What Psychiatrists Said About Anders Breivik

sorheimhusby

Psychiatrists Torgeir Husby and Synne Sorheim testifying during the trial of Anders Breivik

The Commander. The Messiah aspect. Life and death. I’m thinking of the executions. There’s clearly something tending in the direction of grandeur, but are they delusions of grandeur? . . . .Let us look at dissocial personality disorder. Cold indifference to the feelings of others. Marked, persistently irresponsible attitude toward social norms and duties. Lack of ability to sustain lasting relationships. Low tolerance of frustration, low threshold for aggressive outbursts, including the use of violence. Lack of ability to experience guilt or learn from punishment. Marked tendency to generate feelings of guilt in others or to rationalize conduct that has brought the patient into conflict with society. . . .

It is one thing to set off a bomb. It is quite another to go ashore on an island and shoot young people and talk about it as if he had been picking cherries. Is there an illness that could account for what I would choose to call mechanical killing? And there is also a change in sexual behavior, we know that. . . .

Autism, or Asperger’s syndrome. Stuggles to understand social signals. Has problems getting to grips with what others think and feel. . . .Empathy remains theoretical. . . .

The first time I saw Breivik enter this courtroom—and as psychiatrists we attach great weight to the first two or three milliseconds—it is important to note. I did not see a monster, I saw a deeply lonely man….Then, quick as a flash, he was inside his shell, making himself hard. . .At the core there is a deeply lonely man. We have with us here not only a right-wing extremist bastard, but also a fellow human being who, regardless of what he has done to the rest of us, is suffering. We must put ourselves inside his brain, make his world comprehensible. His personality and extreme right-wing ideology are combined in an effort to get out of his own prison. . . .

Conclusion: Breivik suffers from autism or Asperger’s syndrome, Tourette syndrome, narcissistic personality disorder and (possibly) paranoid psychosis.

(Ulrik Fredrik Malt, professor of psychiatry, testimony at Breivik’s trial)

[Breivik invents the Knights Templar because he] he wants to recruit people to a network, but that’s not easy if he’s on his own. And then it helps to generate fear, and he wants his opponents to live in fear. . . And [it helps] to make himself appear a more exciting person. Rather than a failure. . . .Not achieving [his grand ambitions], being a failure, was so hard to bear that it pushed him towards extremism. His ideology became important to him as a way of saving himself.

Conclusion: Breivik does not suffer from any psychotic traits.

(Erik Johannessen, psychiatrist, testimony at Breivik’s trial)

While there are numerous examples of Breivik providing evidence of his having a personality disorder, he was also quite self-reflective. . . . Breivik demonstrated an ability to examine aspects of his own personality. . . . Breivik’s narcissism and arrogance became evident several times during his trial. . . .

Breivik’s writings and actions suggest he is a man with delusional and bizarre beliefs about being part of a secret society of knights hat will save Europe. This, coupled with his devastating act of mass murder, suggests a seriously troubled mind. . . .However, when one begins to look below the surface and dig a little more deeply into Breivik’s compendium, a different picture begins to emerge, of a man who possessed the capacity for complex thought and a well-developed understanding of human nature and emotions. A man whose words and actions . . . demonstrate a mind significantly more rational and reality-based than one might presume at first glance.

Conclusion: Breivik suffers from dissocial personality with narcissistic traits.

(The Case of Anders Behring Breivik: Language of a Lone Terrorist. By Celia Leonard, George Annas, James Knoll, and Terje Torrissen. Behavioral Sciences and the Law 32:408-422 (April 2014)).

From 2010, the observee's mother describes a qualitative change in his way of being. She describes how the observee from this point on was concerned with infection, his own appearance and was uncomfortably intense, irritable and angry. It became increasingly important to him to impart politics and history, and the mother felt pressured by him. She describes that it was difficult for her to understand what he wanted to relay. She described the observee as utterly beyond, and believed in all the rubbish he said. The phenomena are assessed by the psychiatrists to be an expression of psychotic delusions. The observee's mother describes how the observee no longer appeared to know how to keep an appropriate distance from her, as he could go from sitting down much too close to her on the sofa, to not wanting to accept the food she served. This behaviour is assessed by the psychiatrists to be regulation difficulties as a consequence of paranoid delusions. . .

The observee appeared to be emotionally blunted, with complete emotional distance in respect of his own situation and of the expert witnesses. The observee maintains that the killing of the victims was justified, that he has no regrets and feels no remorse [...] Nor does the observee express any emotions in relation to his family and friends. He describes all topics, from his own childhood to the executions of the reported acts in operationalised speech, with no emotional component. The observee appears to be affectively blunted and with serious empathetic failure. . . .

The observee believes that he is by prescriptive right the ideological leader of the organization Knights Templar, which has the mandate to be a military order as well as a martyr organization, military tribunal, judge, jury and executioner. He believes that he is responsible for determining who is to live and die in Norway. This responsibility is perceived as real, but also a heavy burden. These phenomena are regarded as bizarre, grandiose delusions. He believes that a significant portion of the population (several hundred thousand) support the reported acts. He believes that his love is overdeveloped. He believes he is a pioneer in a European civil war. He compares his situation with historical war heroes such as Tsar Nicholas and Queen Isabelle. These phenomena are regarded as grandiose delusions.

The observee believes that it is likely, albeit with somewhat varying estimated degrees of likelihood, that he could be the new regent in Norway following a coup d'état and power takeover. If he becomes the new regent, he will take the name Sigurd the Crusader the Second. He believes that he has donated five million kroner to the fight. He believes he could be given responsibility for deporting several hundreds of thousands of Muslims to ports in North Africa. These phenomena are regarded as grandiose delusions. The observee believes that there is an ongoing process of ethnic cleansing in Norway and that he lives in fear of being killed. He believes that a third nuclear world war could be triggered as a result of the events that he sees himself a part of. He believes that there is an ongoing civil war in the country. The observee is working with proposals for solutions aimed at improving our Norwegian ethnic, genetic pool, eradicating disease and reducing the divorce rate. He foresees reservations (for “indigenous Norwegians”), DNA testing and mass childbirth factories. These ideas are considered as elements of a bizarre, paranoid delusional system.

The observee believes that the Glücksburgs (the Norwegian and European royal families) will be removed by a revolution in 2020. As an alternative to recruiting a new regent from the Guardian Council, DNA testing will be made of the remains of Olav the Holy or Harald Hard Rule. Thereafter, the Norwegian population will be DNA tested in order to find the person with the greatest genetic similarity, who could then be instated as the country's new regent. These ideas are considered as elements of a bizarre, paranoid delusional system. . . .

In his statement to the police at 20:15 on 22.07.2011, the observee states that he is a commander, and he goes on to say: We are crusaders and nationalists. The observee states that the reported acts committed the same day are the manifestations of the beginning of a very bloody civil war. He claims, in the same statement, that the Knights Templar Norway have given him the authority to execute A, B and C traitors and that the organization is the highest military, police and political authority in Norway. These symptoms are considered to be grandiose and paranoid delusions.

The subject believes he knows what the people he is talking to are thinking. This phenomenon is judged to be founded in psychosis. . . .He presents himself as unique and the focal point of everything that happens, believing that all psychiatrists in the world envied the experts their task. He compares his situation to the treatment of Nazi traitors after the war, indicative of grandiose ideas. . . . The subject has no clear perception of his identity as he shifts between referring to himself in the singular and the plural.

Conclusion: Breivik suffers from paranoid schizophrenia.

(Synne Sorheim and Torgeir Husby, the first psychiatrists to interview Breivik extensively after his arrest, (Report to the Court, pp-223-228))

As stated above, the expert witnesses have not found any psychotic symptoms. [...] He has had ideas of heightened self-worth, power and knowledge that may be reminiscent of what is observed in the case of delusional disorders. Not least the ideas concerning the Knights Templar appear peculiar. He has however rationalised this and has explained that it is a willed idea. The experts attach importance to the fact that the observee in police interviews and interviews with the experts is capable of arguing and presenting nuanced statements. He has a capacity for being corrected that is not found in persons with delusional disorders. It does not seem to be of interest to discuss grandiose ideas about his own finances, since income of a certain level has been documented in the course of the investigation.

Another important observation is that he has managed to keep his plans concealed from others. This is not very compatible with ideas of a psychotic nature, where precisely the urge to assert the perceived injustice will be prominent. The observee has demonstrated an unusually stable and good impulse control, which he also demonstrates during detention.

Clinically assessed, one does not find in the observee the psychotic nature that characterises delusions. There may be obvious reasons to apply the concept of flawed perception of reality to his extremist political views; however, as described above these are ideas he shares with a subculture that expresses the same opinions. Issues concerning surveillance and possible somatic delusions have been discussed above. It is thus the experts' assessment that the observee does not have nor has had any delusional disorder.

(Terge Torrissen and Asgar Aspaas, p. 262-263 of Report to Court)

The expert witnesses take for a fact that militant movements sometimes develop a system of rank titles, uniforms, greetings, etc. Despite this, the description of the Knights Templar, and not least the uniform the observee has had made, is characterised as eccentric, theatrical and grandiose. The fact that he has deliberately conjured up a future vision can, nevertheless, not be understood as a sign of psychosis. In the opinion of the expert witnesses, he has all along known that the idea of the Knights Templar is a product of his own imagination.

(Torrissen and Aspass, p. 295 of Report to Court)

It is well described that the observee has withdrawn from friends for long periods at a time. He has also spent a lot of time alone in his room in the mother's apartment to play computer games, especially in 2006/2007. On his withdrawal, the observee has explained that he spent the time on preparations for the terrorist act and that he thus had to give up part of his social life. However, he has stayed in touch with friends, right up until just before 22 July 2011. In the period when he spent a great part of his time on computer games, this happened in a way which, to the knowledge of the expert witnesses, implies that he would to a considerable extent participate in a social interaction with a large number of fellow players through internet-based verbal communication, and for hours on end. No evidence has thus been presented of withdrawal, as seen in psychotic illnesses, in the opinion of the psychiatrists.

(Terge Torrissen and Asgar Aspaas, p. 299 of Report to Court)

Summarized assessment: Based on the Head of Department's log and my own consultation with Anders, I find him to be in good mental shape. I perceive his deviant comments as an expression of an extreme ideology. In no way as a psychotic perception of reality. However, the forensic psychiatric experts, who have had considerably more information on him than I have, will assess this. We know, from history, many sects of religious or other ideological basis in which the members advocate notions of the world and the hereafter shared by few others. Such sects may be quite small or include many people. Although some of these sects may be based on a charismatic leader with delusions and experiences out of touch with reality, for instance based on epilepsy or transient toxic psychoses, this does not mean that all the members have delusions in psychiatric terms, or other serious psychopathology. We know that such sects seek internal confirmation, and may for a long time (generations) maintain notions in no way shared by society at large. I believe that Anders is within such a system. It is unclear to me to which extent he has many people who share his opinions, but he has expressed to me himself that he has based a lot on the British, or rather English movement and [has] not sought contact with the Norwegians of the same ideology, although there are thousands of them, according to him. As long as he stays safe in this universe, we might say that he lives in a ‘bubble,’ but that he lives reasonably well in this 'bubble.'"

(Randi Rosenqvist, commissioned by the prison to interview Breivik)

The Oslo District Court's Discussion of the Psychiatric Evidence in its Verdict

The work and conclusions of the expert witnesses

In the preparations to the proceedings, the District Court appointed four expert witnesses, all specialists in psychiatry, to assess the criminal sanity of the defendant. The expert witnesses have had identical mandates, but have examined the defendant at different times.

Torgeir Husby and Synne Sørheim were appointed on 28 July 2011. They submitted their forensic psychiatric report on 28 November 2011, in which they concluded that the defendant was psychotic at the time of the acts and during the observation. The Board of Forensic Medicine did not make any written remarks to the report of these psychiatrists.

Agnar Aspaas and Terje Tørrissen were appointed on 13 January 2012. In the court order of 10 February 2012, the Court decided, upon request from the psychiatrists, to submit the defendant to psychiatric examination for up to four weeks, cf. the Criminal Procedure Act, section 167. Aspaas and Tørrissen submitted their forensic psychiatric report on 10 April 2012, in which they concluded that the defendant was not psychotic at the time of the acts or during the observation. The believed the defendant suffers from a dissocial and narcissistic personality disorder. In several letters, the Board of Forensic Medicine has raised questions relating to the report of these psychiatrists, and the expert witnesses submitted a supplementary report on 30 April 2012 upon request from the board.

All four expert witnesses were present during the trial and testified in court, maintaining their previous conclusions. Representatives of the Board of Forensic Medicine also testified.

When the court-appointed expert witnesses reach different conclusions, the Court needs to go into the premises of the forensic psychiatric reports and assess these against the oral statements of the expert witnesses and the remaining evidence presented during the trial, cf. the Supreme Court Law Reports 2003 page 23, paragraph 18, cited above. In other words, it is not sufficient to refer to that there is disagreement between the expert witnesses, and then conclude that the standard of proof is not met. In NOU (Green paper) 1990:5, page 47, the following is stated about the responsibility of the court when the expert witnesses disagree: “When the medical principle is retained, it will in reality still be the psychiatrists' task to determine which offenders are exempt from criminal liability. But the principle whereby the court is formally free, in relation to the experts, is retained also after the committee's proposal. In practice, the court's own view will assume particular importance in those cases where the experts disagree.”

When making its assessment, the Court applies this view.

6.3 On psychosis in general

Below, the Court shall discuss the question of whether the defendant was psychotic at the time of the criminal acts, using the assessments of the expert witnesses as a starting point. The experts Husby and Sørheim found that the defendant suffers from paranoid schizophrenia, and the Court will first assess this diagnosis in section 6.4. Next, in section 6.5, the diagnosis of paranoid psychosis will be considered, as the other psychotic disorder discussed by the psychiatrists. The Court will, in section 6.6, give an account of examinations made by treating and advisory health personnel. These examinations are relevant to both diagnoses. Finally, in point 6.7, the compulsory observation is assessed in conjunction with the Criminal Procedure Act section 167, before the Court makes its overall assessment in point 6.8. As it transpires from the above review of the legal aspects, the psychiatric diagnosis system holds a central position in the assessment of criminal sanity.

The expert witnesses Aspaas and Tørrissen provide an instructive summary of the central symptoms of psychosis in point 21.4 of their report. This is cited below, except for the part on hallucinations, which are not relevant in our case: “Psychoses in general Psychosis is understood as a state involving an impaired, erroneous or failing perception or interpretation of reality. The principal symptoms of a psychosis are hallucinations, delusions and disturbing thought processes, characterized as formal thought disturbances. A psychotic disorder is often accompanied by so-called negative symptoms, i.e. functional impairment. Below follows a short description of these symptoms.

– Hallucinations ...

– Delusions are ideas about matters that are contrary to what is perceived as real by others. Examples of delusions are ideas of being under surveillance or being persecuted, that the body is decaying or changing, or entirely unrealistic thoughts about own talents, competence, influence, prosperity, etc. The latter are called psychotic delusions of grandeur or grandiose delusions. Bizarre delusions designate psychotic ideas about phenomena that are not physically possible, e.g. that one's thoughts are broadcast, that thoughts are governed by extraneous forces or that emotions and impulses are forced upon one from outside. When assessing delusions, it is necessary to take into consideration what are generally accepted ideas and thoughts in the culture, subculture or environment in which a person lives.

– Formal thought disturbances designate phenomena related to thought processes. Examples of this are slow thinking (latency), exaggerated vagueness, thoughts coming to a stop or becoming illogical or incoherent, or that thoughts follow arbitrary associations and hence give no meaning. “Neologisms” are a form of thought disturbance designating the coining of new words – incomprehensible words that a person invents himself and which do not exist in the normal vocabulary. Compound words are common in Norwegian and are not normally considered as neologisms.

– Negative symptoms are used to designate various forms of functional impairment which often accompany psychotic disorders. Loss of initiative, passivity, blunted or inadequate emotional life, impaired ability for interpersonal contact, lack of interest or drive, social withdrawal and aimless behaviour are examples of negative symptoms. Often, neglect will be observed in other areas as well, such as personal hygiene, nutrition, control of finances, ability to care for oneself and next of kin, etc.

– Depersonalization and derealisation are terms designating that a person has changed his perception of himself or stands outside himself or sees his surroundings or the world as changed. This can occur in certain psychoses, but can also be seen under severe stress or in the face of serious danger, especially in vulnerable people.”

Before the Court goes into detail on the diagnostic criteria of the psychotic states in question, we include Husby and Sørheim's summary of what they have considered to be the various delusions of the defendant. What follows is from pages 225 to 226 in their report: “The observee believes that he is by prescriptive right the ideological leader of the organization Knights Templar, which has the mandate to be a military order as well as a martyr organization, military tribunal, judge, jury and executioner. He believes that he is responsible for determining who is to live and die in Norway. This responsibility is perceived as real, but also a heavy burden. These phenomena are regarded as bizarre, grandiose delusions. He believes that a significant portion of the population (several hundred thousand) support the reported acts. He believes that his love is overdeveloped. He believes he is a pioneer in a European civil war. He compares his situation with historical war heroes such as Tsar Nicholas and Queen Isabelle. These phenomena are regarded as grandiose delusions.

On pages 227 to 228, they have included the following passage from the defendant's statement made at Utøya: “In his statement to the police at 20:15 on 22.07.2011, the observee states that he is a commander, and he goes on to say: We are crusaders and nationalists. The observee states that the reported acts committed the same day are the manifestations of the beginning of a very bloody civil war. He claims, in the same statement, that the Knights Templar Norway have given him the authority to execute A, B and C traitors and that the organization is the highest military, police and political authority in Norway. These symptoms are considered to be grandiose and paranoid delusions.”

The experts Husby and Sørheim on the one hand, and Aspaas and Tørrissen on the other, disagree as to whether the notions herein described are psychotic delusions or must be understood as an expression of rightwing extremist points of view in combination with a grandiose and narcissistic personality. The defendant has expressed the same fundamental ideas to both sets of experts, but has toned down the presentation of the Knights Templar's and his own role in the consultations with the experts Aspaas and Tørrissen. The Court will revert to the significance of this toning down.

6.4 Paranoid schizophrenia

According to the expert witness' mandate, «the international diagnostic system (currently ICD-10) [...] shall be used for the diagnostics and differential diagnostics relevant to the forensic psychiatric assessment». ICD-10 Chapter V contains a criteria-based diagnostic system for mental and behavioral disorders prepared by the World Health Organization (hereinafter WHO) published in what is often referred to as the «Green Book». WHO has also prepared clinical descriptions and diagnostic guidelines in the so-called Blue Book. It is only the blue book that has been translated into Norwegian. The Court's discussion below takes as a point of departure the research-based and precise diagnostic criteria of the Green Book. According to the expert witnesses, this should not be of decisive importance for the diagnosing, although the Blue Book allows for a higher degree of clinical discretion.

The expert witnesses Husby and Sørheim believe the defendant has had clear psychotic symptoms since 2006 with gradual deterioration. They believe he suffered from paranoid schizophrenia both at the time of the acts and when they examined him. On page 234 of the report they find “his entire symptom picture unaltered from the descriptions before and during the reported acts and until the entire examination.” Consequently, the Court finds it unnecessary to discuss the relationship between his mental state at the time of the reported acts and at the time of the examination.

In the Green Book, the special diagnostic criteria for paranoid schizophrenia (F20.0) are described as follows: A. The general criteria for Schizophrenia (F20.0–F20.3 [above]) [must be met.] B. Delusions or hallucinations must be prominent (such as delusions of persecution, reference, exalted birth, special mission, bodily change or jealousy; threatening or commanding voices, hallucinations of smell or taste, sexual or other bodily sensations). C. Flattening or incongruity of affect, catatonic symptoms, or incoherent speech must not dominate the clinical picture, although they may be present to a mild degree.

The diagnosis paranoid schizophrenia (F20.0) is in other words conditional upon the general criteria for schizophrenia being met, and upon delusions or hallucinations being prominent (exemplified, inter alia, by ideas of being persecuted and being of exalted birth and being convinced of having a special mission in life).

The general criteria for the diagnosis of schizophrenia, cited below, require the presence of at least one symptom from symptom group 1 (letters a) to d)), or at least two symptoms from symptom group 2 (letters a) to d)). Below, the Court shall denominate the symptoms of symptom group 2 by the letters e) to h) in line with the expert witnesses' lettering of the same criteria from the Blue Book. The experts Husby and Sørheim have found the criteria b) (perceptual delusions) and d) (bizarre delusions) from symptom group 1, as well as f) (thought disturbances and neologisms) and h) (negative symptoms) from symptom group 2 to be present. The parties disagree as to whether the defendant meets the general criteria for schizophrenia. This disagreement is in particular linked to symptom group 1 letter d), which in the Green Book is described as follows: “(d) persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. being able to control the weather, or being in communication with aliens from another world).”

Translated into Norwegian, this means persistent delusions that are culturally inappropriate and completely impossible, for instance being able to control the weather, or communicating with beings from an alien world. In the diagnostic conclusion on page 228, the expert witnesses Husby and Sørheim write that the defendant “has had clear symptoms from symptom group ....d) Persistent, bizarre delusions, exemplified by the idea that he is taking part in a civil war where he is responsible for determining who is to live and die, as well as expecting a takeover of power in Europe.”

At the trial, these experts summarized the defendant's fundamental delusions in the following precise wording: “He believes that he is to save us all from doom in a fight between good and evil. In this fight, he believes that he has a responsibility and a calling to determine who is to live and die. This responsibility is rooted in a leading position in a nonexistent organization.”

The experts specified that the core element of these delusions is the defendant's perception of his own role and of this responsibility being a reality. The head of the Psychiatric Group of the Board of Forensic Medicine, Karl Heinrik Melle, stated during the trial that it was not immediately evident to the Group that the delusions described in the expert witness' report were of such a nature as described in criterion d). Nor did the expert witnesses Aspaas and Tørrissen or other health personnel find any delusions under criterion d), a fact to which the Court will return. Ulrik Fredrik Malt, Professor of Psychiatry, who during his testimony in court gave a thorough presentation of the diagnostic criteria under ICD-10, was of the opinion that none of the delusions described in Husby and Sørheim's report fell within criterion d). Svenn Torgersen, Professor of Psychology, who has worked with schizophrenia for many years, expressed the same opinion during his testimony. As regards the more detailed assessment of the criteria under letter d), the Court takes as a point of departure that the delusions must be “culturally inappropriate.”

The experts Husby and Sørheim write on page 57 of their report that they “have not taken a stance on the observee's political message or position.” Nonetheless, during their review of the compendium they have placed his political ideas into a political context when they write the following on page 62: “Without going into the observee's political views, the experts have ascertained that his image of the state of Europe and the state of Norway is extreme and appears to lack any factual basis when it comes to many of his interpretations and assertions. However, the bulk of this material appears more to be an application of existing, political trends than a creation made by himself, as much of it is a cut-and-paste exercise from a variety of websites and historical sources. This also means that his quotations and conclusions are shared by a number of other people both in Norway and the rest of Europe.”

This political context is however absent in the expert witness' running assessment of the defendant's symptoms, and in the diagnostic assessment starting on page 220. In that assessment, the defendant's various statements are understood in the light of his “stable, detailed and all-encompassing paranoid and grandiose delusions,” as described by the experts in their summing up of his delusional universe on page 229 of the report. The Court misses a wider discussion of alternative interpretations of the defendant's various statements, especially on the basis of the right-wing extremist subculture of which he claims to be part. The Court makes reference to the fact that the defendant became politically active at the age of 18. He joined the Progress Party's Youth in 1997 and the Frogner local chapter of the Progress Party in 1999. For some time he held elected offices at the local chapter level in both organisations. The defendant has explained that he was attracted, inter alia, by the Progress Party's restrictive immigration policies. The Court lacks an overview of the defendant's political participation until he was forced to leave the Progress Party in 2006 and left the Progress Party's Youth in 2007. The defendant's friends have however described him as a stubborn person with strong and “strange” opinions and with an intense interest in politics. Since 2009, the defendant has been an active writer on www.dokument.no [sic], a website that is critical to immigration. The defendant's rightwing extremist ideology is also documented through his compendium. During the trial, anti-Islamic and rightwing extremist ideas and rhetoric were thoroughly elucidated. In rightwing extremist circles, words like “war” and “civil war” are used often in a figurative and strongly exaggerated sense. It is not uncommon to use symbols and historical parallels in the communication of extremist messages. Anti-immigration circles also express views of ethnic doom, demographic warfare, and the necessity of a future takeover of power.

In the compendium on page 952, the defendant himself describes what he means by «civil war». The European civil war, phase 1 – 1999–2030 is an “[o]pen source warfare, military shock attacks by clandestine cell systems» and «Further consolidation of conservative forces.” These phrases can hardly be said to contain delusions of an ongoing conventional civil war. A more obvious interpretation is to consider this to be a platform statement on how to reach the defendant's goal of getting the Muslims out of Europe. Such an interpretation is supported by the defendant's statement during the interrogation at Utøya after his arrest when said he participated in a “political” war. The experts Husby and Sørheim have also emphasised the intensity of the defendant's statements. On page 62 of their report they go on to write the following after the above quotation: “However, the experts have been struck by the intensity of the observee's war terminology and his perception and description of being in a war, which in turn leads up the reported acts. The experts have seen, both in the compendium but also in other contacts with him during the course of our own talks with him and examination of the police interview reports, that he in fact has an emotional and real perception of war, doom and own duty as a saviour.”

Also during the trial, these experts noted that the defendant became intense and experienced physiological reactions when acts of murder and violence were described. They believed the defendant was driven by ideas of violence and not by politics.

Nonetheless, the question is whether the intensity of the defendant's ideas indicates that they should be classified as delusions under criterion d). Again, an alternative interpretation would be to understand his intensity as a manifestation of a fanatical and farright extremist worldview, combined with a grandiose and narcissistic personality. The circumstance that the defendant in other contexts has toned down his statements on war, doom and his own task as a saviour, speak in favour of such an alternative interpretation.

The Court's assessment thus far is that the defendant's statement of being a participant in a civil war with expectations of a takeover of power in Europe can be understood in a political context that is significant in far-right extremist subcultures. Nonetheless, the Court assumes that the defendant alone planned the acts of murder concerned, which subsequently seem to have been endorsed by only a quite limited number of persons.

This brings the Court to the second criterion under letter d); that the delusions must be “completely impossible.” During the trial, the experts Husby and Sørheim specified that what is completely impossible is the defendant's self-perceived responsibility and calling to decide who is to live and die. The question is whether the idea of having such a responsibility or calling is completely impossible in the sense used in criterion d). At the trial, Professor Malt explained that the criterion “completely impossible” is not clearly defined, and that consequently there is room for different interpretations. It is common to apply this criterion to delusions that are strange, weird, absurd and beyond what is physically possible. Professor of Psychology Svenn Torgersen explained at the trial that the delusion must represent a “break with natural science thinking.” In their report, the experts Aspaas and Tørrissen use the designation “physically impossible,” which seems to be in keeping with this. In the test SCID-1 under the American diagnostic system DSM-IV, the concept «bizarre» is applied to the same criteria-based delusion.

Naturally, the Court agrees with the expert witnesses Husby and Sørheim in that a self-perceived responsibility or calling to decide who gets to live and die is fully unacceptable from an ethical point of view. However, as the defence also argued, a person's conception of having such a calling goes to the very core of politically or religiously founded terrorism. The defendant has in a fanatical and cynical manner maintained that the selection of victims and object for his misdeeds on 22 July 2011 was politically motivated. It is difficult for the Court to see that his conceptions of murders and terrorist acts to attain a future political goal – regardless how incomprehensible and reproachable they may be – can be “completely impossible,” which is how this diagnostic criterion is normally applied according to information at hand. Like the Court will revert to, the expert witnesses also disagree about whether such conceptions constitute pathological delusions.

In this context, the Court will not pursue the defendant's role in Knight's Templar, since any genuine conviction about playing a leading role in a nonexistent organisation can hardly be deemed to be «completely impossible» in relation to criterion d). The Court will revert to the significance of the Knights Templar below when it deals with paranoid psychosis. Based on the above, the Court believes that the defendant has not had delusions that are sufficiently subculturally inappropriate and impossible to be covered by the usual scientific and clinical application of criterion d). As already mentioned, it will suffice that at least one symptom from symptom group 1 or at least two symptoms from symptom group 2 are met in order for the basic criterion for the schizophrenia diagnosis to be met. Even though the expert witnesses Husby and Sørheim also found that criterion b) in symptom group 1 and criteria f) and h) in symptom group 2 were met, the prosecuting authority said in its closing arguments that its demand for judgment to have the defendant transferred to compulsory mental health care was based on criterion d) being satisfied. This was because the prosecuting authority believed that the other criteria were based on a weaker foundation. The Court has an independent responsibility for the application of law and will therefore also address the other symptoms that the expert witnesses Husby and Sørheim deemed existed. Criterion b) has been defined in the Green Book as follows: “(b) delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions, or sensations; delusional perception.”

Translated into Norwegian this means delusions of being controlled, influenced by external forces, or passivity with a clear reference to body or limb movements, or specific thoughts, actions, or sensations; delusional perception. On page 228 of the diagnostic evaluation, the expert witnesses Husby and Sørheim write that the defendant showed «clear symptoms from symptom group b): Delusions in respect of perception and control, exemplified by the feeling that the observee knows what others are thinking.”

The expert witnesses' observations have been described in more detail in two minuted talks. One observation from the first talk with the defendant on 10 August 2011 is found on page 88 of the expert witnesses' report:

“One of the expert witnesses asks how the observee was to determine whether we were speaking the truth, had we answered the questions. The observee smiles and says: I already know that. Thousands of hours of sales work have enabled me to predict with a probability of 70% what the person I am talking to is thinking. So I know that none of you are Marxistoriented, but both are politically correct and support multiculturalism. ... The expert witnesses ask the observee if he is guessing or if he knows what others are thinking. I know, says the observee, that's a big difference.”

Moreover, the expert witnesses write the following about status praesens following a talk with the defendant on 23 August 2011 page 109: “The observee believes that he knows what people he is talking to are thinking, since he believes he knows how former fellow party members from the Progress Party would characterize him now. The phenomenon is considered to be psychotically based.”

According to Melle's testimony, the Board of Forensic Medicine accepted this as a delusional perception. The defendant made similar statements to the expert witnesses Aspaas and Tørrissen, but they did not interpret the statements as delusional perceptions. Nor did psychiatrist Randi Rosenqvist, advisor to the management of Ila Preventive Detention and Security Prison, interpret similar statements made during her examination of the defendant as signs of psychosis.

In the expert witnesses' evaluation of this criterion, the Court would have liked to see a discussion of possible alternative interpretations by the expert witnesses. Firstly, the expert witnesses could have taken the defendant at his word in the sense that he felt his sales work experience had made him a good judge of character. He could also be perceived as being categorical in his way of thinking by tending to label people. A third possible interpretation could be that he boasts talents he does not have, which would possibly be in line with a grandiose and narcissistic personality.

The Court believes that such alternative interpretations are more obvious for the two observations described by the expert witnesses, and can therefore not see that criterion b) is met.

The Court now moves to discuss symptom group 2, criterion f), which in the Green Book is defined as «neologisms, breaks, or interpolations in the train of thought, resulting in incoherence or irrelevant speech». Translated into Norwegian this means neologisms, breaks in the train of thought, or interpolations in the line of thinking, resulting in incoherent or irrelevant speech.

The expert witnesses Husby and Sørheim have found “clear symptoms from symptom group f): Breaks or interpolation in the train of thought, exemplified by periodic perseveration, associative speech and neologisms.”

Associational disturbance and perseveration (repetition of the same basic topics) have been described under the diagnostic evaluations of these expert witnesses on pages 226–227 as follows: “The observee is at times difficult to follow, because he changes subject quickly and must be brought back to the topic. He associates richly and his associations bring him – almost always and irrespective of angle of approach – back to his political message, his perceived mission and position. The phenomenon is considered to be a moderate associational disturbance. When given the opportunity to speak freely, the observee focuses uninterruptedly on the same topics. He relates time and time again the same details related to his own knighthood, radicalisation process, the Knights Templar organisation, the forthcoming coup d'état and power takeover in Norway and Europe. The phenomenon is regarded by the expert witnesses as perseveration. No latency or thought blocks occur during the talks. The observee does not display disorganised behaviour.”

The expert witnesses Aspaas and Tørrissen also observed the defendant's tendency to revert to a stereotypical political argumentation with a repetition of appurtenant illustrations, e.g. that the bombing of Japan under World War II allegedly saved many lives, and that the riots in Paris before the general election in 2009 had not been fully covered by Norwegian media to prevent a successful outcome for the Progress Party in the election. However, they did not deem this to be a psychotic «repetitive» mode of speech.

At the trial, the Court also noted that the defendant kept coming back to the topics he was most passionate about. However, these repetitions did not result in incoherent or irrelevant speech, as required by criterion f). The Court did not at any point find it difficult to follow or understand the meaning of what the defendant said.

The question of whether the defendant uses neologisms has been strongly highlighted during the trial. A neologism is not defined in detail in the diagnostic system and according to Professor Malt it may open for multiple interpretations. However, it is normally used about a totally incomprehensible new word which somebody has coined him-/herself or about existing words/word combinations which somebody uses in a totally incomprehensible manner.

The expert witnesses Husby and Sørheim said the following about neologisms on page 225: “The observee presents self-coined words such as national Darwinist, suicidal Marxist and suicidal humanism, justiciar knight, justiciar knight commander, justiciar knight master or justiciar knight grand master. These concepts are regarded as neologisms.”

Similar word combinations which the expert witnesses consider to be neologisms are reported several places in the report. According to Melle, the Board of Forensic Medicine believed that the expert witnesses Husby and Sørheim applied the neologism concept unusually. The group would have liked to see the expert witnesses ask follow-up questions. Neither Professor Malt, nor other expert witnesses, supported the expert witnesses' neologism findings, as described in their report.

The presentation of evidence disclosed that several of these word combinations are also used by others. The expert witnesses Aspaas and Tørrissen have e.g. found many of the same word combinations on the Internet, inter alia, in a rightwing extremist context. The knight and justiciar terminology is allegedly also used in the computer game World of Warcraft and in the Masonic Order. Consequently, these expert witnesses did not believe that the defendant used neologisms.

The expert witness Sørheim mentioned in her testimony that the words were neologisms because they formed part of the defendant's delusional universe. The Court believes that such a view may easily lead to circular reasoning. In any case, the Court believes that the expressions and word combinations can be understood in a context that makes them meaningful and cannot see that the word combinations result in incoherent or irrelevant speech, as required by criterion f). On this basis, the Court believes that criterion f) has not been met.

The Court then moves to address criterion h) in symptom group 2, which is the last possible general schizophrenia criterion, defined as follows in the Green Book: “negative» symptoms, such as marked apathy, paucity of speech, and blunting of [sic] incongruity of emotional responses (it must be clear that these are not due to depression or to neuroleptic medication).”

Translated into Norwegian this means “negative symptoms,” such as marked apathy, paucity of speech, blunted emotions or incongruity of emotional responses not due to depression or neuroleptic medication. Blunted emotions imply that a person has a limited range of emotional responses. Such limitations will e.g. manifest themselves in few facial expressions, reduced or inappropriate responses, inadequate body language or reduced spontaneous mobility. The Court's understanding is that impaired empathy, i.e. the ability to feel compassion for others, is not necessarily a negative symptom as described in criterion h).

The expert witnesses Husby and Sørheim found on page 228 of their report that the defendant displayed “clear symptoms of symptom group [...] (h): Negative symptoms, exemplified by appearing to be notably emotionally blunted.” On page 224, this is described as follows: “The observee appeared to be emotionally blunted, with complete emotional distance in respect of his own situation and of the expert witnesses. The observee maintains that the killing of the victims was justified, that he has no regrets and feels no remorse [...] Nor does the observee express any emotions in relation to his family and friends. He describes all topics, from his own childhood to the executions of the reported acts in operationalised speech, with no emotional component. The observee appears to be affectively blunted and with serious empathetic failure.”

The Court does not find it difficult, based on its own observations during the trial, to concur in the observations here described. The Court nevertheless noted that the defendant cried during the showing of his own propaganda film, allegedly because he was touched. Such affect was not immediately comprehensible to others, however. The question is whether the affective flattening in the defendant to a certain degree may be situational, both related to the time while he was in solitary confinement at Ila [prison], and during the trial with all the pressure that it must have represented to him.

The experts Aspaas and Tørrissen explained that they have observed a broader range of emotions in the defendant. During the main hearing, Tørrissen nevertheless reacted to the lack of emotional reactions during the review of the autopsy reports and the statements of the aggrieved parties. This resulted in another consultation between Tørrissen and the defendant at the premises of the courthouse holding cells. According to Tørrissen, the defendant appeared more emotionally flattened in court than what he did at Ila and in the holding cell, where he appeared more relaxed and natural. The observation of the defendant in court did not change these psychiatrists' earlier assessment of the defendant's state of mind in general or of his affective flattening in particular, which they summarize on pages 299–300 as follows: “The observee appears as emotionally blunted when it comes to take to heart the suffering he has inflicted upon others. He shows no remorse and would have done the same again. His acknowledgement of having committed atrocities seems superficial and technical. However, he has shown perfectly adequate abilities to interact and communicate with the expert witnesses and health personnel. His emotional flattening is not assessed to be of the kind seen in serious mental illnesses, but is understood as expressions of pathological personality traits.”

In support of finding negative symptoms under criterion h), the experts Husby and Sørheim have greatly emphasized the decline in the functioning levels of the defendant in the years preceding the terrorist attacks. Using criterion i) of the Blue Book as a starting point, this is described on page 228 in their report as «a considerable and persistent change in quality of certain areas of personal conduct, described through marked functional impairment with social, practical and financial collapse». The Court remarks that criterion i) is not a general criterion for schizophrenia, but belongs to the symptom group of simple schizophrenia (F20.6). These psychiatrists have nevertheless given this criterion great importance, presumably since such withdrawal symptoms usually accompany the negative symptoms described in letter h). In the Green Book, criterion i is described as “a marked decline in social, scholastic, or occupational performance.”

The expert witnesses Husby and Sørheim write the following about the decline in the functioning levels of the defendant on page 227:

“It is the assessment of the expert witnesses that the observee in the period 2002 to 2006 showed a tendency of increasing isolation with gradually declining functioning skills. The expert witnesses do not have any facts to ascertain when the psychotic symptoms of the observee first appeared, but it cannot be excluded that the onset of symptoms was already in this period. From 2006 on, the collected documentation describes a definite shift of the functioning level of the observee. Friends testify that from this time on, the observee withdrew from social contact, turned quieter, moved back in with his mother, and stopped working. These phenomena are considered by the psychiatrists to be withdrawal, isolation and a lacking ability to meet the demands of the working life. The mother of the observee has described that the observee turned day and night around, played computer games a lot, and from this time on mostly stayed in his room. The observee did not take part in cleaning and maintenance of the apartment or his own laundry, and did not cook himself. His mother bought the groceries. The mother of the observee describes how he, upon her incitement, did not want to contact the Labour and Welfare Services (NAV) for assistance, either of practical or financial nature. The symptoms are considered by the psychiatrists to be extensive functional impairment, in practical, social, and economic terms, and with respect to capacity for work.”

The expert witnesses Aspaas and Tørrissen agree that the defendant functioned outside of normal society for a long time, but they believe that this was premeditated behaviour due to his highly special aims and activities. On page 299 in their report, these psychiatrists write, inter alia, the following on negative symptoms: “It is well described that the observee has withdrawn from friends for long periods at a time. He has also spent a lot of time alone in his room in the mother's apartment to play computer games, especially in 2006/2007. On his withdrawal, the observee has explained that he spent the time on preparations for the terrorist act and that he thus had to give up part of his social life. However, he has stayed in touch with friends, right up until just before 22 July 2011. In the period when he spent a great part of his time on computer games, this happened in a way which, to the knowledge of the expert witnesses, implies that he would to a considerable extent participate in a social interaction with a large number of fellow players through internet-based verbal communication, and for hours on end. No evidence has thus been presented of withdrawal, as seen in psychotic illnesses, in the opinion of the psychiatrists.”

The Court does not find sufficient grounds to establish a pathological drop in functioning levels in the period from 2002 to 2006. Investigations have disclosed that the defendant sold false diplomas in this period with a total revenue of nearly NOK 3.7 million, while he was also trading in shares. He moved to live on his own in 2003, but he still kept in touch with friends and family members.

However, there is no doubt that the defendant underwent a considerable professional, social and practical alteration in behaviour in 2006. The Court believes the background of this alteration in behaviour may be complex. The defendant has explained that he discontinued his business activities, which he describes as legal, but immoral, because he was afraid of being negatively exposed in the media. Once his company was dissolved in February 2006, he set up his account in the World of Warcraft in March, i.e. half a year prior to moving back to his mother's place. The Court believes a form of compulsive gambling may have been a contributing factor to why he chose to move back in with his mother and withdraw from a social and active work life.

The Court furthermore does not disregard the possibility that the underlying relationship to his mother may explain some of the defendant's dependency upon her in practical matters. The experts Husby and Sørheim include, on pages 48–50 in their report, documents from the National Centre of Child and Adolescent Psychiatry (SSBU) from 1983, in which there is mention of the relationship between the defendant and the mother. Furthermore, on page 68 in their report, they have included a letter from the halfsister B to the mother, presumably from 2009 or 2010. In the letter, B addresses what she perceives as problems with her brother that have lasted for years, and she writes the following, among other things: “I am like an echo stating what I have said for so many years, actually ever since I was little, as far back as I can remember – let him have his own life!” The Court has, in the extension of this, also noted the information that the mother cleaned the apartment of the defendant after he moved into a place of his own.

The Court believes that at any rate, the deviant conduct of the defendant may be understood in the light of his personality. Already in 1998, he made an untraditional choice by leaving school in the third [and final] year of upper secondary school to earn money and become an entrepreneur. This was in spite of him doing well in school, in spite of both knowledge and his resume being important to him, and besides he was in a community where it was common to complete twelve years of school. The business areas which he later chose to try out must also be said to be peculiar; especially the diamond trading in Liberia in 2002 and the production of false diplomas from 2002. Friends of the defendant have described him as a social and good friend, though at the same time as “stubborn” with “eccentric” opinions, “the outsider of the group,” “goal-oriented” and as a person who committed “110%” to what interested him.

Furthermore, it is well documented that the defendant was both goal-oriented and “productive” from the time when he moved back to his mother's house in 2006, until 22 July 2011. From 2006 he played World of Warcraft at a high level, and according to the testimony of a fellow player, he was «the best officer» this player had ever had. As previously described, the game is social and requires good communication between the players. The defendant later prepared his ideological compendium in English of nearly 2.000 pages, including, inter alia, a detailed terrorism manual. He gradually acquired knowledge on the production of bombs, got hold of weapons, effects, and equipment. He made several trips abroad in 2009 and 2010, and joined Oslo pistolklubb [Oslo Pistol Club] in 2010. He founded the company A Geofarm as a sole proprietorship in May 2009, signed a rental contract and moved to Åsta farm in the beginning of May 2011. Here, he produced the bomb and made a test explosion. The defendant succeeded in keeping his extensive terrorism preparations hidden from the surrounding world. He carried out the terrorist attacks on 22 July 2011 in line with his plans, and the witnesses from Utøya have explained that he walked around the island calmly, aiming precisely when shooting at his victims.

The activities described above show that the defendant had stamina, impulse control and good cognitive functions related to the tasks he assigned himself. The Court finds the defendant's ability to plan and implement in these various areas hard to reconcile with untreated paranoid schizophrenia with a gradual deterioration from 2006. The experts Husby and Sørheim did explain this by stating that the defendant is among the onethird of schizophrenics who retain most of their cognitive functions. The Court still wonders whether this explanation is reconcilable with their assessment of the defendant's pathological and total functional impairment in all areas. In the assessment of the defendant's functioning, the Court will at any rate emphasize that in the period from 2006, he maintained, and in part resumed, certain normal activities. All this time, he would pay his mother NOK 3.500 a month out of his savings, and besides he was well dressed and groomed. He continued to trade in shares, and is registered with 60 transactions in 2008 at his most active. In 2006 he joined the Masonic Lodge, where he attended a few meetings and was later promoted in the degrees every year, most recently to the 3rd degree in 2009. In 2007/2008 he resumed contact with friends with whom he travelled to Budapest in 2009. The friends have not reported any conspicuous behaviour on behalf of the defendant after the contact was reestablished. Furthermore, it has been stated that the defendant was on Facebook and had a number of email addresses. Although social contact on the Internet cannot be compared to social contact in the real world, the Court nevertheless believes it to be relevant in the overall assessment of the functioning of the defendant.

The experts Husby and Sørheim appear to have placed great emphasis on information from the mother on the defendant's functioning in the year prior to the indicted acts. On page 223 of their report, they write as follows: “From 2010, the observee's mother describes a qualitative change in his way of being. She describes how the observee from this point on was concerned with infection, his own appearance and was uncomfortably intense, irritable and angry. It became increasingly important to him to impart politics and history, and the mother felt pressured by him. She describes that it was difficult for her to understand what he wanted to relay. She described the observee as utterly beyond, and believed in all the rubbish he said. The phenomena are assessed by the psychiatrists to be an expression of psychotic delusions. The observee's mother describes how the observee no longer appeared to know how to keep an appropriate distance from her, as he could go from sitting down much too close to her on the sofa, to not wanting to accept the food she served. This behaviour is assessed by the psychiatrists to be regulation difficulties as a consequence of paranoid delusions.”

In their letters of 23 April and 31 May 2012, the Board of Forensic Medicine criticizes the expert witnesses Aspaas and Tørrissen for not having procured data from supplementary informants on the defendant in his childhood and adolescent years and in early adulthood, especially from the years when he lived with his mother as an adult. They have also found it to be a significant flaw of the report that these psychiatrists have not stated their grounds for «how such potentially important information [from the mother] is neither considered in the SCID-1 scoring nor in the general diagnostic assessment.”

In the supplementary report of 30 April 2012, these objections are met with, inter alia, this reply: “The most immediate source of obtaining firsthand information from a supplementary informant would be from the observee's mother, who has had close contact with him over the years. The mother has been interviewed by the police six times, [resulting in] altogether more than 200 pages of statements. She has also been interviewed by the expert witnesses Husby and Sørheim. In this manner, we have had access to extensive information from her. It is noted that in early statements, she has given a fairly normal description of the observee. Though she has indeed worried about him not being in permanent employment, she has otherwise described him as kind, considerate, a problem solver for his friends, hard working. On the eve of the indicted acts they had a good time together and there was unusual to point out. Later, and especially to expert witnesses Husby and Sørheim, she has meant that he ‘must be insane’ and has talked of him as ‘utterly beyond, and believed in all the rubbish he said.’ Hence, we would unavoidably face contradictory information from the mother if a new interview were done. Considering this factor, as well as the information that she has serious health problems (which have also made her exempt from appearing in court), the expert witnesses have refrained from asking her to meet us for a consultation.”

The Court interprets the experts Aspaas and Tørrissen as having assessed also the extensive material from the various statements of the defendant's mother's when making their diagnostic assessment, which they confirmed at the trial. The Court does however agree with the Board of Forensic Medicine in that it would have been clearly advantageous if these experts had gathered first-hand information from the defendant's mother, having in mind also the contradictions they noted in her various statements.

Nonetheless, the Court believes that the defendant's behaviour towards his mother from 2010 onwards most likely can be understood against the background of the upcoming terrorist attacks, which he at the time was in full swing preparing from their shared home. As a part of these preparations, in the winter of 2010 he took his first course of anabolic steroids, which also may have influenced his behaviour towards her. Additionally, the information provided by the defendant's mother seems to contrast somewhat with witness statements from friends saying that the defendant was approaching his «old self» in the course of 2010/2011. Nor have any other family members reported anything unusual from the family gathering at Christmas 2010 in their police interviews. The defendant's half-sister on his father's side stated in a police interview that “A was the way he has always been; articulate, knowledgeable, and it seemed like he was doing a lot of thinking. He knew a lot about history and religion,” cf. the quotation in the report of the experts Aspaas and Tørrissen on page 122.

As regards the experts Husby and Sørheim's description of the regulation problems in the above quotation, the Court notes a similar ambivalence between closeness and distance in mother's relationship to the defendant described in the documents from the National Centre of Child and Adolescent Psychiatry from 1983. This information, which the Court does not find reason to discuss in further detail, may support the notion that the described behaviour is relationally based and not a manifestation of paranoid delusions.

Following the above, the Court believes it is more obvious to interpret the defendant's changes in behaviour in 2006 and 2010 in the light of his particular personality and what he had set out to do, rather than as being negative symptoms of schizophrenia. However, the Court does not take a stance on whether the defendant's flattened affectivity, considered in isolation, falls under criterion h), as the existence of a single symptom from symptom group 2 in any case is insufficient.

The Court's conclusion thus far is that the defendant did not have symptoms that fulfil the general ICD-10 criteria for schizophrenia, the way these criteria are normally applied in clinical and scientific practice. Besides, as already mentioned, the Board of Forensic Medicine did not unconditionally agree with the experts Husby and Sørheim's findings of bizarre delusions and neologisms. According to Mr. Melle's statement, the Board of Forensic Medicine nonetheless refrained from making written remarks to their report because they believed the symptoms described in any case were compatible with a paranoid psychosis (F22). The Court does not agree with the Board in this line of reasoning. After all, the experts Husby and Sørheim had themselves rejected this diagnosis; amongst other things because they believed that the defendant's marked flattening of affect was incompatible with the ICD-10 criteria for paranoid psychosis. Moreover, had not representatives of the Board been summoned later to give evidence at the trial, the Court would have remained unaware of the Board's assessment that central diagnostic criteria for schizophrenia were poorly documented. Additionally, the Court cannot see that the Board's substantive remarks to the report of the experts Husby and Sørheim are less significant than the written remarks to the report of the experts Aspaas and Tørrissen. As the Court will discuss below, these remarks concerned, inter alia, documentation of the general criteria for the diagnosis of personality disorder, which is not of decisive importance for the question of criminal sanity.

Consequently, in its assessment of the evidence the Court will not attach any independent importance to the fact that the Board of Forensic Medicine made written remarks to only one of the two reports. The Court now proceeds to discuss the alternative psychosis disorder that has been addressed by the expert witnesses.

6.5 Paranoid psychosis

The experts Aspaas and Tørrissen have assessed whether the defendant may have had a paranoid psychosis at the time of the reported acts. Paranoid psychosis (F22) is a more limited delusional disorder that is presented with six diagnostic criteria in the Green Book, including the following: A. A delusion or set of related delusions, other than those listed as typically schizophrenic in criterion G1 (i) b or d for F20.0–F20.3 (i.e. other than completely impossible or culturally inappropriate) must be present. The commonest examples are persecutory, grandiose, hypochondriacal, jealous (zelotypic), or erotic delusions. B. [...] C. The general criteria for schizophrenia (F20.0-F20.3) are not fulfilled. [...]

Translated into Norwegian this means that the disorder is characterised by a delusion or a set of related delusions that should not be bizarre, exemplified, inter alia, by paranoid and grandiose delusions. Since the experts Husby and Sørheim believe the defendant suffers from paranoid schizophrenia with allencompassing delusions, they do not discuss this diagnosis. As already mentioned, they nonetheless make the remark that the defendant's marked flattening of affect is incompatible with a paranoid psychosis.

In their report, the experts Aspaas and Tørrissen present a SCID-1 interview, which is a structured interview under the parallel American diagnostic system DSM-IV. Below follows their assessment of paranoid psychosis found on pages 262–263:

“As stated above, the expert witnesses have not found any psychotic symptoms. [...] He has had ideas of heightened self-worth, power and knowledge that may be reminiscent of what is observed in the case of delusional disorders. Not least the ideas concerning the Knights Templar appear peculiar. He has however rationalised this and has explained that it is a willed idea. The experts attach importance to the fact that the observee in police interviews and interviews with the experts is capable of arguing and presenting nuanced statements. He has a capacity for being corrected that is not found in persons with delusional disorders. It does not seem to be of interest to discuss grandiose ideas about his own finances, since income of a certain level has been documented in the course of the investigation.

In the general diagnostic assessment of whether the defendant may have suffered from a psychotic disorder at the time of the reported acts, they present the following conclusion on pages 302–303 of their report: “As stated above, the experts have not assessed his ideas as being manifestations of psychotic thought processes, but as extreme political views, combined with the conscious disregard for opposing views. The experts assume the existence of an ideological subculture that shares the observee's ideological and political views. Consequently, there are no grounds for a delusional disorder (F22.0 Paranoid psychosis).”

The experts Aspaas and Tørrissen interpreted the defendant's fear of surveillance by the Police Security Service (PST) and isolated instances of him using a face mask as exaggerated caution and fear of illness during the planning of the terrorist acts, and not as psychotic delusions. Contrary to the experts Husby and Sørheim, they have not perceived the defendant's use of the word “we” instead of “I” to be an identity disturbance, but an expression of him intending to speak on behalf of likeminded persons. In its statements of 23 April and 21 May, the Board of Forensic Medicine has questioned the validity of the defendant's answers to, inter alia, the SCID-1 interview, considering his tendency to answer strategically. In their introductory description of SCID-1, the experts Aspaas and Tørrissen have addressed this issue, writing that they, inter alia, have taken as a point of departure and have confronted the defendant with his earlier statements in police interviews, in conversations and in the compendium. Next, these statements have been «weighed against the clinical impression and the way in which he answers». Also in the introductory general remarks on page 12 of their report, they raise the question of whether the defendant in his conversations with them “has adapted himself to his knowledge at any given time of the case complex, the police investigation, the previous forensic psychiatric report, etc.” Against this background, they have assessed and “compared his statements to the expert witnesses in February/March 2012 with what emerged during the early stages after his arrest (documented in a police interview recorded on DVD), as well as his statements to the health service and the earlier expert witnesses in July/August 2011.” Additionally, the questions of dissimulation and a possible false negative conclusion are discussed in connection with the diagnostic assessments on page 300 and in the supplementary report of 30 April 2012.

The Court agrees that the defendant's tendency to adapt his answers in tests and in his conversations with the experts may, considered in isolation, weaken the value of the observations of the experts Aspaas and Tørrissen. Notwithstanding this, the Court notes that as early as in the first conversation on 9 September 2011 with psychiatrist Arnhild Flikke, the defendant described himself as a “foot soldie,” see the above quote. Flikke is a senior medical officer within the Specialist Health Service of Bærum Municipality, the District Psychiatric Centre (hereinafter DPS), and she has been a member of the «Ila Team» since 2007. Also in a police interview on 18 October 2011 did the defendant moderate statements in the manifesto that he has also cited during early police interviews as well as in conversations with the experts Husby and Sørheim. In the police interview he said, inter alia, that the way he had «described the Knights Templar, it is a glossy picture of the Knights Templar, but in practice the Knights Templar is in the process of being established», see the quote from this interview on page 82 of the report of the experts Aspaas and Tørrissen. Additionally, policemen who carried out the interviews of the defendant confirmed at the trial that they noted a certain toning down of the defendant's previous statements from the police interview on 18 October 2011, and a marked toning down from the police interviews in March 2012. It is furthermore clear that the defendant toned down the description of the Knights Templar and his own political role in his conversations with the experts Aspaas and Tørrissen, and also in his statement during the trial.

The Court believes that the circumstance that the defendant is capable of moderating his statements is also relevant diagnostic information. On pages 296–297 of their report, the experts Aspaas and Tørrissen describe the defendant's high opinion of, inter alia, “his own importance for the future of the country and Western Europe.” Here, they draw a parallel with a condition that in specialist literature is termed “pseudologia fantastica,” and which refers to conditions where a person with theatrical personality traits makes up stories that make them important. They write the following about the difference between persons with such personality traits and psychotic persons: “It is characteristic that these kinds of stories are toned down when the person concerned is confronted with facts or opposing views. In psychotic patients, the opposite is often observed; when they are confronted with ambiguities and improbabilities, their statements will become increasingly unclear and improbable, and when patients are subjected to pressure they may show signs of stress and psychological decompensation. «Pseudologia fantastica» is not a separate diagnosis in the diagnostic systems, but the phenomenon may provide a basis for personality diagnoses.”

Also other expert witnesses within psychiatry described at the trial how genuine delusions normally are defended by the patient in the case of resistance. Patients often turn aggressive and angry or sulky and silent when their delusions are challenged. Overall, psychotic patients have limited capacity for moderation. There also seems to be agreement among these witnesses that a psychotic person hardly would manage to adapt during hours-long interviews in pressed situations. According to the information provided, the police interviews lasted for up to 11 hours. The defendant's statement at the trial also lasted for many hours every day for more than a week. If one disregards the contents of the defendant's statements, under the circumstances he gave evidence in an inconspicuous way. He gave the impression of being controlled and collected. He let himself be corrected and moderated, and he demonstrated a capacity for flexibility in various contexts.

Against this backdrop, the Court agrees with the expert witnesses Aspaas and Tørrissen's conclusion that the defendant's use of terminology and various statements including historical references about civil war, power takeover in Norway, ethnic cleansing, breeding institutions and genetic testing of our future regent can all be understood in a political context. The same goes for the use of the plural «we» as a reference to the defendant's fellow rightwing extremist peers. The defendant's periodic use of mouth mask and his feeling of being under surveillance seem also to have plausible explanations. No similar behaviour or statements by the defendant have subsequently been reported.

The prosecution has focussed on whether the defendant's conception about the Knights Templar can be regarded as psychotic delusions under the presumption that the organisation does not exist. Investigations have not produced any evidence to indicate that such an organisation exists.

The expert witnesses Aspaas and Tørrissen write the following about the Knights Templar on page 295 of the report's diagnostic evaluation: “The expert witnesses take for a fact that militant movements sometimes develop a system of rank titles, uniforms, greetings, etc. Despite this, the description of the Knights Templar, and not least the uniform the observee has had made, is characterised as eccentric, theatrical and grandiose. The fact that he has deliberately conjured up a future vision can, nevertheless, not be understood as a sign of psychosis. In the opinion of the expert witnesses, he has all along known that the idea of the Knights Templar is a product of his own imagination.”

At the trial, the defendant maintained the basic features of the compendium's description of the founding and structure of the Knights Templar. Among other things, he explained that he met a Serbian war criminal in Liberia whom he later represented at the founding meeting in London in 2002. He also maintained that there were three single cells in Norway and approximately 15 to 80 in Europe, and that the cells have no contact with one another because of the risk of being detected by the intelligence service in the various countries. The Court believes that the defendant may have various reasons for insisting on the existence of the Knights Templar. By anchoring the acts for which he is indicted in an alleged organisation, he can give others an impression of grandiosity and legitimacy and can thereby also help promote future recruitment. In addition to this, an alleged organisation can give rise to fear in the population, a motive which goes to the very core of the terrorism provision on which the indictment is based. Retracting what he has said about the Knights Templar, which forms such a vital part of the compendium, can ultimately appear to be psychologically or ideologically impossible.

Ever since the defendant was apprehended, he has been reluctant to answer questions about the Knights Templar, including questions about its supporters and foundation, despite the fact that other information has flowed from him like «water from a faucet», to use the words of the expert witness Husby. As mentioned above, he has also toned down his presentation of the organisation and significance of the members. During the compulsory observation, he did not focus on the Knights Templar according to the observation team from Dikemark. The Court is also of the opinion that these circumstances speak against concluding that the defendant carries a genuine psychotic conviction about the organisation's existence.

The expert witnesses Aspaas and Tørrissen believe that the defendant suffers from personality disorders, which they believe can explain a lot of his symptomatology. One may query whether these expert witnesses' interpretations of potentially psychotic symptoms were influenced by them having found, on possibly shaky grounds, such alternative explanation models.

The expert witnesses performed, inter alia on the basis of a SCID-II interview based on the parallel US diagnostic system, a thorough review of the special criteria for various personality disorders in ICD-10 and concluded that the defendant had the diagnoses “F60.8 Other specified personality disorders, narcissistic,” and “F60.2 Dissocial personality disorder.” The Board of Forensic Medicine stated in its letter of 31 May 2012 to Oslo District Court that it cannot “see from the premises that it has been adequately discussed whether the observee from childhood and/or adolescence displayed firmly entrenched and persistent behaviour patterns which were expressed through rigid reactions to a broad range of personal and social situations.”

Under the general criteria for personality disorders in the Green Book, the personality deviation must be stable and of long duration, “having its onset in late childhood or adolescence.” In the US diagnostic system, from which the diagnosis of narcissistic personality disorder is taken, the time of onset is specified to “the beginning of early adulthood.” The expert witnesses seem to agree that the personality deviation must have manifested itself before the age of 18 years. In their supplementary report, the expert witnesses Aspaas and Tørrissen elaborated on the examples of dissocial characteristics from the defendant's childhood, adolescence and early adulthood, maintaining their previous explanation for the manifestation of his narcissistic characteristics. At the trial, Aspaas specified that the narcissistic personality disorder was the main diagnosis.

The Court has not considered how developed and comprehensive the personality deviation must have been before the age of 18 years to satisfy the general criteria for a personality disorder in the Green Book. Beyond the methodological source of error as to interpretation now discussed, the diagnosing of personality disorders does not have any direct impact on the question of the defendant's criminal sanity. Nevertheless, the Court mentions that the diagnosis “F60.2 Dissocial personality disorder” found little support during the presentation of the other evidence. As will be discussed below, the diagnosis «F60.8 Other specified personality disorders, narcissistic», was however supported by therapeutic health personnel at Ila who were part of the specialist health service. Randi Rosenqvist also took note of the defendant's narcissistic personality characteristics. Still the Court finds no grounds for disavowing the expert witnesses Aspaas and Tørrissen's assessments of the psychosis question on the grounds that the general criteria for personality disorders in ICD-10 have possibly not been met. Irrespective of whether the defendant meets the general criteria for a personality disorder, the Court takes for a fact that he displays both dissocial and narcissistic personality characteristics.

6.6 Other health personnel

The Court now moves to account for the therapeutic and advisory health personnel's diagnostic assessments of the defendant, which are more or less consistent with the assessments of the expert witnesses Aspaas and Tørrissen.

The Court said initially that the defendant has not had any contact with the specialist health service for mental disorders prior to 22 July 2011. The medical records from his regular general physician do not contain information about mental disorders either, apart from some incidents of acute stress/situational imbalance with sleeplessness from 1998. The defendant underwent plastic nose surgery in 1999 because he wanted a “straight profile.”

The Court relies on the medical examination where a blood sample was taken on 23 July 2011 between 01:30 and 02:00 hrs, reported on page 37 of Aspaas and Tørrissen's report. The clinical state of the defendant was described as follows: “inconspicuous, but the observee has dilated pupils consistent with the effect of Ephedrine, which he informed us that he had taken. Dilated pupils can also be consistent with mental stress. Seems tired. The conclusion is: slightly under the influence.”

The evaluation reported on page 38 states the following: “The defendant is calm during the examination. He explains things adequately and responds to all questions without any conspicuous hesitation. He cooperates adequately, except that he says that he does not wish his face to be photographed.”

Furthermore, the defendant has had regular contact with the prison health service at Ila Preventive Detention and Security Prison from the time he was remanded in custody on 26 July 2011. Neither the prison physician nor the psychiatric nurse found any signs of psychosis, either when he was admitted or later, according to the notes in the medical records referred to in the expert witnesses Aspaas and Tørrissen's report. In September 2011, the prison health service referred the defendant to the specialist health service of Bærum District Psychiatric Centre (Bærum DPS), inter alia, to assess if there was any suicide risk. Arnhild Flikke, senior medical officer and psychiatrist, had her first talk with the defendant on 9 September 2011. In her notes from this first talk, included in the expert witnesses Aspaas and Tørrissen's report on page 148, she writes the following: “His political conceptions are extreme, but I do not consider that they represent any flawed perception of reality in a psychotic sense, based on my knowledge about common thoughts and ideas in rightwing extremist circles (Islam is seen as the external enemy and most politicians and journalists are seen as the internal enemy who must be defeated to save the nation). He appears capable of seeing that others will perceive his views as extreme. He seems to think that his role in the development is important, but not that he is absolutely vital for the development, compare the statement that he sees himself as a foot soldier.”

During her talk with the defendant on 16 September 2011, Flikke did a number of tests, inter alia, SCID-II with personality disorders in mind, and found that he met the criteria for narcissistic personality disorder. Flikke has had weekly talks with the defendant, of which ten talks alone with him and eight or nine talks together with Eirik Johannesen, a specialist psychologist, also at Bærum District Psychiatric Centre. At the trial, Flikke explained that she after each talk concluded that the defendant was not psychotic. She talked with the defendant about politics, the Knights Templar and his self-perception. She has also read parts of the compendium and seen the defendant's «propaganda video», without having observed any bizarre or other psychotic delusions. She explained that she was very surprised about the conclusion in the expert witnesses Husby and Sørheim's report and that she then made a thorough assessment of possible diagnoses. In a memo of 9 December 2011, quoted on page 150 of the expert witnesses Aspaas and Tørrissen's report, she writes, inter alia, the following: “1) Serious mental disorder. If one disregards a transient psychosis, I believe, based on the information I have gathered so far, that there are more indications which speak in favour of a delusional disorder than paranoid schizophrenia, if one is to take his views of society and his own potential role, as delusions. My conclusion is that I do not perceive his conceptions as psychotic but rather as an expression of rightwing extremism, and I do therefore not conclude with this diagnosis. [...] Conclusion/action: Based on my assessment, he meets the criteria for a personality disorder dominated by dissocial and narcissistic characteristics, and I consequently conclude with these to diagnoses.”

Moreover, Flikke has said that after she received the report by the expert witnesses Husby and Sørheim, she decided to hire Johannesen, a specialist psychologist, to do independent examinations of the defendant. From 23 December 2011, Johannesen had a total of 20 talks with the defendant, of which more than half alone with him and the rest together with Flikke. Johannesen has also had talks with the defendant at Ila during the 10-week trial. The talks between Johannesen and the defendant addressed, inter alia, the defendant's political views and his selfperception. In his assessment, following a talk on 27 January 2012, included in the expert witnesses Aspaas and Tørrissen's report on page 157, Johannesen writes the following: “Assessment/further treatment: The patient appears unchanged from last time and the suicide risk is still considered low. Still nothing has come up in our talk which would corroborate the patient suffering from an active psychosis disorder. The patient expresses a strong sense of paranoid and conspiratorial thinking, shows little emotionality in his communication and appears to be almost totally unaffected by the mass murders he has carried out. In the opinion of the undersigned, this can still be understood rather as a sign of the patient's probable personality disorders with the extensive use of primitive defence mechanisms to maintain a grandiose self-image. During our talks, there has been no indication that the patient meets the criteria for an axis 1 disorder.” (Psychosis is an axis 1 disorder.)

During the main hearing, Johannessen explained that his observations mainly coincide with those of the expert witnesses Aspaas and Tørrissen. He found neither bizarre nor other psychotic delusions. With the exception of how he speaks of his ideology, the defendant showed flexibility and the ability to talk in a nuanced way. In addition to consultations with treating health personnel, as described above, Randi Rosenqvist has assessed the defendant and conversed with him on three occasions. On 18 August 2011, she wrote a memorandum based on the media coverage of the case and the staff's descriptions of the defendant, but without having examined him herself. In the memorandum, included on pages 161–162 in the expert witnesses Aspaas and Tørrissen's report, she writes that upon assessing his state of mind, she gave importance to: “the defendant's thorough preparations, ability to plan, good impulse control, ability to do ‘double bookkeeping;’ he is able to sort what he wishes to go public about, and what he does not wish to announce until at a dramatic moment in time. This requires good cognitive functioning, the ability to judge what is worthwhile to disclose and what should be kept secret, and again, good impulse control. What is remarkable about A is, the way I see it now, his distinct narcissistic personality with grandiose delusions. He has also demonstrated the ability not to show empathy with victims; to which extent this indicates a fundamental relational disorder, pure dissociality or for instance a schizotype disorder, I would need more information to assess. In the information I have on A, there are no facts signalling psychotic functioning today, although how he regards himself indicates a rather flawed perception of reality.”

Following her first consultation with the defendant on 1 November 2011, rendered on pages 162–163 in the expert witnesses Aspaas and Tørrissen's report, [Dr.] Rosenqvist writes as follows: “Assessment: I do not find any signs of psychotic functioning. However, I am not certain that he speaks the truth, although he tries to give that impression. We might thus have a hypothesis that he redefines the information he receives on a psychotic basis and thus has a flawed perception of the reality in which he has lived. I find this farfetched. I find it more likely that he, like most of us, places information and experiences into the world view he has formed. Thus he has his own point of view confirmed. In this process he forms his own understanding, through which he consciously or unconsciously tries to manipulate the surroundings.”

During the main hearing, Rosenqvist explained that after having read the report from the expert witnesses Husby and Sørheim, she had another consultation with the defendant in which she made a more detailed assessment of the psychotic symptoms where they were described. She found the defendant's comments eccentric, but still not psychotic. In Rosenqvist's memorandum after this consultation on 19 December 2011, included on page 164 in the expert witnesses Aspaas and Tørrissen's report, she makes the following summary: “Summarized assessment: Based on the Head of Department's log and my own consultation with A, I find him to be in good mental shape. I perceive his deviant comments as an expression of an extreme ideology. In no way as a psychotic perception of reality. However, the forensic psychiatric experts, who have had considerably more information on him than I have, will assess this. We know, from history, many sects of religious or other ideological basis in which the members advocate notions of the world and the hereafter shared by few others. Such sects may be quite small or include many people. Although some of these sects may be based on a charismatic leader with delusions and experiences out of touch with reality, for instance based on epilepsy or transient toxic psychoses, this does not mean that all the members have delusions in psychiatric terms, or other serious psychopathology. We know that such sects seek internal confirmation, and may for a long time (generations) maintain notions in no way shared by society at large. I believe that A is within such a system. It is unclear to me to which extent he has many people who share his opinions, but he has expressed to me himself that he has based a lot on the British, or rather English movement and [has] not sought contact with the Norwegians of the same ideology, although there are thousands of them, according to him. As long as he stays safe in this universe, we might say that he lives in a ‘bubble,’ but that he lives reasonably well in this ‘bubble.’” f

During the main hearing, Rosenqvist stated that she still did not assess the defendant's extreme thoughts as psychotic delusions, but rather as thoughts of grandeur. The last time Rosenqvist visited the defendant was in March 2012, and she still did not find any psychotic conceptions. Still, she did not disregard the possibility that the defendant might turn seriously ill if the ‘bubble’ in which he lives, were to burst, so that he would have to fully comprehend the atrocious acts he has committed.

The Court remarks in closing that the police officers who conducted the long and numerous interviews with the defendant, did not seem to have reacted to his state of mind either. The police officer who did the seven-hour-long interview with the defendant on Utøya immediately after the arrest, writes e.g. in his closing remarks: “The accused spoke without problems throughout the conversation. He appeared perfectly lucid and reflected. The accused gave his statement in a coherent and detailed manner.”

Police officer Geir Egil Løken stated at the trial that his main impression of the defendant in court is the same as during the police interviews. The defendant was never at any time during the 220 hours of police interviews considered to be in need of health services in relation to the interviews.

The review shows that neither treating nor advisory health personnel have found signs of bizarre or other psychotic delusions in the defendant. Except for psychologist Eirik Johannessen, they have all examined him also prior to the first forensic psychiatric report was submitted and before he had access to the media. The Court finds that this unanimity provides solid support to the assessment made by the expert witnesses Aspaas and Tørrissen that the defendant was not psychotic. As already mentioned, the defendant is a person who is more than happy to talk about the subjects that interest him, except for the Knights Templar.

6.7 Compulsory observation

Oslo District Court decided, as mentioned above in section 6.2, that the defendant was to be subjected to compulsory psychiatric examination for up to four weeks, pursuant to the Penal Code section 167. For security reasons it was simultaneously decided that this examination should take place at Ila Prison and Detention Centre. The psychiatric experts Aspaas and Tørrissen had already asked for such an examination, whereas the psychiatric experts Husby and Sørheim, who had already submitted their statement, did not see any need for it. The examination was done by an observation team from Oslo University Hospital, Department Dikemark, in the period from 29 February to 21 March 2012. In the final report from Dikemark, by the psychiatrist in charge, María Sigurjónsdóttir, included in expert witnesses Aspaas and Tørrissen's statement on pages 165–181, the following is written about the actual observation team: “The observation team was an interdisciplinarily composed group of authorized health personnel employed at the Regional Security Department Helse Sør-Øst [Health South-East], Dikemark, Oslo University Hospital. All members of the observation team have been employed with the Regional Security Department Helse Sør-Øst for some time and have participated in examinations of patients with violent behaviour, where the objective is to clarify whether the patients have psychoses, drug addiction issues and/or personality disorders. Everybody on the observation team participate in the treatment of patients admitted to the Department.

The observation team consisted of altogether 18 persons. Of these, there were 12 nurses (of whom nine were psychiatric nurses), three auxiliary nurses (of whom two with further studies in psychiatry), one clinical social worker, one psychologist and one psychiatrist. Everybody on the observation team also had further studies in various fields within mental health work in addition to their mentioned professional degrees.

The observation team's collective work experience in mental health care is extensive. The observers of the observation team have worked in mental health care for an average of 21 years, (6 years – 34 years, median 19.5 years). (Aspaas and Tørrissen pages 167–168.)

On the importance of the observation, the expert witnesses write the following on page 181: “Observation in an institution implies that the observee has been seen by qualified health personnel for three weeks. The observational basis is thus significantly broader than what may be achieved on the sole basis of conversations with the expert witnesses. One-time conversations are mostly structured by the psychiatrists, whereas round-the-clock observation in an institution implies that he is seen in spontaneous, loosely organized everyday situations, such as general small talk, meals, watching TV, playing games. Besides, it has been possible to capture any possible reactions following police interviews and the conversations with the expert witnesses, as well as reactions to news and debate articles in the media on the 22 July case. The observation made by RSA Dikemark has thus provided the expert witnesses access to essential observational data that may not be obtained in any other manner.“

As was heard in the statements of the participating health personnel at the trial, no signs of psychosis were found in the defendant during the observation. As regards his notions, the following is quoted from the final Dikemark report:

“A significant part of the observee's verbal communication is characterized by the observee's presentation of his own political conviction. His discussion of this subject is not perceived to have deadlocked thought patterns since he demonstrates the ability to regulate and modify his own statements and arguments based on feedback from observers. The observee is able to take in comments from others and use this in further discussions. This happens without any display of exaggerated affect on his part around such a discussion, but a normal level of involvement. The observee often specifies that he understands that others may have other interpretations or meanings, and that this may make others not share his political points of view. The observee has shown the ability of reality testing in that on several occasions, he has asked the observers on various topics of interest to him (including politics), and wondered whether what he thinks and believes has been credible or realistic. The observee has shown the ability to regulate his own statements and thoughts based on feedback given to him, or once the observers have given him more, and sometimes more nuanced, information on a topic he already had an opinion about.

The observee may have eccentric interpretations of concepts and phenomena, which the observers perceive to be adapted to his ideology. All words and expressions used by the observee are understood and have meaning to the observers.

The observee expresses his opinion to be that his political ideology is necessary in order to understand his perception of his situation and the process he believes he is in. This implies great focus on himself and the political ideology he wishes to relay. At the same time, he often says that he understands how other people cannot quite follow his reasoning around some of his opinions, and that others may react with short-term horror. The observee says that the acts on 22 July were horrendous, but must be seen in a longer time perspective, up to 70 years.”

lThe Court finds no reason to go into further detail on the report's thorough description of the defendant's conduct and functioning, but mentions nevertheless that neither social nor cognitive functional impairment was observed, nor thought disturbances such as for instance neologisms.

Sigurdjónsdóttir stated at the trial that the observation team had found on the internet the concepts used by the defendant. It cannot be ruled out that the defendant, helped by his cognitive functions, has been able to conceal psychotic symptoms during the entire observation period. The Court believes, however, that this possibility is so slight, especially when it comes to paranoid schizophrenia, that the Court can disregard it. The Court thus also finds that the observation of the defendant pursuant to the Criminal Procedure Act section 167 provides solid supports to the experts Aspaas and Tørrissen's assessment that the defendant was not psychotic.