Are suicide bombers mentally ill? No, says Simon Wessely of the Institute of Psychiatry. "The one thing we can say, with complete conviction, is that whatever else people who do these acts are, they are not suffering from mental illness," Wessely said. "Sometimes these people are misfits, not necessarily well integrated in school or family, but mentally ill they are not."

Wessely's remarks came during a recent discussion on "Reporting Iraq" at the Frontline Club in London. The wide-ranging conversation, sponsored by the Dart Centre and the International News Safety Institute (INSI), also included group analyst Gabrielle Rifkind and was moderated by Dart Centre Europe director Mark Brayne.

Rifkind, Wessely and other participants discussed psychological aspects of the Iraq War and other related issues (click here to read an edited transcript of the discussion).

Rifkind spoke about "what happens when groups of people — nation states — become traumatised," focusing on the effects on the public and policy makers of the September 11, 2001, attacks.

"One of the things that happens when people are traumatised," Rifkind explained, 'is that they become completely consumed by their own experience; that becomes prime over everybody else’s. There’s a collapse of empathy and you get very, very preoccupied by fear of the repetition of the experience. That clearly affects decision-making, and maybe it’s not by chance that some of the decisions that the Pentagon made — and you possibly could say something similar about what has happened in the Israeli government — had to do with losing the capacity to think about what is happening to the other side."

This effect leads to "a cycle of violence," Rifkind said. And she suggested that news media have an important role in stopping such a cycle: "Journalists have an enormous amount of power in terms of whether they can help people think about what’s going on, or whether they actually stoke up and magnify the intensity of people’s sense of victimhood."

Britain and America: Contrasting Methods

Rifkind and Wessely both spoke about the different approaches taken by the British and U.S. forces in Iraq.

"It’s interesting to examine the different methods used by the British Army compared with the American Army and whether it’s not by chance that in Falluja there has been so much violence compared with somewhere like Basra, where I know the conditions are very different," Rifkind said. "Whether the way the British have responded has done more to contain the violence as opposed to provoking it?" She explained: "When the British Army goes in, they realise from the beginning that they actually have to build up relationships in the community. If there is a bombing they go in and talk to the local leadership, the warlords and they get guidance, they get advice. They still have respect for recognising that the elders will have more understanding of how to manage the violence."

"I actually think that the whole reason for the differences between what’s going on between the British and the Americans, is all down to sunglasses," Wessely said. "I should think the root of the problem is sunglasses. I don’t know if you’ve noticed but you don’t see pictures of British soldiers wearing sunglasses?"

Wessely continued: "I wasn’t being facetious. If you’re in a peacekeeping situation and you actually want to tone things down, it’s quite important that you make eye contact with people ... It’s hard to do when you can’t make eye contact. Sunglasses are dehumanising and British doctrine is, you don’t wear them."

The Psychology of Suicide Bombing

Elaborating on his view of suicide bombers, Wessely said: "as far as I know, there’s never been an individual suicide bombing. These are not people who just get absolutely outraged by the Israelis and decide they’re going to go and blow themselves up. It’s a very, very complicated social activity for which people are groomed; that’s the word in fact, that the Israelis use and it’s probably quite a good one. It takes a long time to train a suicide bomber."

Wessely also tried to dispel the notion that suicide bombers are motivated by poverty or ignorance. "One thing we know about suicide bombers is that they're not from the poorer sections of the affected communities," he said. "On the contrary, most of them come from the middle or lower classes, in particular where we have the best data, Palestine; but also from other conflicts as well. They are most definitely not illiterate. On the contrary, they are often recently well educated."

Asked about the psychological factors behind the recent series of beheadings in Iraq, Wessely said: "I don’t think to use psychiatric explanations is going to be at all helpful. If ever these people are apprehended, they will not be mentally ill, as a psychiatrist would describe it. That I’m sure about."

The Merits of Single-Session Debriefing

Wessely, Rifkind and Brayne each took turns criticizing single-session debriefing.

"There is no doubt whatsoever that psychological debriefing after trauma does not work," Wessely said. "So asking people when they come back to sit down and talk about it becomes a one-off, single session psychological debriefing; not only does it not work, nearly all the studies now show that it actually makes it worse. I'm talking about single-session, psychological debriefing with people straight after they've been exposed to a trauma ... Emotional disclosure shortly after trauma is really not for debate. It doesn't work and most of the evidence suggests that it will make you worse. That is completely different from serious and prolonged psychotherapy."

"What would be the point in having a one-off session just to describe what happens to you?" Rifkind asked. "My answer is processing it and putting it back together in a different way, and that takes time and it takes a relationship."

"There are plenty of surveys to prove that this is at best neutral and at worst can do damage," Brayne said. "In fact I've seen this personally as well, the one-off session where a counsellor comes in who nobody knows, gets a group of people together, they have a big ‘cathart', everybody cries and they go away and that's it. That is bad, it just makes things worse and it's irresponsible." However, he added, "that's not an argument to say we don't do anything at all." The answer, Brayne said, lies in "solid systems of good management, good team relationships, support, collegial support, group work, in the sense of a healthy group that's supporting each other. So people feel supported by management, and don't feel betrayed, humiliated, let down."

"Debriefing makes us feel better," Wessely said. "When we see a disaster with the blue light still flashing and we hear that trained counsellors have been sent, it makes us feel better. It makes us feel that something is being done. It’s a mark of the severity of the disaster; it’s part of the symbolism and the theatre of it and it’s also because we don’t like seeing people in distress. We think a terrible thing has happened but so long as the counsellors get there, we will be spared the sight of people in anguish. That’s why we do it.

"Why doesn’t it work? It’s because, well we’ve already touched on it; it’s too early for some people, for some people talking isn’t necessarily the best thing, some people have different emotional reactions; and most importantly of all, when people really do wish to talk at a time and a place of their choosing, they tend to talk within their own social networks to people they know before and people they know ... Talking to the one-off professional who they’ve never met before and will never meet again, all our research suggests decreases social networks and actually impedes the normal process of social support."