Photo Gallery: How Sick is Anders Behring Breivik?

Foto: Lise Aserud/ dpa

Anders Breivik's World How Sick Is Norway's Mass Murderer?

Seventy-seven people died in the attacks in Oslo and on the island of Utøya last July. The central question in the trial of the perpetrator, Anders Behring Breivik, is whether or not he is criminally liable. There is much to suggest that he is suffering from paranoid schizophrenia. Can a delusional person be punished for their crimes?

On July 22, 2011, Oslo-born Anders Behring Breivik committed a massacre, with eight dead in the government district of the Norwegian capital and 69 fatalities on the island of Utøya, 40 kilometers (25 miles) away. He injured many other people, both physically and psychologically, who were lucky enough to survive and were forced to look on as others lay dying.

Is he schizophrenic? And paranoid? Is he "mad or bad?" Breivik doesn't deny that he committed the atrocities, but he also insists that he is neither guilty nor mentally ill. He says he would do it all again,  and that he would kill even more people the second time.

It is inadmissible to automatically conclude that someone who committed such a vicious crime must be insane. "A normal person doesn't do something like this," many are saying. But even so-called normal people have committed the most abominable crimes. Germans should be the first to recognize this.

But Breivik could be mentally ill. The schizophrenic disorders include a paranoid form characterized by delusional ideas, usually accompanied by delusional perceptions and acoustic hallucinations. It can progress in spurts or a person's condition can deteriorate gradually. Listening to the defendant speaking in the Oslo courtroom, it isn't difficult to become convinced that this man must have felt driven by a homicidal mania at the time of the massacre.

What other logical reason could there be to set off a 950-kilogram (2,094 pound), homemade car bomb that would indiscriminately rip people to pieces? Or to shoot participants at a Labor Party summer camp in the head -- and in the eyes, the mouth, the back and the chest, often multiple times, but mostly in the head, as if Breivik's aim had not only been to kill the young people on Utøya island, but also to extinguish their thoughts? There is no logical reason. Insanity is the only possible explanation.

Breivik speaks quietly, almost timidly at times. At the beginning of the trial, he occasionally smiles knowingly to himself. But eventually the smiles fade and his face becomes impassive. Referring to Breivik, Berlin forensic scientist Hans-Ludwig Kröber says: "It's not uncommon for psychotic offenders to conceal or tone down their delusions, because they are certainly conscious of the fact that others think they're crazy. There are orderly lunatics who get their bread from the baker and lead a quiet life at home, even as they write hundreds of pages detailing their notions of a new world order." Breivik was one of those people, writing a 1,518-page document, his so-called manifesto, to disseminate his confused ideas.

'Psychotic Symptoms'

The Norwegian court psychiatrists Torgeir Husby and Synne Sørheim began their assessment of Breivik on August 10, 2011, shortly after the killings. They spent a total of 36 hours speaking with him at the Ila detention center, one of Norway's two high-security prisons, and they also analyzed interrogations, witness testimony and other documents. In the end, they diagnosed him with "paranoid schizophrenia," as defined by the World Health Organization's International Classification of Diseases (ICD). Most of the ICD criteria apply to Breivik: his blunted affect, his withdrawal from normal life, his bizarre delusions of grandeur, his fear of danger and other symptoms.

One of the psychiatrists' conclusions was that Breivik believed that his life was in danger at the time of the crime. He was convinced that Norwegian women were being raped by Muslims. He believed that the Norwegian people were under attack and faced the imminent threat of ethnic cleansing and genocide, and that he, Breivik, was a commander in a civil war against foreign infiltration. The psychiatrists were unable to determine whether he hears voices. He refused to tell them how he communicated with the people he called his allies, saying only that this was "secret" information. The psychotic symptoms, according to Husby and Sørheim, existed more than half a year before the massacre and prevented him from living a normal life.

The Oslo prosecutor, Inga Bejer Engh, has questioned him for days in the courtroom. He isn't a match for her. He can't evade her questions, and she doesn't let him get away with anything. Her questions are so precise and relentless that he sometimes seems to squirm in his seat.

"Why did you leave school shortly before graduation?" Breivik starts to stutter, and replies: "I felt that it was no longer doing me any good." Bejer Engh asks him about his education, his career, his military service, which he didn't complete, and his interests. He becomes nervous. How did he support himself? How did he pay for the preparations for the attacks? Who were his friends? Did he have any? Why did he move back into his mother's house? What about the companies that he founded and drove into the ground? Isn't it true that his only successful moneymaking venture involved selling fake diplomas, and that he was unsuccessful at everything else?

A Liar, a Failure and a Mass Murderer

Breivik becomes increasingly defensive and starts refusing to answer questions. When has he ever had to justify himself to a woman like this? Aside from the reluctant admission that he read "10 books" on financial subjects, the titles of which he is unable to remember, and educated himself on Wikipedia, he reveals very little of substance. He had believed that the trial would give him the chance to take center stage before the court and the world press. But those hopes were quickly dashed within the first few days of the proceedings.

The prosecutor is familiar with the files and the facts, and she lets him know it. She knows that Breivik will be sentenced to either life in prison or life in a closed psychiatric institution -- knowledge that only strengthens her position.

And what is all this talk about the Knights Templar? And the alleged "cells" of "militant nationalists?" Or was it just a one-man cell in Norway, consisting of Mr. Breivik? And the rest of it? Figments of his imagination.

Bejer Engh makes him look like a fool, and she does it brilliantly. Breivik, for his part, comes across as a liar, a failure and a mass murderer. But if the first psychiatric evaluation is correct, is it acceptable to expose and humiliate a sick man as the prosecutor has done?

Experts say that even a schizophrenic can think in orderly ways, especially when he suffers from the paranoid form and delusions are the dominant symptom of the disease. But most of these patients, says Munich forensic scientist Norbert Nedopil, are incapable of acting in a truly controlled and logical manner. Their thoughts, according to Nedopil, are so muddled that they would hardly be able to pull off the kind of mass killing Breivik planned and executed. So is he delusional? Nedopil cautiously leans toward this assessment.

Paranoid Schizophrenia

With each trial day that passes, it is becoming clearer that Breivik's lack of sympathy for others and his coldness, as well as the fact that these symptoms intensified in 2010, when he began preparing for the attacks, are not the expression of an outlandish political way of thinking, but are probably signs of paranoid schizophrenia.

Another of these signs is the moment in Breivik's life when he became a loner who was no longer capable of accomplishing anything. Starting in 2006, he would withdraw into his small childhood room at his mother's house, where he indulged in his fantasies of being a chosen one whose role was to protect the cultural purity of his people. When, in the real world, he became increasingly unimportant and impotent, he massacred the nonbelievers as a virtual crusader, armed with his sword and shield. This development is also considered typical of a schizophrenic disorder.

It's an interesting question: Does the law matter to a person who believes that he was chosen to rescue Norway from Muslim dominance, and knows that to achieve this he will have to do things that are wrong? Can he be expected to care about the law? "If he believes, within the framework of his delusional system, that he has to do these things to save the world, we can no longer deal with him with our penal system," says psychiatrist Kröber.

If the diagnosis of paranoid schizophrenia is correct, says Norbert Leygraf a psychiatrist in the western German city of Essen, Breivik cannot be punished.

Zurich psychiatrist Frank Urbaniok calls it a "difficult assessment" when experts are asked to decide whether schizophrenics can be declared culpable. "Even if he does suffer from schizophrenia," says Urbaniok, "there may still exist, within his delusional thoughts, the ability to make decisions or the awareness that his actions are wrong."

But if Breivik is found to be schizophrenic, what led to his delusions? Norway is a large country geographically, but it has only five million people who, until oil was discovered off the coast, lived on agriculture and fishing. Breivik is part of a generation that benefited from the natural resource boom. He is the son of a diplomat -- ironically enough -- and a nurse. His parents separated when he was only a year and a half old. None of his father's worldliness rubbed off on the boy. Instead, he grew up with the irritations that the arrival of immigrants produced in some parts of Oslo.

Political correctness, which plays a particularly important role in Norway, greatly influences the public debate over whether this immigration should continue. For some politicians, it would be convenient if Breivik, with his blind xenophobia, were declared insane. Some media commentators are already predicting that the trial will not trigger a new debate over immigration, despite a new study that projects that immigrants will make up 47 percent of Oslo's population by 2040. But this figure also includes children who were born in Norway and have become integrated citizens, as many immigrants already are today.

The attorneys for the victims  openly declared that their goal is to have the killer convicted as a fully culpable criminal.

Different Psychiatric Assessments Seem to Reflect Different Interests

"The victims want Breivik to be criminally liable," says one attorney. This, she adds, is why they were dissatisfied with the first psychiatric evaluation and demanded a second one. In that assessment, prepared by Agnar Aspaas and Terje Tørrissen, Breivik was judged to be fully liable. 

It isn't unusual that an expert opinion is questioned and other experts are asked to prepare a second opinion. But this usually happens with borderline cases that are open to interpretation. In the Breivik case, however, the different psychiatric assessments also seem to be the result of differing sets of interests.

Experience has shown that crime victims demand that a perpetrator be held accountable for the suffering he has inflicted on others. They want his crime to have a face. A disease can hardly be blamed for an unspeakable crime. Doing so prevents the relatives of the victims from regaining normality in their lives, and the deep-seated human desire to punish the evildoer remains unfulfilled -- which is difficult for victims to bear. But can someone who is so delusional that he doesn't know what he is doing be punished for it?

The decision as to which psychiatric assessment should be given preference will be up to the judge. The chief judge in the case, Wenche Elizabeth Arntzen, is confident in her management of the trial. She is a petite, grey-haired woman who wears a white blouse under her robe, and who hands out neither too many smiles nor too few stern looks. Her grandfather, also a lawyer, served as a prosecutor in the trials of Nazi collaborators who were accused of being traitors after World War II. She and Prosecutor Bejer Engh have the makings of becoming the decisive figures in a trial that is being closely watched worldwide.

The defense, on the other hand, especially lead counsel Geir Lippestad, is in a difficult position. Lippestad was initially satisfied with the outcome of the first psychiatric assessment. Then his client said that being declared insane would be the most severe punishment of all for him, which he didn't want. Since then, Lippestad has said the defendant is criminally liable. Whether a criminal attorney chooses to simply do his client's bidding depends on his understanding of his role. "In Germany, someone like Breivik would probably be acquitted and committed to a psychiatric institution. And the First Criminal Division of the Federal Court of Justice would overturn the acquittal," says Munich psychiatrist Nedopil. He knows what he's talking about.

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