Anxiety and the Condemnation of Foolish Societies

The trumping of psychiatry by philosophy and religion

The DSM defines the mental illness of general anxiety disorder as “excessive worry” that occurs over a long time, that’s difficult to control, that negatively impacts the person’s social functioning, and that isn’t caused by other illnesses or physiological conditions such as drug use.

One factor that’s not addressed directly by this definition is whether the anxiety must be irrational, but this seems covered by the reference to the anxiety’s excessiveness. Thus, a fear of healthy tree branches snapping off and falling on your head would be excessive in part because the fear would be irrational.

Are Religious Fears Mentally Disordered?

Notice, then, that a religious fear about demons or divine punishment would be arguably irrational, especially after the Scientific Revolution and the rise of modern philosophy. Yet that fear wouldn’t count as a mental disorder if the anxiety has been absorbed by the culture so that the fear doesn’t impede the person’s social functioning.

A person might even make a living promoting such fears, as a televangelist for example, and there would be no question of his or her having a mental illness on that basis. Or this anxious person might rationalize the fears to get on with her daily work, pushing off to the afterlife the date when the unlikely dreaded events are expected to occur. Thus, she might be a doctor or a lawyer, married with children, and happy for the most part despite her irrational fears, and there would be no psychiatric reason to suggest that those fears would be mentally disordered.

This indicates, however, that were a religious person to take those fears more seriously, and were those fears new and idiosyncratic, as in the case of someone starting a religion, that founder would arguably be mentally ill.

Thus, we can envision a farcical scenario in which a prophet rails against society, proclaiming that God will destroy everyone unless they perform certain rituals and utter some magic words. This prophet is charismatic, and he attracts a large following. Decades later, the cult develops into a religious movement, allowing the followers to be accepted into the rest of society as upstanding members. One such member of the new religion becomes a psychiatrist who sees the elderly founder of his religion as a patient. That founder is still ranting and raving, in the throes of an uncompromising religious vision, whereas the psychiatrist has learned to sublimate or to secularize the very same religious beliefs and fears. Thus, the follower pronounces her religion’s founder to be mentally disordered.

Indeed, this snake-eating-its-own-tail scenario should strike you as familiar since it’s close to the founding narrative of Christianity. In the gospel narratives Jesus withdrew from society and condemned the well-adjusted people’s social functions, based on a radical interpretation of Judaism.

Jesus’s criticisms were seen as irrational and blasphemous at the time, so his society condemned him in turn: not just the Roman establishment that executed him, but the Jewish leaders whose religion was founded by comparable prophets and outcasts, considered him a crazy nuisance. According to Jewish tradition, Moses, for example, renounced Egyptian society, threatened Egypt with plagues from heaven, and drove the Jews from Egypt into the desert where they wandered for decades.

The Meta-Judgment of Society

What this take on the psychiatric treatment of religion suggests is the availability of a meta-perspective for judging social functions themselves to be disordered on philosophical, religious, or some such grounds. The professional talk of mental disorders presupposes the legitimacy of social norms, because one condition of having a mental disorder is that the person should have difficulty fitting into society and performing her social routines. If her mental condition prevents her from doing her job or from caring for her children, she’s liable to be assessed as having a mental disorder that requires medical attention.

Most of us don’t often think for ourselves. We conform, going with the flow of social media and following conventional wisdom to try to be happy in the commonly accepted ways. Our thoughts and behaviours reflect collective expectations, so rather than pondering the merits of our culture or our ethos, we presuppose their validity, perhaps even their supremacy.

Yet for millennia there’s been a tradition of at least a minority of people intentionally dropping out of their society. These have been ascetics, prophets, philosophers, artists, misfits, and drifters who were repelled by the social norms. Sometimes the minority is part of a groundswell which can lead to a political revolution. But more often these critics are outcasts, marginalized and dismissed by the majority.

In some cases, the critics are only rationalizing their failure to fit in, having no sound reasons to complain about the nature of their society. In others, when the criticisms derive from profound insights into how social relationships should work, the objections may be justified.

Assuming, then, there’s this two-way stream of criticisms, of the established majority by the ostracised minority, and of that minority by those who adjust better to social norms, clearly the medical diagnosis can function as part of society’s immune system, as it were, which blocks the maladjusted people’s critiques. Infamously, psychiatrists used to medicalize homosexuality and femininity. More recently, depression and anxiety have become the mainstays.

Before the rise of modern medicine, religions used to be responsible for managing these outsiders. In animistic tribes, the oddballs might have been candidates for their shamans. In theocratic civilizations with a priesthood, these pesky critics would often have been persecuted or executed as heretics or witches.

The scientific approach, though, is to speak not of moral failings but of “psychological dysfunctions” or, at worst, of “cognitive distortions,” as in the case of cognitive behavioural therapy. This therapist helps the patient find coping strategies for solving her life’s challenges and improving her emotional regulation.

There’s no overt moralizing in such scientistic treatments, but an unhealthy dose of politically correct bureaucratese to disguise the underlying value judgments that scientists have no business making. Indeed, the therapists take no responsibility for condemning certain thoughts or behaviours as bad but inherit those judgments from the social norms that set out the “functions” or roles we’re supposed to play. Again, if you have trouble playing those roles, you’re in danger of being condemned implicitly by the majority, which is made explicit by the medical professional who administers treatment.

Of course, such therapies likely work at modifying behaviour — as did locking a heretic in a dungeon or burning her at the stake. At least, both approaches suppress or eliminate the problem of minority dissent. But the question remains whether the dissent is warranted. Science won’t be decisive in addressing that question because science establishes the facts, not the quality of our values.

Environmentalism and Social Progress

Take, for example, the threat that environmentalism poses to Western social norms. This threat traces back at least to the civil rights and socialist movements of the 1960s. The hippies condemned mainstream materialistic culture for violating ideals made plain by visionary experience deriving from mystical religion or from the ingestion of psychoactive drugs. Before the hippies, the beat intellectuals launched the same criticisms in poetry and literature, advocating the withdrawal from the superficially progressive societies.

According to climate science, the facts are dire: our progressive way of life which is meant to maximize human happiness is having the opposite impact in the long term, by overpopulating the planet with meat-eaters who require inhuman factory farms that exacerbate global warming. Moreover, our commercial operations threaten ecosystems and extinguish or endanger many species needed to stabilize the food chains, such as sharks and bees.

The awkward question for psychotherapists is whether an appreciation of these harms should cause general anxiety. Why shouldn’t we be anxious about our collective arrogance and foolishness and about the high cost of our amenities that improve our living standards only by shifting the manufacturing and recycling burdens to the Third World or increasingly to machines that will put most people out of work, and by squandering the unrenewable resources?

Again, that anxiety had its heyday in the 1960s, but consumer society coopted the malcontents, as that society periodically coopted rebellious rock music. That paradox led Nirvana singer Kurt Cobain to kill himself. Most hippies sold out their visionary counterculture, stopped taking drugs and got jobs. What else could they have done? The afterglow wears off, as it did after Woodstock and as it did in early Christianity when Jesus never returned to usher in God’s final judgment and when the Christian movement had to face extinction or to grow up and accept Rome’s imperial patronage.

Today, governments have difficulty convincing the public to take the threat of global warming seriously enough to solve the problem and to prevent catastrophe. One reason is that our jadedness is based on our familiarity with those historical co-optations. We’ve been through many periods of doomsaying, and mass society marches on, ultimately in a progressive direction; after all, we’d all rather live in the twenty-first century than in the twelfth.

The Environmentalist’s Anxiety

Suppose, though, someone decided to take environmentalism to heart, someone like young Swedish activist Greta Thunberg or an ecoterrorist, as in the 2017 movie “First Reformed.” Suppose this activist were so repulsed by the hidden or long-term effects of our so-called progress that she declines to participate in that delusory enterprise of self-destruction. Not only does she rebel in various ways, but she suffers from anxiety.

Now, that environmentalist anxiety would be rational since it would be based on hard evidence and scientific forecasts — unlike religious fears about the supernatural that are commonplace and accepted as normal by the mental health community. But the environmentalist’s anxiety would impede her ability to adapt to social norms. Indeed, this anxiety would result from her explicit condemnation of those norms.

So would this environmentalist be mentally disordered? Of course, Thunberg’s critics from the disingenuous right accused her of being mentally ill. Indeed, Thunberg admitted she has Asperger’s, an inherited difficulty reading social cues. But that’s precisely the type of impediment that can drive someone to that meta-perspective on society. If you already find social interaction difficult, chances are you might find yourself examining society objectively, in which case if you discover your society is, say, grossly unwise, you might condemn the lot of us.

Here, then, is the larger context of mental disorders like general anxiety. If you’re well-adjusted and happy with the status quo, you won’t think twice about any of this, but will presuppose social standards and defer to the therapists who defer in turn to what’s popular (to the prevailing social norms and functions).

However, if you’re idealistic, skeptical, artistic, sensitive, cynical, or objective, you may not accept as final the establishment’s judgment of the dysfunctional minority, at least not when the discontent is arguably rational or seemingly profound. You may suspect that society isn’t immune from criticism, that the greatest critics and drop-outs have in fact been worshipped even centuries afterward as revolutionary “sons of God.” You’ll balance society’s estimation of its implicit or explicit critics with an appreciation of the outcast’s meta-judgment of so-called civility.