In my therapy session with a formerly abducted 45-year-old-man at the rehabilitation centre, he described his life in militant captivity and his coping strategies, and suggested ways of reintegration. He witnessed, endured and participated in hideous atrocities while in militant captivity. Vigilance, absolute obedience and cooperation with his captors, prayer and hope, denial, blaming others, constant preparedness to flee, use of traditional medicine and resilience and perseverance were some of the coping strategies he employed while in captivity and during escape. This reminded me of Shahbaz Taseer and Ali Haider Gilani among others who were kidnapped between August 2011 and May 2013 respectively. Both kidnappings were linked to the Tehreek-e-Taliban Pakistan (TTP). To understand the effects, both long-term and short-term, on individuals and their families, they should all be viewed in the context of limited negotiations between the government and the TTP, and the continuing conflict. This is an important issue for both clinical and political reasons. The advice of mental health professionals may be sought with regard to the strategic management of hostage incidents and the clinical management of those who have been abducted. There is evidence to suggest that how best to help those who have been taken hostage is a sensitive and complex matter, and those who deal with such individuals should be as well informed as possible since such events can have long-term adverse consequences, particularly on hostage victims and their families. Former Prime Minister (PM) Yousuf Raza Gilani said that he had been in contact with his son’s kidnappers over the past year, and that they wanted the release of prisoners from Adiala Jail in Rawalpindi, not a ransom, in exchange for Ali Gilani’s release. Yousaf Gilani has not confirmed who he had been in contact with, since Interior Minister Chaudhry Nisar Ali Khan has stated that he is not being held by the TTP. Motives can be expressive and instrumental. In reality, it is usually difficult to identify any single motive, particularly when the event is terrorist-inspired. The motive here appears to be largely criminal, for financial gain, rather than political. Sometimes such events are described as ‘economic extortive kidnapping’. These events can have demoralising effects on families, who may lose all faith in government agencies and intelligence organisations. Material motives (e.g. ransom) may be conveniently masked by alleged religious, political and moral ones. Moreover, ransoms may be used to fund political and religious activities. Also, some insurgency groups sell hostages on to other groups for their own purposes. Although the history of kidnapping and hostage taking is a long one, it is only relatively recently that there has been a systematic surge in these activities. Hostile conditions in Pakistan have not changed significantly, making it difficult to assess conclusively whether the current threat of kidnapping is less than what it once was. However, given the increase in terrorist attacks and nascent speculation as to their causes, various factors underpinning kidnapping for ransom are worth considering. Hostage taking has become a particularly popular modus operandi for terrorists who tend to be well organised and selective in their ‘target’ hostages, particularly due to their cynical but effective use of extensive media coverage. Unfortunately, the death toll among hostages is high in Afghanistan and Pakistan, and the frequency of kidnapping of politicians, professionals and businessmen has markedly increased in Pakistan since the US invasion of Afghanistan in 2001. A particularly distasteful feature of hostage taking is the videotaped executions of hostages, such as those of paramilitary personnel in the tribal areas. It is important to examine how geo-political analyses of terrorism in this part of the world have provided some harsh insights that do follow a chain of rogue economic reality. Some forceful counter-terrorism interventions are therefore required that concern terrorist targeting of businesses, officials, and the general public, where targets can work at cross-purposes as they attempt to deflect the attack. Other urgent measures involve government choice among alternative anti-terrorism policies and government concessionary policy when terrorists are either hardliners or moderates in their viewpoint. It transpires that terrorism-related incidents of hostage taking differ from others. Hostage taking by terrorists tends to involve well trained and well organised groups, and their hostages are likely to have been carefully chosen, particularly in anticipation of the likely effect that their abduction will have on others. Taking hostages has now become a method with variable effectiveness and is successfully used to secure concessions from individuals, organisations and governments. More recently, it has become a popular tactic among the Taliban. When negotiating with the terrorists, use of force to rescue hostages is a complex and sensitive matter. Attitudes have changed over time and successful resolution by force requires exceptional training, planning and execution. Tactics require that the location where hostages are detained will influence the negotiation process and shape the likelihood of a safe release. Negotiations and rescue operations are made more difficult if the hostages are held where the local population is hostile and fervently protesting. Once out of captivity, the psychological impact of being taken hostage is similar to that of being exposed to other trauma, including terrorist incidents. Typical adult reactions include intrusive thoughts, flashbacks and memories, hyper-vigilance and hyper-arousal, and social withdrawal. Denial, a complete or partial failure to acknowledge what has really happened, has often been maligned as a response to extreme stress but it has short survival value by allowing the individual a delayed period during which he has time to adjust to a painful reality. Two extreme reactions have also been noted, namely, ‘frozen fright’ and ‘psychological infantilism’. The former refers to a paralysis of the normal emotional reactivity of the individual and the latter reaction is characterised by regressive behaviour such as clinging and excessive dependence on the captors. Extended periods of captivity may also lead to learned helplessness in which individuals come to believe that no matter what they do to improve their circumstances, nothing is effective. Victims have been described as developing Stockholm Syndrome where they develop an emotional bond with an abuser as a survival strategy. Certainly, it is worth emphasising that many survivors do appear to cope over time, particularly if their family and social environment is supportive. Hostage taking has become a frequent crime and political weapon. In the long term, resilience may be the norm, but being taken hostage can be a deeply disturbing event with long-term emotional and physical sequelae, which requires skilled, informed care and advanced post-trauma support units at the national level. The writer is a member of the Diplomate American Board of Medical Psychotherapists Dip.Soc Studies, member Int’l Association of Forensic Criminologists, associate professor Psychiatry and consultant Forensic Psychiatrist at the Huntercombe Group United Kingdom. He can be reached at fawad_shifa@yahoo.com