Contributor Perspectives

Psychosomatic Responses: Fear as a Terrorist's Force Multiplier

Feb 28, 2007 | 23:55 GMT
By Fred Burton French police wearing hazmat suits ordered the evacuation of the Canadian Embassy in Paris (and the surrounding neighborhood) on Feb. 19 after an employee who opened a suspicious package suddenly fell ill. The package contained a piece of tissue soaked in a liquid that was later found to be nontoxic. On the same day, two workers at the Zondervan Christian publishing company in Cascade Township, Michigan, got sick after opening a suspicious package in the mailroom. The building was evacuated, and one of the employees was rushed to the hospital for treatment. The package later was found to contain no hazardous materials. The Feb. 19 incidents are just two in a long string of cases in the United States and elsewhere in which someone who opened a letter, package or container found odd substances and had a sudden and dramatic psychological reaction. It is significant, of course, that the contents of the letters in the two recent cases and many others were found to be harmless. Because there were no actual chemical or biological agents involved in these cases, the physiological responses of the "victims" were purely psychological — most likely a reaction to fear and panic. Overwhelming fear in these situations can cause a person to exhibit physical symptoms — including dizziness and even loss of consciousness. That is true for receptionists, mailroom clerks and other typical civilians, but also for others: Police, security officers, firefighters and other "first responders" — people who are more highly trained than the population at large in dealing with physical threats — often react this way as well. The implications are obvious: Fears about chemical and biological agents, which are not always readily identified or widely understood, can and do heighten the "terror" aspect of terrorism (real or perceived). In fact, if a chemical or biological attack were to take place in a large U.S. city — a scenario government security agencies have discussed publicly on many occasions — the number of people who would become "psychological victims" of the attack could be quite large, and could perhaps dwarf the number of "actual" victims. As police and other emergency responders have found, however, the most effective antidote to the fear and psychosomatic reactions in such situations is situational awareness and education. Post-Anthrax Fears The public's awareness of and reactions to strange substances arriving with crank and anonymous letters has changed markedly during the past five years. Certainly, the tactic was common long before 2001, but "crank" letters and other things viewed today as threatening generally were ignored. A few law enforcement organizations did put some effort into investigating them as time permitted. Many of these agencies worked with the FBI, which would examine the letters and maintain the results of forensic examinations in its "anonymous letter files." But, for the most part, such letters were deemed as a mere nuisance, and even ones that contained things like body fluids were thought of as more "yucky" than "scary." That mindset changed almost overnight with the emergence of "anthrax letters" in September and October 2001. Though there were only a small number of cases involved in the entire anthrax scare — it is believed that seven letters were sent, and five people died — the incidents had a disproportionate effect on the collective American psyche. The impact was heightened by timing: The first batch of letters was postmarked only a week after the 9/11 attacks, and the second a few weeks later — during a period when American society as a whole was experiencing an unprecedented sense of vulnerability and fear. The public fears arising out of the 2001 attacks were augmented by extensive media discussions about the use of anthrax as a weapon, and further heightened by the fact that the perpetrator was never identified or apprehended. There now have been untold thousands of instances in which irrational panic caused office buildings, apartment buildings and factories to be evacuated. Previously ignored piles of drywall dust and the powdered sugar residue left by someone who ate a donut at his desk led to suspicions about terrorists, who suddenly seemed to be lurking around every corner. It didn't matter, in the midst of the fear, that the place where the "anthrax" was found could have absolutely no symbolic or strategic value to the Islamist militants that most Americans pictured in their minds. The sense of threat and personal vulnerability was pervasive. Opportunistic pranksters and others quickly found ways to exploit the mentality. For example, anti-abortion extremist Clayton Lee Waagner, who had escaped from prison in February 2001, reportedly sent more than 500 anthrax hoax letters to abortion clinics throughout the United States in November 2001. Other pranksters followed suit, and anthrax hoax letters containing "white powder" — such as talcum and cornstarch — now have been reported by incredibly diverse recipients worldwide. However, even though hoaxes are by now quite common, dramatic psychological responses — like those seen in Paris and Michigan last week — remain common as well. Reactions Explained There is a scientific explanation for these responses. Years ago, law enforcement trainers who studied officer-involved shootings made a disturbing discovery: A number of cops were dying from "nonfatal" wounds. In these cases, an officer who had been shot would go into shock and black out, even when the bullet had not struck a vital area. Some died as a consequence of shock; in other cases, the gunman involved followed through and administered a coup de grace. To combat this issue, many police departments and federal agencies embarked on an aggressive education campaign, teaching officers and agents that a gunshot wound is not always fatal and instructing them to continue to fight, even after being shot. A 1986 shooting involving the FBI and two bank robbers in Miami quickly became a case study used by trainers: A critically wounded criminal kept firing at the agents, and the gunfight was ended by an agent who, though seriously wounded, squeezed off several shotgun rounds with his one working arm. In the wake of the Miami shooting, many departments also implemented "disabled officer" range training courses, teaching police and government agents how to handle and fire their weapons when wounded. The lessons derived from the firearms study are just as applicable to cases involving real or suspected chemical or biological attacks, in which the potential for psychosomatic reactions also are high. For instance, a police officer in Austin, Texas, passed out cold on the street in October 2000 after he opened the trunk of a terrorist suspect's car, smelled mildew and thought he'd been hit with a chemical weapon. This fear of chemical and biological weapons should not be trivialized and is not totally unfounded — as a recent spate of attacks in Iraq that involved chlorine and vehicle-borne improvised explosive devices attests. But, again, fear can be tempered and controlled with general awareness and sound information. Real and Imagined Effects One thing that biological agents like anthrax generally do not do is immediately incapacitate a person and cause them to black out. In fact, the victims who received real anthrax letters in 2001 did not even realize they had been infected for several days. It is believed that Robert Stevens, the first person to die from the attacks, received his fatal letter around Sept. 22, but he was not hospitalized until Oct. 2, three days before his death. Ernest Blanco — who, like Stevens, worked in the offices of American Media Inc., in Boca Raton, Florida — was hospitalized on Oct. 1 for what doctors believe to be pneumonia. (Blanco later was treated for anthrax and survived.) The cases of others infected by anthrax letters also demonstrated that it took many days — for many, more than a week — for the spores to germinate and create significant symptoms. Because biological agents work so slowly, anyone who believes they have been affected by such an attack should attempt to stay calm and remain where they are. They should seal their area as well as possible, shut down any fans or air conditioning systems and immediately call authorities. Anthrax spores, for example, are very small and easily can be spread, infecting others. Conversely, chemical agents can be rapidly effective if a large dose is inhaled, ingested or absorbed through the skin. However, because these agents (which include sarin and hydrogen cyanide gas) tend to disperse quickly, it is quite difficult to weaponize them in a way that delivers a large lethal dose effectively. In fact, most terrorist attacks involving chemical weapons have been less than devastating. Given the challenges, history has shown that most people exposed to chemical agents in a terrorist attack will not immediately receive a fatal dose — even in strikes involving an extremely deadly substance, such as sarin. As a nerve agent, sarin interferes with the chemicals that allow muscles and glands to "switch" off. Symptoms therefore include things like a very runny nose, watery eyes, headache, drooling, excessive sweating, muscle twitches, nausea and abdominal pain. If the victim does not get medical assistance, critical muscles — such as the diaphragm — can grow too exhausted to function. Cyanides, like hydrogen cyanide gas, are called "blood agents": They interfere with the body's ability to absorb oxygen, leading to suffocation. Hydrogen cyanide gas will cause symptoms such as headaches, dizziness, nausea and shortness of breath. Though these symptoms all are somewhat debilitating — and certainly frightening — none will keep a victim from leaving the area of the attack and finding fresh air and medical attention. These compounds do pose an immediate threat, but because they are volatile and will disperse rapidly, a victim who does not receive a lethal dose has a good chance of getting away from the source of the agent and surviving. However, if a victim of such an incident passes out for psychological reasons, emergency responders — unable to communicate with him or her about symptoms or triggers — will focus on that victim as others who are still conscious perhaps go untreated. And in circumstances that generate a public panic, the effectiveness of emergency teams can be strained or overwhelmed — perhaps preventing people who actually were exposed to a dangerous substance from getting the medical attention they need. In short, chemical and biological agents all have their dangers, but the consequences of a psychosomatic reaction differ, depending on the agent used. The means of exposure — rather than the duration of that exposure — is the key factor in biological attacks, so even if someone swooned in fear, there still would be time for medical treatment to be effective. However, passing out at the first sign of chemical attack, in which the duration of exposure is key, could prove deadly. In the Jihadist Context Information is just as powerful an antidote to fear in the broad context of the U.S.-jihadist war as in the narrow context of mailroom clerks and receptionists handling the daily post. In this war, the United States and its allies find themselves facing an opponent who takes a long view of the conflict, who claims to be justified in striking at civilian targets and who repeatedly has done so. The jihadists also have demonstrated a fascination with spectacular mass-casualty attacks and in using chemical, biological and radiological weapons. Despite the technical inefficiencies, many jihadists appear to remain fixated on them as "super weapons" — a mindset perhaps underscored by the recent chlorine attacks in Iraq. In fact, we are rather surprised that there have not been more reports of actual or attempted chemical or biological attacks, given al Qaeda's history in this area. Overall, there remains a very real possibility that al Qaeda or a group of grassroots jihadists might attempt a chemical or biological attack in the United States, the United Kingdom, Australia, Canada or another allied country in hopes of inflicting mass casualties. One attack of this sort, or even a series of them, likely would not achieve the "weapon-of-mass-destruction-level" results of 9/11. But a certain level of danger does exist — and without situational awareness, a general understanding of risks and proper responses, or a contingency plan, the potential for deadly results is amplified.

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