Paging Doctor Obama

Well, I swore off writing about psychiatry. (How many times can you point out the obvious?) Then I swore off writing about David Brooks. (I really truly began to feel sorry for the big lug–not for having to suffer my yapping around his ankles, but for having to be David Brooks.) Then my town decided not to lynch me. Some people seem to have forgiven me for introducing sex offenders into their midst. And I them. Wendy, the avenging mom who led the charge, is now a member of the zoning commission. She’s not quite my new BFF, but I just appointed her to lead an important subcommittee. And I personally invited Pete the Farrier to come to a hearing and deliver his stump speech about the Constitution and the evils of regulation and high taxes and people just trying to survive, all to help us decide whether or not to limit backyard pigkeepers to five or fewer pigs. Which he did, eloquently as usual, and then we shared a cigarette out by his pickup, not exactly  postcoital, but a cigarette nonetheless.

So all that swearing off and kumbaya left me with nothing to write about. Which is fine. I did write a pretty blistering letter to the head of the state technical school system, explaining why we were withdrawing my son from their school. She had one of her assistant wardens call me a couple weeks later to assure me that my letter “had not fallen on deaf ears,” but I think he was kidding. Or protesting too much. The withdrawal has been mostly a good thing. Turns out the fundamentalist Christians among us have contributed more to our society than the occasional Planned Parenthood shooting. In their zeal to protect their children from knowledge, they’ve created a homeschooling infrastructure, one that includes easy online access, reasonable fees, and a bona fide, fully accredited high school diploma. It also turns out that the curriculum is not entirely dedicated to teaching ignorance. The science section (earth science) did not insist that the earth was created in 4004 BC and that dinosaurs romped with  Pebbles and Bam-Bam, and in English he’s reading Midsummer Night’s Dream. He’s been plugging away at it (at other people’s homes, thank the Christian God), and I think he will be a high school graduate in a few weeks, thus sparing him more than a year of spending his days doing what he’s not good at and fighting with us about it. We’ll send him to welding school, get him a commercial driver’s license, maybe buy him a little more machinist training, and then it’s off into the world with him. Meantime, he’s putting a Ford V-8 into a Chevy S-10. Last night he painted the transmission. He’s around home a little too much for his misanthrope father, but we do sometimes happily gearhead out together, and removing the stress of school has really improved our home life. I will never forgive the public school system for the damage and suffering it inflicted upon us, nearly all of it unnecessary.

But that’s a topic for a different day. Today, I’m afraid I’m back to psychiatry, but only temporarily. Another thing I did this year was help someone out with a book on terrorism. And I just finished up an essay for Harper’s about religious conversion, especially of the Islamist type. Plus which I read the paper (when I can find one to buy–they’re disappearing as fast as buggy whips did). So the subject was already on my mind when Richard Friedman, the psychiatrist who writes an occasional column in the New York Times, checked in with his suggestion that in response to the Recent Unpleasantness, Barack Obama should become “our therapist-in-chief and give us all a dose of cognitive-behavioral therapy for the country.”

Now, before I get started on this, let me just say that I think Richard Friedman sounds like a really nice man, warm and humane and compassionate. He also seems unusually honest. He’s written about how the choice of which antidepressant to prescribe amounts to a flip of the coin, or when he acknowledged that the effectiveness of SSRIs does not mean depression is caused by serotonin deficiencies. I’m guessing he’s a good clinician, as many psychiatrists are. I think he understands that his profession has a limited scientific infrastructure and that he has to make the best of it. If he doesn’t go the next step and talk about how psychiatry’s power ought to be commensurate with that infrastructure–i.e., less than what it is–you can’t fault him too much for that. And he’s humble enough that he’s probably helping more people than he’s hurting, which is all that any of us in the mental health racket can hope to do. And a final caveat: Friedman is writing in an excruciatingly circumscribed forum–a <1000-word column in a daily paper. So his opportunity to get nuanced is limited, as is his time for reflection.

But even so, one wishes his critiques did not seem so inadvertent, or to put it another way, that his critical faculties were more engaged. His suggestion that Obama identify, challenge, and correct “the mistaken and distorted thoughts that generate distress” reminds me of something Freud once said: that medical school is exactly the wrong education for a psychotherapist. “It burdens [a doctor] with too much of which he can never make use,” he wrote, “and there is a danger of its diverting his interest and his whole mode of thought from the understanding of psychical phenomena.” Among the topics from which the would-be doctor is diverted is “the history of civilization,” and in its place is offered “anatomy, biology, and the study of evolution.” The same can be said of psychologist education, the doctoral programs that increasingly are dominated by the cognitive-behavioral school and thus offer the study of evolution and of the mind as a computer made out of meat. And what both educations also have in common is their almost criminal historical naivete, their failure to convey to students (who then to on to become teachers as well as clinicians) the history of their fields, the philosophical and cultural and economic events that gave rise to the understanding of human behavior which underlie their efforts to relieve our suffering.

Because what else besides naivete can explain Friedman’s suggestion that President Obama relieve our terror by putting these attacks in perspective? Perhaps he should remind us that religious terrorists, Christian and Muslim, have managed to kill fewer than 100 people in the last fifteen years, that 9/11  killed less than one-tenth of the number of people killed in car wrecks in 2001, that lightning strikes more often than terrorists, and so on. There’s always a chance that your coworker will turn out to be a religious zealot armed with a legally purchased AR-15, the kind of guy who makes sure his kid is looked after before he and his wife and slay a roomful of fellow bureaucrats, but once our attitudes are properly adjusted, we will be able to “find a way to live with this uncertainty and put it in perspective.” Chillax, dude, the therapist-in-chief should say, it’s probably not going to happen to you, so turn that frown upside down and get out there and buy some Christmas presents already. Maybe an AR-15 for the wife and Glocks for the kids.

I wish I was exaggerating, but I’m really not. (OK, I am, but deal with it.) The education Freud favored was of more than intellectual interest. It could remind clinicians of the contingency of our theories and otherwise keep us humble, fully in the grips of our negative capability, which is, I believe, the talent we should cultivate the most. A historically informed understanding of cognitive-behavioral therapy would acknowledge that it is a peculiarly American way of understanding what’s wrong with us and how it can be made right. Specifically, it can be read as an ideology of optimism. According to CBT, we are meant to be resilient, forward-looking, stable, and hopeful, and when we are not, when we are anxious and/or depressed instead, it is because of those mistaken and distorted thoughts which Friedman wants Dr. Obama to disabuse us of. CBT, in other words, hinges on is the idea that rationality should prevail, and when it does, then we will see the world as it is–a place of uncertainty, to be sure, but nothing that should put our hair on fire and really, on balance, quite a fine place to spend our three score and ten. (Unless you are depressed or anxious, in which case, hie thee to a CBT practitioner and learn how to manage that shit.)

I have all sorts of objections to this ideology, not the least of which is that it pretends not to be an ideology (and I am duty bound to point out that the presidential candidate most interested in mobilizing optimism is Donald Trump), but the one that Friedman’s column reminded me of is the one about how weak and unreliable (and, as a way to guide life, historically contingent) rationality really is. Freud knew this, of course, and it was this aspect of psychoanalysis that Aaron Beck, the founder of CBT, meant to challenge when he developed his theory–not coincidentally,  in the early 1960s, in the middle of the American Century, at a time when it sort of made sense for people to believe that pessimism was a pathology. After all, full employment, a young handsome president, rockets headed to the moon, what could possibly go wrong?

But much as I am a fan of rationality and all that it has brought with it–science, capitalism, democracy, universal human rights, the nation-state, etc.–the idea that it ought to guide our lives is a relatively new one. It’s not our genetic destiny, and it has its flaws. They’ve been noted by religious people forever, and not just Popes and Jihadis, but by sober thinkers like Robert Bellah (and, dare I say it, DAvid Brooks, who has been sober since his teen years), who remind us that rationality is what killed God and left us bereft of the agreed-upon meanings that can hold a world, not to mention an individual life, together. You want to be free to figure things out for yourself? Fine, but in return you have to accept that you’re on your own, and that little rational mind of yours, which is all you have to figure out the Big Picture, what life is supposed to be and why–it doesn’t know shit.  And the corollary: you are totally dependent on other people agreeing with you that science, capitalism, democracy, universal human rights and the nation-state represent progress, that rational is how we are meant to be. They have to share your faith, in other words. And if they don’t, well, then all bets are off. Can you say nasty, brutish, and short?

This is why people of such disparate politics, like Samuel Huntington and Christopher Hitchens, can agree that we’re in the midst of a clash of civilizations, and that we really have to win this war. (Which is an attractive idea, I have to admit, although it’s hard to know exactly whom to engage and on which battlefield.) What they have in common is their belief that the Enlightenment was a Good Thing. It’s a view to which I am sympathetic, but not enough not to see and note its pathologies: climate change, materialism,  individualism, nuclear weapons, amazon–none of which are going to be CBT’d away anytime soon; indeed to the extent that they have been glossed over in favor of feeling better, it’s been to our detriment. And surely not sympathetic enough to believe that doubling down on the Enlightenment virtues, whether through war or CBT, is really going to save the day.

Because the rot is within us. The reason a married couple with weapons and a dream can dominate our conscious minds is not only that we can all imagine ourselves in that room, or its equivalent, helplessly facing their blazing hatred. It’s that they seem to have found the weak spot in Western civilization. Or at least they stand for all the ways that irrationality can pierce the veil, all the ways that horror lurks just beyond our view. The last five hundred or so years of human history have bequeathed us much that is wonderful. But it has also given us a very unrealistic idea of how much safety we can expect. (Indeed, it seems that the generation now coming of age has come to believe it is entitled to safety in the form of shelter from anything that might disturb their psyches.) The real answer is: very little. You’re much more likely to get done in by an exploding artery in your brain than by an exploding Muslim; in fact you’re living on top of a time bomb, or, to mix metaphors shamelessly, there’s a bullet out there with your name on it, and it’s only a matter of time before it finds you, and you are fully cognizant of what that means: that your little life will soon be over. To be capable of knowing this may give rise to all sorts of fruitful endeavor, but it absolutely does not make sense. It is not rational. And whatever distress you feel about it is not the result of distorted and mistaken thoughts. To the contrary, whatever shelter you find from it is built out of them.

But I digress. Here’s what I want to say about religious terrorism. It’s terrifying in the same way that it would be terrifying if suddenly people randomly stopped driving on the right side of the road (or in the COmmonwealth, the left). It makes us realize just how dependent we are on people agreeing on basic things like the value of life, on that most fragile of human arrangements: the promise. It makes us see that when it comes to those basic things, it’s history all the way down. The guiding signs did not come from Heaven. People put them there, and not one at a time, or in  full understanding of what they were doing, which means there is no one to blame, and no originary moment to be revisited and undone. You can’t edit history. We’re stuck with it, the epiphanies and the pathologies both, the terrorists and the saints.

Not every problem has a solution. But every civilization falls.

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