By Dr Stella Compton-Dickinson, author of The Clinician’s Guide to Forensic Music Therapy (Jessica Kingsley Publishers).

Stella Compton Dickinson

Stella Compton Dickinson

How do we deal with the fear of death? What leads someone to be willing to kill others? And what happens when to them when they do?  

Dealing with fear.

Let’s start by looking briefly at how we can deal with our current fears of terrorism and death?

In peacetime, we can do this by mindfully observing through each of our senses rather than just through our eyes. On the street, we can be more observant instead of blocking out our ears and eyes by using our phone or listening through headphones.

We can relieve anxiety by knowing how to breathe mindfully, to be creative through culture and music, through the sensations of touch, smell, sound, sight and taste.

What may lead someone to kill others through terrorism?

Were terrorised into becoming a terrorist before they began terrorising others?

The answer to this is best illustrated by cognitive analytic therapy, where we explain how people relate, as if on a see saw. It is easy to understand when one person is in control of the weight at bottom end, the other person is suspended up high and has no control. In this polarised position nasty things can happen. The solution only appears when one person takes the middle position, having leverage in both directions - like a good negotiator would.

We call this concept a reciprocal role. This idea applies to every human interaction: if one person is loving, the other feels loved. If someone is rejecting, the other person feels rejected. If someone is behaving in an attacking way, someone feels attacked.

Might a terrorist recruit feel terrorised by those they look up to, and if so are they themselves vulnerable to oppression or mentally unstable with depression or anxiety? Do they feel they must obey? Does this mean that they cannot think for themselves anymore? 

My work with mentally disordered offenders who have killed, demonstrates how instinctual, mindless impulses result in high-risk behaviours. These become observable in body language and symbolic gestures, which can be explained and understood.

For example, if someone feels excluded - then we can often see this as a pattern that has gone on throughout their lifetime and it can start to be addressed in a cognitive analytic approach by including them instead.  In this way patients have what Yalom would call a ‘corrective experience’.

The psychological impact of killing.

If an individual is not able to talk about their experiences and losses for fear of shame or flashbacks, then there is an inability to mourn. In effect, the individual is unable to feel the grief. As a result, some will turn to alcohol or drugs to fend off the pain - just as described in a Pink Floyd song, they become ‘comfortably numb’.

The men who came back from the first World War could not talk about the horrors that they witnessed, instead with a return to civilian life, as portrayed so vividly in the TV series ‘Peaky Blinders’, they maintained their own ways of being loyal to each other. After going through so much conflict and trauma, they turned to what was familiar through different forms of risk-laden responses; bare knuckle-fighting, thrills through gambling and drinking. And, to numb out the flashbacks and nightmares, they smoked opium.

So, we see that there is an emotional trauma that is endured when killing, which can lead to the loss of mental health, with subsequent diminished responsibility.

That lack of responsibility for one’s own actions cannot always be explained through mental illness. For example, if a terrorist commits martyrdom, this pre-meditated and he prepares himself psychologically. If the perpetrator lives he has committed the offence of murder and is incarcerated in prison.

The future.

Perhaps the world will become a better place as our increased knowledge of the human brain continue to inform treatment developments, which can include non-medical and creative resources that diminish aggression and promote mutual understanding.

In this way people may tolerate their differences without judging others for their ways of living; good or bad, or right or wrong. Instead, being accepting of others and accepted by others; understanding that they are as they are right now, and this is just how it is right now - and in the present there is the power to change things for the better.


Dr Stella Compton-Dickinson is a London-based Health and Care Profession council registered music therapist, accredited supervisor, professional oboist and lecturer, UK Council for Psychotherapy registered Cognitive Analytic Therapist and Supervisor. She is author of The Clinician’s Guide to Forensic Music Therapy (Jessica Kingsley Publishers), and  has her own private practice and twenty years' experience in the National Health Service as a Clinician, Head of Arts Therapies and Clinical Research Lead her research was awarded the 2016 Ruskin Medal for the most impactful doctoral research.