Since the terror attack at Fort Hood there has been a great deal of teeth gnashing and brow furrowing in the media and among military and government officials trying to make sense of what the President, in his speech, deemed incomprehensible. When a person commits an incomprehensible act it is commonplace to wonder if he were psychotic, ie out of touch with reality. NPR asks the question explicitly:
Walter Reed Officials Asked: Was Hasan Psychotic?
Starting in the spring of 2008, key officials from Walter Reed Army Medical Center and the Uniformed Services University of the Health Sciences held a series of meetings and conversations, in part about Maj. Nidal Hasan, the man accused of killing 13 people and wounding dozens of others last week during a shooting spree at Fort Hood. One of the questions they pondered: Was Hasan psychotic?
"Put it this way," says one official familiar with the conversations that took place. "Everybody felt that if you were deployed to Iraq or Afghanistan, you would not want Nidal Hasan in your foxhole."
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Both fellow students and faculty were deeply troubled by Hasan's behavior — which they variously called disconnected, aloof, paranoid, belligerent, and schizoid. The officials say he antagonized some students and faculty by espousing what they perceived to be extremist Islamic views. His supervisors at Walter Reed had even reprimanded him for telling at least one patient that "Islam can save your soul."
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But psychiatrists and officials who are familiar with the conversations, which continued into the spring of 2009, say they took a remarkable turn: Is it possible, some mused, that Hasan was mentally unstable and unfit to be an Army psychiatrist?
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One official involved in the conversations had reportedly told colleagues that he worried that if Hasan deployed to Iraq or Afghanistan, he might leak secret military information to Islamic extremists. Another official reportedly wondered aloud to colleagues whether Hasan might be capable of committing fratricide, like the Muslim U.S. Army sergeant who, in 2003, killed two fellow soldiers and injured 14 others by setting off grenades at a base in Kuwait.
I quoted liberally from the NPR article because it suggests some of the terrible difficulties we have in comprehending what is in reality not incomprehensible, and the ways in which our mental set, weltanschauung, inhibits our ability to understand and deal with Jihadi behavior.
The usual definition of psychosis is "a mental disorder characterized by symptoms, such as delusions or hallucinations, that indicate impaired contact with reality." Since there is thus far no evidence that Hasan suffered from hallucinations (hearing voices), his psychosis would need to depend upon the existence of delusions, defined as "Psychiatry. a fixed false belief that is resistant to reason or confrontation with actual fact: a paranoid delusion."
There is an obvious limitation with this definition of delusion. After all, to a non-believer, most religious dogma and mythology would be considered delusional. what must be added to the definition is that the "fixed, false belief" be idiosyncratic; in other words, the particular belief is not part of a shared system of thought. As an example, if a single person in 1985 became convinced that human activity was warming the earth irreversibly and would lead to the destruction of the biosphere (in the absence of any scientific data) we would have had no trouble considering him to be out of touch with reality, as understood at the time. Today we might dispute the scientific data, remain convinced that most people who support AGW do not have a scientific grasp of the data, and that proposing to destroy our economy to "save the planet" is pernicious nonsense; however, it is clear that enough people share the belief system that it does not represent a delusion. A person who believed in AGW because G-d told him the planet would be destroyed because of man's sins would be psychotic; a person who believed in AGW because AL Gore told him the planet would be destroyed because of man's sins would not be psychotic. (Please don't take this as another argument about AGW; that has been discussed innumerable times here and elsewhere; eventually, the data will be determinative.)
The problem for all of those wondering about Major Hasan is that they are restricted by their own frame. In a vacuum, an American who believes that the United States is waging war on Islam, that the West, especially the Jews and Americans, conspire to keep the Muslim world in despair, and that murdering unarmed American soldiers is an assured way to gain entrance to Paradise as a Jihad martyr, would be considered to have lost contact with reality. Unfortunately for a Muslim int he Ummah these "delusional" ideas are shared by a significant portion of their coreligionists. If major Hasan is delusional and psychotic then so are members and supporters of al Qaeda, Hezbollah, Wahhabi and Deobandi Islam, and a host of other sects and groups. The only way Major Hasan could be considered mentally disordered based on his belief structure would be were there to be an idiosyncratic component. For example, if he were to believe that he is the embodiment of Mohammed, we would be correct to think of him as psychotically deluded, just as we characterize the multitude of psychotic patients through the ages who were convinced they were Jesus Christ.
The conundrum for all the sages in the media and our government remains how to determine that Major Hasan was a lone psycho rather than a Jihadi. We may well be treated to an interesting juxtaposition as Khaled Sheik Mohamed, during his trial, espouses the same motivating "delusions" as major Hasan at his trial. The reporting in the MSM should be fascinating.
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