October 19, 2002

Therapy for Saddam and Islamo-Fascists?

     When I began my psychiatric residency training I was assigned a patient who was supposed to be in the grip of violent, paranoid psychotic delusions. Yet when I met him he spoke quite rationally and intelligently about his life. He explained in a quite logical way how, through a series of misunderstandings, he landed in a psychiatric ward. He seemed quite friendly and I quickly dismissed from my mind his potential for psychotic rage. He even offered to discuss with me his theory that the earth was really the center of the universe. When I raised an eyebrow he became a little less jovial but said he could prove it mathematically, if I wished to learn. Instead of recognizing his delusional conviction that he was the center of the universe, I empathically tried to help him see the mathematical errors he had made. I praised his mathematical skill while pointing out his mistakes, hoping we could arrive at a shared view of reality. The more I reasoned with him, the angrier he became--and the more anxious I became. Finally I realized that my empathy was making things worse, that whatever the 'root causes' of his anger--and there were many--I had best defend myself before he sought to prove the correctness of his views by attempting to kill me. I signalled two of the heftier aides on the ward and we were able to subdue him.

     It is a natural tendency of the human mind to wish to deny the presence of danger, to explain it away. This is especially true when faced with the possibility that one's very life is in danger. It is not surprising that entire societies seek to avoid the dangers posed by madmen like Hitler, Stalin, Pol Pot and Saddam and instead wish to assume their grievances are rational and can be addressed through understanding. In our therapeutic culture this takes the form of the conviction that bad behavior is always a reaction to failures of nurturing and empathy. However as Mark Steyn has pointed out, we are dealing with not just isolated madmen, but a vast culture gripped by paranoid delusions. There is abundant evidence that our enemies truly believe that slaughtering infidels can restore an Islamic paradise. These utopian fanatics repeat over and over paranoid fantasies about Jews, Israel and the United States as they applaud the cowardly slaughter of 'infidels'. As dangers multiply, the temptation to evade reality increases. The more the evidence mounts, the louder grow the voices of appeasement. Victor Hanson writes "Appeasement wins applause for its ethical posturing and non-belligerency; and even when the corpses later pile up it rarely earns the disgust it deserves for getting thousands killed. In contrast, preemption is always equated with blood lust; and even when it saves thousands, critics sigh that in retrospect there must have been a better way." Not only do we derive ethical pleasure from non-belligerency, but we share in the assumptions of the therapeutic culture.
    The therapeutic approach to deluded cultures makes us feel good about ourselves. After all, by reasoning with the insane, we are reaffirming our civilized, superior natures- our mental health. We feel healthy for rising above such base emotions as anger. Were we to resort to violence how could we flatter ourselves as being emotionally and morally superior? Yet unless we are willing to employ necessary force to crush our enemies, unless we are willing to acknowledge our own capacity for rage, we will remain vulnerable and will pay in rivers of our own blood.

     And perhaps you're wondering what happened to that delusional patient? Once he recognized that we possessed the overwhelming force required to keep him from hurting anyone, he began the long process of adjusting to his own failings and limitations. When his megalomaniacal mathematics gave way to ordinary calculation he began the long road to rejoining the community of his fellow limited human beings.

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