Do cases like that of Anders Breivik show that fanaticism is a form of madness? No

Dangers of broader definitions

The legal insanity test in Norway simply requires the accused to have acted under the influence of psychosis at the time of the crime. It is not required to test the offender’s awareness of the nature or wrongfulness of their actions. In such a legal system, insanity can become a convenient verdict for dangerous, subversive, or publicly reviled offenders or fanatics, since it presents the option of indefinite detention in a mental hospital rather than a finite prison sentence. This verdict has been abused in totalitarian regimes, such as the Soviet Union, where political dissidents, who might also have been deemed fanatics, were locked away in psychiatric hospitals. There is also a possibility of abuse in liberal democracies where legal and human rights constraints limit the authority and flexibility of the criminal justice system in managing the risk posed by a small group of very dangerous individuals.

Psychiatry should not be seduced into this abuse of power. Psychiatrists must justify their existence by the effectiveness of their treatments rather than the security of their perimeter fences or their willingness to compensate for the limitations of the criminal justice system.

Fanatics are sane

If there is disagreement about Breivik’s alleged “madness,” the suggestion that he is a fanatic will be less controversial. The Oxford dictionary defines a fanatic as someone with an obsessive interest and enthusiasm for a subject. The term is commonly applied to those with extreme interest in religion, politics, fitness, football, etc. The term does not imply madness but an excessive interest, sometimes at the expense of a balanced lifestyle. Breivik’s self agrandising fanatacism, unconstrained as a consequence of his extreme narcissism and lack of empathy, represents the tip of an iceberg of fanatical xenophobic and racist views rather than a delusional revelation. Clinicians who work with violent men will be aware that such fanaticism is often a reaction to social incompetence, feelings of inferiority, and resentment stirred by childhood neglect or abuse. To label such views as madness is to exempt politicians, teachers, community leaders, and ordinary citizens from their responsibility to understand and address the social, cultural, and developmental origins of extremist political beliefs.

Studies of violent political or religious fanatics do not support the proposition that mental illness plays a part in the development of extremism.1 As a rule, terrorists and suicide bombers are not mentally ill or emotionally disturbed. The most fruitful explorations of the psychology of the violent extremist come from sociocultural and political studies rather than studies of individual psychology. Even in the case of socially isolated extremists such as Breivik, beliefs and behaviours have been shaped and validated by web based interactions. The factors that distinguish the violent fanatic from those who simply seethe on blogs and internet discussion groups may be the additional role of personality factors such as narcissism. It is also important to acknowledge the contribution, and question the sanity, of laws that permit an isolated fanatic to legally purchase a semi-automatic rifle, a Glock pistol, and six tons of explosive chemicals.

In conclusion, it is a mistake to classify fanatics as madmen. Those football fanatics who sacrificed family and work responsibilities to follow hopeless national teams to Euro 2012 were sad rather than mad. They will derive no benefit or solace from psychiatry. Similarly, psychiatry cannot correct the views of violent racists or political fanatics. To mislabel such individuals as mad is to distract from the individual’s personal moral and legal responsibility for their opinions and actions and the necessity that we understand and address the social and political origins of abhorrent fanatical opinions in an ethnically diverse society.