Khalid Sheikh Mohammed: Will the Trial in New York be Traumatic or Therapeutic?

First published in Psychology Today, November 30, 2009

At a review tribunal conducted at Guantanamo Bay in 2007, Mohammed, who was raised in Kuwait and graduated in 1986 from North Carolina State University with a degree in mechanical engineering, claimed responsibility for conducting  jihad, and to serving Bin Laden as operational director for the "organizing, planning, follow-up, and execution of the 9/11 operation." 

In fact, while in detention he confessed to planning and conducting numerous terrorist plots around the globe, including:

• the 1993 World Trade Center bombing  

• the decapitation of Wall Street Journal reporter Daniel Pearl 

• Richard Reid’s failed shoe bomber operation  

• the nightclub bombing in Bali, Indonesia

• an assassination plot against former President Carter and former President Clinton

• planning for a second wave of attacks on the US, allegedly targeting the Liberty Tower in Los Angeles, the Sears Tower in Chicago, the Plaza Bank in Seattle, and the Empire State Building in New York

• plotting to attack Heathrow Airport and Canary Wharf

• launching a Russian-made SA-7 missile at a commercial jet departing Mombasa

• planning to attack nuclear power plants in the US

• planning to destroy 12 US commercial jets in flight at the same time

The decision by Attorney General Eric Holder (with the approval of President Obama) to move the Sheikh’s trial out of a military court in Guantanamo Bay to a Federal Court in Manhattan has far-reaching implications. 

There are several consequences that conducting a trial for one of the world’s most dangerous terrorists in New York will have on the public health:

• It raises the vulnerability of the city to retaliation.

• The accompanying media attention will expose trauma victims to the perpetrator, thereby unleashing unresolved grief and stress. 

• The government risks acting out its ambivalence toward Muslims, who claim that it is they who are the victims.

One has to consider the effects of trauma reactivation on two groups: 

1. A significant minority of individuals whose emotional wounds are still raw

2. The rest of the community, while not overtly symptomatic, remain vulnerable to reactivation of their original trauma-induced stress symptoms

Those most likely to have more serious residual symptoms of trauma include immediate eye-witnesses, emergency on-site rescue personnel, and individuals who experienced a personal loss as a result of the terrorist attack.

There is another factor that will also affect the public’s response to the trial: Communities tend to have a collective structure whereby members strongly identify with fellow citizens under attack.

While one may heuristically distinguish between one group of the population who are currently symptomatic, and another group who are not, the psychologically healthier group, to some extent, will coalesce with those who remain damaged.

Whether or not victims of trauma remain currently symptomatic, they are prone to experience symptom-relapse when confronted with trauma reminders.

When it comes to the public health challenge of managing and “containing” the painful symptoms that victims experience when they are re-exposed to their perpetrator, there has been a significant shift by trauma experts over the past ten years in their philosophy about the best therapeutic approach.

It is in the context of this safe “holding environment” that the victim is able to organize a coherent trauma narrative.

The narrative should preferably satisfy the victim’s need for compensation and justice, even at a symbolic level, to allow full psychological closure.

An example of a landmark trial that provided a therapeutic narrative occurred when Mossad agents captured Adolf Eichmann in Argentina and brought him to Israel.

His kidnapping by Mossad agents was carried out at an enormous logistical and political risk.

For thousands of holocaust survivors, his trial, conviction, and execution served a symbolic function of reminding the world (which had not lifted a finger to disrupt the genocide of 6 million) that justice would eventually be served.

Since his mere presence was expected to evoke such collective rage, he was boxed in bullet-proof glass throughout the trial.

But this was a rare moment in history when a government was resolved to satisfy the collective need of the public that it served.

This stands in sharp contrast to the current U.S. Administration which has left the public wondering about its motives. 

Since Mohammed was subject to some of the harshest interrogation tactics used by US officials, including torture by repeated waterboarding, it remains unclear whether his confessions can be admitted as evidence in a civil trial. 

There is no indication that New Yorkers currently feel any great appetite to revisit the crime scene of 9/11 by hosting the trial of the suspected mastermind of this egregious act.

But there still are wounds which will undoubtedly be reopened by dint of this decision.

The thought of warehousing him in New York not only reactivates traumatic memories in some, it also makes people feel more prone to another attack.

In order to help victims maintain their sense of safety, one should keep them as far away from the perpetrator as possible.

While one may be comforted by the fact that the self-confessed terrorist is incarcerated, one has no measure of his outreach or ability to constellate a network of homegrown or imported sympathizers.

For the tens of thousands of individuals who lost beloved family members or friends, confronting one of the ringleaders will unleash many emotions, including bereavement and anger.

There are many legal implications arising from this change in format that will work to the advantage of the alleged terrorist.

In the case of the Khalid Sheikh Mohammed, the government runs the risk of contaminating its prosecution of the perpetrator with a completely different agenda, namely its embarrassment about Guantanamo. 

New Yorkers might discover that they have been selected to provide a platform for an Administration desperately in need to purge itself of previous misdeeds by transforming its “persona” to one that is benevolent in the eyes of the Muslim world.

The most un-therapeutic dynamic that could play out would be anything remotely resembling the “O.J. Simpson Trial,” where skilled attorneys garnished the sympathy of the jury and exposed the ineptitude of the District Attorney and LAPD, leading to an acquittal.

That type of narrative would not sit well in this context.

This underlines the challenge posed by having Khalid Mohammed’s case moved to New York and opened to the public:

Will we New Yorkers once again feel safe, and will the hearings and outcome provide therapeutic closure, or will we once again become the victim?

Pan Am Flight 103 – Convicted Bomber Mohmed al-Megrahi’s Release May Exacerbate PTSD

First Published in Psychology Today on August 24, 2009

On August 20, 2009, Mohmed Megrahi, convicted in 2001 for the murder of 270 people on Pan Am flight 103 over Lockerbie, Scotland, was freed from prison due to a diagnosis of advanced cancer of the prostate. His 27 year sentence was commuted by the Scottish Justice Secretary on the grounds of compassion. 

Arriving in Libya, he was met by the son of Colonel Kaddafi. Thousands celebrated in the city of Tripoli, where he is regarded as a hero. 

This contrasted sharply with the outrage expressed by American relatives of victims. Upon learning of Megrahi’s release, Stan Maslowski, whose 30 year old daughter Diana died in the bombing, reported that he found himself crying in bed as he “relived” the experience that he had when first told there were no survivors from the Pan Am bombing. “I don’t think there will ever be any closure for any of us.” 

In Carl Jung’s Collected Works (Vol. 16, 1928), he explains how unforgotten “traumatic complexes” dissociate from the psyche and become autonomous.  They then can force themselves tyrannically on the conscious mind of the victim, or invade at night in dreams symbolized as “attacking enemies.” 

The trauma narrative is a more tolerable burden when there is a sense of justice being served.

When responsible law enforcement agencies apprehend and punish the offender, survivors as well as relatives of non-survivors are given the opportunity for “therapeutic closure.”

 The process of healing from psychological trauma involves shifting brain activity away from those areas involved in sensory-perceptual activity towards the brain areas involved in labeling and interpretation.

 Imaging studies show that formation of trauma narratives shifts dominant brain activity from the right side of the brain (which is sensory-dominant) to the left (which is language-dominant) (Bremner, J.D., et al. “MRI-Based Measurement of Hippocampal Volume in Patients with Combat-Related Post Traumatic Stress Disorder.” Am J Psych, 1995).

While the sensory aspect of brain activity is vivid and intense, the words and meaning of the trauma narrative transforms the initial sensory experience of the trauma into one that is coded into a distant memory abstract.

Failing this, there may never be closure to the narrative. It is only when the victim creates a meaningful narrative that the traumatic event can be safely relocated into the past. To the victim, the narrative must make sense.

In contrast, when offenders of all types are not punished in a way commensurate with their crime, victims continue to feel distress. Instead of the psyche being allowed to process the traumatic experience into a more meaningful narrative and move on, the psychological world of the victim remains hostage to the unwanted visitations of intense and distressing images of the unresolved trauma.

The lawmakers and politicians responsible for Megrahi’s release have not only silenced the 270 innocent citizens who perished by establishing an alliance with their perpetrators, but have reversed the trauma narrative which had provided some form of “closure” for their relatives. 

This might very well have unhinged the crucial component of trauma recovery.

Civilized societies owe respect to “caretakers” who show moral responsibility to the plight of victims. 

If the release of Mohmed al-Megrahi turns out to have been motivated by political favors and oil-profiting, this form of government collusion betrays everyone.

Chabad and Brooklyn Bridge Shooting

This article was first published in the American Journal of Psychiatry, May 1996, and later published in revised form in Psychology Today, December 18, 2009.

Chabad Chasidim established settlements in Hevron in 1816 at the behest of Dovber Schneursohn, the second Chabad Rebbe. 

The first terrorist attack on the community involved the massacre of seventy devout Jews (many of them Yeshiva students) in Hevron in 1929, following the visit of Rabbi Joseph Yitzchak Schneursohn to the Tomb of the Patriarchs. 

While we now exist in a political environment where terrorism appears focused on nationalistic aspirations, this attack indicates a conflict that clearly predates any of the tensions generated by current political disputes.

The second attack involving the Chabad community occurred on the Brooklyn Bridge in 1994.

Also that year, there were several terrorist attacks against a variety of other Jewish civilian targets. This included the bombing of a Jewish community center in Buenos Aires, a suicide attack in a Jerusalem cafeteria, and the bombing of a bus in downtown Tel Aviv. 

The attack by Islamic extremists specifically on Chabad of Mumbai in 2008 was the third that singled out this specific religious group.

In December 2009, Devorah Halberstam, mother of the slain victim of the Brooklyn Bridge attack, received the FBI Director’s Community Leadership Award for her relentless pursuit of the true nature and origin of the Brooklyn Bridge attack. 

Following her son’s murder, the charismatic mother of 5 children pounded the halls of Congress to pass new legislation affecting laws on immigration, terrorism, and gun control. 

FBI Assistant Director in Charge (ADIC) Joseph Demarest, in presenting the award, noted that “We are honored to recognize a true fighter against terrorism. A woman who has demonstrated an endless pursuit of justice, everlasting love for her family, dedication for victim’s rights and patriotism for her country.”

In receiving the award, she stated that the FBI had come a long way since its 1994 labeling of the event as an isolated act committed by a disgruntled loner, rather than an act of terror.

Subsequent investigations by intelligence agencies revealed that Ari Halberstam’s murder followed a trail that led to an organized cell of Islamic terrorists operating out of Gaza and the West Bank.

Chabad centers frequently appear as high-ranking on the lists of Al Qaeda targets.

Rabbi Menachem Mendel Schneursohn (also known as “The Rebbe”) spent his childhood in Dnepropetrovsk, Ukraine, under the tutorship of his father, the Chief Rabbi, Levi Yitzchak Schneursohn.

After Germany invaded France in 1940, the Rebbe, with his wife, began their long voyage to New York.

After his arrival in 1941, the Rebbe worked for the U.S Navy as an engineer designing warships while simultaneously directing all Chabad educational activities and publications.

During his tenure of leadership for over 40 years, he developed the worldwide movement, inspiring thousands of people from all walks of life, and was considered by most as the undisputed Spiritual leader of World Jewry. 

Lubavitch Headquarters consists of its main synagogue “770,” a library housing original sacred manuscripts rescued from the Holocaust, a children’s museum, and yeshivas for rabbinical students.

Its philosophical teachings, based on esoteric Kabbalistic sources, have been made accessible to the uninitiated via translation into dozens of languages for the thousands of Chabad Centers established around the world by the Rebbe and his emissaries. 

On March 1, 1994, the Rebbe underwent ambulatory surgery in Manhattan. 

Returning to Crown Heights, his ambulette was accompanied by an informal convoy of cars and vans. As a security, the convoy split into two columns. 

Instead of returning to Brooklyn via the Brooklyn Bridge, the Rebbe’s vehicle was deliberately detoured via the Brooklyn-Manhattan Tunnel.

As the convoy entered the bridge ramp, a white van carrying fifteen yeshiva students was ambushed by a Lebanese male named Rashid Baz. 

One student was killed instantly and another critically injured with a bullet wound to the head. Approximately thirty bullets were fired into the van. 

In the ensuing chaos, one student tried to control the profuse bleeding from a head wound to the student next to him. 

The gunman who drove his car alongside the van for the length of the bridge continued firing at close range using two semi-automatic pistols. 

Two additional students were wounded in the ensuing chase, one receiving a serious bullet wound to the abdomen.

I evaluated and began debriefing eleven of the survivors within twenty four hours of the attack.

Eleven survivors of the shooting underwent ten weeks of trauma group therapy.

Clinical and psychometric examinations were performed prior to, and at the completion of treatment. 

Initial assessments were made within one week of the attack using the PTSD Symptom Scale, Beck Depression and Anxiety Inventory, and the Revised Impact of Events Scale.

Study participants were compared to age-matched volunteer students who were classmates of the van group.

Of the eleven students in the trauma group:

• Four survivors met DSM-IV criteria for PTSD. 

• Four survivors showed significant elevations of stress levels (including anxiety and depression)  

• Three survivors did not meet criteria for a DSM-IV Diagnosis 

The most distressing symptoms were visual flashbacks, dissociative symptoms and hyper-arousal. 

Avoidance symptoms were the most persistent, with most of the terror victims showing extreme reluctance to travel the Brooklyn Bridge. 

Several needed continued exposure therapy after the completion of the ten formal therapy sessions.

When treating the eleven students that survived the “Brooklyn Bridge shooting,” the final and most difficult task was to drive the boys over the Brooklyn Bridge in a van.

I must stress here that this was only possible for some of the students following the twelve sessions, during which they learned a variety of cognitive behavioral coping strategies followed by individual “exposure” management.

Like other studies of recovery in PTSD, overcoming the fear and avoidance of trauma triggers was identified as the final objective of successful treatment.

All survivors are now vibrant members of the Chabad community, a movement that has thousands of satellite centers throughout the globe. 

Its emissaries also practice the most basic tenets of the Jewish Faith as espoused by the Baal Shem Tov: “Respect the sanctity of all life and Serve the Master of Creation with joy, meditation (prayer), and acts of kindness.”

 

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