The New York Sun has an interesting editorial report on Mayor Bloomberg's visit to the State Department yesterday. In Bloomberg at Foggy Bottom, our Mayor discusses the economic benefits of keeping the UN in New York and the article contained a number of remarkable statements, but the one I find most revealing is this:
In addition to the financial benefits that would accrue to New York were the United Nations to be moved out of the city, there is the political — or even moral — dimension to the question, on which the mayor, in his remarks in Washington yesterday, gave a little homily as well. "From America's and the world's point of view, I don't agree with a lot of the things that are said in the United Nations," he said. "But it's kind of hard to argue, I think, that talking — it may not bring you anything, but I don't see any downside. And just maybe, every once in a while, people looking each other in the eye and talking will come up with some ways to make the world a safer, better place."
This is, of course, nothing more than a restatement of the conventional wisdom that talking, usually inaccurately described as diplomacy, is always beneficial and always preferable to the alternatives. This idea is worth examining.
Consider the paranoid patient. The fundamental psychological process in paranoia is projection, the unconscious defense whereby a person attributes his own (disavowed) impulses, thoughts, and feelings to others. The paranoid often feels suffused with helpless murderous rage, which is unacceptable, and projected into the outside world. "I do not hate and want to kill you; you hate and want to kill me!" When paranoids become dangerous is precisely when their projection is most intense and feels most real to them. At those moments, the plots which surround them and focus on them are absolutely real to them. Once their reality testing has become so impaired that they cannot see anyone as neutral or benign, they are at risk of acting on their terror and attacking others.
[Please note, for all those who may be confused about how to tell paranoid projection from realistic fear, in the case of realistic fear there is always a clearly identifiable basis, in reality, for the fear. Thus, our fears of Iraqi WMD may have been exaggerated and based on incorrect intelligence, but the fears were in no way a projection, since there was good reason to believe in their existence at the time and even better reason to believe that Saddam Hussein had the intent to use WMD and reconstitute his full program once UN sanctions were lifted.]
In my work over the years with paranoid patients, most fit into the more benign category of impaired people who were usually of most danger to themselves. These people were certainly paranoid and frightened, but by virtue of their innate passivity or some residual reality testing, would be very unlikely to act on their paranoia. Often they would tolerate treatment with the powerful medicines necessary to treat their conditions. (This could almost never be initially accepted as direct treatment for their delusions, but would often be tolerated as medicine which could help them ignore the "external" influences that were affecting them, or allow them to sleep, to quiet voices, etc.)
A second, rarer, more troublesome type of paranoid was the patient so caught up in his delusions that he was not amenable to any kind of reason. Offering medicine or hospital admission was a priori evidence that the Psychiatrist had become "one of them", one of the enemy who devoted time and energy to keeping the paranoid down and preventing him from achieving the greatness that would otherwise be his deserved fate. In such cases, there was always a real danger that the patient could act out in an explosive way. However, the judicious appearance of the Hospital Police, preferably 4-6 men exceeding 6 feet in height, would have a salutary effect on the patient and allow his to use whatever vestiges of reality testing that he had retained to peacefully accept his fate. There were often tense moments, but the actual danger, in a well managed situation, was negligible. The key point was to recognize that the patient was terrified of (his disowned) aggression. If the Psychiatrist behaved in an obsequious manner, the patient would correctly deduce that the Psychiatrist was frightened. That would increase the patient's insecurity and make violence more, not less, likely. This lesson was painfully learned on many occasions by Psychiatric Residents at Bellevue Hospital and most Residents interviewing patients new to them in the Emergency Room always made sure to keep the Hospital Police in sight or earshot.
The rarest of the paranoid patients were the most frightening. One particular patient I saw, while on a rotation during Medical School through the prison ward at Bellevue Psychiatric Hospital, was instructive. Mr. H was a 6' 4" man, over 200 pounds, and stocked with "prison muscles." He had a history of violence and was facing assault and murder charges. He had been remanded to the Bellevue Prison Ward to ascertain his psychological fitness for trial. The prison ward had a 12' X 12' cage, enclosed by bars, in which we would meet any new prisoners during our morning rounds. The Attending Psychiatrist and I would interview the patient and come up with a working diagnosis and treatment plan. On this particular morning Mr. H, a hulking, intimidating presence, appeared before us. There were two rather sizable guards (Corrections Officers, with significantly better training, rather than Hospital Police) in the enclosure with us, which normally led to feelings of relative security, though they were dwarfed by Mr. H. He was polite, soft spoken, and answered all our questions. He knew why he was there and understood the charges against him. He then proceeded to explain that he was being held against his will, that he was innocent, and in reality he was the victim of persecution by various hostile forces arrayed against him. He continued in the same polite tone that he was in full command of his faculties and ready to leave; if we let him go he would be able to find and uncover the plot that had led to his arrest. The Attending explained that we did not have the authority to release him but would let the Judge know what he had said. He insisted he had to be released. The tension level began to rise and an additional number of guards moved toward the cage. In a matter of moments, Mr. H rose to his full height, slammed his fists on the table between us (rarely have I been so pleased to be sitting behind a desk) and attempted to pick up his chair, which was bolted to the floor. The two guards acted quickly but were unable to control this now frightening man raging with psychotic strength against us, against the guards, the system, descending into screaming incoherence. It took 6 guards to subdue the man, two of whom ended up in the hospital, one with a concussion and the other with a fractured arm. Unless you have seen this kind of inchoate, primitive rage at first hand, you do not know what anger can be. The point is that no amount of talk, no amount of diplomatic niceties, was going to have any impact on this man.
Here the question becomes, are we dealing in the international arena with rational actors who sometimes knowingly use externalization, a more nuanced and reality based form of projection, or are we dealing with people who have lost the capacity to differentiate between their own delusional projections and reality.
I purposely started this post with some comments about the UN, an organization that represents the apotheosis of the international community's conviction that talk is always the answer. The Middle East is the part of the planet where such questions, about the depths of paranoia and the limits of talk, are most acute.
A current source of outrage in the Middle East is the Israeli Mughrabi renovations, which are taking place hundreds of meters away from the Al Aksa Mosque, yet are being used to foment violence and direct Palestinian, and Arab, hostility where it presumably belongs, onto the Jews:
Numerous Arab leaders, Islamic groups and Palestinians have called for violence and jihad if the work were not immediately halted.
The Elder of Ziyon discusses the question, Where are the Muslims who can distinguish facts from fiction? and helpfully, documents Arab projection:
The answer can be summed up as Elder's First Rule of Muslim Projection: Muslims will project their own crimes and worldviews on everyone else.
It cannot be denied that Islam, along with many other religions, holds a supremacist worldview. This is natural - everyone believes that their belief system is superior to others. But what is little discussed in the West is how extreme Islam's brand of supremacy truly is.
I cannot claim to be an Islamic scholar but it is very hard to find Islamic leaders saying that they do not subscribe to the idea that Islam is meant to literally rule the world, by any means possible - by proselytizing, by demography, by war. The thinking is simple and explicit: dhimmis live as second-class citizens, infidels do not live.
When one grows up with this viewpoint, one assumes that his enemies also grow up with their own versions of the same viewpoint. So for Muslims to say that non-Muslims are determined to destroy Islam is a natural and foregone conclusion, and that is where fantasy becomes Muslim reality.
In other words, Muslims view the West - and Jews in particular - as if they think like Muslims do. Just as Jordan destroyed every synagogue in Jerusalem's Old City in a matter of days after gaining control in 1948, and this was considered natural, the Muslims assume that Jews have been planning the destruction of all mosques in Jerusalem since 1967 (the oft-repeated "Judaizing" meme.)
Read his post, especially to see the article from 1948 that explains his points, and try to answer his question:
The next question then becomes, how can Israel or the West as a whole negotiate with a people who cannot distinguish between reality and their own paranoia?
The most benign interpretation is that the Palestinians, and their Arab enablers, are knowingly using the Mughrabi construction project as a pretext to facilitate externalizing their problems onto the hated Jews. More ominous interpretations would be that many, perhaps most, of the Arabs believe their projections and are effectively paranoid, reflecting a culture that facilitates paranoid thinking. I would suggest we are well past the point where talking can have any impact on such thinking. Ideally, the Western world would unite and demand, with the implicit threat of force, that the Palestinians behave as members of the civilized world, even if the Palestinians continue to believe in their most paranoid fantasies. By appeasing their delusional projections, more violence is almost guaranteed; that is how paranoia works.
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