Apr 23, 2013

Preventing the next bomb plot

Detecting suicidal thinking can stop bomb plots like Boston’s. Like every one of our recent mass killings, this was suicide with a murderous twist. 

The minimum requirements for suicide are suicidal intent and access to a means of suicide.

If the means of suicide is a weapon, there is a possibility of harming another in the course of the suicide.

If there is also an intent to murder someone, or make a statement, or respond to another person’s influence, then someone or something may likely get attacked as the suicide plays out.

If a group is promoting suicide terrorism, or if there is social shame attached to suicide but cultural approval of suicide martyrdom, then the suicide attack can become a terror strike.

National security expert Adam Lenkford writes:
Homicidal intent often increases the severity of attacks…truly homicidal suicide terrorists are motivated to maximize enemy casualties.

A sponsoring terrorist organization may increase suicidal and homicidal intent, provide access to weapons and enemy targets, and boost social approval of suicide terrorism through its use of propaganda…
Social stigmas surrounding conventional suicide and social approval of suicide terrorism often work together. When a community strongly condemns conventional suicide as a certain path to hell, it virtually disappears as a potential escape route. And when a significant percentage of people believe that suicide terrorism is justified, a new door opens for desperate individuals.  
I believe that ordinary Americans have the best opportunity to detect suicidal thinking among our friends and family members. Saving them saves us.

In 2009, at age 22, Tamerlan Tsarnaev told his uncle he was not concerned about work or studies because God had a plan for him. He was flunking out of accounting school. His boxing career was close to over. He identified himself as a very devout Muslim. In 2013, after his trip abroad, he was effectively silenced within the community of his Boston area mosque for the way he expressed his disruptive radicalism.
When a preacher at the same mosque says slain civil rights leader Martin Luther King Jr. was a great person, Tsarnaev stands up, shouts and calls him a "non-believer," the Islamic Society of Boston said. Tsarnaev accuses the preacher of "contaminating people's mind" and calls him a hypocrite. People in the congregation shout back at Tsarnaev, telling him to "leave now." Leaders of the mosque later tell him he will no longer be welcome if he continues to interrupt sermons. At future prayers, he is quiet.
Tsarnaev had become a shunned, alienated, isolated, radicalized has-been boxer, a “loser” as described by his uncle. And an outlaw. Look at the social boundaries he is willing to violate as he challenges the authority of the preacher at his mosque, demonizing, of all people, Martin Luther King Jr.

Who was the person best placed to take this young man aside, befriend him, and find out what he was facing, what he was contemplating?

What everyone can do to prevent attack-suicides

In most of these situations the only possible intervention is below the level of our formal systems. 

Prevention is the responsibility of family, friends, co-workers and neighbors. Even if reported, emergency responders can't act forcefully if the risk is not immediate and serious. Sometimes the police or a crisis team might be able to make a safety check visit to a person's home.

The best thing anyone can do is to support their friend. This helps prevent feeling isolated and helps build resiliency. You are unlikely to ever know if the steps you take to support a friend have prevented a suicide or interrupted a developing course of violence. You want the person to become more resilient and successful, so that the outcome is positive.

Try to have a brief chat in a public place but out of earshot of other people. Ask the following questions one at a time, in order. Practice the questions out loud. Yes, this is awkward. You can use your own words, but follow the pattern. Listen to the person's answer. People benefit simply by knowing they have been heard.

-- What have you accomplished since the last time we talked?
-- What are you facing?
-- Who are your allies?
-- What is your plan?

As you listen, be on the lookout for suicide risk factors. These include prior violence, substance abuse, a failure of addiction or mental health treatment, difficulty verbally expressing feelings, stress, extreme discouragement or recent shameful loss, no ability to make effective plans, trouble relating to other people's feelings, the onset of schizophrenia or another major mental illness, and lack of sources of support.

If you start to feel worried, offer to connect your friend to a more formal source of help. You may have the single most important opportunity to help your friend. If you detect tunnel vision and a sense of diminishing options, or the person talks about suicide, or expresses a lack of hope, ask the person directly about thoughts of suicide. Suicide is much more likely than violence directed against other people. Ask directly using these words: "Are you thinking about killing yourself?"

If you sense that the person is becoming suicidal, stay with the person. Try to persuade them to seek help from their doctor or visit an emergency room. Offer to help them get in contact with a crisis hotline by calling 1-800-273-8255 or dialing 911.

Effective suicide prevention training is available online through the QPR Institute at www.qprinstitute.com/ and from many community groups.

Previous posts

Teach suicide prevention where people buy guns. http://redesigningmentalillness.blogspot.com/2013/02/teach-suicide-prevention-where-people.html

Dear Vice-President Biden, Here’s What It Takes to Fix Mental Health. http://redesigningmentalillness.blogspot.com/2012/12/dear-vice-president-biden-heres-what-it.html

Mass murder is the new flavor of American suicide. http://redesigningmentalillness.blogspot.com/2012/12/mass-murder-is-new-flavor-of-american.html

Lenkford, A. (2013). The Myth of Martyrdom: What really drives suicide bombers, rampage shooters, and other self-destructive killers. NY: Palgrave Macmillan.

CNN. (2013). Timeline: A look at Tamerlan Tsarnaev’s past. Downloaded April 23, 2013 from http://www.cnn.com/2013/04/21/us/tamerlan-tsarnaev-timeline/index.html

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