What is evil?

29 12 2009

Umar Farouk Abdulmutallab

Looking through the paper today, I could not miss the article about the Nigerian guy who tried to blow up the Northwest flight from Amsterdam to Detroit on Christmas morning.

According to an article in the Globe and Mail, December 28, 2009. This baby-faced 23 year old was the quiet and studious son of a wealthy Nigerian banker, who resembles, at first glance any other young man from the northern Nigerian city of Kaduna. He wore designer clothes, sunglasses and fashionable suits. However, there was something  different about him.  His neighbour noticed that he stayed at the mosque far longer than anyone else after prayers. He rarely talked, and when he did it was mainly about Islam. According to the neighbour, “There is a serious and growing problem of Islamic fundamentalism in this part of Nigeria. He is a product of this type of hatred and intolerance.”

His father, a prominent banker, was so worried by the radicalization he saw in his son that he contacted the U.S. embassy in Nigeria to report his concerns.

According to the current world-view, this young man is the epitome of evil. But what is evil?

If we look at Mr. Abdulmutallab through the lens of mental health, there are a couple of things that we can say: He is angry, intolerant, obsessed. He lacks empathy for others, remorse for his actions. He may have even been psychotic at the time. What we can say for sure is that he meets the criteria for what we call anti-social personality disorder. This does not mean that he did not like to socialize, although that may be true. It means he is capable to committing acts that are against the most basic social norms.

Again, the Western media is happy to moralize these traits as “bad”. But it might be more appropriate to view these traits under the umbrella of “sick”. In fact whenever the veneer is stripped back on people who commit these types of acts, they often come across more as “troubled” rather than evil. In many other aspects of their lives they seem either very normal, or often, subject to real or perceived trauma.

Take the young men at the centre of the Columbine massacre. They were the victims of relentless bullying….

We don’t know why Mr. Abdulmutallab saw fit to try to blow up an airplane full of people, but it seems to me this is more the domain of forensic psychiatry than morality.

This is neither to condone, nor to justify, terrorism. The taking of innocent lives for any reason is always a tragedy. It is an act for which we must hold people accountable. However, if we can understand why people commit acts of terrorism, maybe we might be more successful at fighting it. On the face of it, we have spent billions of dollars and sacrificed thousand of lives and we seem no further ahead in the fight against terrorism. A terrorist can be anybody. A suicide bomber will be effective in any small crowd. It seems to me, this is not the sort of thing you can fight using conventional warfare.

The person who commits terrorism, especially through suicide, obviously feels deeply wronged on some level. Real or perceived, that sense of injustice is so great, that the person feels it is worth dying for. We ignore these underlying causes at our peril.

That’s what bullies do. They are neither attentive to, nor do they take responsibility for the wrongs that they perpetrate on their weak or innocent victims; Then they are surprised that their victims lash out using what seem like cowardly methods; Finally, they retaliate with the fury of righteousness on their feeble attackers.

Again, this is not to blame the US, nor any other country or target of terrorism, it is merely an attempt to make sense of this seemingly senseless act and perhaps to cast it in less moralistic terms in the hopes that we might avert some of the negative consequences.

A healthy person who is wronged and then invalidated might feel helpless. An angry, intolerant, anti-social person is more likely, in a final act of defiance, to lash out in the most extreme way possible, by sacrificing his/her life to harm his tormentor .

In the mental health business, we have a name for the disorder that allows someone to harm others with no remorse. We call it “attachment disorder”.

It is often the case that bullies have at one time been traumatized themselves. As mentioned earlier, this may may be real or perceived. It doesn’t really matter. People who suffer from attachment disorder, feel no attachment to others and are therefore insensitive to the hurt that they may cause. As opposed to a psychopath who chops off someone’s head in a mad impulse, the person with attachment disorder has pre-meditated the consequences of his/her actions in gruesome detail, but without a whiff of remorse.

The theory goes like this: The person with attachment disorder was never properly nurtured by his/her primary caregiver. On the contrary, he/she was likely verbally, emotionally, physically and/or sexually abused, neglected, shamed and/ or abandoned. Often this type of abuse is repeated, ritualized and/ or relentless. For the record, this is not rare.

There are millions of people in our society who have endured tis kind of trauma, somewhere in their lives. According to the theory, if the people who are supposed to care for you, don’t, then why would/should you care about anybody else. And when you don’t care about anybody and you are or feel wronged and invalidated you become the kind of person that can blow up an airplane full of innocent people Christmas Day.

Now, I don’t know Mr. Abdulmutallab, nor is there any suggestion that he had this kind of background, so for the moment this is purely speculation, but anyone who is capable of such an act, despite their outward appearance, is usually someone who is acting from a place of extreme hurt. So, if this is the case, what is evil and how should we best deal with it?

Dr. Anthony Ocana
MSc, MD, CCFP, ABAM

Addiction Specialist
Co-founder NorthShore ADHD Clinic
http://www.northshoreadhd.com

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Everybody makes mistakes.

23 11 2009

Sam Brown

Last week I watched a documentary, on CBC’s The Fifth Estate, on one Sam Brown, a thrill seeking, award-winning, mountain-biker from Nelson BC, who found the greatest thrill was hauling hockey bags full of pot across the border to the US. (http://www.cbc.ca/fifth/2009-2010/over_the_edge/)

Sam didn’t fancy himself a drug dealer and would be offended at the suggestion. In his mind, he was just having fun. The more dangerous the mission the better. He revelled in pushing the limits and fancied himself as quite the tactician. And as time went on, the rewards got bigger.

Sam surrounded himself with fancy bikes, fancy sleds and fancy girls.

But the risks got bigger too. Soon enough, Sam was not only dropping off pot, but hauling back coke on the return trip, hundreds of kilos worth.

Even his Dad figured something was up when Sam came home one night with a helicopter for his Dad to fix. You’d think Dad would say something like, ‘What the hell are you doing with a helicopter. Are you out of your frickin’ mind. Do you know what the American’s will with you if they catch you? But instead his attitude was, ‘Don’t ask, don’t tell’. “I’d rather aid and abet my son’s illegal activity, than watch him crash because of faulty equipment”.

As it happens, one of Sam’s associates found herself with faulty equipment caught in the wrong place at the wrong time by the Feds and doing time, awaiting trial in the US. With the heat on, Sam starts wondering whether maybe he should quit while he’s ahead. Plan B was to cash out and maybe find something a little more mainstream. But, of course, there would have to be one last run to raise money for his associates’ legal fees.

As it happens, the DEA was on his tail too… and on that fateful night, with darkness falling and wind and snow closing in on him, he flew right into the web that his captors had set for him. Long story short, when they stuck this young man in the local jail, his characteristic bravado nowhere to be found, he hung himself with a bed-sheet.

Lyndon Mackintyre who I have always found to be an excellent journalist ends the piece with a sob-story about how this is his handler’s fault, the American’s fault, the drug culture’s fault, his parent’s fault. Everyone is to blame, except Sam. I nearly threw up.

But then I though, maybe I’m being a little too judgmental. So, I’m exploring the topic today in QuestForFire because it brings up a number of issues that I think are at the heart of our societies current ambivalence towards addicts and addiction.

My sense is that people are drawn towards one side or the other based on their inherent empathy quotient.

On the one side, those who do not fell for Sam, see him as the master of his own fate and as awful as it may seem, shed no tears for the daredevil drug dealer. This is the side to which, I must say, I gravitate to, at least initially. It’s not so much that I have no empathy for him, but rather that I have more empathy for the drug users who end up homeless, psychotic or in a ditch somewhere, as a result of the crack, that Sam was able to supply them with. As an addiction specialist, I am only too familiar with the shattered lives that drugs (and alcohol) leave in their wake.

On the other side, are people with a high empathy quotient who feel sorry for Sam and his family. They see Sam the victim, the young man with poor judgement. “Everybody makes mistakes”, they say.

Sure, everybody makes mistakes. But this was not an act of impulse. This was a repeated and persistent pattern of willful anti-social behaviour.  Sam was happy to enjoy the fruits of his labour and even took umbrage at being labelled a trafficker. But that’s what he did without any thought of the consequences to himself or to others.

Some have said, he was just looking out for number one. And if he didn’t deliver those drugs, well someone else would. And that’s true. But it doesn’t change the fact that it was wrong, and he knew it.

But there is another way of looking at it… that was not raised in that very long list of viewer feedback on the CBC website. Sam Brown was a daredevil, a thrill seeker, an adrenaline junkie. He had to to push the limits, because doing what everyone else does, the way everyone else does it, is just too boring. I know the type. I work with them every day. As an addictionologist, understanding this, is my stock in trade. Maybe Sam Brown was just a different kind of addict.

There is quite a bit of science that says that Sam Brown was likely suffering from Attention Deficit Hyperactivity Disorder. He has all the hallmarks: He was smart, but did not do well in school. He was hyperactive, never could sit still. And he was impulsive, to the nth degree. About 50% of ADDers suffer from one or more addictions (if you include nicotine) and probably higher if you include behavioural addictions such as compulsive shopping, gambling, gaming, sex and eating.

Addiction and ADHD have a lot in common. They are both associated with dysfunctional dopamine circuits. (read more about it on my web-site, northshoreadhd.com. I won’t go into anymore detail on that, but suffice it to say, both addicts and ADDers have chemical imbalances that lead them to be easily bored, to be unlikely to learn from their mistakes, and to have difficulty saying, “no” to temptation. And that leads them to make exceptionally bad choices, and to have the kind of poor judgement that can kill you.

So, I guess, if I think about it, maybe I can find some empathy in my heart for Sam Brown. I certainly feel for those who lost a friend or a family-member.

As a physician, hearing a story like this I find myself wondering, “what if”. What if someone had seen the ADHD pattern and directed him to some treatment. Or what if he had been able to stick to a less dysfunctional addiction such as extreme mountainbiking.It would have been nice to have been able to help this young man before he felt so desperate that he ended up taking his own life. I now if he were my patient, I might be able to look past his poor judgement. As long as he/she were willing to take some ownership of their actions. Those with a higher empathy quotient might say, “Let he/she who has not made mistakes, cast the first stone”.

Cheers, A

Dr. Anthony Ocana   MD, MSc, CCFP, ABAM                                                   Family Physician, Addiction Specialist                                         drocana@telus.net