Extreme Overvalued Beliefs

Clinical and Forensic Psychiatric Dimensions

This foundational work demystifies the motives behind targeted attacks.

In October of 2018, Cesar Sayoc mailed pipe bombs to sixteen supposed critics of former president Donald Trump. After his arrest by the FBI, Sayoc eventually pled guilty to multiple felony charges including using weapons of mass destruction in an attempted domestic terror attack. At the time of his sentencing, Sayoc’s defense attorneys used the terms “delusion” and “obsession” to describe the beliefs that led to his actions, arguing that he acquired these beliefs from right-wing media and Facebook interactions.

Tahir Rahman (Photo: Washington University)

Riveting and surprising in its persuasive simplicity, Extreme Overvalued Beliefs makes a profound argument that most violent targeted attacks are incorrectly classified as motivated by delusions or obsessions. Drawing on exceptionally clear and vivid details of crimes such as the JFK assassination, Oklahoma City bombing, and the January 6th US Capitol attack, as well as the Sandy Hook and Uvalde school shootings, the monograph illuminates three easily understood cognitive drivers of targeted attacks, arguing that we must embrace these in order to thwart future incendiary acts.

Reprising the work of neuroscientist Carl Wernicke, Rahman elegantly separates culturally shared, relished, and extreme ideologies from delusional thinking. Extreme Overvalued Beliefs belongs in the libraries of mental health and legal professionals but will also appeal to those yearning to learn more about the epidemic of mass violence we have become accustomed to living with.

About the author

Tahir Rahman, MD, is associate professor at Washington University School of Medicine in St. Louis. Rahman completed his psychiatry residency at Johns Hopkins Hospital, Baltimore. He has 25 years of clinical and forensic experience, and has testified as an expert witness in several high-profile insanity cases.

Rahman teaches forensics and led the first description of extreme overvalued beliefs in response to an analysis of the insanity trial of Anders Breivik, a terrorist responsible for the massacre of 77 people in Norway. The central focus of his research is on pathological fixations–with an emphasis on concise definitions of delusions, obsessions, and extreme overvalued beliefs. Since then, his research has focused on threat assessment and management. One overarching goal is to end targeted attacks, especially school shootings, by the end of this decade.

In his distinguished career, Rahman has won several teaching awards, and he published numerous peer-reviewed articles in both psychiatric and threat assessment journals. He is a member of the American Academy of Psychiatry and the Law, the Association of Threat Assessment Professionals, and the American Psychiatric Association, as well as a consultant for the FBI Behavioral Analysis Unit, Quantico.

Jeffrey Abugel has been an editor and writer for more than 30 years. He is a member of the American Medical Writers Association and founder of the nonprofit Initiative for Depersonalization Studies.