Helsinki Syndrome

Helsinki Syndrome Definition

Helsinki Syndrome is alternatively known as Stockholm syndrome. In medical literature, the term ‘Helsinki Syndrome’ has no acceptance, as this condition is described as Stockholm syndrome.

Helsinki Syndrome rather Stockholm syndrome is a psychological condition and symptoms arise in a confined or imprisoned situation. An inconsistent attachment developed between captor and captive. In this psychological state, defeated becomes sympathetic to the demands of the captor. ^[1,2]

Origin

Stockholm syndrome become popular in Helsinki Syndrome because in “Die Hard” movie the syndrome is represented as “Helsinki syndrome” in 1988 and media hype this term and make this name popular. After this Stockholm syndrome is established as ‘Die Hard Helsinki Syndrome’ in general public. Though there are much more examples which describe the situations in the real world.

In 1973, bank robbery case in Sweden first revealed the condition in the real world. Robbers have kidnapped 4 bank employee and kept them detain for 131 hours. Finally, robbers release the for detainer, but the released victims had an emotional attachment with their captors. The  renowned addiction researcher Nils Bejerot (1921–1988) named psychological condition as Stockholm syndrome. ^[2,3]

Features

According to most of the psychological experts, three classic features are associated with Helsinki Syndrome/ Stockholm syndrome. These are:

• Pessimistic thoughts of hostages against the law enforcement or police authorities
• The hostages feel emotional attachment toward their kidnapper (s)
• Kidnappers become helpful and caring towards hostages due to emotional bonding ^[4]

Causes

The exact cause of Helsinki Syndrome rather Stockholm syndrome is not identified, as different psychological studies showed that even in the same condition some may develop Stockholm syndrome and some may not. Usually, emotional and sensitive people are mainly affected with Helsinki Syndrome/ Stockholm syndrome. But some influential situations can trigger the onset of syndrome, which include

• Any type of catastrophe situation arises at incarcerating and lasts for long period
• Direct contact between captor and captive that can arise due to sharing of the same room
• Captor not harms captives or captor shows some compassion towards captives ^[4,5]

Symptoms

The symptoms of Helsinki Syndrome is not very specific , but quite similar to posttraumatic stress disorder(PTSD). The included symptoms are as follows:

• Insomnia
• Nightmares
• General irritability
• Difficulty concentrating
• Being easily frighten
• Feelings of unreality or confusion,
• Failure to enjoy previously pleasurable experiences,
• Increased distrust of others
• Flashbacks ^[2,5]

Diagnosis

There are no specific diagnostic criteria followed to assess Helsinki Syndrome, rather it is important to evaluate the pattern how a captive react in a post-traumatic situation. The psychiatrists usually follow the same diagnostic criteria  used for evaluation of patient suffering from acute stress disorders, which mainly based on general question answering session. ^[6]

Treatment

The treatment plan for Helsinki Syndrome depends on upon the severity of the symptoms that patient experience. The treatment process is same as followed in Post-traumatic stress disorder.

Medications

• Selective serotonin reuptake inhibitor (SSRI) drugs act as antidepressants and preferably prescribed for controlling the depressive symptoms of the Helsinki Syndrome. In market different generic and brand named medications are available, such as sertraline, paroxetine etc.
• Short term prescription of Anti-anxiety medications is also prescribed in  Helsinki Syndrome. This can control stress and anxiety and also helps to improve feelings. This category medications can abuse, as they have an addictive effect and therefore prolonged use is restricted.
• Prazosin is also prescribed to control nightmares and also restrict nightmares. Though this drug is considered as off prescription for PTSD, as FDA does not approve this medication for specifically to treat this condition. ^[6,7,8]

Psychotherapy

Psychotherapy is required to treat Helsinki Syndrome and different therapy use for this purpose are:

• Cognitive therapy is applied to improve the perception of the real world and reduce the negative thoughts against the police or other law and justice authorities.
• Along with cognitive therapy, exposure therapy helps to identify the situation when patient become frighten or produce negative feeling against the real world and also assist in coping up with the situation and allows the patient to re-enter in the normal life. ^[6,7]

Prognosis

The overall prognosis of the treatment outcome in Helsinki Syndrome/ Stockholm syndrome is good. However, the duration of the treatment is not fixed and depends on upon patient response and compliance. Other included factors which influence treatment prognosis are the duration of the period of detaining , crisis period, previous history of similar experience. [7,9]

Prevention

The following measures can prevent Helsinki Syndrome:

• Strengthening of security and law system to prevent the incidence of detaining or kidnapping.
• Identify the persons who have a greater risk to develop Helsinki Syndrome after rescuing them from kidnappers and initial counseling can start before symptoms overwhelm the individual. ^[7,9]

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision.Washington, DC: American Psychiatric Association, 2000.
2. Graham, Dee L. R., with Edna I. Rawlings and Roberta K. Rigsby. Loving to Survive, Chapter 1, “Love Thine Enemy:Hostages and Classic Stockholm Syndrome.” New York and London: New York University Press, 1994.
3. Herman, Judith, MD. Trauma and Recovery, 2nd ed., revised. New York: Basic Books, 1997. Chapter 4, “Captivity,” isparticularly helpful in understanding Stockholm syndrome.
4. Bejerot, Nils. “The Six-Day War in Stockholm.” New Scientist 61 (1974): 486-487.
5. Fuselier, G. Dwayne, PhD. “Placing the Stockholm Syndrome in Perspective.” FBI Law Enforcement Bulletin (July1999): 23-26.
6. Grady, Denise. “Experts Look to Stockholm Syndrome on Why Girl Stayed.” International Herald Tribune, 17 March2003. A newspaper article about the Elizabeth Smart kidnapping case.
7. American Psychiatric Association. 1400 K Street, NW, Washington, DC 20005. www.psych.org.
8. Federal Bureau of Investigation (FBI). J. Edgar Hoover Building, 935 Pennsylvania Avenue, NW, Washington, DC 20535-0001. (202) 324-3000. http://www.fbi.gov.
9. Carver, Joseph M., PhD. Love and Stockholm Syndrome: The Mystery of Loving an Abuser. http://www.drjoecarver.com/stockholm.html.