How Real Is the Stockholm Syndrome?

The image of heiress Patty Hearst, with her automatic rifle slung over her shoulder during a 1974 bank robbery, is synonymous with any mention of the Stockholm syndrome, described as the tendency for abductees to sympathize with, and even join, their abductors. Thirty years later when kidnapping victim Elizabeth Smart was found to have taken no action to escape her kidnappers after nine months of opportunities, the term was flaunted by the news again. But in psychological circles, the Stockholm syndrome is not necessarily taken for granted quite so easily. Is the Stockholm syndrome a real psychological phenomenon, or is it just a media buzzword, an attention-grabbing label that can be slapped onto every abduction case where the victim could have escaped but didn't?

It was 1973 when furloughed prisoner Janne Olsson attempted to rob the Norrmalmstorg Kreditbanken in Stockholm, Sweden. A police standoff ensued, during which Olsson took four young women hostage who worked at the bank. He demanded his friend Clark Olofsson be brought there from the prison to help him, which police granted. Olofsson joined Olsson and the hostages in the bank vault for six days until the crisis was ended without casualties by police tear gas. Despite two police officers being injured by sporadic gunfire from the robbers, the hostages reported that neither Olsson nor Olofsson mistreated them, and that they were more frightened of the police than of the robbers. Although Olsson went back to jail, Olofsson's conviction was dropped and he later became friends with one of the hostages and her family. The hostage negotiations were assisted by a psychiatrist named Nils Bejerot, and it was he, who, during a later interview, first used the term Stockholm syndrome.

It has come to be applied by the media whenever hostages express empathy toward their captors. Upon examination, it seems a radical and paradoxical idea. Should not one tend to feel hatred toward a captor who has threatened your life? And yet an important aspect of the syndrome is that hostages tend to resist being rescued, even passing up opportunities. They are said to want to defend their captors against the rescuers. Some, like Patty Hearst, join them and take up arms against the authorities. Surely such profoundly counterintuitive behavior must be described prominently in the psychological literature?

But it is not. There is no "Stockholm syndrome" in the psychology textbooks, or in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, which is the Bible of the psychological profession). It's also not a Medical Subject Heading (MeSH); these are all the entries in the U.S. National Library of Medicine vocabulary used for indexing journal articles in the life sciences. So, strictly speaking, the Stockholm syndrome is not a recognized condition in the medical or psychological literature.

Moreover, it's definitely not a syndrome in the clinical sense. Syndrome implies a pathology, and the whole idea behind the Stockholm syndrome is that it is a normal, if surprising, reaction to a hostage situation. But whether the terminology is accurate or not, that's what has stuck.

But the lack of clinical acknowledgment doesn't mean people don't study it and write about it. Psychologists have generally defined the phenomenon we call the Stockholm syndrome well enough that we're able to look at real-world cases and be able to decide which ones should count and which shouldn't. This hinges on the specifics of the hostages' situation prior to the development of their positive bond with the captor. The most often accepted criteria are these, though many researchers will give a slightly different list:

• The hostages have to genuinely believe that they are under a real threat of death.
  
  
• The hostages have to perceive some small act of kindness from the captor.
  
  
• The hostages have to be isolated from outside influences such that their captor's perspective is the only one to which they're exposed.
  
  
• The hostage must perceive that there is no possibility of escape.

If all four of these are the case, and the hostage then develops a positive bond with the captor, such as defending or supporting him, or preferring to remain with the captor than to go with rescuers, then their behavior qualifies to be called the Stockholm syndrome, at least for the purposes of research and study.

One of the questions such research has tried to answer is how and why would such a thing exist? Why would mentally healthy people exhibit such self-defeating behavior? It's important to note that a lack of data has hampered the research, so the suggestions to answer this question are really just educated guesses. Here are a few:

• The circumstances of a hostage situation mean that the hostages are dependent upon the captors for everything from food and bathroom breaks to life or death. Some hostages who are young or otherwise tend toward dependency may have difficulty breaking this bond.
  
  
• Some hostages may misinterpret the hyperarousal caused by fear (also called the acute stress response) as an attraction or a powerful bond.
  
  
• Some hostages may involuntarily assume a pseudo-identity as a way to cope, perhaps an identity who is on good (and thus safe) terms with the captor.
  
  
• Adopting friendly behavior can reduce the perceived stress of the situation, making it easier to adapt and cope.

Research done at Virginia Commonwealth University and published in 1994 set out to see how and why this could happen. Researchers created a "highly stressful simulated captivity situation" with terrorists and hostages in an experiment that was designed explicitly to test the Stockholm syndrome. Afterwards, participants were interviewed to learn what sort of relationship developed between them. What transpired in this case was in line with what we expect in normal life with no paradox: When the hostages and the terrorists got along reasonably well, the experience was reported to be less negative; while in cases where they did not get along well the experience was reported as more negative. A less dominant and more friendly terrorist was found to be more likely to build a rapport with his hostages than was a terrorist who was more dominant and less friendly.

But this study design had a weakness in relation to the standard definitions of the Stockholm syndrome: its hostages were placed in a stressful situation, but did not (could not) believe they were actually going to die. It's not very easy to create an experiment to study the Stockholm syndrome because of ethical considerations. Looking back at our criteria, it's important for the hostages to believe that their lives are in real danger and that there is no possibility of escape. Well, try setting that up with a bunch of college students, and you're going to find yourself on the wrong end of more lawsuits than you can count.

Research published in 2007 took a slightly different angle to avoid this problem. Since they were studying the possible evolutionary basis, the researchers figured one evolved primate was as good as another, so they surveyed the literature looking for cases where chimpanzees had been subjected to "traumatic entrapment" — hoped to be a good enough substitute for a human hostage situation. They found responses similar to what we call the Stockholm syndrome. After a chimp was attacked by another and suffered post-conflict anxiety, it tended to return to the attacker for comfort. Why? They concluded that if the defeated chimp went to other chimps for support, the dominant attacker chimp might interpret that as rallying support for another fight. This return to the attacker for support would have the effect of defusing potential future fights, which is good for everyone.

It's also noteworthy that the Stockholm syndrome is really only one very specific manifestation of the broader phenomenon of "misplaced attachment". Consider some of the other more familiar cases, that when examined in closer detail, are just as self-defeating:

• Intelligent people who join strange cults and devote their entire lives to a leader.
  
  
• Boy soldiers who unquestionably follow every order of brutal officers.
  
  
• Abused women who stay with violent husbands and often defend their actions.

Misplaced attachment is not an urban legend. Most such cases involve people exposed to highly stressful (and often dangerous) situations for protracted periods of time. This isn't easy on anyone. Stress is very powerful, and is quite capable of inflicting lasting changes on a person.

Most people are familiar with Posttraumatic stress disorder (PTSD) where the victim of a stressful trauma may experience flashbacks and other such symptoms, combined with the acute stress response or "fight-or-flight" response. But there is also a less familiar type called complex PTSD, which has been closely associated with the Stockholm syndrome and includes personality changes, behavioral changes, and changes in identity and self control.

The triggering causes of complex PTSD are generally described as taking place over a long period of time, such a long period of an abusive relationship. In the worst cases, the coping mechanism includes an almost obsessive preoccupation with the abuser, sometimes believing him to be God, and/or believing that the relationship has supernatural aspects , e.g., the victim may believe herself to be a "chosen one". In cases where the abuser has a specific belief system, it is common for the victim to adopt that belief system too. Given these admittedly shocking responses seen in complex PTSD, Stockholm syndrome behavior seems tame and harmless by comparison.

Sometimes we speak of the Stockholm syndrome almost like a joke or a jab. Someone doesn't quit their job under an idiot boss? Oh, it's the Stockholm syndrome. Or we express bewilderment at real cases: We hear about the kidnapped teenager who lives for years with a captor, abused daily, and actively avoids making an easy escape. Are these people nuts? —because that's what a "syndrome" suggests. They're not nuts. They are reacting along one expected pathway, according to evolved behavior, to an extraordinarily stressful assault. Their reaction may not be the best one from a practical standpoint, but for their own psychology, or for the broader desirable outcome of reduced conflict, the misplaced development of a positive bond is one natural and understandable resolution. Clinically, the Stockholm syndrome probably doesn't deserve a place of its own, but only because complex PTSD is already there. Complex PTSD is serious — many of us know someone who genuinely suffers from it or from regular PTSD — so let's not take any part of it lightly, including that particular manifestation from Sweden with the catchy media label.

By Brian Dunning
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