and obvious proof or evidence to the contrary, not one ordinarily accepted by other members of the culture or subculture.” What begins as bias and opinion, usually tolerated, can lead to distortion, then wrongful belief. Reinforced by charismatic leaders, there can be a downward spiral into delusion. Genocide in Nazi Germany and recently in Rwanda and the Sudan is evidence of this tragic process. And it is not limited to mass behavior. Street crime and domestic violence reflect Elbert Hubbard’s observation a hundred years ago: “So long as governments set the example of killing their enemies, private individuals will occasionally kill theirs.”

The environment in war lacks external controls. Societal values weaken. War disinhibits and desensitizes. The horror of the holocaust of World War II became evident only as time passed, not immediately. The Allies did not give it a high priority while it was happening. The perpetrators denied personal responsibility, using “the Nuremberg defense” that they were simply following orders. Defense mechanisms of denial, externalization, projection, rationalization, and splitting block reality testing have the effect of reducing anxiety and protecting against stress. Violence then becomes part of the array of defense mechanisms.

The strong drive that leads to the practice of beheading victims, common among Islamic extremists, suggests an entrenched, inflexible belief system of delusional proportion. It involves a grandiose quality the DSM-IV-TR describes as one “of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person” (p. 160). Wartime behavior suggests an extreme mental state of psychotic proportion and with it, often paranoid ideation–a simplistic “us or them” dichotomy. Killing becomes routine “business as usual.”

Delusional thinking is encouraged in signs, posters, banners, and statues that propagandize or deify a cause, leader, or martyr. Iran’s Ayotollah Khomeini, Iraq’s Saddam Hussein, and North Korea’s Kim Il Sung are examples. Emotion overrides reason and logic in public education and controlled news media that reinforce aggression. Schools teach children a biased version of history and current events, reinforced with songs and recitation: Hitler Youth, China and Russia’s Young Pioneers, North Korean “patriotic” school activities, and anti-West Islamic school curricula. Singled out, the United States is the common enemy (”Satan America”) and the cause of a nation’s problems. According to the DSM-IV-TR, these are neurotic defenses (externalization, displacement, isolation, denial, and rationalization).

On a smaller scale, cult-like groups develop similar impaired reality testing. Jim Jones in his People’s Church in Guyana caused the suicides of 913 men, women, and children by propagating the delusional belief the U.S. would soon invade their commune. David Koresh of the Branch Davidians refused to submit to lawful authority for almost two months, leading to his death and the deaths of most of his followers. Marshall Applewhite led the Heaven’s Gate cult in a group suicide to join with alien super-beings in Halley’s comet. The Taliban in Afghanistan executed people at soccer games, beat “uncovered” women on the street, and blew up centuries-old Buddha statues. These behaviors are not consistent with any definition of normality or sanity.

“Shell shock” of World War I and “combat fatigue” of World War II were precursors of what we now diagnose and treat as post-traumatic stress disorder (PTSD). This condition is evidence of the harmful impact of the wartime environment on both military and civilian populations. The phenomenon of war has been with us since cave dwelling tribes. Many of our fathers fought in World War I, brothers in World War II, we in Korea or Vietnam, and our children in the Persian Gulf, Afghanistan or Iraq. Throughout history, war has been taking place somewhere in the world.

A major feature of psychosis is impaired reality testing, and it is evident in wartime behavior. Hinsie and Campbell (1973) observed that “psychoses differ from other psychiatric disorders by certain features.” They listed four distinguishing features: disruptive severity, withdrawal in which “objective reality has less meaning,” affect that is “qualitatively different,” and regression that “may include a return to early and even primitive patterns.” They suggested the term “collective psychosis,” if it is shared “by an entire group.”

Freud had much to say about behaviors common in wartime. He survived the rise of Nazism in Vienna and saw firsthand its aggression and violence. He saw aggression as a basic drive that inevitably leads to conflict. There is a tendency to project it onto others, for instance, Nazis onto Jews and Muslim extremists onto “Satan America.” As early as 1933, he traced psychosis to a “repressed unconscious too strong that overwhelms the conscious” and a state “when reality becomes so unbearably painful the threatened ego succumbs to unconscious impulses.”

Experimental evidence of antisocial behavior in otherwise “normal” people exists. Milgram in 1974 and Zimbardo in 1973 showed how it is possible to violate societal norms. Milgram instructed volunteers to administer what they were told were dangerous electric shocks to others. Actually, there was no current in the equipment but volunteers did not know that. Zimbardo stopped his experiment of a mock prison when “guards” became increasingly aggressive. The behavior of army reservists at Baghdad’s Abu Ghraib prison is a recent real-life example of how aggression can become the norm in an environment of little or no external control.

Hopeful signs exist, however. The world now has a United Nations. For a thousand years, major world religions have developed and promoted moral standards. Colonialism and imperialism have given way to independence among nations. Science and technology improve the quality of life.

But wars continue. Technology develops more weapons. As in ages past, soldiers face each other with the stark realization that only one will survive. To people in war-torn nations, it may seem the world has gone mad. Many veterans of wars return home unable to cope with their own and others’ extreme behaviors.

War is a tragedy for both sides. That it continues is an even greater tragedy, a downward spiral of world civilization of psychotic dimension.

War is a psychosis!

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