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\title{The Violent True Believer as a “Lone Wolf”}
\date{2014}
\author{J. Reid Meloy and Jessica Yakeley}
\subtitle{Psychoanalytic Perspectives on Terrorism}






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The existing research on lone wolf terrorists and case experience are reviewed and interpreted through the lens of psychoanalytic theory. A number of characteristics of the lone wolf are enumerated: a personal grievance and moral outrage; the framing of an ideology; failure to affiliate with an extremist group; dependence on a virtual community found on the Internet; the thwarting of occupational goals; radicalization fueled by changes in thinking and emotion — including cognitive rigidity, clandestine excitement, contempt, and disgust — regardless of the particular ideology; the failure of sexual pair bonding and the sexualization of violence; the nexus of psychopathology and ideology; greater creativity and innovation than terrorist groups; and predatory violence sanctioned by moral (superego) authority. A concluding psychoanalytic formulation is offered. Copyright (C) 2014 John Wiley \& Sons, Ltd.



\begin{verse}
I will send my terror before you. \\{}
And will throw into confusion all the people\dots{}

Exodus 23:27
\end{verse}


The violent true believer is an individual committed to acts of homicide and\Slash{}or suicide to advance his particular political or religious beliefs (Meloy, 2004, 2011; Meloy \& Mohandie, 2014; Meloy, Mohandie, Hempel, \& Shiva, 2001). The violence is intended, and often targets civilians who are considered culpable actors, unbelievers, or members of the out-group (Becker, 197 5) deserving of hatred and contempt. In many cases, such acts will meet several tactical and\Slash{}or strategic definitions of terrorism:



\begin{quote}


The unlawful use of force or violence committed by a group or individual against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives (FBI, 28 CFR, Section 0.85).


Terrorism \dots{} is violence or the threat of violence against noncombatants or property in order to gain a political, ideological, or religious goal through fear and intimidation (Post, 2007, p. 3).



\end{quote}


The violent true believer, however, is not a homogeneous type. Earlier work has attempted to delineate subtypes, including the unwavering, affiliative, opportunistic, psychotic, criminal, betrayer, and fledgling violent true believer (Meloy, 2011). In this study, we attempt to explore aspects of the mind of the violent true believer as a lone terrorist, lone offender, or so-called “lone wolf”\footnote{The definition of lone wolf behavior for this study is from Simon (2013): “the use or threat of violence or non-violent sabotage by an individual acting alone, or with minimal support from one or two other people, to further a political, social, religious, financial or other related goal, or, when not having such an objective, nevertheless has the same effect upon government and society in terms of creating fear and\Slash{}or disrupting daily life and\Slash{}or causing government and society to react with heightened security and\Slash{}or other responses” (p. 38).} (Simon, 2013) — at the point where violence toward others and the self is considered the only and most reasonable, if not praiseworthy, course of action. Although motivation for such violence varies, it likely has both conscious and unconscious elements, is dynamic over time, and may not be immediately discernible. The lens through which we view the violent true believer as lone wolf is contemporary psychoanalytic theory, with an emphasis on attachment, object relations, mental structure (particularly superego identifications and defenses), and developmental course. As our empirical base, we rely on contemporary data sets that have been gathered on individuals who approximate to our definition of the violent true believer who is also operating as a lone wolf. We develop such theory from these samples to address the recurrent criticism that psychoanalytic thinking is not evidence-based, and often relies on a few individual clinical case studies to advance theory.


This thinking, however, is not without its limitations. To be recognized are the larger social, religious, and political forces at work in terrorism in general, and we commend those who have delineated such variables, both empirically and theoretically (Armstrong, 2000; Berman, 2003; Borowitz, 2005; Borum, 2011; Buruma \& Margalit, 2004; Dees, 1996; Department of Homeland Security, 2009; Gibson, 1994; Hoffman, 1998; Juergensmeyer, 2000; Krakauer, 2004; Lafree \& Dugan, 2007; Lewis, 2003; Lifton, 1999; Post, 2007; Sageman, 2004, 2008; Soufan, 2011; Spaaij, 2010, 2012; Stern, 2003, 2013). Yet in the final analysis, acts of political violence, terrorism, or civilian massacres (Biesterfeld \& Meloy, 2008; Lankford, 2013; Meloy et al., 2004; Mullen, 2004) are personal — whether ideologically driven or not — in the sense that an individual decides to commit the act alone or within a closely affiliated group (Sageman, 2004; Volkan, 2004), and the individual’s own mind is what differentiates him from the many who are protestors or extremists who do not carry out acts of violence.


Moreover, as Sageman (2008) has noted, many lone wolves do not know what actually motivates them, although they may have many conscious rationalizations for their behaviors. As Post (2007, p. 6) said, “the cause is not the cause.” In this article, we focus on psychodynamics, and distinguish them from larger sociopolitical events. By limiting this psychoanalytic study to the lone wolf, we are also deliberately selecting subjects whose individual psychologies have likely played a much larger role in their radicalization than those terrorists who are directly embedded in a terrorist organization and therefore heavily influenced by interpersonal and other social pressures (Post, 2007; Sageman, 2008). There are also some suggestive data that lone wolf terrorists may be more mentally and\Slash{}or personality disturbed than other terrorists embedded in groups (Gill, Horgan \& Deckert, 2013; Hewitt, 2003; Puckett, 2001; Simon, 2013; Spaaij, 2010, 2012). However, there is certainly no bright line between the psychology of the lone wolf and some terrorists who remain within a group, and we are making no such assertion. This question is being empirically studied (Gruenewald, Chermak \& Freilich, 2013).

\section{Psychoanalytic Contributions to Understanding Terrorism}


In the wake of 9\Slash{}11 and the rise of suicide bombers in the Middle Eastern conflict, a body of literature has accumulated offering a psychoanalytic perspective on terrorism. Such interest stems from a minority of psychiatrists or psychoanalysts who have examined or even treated terrorists, notably Post (2007) and Alderdice (2005, 2007, 2009) in their work with Palestinian and Northern Irish terrorists, respectively, as well as psychoanalytic theorists such as Volkan (1988, 2004), Akhtar (1999) and Varvin (2003), who have applied their knowledge of the psychodynamics of groups and sociopolitical conflicts to elucidate the origins of terrorist violence. Several important themes emerge from this literature, which we believe are germane to the study of terrorism in general.


The first is that terrorism represents a meaningful communication enacted through violence. Terrorism utilizes bodily action to create psychological warfare. One of the fundamental principles of psychoanalytic theory is that of psychic determinism, the notion that one’s conscious thoughts and actions are shaped and controlled by unconscious forces and that manifest symptoms and behaviors contain unconscious and multiple symbolic meanings. Violence, however horrific and devastating, may nevertheless represent a communication with conscious and unconscious meaning. The terrorist may deliberately convey an overt political or religious message in his violent actions. However, the terrorist act also contains within it a myriad of unconscious individual and collective fantasies, traumatic memories, defenses and wishes, that the individual may be less aware of, yet may be understood.


The second theme is how terrorism may be viewed as a re-enactment of historical trauma. This underscores a further key psychoanalytic principle, in that the past influences and infiltrates the present, and if historical traumas remain unresolved, unsymbolized and unspoken, they will continue to be perpetuated. This is Freud’s concept of the repetition compulsion (Freud, 1914). Most psychoanalytic writers on terrorism emphasize the importance of understanding the impact of historical events and trauma on both individual and group identities. For example, the rise of terrorism among Arabs, especially the Palestinians, can be linked to a traumatic and threatened identity due to a history of catastrophic losses and experiences of humiliation and subjugation by western countries (Awad, quoted in Elmendorf \& Ruskin, 2004). The meaning of terrorist violence in some cases may become clear through an understanding of the collective traumatic history of the group: terrorism is viewed by its perpetrators as justifiable revenge for social and cultural wrongs that may go back generations, if not centuries. Among lone wolves, if there has not been the personal experience of trauma, there is often a vicarious identification with it (Sageman, 2008).


This leads to an important third theme in the psychoanalytic literature on terrorism: the role of large group dynamics. Psychoanalytic thinking traditionally focuses upon individual differences, and attempts to understand the unconscious variables, such as ideation, fantasies, emotions and defenses that determine an individual’s behavior. However, the study of terrorism necessitates consideration of the wider group as well as that of the individual: the intersection of individual psychopathology and culture. Volkan (1988) highlights the importance of studying large group identity in shaping the terrorist’s core individual identity. Large group identity emerges through shared mental representations of the large group history. This will include historical traumas and triumphs involving collective pride and shame that have been unconsciously chosen and ritualized by the group to strengthen group cohesion and differentiate the group from the enemy. For groups of terrorists motivated by a sense of injustice regarding their national, ethnic or religious identity, interventions will only be effective if they are aimed at resolving large group issues, rather than individual psychopathology. Some of these will be individuals who have experienced insecure attachments in childhood and a poor sense of core individual identity, who need to adopt the identity of the large group to function. Fonagy (quoted in Hough, 2004) proposes that membership of the large group activates the attachment system, a psychobiological process which offers the individual a sense of belonging and safety. From this perspective, normality, not pathology, drives the terrorist. For the lone wolf, this group identity may be found and fostered in a virtual community on the Internet, and may have been preceded by social rejection from an actual idealized extremist group. In fact, the general structure of terrorist organizations is a centralized command with decentralization for execution of their plans. This decentralization may actually increase the potential for lone wolves, since their pushing for more aggressive acts may lead to ostracism and further radicalization.


The effect of large group dynamics in fostering regression from higher mental functioning to more primitive mental states is also important in understanding terrorism. Rational thought gives way to powerful affects and impulses that dominate terrorist behavior. This amounts to a loss of reflective capacity or mentalization and a regression to more infantile modes of thinking. Akhtar (quoted in Hough, 2004) suggests that in terrorist groups, as in street gangs and cults, there is idealization of the in-group, denigration of others, and intolerance of difference. Primitive affects, particularly hatred, contempt, disgust, shame and humiliation, dominate and motivate violent action. Terrorist violence, via its overwhelming traumatic impact, also renders its victims and intended audience mindless: understanding is lacking and resisted, and revenge and concrete solutions predominate.


Such powerful group dynamics and severe regression may lead to a process of dehumanization in which human victims are treated as inanimate objects to be disposed of indiscriminately. Dehumanization is directed against the natural human inclination towards empathy and remorse, as well as self-concern. In terrorism, the perpetrators themselves are subject to a process of dehumanization, which is utilized as a deliberate ego strategy in suicide bombers to produce a dehumanized self as a lethal weapon delivery system (Akhtar, quoted in Hough, 2004). Such violence is motivated by a state of mind in which the capacity to think and symbolize is absent.


As a counterpoint to the extant research on terrorism by psychoanalysts, which has developed the themes of meaningful communication, re-enactment of trauma, and large group identification, we turn to the “lone wolf” terrorist, who has not been explored, to our knowledge, through the lens of psychoanalytic theory.

\section{Current Empirical Research}


Lone wolf terrorists — those who research, plan, prepare and implement an attack on their own and do not rely on external command and control — comprise a very small proportion of terrorist attacks, probably less than 2\%, both in the United States and abroad (Hewitt, 2003; Spaaij, 2012). Yet recent attacks in the US and the United Kingdom, including the Boston Marathon bombings in April, 2013 and the London murder and mutilation of British soldier Lee Rigby in May, 2013, underscore the unpredictable risk posed by such individuals.\footnote{The reader will note that both of these examples involved two perpetrators acting in concert; the authors have included such examples in their study within the definition of lone wolves.} Culling the terrorism research and theoretical database over the past 15 years reveals the presence of several studies that form the empirical basis for our thinking: Sageman (2008) accumulated a large database of “leaderless jihad” cases but did not specify the exact number; Spaaij (2012) published a study of 88 lone wolf terrorists from 15 different countries in both the US and Europe; Simon (2013) accumulated a small group of prominent case studies which he discussed as “lone wolves” in descriptive detail; Puckett (2001) completed an unclassified FBI study of 10 domestic “lone terrorists” in the US; and the first author (J.R.M.) has indirectly assessed or clinically evaluated in the course of criminal litigation a series of lone wolves, both domestic and foreign, in his consultations with the FBI and his private forensic practice over the past 20years. Although the degree to which each of these studies delved into the psychology of the lone wolf terrorist varied considerably, they provide a rich empirical grounding for our thinking. In addition to direct reliance on these case studies, this work has been further informed by the writings of experts in terrorism and risk of violence, including Stern (2003), Post (2007), Gibson (1994), Lifton (1999), Borum (2011), Armstrong (2000), Hoffman (1998), Monahan (2012), and Soufan (2011).

\section{A High-risk Developmental Period}


A minority of violent true believers who are “lone wolves” — regardless of the content of their conscious beliefs — are late adolescent or young adult males, probably due to the relative immaturity of the prefrontal cortex and consequent impulsivity, psychological grandiosity, identification vulnerability, and biologically based androgenic drivers that peak during this growth period. As Erikson (1950) noted, this is a developmental period wherein identifications are either integrated or not, and may result in confusion about who one is, or, in the context of lone wolves, an identification with another terrorist or soldier in the cause (fictional or non-fictional) who has preceded them (Meloy, Hoffmann, Guldimann, \& James, 2012). In a non-psychoanalytic context, this could be understood as imitation. Violence, whatever the cause, significantly diminishes in frequency among males by their mid-20s, and appears to correlate with the increasing myelination of the prefrontal cortex (Giedd, Raznahan, Mills, \& Lenroot, 2012). Aging is likely one of the most effective de-radicalization strategies for some of these individuals.

\section{General Findings Across Studies and Cases}


A review of the available empirical studies and case experience with lone wolves indicates the following characteristics, which appear to be generalizable regardless of ideological motivation.

\subsection{Personal Grievance and Moral Outrage}


The desire and decision to commit a terrorist act are often motivated by a combination of personal grievance and moral outrage concerning particular historical, religious, or political events. However, the moral outrage is often vicariously experienced, and not embedded in the personal life history of the lone wolf (Sageman, 2008; Simon, 2013; Spaaij, 2012). These are processes of identification and projection. For example, US Army Major Malik Hasan’s personal grievance was his imminent deployment to either Iraq or Afghanistan as a psychiatrist, and his strong opposition to his active participation in these wars. He was told he would be deployed three weeks before his attack — despite his legal efforts to postpone it — and the day of his attack was his unit’s appointed time to report to the Ft. Hood medical processing center where the November 5, 2009 massacre unfolded. This personal grievance was conflated with his identification with those at war with the US, explicitly utilized when he attempted to mount a legal “defense of others,” namely the Taliban, at his trial in 2013. Dr. Hasan, however, had never been personally attacked by the US, had no military comrades who were members of the Taliban; and, in fact, had substantially benefited from his commission in the US Army, completing medical school, his residency, and his fellowship at US Government expense, and attaining the rank of major. Lone wolves identify with the perceived suffering of others, which, in turn, provides emotional fuel for a personal grievance. Personal grievances necessitate the use of projection as a psychological defense to attribute blame to others — and the disavowal of any personal responsibility for one’s circumstances.

\subsection{Framed by an Ideology}


The intent to act is consciously framed by an ideology, or belief system, which is based in a religious tradition, a political philosophy, a secular commitment, a one-issue conflict, or an idiosyncratic justification (Simon, 2013). This is not the valueless violence of the psychopath (Meloy, 1988), but instead, is superego-driven homicidal aggression: a rigidly held value compels the targeted violence\footnote{On occasion, however, a lone wolf terrorist can be severely psychopathic. Sometimes the motivation is a belief system which endorses a thinly disguised prejudice and hatred of perceived inferior groups, often blacks and Jews. Joseph Paul Franklin, a psychopathic lone wolf who was intent on serially killing biracial couples, and did so over the course of three years (1977–1980), is a good example (Puckett, 2001). He also shot and wounded Urban League President Vernon Jordan and crippled Larry Flynt, the publisher of Hustler Magazine, during his criminal career as a serial sniper. Flynt had published photos of mixed racial couples having sex. Franklin was executed by the state of Missouri on November 20, 2013. But not all bigots, however detestable, are psychopaths.} which is sanctioned by an externally perceived moral authority. Current ideological sources for lone wolves include right-wing extremism, Islamism, anti-abortion beliefs, and nationalism\Slash{}separatism (Spaaij, 2012). The conscious belief system, however, is upon closer examination often quite superficial: a cherry-picked cluster of prescriptive or proscriptive statements that provide a broad rationalization for the homicidal aggression. For example, Timothy McVeigh, the bomber who committed a civilian massacre at the US federal Murrah building in Oklahoma City on April 19, 1995, was a believer in the philosophy of the Patriot Movement, a group which, in turn, believed that the US federal government had become the enemy because it violated the US Constitution at every step. He conducted no intellectual analysis of the veracity of their claims, but rather found favorite phrases to justify, if not mandate, his terrorist act: he wore the words of the US President Thomas Jefferson, “the tree of liberty must be refreshed from time to time with the blood of patriots and tyrants,” on a T-shirt at the time he carried out the bombing. Such ideological framing — absolutist and simplistic — leads such lone wolves to fall prey to “seductive Manichaean arguments” (Sageman, 2008, p. 60). In other words, morality becomes a simple and dualistic choice between good and evil. Such defensive splitting cleanses the air of the often difficult ambiguities of actual moral choice, while at the same time fostering regression to a simple internal world of good objects and bad objects — rather than whole objects with both good and bad qualities (Kernberg, 1976). Such defensive maneuvers are often part of a pathological narcissism in which the good object is within and the bad objects are all without; lone wolves’ pervasive narcissism is a reasonable inference from their behavior, since they display an entitlement to kill other people to advance a belief and a callousness to do so.

\subsection{Failure to Affiliate with an Extremist Group}


Puckett (2001) discovered that actual rejection by an extremist group with which the lone wolf initially wants to affiliate is often a prelude to further isolation and the hardening of the belief system that violence is the only alternative. The failure to be accepted, or accept, is often due to a lifelong pattern of difficulties with interpersonal relations. Paul Hill, the minister and anti-abortion activist who murdered physician John Britton in 1994, was excommunicated three years earlier by his orthodox Presbyterian congregation in Florida, who found him becoming too extremist in his beliefs (Puckett, 2001). Timothy McVeigh and Terry Nichols were told not to come back to meetings of the Michigan Militia because their advocacy of violence against the government was unpalatable to the group (first author case files). Buford Furrow, an anti-Semite who attempted to kill Jewish children in Los Angeles in 1999, left the Aryan Nation in Idaho, believing that their membership requirements were too permissive, and was abandoned by his new wife after six months — a woman who had previously been married to Robert Matthews, the leader of The Order, a right wing terrorist group — because he demanded her complete submission (Puckett, 2001). These actual social rejection experiences among contemporary lone wolves are now ameliorated to some degree by the Internet, but cyberspatial relationships are largely fantasy-based, and attachments to people or belief systems are no longer anchored by talking, listening, touching, feeling, and seeing others as real objects. Fantasy predominates (Person, 1995) and, along with it, inclinations for the subject to become both grandiose and paranoid. Often these qualities of self-expansiveness and fear of others play off each other: after all, one must have attained a certain level of importance in order for others to care enough to persecute. Such fantasy-laden and unrealistic beliefs, occasionally rising to the level of delusion, also help to attenuate their intolerance of others being \emph{indifferent} to them (Auchincloss \& Weiss, 1992).

\subsection{Dependence on the Virtual Community of the Internet}


The contemporary lone wolf is dependent upon the Internet as a “virtual community” (Sageman, 2008; Simon, 2013). Sageman (2008) emphasizes that it is not the passive viewing, but the active system of communication among people through social media, chat rooms, e-mails, list-servs, texting, tweeting, etc., that radicalizes. Anonymity leads to a greater likelihood of self-disclosure, which in turn leads to greater feelings of intimacy toward individuals and the group. Online feelings have been found to be as strong as, if not stronger than, offline feelings. As Bargh \& McKenna (2004, p. 586) wrote:



\begin{quote}


Research has found that the relative anonymity aspect encourages self-expression, and the relative absence of physical and nonverbal interaction cues (e.g., attractiveness) facilitates the formation of relationships on other, deeper bases such as shared values and beliefs. At the same time, however, these “limited bandwidth” features of Internet communication also tend to leave a lot unsaid and unspecified, and open to inference and interpretation.



\end{quote}


The lack of negative emotional consequences for online behaviors also intensifies the lone wolf’s willingness to express in words his anger, hatred, contempt, and disgust for out-groups (Le Bon, 1895), fostering the use of more primitive psychological defenses: others are to blame (projection); others are threatening him (projective identification); others are all bad (splitting). As noted earlier, psychoanalytic writers on terrorism have emphasized the role of group dynamics in fostering regression from higher mental functioning to more primitive mental states. In commenting on Le Bon’s work concerning tribal regression — which likely also exists in the virtual world of cyberspace — Dutton (2007) wrote, “This occurred \dots{} because of the anonymity and consequent loss of personal responsibility in crowds coupled with a form of contagion, where normally proscribed acts would be mimicked and enacted” (p. 24). A “propaganda of successful action” (Sageman, 2008, p. 122), dictated by the few users of any Internet forum who actually commit acts of violence, is intensified and instantly communicated. This is also a contemporary acceleration of the propaganda of the deed (Bakunin, 1870), first articulated by anarchists of the late 19\textsuperscript{th} century, since failures are ignored or not reported on the Internet.


Two types of pseudo-community are also created: a paranoid pseudo-community (Cameron, 1943, 1959), e.g., the Zionist Occupation Government (ZOG), infidels, Islamists, the federal government, feminists, unbelievers, Jews, or others who are conspiring against him; and a pronoid pseudo-community (Mohandie \& Meloy, 2010), which begins to inhabit the lone wolf’s mind — the belief that many others are like him and agree with him — and which, in turn, contributes to the “hardening of strange beliefs via partisan chat rooms” (Sageman, 2008, p. 117). Dzhokhar Tsarnaev posted the following on the Internet a week before the April 15, 2013 Boston Marathon bombings: “If you have the knowledge and inspiration, all that’s left is to take action.” Such a statement appears to hold within it the anticipation of an audience of like-minded believers. Although Cameron’s (1943, 1959) original formulations were limited to paranoid delusional beliefs and were clearly psychopathological, it appears useful from a threat assessment perspective to consider such pseudo-commmunities on the Internet (whether paranoid or pronoid) to potentially range along a spectrum from moderate reality distortion to frank delusion.


In-group cohesion can then intensify, which can breed out-group hatred if a threat is perceived. Both Freud (1921) and Becker (1973, 1975) contributed to the understanding of the dependence on the (virtual) community as a panacea for both the alleviation of social anxiety through violence as well as a denial of death through omnipotent control. Freud (1921) wrote of the “common ego ideal” of the group, binding followers to each other as well as to the perceived leader, and fostering the suspension of rules against aggression. Becker (1973, 1975) took a deeper turn, postulating that identification with the group transcended the reality of individual death, and through regression generated a sense of immortality. Successful avoidance of death, however, mandated control of the out-group and the illusion of control of the universe. As Becker (1975) wrote, “for man, maximum excitement is the confrontation of death and the skillful defiance of it by watching others fed to it as he survives transfixed with rapture” (p. 111). Continuous identification with death is seen in terrorist group leaders, as well as the embracing of homicide and suicide in acts of martyrdom among lone wolves: the idealization of death through omnipotent control of the object(s) by killing it. As Osama bin Laden said, “We love death. The US loves life. That is the difference between us two.”\footnote{Retrieved at \href{http://www.brainyquote.com/quotes/authors/o/osama\_bin\_laden.html}{http:\Slash{}\Slash{}www.brainyquote.com\Slash{}quotes\Slash{}authors\Slash{}o\Slash{}osama\_bin\_laden.html} on September 24, 2013.} Paul Hill, the anti-abortionist lone wolf, wrote in a letter on December 22, 1997 (Puckett, 2001, p. 70; also see Kemberg, 2009):



\begin{quote}


\dots{}when the prosecution announced they were seeking the death penalty, my response was to welcome the heightened threat. I was not inclined to resist their persecution, rather I embraced it. I am convinced that I can save more people by being willing to die for the unborn than if I were to fight to save my life.



\end{quote}

\section{The Thwarting of Occupational Goals}


Some lone wolves have had histories involving thwarted occupational goals. They become disillusioned with the social order around them and resentful of the narcissistic wounding, an emotional consequence of their failed rendezvous with their internalized object of destiny (Grotstein, 1982) and an absence of feelings of anticipated pride. Such a structured representation surrounded by affect (Kemberg, 1976) is consciously experienced as a desired fantasy of the self as a mature and successful adult. But lone wolves are caught between the identity confusion of late adolescence, and the identity integration of adulthood (Erikson, 1950). According to Olsson (2007), they are “in-betweeners” (Singer, 1995), particularly vulnerable to any adult role models who convey authority and a belief. Olsson (2007) has also noted the “father hunger” (Herzog, 2004) that may be apparent in some of these individuals due to a neglectful or abandoning father as a child; this may be seen in the transferential ease with which older adult males are accepted as sanctioners of their planned violence. Sirhan Sirhan, the assassin of Senator Robert Kennedy in 1968, due to his betrayal of the Palestinians for selling fighter bombers to the Israelis six months earlier, wanted to be a jockey, but was injured while riding a horse as an adolescent. His father physically abused him while they lived in Palestine and then abandoned him in Pasadena when he was about 13 years old. Timothy McVeigh, who wanted to be the “ultimate warrior,” was rejected from the selection process for the US Army Special Forces when he failed an initial endurance run, and never returned to try again despite an invitation to do so. His mother abandoned him as an adolescent. Muhammad Atta, although not a lone wolf, attended engineering school in Germany but did not excel in his education in the way that his sisters did. Upon his return to Cairo he witnessed the Americanization of his city and feared the persecution of the Muslim Brotherhood by Hosni Mubarak. His father shamed him as a “mama’s boy,” yet his father denied his involvement in the attack and claimed he spoke to him by telephone after September 11, 2001 (9\Slash{}11 Commission Report). Richard Reid, a solo terrorist who was under external command and control — not a lone wolf in this context — devolved into a criminal lifestyle as an adolescent, having been abandoned by both his biological mother and father, and was caught between his bi-racial identity as British and Jamaican but accepted by neither group. While thwarted success is not specific to lone wolf terrorism, and is endemic in our current economic environment for many young people, what is unique is the addition of a search for someone or some group to hate — an object of intense grievance that can be framed by a cluster of beliefs and saddled with responsibility for the lone wolf’s occupational failures. Instead of grieving losses, targets of grievance are found.

\subsection{Radicalization Fueled by Structure of Thinking and Change in Emotion, not Ideology}


The intelligence analysis and threat mitigation of terrorists often focus on the deradicalization of the \emph{content} of their thinking. For example, intellectually contrasting Salafism, a very conservative tradition within Islam which insists on \emph{Shariah} as the law of the caliphate, with the adoption of secular law and a tolerance of different religions within a westernized democracy, is an intellectualizing error, because it tends to ignore the structural change in thinking and emotion that occurs within a terrorist, specifically a lone wolf. The content of the belief system, or the convenient texts that are adopted to serve the desire to homicidally aggress, usually against the self and others, is important since it can determine specific behaviors, but it is secondary.


The hallmarks of \emph{structural} changes in thinking are often interpersonally quite evident. The willingness to argue a particular position with another, to actively engage in an exchange of opinion, and respect the other, begins to dissolve. Lone wolves become more intense, humorless, strident in their opinion, and attempt to impose their beliefs, rather than to persuade. They may begin to preach to others, and there is clear evidence that their thinking is more rigid, absolute, simplistic, concrete, and will broach no compromise. Whether they have adopted religious or secular content, they will find a moral authority for that content that they consider absolute and trust only that authority (Gartenstein-Ross \& Grossman, 2009). They follow the mantra, “Don’t think, just believe.” This is basic to all fundamentalist belief systems regardless of their religious or secular content. Critical analysis, from them or others, is not tolerated, and is met with an intensity of affect, usually anger, that provokes or frightens others. As Ted Kaczynski, the so-called Unabomber, wrote, it is “a kind of contemptuous disregard for all the rest of the human race and its opinions” (Puckett, 2001, p. 75). This is often accompanied by an intolerance of difference, expressed in difficulty with being in close physical proximity to others who may not accept their beliefs. It may contribute to the lone wolves’ social isolation.


In their inner life, narcissistic linking fantasies (Meloy, 1998) begin to develop. These are conscious fantasies of a special and idealized relationship with another. For lone wolves, this could be a growing identification as an agent or soldier for their cause (Meloy et al., 2012; Meloy, Hoffmann, Roshdi, Glaz-Ocik, \& Guldimann, 2014), and feelings of affection and admiration for those who have preceded them in the vanguard, often as soldiers or warriors. It could be a fantasized bond to a secular or religious figurehead. The fantasies often become internal representations of the self as omnipotent, grandiose, and violent, a warrior who vanquishes enemies — now more clearly understood and visualized in their mind — and anticipates a violent but glorious death. Such fantasies often compensate for real-world sexual, social, and occupational failures. These fantasies stimulate positive feelings, perhaps the only emotions they have that are experienced as pleasurable, and hence there is a desire to withdraw into them when not engaging with those who do not believe. Such fantasies of glory, coupled with moral outrage and grievance, and the adoption of snippets of a belief system that sanctions violence, become the internal template for the beginning of a pathway to violence (Calhoun \& Weston, 2003). Anders Breivik believed he was a modern incarnation of the Knights Templar, a 12\textsuperscript{th}-century group of elite warriors who were the tip of the spear during the Christian crusades. He designed his own uniform and had photographs taken of himself, which he attached to his manifesto and posted online before his attacks. His moral outrage was at both multiculturalism in Norway and the influx of Muslim immigrants into his country and Europe (Meloy et al., 2014).


The emotional life of lone wolves will be both dynamic and individually nuanced, but there appear to be three common characteristics. First, the personal grievance and moral outrage are often intensified due to a pathological narcissism that sensitizes them to rejection. The underbelly of an inflated sense of self is a vulnerability to deflation given the slightest wound, and with such collapse a deeply felt shame — the self as bad — is exposed. This is quickly defended against with rage, especially in males, and may provide the initial emotional fuel that motivates them to find an ideology within which to frame their grievance. The personal grievance may also be conflated with actual real-world events that have shamed their people, as recounted earlier in the Sirhan case. As Pape (2005) found, most suicide bombers are motivated by liberation of their identified tribe from an actual perceived occupier.


Secondly, Collins (2012) has elaborated upon the secrecy that surrounds the pathway toward violence and its stimulation of “clandestine excitement” in young mass murderers. The lone wolf finds that secret planning and preparation bring with it an excitement that he has rarely felt, intensified by its clandestine nature and the fact that even his closest friends and family may not be aware of his activities.\footnote{This secrecy has important threat assessment implications when applied to the accumulation of weapons. A gun enthusiast who accumulates firearms cannot wait to show his newest purchase to his best friend, and is eager to display his collection to all those who are interested. On the other hand, the secret accumulation of weapons may indicate that a subject is in the final stages of a pathway toward targeted violence.} This places him, perhaps for the first time, in a position of relative power and dominance toward others in fantasy; and reciprocal affection, the bedrock of most relationships, must be suppressed, or perhaps only felt in his virtual community of believers on the Internet. He may feel a sense of expansiveness, and anticipate an omnipotence in his act of anticipated violence that heretofore has been completely absent in his life. Deception breeds excitement, but may also cause guilt. Taimour al-Abdaly, the lone wolf Islamist bomber in Stockholm, Sweden, on December 11, 2010, sent a taped audio threat to the national press before his attack, but within it was a confession to his family: “I love you all. Please forgive me if I lied to you. It wasn’t easy to live the last four years with the secret of being \emph{mujahid,} or as you call it terrorist\dots{} you and the children are the best of what happened to me in this life” (Meloy et al., 2012, p. 272).


And thirdly, Monahan (2012) linked the importance of moral emotion in the risk assessment of the individual terrorist. Moral emotions are feelings that condemn others, and research has focused upon anger, contempt, and disgust (Haidt, 2007). This is critical to an understanding of the emotional pathway of the lone wolf, and proceeds in sequence. People may feel angry toward those who believe differently, and express such emotion in heated argument, but the underlying assumption is of a level playing field: opponents in the argument have a right to their difference of opinion, just as they have a right to exist as a whole object with their own thoughts, feelings, and desires. The sequential movement to contempt, however, brings with it a condemnation of the other. They are now devalued, both their opinions and their beliefs, and a disdain appears on the face and within the attitude of the lone wolf. Opinions become more strident and preachy, because there is no longer a need for a heated exchange of ideas, since the other is wrong. The object is devalued. The sequencing to disgust is most critical. Disgust is likely tied to an evolved physiological defense to keep humans away from toxins and poisons in the environment. The disgusting object is not argued with or viewed with disdain. The impulse is to eliminate it. Vermin disgust. Contaminated food disgusts. If it accidentally enters an oral cavity, it is immediately expelled. The Nazis equated the Jews with rats and other vermin to stimulate disgust in the German people, not anger. Disgust justified elimination. There is a small physiological literature that has found statistical relationships between the physiology of disgust and moral judgment (Chapman, Kim, Susskind, \& Anderson, 2009). Disgust may be the endpoint emotion that allows the lone wolf to morally sanction his violence against innocents. McVeigh characterized the deaths of children in his bombing as necessary collateral damage. One of the technological waves of the future in the identification of lone wolves maybe data mining of social media to find this sequence of anger → contempt → disgust in language content as early-warning emotional signals of a planned act of targeted violence (Bringuel, Janowicz, Valida, \& Reid, 2010; Sanfilippo, McGrath, \& Bell, 2014).

\subsection{The Failure of Sexual-Intimate Pair Bonding and the Sexualization of Violence}


Menninger (1938) noted three motives for martyrdom: the self-punitive or suicidal motive; the aggressive, or homicidal motive; and the erotic, or sexual motive. He characterized the erotic motive as a flight from one’s own mother, a renunciation of actual sexuality, and moral masochism — the zest with which martyrs would seek their own death. Meloy (2004) added a fourth aspect: the idealization of sexuality in fantasy, “no more apparent than the young Islamic martyr’s hope, and fantasy, of dozens of black eyed virgins in his afterlife” (p. 139). Reik (1941) also underscored a fantasy factor in the martyr’s same-sex identification with a divine figure.


As the lone wolf radicalizes, he becomes increasingly ambivalent toward the feminine, typically first represented as an internalized object by his actual mother. The more radical and fundamentalist the belief system, the more control of the woman is required. He distrusts younger women now, and manages his feelings through disavowal of his own sexual desires, detached idealization, and attempts to control them. The actual renunciation of any sexual pursuits as a young Islamist\footnote{It is not clear, however, that devaluation of women is generally observed in all terrorist groups; e.g., one exception would be the Red Army Faction (Baader-Meinhof Group) in Germany in the late 20\textsuperscript{th} century.} male is all the more remarkable given the intensity of sexual desire at that age — and is a measure of the power of the belief system to trump such a fundamental biological urge at its apex. The female is reduced to aspects of a part object that cannot be trusted: she sexually provokes, and may drain energy, but she is necessary to produce a new generation of warriors. In war, however, there is no mother at all. Older women remind him of his past dependencies on the nurturing female as a boy and his own weaknesses. The lone wolf is reborn without a mother, separation from her and all young women is idealized, seen as a source of power if kept at a distance, and becomes a mark of maturity (Gibson, 1994). Paradoxically, the developmental task of actual emotional separation from the mother while maintaining her as a loved internal object (Greenson, 1968) is sabotaged, as there are no young women recognized as peers; they are distrusted, and therefore lost as potential objects with whom to form sexual pair bonds. Maturity stagnates.


These dynamics are all apparent in the actual behavior of a number of lone wolves. There is no evidence that Timothy McVeigh had a sexual pair bond from puberty until his execution in 2001 for the Oklahoma City bombing. He was closest to his younger sister Jennifer,\footnote{This is apparent in the “Freikorps” novels in Germany after World War I wherein the sister was the only safe relationship with whom the warrior could relate. She was sexual taboo and often younger; but any other women were uncharted and dangerous territory (Theweleit, 1987).} and, as noted earlier, abandoned by his mother as a mid-adolescent. He wrote letters to his sister that he wanted to become “the ultimate warrior” (Meloy case files). Muhammed Atta, the cell leader for the 9\Slash{}11 attacks, although not a lone wolf, had no known sexual pair bond from puberty until his death. He once attempted to initiate a relationship with a young Egyptian woman, but found her to be too independent and permissive. There were no others, and he appeared to remain a virgin until his death. Malik Hasan, the lone wolf who massacred soldiers at Ft. Hood, Texas, in 2009, had no known sexual pair bond from puberty until his death. Ted Kaczynski, the American Unabomber, despite his formal academic success, was a lonesome and abject social failure and deeply confused about his own sexual identity, once exploring the possibility of sex change (transgender) surgery. He wrote while at the University of Michigan (Puckett, 2001, p. 74):



\begin{quote}


I had no social life at this time and more than ever I made it a principle to be both asocial and amoral\dots{} I often had fantasies of killing the kind of people whom I hated (e.g., government officials, police, computer scientists, behavioral scientists, the rowdy type of college students) \dots{} and I had high hopes of eventually committing such crimes.



\end{quote}


The renunciation of actual sexual expression with another is defended against with the sexualization of violence and weapons. One manner in which this is done is through “aggression immersion” (Meloy \& Mohandie, 2001), wherein hours are spent visually viewing and interacting with the Internet: visits to weapons websites, viewing of videos concerning the construction and use of weapons, viewing of violent and sexually violent videos, and first-person shooter games on or offline. In one of the earlier \emph{Grand Theft Auto} series of interactive videos, one could kill a prostitute to gain a gaming reward. This may also be the first introduction of the young male to predation as a “pseudocommando” (Dietz, 1986; Knoll, 2010), engaging in a form of virtual “novel aggression” (Meloy et al., 2012) to take a measure of his psychological reaction to “killing” and refine his technical skills. The act of killing itself and the weaponry used to do so may symbolically represent the hardening of the penis, the intimacy of skin contact with the victim, and the contortions of the body in death and orgasm as biology overrides choice, control, and the psychological distinction between objects. Killing becomes an act of sexual release, but the enemy still represents uncontrollable human desire, in contrast to the lone wolf’s discipline and the moral sanctioning of his duty to kill.

\subsection{The Nexus of Psychopathology and Ideology}


In some cases, ideology is the fuel poured on the fire of psychiatric decompensation. Although several psychiatrists have commented on the essential normality of terrorists (Post, 2007; Sageman, 2008), others have asserted that psychopathology is more prevalent among lone wolves (Gill et al., 2013; Hewitt, 2003; Puckett, 2001; Simon, 2013; Spaaij, 2010, 2012). Extant terrorism research has often formulated this debate as an either\Slash{}or proposition, but this is likely a false dichotomy. As the content of delusions is often shaped by cultural and social forces (Suhail \& Cochrane, 2002), why is it not feasible that patently bizarre perceptions of reality, represented in various extreme belief systems, would not either rationalize and\Slash{}or intellectualize, and therefore perhaps buffer against, the anxiety-producing internal experience of a decompensating mind? Here one may utilize Freud’s (1924) conceptualization of psychosis as withdrawal from the external world and regression into a narcissistic state, where hallucinations and delusions are an attempt to repair a fragmentary world: “The delusion is found applied like a patch over the place where originally a rent had appeared in the ego’s relation to the external world” (p. 151).


Sirhan Sirhan’s trial focused on expert witness disagreement as to whether he was paranoid schizophrenic and dissociating at the time of the assassination, or whether he was a borderline schizophrenic — what we now term borderline personality disorder — with certain paranoid and hysterical features. Little was said at trial concerning his conscious motivation: his desire to retaliate on the anniversary of the Six Day War against Robert Kennedy for his betrayal of the Palestinians five months earlier when he voted as a Senator to sell fighter jets to Israel. In this case his traumagenic history and physical abuse by his father likely contributed to his borderline personality disorder, and the historical trauma of the Six Day War for the Arabic nations provided the conscious political motivation for the date of his targeted assassination (Kaiser, 1970; Meloy, 1992).


Ted Kaczynski was provisionally diagnosed with schizophrenia, paranoid type, episodic, and paranoid personality disorder with avoidant and antisocial features, premorbid, by a Federal Bureau of Prisons psychiatrist (forensic evaluation by Sally Johnson, MD, on January 16, 1998); psychiatrists retained by the prosecution did not clinically evaluate him (P. Resnick, personal communication, September, 2013). Nevertheless, he railed against the developing encroachment of “technological society,” yet utilized technology to build smaller and more lethal bombs over the course of his 17-year career as a lone wolf terrorist.


Parallels have been drawn between his beliefs and those of the 19\textsuperscript{th}-century Luddites, and delusional beliefs of persecution by forces outside the self are one symptom of paranoid schizophrenia (American Psychiatric Association, 2013). Here again, ideological commitment may have buffered the chronic presence of mental illness.


Jerrod Loughner is a third example. Although not considered a lone wolfby most -and there is no evidence that he carried out his mass murder to advance political, religious, or social change — Loughner was first publicly diagnosed with schizophrenia during his competency commitment, and also voiced a conscious belief in nihilism, an esoteric philosophy which asserts that life is without objective meaning, purpose, or intrinsic value. As he appeared to decompensate further into psychosis, he became increasingly disruptive in his classes at Pima Community College, and on one occasion in the spring of 2010, he said this as recorded by campus police (PCC police report, September 23, 2010):



\begin{quote}


He very slowly began telling me in a low and mumbled voice that under the Constitution which had been written on the wall for all to see, he had the right to his freedom of thought and whatever he thought in his head he could put on paper. By placing his thoughts in his homework assignment his teacher ’must be required to accept it’ as a passing grade.



\end{quote}


Here again the nexus between ideology and paranoia is suggested as dominant forces outside the self are perceived to be attempting to control his thoughts and are linked to an esoteric belief system; moreover, unknown to the police at that time, Loughner was nurturing a grievance toward Congresswoman Gabrielle Giffords from three years earlier when she did not answer his written question, “What is government if words have no meaning?” He carried out her attempted assassination and a mass murder in January, 2011.


It would be remiss not to mention the recruitment appeal, perhaps via the Internet, of those young people who are clinically depressed and suicidal, yet still drawn to search for an ideology. Successful recruitment may mean that the urge to suicide is redefined and positively valenced by viewing it as act of martyrdom to advance a cause.

\subsection{Greater Creativity and Innovation}


Simon (2013) noted that lone wolves are typically more creative and innovative than terrorist groups. This may apply to some, but not to all such individuals. They may be able to tactically think “outside the box” due to the lack of bureaucratic stifling or the burden of authority from others within a terrorist organization. Dr. Bruce Ivins, the “most infamous lone wolf bio terrorist in US history” (Simon, 2013, p. 103), was able to operate for years as an anthrax researcher at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) despite a history of psychiatric disorder and violations of biosafety and biosecurity parameters (Expert Behavioral Analysis Panel, 2011). His intellectual brilliance, coupled with complex motivations involving revenge, personal validation, career preservation and professional redemption, and loss, culminated in two waves of anthrax attacks in September and October, 2011, which took the lives of five individuals (Expert Behavioral Analysis Panel, 2011) — and further terrorized the US on the heels of 9\Slash{}11. Simon (2013) also noted that the lone wolf is willing to try anything due to his absence of fear of failure and no need to weigh the political and social consequences of an interdicted or aborted attempt to wreak havoc. Anders Breivik, the Norwegian lone wolf who launched a bombing attack and subsequent mass murder, planned his deceptions, tactics, and strategies for years in meticulous detail, and documented his efforts in “2083 — A European Declaration of Independence,” a 1,518-page document posted on the Internet several hours before the bombing of the national parliament and subsequent island attack on July 22, 2011. He killed 77 people, most of them adolescents. Breivik took solace in the judicial finding that he was sane at the time of his crimes (Meloy et al., 2014). However, such intellectual precocity and apparent maturity of ego functioning may compensate for or obscure more primitive deficits in affect regulation, emotional intelligence, and object relating.

\subsection{Predatory (Instrumental) Violence}


Although the early stages of a pathway toward violence may be suffused with anger, if not rage — what we have noted as both moral outrage and grievance — the lone wolf appears to shift into a predatory mode of violence as research, planning, preparation, and implementation of the actual violence occur. Predatory violence, also called instrumental or targeted violence, appears to be devoid of emotion (Meloy, 1988, 2006), and there is animal research that strongly suggests there may be a biological underpinning for such a state. Siegel and Victoroff (2009) have found that gamma-aminobutyric acid (GABA) will suppress emotionality during predatory violence in other mammals, which is consistent with the clinical observation of an absence of any stated feeling among predatory offenders, including lone wolves, when the violence is enacted. This also serves the tactical desire for surprise of the target, and is consistent with the finding that most acts of targeted violence are not preceded by a direct threat to the target beforehand (Meloy et al., 2014). The more common garden variety mode of violence, referred to as affective or reactive violence, is typically accompanied by anger, fear, or both. It is defending against a threat, rather than attacking a selected target (Meloy, 2006), and is typically not the mode of violence in lone wolf terrorism.


What distinguishes the predatory violence of the lone wolf — and many other terrorist organizations — from other cases of instrumental violence is the moral sanctioning of the act. This is superego-driven homicidal aggression wherein the lone wolf finds a mandate for his violence: the drive to punish those who are judged morally wrong and therefore disgusting, and the wish to establish an ideal state, or state of mind, that has heretofore eluded him.

\section{Conclusions: Toward a Psychoanalytic Formulation}


Attempts to elucidate the psychopathology or “mindset” of the terrorist have invited intense nosological debates; for example, psychiatrists evaluating Anders Breivik were split between those who asserted he was suffering from a psychotic illness and those who diagnosed him with a severe personality disorder. However, we suggest that this polarization is unhelpful and exposes the limitations of our current categorical diagnostic systems, such as the \emph{Diagnostic and Statistical Manual of Mental Disorders,} fifth edition (DSM-5; American Psychiatric Association, 2013), when applied to individuals who commit acts of ideologically motivated violence. In our study of the lone wolf violent true believer, we find it more helpful to think about more dimensional aspects of the subject’s mental structure and functioning, focusing on psychodynamic disturbances in the nature of their cognitions, ideations and fantasies, affects, psychological defenses, object relating, moral functioning, and impulse control. We propose that psychoanalytic formulation lends itself to such inquiry.


Review of the literature and case experience leads us to postulate that the mind of the lone wolf has at its foundation a pathologically narcissistic self-structure in which primitive modes of thinking predominate. The capacity for forging normal attachments and object relating is seriously impaired, as evidenced by a failure to sustain meaningful relationships with either a partner or peers. Relations with others are narcissistically driven, the lone wolf’s self-image fueled by omnipotent and grandiose fantasies while he views other people as objects to be denigrated or destroyed. This reflects a primitive, pre-Oedipal internal world in which part object relations predominate and are governed by early defense mechanisms such as splitting, denial, omnipotence, and projection, with a lack of more mature defense mechanisms such as repression and sublimation. Similarly, primitive affects such as shame, excitement, envy, rage, contempt, and disgust are prominent, whereas more mature affects, such as guilt, fear, depression, remorse, empathy or joy, which involve an appreciation of whole objects and a capacity for actual bonding, are impaired. This affect regulation and object relating are underpinned by developmentally primitive modes of thinking, such as psychic equivalence and teleologic (Fonagy \& Target, 1996, 2000, 2007), which are characterized by rigidity, concreteness, simplicity, and certainty, and in which reflective capacity, symbolization, and mentalization are lacking. Moreover, although the lone wolf may consciously express ideological rationalization for his targeted violence, his moral outrage is the unconscious projection of personal grievance that defends against deficits in moral reasoning and superego functioning, and in some cases against psychotic decompensation.


Although a potential high-risk developmental period for the lone wolf in his adolescence is highlighted here, the disturbances in his object relations point to the likelihood that there is a much earlier risk developmental period, that of infancy and childhood, in which genetic influences and environmental adversity combine to form attachment difficulties. However, although anecdotal reports of personal histories of absent fathers and rejecting mothers may support such an hypothesis, there is currently insufficient evidence to confidently identify the etiological factors that contribute to the disturbed state of mind of the lone wolf terrorist. Such early experiences are not specific to terrorist activity, of course; and distal events are typically not as useful in threat assessment, for example, as the more proximal static and dynamic characteristics that are described here (Meloy \& Hoffinann, 2014).


Nevertheless, the authors have attempted to deepen the understanding of lone wolves by interpreting extant empirical research and case experience through the lens of psychoanalytic thought. These formulations should be considered preliminary and subject to further large group and case study analysis. Although many of the described characteristics are inferential, the authors have taken care to begin with known developmental histories, statements made by lone wolves, specific behaviors, and fact patterns surrounding their terrorist attacks to advance knowledge. It is hoped that the risks posed by such individuals will be mitigated by a better understanding of how they think and feel. As Hoffer (1951) wrote, “The vanity of the selfless, even those who practice utmost humility, is boundless” (p. 15).

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The Ted K Archive





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J. Reid Meloy and Jessica Yakeley

The Violent True Believer as a “Lone Wolf”

Psychoanalytic Perspectives on Terrorism

2014


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Behavioral Sciences and the Law. DOI: 10.1002\Slash{}bsl.2109\forcelinebreak \textbf{Correspondence to:} J. Reid Meloy, 334 Westbourne St, La Jolla, CA 92037, U.S.A. E-mail: \href{mailto:reidmeloy@gmail.com}{reidmeloy@gmail.com}\forcelinebreak \textbf{Author affiliations:} J. Reid Meloy, Ph.D., Clinical Professor of Psychiatry, University of California, San Diego, School of Medicine; Faculty, San Diego Psychoanalytic Institute; Fellow of the American Academy of Forensic Sciences.\forcelinebreak Jessica Yakeley, M.D., Consultant Psychiatrist in Forensic Psychotherapy, Portman Clinic; Director of Medical Education and Associate Medical Director, The Tavistock and Portman NHS Foundation Trust; Fellow of the British Psychoanalytical Society.
   

       

       

       
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