A bitter pill to swallow

The sketchy evidence for the effectiveness of homoeopathic medicine has no scientific basis, and pos

There was an outcry in September when we learned that children in Scotland were being given a homoeopathic "MMR vaccine", a product that offered no protection against the serious dangers posed by measles, mumps and, for pregnant women, rubella. This had echoes of the discovery a few years ago by Sense About Science, Simon Singh and Newsnight that some pharmacists were offering homoeopathic pills for protection against malaria to people travelling to Central Africa. Such practices may be disturbing, but they occur because we tend to think there is no harm in indulging the clamour to maintain the alternative health market.

Reading the 11 October issue of the New Statesman, I was shocked by an advertisement in the accompanying supplement, "Social Care: Who Pays?", referring to me and my work. Rarely had I seen an advert so inaccurate and borderline libellous in a respected publi­cation. The advert, which appeared to breach the British Code of Advertising, was by a lobby group called Homeopathy: Medicine for the 21st Century (H:MC21). It contained unjustified attacks on myself and colleagues, including statements that gave a dangerously false impression of homoeopathy's therapeutic value.

As the advert questioned my own competence, I should address this first. I started my medical career in a homoeopathic hospital, where I was trained in homoeopathy for several months. Many years later, it became my job to apply science to this field and I felt I had a duty to keep an open mind - open but not uncritical.

A critical mind would notice that the two basic principles of homoeopathy fly in the face of science, logic and common sense. The first assumption is that "like cures like". For instance, if onions make my eyes and nose water, homoeopathic remedies derived from onions can be used to treat my patients' hay fever, which sometimes causes runny eyes and noses. The second assumption proposes that diluting remedies homoeopathically makes them not less but more potent, even if the final preparation no longer contains a single molecule of any active substance. These theories are not based on anything that remotely resembles fact. Like does not cure like, and endlessly diluting remedies certainly does not render them stronger, but weaker. But is there some entirely new energy to be discovered that we do not yet comprehend? Not understanding homoeopathy does not necessarily mean that it is useless.

The best way to find out is to determine whether homoeopathic remedies behave differently from placebos when patients use them. In other words, we need clinical trials.

Data gap

About 150 such studies (mostly conducted by homoeopaths) and well over a dozen syntheses of this research are available. Their results are sobering: the totality of the most reliable evidence fails to show that homoeopathic remedies work better than placebos. So, after about 200 years of research, there is no good data to convince non-homoeopaths that homoeopa­thic remedies are any different from pure sugar pills. Pro-homoeopathic lobby groups such as the one that placed the advertisement therefore have to employ propaganda to try to convince consumers who may not know better. This is perhaps understandable, but surely not right.

What of patients' experience, some might ask. Thousands of people across the world swear by homoeopathy. Are they all deluded? Clearly not. People undoubtedly do get better after seeing a homoeopath. There are many observational studies to show that this is true. Homoeopaths therefore keep telling us that their treatments work, regardless of the implausibility of homoeopathy's principles and the largely negative trial evidence.

When we rationally analyse this apparent contradiction of evidence versus experience, it quickly dissolves into thin air. The empathic encounter with a homoeopath is just one of many factors that provide ample explanation for the observation that patients can improve even when they receive placebos. A case in point is Bristol Homoeopathic Hospital's 2005 study, cited in the offending advert. The 6,500 chronically ill patients might have im­proved because of the concomitant use of conventional treatments, or because of the attention they experienced, or because of their own expectation to improve, or because the disease process had come to an end. In fact, they might have improved not because of, but despite, the homoeopathic remedies they were given.

Still, some people ask what is wrong with using placebos as long as they help patients feel better. The answer is that it prevents clinicians telling the truth to patients. Being honest would defeat any placebo effect: if I tell my patient, "Take this remedy; it contains nothing and the trial data shows nothing," she is unlikely to experience a placebo response. Hence, homoeopaths, knowingly or unknowingly, deprive patients of informed consent. This paternalistic approach is recognised as unethical. Also, placebo effects are unreliable and normally short-lived; they happen occasionally but often do not. Even if placebo responses are generated, they are usually small - certainly too small to compete with effective therapies.

Twin-track effect

Endorsing homoeopathic placebos would mean that people might use them for serious, treatable conditions. In such circumstances, homoeopathy can even cause (and has caused) the death of patients. Furthermore, if we allow the homoeopathic industry to sell placebos, we must do the same for "Big Pharma". Imagine a world where pharmaceutical companies could sell us placebos for all sorts of conditions just because some patients experience benefits through a placebo response.

Crucially, and paradoxically, we don't need placebos to generate placebo effects. If I, for instance, prescribe an antihistamine for a patient suffering from hay fever, with empathy, time and understanding, that patient benefits from a placebo effect as well as the pharmacological action of the antihistamine. If, by contrast, I prescribe a homoeopathic remedy, I deprive her of the latter, crucial benefit. It is difficult to argue, as most homoeopaths try to, that this approach would be in the interest of my patient.

What follows is straightforward: there is no good evidence that homoeopathy does more good than harm. This is not just my conclusion after 17 years of researching the subject, but a fact based on the best available evidence, which is supported by virtually all experts who are not homoeopaths. The recent decision by the coalition government to continue homoeopathy on the NHS is thus puzzling, to say the least.
The advertisement that prompted this article is misleading about the work of experts which has conclusively shown that homoeopathy can have no place in evidence-based medicine. It is an insult to our intelligence.

Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter, and co-author, with Simon Singh, of "Trick or Treatment? Alternative Medicine on Trial" (Corgi, £8.99)

Here comes the non-science

Homoeopathy was developed in 1796 by the German physician Samuel Hahnemann. He based his treatments on the twin ideas that "like cures like" and "less is more". The latter notion was implemented by taking a substance and diluting it over and over again, so that the final product generally contains not a single molecule of the original active ingredient.

Homoeopaths accept that most of their remedies are devoid of pharmacologically active principles, but they argue that the pills contain a "memory" of the original ingredient. The memory is supposedly imprinted in the diluting agent, which is used to moisten sugar pills.

Although homoeopathy defies the laws of physics, chemistry, biology and therapeutics, there have been numerous attempts to test its impact on patients through clinical trials. In 2005, Aijing Shang and seven colleagues from the University of Berne published an analysis of the best trials in the Lancet.

Their findings confirmed many other such published assessments. Commenting on the paper, they wrote: "This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects." An accompanying editorial entitled "The end of homoeopathy" said: "Doctors need to be bold and honest with their patients about homoeopathy's lack of benefit."

This article first appeared in the 08 November 2010 issue of the New Statesman, Israel divided

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The age of hyper-terrorism

Jihadis, spectacular mass-casualty attacks and the myth of an apocalyptic new world order.

Speaking at the Munich Security Conference on 13 February, the French prime minister, Manuel Valls, announced the arrival of an age of unprecedented terror. “We have entered . . . a new era characterised by the lasting presence of ‘hyper-terrorism’ . . . There will be attacks. Large-scale attacks. It’s a certainty. This hyper-terrorism is here to stay. The force of the ideological fascination is formidable, and if we have changed era it is because this hyper-terrorism is in the heart of our societies.”

The attacks on Brussels Airport and on a Metro station during rush hour in the Belgian capital on 22 March show the extreme difficulty of protecting soft targets in open societies. Some will argue that, harbouring a much higher proportion of jihadis than other European countries, Belgium has once again been shown to be a black hole in European security. As it took four months to apprehend Salah Abdeslam, the chief surviving suspect in the November 2015 Paris attacks, who was hiding in plain sight in the Brussels borough of Molenbeek, that suggestion may not be unreasonable. But the danger is not confined to any single country, and these atrocities will surely not be the last.

The conditions that produced the co-ordinated assault on Paris and Brussels have not changed. One of the triggers for the attacks has been setbacks for Isis on the ground in Syria. Since Palmyra – until now a symbol of the seemingly unstoppable advance of Isis – has been retaken by Bashar al-Assad’s forces, backed by Russian firepower, there must be a prospect of further mass-casualty operations against European cities. Linking guerrilla-style warfare with spectacular urban terror is one of the group’s trademarks and a feature of the hyper-terrorism that it practises. Occurring only four days after Belgian police finally captured Abdeslam, the Brussels attacks may have been acts of reprisal or defiance. The two suicide bombers whom Belgian law-enforcement officials have named as the perpetrators of the airport attack were already under suspicion for involvement in the November attacks in Paris. Whatever occasioned the most recent actions, Isis has claimed responsibility for all of these atro­cities, and will go on practising its brand of terrorism in Europe and elsewhere in the world. Unlike the IRA, hyper-terrorists are moved not by the prospect of achieving any concrete goals but by apocalyptic myths of a new world. Because this vision is unrealisable, hyper-terrorism will continue in some form for as long as the groups that practise it continue to function as effective forces.

Yet if hyper-terrorism seems sure to be a lasting presence, this is not just because of current conflicts in Syria and Iraq. The roots of violent jihadism lie in aspects of contemporary life that prevailing theories of modernisation – which have guided the West’s disastrous interventions in Muslim-majority countries – ignore or deny. According to these theories, Islamic societies are engaged in a struggle to catch up with the West. The journey may be long and arduous but there is no alternative. To modernise means to replicate the course of development that culminated in the liberal-democratic nation state. Once this process has been repeated in Islamic societies, the jihadist threat will diminish and eventually disappear.

Some such theory informs the faddish discourse of radicalisation, which tells us that people join Isis and similar jihadist groups because they have been brainwashed. Indoctrinated into extremist beliefs, they embark on a career of savagery and terror that they would never otherwise have envisioned. Prised out from their own societies, they then throw away their lives in the service of a suicide cult. But it is a cult that has set itself against the modern world, and all it can do is revel in nihilistic violence.

This is a frightening picture, but it is also decidedly optimistic. If the young men and women who leave the London suburbs and the banlieue of Paris to fight in Syria or Iraq have been indoctrinated, the problem can be solved by re-educating them. Like children who have been abducted by a freakish sect, they can be deprogrammed and reintegrated into the mainstream. In this comforting story, jihadism is a roadblock standing in the way of what Barack Obama has called “the arc of history”. Liberal values show the direction in which all of humankind wants to move. Once the roadblock has been removed, the normal course of progress can resume.

One difficulty with this reassuring story is that it passes over the role of Western policies in creating the conditions from which Isis emerged. Much of the ruling elite of Isis was recruited from the secular Ba’ath Party, in the vacuum the Americans created when they dismantled the state of Iraq shortly after invading the country. Equally, the Western policy of promoting regime change in Syria has had the effect of strengthening Isis (in part by relying on exaggerated or non-existent “moderate forces”). And toppling Muammar al-Gaddafi in Libya has created a zone of anarchy from which jihadists can operate freely, and through which hundreds of thousands more desperate migrants may flow into Europe this summer.

But there is a still larger flaw in the ­ruling narrative, in which terrorism will wither away as the Middle East modernises. The belief that underpins Western policies, which holds that the overthrow of despots allows a popular embrace of liberal values, is groundless. Liberal democracy is not the modern norm and everything else a temporary aberration. The modern world has been as fertile in producing tyrannies as democracies, if not more so, and there is no reason why this should cease to be the case in future.

The collapse of the Soviet Union has been followed not by any sort of liberal regime, but by a hypermodern autocracy that has achieved high levels of popular support by promoting Russian nationalism and Orthodoxy through skilful use of the media. Demonstrating a capacity for framing and implementing policies with defined and realisable goals that no Western government has displayed in the Middle East, it is this autocracy that, with a short, sharply focused and easily renewed military intervention, has secured the power to dictate the terms of any possible peace in Syria. Again, post-Mao China is not moving towards becoming a Western-style economy or polity. Market reform, which everyone in the West expected would continue, is being set aside in order to consolidate the power of Xi Jinping and the Communist Party. Each of these regimes faces large challenges – Russia the risk of a long period of low oil prices, China the hazards of economic slowdown. But in neither case is there any reason to suppose they will respond with policies of liberalisation: an increase in authoritarian repression (not necessarily unpopular) is far more likely.

Meanwhile, Western institutions – supposedly the endpoint of a global process of development – are also mutating. A type of illiberal democracy is on the march in post-communist Europe, while the European Union is in a state of paralysis and even disintegration. In these circumstances, the belief that liberal values are on “the right side of history” is an expression of blind faith.

The dangers of this faith are illustrated in Western policies towards Saudi ­Arabia – the country that has been at the centre of global jihadism. Liberals rail against Western policies that allowed the Saudi ambassador to join the march in support of Charlie Hebdo in Paris and enabled a Saudi representative to have a key role on the Human Rights Council at the UN. Certainly there is an element of black comedy in a regime that sentences a peaceful blogger to a thousand lashes and that denies elementary freedoms to its female population being touted as an authority on human rights. But this evident absurdity masks a more intractable truth, which liberals deny: there is no realistic prospect of human rights being respected in Saudi Arabia at any time in the foreseeable future. If the House of Saud is toppled, it will be replaced by something worse – a state of anarchy, followed by a regime that would enforce theocracy and promote jihadism more wholeheartedly and ruthlessly than the Saudis have done.

***

The role of the kingdom of Saudi Arabia in promoting Wahhabism – a variant of Sunni fundamentalism that emerged in the desert region of Najd during the 18th century – is not in doubt. Nor are the affinities between the teachings of Wahhabism’s founder, Muhammad Ibn ‘Abd al-Wahhab (1703-92), and the most extreme jihadist movements today. ‘Abd al-Wahhab condemned the Islam of his day as decadent and impure. Practices such as Sufism and reverence for saints were idolatrous; anyone involved in them was not a Muslim but an infidel who could lawfully be killed. When the Ibn Saud clan adopted ‘Abd al-Wahhab’s teaching in the 1740s, this was the doctrine it accepted.

The genealogy of jihadist thinking is complex and includes important strands derived from radical Western ideologies such as Leninism and fascism. There are many varieties of jihadism, whose origins and identities are intensely contested, both by scholars and by the very groups. Some have described Isis as Salafist-jihadist – one of a host of groups holding to a fundamentalist version of Islam that were radicalised by the war in Afghanistan and joined conflicts in Iraq, Syria, the Russian Caucasus and elsewhere. Like al-Qaeda before it, Isis is a hybrid expressing many ideas and forces. Even so, there are many points of contact between ultra-fundamentalist Wahhabism and the ideas driving groups such as Isis.

Wahhabism might have remained a marginal current within Islam were it not for two events: the appropriation of ‘Abd al-Wahhab’s teaching as the theological source of state authority when the present Saudi kingdom was founded in the 1930s, and the oil wealth it accumulated in the second half of the 20th century, which has been used to export Wahhabism throughout the Muslim world, and to countries beyond it – including Belgium, where Saudi-funded Salafists have been active in many mosques.

The commitment to Wahhabism is essential in legitimating the Saudi state. It is also pivotal in the Saudi conflict with Shia Iran. Adhering to rival versions of Islam, the two states are locked in an escalating struggle for hegemony in the Middle East. But Western geopolitical strategies have played a part in enabling the Saudi state to serve as a channel for jihadism. When in February 1945 the then Saudi monarch, Abdul Aziz, met Franklin D Roosevelt on an American warship in the course of the president’s return from the Yalta Conference, the Saudi state became an integral part of the postwar Western power structure.

As an ally of the West, the kingdom has secured the flow of oil in exchange for a guarantee of its own security – a mutually advantageous arrangement, but one that has had some unfortunate consequences. By turning a blind eye to ways in which funds flowing from Saudi Arabia have promoted the beliefs that fuel jihadist movements (and also failing to admit the role of Pakistan, another supposed ally, in backing the Taliban in Afghanistan), Western governments ensured that the “war on terror” that followed the 11 September 2001 attacks would be a gruesome fiasco. (Fifteen of the 19 militants who carried out the 9/11 attacks were Saudi.)

The Saudi case is instructive for several reasons. For one thing, it demonstrates the continuing potency of religion in politics and war. Endemic conflict in the Middle East has many different sources, including inheritances from European colonialism, the follies of recent Western policies and geopolitical rivalries between the major regional powers. Even so, these conflicts are also wars of religion.

According to prevailing theories, when societies modernise they become more secular; over time, religious faith becomes a private matter. But this is to generalise from a highly specific history. Originating in the European wars of religion, secularisation is a late offshoot of Judaism and Christianity. (Nothing like the separation of church and state existed in ancient Greece or Rome, which lacked the idea of “religion” as a distinct sphere of life.) While Islam has produced regimes of pluralism and toleration, such as the one that existed in the Ottoman empire when Europe was still blighted by religious wars and persecution, there is no reason for thinking that Muslim cultures are going to embrace secularisation or liberal values, even over the long run. Attempting to export these practices and values to countries with very different histories has predictably counterproductive results.

***

The Saudi case is also instructive in demonstrating the vanity of liberal hopes of reform. The kingdom can no more be reconstituted on a liberal model than could Iraq, Libya or Syria. In every case, the regime and the state are closely intertwined: if you overthrow one, you destroy the other. In the Saudi case, the House of Saud is the Saudi state – the product of a strategic bargain between the ruling dynasty and Wahhabism. The predictable result of any attempt at reform would be to threaten this pact. At that point, Isis or some successor Salafist-jihadist group would step in as the embodiment of true Wahhabism. The monster the Saudis have fed would then ­devour them.

This is a danger of which the new Saudi king, Salman, seems all too aware, and may account for Saudi Arabia’s untypically direct involvement in Yemen and threats to put boots on the ground in Syria. There is a mood of mounting panic beneath these and other Saudi policies. Levering down the oil price through oversupply may be a tool in the Saudis’ attempt to maintain market share by bankrupting the US shale industry. But it is also a response to the re-emergence of Iran as an energy superpower. Burning rapidly through the surplus wealth that has helped the Saudis to buy off fundamentalist forces, it is a risky tactic. As the former diplomat John Jenkins wrote in this magazine last year, the Saudis feel besieged on all sides. In these circumstances, the kingdom’s ruling dynasty is not going to compound the dangers it faces by implementing liberal reforms that could undermine the basis of its very existence.

When they insist that the future for the Middle East lies in moving towards liberal democracy, progressive thinkers demonstrate a refusal to learn from history – and not only that of the Middle East. Where some sort of democracy can be found in the region – as in Iran and the rump state of Iraq – it is of an illiberal variety that promotes sectarianism. The regimes of Hugo Chávez in Venezuela and Carlos Menem in Argentina were democratic inasmuch as they recognised the will of the people as expressed in elections to be the ultimate source of political authority; but they also recognised few limitations on the powers of government. Illiberal democracy is a recurring feature of modern political life which is now under­going a resurgence.

Nineteenth-century liberals recognised that democracy comes in various forms, and dreaded the version advocated by Rousseau, in which an inspired lawgiver interprets and implements the will of the people. Nowadays such fears are dismissed as elitist. But the old-fashioned liberals grasped a vital truth: popular government has no necessary connection with the freedom of individuals or minorities. Of course, liberals today will say this can be remedied by installing the rule of constitutional rights. Such systems are fragile, however, and count for nothing when large sections of society are indifferent or actively hostile to liberal values. Where this is the case, democracy means not much more than the tyranny of the majority.

In Europe the dissociation of democracy from liberalism is a rising trend. Until recently it was possible to view Viktor Orbán’s regime in Hungary – even though he has described it as an illiberal democracy akin to those of Vladimir Putin in Russia and Recep Tayyip Erdogan in Turkey – as a one-off affair. Since the election of the Law and Justice party in Poland last October, that is no longer possible. Orbán has used various devices – including announcing a referendum, which he will undoubtedly win, authorising him to reject EU migrant quotas – to transform the Hungarian political system into a type of democratic authoritarianism.

The new Polish regime has gone further, altering beyond recognition institutions that were put in place in the country after the fall of communism. The political independence of the constitutional court, the judiciary and the civil service has been curtailed and pluralism in the media attacked. Echoes of a dark past can be heard in reports that the government is considering stripping Princeton’s distinguished, Polish-born Holocaust scholar Jan Tomasz Gross of the Order of Merit because he has noted the participation of parts of the Polish population in anti-Semitic mass murders during the years of Nazi occupation.

Linking illiberal democracy in Europe with developments in the Middle East, Turkey, under the leadership of Erdogan, has swung towards popular authoritarianism, clamping down on freedom in the media and expanding his powers as president to enable greater control of the machinery of state. Brussels condemns these developments but is powerless to do anything about them. Indeed, the deal to block migrant flows that Germany’s chancellor, Angela Merkel, is promoting with Turkey would strengthen Erdogan’s power – without in any way changing Turkey from a semi-failed state that treats the Kurds as a greater threat than Isis. Whatever pretensions the EU may have had as a guarantor of liberal values have been shown to be practically worthless.

The shift to illiberal democracy in Europe (and in the United States, through the rise of Donald Trump) has a number of causes, but the migrant crisis is the most powerful one. Merkel’s declaration that migrants were welcome was at first lauded by liberals throughout the world, while the refusal by post-communist countries to accept EU migrant quotas provoked indignation in Brussels. Yet the progressive states of Scandinavia are little different: Sweden is apparently ready now to reject large numbers of asylum applications and deport many of those who have already arrived. There is a logic to these responses that liberals are unwilling to understand. Open borders, liberal democracy and highly developed welfare states are not simultaneously sustainable. Except where it adjoined the Romanov and Ottoman empires, pre-1914 Europe could be largely borderless because democracy was limited and the welfare state only just beginning. In Britain, controls on immigration were put in place with the Aliens Act 1905. But in continental Europe the chief drivers of immigration control were the First World War and the ensuing rise of self-determining nation states from the ruins of collapsed empires.

Today, large-scale immigration comes up against resistance from majorities that see migrants as threats to welfare provision (and their wage levels). Lacking democratic legitimacy, having no effective control over its perimeter borders and responsible for savage rollbacks in welfare as part of its austerity policies, the EU is finding that this is a trilemma it is incapable of resolving. As a result, the task has fallen to national governments, which have responded by closing borders or introducing emergency controls. It will not be surprising if Germany – following Merkel’s noble-sounding but ill-judged declaration, which empowered the far right in regional elections in March – soon follows suit.

The advance of illiberal democracy in post-communist Europe is part of a larger shift. A continent-wide process of “Orbán­isation” is under way, in which power is leaking away from the EU. Schengen has in effect collapsed, and given that reinstating it would increase flows of migrants to a degree that cannot be democratically legitimated, it will surely not return. However, closing Europe’s borders now will not prevent further terrorist attacks. Thousands of jihadist militants, battle-hardened in Iraq and Syria, may already have slipped into European countries. European institutions lack the capacities that are needed to monitor these flows and take effective action. Given the disintegrative forces that are at work in the European Union, this is not a fully soluble problem.

***

Europe is ill-prepared to deal with hyper-terrorism, but the phenomenon is hardly unprecedented. Modern history abounds with violence fuelled by apocalyptic myths, not always explicitly religious in nature. When in his 1907 novel, The Secret Agent, Joseph Conrad depicted the hyper-terrorist of his day, he presented the reader with the Professor, a cere­bral fanatic who announces “doctorally” that the only way humankind can be roused from ignorance and lethargy is through acts of sheer terror. “Madness and despair!” he cries. “Give me that for a lever, and I’ll move the world.” Dedicated to reason and science, the Professor has concluded that both reform and the seizure of power in a conventional revolution are futile. Yet a new world is within reach if terror is applied methodically, and with a ruthless ferocity that seems insane.

Conrad’s Professor and his fellow revolutionists were representative of their time. Especially in Russia, where the casualties (mostly tsarist officials) numbered in the many thousands, the early years of the 20th century were marked by a type of spectacular violence that has striking affinities with the hyper-terrorism of today. Granted, there are important differences. The anarchists did not target the civilian population as Isis does. The myths that possessed anarchists in their campaigns of assassination were not religious; they were secular myths of social transformation. Most importantly, early-20th-century anarchism never acquired a mass base. Violent jihadist movements cannot claim the support of a majority of Muslims anywhere in the world. In the regions it has conquered so far in Iraq and Syria as well as Libya, Isis rules by instilling fear. But no other jihadist organisation so successfully combines ultra-violent fundamentalism with hypermodern propaganda methods and the business structures of a global criminal cartel. It is not unrealistic to think that, in some contexts – a destabilised Saudi Arabia, for instance – a group like Isis could attract significant popular support.

Although liberal thinkers believe that terror declines as societies modernise, the reality is that terror and modernisation have more often gone hand in hand. The aim of the Jacobin terror in revolutionary France was the creation of a modern state. If the violent suppression of the peasant revolt in the Vendée is included, the casualties ran into the hundreds of thousands.

Lenin avowedly followed the Jacobin example when he used the Cheka to create a modern state in Russia. One of the factors that distinguished Nazism and fascism from conventional tyrannies was the belief that a new society could be fashioned by the  systematic use of terror. Violent jihadism has more in common with these modern totalitarian movements than is commonly supposed.

The terrorist threat in Europe today seems unique only because these precedents have been largely forgotten by many people. Calling jihadist violence nihilistic is a symptom of this amnesia. At present, “nihilism” is a vacuous concept whose function is to block out from awareness any evil that cannot be fitted into the ruling progressive narrative. The effect is to underestimate the gravity of the danger. The next wave of hyper-terrorism will not be diverted by education campaigns or by mind-changing therapies. Uncovering members of jihadist networks and those who sponsor and recruit them is a vital task – one that may have been significantly advanced by the reported leak to German intelligence and Western media of Isis documents giving away the identities of more than 20,000 recruits. But the greater danger is of whole societies descending into deeper and more intractable conflicts in Syria, Iraq and Turkey, possible upheaval in Saudi Arabia, and other large-scale convulsions that cannot be foreseen. In these conditions, if Isis weakens in coming years it will not be long before new jihadist groups take its place.

Hyper-terrorism today is the product of an interaction of tangled geopolitical conflicts with the resurgence of apocalyptic religion. Dealing with the threat requires an understanding of this combustible mix. The narrative of modernisation that imagines terrorism can be countered by exporting Western institutions impedes any clear perception of the scale of the threat. The ongoing attacks that are now certain continue a history of violence that has shaped the modern world. If hyper-terrorism is here to stay, one reason is that it never went away.

John Gray is the New Statesman’s lead book reviewer. His latest book is The Soul of the Marionette: A Short Enquiry into Human Freedom.

This article first appeared in the 31 March 2016 issue of the New Statesman, The terror trail