You can persuade yourself into the symptomatology of a hundred diseases merely by reading a medical textbook; how much easier is it to do so when the symptoms are explicitly in the mind!

The expansion of psychiatric diagnoses leads paradoxically and simultaneously to overtreatment and under-treatment. The genuinely disturbed get short shrift: those with chronic schizophrenia, which seems most likely to me to be a genuine pathological malfunction of the brain, are left to molder in the doorways, streets, and stations of large cities, while untold millions have their fluctuating preoccupations attended to with the kind of attention that an overconcerned mother gives her spoiled child – with more or less the same results.

Considering all diagnosis equal

There is a demand for parity of thought, feeling, and judgment (or lack of it) when we meet or consider people with psychological disturbances. They are never to be thought of as responsible for their own condition or situation, but rather as victims of something exterior to themselves.This determination not to judge is compounded of three intertwined things: <ol><li>fear</li><li>a wish</li><li> hope</li></ol>

Why there is demand for equality of diagnosis?

Self-esteem is a concept that belongs to the psychology of the Real Me. The Real Me is someone who is inherently good and admirable, by nature good and inside every bad man there’s a good one trying to get out.The Real Me may have no connection to the Me as it acts in the world and appears to others. It is a secret and beautiful garden often accessible only by means of psychology.Real Me is admirable evasion – it allows us to do as we please without having to think badly of ourselves, to experience genuine remorse, or even to examine ourselves honestly.

Psychology of the Real Me

I do not mean here in any way to decry neurophysiology and its accomplishments. But what begins as a scientific advance quickly ends as an urban myth.It is now not uncommon to overhear people talking of their own brain chemistry.They speak with the strange authority of the religiously certain, the imbalance of their brain chemistry being as evident a fact to them.

Arcane science of neurochemistry

As is almost always the way with converts to anything, believers in CBT come wildly to overestimate its scope, and regard it as a panacea for most, if not all, the disgruntlements of Mankind. Misery has a tendency to rise to meet the means available for its alleviation.It is part of the very foundation of CBT that this is what people commonly do. Therefore, the effectiveness of CBT is perfectly compatible with the spread in the population of the very condition for which it is supposedly the effective cure.

... but it is overrated

First, because of the development of new antidepressants, the famous – or infamous – SSRIS mentioned above.Second, the very word unhappy has been all but eliminated from common parlance. If someone admits to unhappiness, it might be that his own ill-conduct, foolish or immoral, has contributed to it; but if he is depressed he is the victim of an illness, of something which, metaphysically speaking, has fallen from the sky.

Why is still neurochemical disbalance so popular?

Changes in brain scans have been found in drug addicts so the National Institute on Drug Abuse has drawn the conclusion that drug addiction is a chronic relapsing brain disease and nothing else.But the brains of London taxi drivers, for example, have been shown to differ from those of the non-taxi-driving inhabitants of London because those drivers have all mastered.This means that changes in the brain do not indicate that whatever causes them is a brain disease.

Behavior ↔ brain

The notion of self-love or self-esteem is in itself either ridiculous or repellent. No one ascribes his good character or successes in life to an adequate fund of self-esteem.Self-doubt, within reason, is something to be overcome; self-esteem is complacency elevated to an ontological plane.No sensible person thinks for a moment about whether he loves or esteems himself. To do so is inherently a form of vanity.If it were possible to have too little self-esteem, it is also possible to have too much of it but if any person has – too much or too little (or just enough) – requires a moral judgment.

Focus on the self-esteem and self-love is vanity

Effort of the social security system is even larger. There has long been a struggle to have psychological disorders treated by the system in the same way as physical illnesses, a struggle in which psychiatrists and psychologists have taken part without acknowledging that they (who see vested interests everywhere else) might themselves have a vested interest in the matter.The government agrees to it because this not only creates a new class of dependents upon itself, but allows it to minimize the rate of unemployment: for a sick person is not unemployed, he is sick.

Incentives to suffer – Social security system

We wish to appear understanding. To understand all is to forgive all; therefore, if we forgive all, we understand all. We thus put ourselves in the position of an all-merciful deity, the very deity whose existence we often are angrily to deny. Suffering of any kind, even that which would once have been deemed by most people as self-inflicted, is *ipso facto* evidence of victimhood. Our philosophy is: *I think, therefore I am*, but *He suffers, therefore he’s a victim.And only then can we maintain our pretense to universal understanding and experience the warmth of our own compassion.

2. Wish to appear understanding

Everything in human self-understanding is shouting: only the details have yet to be filled in. Soon, there will be no more puzzles and no unpleasant surprises, no agonizing dilemmas in human existence; the question of the good life will have been settled once and for all, scientifically, without the necessity of endless, unprovable metaphysical speculations. To understand all will no longer be to forgive all, for there will be nothing to forgive; everyone will behave reasonably in the first place.I don’t believe it. and I’m not sure that I would want to live in such a world if it were true.

Do we understand everything about ourselves or only think so?

This neurotransmitter reductionism, in which an over-or undersupply of a handful of biological substances in the brain supposedly accounted for all our disasters, should have been laughed out of court on commonsense grounds. The number of conditions for which the SSRI's were prescribed, some of them specially invented to fit the drug, gradually increased until it almost seemed that the whole of human misery was accounted for by errors of cerebral serotonin metabolism. Unhappy? Given to eating in binges? Shy at parties? Take Prozac, or one of its analogues.

SSRI's as panacea

Consider a person accused of a crime. To control himself and behave otherwise than he did. The assumption is that, if it can be shown that the person is neurologically deficient in self-control, he will escape punishment, since he will have been shown thereby to lack the *mens rea* necessary for a crime to have been committed at all.Actually, the logical consequences of this approach are not as liberal as often conceived, and are precisely illiberal, because they Remove moral responsibility from the law, and what you are left with is technical administration.

Paradox of responsibility

Perhaps there is a prevalence of certain conditions, such as obsessive-compulsive disorder, that is “natural” and cannot be reduced, but one cannot help but wonder whether many conditions (for example, various kinds of eating disorders) spread in proportion as they are known about.The Werther effect, after all, is well known: it was named for an epidemic of suicides by young men all round Europe after the publication of Goethe’s *The Sorrows of Young Werther*, in which the romantic hero kills himself because of impossible love.

From knowledgable to sick

If complex behavior such as addiction is a chronic and relapsing brain disease, no one should be surprised if addicts awaited their salvation by means of a magic bullet. But to imply that there is or could be such a magic bullet is, in effect, to compound the problem for addicts; it is just what they want to hear so that they can continue their self-destruction with a clear conscience and that self-righteousness that comes nowadays with the awareness of being a victim – the victim of a chronic, relapsing brain disease, as revealed by brain scans.

Counterproductive label

That is why it is not uncommon nowadays to hear someone say “I’m learning to forgive myself” (usually under the guidance of a therapist), as if such learning were hard and valuable work.According to more traditional ways of thinking, learning to forgive oneself is learning how to act without scruple, how to forge ahead without regard to other people, how – in effect – to become a psychopath.Whatever else you may do, you must always love and esteem yourself, otherwise you are doomed to a life of sterile self-denigration.

We try to make it easy for ourselves

"Virtue is not manifested in one’s behavior, always so difficult and tedious to control, but in one’s attitude toward victims. This view of virtue is both sentimental and unfeeling, cloying and brutal: for it implies that those who are not victims are not worthy of our sympathy or understanding, only of our denunciation."

We fear to judge because, in judging, we may blame those who are truly not blameworthy. We fear to appear censorious, as if there were nothing between complete and consistent moral latitudinarianism and Dickensian hypocrisy. Since the latter is now the only sin, it is best to make no judgment at all.By not judging, we avoid the possibility of error – at least the error of blaming the victim – though not that of exculpating the perpetrator.

1. Fear of misjudgement

The purpose of such all-encompassing understanding, other than moral self-aggrandizement, is the evasion of one’s own moral responsibility; for it follows that if no one is to be judged (because to judge is to judge harshly), then we can hope that one is not oneself to be judged – not even by oneself. This, in effect, means carte blanche to do as you feel like, because all behavior is put on an equal moral footing.

3. Hope not to be judged

although Freud was personally conservative in his manner and morality, except where his incestuous adultery with his sister-in-law was concerned, his effect, if not his intention, was to loosen Man’s sense of responsibility for his own actions.Freud powerfully alienated men from their own consciousness by claiming that what went on in their conscious minds was but a shadow play, and that the real action lay deep beneath it, all undiscovered (and undiscoverable) without many hours of talking about oneself in the presence of an analyst.

Freud started it

The popularity of brain chemistry as the explanation of all human behavior began in the 1980s with the extremely successful marketing of supposedly antidepressant, called selective serotonin reuptake inhibitors (SSRI's).They were undoubtedly effective,  but they had a number of troublesome side effects, not least among them a propensity to send patients to the opposite end of the mood spectrum, where they became manic.Though unproved and now discarded by almost everyone (at least as to the biochemical substance supposedly disordered), helped “to establish a biochemical basis for depression.”

Neurochemical imbalance is not entirely valid

I do not wish to deny that psychologists have done many intriguing and ingenious experiments. But the overall effect of psychological thought on human culture and society, I contend, has been overwhelmingly negative because it gives the false impression of greatly increased human self-understanding where none has been achieved, it encourages the evasion of responsibility by turning subjects into objects where it supposedly takes account of or interests itself in subjective experience, and it makes shallow the human character because it discourages genuine self-examination and self-knowledge.

Net impact of psychology

There are other ways to promote psychological fragility – by rewarding it. Plaintiffs have a vested interest in maximizing the harm that they have suffered from an accident of some kind. Psychological consequences of injury are both easy to fake and difficult to disprove.And, since the law’s delay is long, the person who fakes neurosis for long enough actually becomes neurotic.Since most people do not like to think of themselves as frauds, the symptoms continue even after the case is settled, so they do not come out as frauds.

Incentives to suffer – courts

The absurdity of treating humans as glorified Pavlov’s dogs having become evident and inescapable, a new element was then added to the recipe: *thought*. “Cognitive-behavioral therapy seeks to improve functioning and emotional well-being by identifying the beliefs, feelings and behaviors associated with psychological disturbance, and revising them through critical analysis and experiential exploration to be consistent with desired outcomes and positive life goals.”For those with obsessions and compulsions or mildly depressive feelings, CBT works.

Cognitive behavioral therapy (CBT) works

The author of Admirable Evasions is Theodore Dalrymple, the pen name of Anthony Daniels, a British cultural critic, psychiatrist, and former prison doctor. He is best known for his sharp critiques of modern culture, ideology, and the psychological worldview that he argues has replaced traditional moral thinking.

In Admirable Evasions, Theodore Dalrymple explains why human self-understanding has not been bettered by the false promises of the different schools of psychological thought. Most psychological explanations of human behavior are not only ludicrously inadequate oversimplifications, argues Dalrymple, they are socially harmful in that they allow those who believe in them to evade personal responsibility for their actions and to put the blame on a multitude of scapegoats: on their childhood, their genes, their neurochemistry, even on evolutionary pressures. Dalrymple reveals how the fashionable schools of psychoanalysis, behaviorism, modern neuroscience, and evolutionary psychology all prevent the kind of honest self-examination that is necessary to the formation of human character. Instead, they promote self-obsession without self-examination, and the gross overuse of medicines that affect the mind. Admirable Evasions also considers metaphysical objections to the assumptions of psychology, and suggests that literature is a far more illuminating window into the human condition than psychology could ever hope to be.

JEROME K. JEROME, THREE MEN IN A BOAT

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