Surviving a terrorist attack changes a person. I know; I survived two. It would have been easy for me to recoil in fear, trapped by trauma. Others lash outward in retaliation. As a psychiatrist, I became passionate about understanding the origins of terrorism—examining how a world could create the kinds of destructive aggression that now are a daily occurrence.1 As a woman desiring to recover from the aftermath of developing breast cancer and being poisoned, I was open to every avenue of healing. It was at the intersection of understanding and surrender where I found transformation. When viewed through a lens of spirituality, I found that the desire for destruction is a desire for connection in tattered clothes.
Catalyzed by surviving terrorism and its traumatic impact, I had a spiritual awakening that was essential to my recovery. This awakening consisted of an active awareness of a profound interconnectedness with something much larger than myself—be it God or the cosmos. Poisoning ironically provided a path, both for myself and some of my patients, to shift from submission (signified by the need either to acquiesce or rebel) to surrender (signified by being open to and expanded by the subjectivity of the other). Spirituality—a sense of interconnectedness to oneself, society, and the cosmos—can be an antidote to trauma. Rather than reenacting violence, the spiritual journey involves turning inward to transcend trauma. This is a journey people shouldn’t have to go to prison to begin.
My psychiatric research team’s cutting-edge, quantitative research2—illustrating the prevalence of undiagnosed psychiatric illness among domestic mass shooters—encouraged a dialogue about the stigma of mental illness and challenged the perception of terrorists as monsters with no societal responsibility. In addition to untreated mental illness, our research found that many mass shooters suffer from abuse and marginalization. Tragically, the stigma of mental health also played a significant role in these assailants not securing psychiatric treatment.
Rather than dismissing adolescent school shooters as “oddballs,” the abuse of children that deprives them of their identity and the ability to feel joy was experienced by many of these assailants.3 Common themes in these adolescent shooters were abuse, a sense of alienation, online radicalization, and exposure to firearms. In part due to the fear of being stigmatized, these adolescent shooters and their families concealed psychotic symptoms from their treating psychologists, which contributed to not being properly diagnosed. When misdiagnosed, their underlying psychotic symptoms were exacerbated. Many of these individuals were capable of being psychotic, while still having the ability to plan and execute a mass shooting.
The possibility of incorporating spirituality as one path to healing from trauma is the case of an undiagnosed, untreated schizophrenic adolescent domestic mass shooter. Consider "A.M.," one adolescent from our study. Tragically, only after being incarcerated and properly medicated was this adolescent able to not only have his chronic auditory hallucinations stop, but eventually to also experience a spiritual transformation.
At the age of 15, he first shot and killed both his parents. The next day he engaged in a high-school shooting that left two students dead and 25 others wounded. Similar to the history of many of the adolescent shooters we reviewed, A.M. had high intelligence, struggled with a learning disability, and was bullied.
Starting at the age of 12, he suffered from auditory hallucinations of male voices. One voice would put him down and deride him, and the second told him to kill. He also had delusions that the government placed a chip in his brain and he believed that the chip caused his auditory hallucinations. Prior to the shooting, A.M. had a history of violence, using explosives in a futile attempt to stop his auditory hallucinations. After his shooting spree, the forensic psychiatrist who evaluated him at trial stated that his violent crimes were a direct result of his unmedicated psychotic process that had been building for over three years and took over his ego.
A.M. looked “normal” and hid his psychotic symptoms from judges, attorneys, and doctors because this tormented adolescent was terrified to be labeled mentally ill. Prior to the shootings, his parents also hid their own extensive mental health illness, on both sides of their family, from their son’s treating psychologist. His parents stopped A.M.’s therapy a few months before the shooting. Despite his auditory hallucinations, they claimed that he was doing “well” and no longer needed psychological care. However, his father admitted to a friend that he was “terrified” of what his son might do but felt he “was out of options.” He threatened to send his son to a military school.
The ironic tragedy of A.M. and many of the other shooters we examined was that their psychosis responded well to antipsychotic medication. Their violent acts could have been prevented if they had received proper psychiatric treatment prior to their shooting spree. Sadly, in the aftermath of the shooting, just 10 days after receiving antipsychotic medication, A.M. no longer suffered from auditory hallucinations and expressed remorse for having killed his parents and fellow students. Currently, A.M., who is incarcerated, is compliant with antipsychotic medication, and no longer psychotic or violent.
While incarcerated and properly medicated, A.M. obtained his GED and a BA degree, and began a spiritual journey. He teaches yoga in the mental health ward of the prison and maintains a daily spiritual practice, where he meditates and prays for those he harmed.
Healing is twofold. The forgotten collective humiliation of the marginalized―which in turn breeds a desire for destruction―can be transformed by incorporating a new spiritual lens of interconnectedness. Effective psychological and psychiatric treatment is also vital. This healing can only happen when we decrease the stigma of mental illness, respect the needs of those suffering from mental illness, and stay open to new pathways for healing. Children shouldn’t have to go to prison to receive the treatment they so desperately need.
References
1. Cerfolio, NE. (2023). Psychoanalytic and spiritual perspectives on terrorism: Desire for destruction. Routledge.
2. Cerfolio, NE, Glick ID, Kamis D, Laurence M. (2022). A retrospective observational study of psychosocial determinants and psychiatric diagnoses of mass shooters in the United States. Psychodynamic Psychiatry. 2022; 50 : 513-528.
3. Shengold, L. Soul murder: the effects of childhood abuse and deprivation. (1989). Yale University Press.
How to Alchemize a Desire for Destruction Into Connection
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19.04.2024
Surviving a terrorist attack changes a person. I know; I survived two. It would have been easy for me to recoil in fear, trapped by trauma. Others lash outward in retaliation. As a psychiatrist, I became passionate about understanding the origins of terrorism—examining how a world could create the kinds of destructive aggression that now are a daily occurrence.1 As a woman desiring to recover from the aftermath of developing breast cancer and being poisoned, I was open to every avenue of healing. It was at the intersection of understanding and surrender where I found transformation. When viewed through a lens of spirituality, I found that the desire for destruction is a desire for connection in tattered clothes.
Catalyzed by surviving terrorism and its traumatic impact, I had a spiritual awakening that was essential to my recovery. This awakening consisted of an active awareness of a profound interconnectedness with something much larger than myself—be it God or the cosmos. Poisoning ironically provided a path, both for myself and some of my patients, to shift from submission (signified by the need either to acquiesce or rebel) to surrender (signified by being open to and expanded by the subjectivity of the other). Spirituality—a sense of interconnectedness to oneself, society, and the cosmos—can be an antidote to trauma. Rather than reenacting violence, the spiritual journey involves turning inward to transcend trauma. This is a journey people shouldn’t have to go to prison to begin.
My psychiatric research team’s cutting-edge, quantitative research2—illustrating the prevalence of undiagnosed psychiatric illness among........
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