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Psychiatry and Radical Forgiveness

Summary:
But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you. – Matthew 5: 34 I’ve been reflecting further on this passage in Scott Alexander’s critique of my perspective on mental illness: And the others? The alcoholic who says “Yup, I’m drinking myself to death and you can’t stop me?” I agree that it is in some sense rational. It is rational because that person has so many problems that drinking alcohol becomes more pleasant than dealing with them. Often, these problems are related to psychiatric issues – for example, many people with PTSD become alcoholics because alcohol helps them briefly forget their traumatic memories. There are many people who say they don’t

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But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you. – Matthew 5: 34

I’ve been reflecting further on this passage in Scott Alexander’s critique of my perspective on mental illness:

And the others? The alcoholic who says “Yup, I’m drinking myself to death and you can’t stop me?” I agree that it is in some sense rational. It is rational because that person has so many problems that drinking alcohol becomes more pleasant than dealing with them. Often, these problems are related to psychiatric issues – for example, many people with PTSD become alcoholics because alcohol helps them briefly forget their traumatic memories. There are many people who say they don’t want help with their drinking problem because they expect “help” to mean “take away the alcohol but give them nothing in exchange”. If “help” meant “replace the alcohol with some healthier coping mechanism that works just as well”, many of these people would take it in a heartbeat.

“Many of these people would.”  I agree.

But note: a writer as careful as Scott doesn’t say “many” when he means “most” or “all.”  Which should make you wonder: Why wouldn’t every alcoholic take Scott’s deal?

On reflection, the list of contrary motives is long.

Many alcoholics would refuse out of sheer stubbornness.

Others would spurn the offer out of pride.

Still others would keep drinking because the bottle doesn’t just help them “cope”; it gives them affirmative pleasure.

Some people would refuse because they actually enjoy upsetting the people close to them.  As in “I wouldn’t give you the satisfaction.”

If you’ve ever tried persuading any person to start making choices that seem obviously superior for them, you’ll recognize these motives. You can call such motives “diseased” if you want.  The word you’re really looking for, though, is: bad.  As in: morally bad.

I understand why working psychiatrists like Scott avoid such talk.  Telling people, “You’re morally bad!” rarely opens a fruitful conversation.  Yet many unproductive statements are, in fact, true.

You could reply, “Stubborn alcoholics aren’t morally bad.  You’re morally bad for judging them.”  Needless to say, you’d be in good company.  After all, Jesus preached radical forgiveness in his Sermon on the Mount.

What’s deceptive about psychiatry, though, is it masks this extreme moral position in the language of medicine.  If psychiatrists merely preached, “Forgive heavy drinkers no matter what they do, and no matter how many times they do it,” who would listen?  Yet when they solemnly remind us, “Alcoholism is a disease like any other,” the world listens.

Questions for Scott: To what extent do you personally embrace the ethic of radical forgiveness?  If you do, to what extent is psychiatric language a rhetorical tactic rather than a neutral description of human behavior?

Psychiatry and Radical Forgiveness

Bryan Caplan
Bryan Caplan is Professor of Economics at George Mason University and Senior Scholar at the Mercatus Center. He has published in the New York Times, the Washington Post, the Wall Street Journal, the American Economic Review, the Economic Journal, the Journal of Law and Economics, and Intelligence, and has appeared on 20/20, FoxNews, and C-SPAN. Bryan Caplan blogs on EconLog.

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