With the constant threat of terrorism, people may feel fearful about death when going about their business. Existential psychiatrist Irvin Yalom in his book Staring at the Sun explains why death anxiety is the most common reason why people seek psychotherapy. Sudden death of a loved one is one of the worst sort of trauma for survivors to manage.

Motivation for a terrorist act is premeditated; therefore, to start to understand how to deal with the fear of death, I will refer to a play that is set 100 years ago.

Journey’s End by R.C. Sherriff is set in a British trench towards the end of the First World War. The theme provides an exploration of how war changes men (and women) and how men respond to the constant threat of death.

The captain of the company turns to alcohol, which he knows is wrong since it gives him an underlying sense of guilt and cowardice. He has an inner conflict because he has a keen sense of duty but also an addiction. Instead of looking at his own problem, he openly criticises a colleague who he considers is feigning illness in order to avoid going over the top.

The story unfolds as a junior officer, who hero-worshipped the captain when they were at school together, has signed up to the regiment. This is disturbing to the captain who knows that he is a changed man, not worthy of that admiration and unable to live up to expectations. The young second lieutenant is naive and has built up an idealised view of the captain and of war. His way of coping with danger was by seeing the captain as a fine leader who may save him. But this was unrealistic.

Other members of the company escape the reality of their circumstances by thinking about the hopefulness of new growth in spring and the flowers that they planted at home. Yet, the futility and paradoxes of war are highlighted as the men talk about how men who have been wounded are rescued from no-man’s land without firing from the opposition. Profound pain and fear follow injury and a ceasefire is an act of mercy that enables rescue by the stretcher-bearers. This raises the unspeakable question of whether it is better to die outright in those circumstances rather than to be wounded.

There are many paradoxes in this story and these include the role of illness and heroism, there are no easy answers to when it is and is not appropriate to fight. The psychological need to numb oneself from emotional pain through addiction is common, rather than learning how to tolerate the mess of life and to be mindful of all the beautiful moments in life.

So how do we relate this to current fears?

In peacetime we can do this by mindfully observing through each of our senses rather than just through our eyes. On the street, we can be more observant instead of blocking out our ears and eyes by using our phone or listening through headphones.

We can relieve anxiety by knowing how to breathe mindfully, to be creative through culture and music, through the sensations of touch, smell, sound, sight and taste.

In cognitive analytic therapy we explain how people relate, as if on a seesaw. It is easy to understand when one person is in control of the weight at bottom end, the other person is suspended up high and has no control. By taking turns, each has the feeling of being at the controlling end and then also of feeling controlled. We know both extremes and the associated feeling between each other, but this is too polarised, and nasty things can happen. The solution only appears when one takes the middle position, having leverage in both directions – like a good negotiator would.

Might a terrorist recruit feel terrorised by those they look up to, and if so are they themselves vulnerable to oppression or mentally unstable with depression or anxiety? Do they feel they must obey? Does this mean that they cannot think for themselves anymore?

My work with mentally disordered offenders who have killed, demonstrates how instinctual, mindless impulses result in high-risk behaviours. These become observable in body language and symbolic gestures, which can be explained and understood.

For example, if someone feels excluded, then we can often see this as a pattern that has gone on throughout their lifetime and it can start to be addressed in a cognitive analytic approach by including them instead. In this way patients have what Yalom would call a ‘corrective experience’.

The way forward in resolving conflict

The men who came back from the First World War could not talk about the horrors that they witnessed, instead with a return to civilian life, as portrayed so vividly in the TV series Peaky Blinders, they maintained their own ways of being loyal to each other. After going through so much conflict and trauma, they turned to what was familiar through different forms of risk-laden responses:bare knuckle-fighting, thrills through gambling and drinking, and to numb out the flashbacks and nightmares by smoking opium.

There were unpredictable, impulsive violent outbursts of rage from shell-shocked peers that were difficult for them all to understand. These we now know come from neurological responses to trauma that can be triggered by similar sounds, smells and colours, from which incidentally the expression ‘seeing red’ comes. Research has shown that red has psychological meaning that is associated with interpersonal hostility.

That lack of responsibility for one’s own actions cannot always be explained through mental illness. Nor is it faced if a terrorist commits martyrdom, for which he prepares himself psychologically, but which in Western mental health terms is referred to as suicide. If the perpetrator lives he has committed the offence of murder, incarcerated in prison, pays the price of the loss of freedom having inflicting loss on innocent others through violent aggression.

Perhaps the world will become a better place as our increased knowledge of the areas of the human brain continue to inform treatment developments, which can include non-medical and creative resources that diminish aggression and promote mutual understanding. In this way people may tolerate their differences without judging others for their ways of living; good or bad, or right or wrong. Instead, being accepting of others and accepted by others; understanding that they are as they are right now, and this is just how it is right now; and in the present there is the power to change things for the better.

Stella Compton-Dickinson, PhD is a London-based music therapist, accredited supervisor, professional oboist, and lecturer.