M. Grimland et al.: The Pheno
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Research Trends
The Phenomenon of Suicide Bombing
A Review of Psychological and Nonpsychological Factors
Meytal Grimland1, Alan Apter1, and Ad Kerkhof2
1
Feinberg Child Study Center, Schneider’s Children’s Medical Center of Israel, Sackler School of
Medicine, University of Tel Aviv, Israel, 2Vrije Universiteit Amsterdam, The Netherlands
Abstract. This article reviews the literature on the phenomenon of suicide bombing. It addresses the question of just how much a
psychological understanding of the individuals involved can aid in prevention. The article looks at historical, epidemiological, and cultural
perspectives and compares the nonpsychological and psychological approaches to suicide bombing. On the basis of the material available
it seems that social processes such as group-dynamic indoctrination and political factors are decisive in analyzing this problem. Cultural,
nationalistic, and religious factors are important. The conclusion is that in suicidal bombing, suicide is instrumental in the context of war,
not in the context of psychopathology. Suicide bombing is instrumental in realizing fatalities, and it is only one of many weapons. The
act of killing in warfare is more important to understanding suicidal terrorism than the act of suicide. This explains why psychological
profiling of suicidal terrorists has to date not been successful.
Keywords: suicide, terror, bombing, indoctrination, psychological and nonpsychological approaches
Authors’ Note
This manuscript was prepared for the IASP Taskforce on
Suicidal Acts in Terrorism. This manuscript reflects only
the views of the authors. The purpose of the Task Force is
to offer recommendations to the IASP. Thus, this manuscript does not reflect the standpoint or views of the IASP.
The authors wish to state the following: Suicide bombing
is a complex issue with widely different views attached to it.
It is, therefore, very difficult to be objective. As are most
people, the authors are emotionally touched by this practice.
One cannot avoid reacting in a subjective manner. In the following text we do not claim to be totally objective, since we
approach the topic from an Israeli and Western European
perspective. We accept the likelihood that the following text
will not be regarded as objective by all the readers. Yet, we
have tried to be as neutral as we possibly could.
Introduction
The past few decades have witnessed an alarming rise in
the number and scope of targeted suicide bombing attacks
worldwide. Besides their potential to inflict many casualties, suicide bombing attacks are particularly dangerous because they are so difficult to combat. By virtue of their
ability to carry out the attack where and when it will cause
© 2006 Hogrefe & Huber Publishers
the most damage, suicide terrorists are extremely likely to
succeed. At the same time, the attacks inspire religious or
ideological zeal, which increases the threat to society (Ganor, 2001). As even the least effective attack can strike a
deadly blow to public morale, suicide bombing causes not
only direct damage to individuals in its path, but also severe
psychological damage to the population at large. The fear
of terror, which is usually stronger than the threat itself, is
largely the result of its unpredictability. Living under terror
means being on constant alert. The single attack on September 11, 2001 in the United States suddenly made people
aware of how vulnerable they are simply because of their
dependency on modern mass transport, electricity, and pure
water supplies.
Suicidal behavior is not easily definable, since there appear to be fundamental differences between people who
attempt suicide and people who die from suicide. Furthermore, the true intentions behind the act and the degree of
consciousness preceding it often remain unclear (Merari,
1998). Another difficulty is the distinction among those
who are ready to die, those who seek to die, and those who
are indoctrinated into suicide.
For the purpose of this paper, a suicide bombing attack
is defined as a politically motivated, violent attack perpetrated by a self-aware individual who actively and purposely causes his own death by blowing himself up along with
his chosen target. The perpetrator’s death is a precondition
for the success of the mission (Schweitzer, 2001).
Crisis 2006; Vol. 27(3):107–118
DOI 10.1027/0227-5910.27.3.107
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M. Grimland et al.: The Phenomenon of Suicide Bombing
Whether mental-health professionals should take an interest in suicide bombing is a moot point. Is there a psychological profile that characterizes suicide terrorist? Can
we understand the mind of a suicide terrorist? Such questions are, of course, of vital interest to counterintelligence
agencies. Yet society, too, is facing the possibility of new
and greater mass-destructive attacks. Should we not also
seek to decipher the states of mind that are conducive to
such actions and the psychology underlying personal decisions to cause horrible suffering and grief to an untold number of people?.
This paper attempts to tackle some of these issues and
to review the various theories suggested to explain the phenomenon of suicide bombing.
History
While terrorism is not a new phenomenon and has always
carried a high risk for its perpetrators, what is new is the desire
of certain individuals to kill others while killing themselves
(Merari, 2004). Although some authors claim that before the
early 1980s suicide bombing was rare but not unknown
(Lewis, 1968; O’Neill, 1981; Rapoport, 1984), a more thorough examination of these reports shows that the early cases
cited were not true suicide bombing events because they did
not include the element of self-killing.
Amnon Lipkin-Shahak (2001), former Chief-of-Staff of
the Israel Defense Forces, speculated that the first person
to take the lives of many others while committing suicide
was Samson. However, though he performed his act out of
rage, revenge, and desperation, Samson was not a terrorist.
Accordingly, the Jewish Sicarii in the 1st century AD and
the Persian Assassins (Hashishiyun) in the 11th–13th centuries AD, who killed their opponents by dagger and were
highly likely to be caught in the process and executed themselves, did not kill themselves deliberately. In this respect,
they were not different from the 19th century anarchists,
the early 20th century Russian social revolutionaries, and
the late 20th century Latin American terrorists (Merari,
2004). The early terrorist attacks in Israel in the 1970s were
actually intended for purposes of hostage taking, and incidentally turned into suicide. They differ from modern suicide bombing in that they did not originate from an organizational decision to kill by suicide. By contrast, the Japanese Kamikazi pilots of World War II were indeed
suicidal, but their actions were performed in the context of
a military operation. Conceivably, the psychological processes inherent in forming a military suicide unit differ
from those involved in producing an individual suicide terrorist, though there may be overlap with the recruitment
methods used by insurgent organizations that operate in a
military or guerilla warfare context. So far, the only insurgent group to employ suicide bombing attacks to undermine enemy soldiers are the Tamil Tigers (LTTE) in Sri
Lanka.
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The LTTE adopted the tactics it used to kill the heads of
state of Sri Lanka and India from the Hezbollah in Lebanon, the first nonreligious group to engage in what we define as modern suicide bombing. These attacks were successful in removing foreign UN peacekeeping forces from
Lebanon and, later, in destroying a Jewish Center in Buenos Aires. They were largely based on the religiously inspired suicide bombing of the Sunni fundamentalists supported by Iran. Other secular groups that used these tactics
were the Tanzim (armed wing of the Fatah), al-Gama’at
al-Islamiyya in Egypt, the Kurdistan Worker’s Party (PKK)
in Turkey, the Syrian Social Nationalist Party (SSNP), the
Baath party, and the Lebanese communist party (Merari,
2004; Schweitzer, 2001). The most notorious acts have
been carried out by al-Qaeda, headed by Osama bin Laden,
which has close operational links with Egyptian groups.
Chechen rebels, as well, have carried out at least 16 suicide
attacks against Russia in the past few years
. Evidence suggests that the Chechen implementation
of suicide attacks as a main mode of operation was prompted by the success of al-Qaeda (Paz, 2001). In Iraq, largescale suicide attacks have been instituted recently in response to the U.S. occupation. In the countries where suicide attacks were used by terrorist groups, they caused far
more casualties than any other mode of terrorist operation.
Epidemiology
The most striking epidemiological feature of suicide bombing is its almost epidemic-like increase over the last two
decades, and especially, the last 5 years. Today, terrorist
organizations rely increasingly on suicide attacks to
achieve major political objectives, and the attacks are
growing in both tempo and location (Pape, 2003). It is extremely difficult to profile suicide terrorists because they
come from a wide range of backgrounds. In a study of Palestinian terrorists Merari (2004) found no differences in the
distribution of socioeconomic or educational factors from
the general Palestinian population. Others have noted some
similarities with nonterrorist suicide victims, namely predominantly male sex (although this is changing) and unmarried status. Religious groups such as Hamas and Palestinian Islamic Jihad (PIJ) generally reject candidates who
are married, under 18 years of age, sole wage earners in the
family, or burdened with other family responsibilities. Interestingly, however, religion is a risk factor, not a protective factor (see Kershner, 2001).
According to Hassan (2001), the typical Palestinian suicide terrorist is religious, “normal, polite, and serious.”
They are motivated mainly by the effectiveness of suicide
bombing as a military strategy, nationalistic pride, need to
revenge national and personal humiliation, and hatred of
Israel and America.
Joseph Lelyveld (2001), the New York Times journalist,
claimed that suicide bombers have no underlying psycho© 2006 Hogrefe & Huber Publishers
M. Grimland et al.: The Phenomenon of Suicide Bombing
pathology, and that it is, in fact, their mental stability that
helps them to endure pressure. He underscored the LTTE’s
routine exclusion of unstable persons as candidates for suicidal terrorism, in addition to the ability of the 9/11 attackers to remain patient and focused for so many months before taking action; observers described the latter as being
quiet, aloof, and laconic – far removed from the preconception of an impulsive violent terrorist (Meloy et al., 2001;
Restack, 2001). Further support of this notion was provided
by Moghadam (2003) who reported that Hamas and PIJ
recruiters will not select candidates they deem to have suicidal tendencies. One PIJ member is quoted saying, “In
order to be a Martyr bomber, you have to want to live.”
Merari (2004) interviewed 34 parents and siblings of
suicide bombers from 1993 to 1998 and found no clear evidence of psychopathology and no common personality
type. Yet, about one-third of the terrorists had suicidal tendencies, although they did not display the main recognized
risk factors for suicide, namely, clinical depression, alcoholism, or drug abuse, or history of suicide attempts.
Having said that, it should be noted that no clear evidence of psychopathology does not mean that suicide terrorists are “sane” or without major psychological disturbance that might be detected if there were an opportunity
to evaluate them.
Though traditionally considered a male dominion, more
and more female terrorists are joining the fray. Some past
examples are Turkey (PKK), Sri Lanka (LTTE), and Lebanon (SSNP). Beyler (2003) reported that women are more
likely to become suicide terrorists for nationalistic rather
than religious motives. Some religious groups, such as Hamas and PIJ, use women too, but they also have nationalist
goals. Cultural influences apparently play a major role in
this phenomenon. Thus, it is not solely a woman’s willingness to commit a suicide attack, but the recruitment policy
of the particular group she seeks to join. Women so far have
accounted for 30–40% of the suicide attacks of the LTTE,
11 of the 15 suicide bombings of the PKK, and 5 of 12
suicide attacks of the SSNP. The women are chosen to deceive security officials by their innocent appearance (they
are often dressed to look pregnant) and for the stronger
psychological impact of their actions (Schweitzer, 2001).
Laqueur (1987) claimed that female terrorists are also more
loyal and fanatical than their male counterparts, but he does
not qualify this impression with empirical evidence.
The role of women in the PKK has been extensively
described by Ergil (2001). The Kurdish rural community is
very traditional and affords few freedoms to women. Women have little contact with the outside world, and their place
in the family depends entirely on men. Most have no
schooling. Thus, for women, the PKK means both ethnic
and gender emancipation. They are given equal status with
men and undergo military training. Since they are less effective than men in regular military operations for physical
reasons, suicide missions give them an opportunity to prove
their equality.
Similarly, Beyler (2003) described the female Birds of
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Freedom suicide commandos, part of the Sri Lankan LTTE,
currently an estimated 5000–9000 strong. These women
are regarded as equal to men, and their training is extremely
rigorous. Some were recruited as children; even 10-yearolds have carried out suicide missions. Many of the women
are rape victims and view the suicide mission as a means
of restoring their self- and public esteem. This tendency is
now spreading to other essentially patriarchal societies,
such as the Palestinians in Israel (Beyler, 2003), where
women are “literally and metaphorically dying to become
more involved in the armed conflict.” It has caught both
the Israel Defense Forces and Palestinian society largely
by surprise. Palestinian clerics have been forced to issue
retrospective religious rulings (Fatwas) to justify these actions.
The Media
The media play a vital role in the propagation of terror-related suicide. Studies have shown that sensational media
reporting induces “copycat” suicidal behaviors; this has
been termed the Werther effect. It is particularly relevant
to suicide bombing, where the attempt to inflict as many
casualties as possible arouses tremendous media coverage.
The primary target has switched from physical damage to
media interest and recruitment of “volunteers” (Schweitzer, 2001). For example, one young Palestinian interviewed
by an A.P. reporter after a suicide attack in Israel exclaimed, “Did you see how the Jews were crying on television? I want to become a Martyr like that to scare the
Jews, to send them to hell.” This practice was confirmed
when the stone throwers in the first Palestinian Intifada –
who did not generate much media interest – were replaced
by suicide bombers in the second Intifada. Bassiouni
(1983) showed that repeated suicide bombing attacks generate more and more media reports, keeping the public’s
attention focused on the terrorist organizations’ goals and
ideology. This cycle creates, in the words of Hoffman
(1998), an “inherently symbiotic relationship” between terrorism and the media – a relationship that has been further
strengthened by recent innovations in media technology
enabling simultaneous reporting from many different sites,
combined with the increased use of women suicide bombers to heighten the dramatic effect. Accordingly, when a
29-year-old female lawyer blew herself up in a crowded
Haifa restaurant, killing 20 people, Arabs and Jews, many
of them children, she became an instant media star. Details
of her biography were published for weeks in the newspapers, and her family was interviewed constantly on television, saying how proud they were for what she had done.
Other instances of propagation of terror-related suicide
come from the UK (The London Bombings in 2005) and
The Netherlands (the assassination of Theo van Gogh, with
the intention of being killed after the act) where radical
terrorist groups adopted suicidal strategies after having reCrisis 2006; Vol. 27(3):107–118
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ceived information through news agencies such as Al Jazeera and through the internet. It appears that groups of
young muslims from second generation immigrants “selfignited” without having had contact with Al Qaeda. These
“self-burners” expose themselves to indoctrination through
web-sites and news agencies and operate without any training.
Means of Suicide Bombing
Crenshaw (1990) suggested that technological improvements in explosive devices alongside the growing ease of
access to technological information on the Internet are major factors in the increased use of suicide bombing in terror
attacks. With the exception of the malleable plastic explosives and detonator, jackets are easy to make from components bought at the local tailor (stretch denim) and auto
shop (steel ball bearings, wires, batteries, and switches),
and the resulting bomb is equally easy to operate. The cost
of the whole package is about $150. As a Palestinian security official pointed out in one interview, “. . . the most expensive item is the transportation to the Israeli town” (Hassan, 2001).
Cultural and Religious Factors
Culture and religion often set the conditions under which
persons may commit suicide and, sometimes, what means
they can employ. They also influence peoples’ concepts
and expectations of life after death. Durkheim (1898/1951)
suggested that the wide differences in suicide rates across
countries are probably explained at least in part by cultural
and religious differences. He identified four types of suicide characterized by the integration of an individual to the
society. The most germane is the altruistic suicide which
Durkheim defined as “where the ego is not its own property, where it is blended with something not itself, where the
goal of conduct is exterior to itself, that is, in one of the
groups in which it participates” and continues by saying
“the individual . . . seeks to strip himself of his personal
being in order to be engulfed in something which he regards as his true essence” (see Leenaars, 2004). That is, the
individual commits suicide for something he loves more
than himself, his needs are not that important. Society in
return would support the act, in fact it will benefit from it,
not necessarily materially, but in the sense of reinforcing a
value of its cultural beliefs (Stack, 2004). Being absorbed
into something more valuable than one’s own life and the
public support for such an act are presented in the following
section.
Although both Judaism and Christianity promise life after death, both condemn suicide as a means of achieving it.
Judaism permits a person to kill him/herself only when doCrisis 2006; Vol. 27(3):107–118
ing so will prevent that person from committing a murder,
performing incest, or worshipping a false god. The preservation of life (pikuah nefesh) supersedes all other religious
and social dicta. Persons who commit suicide for other than
the permitted reasons are maligned; they may be buried
only outside the cemetery walls. Modern Christianity is
less clear about suicide, though in general the Church considers suicide a rejection of the gift of life and will not bury
victims in hallowed ground.
In fact, when Battin (2004) raises the question of why
the West doesn'’t adopt the tactic of suicide bombing in
response to the Jihad actions, (why is it more problematic,
more wrong than the other ugly actions of war) she believes
that it is the Judaeo-Christianity cultural tradition disparaging suicide that makes it unthinkable to the West to use
it as a method of attaining goals. It draws a line between
suicide and martyrdom in a way that precludes suicide
bombing. It is not that the West does not have this weapon;
rather it cannot use it because of its cultural foundations.
The concept of martyrdom simply doesn’t exist.
Nonetheless, it should be clear that Islam strictly forbids
suicide. Studies of Muslim countries report even lower
rates of suicide than for Israeli Jews, except for a substantial increase recently among Israeli Arabs. The Shi’ite survival code (Taqiyya) adheres strongly to the preservation
of life, even allowing followers to pose as Sunni to save
themselves (Merari, 1998). Along with the low suicide rate
in Arabic Islamic countries, Abdel-Khalek (2004) cites research indicating higher means than Western samples on
measures of psychological disorder, such as depression,
which usually serve as predictors of suicide. Abdel-Khalek
(2004) solves this supposedly contradiction by emphasizing the functioning of religion as a buffer, an explanation
that was confirmed in other studies as well. He writes that
a true Muslim believes that he is the servant of Allah, the
creator and the provider who determines the life span of his
creatures; a Muslim is not free to end his life when ever he
wants, and by killing oneself or another is doomed to great
punishment. Moreover, Islam considers the killer of one
single person as the killer of all people, as if he killed all
mankind. Abdel-Khalek (2004) seem to represent an almost unheard voice in Western literature by praising the
beauty of the Islam and its supreme values, which he summarizes as friendship, mercy, cooperation, altruism, sacrifice, and self-denial, and the relationship with non-Muslim
as those of knowing one another, cooperation, righteousness, kindness, and justice. In that spirit, the word Islam is
taken from the word Salaam, “peace” in Arabic. He realizes
there may be a gap between the high principles of the Islam
and their application and justifiably mentions the difficulty
of controlling the behavior of a billion and a quarter believers in Islam. He continues by saying that a superficial and
biased reading of the Holy Koran may lead to a premature
conclusion that this is a religion that encourages violence
but than argues that there is neither war nor hatred between
a true Muslim and any Christian or Jew, person or state with
the exception of the Zionist in Israel. This statement raises
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M. Grimland et al.: The Phenomenon of Suicide Bombing
questions if one considers the acts of suicide bombings
against Jews in Argentina or Kenya or the 9/11 attack on
American soil designated against American citizens
whomever they are. How, than, does he explain suicide
bombing? Abdel-Khalek (2004) claims that Islam is not a
religion of submission or of oppressed human beings and
the Palestinians, as a case study, have a deep feeling of
injustice and humiliation after being chased out of their
own country and conquered by the Israelis, feelings that
may very well be true. Yet provocative, unsubstantiated
statements such as “All of these are caused by what the
Israeli army has done against the Palestinians by killing and
imprisoning, then burying prisoners of war alive, using the
arrested people as human spare parts in Israeli hospitals for
the wounded Israelis . . .” makes the possibility of conducting an objective discussion far more difficult. Portraying a
picture where the Palestinians are the sole victims and Israel is the only one to blame for the conflict seems partial
to say the least.
What about he who carries the martyrdom? The concept
of the shahid or Martyr is, by Islamic definition, a warrior
killed by the enemy in battle in the name of Allah. This entitles him to life after death in paradise with 70 of his dearest
relatives and friends and the pleasure of 72 virgins (Hassan,
2001). Recent religious and political authorities, however,
have adopted the use of the term shahid for suicide bombers
to overcome the Islamic stricture against suicide and to encourage new recruits (Merari, 1998). Kershner (2001) cites
the work of Dr. al-Saraj, a Gazan psychiatrist who reported
that the belief in a sinless afterlife is cultivated in potential
suicide bombers and it serves as a prominent factor in their
willing recruitment. “If these people believed that death was
their real end,” he claims, “they would never do it.” In addition, some religious authorities have been heard voicing militant stands. The Mufti of Jerusalem, Ikrama Sabri, has
claimed that “the Muslim embraces death . . . the Muslim is
happy to die.” These statements are very popular in Gaza and
the West Bank, and are connected to the teaching that Western
peoples, including Jewish Israelis, are morally corrupt and
“protect their lives like a miser protects his money.” This
manner of thinking may prompt “wannabe” Shahids to prove
that, unlike the cowardly infidel, they are not afraid to lose
their life (Moghadam, 2003).
Moreover, Islamists in general perceive the West, and in
particular the United States and Israel, to be at the forefront
of an anti-Islamic conspiracy that tries to undermine their
religion, culture, and values. This perceived threat has led
many to declare jihad, or holy war, in self-defense against
the “enemies of God,” thereby legitimizing suicide bombings and other violent acts. In the words of the former spiritual leader of Hezbollah, Sheikh Muhammad Hussein Fadlallah, those who commit such activities “are not preachers
of violence . . . Jihad in Islam is a defensive movement
against those who impose violence” (Moghadam, 2003).
Not all modern suicide bombing is limited to Islamic
fundamentalist groups, although they receive the most attention in the Western media. For the last 20 years, the
© 2006 Hogrefe & Huber Publishers
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world leader in suicide bombing attacks (more than 170
attacks) has been the LTTE, who recruit from the predominantly Hindu Tamil population in northern and eastern Sri
Lanka and whose ideology has many Marxist-Leninist elements (Gunaratna, 2000; Schweiter, 2001). They have only recently been exceeded by the Palestinians (Merari,
2004) but the number of attacks on Iraqi soil since the
American occupation seems to exceed even that.
Community support is also a crucial factor in suicide
bombing, which is illustrated by the fact that Muslim culture
does not use the Western term “suicide bombing” but rather
Istishad-Martyrdom, or self-sacrifice in the name of God
(Paz, 2001). Palestinian society places great weight on respect and dignity, and considers martyrdom the ultimate honor (Moghadam, 2003). The acceptance of suicide bombers as
Martyrs is further encouraged by broadcasting videos of past
and future volunteers, distributing their photos in leaflets,
posters, and calendars, and reenacting famous acts in pageants and school plays. The suicide terrorist, thus, becomes a
source of envy and pride for his (or her) family (Hassan,
2001). Polls conducted by the Palestinian Center for Policy
& Survey Research, directed by Khalil Shiqaqi, show that the
level of social support of suicide bombers in the current Intifada fluctuated between 55% and 75%.
The new social status of the suicide bomber was clearly
depicted by Dr. al-Sarraj, a Palestinian psychiatrist (see
Butler, 2002): “In the last uprising, children used to play a
cowboys-and-Indians-type game called ‘Intifada.’ Some of
the kids took the role of Israeli soldiers armed with ‘guns’
(really sticks) and the others the role of the Arabs wearing
kufiyyahs and armed with stones. Many of the children preferred to play the soldiers, because they represented power.
Today, this game has entirely disappeared. Today, the symbol of power is the Martyr. If you ask a child in Gaza today
what he wants to be when he grows up, he doesn’t say he
wants to be a doctor or a soldier or an engineer. He wants
to be a Martyr.”
Orbach (2004) observed that in the past the Palestinians
were perceived by the Israelis and by themselves as helpless, inefficient, and passive but the image now has
changed and Palestinians are now perceived as courageous
and heroic. The new self-image of the young Shahid is of
a powerful, committed hero who succeeded in shaking the
confidence and security of the Israelis. Moreover, Orbach
(2004) thinks that the self-image metamorphosis is not just
a personal change but it carries with it a glorification of the
entire Palestinian people. He quotes a newspaper editor
saying after a suicide bombing “This is the mighty Palestinian nation, a nation that does not fear death, a nation that
does not know how to surrender.”
The Nonpsychological Approach
One of the most articulate protagonists of the nonpsychological approach is Martha Crenshaw of Wesleyan UniverCrisis 2006; Vol. 27(3):107–118
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sity in the United States. She believes that although the
tactic of suicide bombing may be innovative, it is in actuality a combination of familiar methods, targets, and motives and should not be regarded as a sui generis phenomenon (Crenshaw, 2000). The motives for suicide bombing
do not appear to differ significantly from the motives for
terrorism in general – revenge, retaliation, and the provocation of government overreaction. Indeed, she found that
the outstanding common characteristic of terrorists is their
normality. In her thoughtful review, “The logic of terrorism,” Crenshaw (1990) showed that terrorist action is the
product of strategy, not a consequence of psychological or
sociological factors. Terrorist organizations wish to effect
political change as quickly as possible in the face of a strategic inferiority. Her contention is supported by findings
that the attacks of September 11, 2001 in the United States
caused nearly 10 times more fatalities than any previous
terrorist attack in history. Furthermore, in Israel, suicide
attacks in the course of the Palestinian Intifada constituted
less than 1% of the total number of terrorist attacks, but
caused 51% of all Israeli fatalities (Israel Defense Forces,
2003). According to Crenshaw (2000), during the past 20
years, suicide bombing has been steadily rising because terrorists have learned that it is effective. Suicide terrorists
sought to compel American and French military forces to
abandon Lebanon in 1983, Israeli forces to leave Lebanon
in 1985, Israeli forces to quit the Gaza Strip and the West
Bank in 1994 and 1995, the Sri Lankan government to create an independent Tamil state starting in 1990, and the
Turkish government to grant autonomy to the Kurds in the
late 1990s. In none of these cases did the terrorist groups
achieve their full objective. Nevertheless, in all of them,
except in Turkey, the particular terrorist group could boast
greater political gains than those made before it resorted to
suicide operations. That is, suicide bombing made target
nations somewhat more likely to surrender modest goals
(Pape, 2003). While it is too early to assess at this fluid
stage the impact of the Iraqi attacks on the future of Iraq in
particular and on the American war on terrorism and the
U.S. political-strategic situation in general, it seems likely
that it will be considerable (Merari, 2004).
Pape (2003) described a number of properties that are
consistent with suicide bombing as a specific, directed, rational strategy:
1) Timing. Nearly all suicide attacks occur in organized,
coherent campaigns, not as isolated or randomly timed
incidents. Accordingly, Merari (2000) reported that he
did not know “. . . of a single case in which an individual
decided on his own to carry out a suicide attack. In all
cases it was an organization that picked the people for
the mission, trained them, decided on the target, chose a
time, arranged logistics and sent them.” Thus, suicidal
terrorist attacks are not done on the spur of the moment,
as often occurs in suicide.
2) Nationalist goals. Suicide terrorism is aimed at gaining
control of what the terrorists believe is their national
homeland territory; that is, at an existential threat, an
Crisis 2006; Vol. 27(3):107–118
extreme circumstance, which warrants extreme means
(Merari, 2004). This was true for Hamas in 1993, who
believed the Israeli-Palestinian peace process directly
threatened both its ideology and its independent organizational existence. It was also true for the LTTE in 1987,
when the Sri Lankan army was forcing their retreat (Gunaratna, 2000), and for the Kurdish PKK in 1999, when
the group was suffering a severe deterioration in morale
following heavy blows from the Turkish army and the
capture of its leader, Abdullah Ocalan (Ergil, 2001;
Schweitzer, 2001).
By contrast, many attacks by other groups, notably al-Qaeda and its satellites in Indonesia, Saudi Arabia, Morocco,
Tunisia, and Turkey, do not fit the pattern of a desperate
situation. Al-Qaeda was not under a devastating American
offensive when it decided to carry out the suicide attacks
in 1998, 2000, and 2001; nor did al-Qaeda- affiliated
groups in Turkey and Indonesia face a direct local threat in
the aftermath of 9/11, despite America’s war on terrorism.
Nevertheless, while the use of suicide bombing may be at
least in part a reflection of its new “fashionability” and its
current status as the trademark of militant Islamism, Merari
(2004) believes these reasons are insufficient to sustain
massive, long-term campaigns of suicide bombing, such as
those conducted by the Palestinians or Chechens, for whom
cultural background and ideology are probably less important than perceived necessity.
Be that as it may, it is the individual’s willingness to die
that makes suicide bombing seem irrational. Despite the
practical considerations of evading defenses and gaining
access to desirable targets, doesn’t the individual terrorist’s
willingness to experience certain death require a psychocultural explanation? In response to this issue, Crenshaw
(1990) emphasizes the crucial role of martyrdom in suicide
bombing. Were martyrdom not highly valued by the society
or at least by the subculture, individuals would not seek it.
Martyrdom represents the legitimacy and authenticity of
the cause, and the willingness of the individual to sacrifice
everything for the cause establishes its ultimate truth. For
example, in one of the most effective terrorist organizations, the LTTE, the devotion of the members to the group
is fierce, and all carry a capsule of cyanide to be consumed
at capture to prevent their betraying their comrades
(Schweitzer, 2001).
Psychological Approach
Perhaps the greatest research effort by psychoanalytically
oriented theorists in this field was performed by the Group
for the Advancement of Psychiatry (GAP) in 1978. Although this study was done long before the outbreak of
modern suicide bombing and is, thus, somewhat beyond
the scope of the present report, it is the most systematic
review of the psychoanalytic approach to terror and, there© 2006 Hogrefe & Huber Publishers
M. Grimland et al.: The Phenomenon of Suicide Bombing
fore, worth summarizing here. The study was based on a
series of systematic interviews of Palestinian Arabs living
in refugee camps in Gaza and Jordan, in Cairo and Jerusalem, and in Arab villages in Israel. The researchers hypothesized that a real or imagined threat or injury to the nation
may be perceived by the individual as a danger or humiliation to the self, and that the individual response to the
threat is substantially rooted in the distinctive psychological dynamics of the self and its extensions. Furthermore,
the potential for violence is inherent in the reaction of the
self to injury or to a threat to cohesion and continuity,
whether addressed directly to the core (self) or its extensions. Most of the findings were explained according to the
narcissistic-self psychological theory of Kohut (GAP,
1978).
Kohut (GAP, 1978) claimed that narcissistic rage arises
when the self-object fails to live up to absolutist expectations. Although this occurs in all individuals, in those for
whom a sense of absolute control over an archaic environment is indispensable, the narcissistic rage takes on violent
forms. In these people, the maintenance of self-esteem and
of coherence of the self depends on the unconditional availability of the approving mirroring function of an admiring
self-object or on the ever-present opportunity for a merger
with an idealized one. This injury of self-regard is also a
principal source of group aggression. At the group or national level, the rage is directed against the enemy who is
seen as violating the self, the extensions of the self, and the
extended self – including one’s land, village, customs, etc.
However, the enemy who elicits the archaic rage is seldom
understood by those wh are narcissistically vulnerable.
There is a suspension of empathy and rational analysis so
that the enemy becomes “not an autonomous source of impulsions but a flow in a narcissistically perceived reality.”
Rochlin (GAP, 1978) argued that aggression is part of
the defense of self. Therefore, instead of asking what makes
man aggressive and hateful, he asked what makes man
prone to humiliation and vulnerable to injury. He suggested
that narcissistic humiliation plus the license that goes with
group sanction creates a dangerous mix.
Fromm (GAP, 1978) pointed out that this “group narcissism” involves unforgiving injury. When one’s country is
slighted, the narcissistic rage is labeled patriotism or loyalty, and the individual’s motives are, therefore, never questioned.
It is noteworthy that by the year 1960 a large majority
of the Palestine Arab population had established a distinctive Palestinian identity and had entered a phase of nationalistic peoplehood, with the definitive goal of returning to
their homes in Palestine. The Palestinians interviewed by
the GAP group asserted this uniquely Palestinian identity
positively and vigorously. The most powerful element
heard was their narcissistic rage for the Palestinian people,
like that for the self, which arose from a sense of injury and
shame and, in accordance with the narcissistic theory of
Kohut (GAP, 1978), “the need for revenge, for righting a
wrong, for undoing a hurt by whatever means, and a deeply
© 2006 Hogrefe & Huber Publishers
113
anchored, unrelenting compulsion in the pursuit of all these
aims.” These emotions were voiced by both poor and materially wealthy Palestinians. The subjects also shared another characteristic of narcissistic injury noted by Kohut
(GAP, 1978): an intact and even sharpened “. . . reasoning
capacity while totally under the domination and in the service of the overriding emotion.”
Post (1998) leans on Kohutíans terms as well when he
argues that political terrorists are driven to commit acts of
political violence as a consequence of psychological forces
and that such individuals are drawn to the path of terrorism
in order to commit acts of violence. He supported his contention with several studies, although he admitted that all
were limited by poor methodology. Specifically, West German and Italian social scientists found that members of the
Red Army Faction and the Red Brigade had a high incidence of fragmented families, loss of a parent at an early
age, severe conflict with parents, and hostile fathers. Many
had unsuccessful personal, educational, or vocational lives
leading to feelings of inadequacy. Psychoanalytically oriented interviews revealed “developmental histories characterized by narcissistic wounds and a predominant reliance
on the psychological mechanisms of splitting and externalization.” Combined, these factors caused them to seek out
attractive groups of like-minded individuals with an “It’s
not us, it’s them” credo. Similar findings were reported for
Basque and Armenian terrorists as well.
Pearlstein (1991) noted evidence of narcissistic injury in
many first-generation and some-second generation terrorists, namely, massive and lasting damage to self-image and
self-esteem severe enough to force the discredited self to
seek a new, positive identity. These people “represented the
kind of human raw material a recruiter for some terrorist
organization would find it easy prey upon . . . All had a lack
of other satisfying career options. All had no compunctions
against the use of violence.” However, he claimed that
these psychological factors do not apply to today’s suicide
bombers, who appear to be motivated overwhelmingly by
religious beliefs, or at least, by their interpretation of religious faith. “Indeed, their audience seems to be Allah, not
the office workers in New York, Kenya or, Tanzania, where
their bombs have detonated.”
By contrast, Moghadam (2003) argued that if religious
fervor alone could explain the phenomenon of suicide
bombing, then acts of suicide bombing would be expected
to occur more frequently in countries where deep religious
beliefs, let alone religious fundamentalism, is a powerful
force.
Stein (2003) sought to explain a letter left behind by
Mohammed Atta, leader of the 9/11 suicide bombing
group, in psychoanalytic terms. Despite the obvious limitations of such an approach, we thought it interesting to
consider a more radical psychoanalytic view of suicide
bombing, although the author focused on the willingness
to kill others, not the self. Her hypothesis was based on
Freud’s statement: “It seems to me a most surprising discovery that the problems of social psychology, too, should
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M. Grimland et al.: The Phenomenon of Suicide Bombing
prove soluble on the basis of one single concrete point –
man’s relation to his father.” (Freud, 1913). Specifically,
Stein claimed that the letter was intended to serve as a
means of fortifying the minds of terrorists who are about
to commit an act of mass destruction. Its tone resembles,
according to Stein, the voice of a wise father instructing his
sons in the correct manner to approach a mission of great
importance. Although we would expect such a document
to contain exhortations of hate, cries to destroy and annihilate, instead it reassures, calms, calls for restraint and
thoughtful control, and appeals for heightened consciousness. It does not speak of hatred. It is past hatred. Absurdly
and perversely, it is about love; the love of God. The letter
frequently mentions God’s satisfaction with the act to be
accomplished and the things the men need to do in order to
enter God’s eternal paradise. Although we know that these
include annihilation of the “enemies of God” and of the
terrorists themselves (the tools of such annihilation), this is
not spelled out in the letter. The letter describes a ritual at
the end of which the supplicant is to receive God’s approval
by doing what pleases God – purifying the world of contaminating infidels. The confident intimacy of a son close
to his father, who has attained a long-promised love that is
no longer withheld, is almost palpable. If this feeling is
sustained inside oneself, it does not have to be demonstrated externally. “You should feel complete tranquility, because the time between you and your marriage . . . is very
short.” Inasmuch as nothing further is said about that marriage, and particularly whom one will marry, the idea that
the marriage is that of the son(s) to God does not sound
absurd at all.
Is there a root affinity between a son’s love for his divine
father and the religious devotion and intimate communion
with God leading to infliction of mass killing and destruction in His name? Do they spring from the same psychic
source? Do they bear on the image of the father, in the
words of Benjamin (1995), as the “liberator” who opens
the window to the outside world and offers (in Benjamin’s
case) his daughter freedom from domesticity and mother’s
absolute power? Is there any similarity between the father
of freedom and creativity, and the father who loves those
who kill his enemies and chooses those killers as his accepted sons? In both instances, the “father” not only empowers and inspires, he also imparts a sense of fulfillment
and joy of deliverance from a confining life and the identification with new ideals. Benjamin’s words thus acquire
an added resonance.
Lacan (1994) claimed that the process of legitimizing
butchery by formulating a God who is feared and loved and
who does not say no to dissoluteness and crime (“the imaginary father” in Lacan’s words, 1953–1954) must be complemented by the mental obliteration of all vestiges of humanness from a large segment of human beings. Along the
same line, Lifton (1979) suggested that severing the outer
world from human meaning may make it possible for terrorists both to focus on the instrumental tasks at hand and
to remain immersed in an intensely religious state of mind
Crisis 2006; Vol. 27(3):107–118
that screens out undesirable affects and thoughts. He calls
this “a numbing process . . . similar to that cultivated among
Japanese soldiers during WWII in serving the Emperor, as
well as among the Nazis. The soldier was to steel his mind
against all compunctions or feelings of compassion, to
achieve . . . a version of the ‘diamond mind’ that contributes both to fanatical fighting and to grotesque acts of
atrocity.” In addition to its capacity to enhance functioning,
a mesmerized, mechanized mind feeds on hatred and loathing, the building blocks of dismissive contempt. It uses the
power of contempt to chill any affiliative, compassionate
emotion. However, for religious terrorists, the psychic transition does not stop here. The loathing and contempt are
further transformed into a state of enthrallment and deep,
total love for the superior divine power.
The intriguing process whereby contempt becomes love
and adoration poses a major challenge to psychoanalysts.
How can we describe the nature of such love? How does
one make the passage from abhorrence of killing to the
sanctification of killing as good and noble? What mechanism underlies the subversion that culminates in this radically altered perception of human beings? As Oppenheimer
(1996) writes, “The eyes of the evildoers and their followers must be taught to see the ordinary as freakish and [subsequently] to consider the freakish as horrible and as worthy of extermination, as insects and diseases. Any sort of
violence . . . becomes intelligible and necessary when dealing with creatures, formerly considered human, who are
suddenly shown to be poisonous.”
Clinicians must bear in mind that all these psychoanalytic explanations lack a direct source of information on the
mindset and motivation of suicide terrorists. In the absence
of empirical evidence, they should be regarded as purely
speculative.
Bandura (1998), a prominent social scientist, used a
more cognitive- and behavior-oriented approach to describe the mechanisms of moral disengagement from inhumane conduct – the mandatory precursor of the performance of actions the person would formerly have considered reprehensible. These include moral justification,
palliative comparison, and euphemistic labeling. Combined, they allow the perpetrator to minimize or ignore the
consequences of his act and to displace or diffuse responsibility for it and to ultimately dehumanize and blame the
victim. All of them require a degree of self-deception. This
raises a crucial question among psychoanalysts, because it
is impossible to be both deceiver and deceived simultaneously. So far, efforts to solve this enigma have met with
little success. “Given the existence of so many psychological devices for disengagement of moral control, societies
cannot rely on individuals, however righteous their standards, to provide safeguards against destructive behaviors”
(Bandura, 1998).
Volkan (1997), to aid clinicians in the understanding of
the suicide bomber, introduced the concept of placement.
He suggested that, for suicide terrorists, personal identity,
which has been shattered by helplessness, shame, and hu© 2006 Hogrefe & Huber Publishers
M. Grimland et al.: The Phenomenon of Suicide Bombing
miliation, is replaced by group identity. This notion was
supported by Sarraj (see Butler, 2002) in his discussion of
the Palestinian uprising. Serraj argued that the people who
are committing suicide bombings in the present (second)
Intifada are the children of the first Intifada. During their
growth and development in the time of the first uprising,
their self-identity merged with the national identity of humiliation and defeat. Today, they believe they are avenging
that defeat at both the personal and national levels. Serraj
contended that the hopelessness and despair that derives
from living in a situation that keeps getting worse makes
living no different from dying. Desperation is a very powerful force because it is not only negative, it also propels
people to actions they would otherwise have found unthinkable. Studies show that during the first Intifada, 55%
of Palestinian children witnessed their fathers being humiliated or beaten by Israeli soldiers. The psychological impact was stunning. Their authority figure had become
someone who could not protect himself, let alone his children. So the children became militant, violent. People are
the products of their environment, and children who have
seen so much inhumanity will inevitable respond inhumanly. “This,” says Serraj, “is how we can understand the suicide bombings.”
In 2002, Volkan proposed the notion of a “regressed”
society which posits rigid societal obligations and also permits behavior ordinarily thought to be immoral. Outside
groups and their members, thereby, become dehumanized.
Accordingly, the author suggested that to understand the
mind of the suicide terrorist, we need to understand the
psychology of large-group identity. He claimed that intense
suicide bomber training (see section on “Indoctrination”)
has become less necessary of late in the Palestinian-Israeli
conflict because terrorist acts have become “endemic” to
Palestinian culture. As a result, even relatively brief, less
organized training can now produce suicide bombers. Furthermore, because people cling more firmly to their largegroup identity in societies under stress, today even “normal” persons can be pushed to become candidates for terrorist acts.
What about the people who stand behind the suicide terrorist campaigns? Berko (2004), in a study of Palestinian
terror organizations, found controllers to hold a double
moral standard composed of normative moral attitudes to
their own families and a blazing hate toward Israelis, Jews,
and the West in general. They morally justify their acts by
emphasizing their role as victims, their traumatic refugee
existence, and their sense of humiliation and deprivation.
They rationalize their death sentence to others but not
themselves, in what Berko (2004) terms a “distribution of
duties.” In one interview, a controller pointed out: “That is
the way it is . . . that is how it is done . . . here is a soldier
and there is a commander.” The author believes research
should focus more on the population of the controllers “the
cannon shooting the missile,” for they are the key to understanding the phenomenon of suicide terrorists.
More recently the phenomenon of groups of young mus© 2006 Hogrefe & Huber Publishers
115
lims in Western Europe who radicalize into terrorist cells
has attracted attention. In The Netherlands and in the UK,
groups of young, apparently modernized, second-generation immigrants developed into terrorist cells, ready to kill
themselves in an organized suicide spree, or to kill public
figures or members of parliament who publicly criticize
Islam. Substantial information was collected by police investigations after the London bombings and the assassination of Theo van Gogh by a member of the so-called Hofstad group. These young radicals formerly were well educated, adapted to western European lifestyle, and did not
show any signs of psychopathology. The pathological aspect here was the speed with which they suddenly changed
into fierce combatants hating everything the Western European culture stands for. It appears that these small groups
of young persons knew each other from the neighborhood
or mosque, isolated themselves from the society, and
formed sect-like cells with very strict rules of conduct and
authoritarian leadership. Probably the study of group dynamics in the formation of radicalization is more important
here. This radicalization may also be conceived as a reaction to the perceived “group tyranny” of the Western world,
a reaction to the “crusade against terrorism” (Segal, 2003).
In summary, despite many attempts to psychologically
profile suicide bombers, it has not been successful. Some
people still see possibilities here (e.g., Lester, 2004), but
these possibilities to date are still very speculative. Of
course this does not imply that suicide bombers are “sane.”
It only implies that we cannot predict who will and who
will not become a suicide bomber.
Indoctrination
Merari (1998), a major contributor to the analysis of the
suicide terrorist, especially in the context of the Middle
East, places special importance on the role of indoctrination.
Indoctrination may be long or short term. The main tool
in long-term indoctrination is education – by schools, the
media, parents, and friends. The purpose of this process is
to convince the person of the importance of the cause and
of the righteousness of the means necessary for its implementation. Erlich (2002) described the incitement and hatred replete in the Jordanian and Egyptian textbooks that
have been used by the Palestinian educational system since
1996, when it was transferred from Israeli authority. These
books – geared to elementary school and high school students – are indicative of the current mentality of “war to
the death” against Israel and Zionism. One example is listed below (Erlich, 2002):
The Jewish people – The textbooks are fraught with expressions of hatred and hostility against the Jewish people. Quotes
from the Koran are used to show that the Jews are corrupt,
dishonest, and anti-Islam. They claim that according to the TalCrisis 2006; Vol. 27(3):107–118
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M. Grimland et al.: The Phenomenon of Suicide Bombing
mud, Jews believe the human animal was created to serve
them, and that they are permitted to deceive the gentiles who
have satanic souls.
Indoctrination may also be short-term, focused, and mission-oriented (Merari, 1998). In these cases, it is usually
carried out by a charismatic political, military, or religious
leader, close to the time of the mission. All Palestinian
groups have used short-term indoctrination of Fedayeen
(“men of sacrifice”). Abu Jihad (also known as Khalil elWazir), the revered military commander of Fatah, the largest of the PLO terrorist groups, routinely delivered a farewell speech to all teams of Fedayeen just prior to their hostage-taking incursions into Israel. Fundamentalist Shi’ite
terrorists are said to have received a blessing from an Imam
or an admired sheikh before going on a suicidal car bombing. This kind of indoctrination may serve as an ancillary
factor by strengthening already existing convictions and
behavioral tendencies with an element of personal commitment to the particular mission. Nevertheless, it will probably not induce suicidal behavior in the absence of other,
more important elements.
Several researchers have described the preparatory procedure used by Palestinian suicide terrorists before attack.
According to Volkan (2002), the candidate’s “teachers”
break off his affairs in the “real world” by cutting off meaningful communication and other ties with his friends and
family, and by forbidding music and television on the
grounds that they may be sexually stimulating. During the
last week before the mission, he (or she) will be carefully
watched for signs of doubt, and a “trainer” is assigned to
guide the potential terrorist through any hesitations. Ganor
(2001) noted that some candidates are asked to lie in a
graveyard for a few hours to help them overcome fears of
dying. A few days before the operation, candidates are
filmed holding a gun in one hand and the Koran in the other
while declaring their calling and encouraging others to follow. They also emphasize the voluntary basis of the mission. Several hours before a planned attack, the terrorist
undergoes an intensive spiritual exercise, including prayers
and recitations of the Koran, religious lectures, and fasting
(Hassan, 2001). He pays off all debts and asks for forgiveness for offenses. Just before embarking on the mission, the
terrorist performs a ritual ablution, puts on clean clothes,
and recites the traditional precombat prayer in which he (or
she) asks for Allah’s forgiveness and his blessing. Once
ready, the terrorist takes on a new identity, and is no longer
considered one of the living. He becomes al-shahid alhayy, a warrior awaiting martyrdom.
Merari (2002) views the psychological process of preparation as a “production line,” where you enter at one end
and come out as a complete suicide bomber at the other.
The line is dotted with “crossroads” or social contracts that
are, in effect, points of no return, because breaking them
will heap shame and dishonor on the person and his family.
In this manner, beyond the personal commitment to the
cause, the terrorist develops a social commitment to stick
Crisis 2006; Vol. 27(3):107–118
to the mission to the end despite hesitations and second
thoughts.
To enforce bonding, Hamas and PIJ often prepare candidates in cells of 3–5 volunteers. They are termed khaliya
istishhadiya, or martyrdom cells, to differentiate them from
ordinary khaliya askariya, or military cells. The LTTE also
has special suicide units for men (Black Tigers) and women
(Birds of Freedom) who are bonded by a social contract to
commit a suicidal mission. The power of group commitment was also the basis of the willingness of Japanese pilots to fly kamikaze missions in World War II. Their last
letters to their families, written shortly before their final
flight, showed that while some were enthusiastic participants, others regarded the suicide mission as a duty they
could not evade. Presumably, an element of group commitment was also influential in the September 11 attack in the
United States.
Conclusion
The act of suicide is the result of a highly complex interaction between many forces. This is even truer for suicide
bombing. Some of the prevention methods propagated by
suicidologists are applicable here, the most practical being
working with the media to downplay the glorification of
terror and to change attitudes to suicide bombing. The latter
should also be accomplished by de-glorification in educational programs in the schools, starting from nursery school
up, and in the community. Policymakers should prevent the
humiliation, oppression, or abuse of sectors of the general
population – an especially difficult challenge in countries
where wars are being conducted, such as in Israel, and soldiers’ lives hang in the balance.
There are very interesting lessons to be learned by social
and political scientists, and also by psychoanalysts, from
the psychopathologic study of the personality of suicide
terrorists. However, we believe the ability of psychology
and psychiatry to contribute in a practical manner is very
limited. Psychological profiling of suicide bombers has not
yet been successful. We agree with the suggestion of Merari (2004) and Berko (2004) that a shift to the study of the
processes of propagation, screening, and training of suicide
terrorists and selection of individuals for leadership roles
in terrorist organizations would yield more useful means
for combating suicide bombing. Since suicide bombing is
instrumental in warfare, the prevention of suicide bombing
will be more effective in the political arena.
Suicide bombing looks like suicide, but in important aspects it is incomparable with suicide. In more aspects it is
comparable to killing in a war. Mostly it is part of a political
and military strategy. It is a defense against perceived enemies. Religious and nationalist goals are important here.
Psychology and psychiatry have little to offer until territorial disputes have been settled.
© 2006 Hogrefe & Huber Publishers
M. Grimland et al.: The Phenomenon of Suicide Bombing
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Crisis 2006; Vol. 27(3):107–118
About the authors
Meytal Grimland, MA, is a student in the clinical program at the
Department of Psychology at Tel Aviv University and a research
assistant at the Feinberg Child Study Center, Schneider’s Children’s Medical Centre of Israel, Sackler School of Medicine, Tel
Aviv, Israel.
Alan Apter, MD, is Director of the Feinberg Child Study Center,
Schneider’s Children’s Medical Centre of Israel, Sackler School
of Medicine, Tel Aviv, Israel.
Ad Kerkhof, PhD, is Professor of Clinical Psychology at the Vrije
Universiteit, Amsterdam, The Netherlands. He was Co-Editor-inChief of Crisis from 1992 through 2003.
Alan Apter
Department of Psychological Medicine
Schneider’s Children’s Medical Center of Israel
14 Kaplan St.
Israel
49202
Tel. +972 3 9253232
E-mail eapter@clalit.org.il
© 2006 Hogrefe & Huber Publishers