Bruce E. Ivins went to work each day in a high-security federal laboratory where he handled some of the world’s deadliest substances. But more than a year before the 2001 anthrax attacks, the scientist admitted to himself that he was losing his grasp on reality.
“Paranoid man works with deadly anthrax!!!” he wrote in one e-mail message in July 2000, predicting what a National Enquirer headline might read if he agreed to participate in a study on his work.
“I wish I could control the thoughts in my mind,” he added a month later in another message to a colleague. “It’s hard enough sometimes controlling my behavior. When I am being eaten alive inside, I always try to put on a good front here at work and at home, so I don’t spread the pestilence.”
He continued, “I get incredible paranoid, delusional thoughts at times, and there’s nothing I can do until they go away.”
These e-mail messages and dozens of others are a central element in the case the Federal Bureau of Investigation laid out on Wednesday against the man they say is responsible for the anthrax attacks that killed five people and panicked the country. They provide glimpses into the personality of a man obsessed with a sorority that he first encountered while an undergraduate, asserting in an e-mail message that the women’s group was waging a “fatwah” against him.
Dr. Ivins composed poems — scripted to the nursery rhymes “Hickory Dickory Dock” and “I’m a Little Teapot” — about having two personalities. And he went on what he called “mindless drives” to mail gifts and letters anonymously, the document said, and then “set back the odometer in his car” to fool his wife.
From this quick read of the article, my strong suspicion is that Ivins qualified for a diagnosis of Delusional Disorder. In my capacity as a forensic psychologist, I have on many occasions examined and evaluated people who have committed criminal offenses while under the influence of paranoid delusions. Sometimes these people were suffering from paranoid schizophrenia, which is usually quite incapacitating (these individuals rarely are capable of holding down a job); other times, the correct diagnosis is Delusional Disorder. In the latter cases, the individuals are in fact likely to be holding down jobs, perhaps in highly responsible positions; Delusional Disorder is less disabling than Schizophrenia, in part because it does not cause hallucinations or grossly disorganized behavior. Instead, the person retains an overall capacity to function in a goal-directed manner, with reasonably intact social skills... yet s/he strongly believes things that certainly are not true, and s/he sometimes acts on those beliefs. Because the beliefs, or delusions, are often paranoid in nature, the person feels threatened... and this makes him (most of these patients are male) dangerous. Unfortunately, delusional disorder is quite resistant to treatment; these patients (like narcissistic and antisocial patients) do not believe there is anything wrong with them, so they are not likely to seek out or benefit from treatment); moreover, antipsychotic medications, which are fairly effective in Schizophrenia, are much less effective in Delusional Disorder.
Sad to say, contemporary science at this time gives us few answers as to the causes, or potentially effective treatments of, Delusional Disorder. However, I would suggest that in certain workplace settings it is exceedingly critical that individuals who are engaged in the kinds of communications and behaviors described in the case of Ivins (above) be identified, and that every effort be made so that competent risk assessments can be undertaken, in the hopes of preventing disastrous outcomes.
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