Psychiatrists in Norway who examined him say he’s as sane as you or me. But that verdict was immediately questioned by two eminent figures as Breivik went on trial for the murder of 77 people: the psychiatrists Dr Raj Persaud and Dr Ramon Spaaij, an expert on so-called “lone wolf” killers.
Writing for the online Huffington Post recently, Persaud and Spaaij suggest Breivik may be suffering from narcissistic personality disorder. NPD isn’t defined a mental illness, it is, as its sobriquet suggests, a specific form of deviant personality.
Chief hallmarks are monumental arrogance, complete lack of empathy with others, unquenchable thirst for admiration and a preoccupation with fantasies about unlikely outcomes.
So NPD places him somewhere down the line towards insanity but not quite in the zone. Unless you compare the definition of NPD with that of a psychopath.
The Oxford Dictionary definition of a psychopath is “a person suffering from a mental illness which makes them behave violently”.
Other clinicians have fiercely challenged this, saying that Breivik was far too well organised to be psychotic, and that there was no evidence he was hallucinating when he slaughtered the next generation of Norway's Labour Party in July last year. Following appeals from the lawyers of victims, Oslo's district court ordered a second evaluation by a different pair of psychiatrists.
They came to the opposite conclusion: that Breivik was not psychotic, unaware or severely mentally handicapped in any way when he committed his atrocities, nor was he psychotic when they examined him. They also concluded there was a high risk he would repeat his violence. That second report now goes to a Forensic Medicine Commission for scrutiny, and the commission will submit its own report before all the experts must testify in June at Breivik's trial.
Whatever the court finally decides, Breivik is likely to be locked up for a long time. But the way his actions are framed, and the form his incarceration takes - hospital or jail - will shape the way Norwegians will make sense of the tragedy. For many, the idea that his brutality will be attributed to individual pathology is in itself a dangerous prospect because it would short-circuit scrutiny of the right-wing extremist ideas he used as his justification.
They came to the opposite conclusion: that Breivik was not psychotic, unaware or severely mentally handicapped in any way when he committed his atrocities, nor was he psychotic when they examined him. They also concluded there was a high risk he would repeat his violence. That second report now goes to a Forensic Medicine Commission for scrutiny, and the commission will submit its own report before all the experts must testify in June at Breivik's trial.
Whatever the court finally decides, Breivik is likely to be locked up for a long time. But the way his actions are framed, and the form his incarceration takes - hospital or jail - will shape the way Norwegians will make sense of the tragedy. For many, the idea that his brutality will be attributed to individual pathology is in itself a dangerous prospect because it would short-circuit scrutiny of the right-wing extremist ideas he used as his justification.
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| Eurabia, part of Breivik's world view. The map shows where and how far the Muslim invasion will occur |
Breivik claims he spent nine years plotting his assaults. It is clear his schemes were at least three years in the making, because it was in 2009 that he founded a farming company as cover for his purchases of fertiliser for making bombs.
However deluded his world view - he saw himself as a modern Knight Templar charged with saving Europe from multiculturalism and Muslim invasion - his ability to plan was clearly unimpaired. He tried to buy illegal weapons in Prague but failed, so he used legal methods of purchase in Norway instead. He acquired high-powered guns and rifles legally, through membership of a pistol club and through owning a hunting licence. He went on a weight-training program and boosted his strength with testosterone supplements.
He wrote a 1500-page manifesto laying out his political view of the world: the European Union was going to betray its people by allowing Muslim immigration in return for oil; women had emasculated men and stopped breeding enough to fend off the invading hordes; and the left wing was destroying European identity with multiculturalism.
He has admitted his crimes but denied legal guilt on the basis that he was engaged in a war to protect Europe. ''In the defendant's own opinion, these acts have been legitimate and lawful,'' prosecutors said in his 18-page indictment.
The two psychiatrists who examined him originally concluded in a 243-page report not released to the public that Breivik was a paranoid schizophrenic. A psychoanalyst unrelated to the case, Darian Leader, later pointed out in an article for The Guardian that it is possible to have a ''discreet'' psychosis that fits in well with society for years and might never disintegrate into crisis or breakdown.
He wrote, ''Paranoia has three classical components. The paranoiac has located a fault or malignancy in the world, he has named it, and has a message to deliver about it. For Breivik, the conviction is that Europe is rotten, that the name of this rottenness is Islam and that it is his mission to expose it.''
A copy of the original psychiatric report was leaked to a Norwegian newspaper, which said it concluded he was incapable of feeling guilt. The psychiatrists also described Breivik as unemotional and as having a hypnotic stare.
The newspaper report revealed his mother said he showed signs of paranoid delusions as early as 2006: ''He must have been insane; he became so different.'' She said it was then that he became obsessive about politics and history: ''He was totally beyond reason and believed all the nonsense he said.''
By April last year, when he was in the final stages of preparing for his attacks, Breivik began wearing an antiseptic face mask whenever he was in the house with his mother, fearing she would infect him. At one point he called the family doctor saying his mother had infected his sinuses.
The diagnosis of paranoid schizophrenia triggered a public outcry, not just from victims and their families but from clinicians concerned that it was not well grounded. To be considered insane, Breivik would have had to be so removed from reality that he was at the point where he could not have controlled his actions.
But while he was shooting on Utoya, says Svenn Torgersen, ''He doesn't seem to have been hallucinating. He had put music in his earphones and he had taken some pills to get himself activated. If you are psychotic, you don't need pills to get activated because you are steered by voices, by your distorted reality.''
Torgersen is professor of clinical psychology at Oslo University. He believes the original diagnosis was mistaken on several counts. ''They classified his ideas as 'bizarre'. That's very important in schizophrenia. But to be bizarre, ideas have to contradict the rules of physical phenomena; it's science fiction - if you think people are inside your head or monitoring your behaviour, or that you can control other people by putting your thoughts into their heads, or if you think you get a message from the TV.
''[Breivik's] idea that people are coming to Norway and taking over the country because we are too liberal - it's not bizarre as defined by the diagnostic system. They're not coming from Jupiter or Mars or Venus.''
He said the fact that Breivik had made up words had also been counted as a symptom, ''But a schizophrenic makes up words and thinks that others can understand him. Breivik knew that he was making up words. He even explained them. And some of those words were already being used on the internet.''
His organisational skills and long-term planning abilities also contradicted the diagnosis: ''He did very many things very right. He did better than most of us would be able to do. He was very clear-thinking.''
The original psychiatric report gave Breivik a score of only two on a scale of 100 on the ''Global Assessment of Functioning'', a measure that represents the severity of clinical symptoms and a person's ability to operate in the world in their different roles as family member, worker and so on. ''That score would be rather ridiculous,'' says Geir Pedersen, senior researcher in psychological psychometrics at Oslo University Hospital.
Pedersen teaches students how to apply and interpret the test. ''Breivik's score is desperately wrong,'' he says. ''At 60, you are not fully able to work or study. When you reach down to 40, your ability to test reality becomes poor; you are not psychotic but you are interpreting your surroundings maladaptively. Down to 30, you often need to be taken by force into treatment. Below 20, you are not able to do anything; you would not even be able to feed yourself properly, and hallucinations are often present. Below 10, you would not get any reason out of your surroundings. Two is a hypothetical measure and … a misuse of the scale.''
Pedersen believes the doctors writing the report scored Breivik on what they believed to be the level of danger he represented to others, a measure for which this test was not designed.
''A lot of clinicians would say he has malignant narcissism,'' he says. ''That's a description, not a diagnosis. A lot of clinicians would say he is psychotic because his delusions are so grandiose and so maladaptive. But schizophrenic? That's questionable.''
However deluded his world view - he saw himself as a modern Knight Templar charged with saving Europe from multiculturalism and Muslim invasion - his ability to plan was clearly unimpaired. He tried to buy illegal weapons in Prague but failed, so he used legal methods of purchase in Norway instead. He acquired high-powered guns and rifles legally, through membership of a pistol club and through owning a hunting licence. He went on a weight-training program and boosted his strength with testosterone supplements.
He wrote a 1500-page manifesto laying out his political view of the world: the European Union was going to betray its people by allowing Muslim immigration in return for oil; women had emasculated men and stopped breeding enough to fend off the invading hordes; and the left wing was destroying European identity with multiculturalism.
He has admitted his crimes but denied legal guilt on the basis that he was engaged in a war to protect Europe. ''In the defendant's own opinion, these acts have been legitimate and lawful,'' prosecutors said in his 18-page indictment.
The two psychiatrists who examined him originally concluded in a 243-page report not released to the public that Breivik was a paranoid schizophrenic. A psychoanalyst unrelated to the case, Darian Leader, later pointed out in an article for The Guardian that it is possible to have a ''discreet'' psychosis that fits in well with society for years and might never disintegrate into crisis or breakdown.
He wrote, ''Paranoia has three classical components. The paranoiac has located a fault or malignancy in the world, he has named it, and has a message to deliver about it. For Breivik, the conviction is that Europe is rotten, that the name of this rottenness is Islam and that it is his mission to expose it.''
A copy of the original psychiatric report was leaked to a Norwegian newspaper, which said it concluded he was incapable of feeling guilt. The psychiatrists also described Breivik as unemotional and as having a hypnotic stare.
The newspaper report revealed his mother said he showed signs of paranoid delusions as early as 2006: ''He must have been insane; he became so different.'' She said it was then that he became obsessive about politics and history: ''He was totally beyond reason and believed all the nonsense he said.''
By April last year, when he was in the final stages of preparing for his attacks, Breivik began wearing an antiseptic face mask whenever he was in the house with his mother, fearing she would infect him. At one point he called the family doctor saying his mother had infected his sinuses.
The diagnosis of paranoid schizophrenia triggered a public outcry, not just from victims and their families but from clinicians concerned that it was not well grounded. To be considered insane, Breivik would have had to be so removed from reality that he was at the point where he could not have controlled his actions.
But while he was shooting on Utoya, says Svenn Torgersen, ''He doesn't seem to have been hallucinating. He had put music in his earphones and he had taken some pills to get himself activated. If you are psychotic, you don't need pills to get activated because you are steered by voices, by your distorted reality.''
Torgersen is professor of clinical psychology at Oslo University. He believes the original diagnosis was mistaken on several counts. ''They classified his ideas as 'bizarre'. That's very important in schizophrenia. But to be bizarre, ideas have to contradict the rules of physical phenomena; it's science fiction - if you think people are inside your head or monitoring your behaviour, or that you can control other people by putting your thoughts into their heads, or if you think you get a message from the TV.
''[Breivik's] idea that people are coming to Norway and taking over the country because we are too liberal - it's not bizarre as defined by the diagnostic system. They're not coming from Jupiter or Mars or Venus.''
He said the fact that Breivik had made up words had also been counted as a symptom, ''But a schizophrenic makes up words and thinks that others can understand him. Breivik knew that he was making up words. He even explained them. And some of those words were already being used on the internet.''
His organisational skills and long-term planning abilities also contradicted the diagnosis: ''He did very many things very right. He did better than most of us would be able to do. He was very clear-thinking.''
The original psychiatric report gave Breivik a score of only two on a scale of 100 on the ''Global Assessment of Functioning'', a measure that represents the severity of clinical symptoms and a person's ability to operate in the world in their different roles as family member, worker and so on. ''That score would be rather ridiculous,'' says Geir Pedersen, senior researcher in psychological psychometrics at Oslo University Hospital.
Pedersen teaches students how to apply and interpret the test. ''Breivik's score is desperately wrong,'' he says. ''At 60, you are not fully able to work or study. When you reach down to 40, your ability to test reality becomes poor; you are not psychotic but you are interpreting your surroundings maladaptively. Down to 30, you often need to be taken by force into treatment. Below 20, you are not able to do anything; you would not even be able to feed yourself properly, and hallucinations are often present. Below 10, you would not get any reason out of your surroundings. Two is a hypothetical measure and … a misuse of the scale.''
Pedersen believes the doctors writing the report scored Breivik on what they believed to be the level of danger he represented to others, a measure for which this test was not designed.
''A lot of clinicians would say he has malignant narcissism,'' he says. ''That's a description, not a diagnosis. A lot of clinicians would say he is psychotic because his delusions are so grandiose and so maladaptive. But schizophrenic? That's questionable.''
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| Breivik's legal team |
Whether or not he is mad, no one doubts that Breivik remains a dangerous man. The original pair of psychiatrists also warned that he was likely to try further attacks, including suicide bombings, if he were ever released. In their 36 hours of interviews with him, he had repeatedly spoken of plans to kill Prime Minister Jens Stoltenberg and members of the Norwegian royal family. On Utoya island with police for a reconstruction of his crimes, he showed no remorse.
Many Norwegians have expressed concern that medicalising Breivik's behaviour also lessens the need to examine the darkest corners of extreme right-wing politics and the rhetoric that he adopted as his raison d'etre. But at least one specialist thinks the two might be intertwined.
Simon Baron-Cohen is professor of developmental psychopathology at the University of Cambridge and a specialist in empathy. He says Breivik has low levels of empathy for others, a basic precondition for cruelty, but this is something that, on its own, does not inevitably lead to cruel acts. He suggests that in Breivik's case, his ideological convictions may have been an extra ingredient in the deadly mix.
Writing in The Guardian, Baron-Cohen likened Breivik to the young Hitler: both thought they were starting a revolution, both wanted to use trials to spout politics, both wrote long manifestos justifying their beliefs - and both were so convinced they were right that they were willing to sacrifice people to achieve their ends.
Many Norwegians have expressed concern that medicalising Breivik's behaviour also lessens the need to examine the darkest corners of extreme right-wing politics and the rhetoric that he adopted as his raison d'etre. But at least one specialist thinks the two might be intertwined.
Simon Baron-Cohen is professor of developmental psychopathology at the University of Cambridge and a specialist in empathy. He says Breivik has low levels of empathy for others, a basic precondition for cruelty, but this is something that, on its own, does not inevitably lead to cruel acts. He suggests that in Breivik's case, his ideological convictions may have been an extra ingredient in the deadly mix.
Writing in The Guardian, Baron-Cohen likened Breivik to the young Hitler: both thought they were starting a revolution, both wanted to use trials to spout politics, both wrote long manifestos justifying their beliefs - and both were so convinced they were right that they were willing to sacrifice people to achieve their ends.
Further reading
Breivik's legal team have gone to the trouble of sitting for a professional publicity shot.
ReplyDeleteIt looks more like a promo shot for an upcoming Foxtel series.
Bizarre.