23 May

Diagnosing Delinquency

Historian David Starkey has opined in a speech to a Headmasters’ Conference that the moribund state of British education is our ‘greatest national crisis’.  The ‘missing ingredient’, he argued, ‘is simply what we call discipline’, which is all too often substituted by an ‘indulgence of individual misbehaviour’.  But why this indulgence?  Could it be because misbehaviour – not only of children but of adults too – is no longer seen as misbehaviour at all?

The school cane has been replaced by the psychiatrist’s couch, upon which it seems youngsters are frequently diagnosed with one of an ever growing number of ‘disorders’.  One does not have to be a medical expert to raise objections about some of these ‘diseases’.  The World Health Organisation’s (WHO) lists ‘Oppositional Defiant Disorder’ (ODD), for example, as a condition ‘characterized by markedly defiant, disobedient, disruptive behaviour’.  Another diagnostic manual lists some symptoms by which the unfortunate sufferer of ODD can be identified:

  • often loses temper
  • often argues with adults
  • often actively defies or refuses to comply with adults’ requests or rules
  • often deliberately annoys people
  • often blames others for his or her mistakes or misbehaviour
  • is often touchy or easily annoyed by others

No doubt this list will sound familiar to many parents with teenage sons!  The WHO further gives the game away when describing a disease known as ‘Nonorganic Encopresis’ which is characterised by ‘repeated, voluntary or involuntary passage of faeces . . . in places not appropriate for that purpose in the individual’s own sociocultural setting’.  The emphasis is mine for, whilst involuntary incontinence is an embarrassing problem deserving of medical assistance, a voluntarily emptying of one’s bowels in inappropriate settings is surely a moral problem – a bad habit which children ought to be encouraged to overcome.  Behaviour which is voluntary – i.e., proceeding from the will as the result of a deliberate choice – is entirely outside the scope of medical science, and always will be, as the human will is an immaterial faculty.

This transformation of morality into medicine is not confined to the sulks and tantrums of youth, but embraces also the defects of adults.  Some therapists are now spilling much ink over a frightening new disease known as ‘Internet Addiction Disorder’, which can apparently be eased by cognitive behavioural therapy.  What, you ask, are the symptoms of this tragic malady?  I shall leave the reader to guess.

It is worth considering whether some recent philosophical errors have not contributed to this ‘medicalisation of misbehaviour’, as one BBC Radio program has named the phenomenon.  One is a reductionist materialism which attempts to reduce reality solely to the level of phenomena which can be observed by the senses.  But perhaps the key error we need to grasp in order to understand the current trend for labelling as illnesses what were once considered moral faults or defects of character is determinism – the denial of free will – which follows naturally from reductionist materialism. For, if the will is immaterial, and reality reduced to what is material, it follows that the experience of free choice in one’s actions is an illusion, and therefore there is no genuine difference between deliberate behaviour and mere physical action.  The shaking hand of the man with Parkinson’s Disease is to be placed in the same category as the teenage hooligan throwing chairs and tables around the classroom, both being simply consequences of chemicals sloshing around inside the brain.  Every facet of human life is gradually brought within the domain of one or other of the material sciences, with moral problems morphing into psychiatric conditions.

Freud's famous sofa

We inhabit, moreover, a culture which finds compassion very difficult.  Whilst we sympathise with those suffering from a disease, the thought that we might – without condoning their behaviour – have compassion upon moral delinquents, and that this compassion could be based on our awareness of the fact that we share the same human nature and are susceptible to making the same mistakes, is not very popular.  It is easier for libidinous celebrities to claim they are ‘suffering’ from ‘sex addiction’ than to admit that they lack self-control, because people will pity them for the former but despise them for the latter.

The material sciences, properly used, can contribute to our understanding of certain aspects of human behaviour, and we would be wrong to reject therapy and the like as merely ‘touchy feely’ rubbish, as it can play an important role in moral reformation for some people.  Nevertheless, we ought to be suspicious of alleged ‘diseases’ without physiological symptoms and characterised solely by inappropriate behaviour, particularly when – as is all too often the case with childhood ‘disorders’ – the principal ‘treatment’ on offer is drugs.

Although turning morality into medicine apparently solves the awkward problem of taking responsibility for our faults, it also takes away the joy of moral improvement, and the energy that this process imparts to the whole of society.  What would the world be missing out on if St. Monica, instead of praying for St. Augustine’s moral and religious conversion, asked the doctor to prescribe some drugs to calm him down?  Though our behaviour is influenced by external factors, some of which may usefully be studied by science, if freedom of the will remains – as it surely does in all but rare cases – then we have a problem which is essentially moral rather than medical.  If there is free will, even substantially diminished, there is freedom to do the right thing – not to have that drink I know I should not have; not to throw a chair at my teacher, no matter what factors in my temperament and upbringing may predispose me in a peculiar way to throwing chairs.

So, dear reader, when the doctor breaks the news to you that little Johnny is suffering from Nonorganic Encopresis, consider if the cure might not in fact lie in good old-fashioned potty training.

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(photo of pills: © Sponge; photo of Freud’s sofa: © Konstantin Binder)

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