The profligate spending on wars, occupation and the enormous Homeland Security apparatus has been marked by corruption and incompetence unmatched in any previous national undertaking at home or abroad.1 Tens of billions disappeared into the maw of one company alone, KBR, that did not even bother to provide detailed invoices. $14 billion in 100 bills packed on pallets were flown into Iraq at the orders of Paul Bremer on C-5As only to slip away unaccounted for. $1 billion have turned up in an underground bunker in Lebanon but the Obama administration, acting through its Ambassador in Beirut, has blocked efforts to determine who the custodian is. That might be small change in Washington; but could have consequences were it to find its way into the hands of Hezbullah or IS. This dimension of the GWOT conforms to the fecklessness and slapdash approach that is the hallmark of the entire enterprise – conceptually, organizationally and politically.

Yet, think of the huge disparity between the actual threat and the response. The United States has sent armies to the farthest reaches of the globe in futile campaigns either to stamp out militant Islamic movements that had no direct role in attacking America (the Taliban – Afghan and Pakistani variants) or to destroy a hostile regime whose only connection to the initial traumatic event was that it was Arab and hostile to the U.S. (espousing, in fact, an anti-religious political ideology) i.e. Saddam Hussein’s Iraq. Smaller operations involving the American military have been launched in a few dozen countries spread from the Western Sahara to Mindanao even though the groups targeted have been local in organization and objective. We have built an elite army within an army in the form of the Special Operations Command (SOCOM). Numbering 60,000, they are designed to undertake select clandestine missions – in principle; in practice, they are assigned a wide range of intelligence and political missions as well as commando-type ones. The force is almost as large as that which Imperial Britain deployed to police its far-flung empire.

Psychosis can stem from trauma and acute stress. In our case, the traumatic event was 9/11. Characteristically, an experientially caused psychosis, as opposed to one with organic roots, is short-term. The terror psychosis is well into its second decade with no signs that it is ameliorating. That indicates the active presence of psychosocial factors that perpetuate the acute anxiety and apprehension associated with the original traumatic event. Those factors do not take the form of aftershocks. There have been no serious attacks against the United States over the past 13 years – much less any that registered a facsimile of the damage produced by the precipitating shock. Those that have occurred have had domestic sources, and have been minor by several orders of magnitude.

America is afflicted with a debilitating ailment that has warped the collective national mind. Its symptoms are the experience of persistent delusions and a distorted sense of objective reality. The disorder impairs functioning since the subjective perception of the world does not match actual conditions. That marks the classic psychotic syndrome.

Non-monetary costs include tens of thousands of American casualties – dead, wounded, disabled. Many of those in the latter two categories have received scandalously poor treatment. The system for managing their care seems to have operated more to serve the careerist and financial interests of those who run it than the medical needs of those who fought the GWOT. No one in a high position bothered to check. Foreign casualties number in the hundreds of thousands. The erosion of American moral standing in the world has been aggravated by the conduct of torture as a calculated policy conceived and ordered in the Oval Office itself. Trampling on laws domestic and international has been companion to the violation of the rules of war. The latter range from the prohibition on unjustified aggression against a sovereign state ensconced in the United Nations Charter, to the United Nations Convention on Torture ( Article 5 of the UN Universal Declaration of Human Rights) to the arbitrary abduction and extradition of individuals abroad.

At home, the violations have been just as egregious. The massive, systematic electronic surveillance programs of the National Security Agency have made a mockery of the Fourth Amendment. The President has arrogated to himself the power to kill American citizens abroad without due process or even notification based on nothing more than him own determination and will. President Obama also signed a law that requires the Executive to arrest, imprison indefinitely, and otherwise punish any citizen whom it has determined presents a clear and imminent threat to the country’s security without due process or even public notice of the actions taken. The undermining of the United States Constitutionally grounded legal system has extended to the Judiciary which has been a willing accomplice to these actions.

This pattern conforms to the profile of psychosis.2 Little of this stunning reality is recognized, understood and responded to by an adjustment of behavior. Delusion rules. Thus, behavior remains unchanged. The overshadowing delusion is that the United States is besieged by legions of Islamist enemies scaling the walls of the Republic bent on mayhem. Only the ingenious defenses that we have erected, and the valiant efforts of our warriors in Langley, Fort Meade, and in hundreds of outposts around the world, keep this diabolical foe at bay. Actual reality: there are a few hundred poorly organized, scattered remnants who have the intention and will even to imagine a direct attack on the United States. That small coterie lacks the means. In any case, they could not conceivably replicate anything like 9/11. In our world of delusion, any Islamist group which espouses an anti-American creed is declared a grave threat. What should be an international police exercise to apprehend criminals has been transmuted into a global war on fundamentalist Islam.

Hence, we have populated the world with ghosts and goblins like children who exercise their primordial fears by imaging monsters at the bottom of the cellar stairs. Their behavior is cathartic. The GWOT is not. Instead, the Secretary of Defense John Hagel warns Americans that ISIL is an “imminent” danger to the American homeland without a shred of supporting evidence. Instead, we tremble at the calculated, self-serving rhetoric coming from Saharan brigands, Somali tribesmen and Yemeni insurgents against a corrupt, American backed government – among scores of similar minor villains. Our rulers take every occasion to stimulate our fearful instincts: high officials grab the limelight at photo ops each time that a half-baked plot (as likely as not concocted by the FBI) involving some street corner types doodling on a napkin is “uncovered.” Security barriers, controls, restrictions are omni-present. Hollywood and TV are given inducements to produce streams of confected “reality” shows that depict blood-curdling nightmares of evil-doers at the doorstep. The world of terror delusion has become a national theater of the scary – however absurd.

All of this scare-mongering creates a political climate where elected officials dread doing anything that could expose them to charges of being “soft on terrorism” and putting the country at risk. So they portray themselves as relentless in grim combat with a legion of would-be terrorists. Hence, you have a closed loop of continuous reinforcement between public fears and the actions of leaders that deepen them. This mechanism interlocks with the external mechanism of self-perpetuating jihadism insofar as American military action feeds hostility and paranoia about a Western crusade which in turn produces rhetoric and actions that give material form to the initial perception of threat.

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The mystery is that the psychosis has endured for so long. The first question to ask is whether there is a functional counterpart to the biological component which is the organic basis for the illness’ resilience and persistence in Individuals, i.e. neurological abnormalities, and distotions in brain chemistry.

In other words, does there exist an element in the national mindset that makes American society peculiarly susceptible to this phenomenon? A few candidates do come to mind. The country’s historical invulnerability to attack is one of them. After all, with the historic exception of Pearl Harbor, the United States has not experienced a violent assault on its territory since 1813. Moreover, it has not faced a concrete threat during that period other than the abstract danger of nuclear strikes from the Soviet Union. We should note that the Red menace which the atomic bomb embodies did generate the hysteria of the early Cold War years. But that effect, and conscious fear of the Bomb itself, gradually wore off by the end of the 1960s.

A second feature of the national culture deserving citation is the low tolerance for ambiguity and uncertainty – at least as regards the foundations of the Republic’s peace and tranquility.

That is unique among nations. In the aftermath of 9/11, Americans were haunted by the dread thought that it might happen again. The existence of fundamentalist Islam itself was the incarnation of this phobia. Other countries, which have endured far more awful things, know from experience that it always might happen again. They accommodate to that reality. Americans by contrast believe in absolute security; they find it hard to tolerate anything short of that.

There is some psychological truth to these hypotheses. However, it does not explain adequately either the exaggerated response to a single (if singular) event or the intensity and acuteness of the delusional thinking in the absence of evidence from the real world that the fearful images are justifiable. The objective truth of the real world is overwhelmed by the subjective virtual truths that shape their perception of reality.

This loss of contact with reality is characteristic of delusional disorder in individuals. Often it is associated with the individual’s isolation – from other persons and from the external environment. Just the opposite, though, is the case with the collective psychosis we are examining. For delusions are reinforced through regular contact with other members of society. Here is a clue to one reason for the perpetuation of the delusional state of mind. There is massive reinforcement among persons sharing the same emotional experience, reacting to it the same way, attaching the same meanings, and coping with the same fears. Collective hysteria is a fairly common societal phenomenon. It has been much studied. Witch hunts fall into this category. On a larger scale, chiliastic movements in the past exhibited similar characteristics. The Book of Revelations is a pageant of apocalypse fixated psychosis in addition to encouraging psychotic tendencies to develop into pathologies. Perhaps it is not a coincidence that End Times churches awaiting Armageddon and the ensuing Rapture are flourishing simultaneously with the War on Terror. In this sense, the stunning appearance of ISIS is a like glimpse of the anti-Christ which signals that the climactic battle between Good and Evil is at hand. It is in the Bible Belt that the two psychoses have merged in a potent mix that has given new thrust to the Christian Right and elements of the Tea Party.

One feature of them all is that there is a triggering event. It then is given a larger meaning that reflects underlying emotional substrata of the societies involved. 9/11 is the triggering event in this instance. We noted some of the predisposing elements in the American psyche. But the critical factor is of a different nature. It is the agency of those who stoke the emotions, who propagate the myth of a larger meaning, who direct the febrile energies of the mass in a particular direction against a particular target. That is pretty much what has happened in America over the past 13 years.

The instigators of the delusional break from reality have been our leaders – in government, in the media, among those who are profiting handsomely from the GWOT, and (perhaps saddest of all) the political class and intellectual elites generally who have been either accessories to the plunge into a world of delusion or skillful beneficiaries in status and acclaim. Together, they are the culpable parties who have sealed the country into a bubble of illusion so well insulated from reality that it has become our semi-permanent residence.

The story features two successive presidents who have misled the public into believing that the threat is far greater, more pervasive, and menacing that in fact it ever has been. They bear the primary responsibility, All the details are now known. That many studiously avoid them in no way negates that basic truth. Our leaders’ motives are a bit more complicated – less so for Bush than for Obama. Bush, Cheney et al had two overarching goals. One was to establish American dominance across the world’s most turbulent region through combining the deployment of American military power with the creation of Western oriented, liberal regimes that would sublimate and neutralize forces hostile to the United States. The plan in its essentials had been laid out by Paul Wolfowitz in his notorious memo of March 1992 when he was in the Defense Department under Bush the Elder (who rejected it). The core ideas were the foundation stones for several studies developed under the auspices of neo-conservative and hard nationalist think tanks in the 1990s. The other objective, especially dear to the heart of Dick Cheney, was to augment the prerogatives of the Executive Branch while throwing off the restrictive controls imposed by Congress in the 1970s. In short, a powerful Presidency directing a potent Executive in building American influence in the world while enriching their business allies.

Obama is a more elusive figure. For one thing, the discrepancy between much of his rhetoric and his actions is enormous – even by normal political standards. In addition, his tolerance for contradiction suggests a narcissistic personality whose spoken convictions are genuine but only at the moment they are declared. The record, though, speaks for itself. He has continued the GWOT bequeathed to him by his predecessor with only minor modifications. Commitment in principle to end Bush’s wars in the Middle East in practice meant escalation in Afghanistan and an unrelenting effort to keep a residual force in Iraq – the latter failing only because Bush had been outmaneuvered in the negotiations with al-Maliki on a Status of Forces Agreement. Obama extended greatly the geographic scope of the subterranean war conducted by the Special Operations Command. He expanded the use of drones several fold. He introduced targeted assassinations and ‘signature’ killings of suspects.

On the domestic front, Obama actually has taken more aggressive steps re, surveillance and spying than had the Bush administration. The assault on the Bill of Rights has reached unprecedented levels – including the aforementioned killing of Americans abroad without due process. He has gone so far as to support the CIA’s hacking of the Senate Intelligence Committee’s computers in an attempt to prevent the committee from issuing a damning report on the Agency’s torture and rendition programs. The last is indicative of Obama’s most glaring failure, one that has historic implications. It is the systematic attempt to avoid any national reckoning with the deceit, crimes and disastrous errors of the GWOT. No public examination of the record, no accountability, no pursuit of criminal acts, no apologies, no changes.

The net effect of Obama’s twin policies of keeping the GWOT at full throttle, without any discussion of purposes and premises, and the sweeping under the rug of everything unsavory, has been to favor the creation of delusional myths about the entire era. America’s essential purity was reaffirmed, the justness of America’s cause inscribed in the national memory book, all sins expunged, and thereby all critics were delegitimized. The two primary tools for accomplishing these purposes were to make the horror of 9/11 the central reality of the contemporary American experience (roughly analogous to the way that current Israeli leaders use the Holocaust), and to keep percolating the fear of lurking terrorism (a la the Evil One in the panoply of the Medieval Church).

Rituals to memorialize 9/11 have been instituted that keep prominent the emotions and meanings of 9/11. Remembrance ceremonies are natural. The graphic reenactments through endless repetition and dramatization of the moving imagery, though, borders on being the functional counterpart to the Passion Plays designed to revivify the Christ narrative among the Faithful. In a more minor key, the choreographed celebration of our uniformed soldiers at sporting events serves the same purpose. It is akin to saying Grace before indulging in a sumptuous meal. Omnipresent American flags – from lapel pins to the 30 foot banners that wave above car dealers – are like the crosses that symbolize our collective ordeal and abiding faith. Thereby, the saliency of the War on Terror for individuals and for the nation is maintained – and, with it, susceptibility to the implanting of the delusions that are integral to it. In short, psychotic elements are insinuated into the American psyche.

The media have been a full and witting partner in this dubious project. Profit, laziness and fear of confrontation have carried the day – all cemented by conformist thinkers who share the primitive emotions provoked by 9/11 which haunt the country. A bipartisan corps of timid politicians has found it convenient to go along with the myth-making; it has helped that the absence of alertness and backbone has made most of them amenable participants in the collective delusion. They share it. As for professional associations, academic or otherwise, they have been silenced by their past complicity (e.g. the bar associations) or joined in the scavenging of GWOT victuals, e.g. the think tank world or simply bartered their ethics for a role in the big game, e.g. the American Psychological Association, - albeit a role that places it well below the salt at the feast.

In effect, every public institution and its principals has been compromised. They all have been party to shameful acts as active or passive accessories. That is so for FISA judges, Federal District judges, officials throughout the Executive Branch, elected officials and their staffers, newspaper editors (including The New York Times) and an army of commentators. Their silence now permits the continuation of most of these shameful practices. They lack the courage to admit error or to admit to their unsavory roles. A classic “line of blood” thereby has been drawn between them and the truth which they dare not cross. That solidarity of the culpable and weak keeps intact the world of delusion. It sustains the psychosis.

The tension associated with the psychotic individual’s encounter with objective reality does not arise if the dominant element of that reality is the attitudes and expressed opinions of others who share the underlying delusions. Their subjective state is a crucial part of the external environment. Reality testing, in these circumstances, leads to conformity in viewing the world through the delusional prism – rather than it being a potential corrective.

As for behavior, in theory it could be modified were individuals to feel a sense of shame or guilt about what they have done and supported. Guilt turns on the relationship between the self and the conscience. It can be a private matter. Shame, by contrast, is a social phenomenon; it is a matter of an individual’s sensitivity to how others view him. Moreover, shame may take on collective forms of expression that guilty feelings rarely do; thereby carrying a greater potential for influencing public policy.

Shame loses its force as a motor for changing attitudes and behavior when the social influence is factored out because the widely accepted norm conforms to the “shameful” behavior rather than to its stigmatizing. Guilt is more likely to be internalized in the absence of public condemnation. And less likely to lead to externalized behavior in the form of revelation, protesting or witnessing.

PROGNOSIS

The terror psychosis is now so deeply entrenched in the American psyche as to obviate any possible treatment. There is no such thing as societal psycho-pharmacology; and, in any case, there are multiple other drugs or placebos in wide use that would counteract them. Therapy is out of the question since there is no one to lead it. An exceptional President could perhaps produce some melioration but that person is non-existent. Anyway, therapy could only work if the patient wants to change. There is abundant evidence that self-absorbed Americans are too preoccupied with other problems to appreciate the damage that is being done – including the exacerbation of those other problems.

There is always the “next generation.” We can only hope that the inheritance of socially induced psychosis is less significant that the inheritance of biologically caused psychoses.

Throughout, the GWTO has been marked by arrogance, stunning displays of cultivated ignorance and amateurism. This is not the way a serious government conducts serious international business. Certainly, it clashes harshly with the presumed American role as model and law –giver for the rest of the world. We have made a spectacle of ourselves – from Abu Ghraib to L. Paul Bremer III strutting around the Green Zone sporting a 3-piece Brooks Brother suit and desert combat boats to middle-aged generals striding down the corridors of the Pentagon in the now obligatory camouflage fatigues to adrenalin crazed mercenaries careening through the streets of Baghdad, Lahore and Kabul in frenzied imaginings of Dogs Of War. (Somehow the U.S. won the Pacific war even though Admiral Chester Nimitz and General George Marshall did not convene meetings bare-chested or sleep under mosquito nets).

These unpalatable images makes it all the harder for Americans to escape their world of illusion; for to do so means facing up to an unseemly reality that ill-matches the exalted self-image that we have of ourselves.

NOTES

The latest, and most disturbing revelations are detailed in James Risen’s Pay Any Price (New York: HBH 2014) Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.