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This is the first in a two-part series on terror, torture, and ethnic violence.
By Richard Karel
In the early 1990's, after more than 40 years of living together peacefully, the peoples of the former Yugoslavia turned on each other in an orgy of ethnic warfare and brutality unseen in Europe since World War II.
Why this happened, the prospects for further violence, and the unsettling reality that psychiatrists played a key role in instigating the most brutal aspects of the conflict were among the topics of an annual meeting symposium in May in San Diego on terrorism and violence.
As reports of mass killings flowed from the Bosnian conflict in the 1990's, Kenneth Dekleva, M.D., an assistant professor of psychiatry at the University of Texas Southwestern Medical Center, became intrigued by the leading role played by psychiatrist Radovan Karadzic, M.D., and his mentor, Jovan Raskovic, M.D., in the fanning of ethnic hatred in the former Yugoslavia.
As a "trained psychiatrist and a poet," Karadzic was a particularly fascinating topic of study, said Dekleva. "I wondered how a humanitarian person, a person trained in the arts of psychiatry, of medicine, who embodies those values as well as the humanitarian values of a published poet, . . .could sanction, carry out, and give orders for wholesale, mass murder."
Although Karadzic clearly bears a greater burden of moral responsibility for the genocidal practices during the war than Raskovic, it is impossible to understand fully what transpired, and how Karadzic rose to power, without first understanding Raskovic, said Dekleva. Raskovic was active in the Serbian Psychoanalytic Society and Karadzic was one of Raskovic's pupils in the late 1980's, Dekleva said.
Raskovic was a Dalmatian Serb born in 1929. His early life experiences were characterized by migration during World War II when Croat fascists rounded up many Serbs and executed them. His family was briefly exiled to Italy, but he returned to Serbia and settled down after the war.
He founded the Serbian Democratic Party in Croatia in 1990. As a charismatic "firebrand speaker," he was "thrust into the vanguard of a series of meetings--huge mass rallies that were organized in Belgrade, we later learned, but appeared to have all the flavor of a spontaneous social uprising."
In late 1990 he was eased out of power by "more radical, hard-line Serb nationalists" in the former Croatia and "died a lonely and bitter man in 1992 just before the Bosnian conflict began," said Dekleva.
Raskovic helped fan ethnic hatred and hysteria both through his electrifying public speaking and by casting current events in dark, historical, symbolic terms, explained Dekleva. Raskovic spoke of "how paranoia could provoke and inflame these types of hatreds," said Dekleva.
Karadzic was "a different breed of animal," said Dekleva. He grew up in Montenegro, where his absentee father was convicted of incest with a cousin. In 1960 Karadzic moved with his family to Sarajevo. There he completed medical school, got married, and raised children.
In the late 1960's he began writing poetry. Karadzic saw himself as a brilliant poet and called his poetry "prophetic," said Dekleva. But he also once remarked that he would be "willing to sacrifice an entire generation so that future generations could live better," said Dekleva.
Karadzic has been variously called a "Serb hero-villain with a poet's heart" to "a man of intellectual attractiveness" and finally "a monster from another generation," said Dekleva.
He was twice indicted for war crimes in 1995, although it is unclear whether he will ever be brought to justice.
It is important to "look at the interplay between psychiatric ethics and political behavior, and the boundaries that someone such as Dr. Karadzic had to cross in order to do the things that he's done," observed Dekleva. "And I think it's important to note that this is not the only time that psychiatrists, in history, have been involved in this type of genocidal killing."
Understanding ethnic conflict requires understanding the role of narratives in creating ethnic group identity, according to panelist Stevan Weine, M.D., of the department of psychiatry at the University of Illinois.
"Certainly, Karadzic and Raskovic created narratives--Raskovic was more psychiatric, Karadzic was more poetic," with both centered around personal family experiences of the families in World War II, Weine observed. But it is within families that there "resides a power of a preserver of memory that is strong enough to compete with the modern nation-state. Elders tell stories to younger people" and thus are memories preserved, Weine said.
The case of Yugoslavia raises the question of whether a "society and its culture [can] become captured" as an individual can, by "the burden of too much history," Weine said. "It could be said that this happened in Yugoslavia" after World War II. Under Communism, the government imposed peace between different ethnic-national groups. "A fragile moral order was established in Tito's Yugoslavia, through pushing aside the survivors' memories of World War II and implementing, forcibly, a narrow, state-scripted partisan myth about war and its traumas."
When Tito died and European Communism fell, "Serbian and Croation nationalist narratives started to emerge, drawing strength from those memories that were pushed aside but not forgotten." Now, said Weine, in the aftermath of ethnic cleansing, "Bosnia-Herzegovina is at risk of being captured by the burdens of memory."
There is now "much too much history to bear," Weine said.
Like individuals, nations must confront and understand past traumatic events before they can leave them behind and live normally. Memories exist within the self, within families, and within national groups, with different functions at each level. But too often, said Weine, "the ways of remembering traumatic memories of war" have helped propagate historical cycles of violence, not counter them.
The international community, through the war crimes tribunal, is trying to shape historical memory, observed Weine. "If some guilty persons could be properly identified, then a whole people would not have to be deemed guilty."
But he sees little will to remember in the former Yugoslavia. Perhaps, said Weine, the "presence of too much history, the traumas of ethnic cleansing, and the dissolution of Yugoslavia have shattered the human fabric out of which that society could possibly deploy systems of meaning in order to structure and process their shared traumatic experiences."
As with individual pathologies and symptoms, "social, cultural, and political institutions persist because they meet needs for groups of people," according to panelist David Rothstein, M.D., of the department of psychiatry at Swedish Convent Hospital in Chicago. It is true for both benign and malignant institutions, he added.
In the search for meaning and self-esteem, individuals and societies go to great lengths. "The maintenance of self-esteem may often be pursued more vigorously than the preservation of life itself," he noted. How people view the world is shaped by the language used to define it, he noted. The language "both enables a historical process, while simultaneously being generated by it. The discourse shapes the popular wisdom," said Rothstein.
Discourse may circularly both "result from and reinforce popular perceptions and foregone conclusions," he observed. What is included or excluded from the discourse is critical, and ideas excluded are "not perceived as real or meaningful and not accepted as credible."
Being part of a community confers benefits ranging from personal sustenance and survival to the chance to take part in great cultural achievements. But it can, of course, also lead to killing and cultural destruction in war, he added. It is in war, sadly, that "people experience their most intimate personal involvement in the nation's life, its most intense pitch," Rothstein commented.
The need for political enemies and allies stems from "our effort to find a cohesive self and to form integrated representations of others," said Rothstein. Demagogues exploit this "identification and generation of enemies" to consolidate group, ethnic, and national identity. But leaders are not the sole agents of this process, for they must have willing followers.
Hitler once said that for the German people it was "the miracle of our times, that you found me, among so many millions; and that I found you." Whatever psychological factors led to Hitler's development as an individual, "the matter of understanding his personal development pales in comparison to the question of why the German people followed him," said Rothstein. Even in dictatorship, leaders govern by the consent of the governed, observed Rothstein. Hitler understood group dynamics well, once remarking that "what is essential will always be the inner accord between leader and multitude."
Freud said it is "always possible to bind together a considerable number of people in love, so long as there are other people left over to receive the manifestations of their aggressiveness." In this reside the roots of mass hatred and violence.
By understanding the roots of mass violence, there is hope "for finding and applying processes other than violent conflict to long-standing ethnic rivalries," Rothstein concluded.
South Africa is a positive example of a wounded nation seeking healing by confronting and acknowledging the pain of the past. It is a "rather remarkable thing" to observe the Commission on Truth and Reconciliation going forward there, said panelist Jerrold Post, M.D., a professor of psychiatry at George Washington University in Washington, D.C. Although amnesty is being given to those who confess, it may be the "full acknowledgment and taking of responsibility that is the beginning of the process of healing," Post said.
The prospect for the former Yugoslavia is less bright, said Post. "Can healing ever occur while indicted war criminals have not been held responsible, or will that narrative indeed become ensconced as a bitter internal mythology which lays the seeds for future violence?"
(Psychiatric News, July 18, 1997)