Genocide in Bosnia: The Case of Dr. Radovan Karadzic

Kenneth B. Dekleva, MD, and Jerrold M. Post, MD

From 1992 to 1995 the Republic of Bosnia-Herzegovina experienced a war of genocidal proportions between the Bosnian Serbs, the Bosnian Croats, and the Bosnian Muslims. The International Criminal Tribunal for the Former Yugoslavia has indicted Dr. Radovan Karadzic-former President of the Bosnian Serb Repub- lic, psychiatrist, and poet-as a suspected war criminal for his role in war crimes, crimes against humanity, and genocide. Karadzic remains enigmatic and poorly understood. Psychological profiling highlights in Karadzic's case the complex coalescence of the psychology of a genocide perpetrator with that of a charismatic narcissistic political leader. Such a profile may possess usefulness in forensic psychiatric investigations and legal proceedings.

From 1992 to 1995 the Republic of "grave breaches of the Geneva Conven- Bosnia-Herzegovina experienced a war of tions and other violations of international genocidal proportions, between the Bosn- humanitarian law have been committed in ian Serbs, the Bosnian Croats, and the the territory of the former Yugoslavia on Bosnian Muslims, with deaths among the a large scale," and that the "practice of warring parties ranging from 150,000 to so-called 'ethnic cleansing' and rape and 250,000 persons killed and over one mil- sexual assault, in particular, have been lion refugees displaced.' The Interna- carried out by some of the parties so tional Criminal Tribunal for the Former systematically that they strongly appear Yugoslavia has begun its first war crimes to be the product of a policy" perpetuated trial. based upon the United Nations by the Bosnian Serbs to "ethnically (U.N.) Security Council Commission of cleanse" Bosnia of non-Serb populations, Experts April 1994 report to the U.N. notably the Bosnian ~uslims.~-~ Secretary-General, which concludes that A unique aspect of the Bosnian conflict lies in the fact that Radovan Karadzic, the Dr. Dekleva is Clinical Assistant Professor of Psychia- former leader of the Bosnian Serbs, is a try, University of Texas Southwestern Medical School, psychiatrist.' In 1995 the International Dallas, TX. Dr. Post is Program Director, Political Psy- chology, and Professor of Psychiatry, Political Psychol- Criminal Tribunal for the Former Yugo- ogy and International Affairs, George Washington Uni- slavia indicted Karadzic as a suspected versity, Washington, DC. This paper is based on a presentation made at the 27th Annual Meeting of the war criminal for crimes against humanity American Academy of Psychiatry and the Law, October and The nature of the al- 17, 1996. Address correspondence to: Kenneth B. Dek- genocide.'^^ leva, MD, P.O. Box 38 1759, Duncanville, TX 75 138. leged war crimes has led to comparison

J Am Acad Psychiatry Law, Vol 25, No. 4, 1997 485 Dekleva and Post with the Nazi Holo~aust.'~-'~The indict- itinerant journeyman with a history of ment of Karadzic as a war criminal-the incest and theft. Karadzic grew up fol- first physician to be so indicted since the lowing a war in which over one million 1946 Nuremberg Doctors' Trial- has re- Yugoslavs perished, and allegations have kindled interest in the role of other phy- been made of the elder Karadzic's impris- sicians in contemporary genocide^.'^^ l4 onment for war crimes committed under Both the Nazi Holocaust (as well as the the guise of Chetnik military campaigns Nazi T-4 euthanasia program) and the in eastern Bosnia during World War Armenian genocide of 19 15 involved 11.40-44 the participation, on a political, bureau- Karadzic's adolescence and young cratic and medical level, of medical pro- adulthood were colored by a variety of fessional~.'~-'~ formative experiences. At the age of 15, Karadzic has been portrayed as one of Karadzic moved to Sarajevo; he later the most misunderstood men in the joined the Communist Party and in 1965 Until his political involve- began the study of medicine at the Uni- ment began in 1990 when he became the versity of Sarajevo, specializing in psy- leader of the Serbian Democratic Party chiatry. In 1968, he became involved in (SDS) in Bosnia-Herzegovina, he had had local student politics, was ousted from the a career as a psychiatrist and poet. Psy- Communist Party, and later ostracized- chological profiling approaches may offer many believing him to be a police inform- clues to his motivation and personality. er-from the student movement as well. and such approaches to the study of po- During this time, he married Ljiljana litical leaders encompass a rich tradi- Zelen, with whom he has a daughter and tion.30-35 This article expands upon our a son. Karadzic's wife speaks of him as earlier psychological profile of Radovan "a poetic soul" who wooed her with his Karadzic, highlighting in his case the co- lyrical poetry. Other accounts note his alescence of the psychology of a genocide penchant for drinking, gambling, and perpetrator with that of a charismatic nar- spending thousands of dollars over the cissistic political leader and emphasizing years in casinos. These data are intriguing aspects of such a profile that may prove in light of his propensity for risk-taking as useful in forensic psychiatric investiga- a political leader in the 1990s.~~.46 tions and legal Migration, Identity, and Childhood and Youth: Discontinuity: I968 to 1975 1945 to 1968 Speculations have arisen regarding Data about Karadzic's childhood are Karadzic's status as an outsider, a peasant scant. He is the eldest of three children Montenegrin Serb, struggling to gain ac- born to poor peasant parents in 1945 in ceptance in urban, cosmopolitan Sara- Montenegro, a fountainhead of Serbian jevan society. Sociologic interpretations nationalism. Media accounts describe emphasize the notion of a Dinaric social Karadzic's father as a poor "tramp" and character (referring to Montenegrins,

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Bosnian Serbs, Herzegovinan Croats, and (who has received several literary prizes Serbs of the Krajina region in Croatia) for his poetry) is well known as a trouba- and its associated xenophobic fear and dour, singing his poems to his own ac- loathing of cities such as Sarajevo and companiment on the gusle. the Serbian their urban sensibility.47.48 One sees hints lyre. of change and discontinuity in Karadzic's During the Bosnian war. some of the life-a sense of wanderlust-in his leav- greatest poets of our time, including the ing Montenegro, his new beginnings in Nobel laureates Joseph Brodsky and Cz- Sarajevo, his complex relationship with eslaw Milosz, wrote elegies for Sarajevo. Communism and the Communist Party, But in his poem "Sarajevo," written in his role in the 1968 student movement, 1971, 21 years before the Bosnian war and in his specialty choice of psychiatry. began, Karadzic writes of a calamity In addition. Karadzic interrupted his psy- wherein the imagery of death. plague, and chiatric career to study poetry at Colum- sickness abounds: bia University during 1974 to 1975, an I hear that a calamity really falters toward unusual hiatus suggesting doubts about Its transformation into an insect-as if fated: his chosen profession and identity as a It pulverizes the insect like the ruinous bard, psychiatrist. While Karadzic has fostered Transforming silence into his self-same voice. the notion that he was enrolled in a pro- The city lies ablaze like a rough lump of incense gram of postgraduate study, Columbia Wherein the haze of our awareness twists. University shows no record of Karadzic's The city implodes in latent emptiness. attendance at a formal program during the A stone's crimson death year. Psychoanalytic theories illuminate Bespeaks the house's blood-soaked tide. Plague! the creative aspects of such self-definition Tranquillity. A squadron of white poplars and emphasize how migration may repre- Marches in formation. The tempest sent a way of working through earlier Lifts up the chariots of our soul At times human, at times breathtakingly divine. separation anxieties surrounding child- hood and adole~cence.~~~'' His dark po- I speak of the dawning of a tempest's roar: etry provides intriguing glimpses of the What shapes the metal in the forge? man beneath the political mask, convey- That's it-like fear transformed in its web, It searches its memory for a clue. ing his life-long search for self-definition. Karadzic's poetry is shaped by his Poetry: 1968 to 1971 search for a sense of reflective awareness Little examination of Karadzic's cre- and agency, where each element is part of ative writings has occurred in the English- the poet's arsenal, a tool of transforming speaking A contemporary re- power. Karadzic speaks of his early work ferred to Karadzic as "among the most as prophetic and "out of the range of my gifted of a younger generation of poets in awareness," arising from his sense of be- Sarajevo," although the same critic later ing "trapped in the depth of historical tempered his praise, describing Karadzic mire," and representative of his vision of as a "nickel-and-dime poet." Karadzic confusion, plague. and torment.55p57

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"The Seasons of a Man's Life": providing false medical diagnoses to help 1975 to 1985 people collect insurance or pension ben- Following his return from Columbia efits. Since his rise to power. allegations University in 1975, Karadzic settled of corruption and nepotism have dogged down, tending to the business of building not only Karadzic, but also his wife (in his career as a psychiatrist. He and his her role as head of the Bosnian Serb Red wife (also a psychiatrist) worked in vari- Cross) and his daughter (in her role as ous inpatient and outpatient settings in director of the Bosnian Serb International Sarajevo, both counting many Muslims Press Center), as well as members of the among their friends, colleagues, and pa- inner circle of power in the Bosnian Serb tients.58p6' He had Tavistock Group Republic. After 1985, Karadzic became training, not surprising given his interest politicized and dabbled in various busi- in group psychotherapy, but ironic given nesses and political ventures, including a his later political role.62v63The decade stint as the head of the Bosnian Green from 1975 to 1985 appears to have been a Party in 1989. In 1990 Karadzic was in- period of career consolidation, financial vited to become head of the SDS in stability, and vibrant intellectual life. This Bosnia. His shift into politics and the period of emotional growth, the mid-life, emergence of his political persona paral- is critical to longitudinal adult develop- lels that of the remainder of Yugoslavia in ment, and we concur in highlighting the 1990, a reaction to internal disorganiza- importance of the Dream as central to tion, and a projection of his internal con- adult development and to the consolida- flicts onto a larger political stage. tion of the life structure.64." Karadzic's life during these years, including his Redemption: 1990-1992 home in a mixed neighborhood populated In 1990 Karadzic published his fourth by Serbs, Croats, and Muslims, symbol- major book of poetry, Crna Bajka (The izes his role in the unique ethnic and Black Fable), which had a different tone cultural tapestry of Sarajevo. than his earlier work, revealing an obses- sion with themes of blood and violence. Karadzic's poetry in this volume pos- Watershed: 1985 to 1990 sesses a richness of Homeric themes. In 1985. the 40-year-old Karadzic was which become fused with traditional Ser- convicted in Sarajevo of fraud and misuse bian epic themes. In "The Morning Hand- of public funds, for which he served I I Grenade," he invokes a protagonist months in prison. He has claimed that he whose world has shattered: was a political prisoner, framed by the At last I am bereft "Muslim secret police," and that he Of all benefactors. emerged psychically strengthened fol- I glow like a cigarette's ember lowing this experience. Allegations have Touching neurotic lips: While others search me out- also been made of Karadzic's corruptibil- I await, in dawn's hiding-place ity, of his selling fake prescriptions and The glorious opportunity

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To suddenly forsake all fanned by the psychobabble of the Bosn- That this epoch has bestowed upon me ian Serb President, Radovan Karadzic"; And I hurl a morning hand-grenade, Armed with the laughter such rationalizations have found their Of a lonely man way into propaganda used by the Serbs to With a dark character. incite feelings of victimization leading to In Crm Bajka. other poems reveal a genocidal violence.69p71It may be pre- combination of myths of Greater Serbia, cisely in this realm that psychiatrist-pol- of Homeric return, and of spiritual regen- iticians such as Drs. Raskovic and eration. But these themes of glorious, Karadzic fit into the political landscape of nostalgic return belie the violence that the Yugoslavia of 1990- 1991. such deliverance entails. Such premoni- tions of violence are present not only in Power: 1992-1995 his poetry, but also in his psychothera- Karadzic stands accused of war crimes peutic work: in a 1987 Congress of Psy- including ethnic cleansing. genocide, chotherapists in Yugoslavia, Karadzic mass rape and sexual assault, and the presented a paper discussing an analysis destruction of the Bosnian Muslim cul- of a poem involving a "bizarre fantasy of 7" In 1995 he was indicted as a body m~tilation."~~ war criminal by the International Crimi- Karadzic's appointment as SDS leader nal Tribunal for the Former Yugoslavia, in Bosnia surprised many of his acquain- and in 1996 international arrest warrants tances. The 1990 election platform of the were issued against him following a Rule SDS was shaped by the agenda set by the 61 evidentiary hearing.74375 In 1993 the Milosevic regime. Karadzic identified American Psychiatric Association's with Dr. Jovan Raskovic, highlighting Board of Trustees stated that "Dr. Raskovic's role in the radicalization of Karadzic's actions as a political leader the Serbian "diaspora." Dr. Raskovic was constitute a profound betrayal of the the founder of the SDS in Croatia in 1990 deeply human values of medicine and and had been the director of a major Sara- psychiatry," citing his "brutal and inhu- jevo psychiatric hospital; the composition man actions as the Bosnian Serb leader." of the SDS included large numbers of and castigated him as "accountable for health professionals, especially psychia- the policy of ethnic cleansing, organized trist~.~~Raskovic (who also influenced rape, mass murder, and the establishment the founding of the SDS in Bosnia) was of concentration camps." 763 77 In addition the author of Luda Zemlja (The Crazy to the above condemnation. disturbing ati ion),^^ a discussion of the psychody- suggestions have emerged that Karadzic namics of various ethnic groups in the deliberately used his psychiatric training former Yugoslavia. Cherif Bassiouni to create military and political policies speaks of how "the level of violence [in that would create fear, terror. and exten- Croatia and Bosnia] is due in great part to sive posttraumatic stress disorder in civil- the psychological manipulation of the ian populations. Allegations have been combatants . . . whose hatreds have been made of Karadzic's direct. personal com-

J Am Acad Psychiatry Law, Vol 25, No. 4, 1997 489 Dekleva and Post plicity in acts of violence and torture, massacre. especially when such data cor- including claims that Karadzic has partic- roborate eyewitness accounts. intelli- ipated in and witnessed tortures at various gence data from satellite reconnaissance Bosnian Serb-run concentration camps.78 photos, and Karadzic's statements to the Central in Karadzic's indictment for media. The mass graves have provided war crimes and genocide are legal doc- forensic anthropologic data as well as fo- trines relevant to command responsibility rensic DNA data that may illuminate the and superior orders. The U.N. Security cause and manner of death as well as the Council's Commission of Experts 1994 identity of the victims, a critical portion Report addresses several important ques- of this aspect of the investigation. The tions of international law with regards to investigation of mass graves at Srebrenica the above. noting that "questions of com- has begun, and utilizes forensic tech- mand responsibility and superior orders niques similar to those used in investiga- are well established in international law," tions of war crimes and human rights and stating explicitly that "a person who violations in Argentina, in Guatemala, gives the order to commit a war crime or and in Vukovar, ~roatia.~"-~~Karadzic crime against humanity is equally guilty has made statements that suggest his of the offense with the person actually command responsibility for the July 1995 committing it. This principle . . . applies attack on the safe haven of Srebrenica: to both the military superiors, whether of "We have orders which the commander- regular or irregular armed forces, and to in-chief [i.e., Karadzic] gives from time civilian authorities." The report also to time in which all actions for a specific states that "superiors are moreover indi- period are included . . . I gave my ap- vidually responsible for a war crime or proval for the immediate task [i.e.. of crime against humanity committed by a attacking the safe zones] directly to the subordinate if they knew, or had informa- General Staff and even directly to Gen- tion which should have enabled them to eral Krstic, and was very satisfied with conclude. in the circumstances at the how quickly he managed to take Sre- time. that the subordinate was committing brenica."" He has also stated (in August or was going to commit such an act and 1995 when he attempted to remove Gen- they did not take all feasible measures eral Ratko Mladic from his position as within their power to prevent or repress commander of the Bosnian Serb Army) the act." that his powers as such were vested in his A key feature of the indictments (e.g., Karadzic's) authority as President against Karadzic involves the July 1995 of the Bosnian Serb Republic and Com- massacre by the Bosnian Serb Army of mander-in-Chief of the Bosnian Serb thousands of Bosnian Muslim civilians at Army. The above-mentioned issues of ~rebrenica.~~The presence of numerous command responsibility are central to the mass graves at Srebrenica offers the legal case against Karadzic at the Inter- opportunity to obtain forensic evidence national Criminal Tribunal at the Hague, linking Karadzic definitively to this and such issues will undoubtedly build

490 J Am Acad Psychiatry Law, Vol 25, No. 4, 1997 Genocide in Bosnia upon legal precedents established at of collective Serb nationalist themes es- Nuremberg and Tokyo following World poused particularly by Serbian academic War IT."^^' "Orientalists" and by Orthodox Church Karadzic refutes allegations of geno- leaders in the Serbian Academy of Arts cide by making inflammatory statements and Sciences 1986 Memorandum, which about the Bosnian Muslims. He speaks of gave legitimacy to the age-old Serb Sarajevo as a "Serb city." and of his vi- dream of uniting all Serbs under the ban- sion of Sarajevo-the 1984 site of the ner of one state. Karadzic's language be- Winter Olympics-as "like Berlin when speaks his grandiose sense of destiny, im- the Wall was still standing." When news bued with a collective sense of myth and reports of concentration camps emerged sacrifice. Karadzic speaks of being "a ser- in August 1992, Karadzic challenged the vant of the people," and his language of international community to prove the ex- myth merges with that of sacrifice: "I am istence of a single concentration camp or willing to sacrifice this entire generation. of a single case of organized rape. if it means that future generations [i.e., of Karadzic has exhibited the ability to Serbs] will live better." Karadzic redis- adapt Bosnian Serb military and political covered a mythical, primordial language tactics to external political circumstances, (identifying with Petar Petrovich Njegos. suggesting elements of rationality and Montenegro's 19th-century prince-bishop- calculation in his political thinkmg and poet) in which he evokes themes of actions, rather than a pure destructive- blood-soil and hallowed ground.'025106 ness, collectively suicidal in nature. for its Group therapist to his wounded nation, own sake. Such actions also provide fur- Karadzic-as someone "who [according ther evidence of his command responsi- to his wife] understands the depths of bility. Karadzic has made tactical blun- person's soulm-set himself the task of ders at times, but has shown the ability to healing the collective sorrow of the Ser- compromise, making him appear more bian people, helping him to "play [his] reasonable and rational. The recent splendid The existence of changes in the military balance of power Sarajevo and its pluralistic, multi-ethnic in Bosnia. and the Dayton peace agree- civitasl l0 contrasted with Karadzic's ment (which mandates Karadzic's ab- specter of Sarajevo (and by implication. sence from postwar Bosnian political life) all of Bosnia) as part of a Greater have underscored Karadzic's diminished Serbia. Concepts of narcissism and the narcissis- tic personality are useful in understanding Dreams of Narcissistic Glory the lives of political Karadzic's politics represented a re- Karadzic possesses several attributes of the vival of age-old Serb nationalist dreams, phenomenology of narcissism: extreme and Karadzic's political realignment par- self-centeredness, egocentricity. self-ab- alleled that of his Serb c~untrymen.'~' sorption, grandiose fantasies, object hunger, His political voice resonates with echoes rage, and uncertainty about identity. A par-

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titularly striking feature of many narcissis- anic, narcissistic, grandiose self-concept. tic leaders is their life-long sense of being The 1995 Dayton peace settlement has impelled by boyhood dreams of glory. had profound implications for Karadzic's Karadzic manifests evidence of such a life- political future. Karadzic showed cunning long messianic destiny, especially in his and staying power in defying both the poetry, and his darker, more destructive life international community's and the Bel- trajectory suggests Karadzic's criminality grade government's subsequent attempts as part of a constellation of "malignant nar- to limit his power or to remove him from cissism," with its attendant psychological office prior to the 1996 Bosnian elections, and political implications. although he agreed-pressured by Milos- Many theorists stress the creative and evic-to relinquish his titles and power as reparative aspects of narcissistic fanta- President of the Republika Srspska and sies, reflecting psychic attempts to heal head of the Serbian Democratic Party; he narcissistic defects in the self's sense of continues to exercise behind-the-scenes agency and reflective awareness. Karadz- influence, remaining "a force of evil and ic's story highlights the unconscious, co- intrigue.ml 16-123 Given Karadzic's prior vert dimensions of his personality, and its intimate political relationship with Milos- developmental, epigenetic trajectory in- evic. and his knowledge of the military corporating the poet's search for his au- intricacies of the Belgrade-Pale axis, dience and his muse; the psychothera- Milosevic can be expected to treat him pist's search for empathic attunement with caution and circumspection, and it is with his patients; and the politician's unlikely that-short of being arrested by search for power, dreams of glory and redemption, embodying a personal myth NATO peace-keeping forces-Karadzic will be extradited to the Hague to stand and changing self-concept. While one 124-129 finds elements of a mythology of Greater Serbia in many of his speeches and inter- This profile of Dr. Karadzic suggests views, the stronger myth, the one embod- that part of his unique importance lies in ied in Karadzic's poetry, possesses a the coalescence of features of a genocide more Homeric quality.' l3 Part of Karadz- perpetrator with those of a charismatic ic's initial political success lay in his abil- narcissistic political leader."' The ity to wed these above two myths. themes of his poetry seem to have pre- saged those of his political leadership, Outlook and Karadzic acknowledges, ruefully, a Karadzic's vision represents a pyrrhic prophetic and uncanny quality to his writ- victory obtained at great human ings. His themes of exile. death, destruc- cost. 1 14. 1 15 Karadzic, as an international tion, and nostalgic return to a forsaken war criminal indicted in war crimes in homeland pervade his poetry from his which universal jurisdiction applies, has earliest literary musings, suggesting a had to cope with his own isolation and self-fulfilling prophecy in which the poet- with the attendant wound to his messi- physician turned political leader inscribed

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