Could Breivik (who murdered 77 people in Norway) ever be described as NOT mentally ill?

[AgentZigzag]

Could someone who deliberately chose to murder 77, mostly young, people for an ideological cause, be classified as not mentally ill?

Surely the act of believing such a thing was a 'necessity' indicates he has mental health problems i.e. that something other people have that stops them killing people wasn't there?

But could the level of planning to do such a thing only possible if a person had a level of 'sound mind'?

Just to pre-empt some points that might come up-
-I don't think mentally ill people are 'nutters' or 'mentalists', and know people with mental health problems are more likely to have violence meted out on them than be the perpetrators of violence
-I don't mean any disrespect to the victims or families of the victims asking the question, I was thinking about the 'grey' areas of mental illness where someone's diagnosis might not fit neatly into a category from the DSM
-I haven't spoken to Breivik or know anything about his mental health, so am not passing comment on whether he is mentally ill or not, but am thinking about a wider definitions of people who try to rationalise killing lots of people.

There is a difference between beliefs and delusions. Delusions are concrete and unshakeable. They cannot be challenged.

Those with extreme or unusual beliefs can often understand other peoples points of view or can see the argument against their belief. Those with delusions are unable to do this.

Agree - if we (including me!) use the 'mad' label I guess my feR is we excuse it as not his responsibility and, similarly, don't try to understand it because it's 'the product of an I'll ess' thus 'job don't on any attempts to explain or comprehend?

I think that the thought processes which lead to committing such acts are so far from those that most people (including most people with a mental health issue) have that perhaps concluding he is unwell /not thinking normally is a reasonable reaction.

Where the line between evil and ill comes, I cannot judge.

I think tht to believe people who do such things are unwell, whether true or not, is a self defence mechanism for most of us.

some people are just evil,plain & simple,they use things as an excuse to get away with it and claiming to be mentally ill.

He doesn't have to have been in crisis to do this. He could be functioning quite nicely in his psychotic illness for many years. His acts may not have been the tipping point of his condition.

I've been thinking through my patients recently. Some of them have been up to some pretty complex and well planned misdemeanours just prior to their first presentation. So actually I think he may have been capable of planning this while psychotic.

Breivik isnt claiming to be mentally ill.

I think people's beliefs can be unshakable and unnameable to challenge - that doesn't mean they're mentally unwell.

The line between belief and delusion is notoriously hard to drawn - I tend to focus more on the impact that particular beliefs have a on person and those around them rather than trying to definitively determine if it's a delusion if you see what I mean? But then, I tend to do that for a whole spectrum of symptoms, experiences and emotions!

I don't believe a label helps us to understand what leads someone to such actions. I don't have an answer either mind, but other than from a legal point of view (which is of course a big issue!) what help does a label give us (genuine question)?

They rarely do walk in and say I think I'm delusional.

Well, if he does have a mental illness, it would be worth treating him.

If he doesn't have a mental illness then he needs to be sentenced accordingly.

I also suspect the victims and their families would like to know if he is mentally unwell.

I disagree with delusions vs beliefs. While they interweave to some extent, you can normally tease out what is based in reality etc.

Well I suppose some people see a label as a reason , not a 100 percent one but something that may have contributed or caused whatever the occur. That's sort of how I see it. The label itself obviously doesn't mean someone is a mass murderer but it can sometimes explain why certain acts were commited. It allows some understanding I suppose ?

Terrorists are a good example crescent, the muslim fundamentalists who fly planes into skyscrapers aren't suicidal or mentally ill, and it's those people who someone has to find out why they're doing such a thing if the reasons aren't the 'normal' reasons someone would do such a thing, to try and stop it happening again.

With these types of terrorists I believe social influences rate highly in why they do it, a kind of brainwashing of vulnerable people.

Brainwashing is an effective technique, could it apply to Breivik? Would that make it a rational decision but nothing to do with his mental health?

I suppose there are lots of people who commit heinous crimes - as a poster above pointed out above, think of suicide bombers, or terrorists, or the likes of Ian Huntley or Rose West - not mentally unwell by current medical or legal definition.

If only they had your expertise to draw on at the trial back2two, could have saved the money spent on all those psyciatric reports. Just out of interest, which mental illness do you think he has, and why?

I guess the teasing out reality to help define belief or delusion, helps with diagnosis - I tend to work post-Diagnosis on strategies for adapting, growing and developing - where diagnosis is often less important if you see what I mean?

That's a thought worth pondering- brainwashing.

Did I read somewhere that he used to spend an inordinant amount of time playing violent computer games? Just throwing it in the mix.

I agree, the two disciplines are not so far apart. I do think there is a distinction between awful crime committed because of a mental illness (I.e. A command hallucination ordering the Person to do it while psychotic) and someone who makes a choice to do something awful - hence Huntley in prison, Sutcliffe in Broadmoor.

Yes where does brainwashing fall in or around mentally unwell ? I mean people who are brainwashed could be descibed along those lines couldn't they ? They aren't thinking like a ?normal ? person would.

I guess that would be a temporary rupture in the person's otherwise 'usually held' beliefs? Of which the outcome can be tragic.

Rose west is an interesting case.

She doesn't have what would be diagnosed as a mental illness. She comes from a family with a strong background of mental ill health and her entire background shows her being set up to a point where she was desensitised completely? She was brutalised and abused by her father. Her mother underwent ect when pregnant which no one knows if it's safe or not.

She worked a prostitute - research shows a higher level of mental ill health among them, and many of them having PTSD.

Apparently even now she has no remorse, no empathy about her crimes - its all about the effect on her.

So even thought there is nothing diagnosable there, there is the whole surrounding picture that suggest she is pretty unwell.

As someone said earlier, people who commit horrific crimes often have physical differences in their brains to other people.

I guess point in question - our understanding of mental illness v personality disorder (and bordering on SN in her case if I remember rightly?) is imperfect - and our sympathy towards personality disorder even further from perfect ('us' as in professionals in MH). Ditto our appreciation of the impact of things like maternal ECT (side point - met a psychiatrist few weeks back at conference - very pro-ECt including for pregnant women - stated it's 'safer than medication' in pregnancy. No studies AT ALL to support this presented. But used commonly apparently in US. Shocked and chilled me)

It iis highly likely that he has a personality disorder - mixed psychopathic / narcissistic. This is not a mental illness because it is not amenable to treatment (ie. You can't change the fundamentals of your personality). It would be very bad indeed for those with a mental illness if he was given this label.