Suicidal behaviors in the Borderline Personality (e.g., making suicidal gestures; cutting themselves repeatedly; what are commonly called "parasuicidal behaviors") are an ongoing and extremely frustrating aspect of dealing with these difficult patients. The frequent and continuing self-harming, self-destructive acting-out of Borderline patients is incredibly puzzling and unnerving for most of the physicians and health personnel who try to intervene and stop the cycle of self-violence. Why, these professionals ask themselves, do these people have such incomprehensible behavior?
The short answer, without troubling to go into any deep psychological interpretations, is really extremely simple. These destructive behaviors are effective and get the Borderline what they most want. The attention of the caring people in the medical profession. Since they feel unable to obtain positive attention, negative attention will suffice and is just as good to produce attention.
The practical way to deal with such multidisordered and difficult patients generally focuses on two parallel processes. The first process encompasses changing the patient's behavior through a re-education strategy where the patient is taught new and more effective skills that over time can replace the dysfunctional ones.
The second process is equally important and aims at addressing the enabling environment provided by the medical professionals, who--although they are trying to help--are actually only reinforcing the dysfunctional suicidal behaviors of the patient. Efforts are made by the mental health team to work closely with the doctors and nurses who might come in contact with specific patients; and train them in how to keep the patient safe, but not to give them any reinforcement for the dysfunctional behavior. Patients need to understand clearly that if they are seeking attention, they will not get it for these behaviors. Over time, the dysfunctional behavior is [hopefully] extinguished, and supplanted by new, more postive and functional behaviors.
We can see the success of this strategy in the recent actions of North Korea. Despite Kim Jong Il's blustering and big talk, he has recently reluctantly agreed to sit down at the table for multilateral talks, instead of the direct talks with the US that he was demanding.
Let us now turn to the homicidal and attention-seeking behaviors of international terrorism. Ever since terrorist acts began to come to the public's attention in the late 19th century; to the present acts of unbelievable barbaric mass murder and mayhem, the sad truth about terrorism --like the suicidal behaviors of the Borderline Patient--is that terrorism works. From the French "Reign of Terror" to the Assassination of the Archduke Ferdinand that sparked WWI; to Zionist terrorism against the British that led to the state of Israel; to the Palestinians, who can be traced as the primary generators of terrorism on an international scale--over and over again, it has been shown that terrorism is an effective technique to get noticed and have your message promoted to the rest of the world--even if they don't want to hear it.
Since the late 60's and early 70's the number of terrorist acts have begun to climb exponentially. Why? The answer is unsurprising. It was about this time in history that the focus of the international news media spotlight began to shine on terrorism. Unlike with North Korea, strategies to extinguish terrorist behavior do not appear to work. That is primarily because terrorist groups are able to get what they want from another source: the international news media.
This first became obvious in 1968 with the hijacking of a commercial El Al airline flight from Israel to Rome in 1968 and followed by the gruesome events a few years later at the Munich Olympics; Palestinian terror groups learned a rather important lesson from those two events--which by the way were not particularly successful in achieving the stated goals of the terrorists at the time. The lesson was one that no terror group since has ever forgotten: There is no such thing as a failed terrorist act. Every act that gets you noticed by the international media is a success because--while it might disgust and alienate some of the public from the cause for a while--it will ultimately also have the effect of mobilizing support and sympathy, and getting you and your demands noticed beyond your wildest dreams.
Hollywood types have known this same truth for a long time; and our Borderline patients understand it instinctively. There is no such thing as bad publicity. When your goal is power and attention, bad attention is perfectly acceptable. As the founder of the Palestinian Front for the Liberation of Palestine (PFLP) commented in 1970, "When we hijack a plane, it has more effect than if we killed a hundred Israelis in battle." Indeed, the mere publicity of a terrorist act has such a profoundly positive effect for their overall objectives and goals (power, attention, victory), that the attempt is worthwhile even if any inidividual terrorist act should fail.
As with the Borderline Personality, the strategy to deal with this unhappy fact must be twofold. First, efforts must continue to exert pressure in any way possible to get the terrorist organizations to change their behavior. This is a far more difficult and involved task to accomplish, than it is with the Borderline patients I describe above, but any efforts in this direction are completely and totally futile if the second part of the strategy is not also implemented.
We have experienced this over and over again in Iraq. Just when you think terrorist attacks will certainly cease--they escalate in a classic pattern demonstrating that terrorist behavior has been reinforced strongly in the past, and that the leaders believe eventually--if they are persistent--the behavior will be noticed again by the international media, and hence the international community.
We have neglected to deal with the professionals who are enabling and reinforcing the terrorist and terrorist organizations. The International News Media. (See here for some thoughts on enabling behavior for terrorism)
There already exists a professional code of ethics for journalists, and its states, "Seek Truth and Report It." This seems simple enough, yet one part of the Truth may be that by reporting a story a certain way or under certain conditions set by some groups (i.e., terrorists), then not only are you subverting the Truth, but you are aiding and abetting those who only care to use you to distort that Truth. It is not the fault of journalists that this situation has come to be, just as it was not the fault of the doctors trying to do their best with Borderline patients in a difficult situation. But unless they are willing to acknowledge that they have become part of the problem, it will be difficult to implement any coherent strategy to encourage change.
It may already be too late to stop the now mutually co-dependent behavior that has become increasingly common between terrorism and journalism--the one seeking international attention at all costs; the other seeking a story at all costs. But here are a few ideas that could be discussed (certainly not exhaustive):
- An international conference of media journalists should be convened to come up with the equivalent of a "Geneva Convention" for the reporting of terrorist acts. The details can be decided later, but if the goal is to stop the journalistic profession from being used by terrorism to further their homicidal and non-democratic agendas.
- No terrorist or terrorist group likes to be called a "terrorist"- they prefer the less pejoritive appellations like "freedom-fighter", "rebel", "insurgent", and even "guerilla". Therefore all news organizations should unhesitatingly refer to them as "terrorists" without apology. If it walks like a duck and squawks like a duck, then call it a duck.
- place off-limits and make it unethical for the profession to accept an invitation from any terrorist group to witness a terrorist act
- Journalists must be subject to some professional penalties if they collaborate with terrorists or their organizations for the purposes of obtaining a "story".
If journalists and the newsmedia want to regain the trust of the public, then perhaps it is time to review and update the professional code of journalists and re-commit to the values it embodies.
It is certainly possible as I said before, that the co-dependent behavior of journalists and terrorists will be resistant to intervention. It is also possible that "rogue" journalists or news outlets will disregard any professional rules. But journalism used to be an honorable profession where the personal integrity of the reporter could only enhance his or her story.
In the medical profession the Hippocratic Oath enjoins us to "First, Do No Harm". If we discover that our actions--no matter how benevolently or professionally motivated--are doing harm, we must be willing to look at our behavior and change it to do what is necessary. Journalism and Medicine are certainly not similar professions, but just as Medicine must bow to Truth in its optimal application; so too must Journalism bow to Life.
In these years of living dangerously, journalism could do much worse than adopting a professional oath that minimizes the harm their efforts might wittingly or unwittingly encourage.
UPDATE: Here's an extremely interesting article that details the journalists who are actually rooting for the other side...at least in medicine, doctors refuse to be on the same side as the disease.
UPDATE II: Ben Stein discusses a rather extraordinary case of a lack of journalistic ethics during Vietnam.