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The case of Anders Breivik in Norway reminds us that the relationship between madness and responsibility is complex
The Oslo and Utoya killer Anders Breivik leaving a courthouse on Monday. His lawyers say he may be deemed insane. Photograph: Allover Norway / Rex Features
The announcement by his lawyers that the Oslo and Utøya killer Anders Breivik may be deemed insane has polarised once again society's preconceptions and prejudices around madness and the question of responsibility.
For some commentators, to be judged insane would exonerate him from responsibility for his actions, as if madness and responsibility were mutually exclusive. For others, madness would only exaggerate responsibility for the killings, as if insanity and violence were indissolubly linked.
The fact that media reports of "mental illness" so often associate it with violent crime means dramatic outbursts become almost what we expect. Perhaps, at some level, we not only expect but also desire it, as if to externalise the latent feelings of violence we all harbour within ourselves. The horror at the Norway massacre was, after all, tinged with fascination. Everyone wanted to know more, see more, hear more.
Breivik's case evokes that of Ernst Wagner, the German schoolmaster who strapped guns to his hands and opened fire on the inhabitants of the village of Mülhausen in September 1913. Demonised by the media, his case was used to intensify hostility towards the "mentally unwell". As Wagner's psychiatrist, Robert Gaupp, pointed out bravely at the time, recognising and explaining his patient's psychosis didn't mean that all psychotic subjects would act in the same way.
Old psychiatry studied these discreet psychoses that fitted in well with society, often never disintegrating into breakdown or crisis. This was a quiet, contained madness, and it allows us to understand Breivik's actions far better than the plethora of diagnostic categories already bandied about by "experts". Paranoia has three classical components. The paranoiac has located a fault or malignancy in the world, he has named it, and has a message to deliver about it. For Breivik, the conviction is that Europe is rotten, that the name of this rottenness is Islam and that it is his mission to expose and excise it.
Whereas many schizophrenic subjects experience an invasion inside their body, the paranoiac situates it outside: there is some badness out there in the world. Where for the schizophrenic the other is often too close, intruding into their body; for the paranoiac, self and other are rigidly separated: the other is outside. And hence the paranoiac subject is always innocent: it's the other's fault.
Paranoia here should be differentiated from paranoid. Anyone can be paranoid, but paranoia as such implies a rigid system of beliefs with explanatory power, according the subject a fixed place in the world: for Breivik, that of the "perfect knight" battling Islam. The other common misunderstanding of paranoia is to assume it always involves persecution. In fact, many paranoiacs locate the malignancy not in a person but in some aspect of the world: a disease; environmental problems; danger to children.
They then spend their lives campaigning to remove this fault, whether it is by medical research, projects in education or environmental science. The most noble and charitable of pursuits thus often share something with the most tyrannical and murderous: to remove an evil presence from the world.
The paranoiac's delusion here can be false but it can equally be absolutely true. The FBI may not be plotting against you, but BP may be responsible for destroying nature on part of the American coast. The madness lies not in the content of the beliefs here but in the person's relation to the belief. If certainty about the belief replaces doubt, we are in the realm of psychosis.
This certainty will often spawn enthusiasm, forming groups or movements. Neurotic people are unsure of their aim in life, and sex, death and existence are open questions. Encountering someone who actually knows the answer to these questions will exert a gravitational effect. Breivik, like many others, will probably attract his followers.
This nuances the old-fashioned idea that the subject is only responsible for a crime if he "knew the difference between right and wrong", since the central feature of paranoia is precisely that the person does know the difference. That, indeed, is why they are psychotic: they harbour not doubt but utter conviction that what they are doing is the right thing.
