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Ethically Treating PTSD Resulting from Terroism and other Traumas

Section 16
Use of Ego Defense Mechanisms
by Thomas Strentz

Question 16 | Test | Table of Contents

Whether the incident is a bank robbery in Stockholm, Sweden, a hijacking of an American aircraft over western New York, a kidnapping in South America, or an attempted prison break in Texas, there are behavioral similarities despite geographic and motivational differences. In each situation a relationship, a healthy relationship (healthy because those involved were alive to talk about it), seems to develop within and between people caught in circumstances beyond their control and not of their making, a relationship that reflects the use of ego defense mechanisms by the hostage. This relationship seems to help victims cope with excessive stress and at the same time enables them to survive - a little worse for wear, but alive. The Stockholm Syndrome is not a magical relationship of blanket affection for the subject. This bond, although strong, does have its limits. It has logical limits. If a person is nice to another, a positive feeling toward him develops even if he is an armed robber, the hijacker of an aircraft, a kidnapper, or a prisoner attempting to escape.

The victim’s need to survive is stronger than his impulse to hate the person who has created his dilemma. It is his ability to survive and to cope that has enabled man to advance to the top of the evolutionary ladder. His ego is functioning and has functioned well, performing its primary task of enabling the self to remain alive. At an unconscious level the ego has activated the proper defense mechanisms in the correct sequence - denial, regression, identification, or introjection to achieve survival. The Stockholm Syndrome is merely another example of the ability of the healthy ego to cope and adjust to difficult stress brought about by a traumatic situation.

The application for law enforcement is clear, although it does involve a trade-off. The priority in dealing with hostage situations is the survival of all participants. This means the survival of the hostage, the crowd that has gathered, the police officers, and the subject. To accomplish this end, various police procedures have been instituted. Inner and outer perimeters are well-recognized procedures designed to keep crowds at a safe distance. Police training, discipline, and proper equipment save officers’ lives. The development of the Stockholm Syndrome may save the life of the captor as well as the hostage. The life of the captor is usually preserved, because it is highly unlikely that police will used deadly force unless the subject makes a precipitous move. The life of the hostage may also be saved by Stockholm Syndrome; the experience of positive contact, thus setting the stage for regression, identification, or introjection on the part of all those involved in the siege. The subject is less likely to injure a hostage he has come to know and, on occasion, to love.

How to Foster the Stockholm Syndrome
It is suggested that the Stockholm Syndrome can be fostered while negotiating with the subject by asking him to allow the hostage to talk on the telephone, by asking him to check on the health of the hostage, or by discussing with him the family responsibilities of the hostages.
Any action the negotiator can take to emphasize the hostages’ human qualities to the subject should be considered by the negotiator.

The police negotiator must pay a personal price for this induced relationship. Hostages will curse him as they did in Stockholm in August 1973. They will call the police cowards and actively side with the subject in trying to achieve a solution to their plight, a solution not necessarily in their own best interests or in the best interest of the community.

Unfortunately, it may not end there. Victims of the Stockholm Syndrome may remain hostile toward the police after the siege has ended. The “original” victims in Stockholm still visit their abductors, and one former hostage has been engaged to Olofsson. Some American victims visit their former captors in jail. Others, such as some of the hostages in the Croatian skyjacking of TWA Flight 355 in 1976, have begun legal defense funds for some of their jailed captors. A hostile hostage is the price that law enforcement must pay for a living hostage. Anti-law enforcement feelings are not new to the police. But this may be the first time it has been suggested that law enforcement seek to encourage hostility, hostility from people whose lives law enforcement has mustered its resources to save. However, a human life is an irreplaceable treasure and worth some hostility. A poor or hostile witness for the prosecution is a small price to pay for this life.

Personal Reflection Exercise #7
The preceding section contained information as to how time and inflicting pain affects PTSD. Write two case study examples regarding possible application of these principles.

Update
Data showing that post-traumatic stress symptoms and defense mechanisms change based on perceived stress levels: A multivariate analysis of variance approach during the COVID-19 pandemic

Topino, E., & Gori, A. (2023). Data showing that post-traumatic stress symptoms and defense mechanisms change based on perceived stress levels: A multivariate analysis of variance approach during the COVID-19 pandemic. Data in brief, 48, 109298. https://doi.org/10.1016/j.dib.2023.109298


Peer-Reviewed Journal Article References:
Saltzman, L. Y. (2019). It’s about time: Reconceptualizing the role of time in loss and trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 11(6), 663–670.

Stenius, J., Knekt, P., Heinonen, E., Holma, J., Antikainen, R., & Lindfors, O. (2021). Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence: An evaluation of three methodological approaches. Psychoanalytic Psychology, 38(1), 58–67.

Taylor, S., Charura, D., Williams, G., Shaw, M., Allan, J., Cohen, E., Meth, F., & O'Dwyer, L. (2020). Loss, grief, and growth: An interpretative phenomenological analysis of experiences of trauma in asylum seekers and refugees. Traumatology. Advance online publication. 

QUESTION 16
How can the Stockholm Syndrome be fostered? To select and enter your answer go to Test.