Time for change: Homicide bombers,not suicide bombers

The paper of Bou Khalil (2014) is an important reminder of the complexity of the issues involved in analysing and understanding what have been referred to as ‘suicide bombers’.

This term has entered our lexicon on the obvious basis that although the prime aim may have been the killing of others, the individual perpetrator dies. Indeed, over the last three decades the media, the general public and sometimes the scientific community have uncritically used the words ‘suicide bomber’ to describe the deaths of those who kill others – sometimes a few, usually 10 to 20, or, in the case of 9/11, about 2000 − while at the same time killing themselves.

Like many areas of human behaviour, these actions have been subjected to rigorous investigation in addition to that provided by Bou Khalil (2014), and it is timely to reflect on the findings. Detailed studies have generally shown that there is little in common with those who die by suicide, using ‘suicide’ in its historically clinically accepted sense.

For example, in an early review in 2007, Townsend concluded that available evidence demonstrated that so-called ‘suicide bombers’ had a range of characteristics which on close examination were not truly suicidal, and that attempting to find commonalities between them and those who died by suicide was likely to be an unhelpful path for any discipline wishing to further understand suicidal behaviour (Townsend, 2007).

Furthermore, in 2009, Post and his colleagues referred to the ‘normality’ and absence of individual psychopathology of suicide bombers (Post et al., 2009). Other researchers have reported similar findings, although it is fair to acknowledge that Merari (2010) has expressed contrary views which have stimulated spirited and at times acrimonious debate (Brym and Araj, 2012), and there is the recent polemical work of the English literature graduate Lankford (2013), which has urged for these persons to be considered as mentally unwell.

From the point of view of experienced clinical psychiatrists, the usual feelings of hopelessness and unbearable psychic pain, along with self-absorption and restriction of options in those who are suicidal, are the antithesis of terrorist acts, and mental disorders do not appear to be a prominent feature. In fact, suicidal intent is usually specifically denied by ‘suicide bombers’, as it is proscribed by most religions, including Islam and Christianity. Indeed, Islam condemns suicide as a major sin with committers denied entry to heaven, and, as it is implied that the act of a ‘suicide bomber’ results in a shorter path to heaven, this would not be achieved if suicide intent was present.

Is this focus on the words used simply an academic distraction, or could it be important?

It is pertinent to recall the saying that ‘the pen is mightier than the sword’, attributed to Cardinal Richelieu by Edward Bulwer-Lytton in his 1839 play, which has entered our everyday language. My colleagues, fellow psychiatrist Murad Khan of the Aga Khan University and sociologist Riaz Hassan of Flinders University, who has collated the largest database in the world of such acts (Hassan, 2010), and I are mindful of that saying and believe that the words do matter. We discussed this in more detail in the Asian Journal of Social Science (Khan et al., 2010).

It has long been recognized that inappropriate publicity promotes further suicide, and Littman (1985) noted that the more there is any reporting of suicide, the more there is a tendency for it to be normalized as an understandable and reasonable option. That being so, repeated use of the term ‘suicide bomber’ runs the risk of normalizing such behaviour, simply because of the frequent use of these words.

A logical extension of Bou Khalil’s paper is to address the issue of terminology again. Although the word ‘homicide’ is not entirely accurate because of the political/military context in which these deaths occur, it is more appropriate than the continued use of the word ‘suicide’. Furthermore, it has the potential to modify this behaviour. Thus, whereas suicide is often portrayed as being altruistic in these circumstances, there is nothing glamorous or idealistic about homicide.

Clearly there is no simple answer to what has occurred increasingly over the last decades. However, by the use of the words ‘homicide bomber’ a gradual change in the worldwide interpretation and acceptability of these acts may occur. Representatives of the scientific community and the media are urged to consider this change.

See Viewpoint by Bou Khalil, 2014, 48(6): 505–506.