Barry Mauer: The United States could use a Therapist General

Lately I’ve been imagining the creation of a new office in the executive branch: a Therapist General to advise the president and the nation about psychological problems affecting U.S. citizens, groups and institutions. The person assuming the role could issue an annual report about the state of the nation’s mental health, investigate and report on the likely psychological costs and benefits of proposed laws, and issue recommendations for therapies to improve the nation’s psychological health.

The psychological profession – including psychologists, psychiatrists, therapists, clinical social workers, and mental health counselors – treats individual citizens and sometimes families, but it does not treat groups and institutions. Consequently, policy deliberations rarely, if ever, include discussions about the psychological state of institutions and of collectivities, or groups of people. Yet public policy undoubtedly affects the psychological health of groups.

For example, historians have pointed to evidence that FHA loans and federal highway projects from the 1930s to the 1970s supported the growth of segregated suburbs while devastating minority areas.

New York clinical psychiatrist and public health specialist Mindy Thompson Fullilove concluded that the actions of those federal organizations produced “root shock,” a state of profound alienation and collective trauma. A Therapist General, had one been established at the time, could have alerted policy makers and the public to the likely outcomes of the policies. Of course, those dire outcomes for minorities may also have been intended, in which case the Therapist General would have reported about the pathologies animating the policymakers.

A Therapist General, should such a post be established, ought to pay attention to the U.S. economic system, which is designed to turn every citizen into an addict – a consumer addict, that is. Consumerism drives our economic system and there is no more reliable consumer than an addict. Addicts will do anything to get their “drug,” whether that drug is heroin, cocaine, nicotine, alcohol, fast food, 32-ounce soft drinks, digital devices, $100 skin creams, status cars, sex, guns, gambling, or online shopping. Addicts pursue their drug regardless of the consequences to themselves and to others. Many marketers aim to make addicts of their customers and that’s why they market products such as cigarettes and sugary foods that are addictive and harmful rather than healthy.

A Therapist General might also provide briefs to the U.S. Supreme Court. In 2010, the court decided the Citizens United v. Federal Elections Commission case. The Supreme Court’s decision allowed corporations to spend unlimited amounts of money on political campaigns and to do so in secret. The justices endorsed the logic that corporations have the rights of people. But what kind of a person is a corporation?

The documentary film titled “The Corporation,” directed by Mark Achbar and Jennifer Abbott and released in 2003, makes a compelling case that if the corporation is indeed a person, that person is a psychopath. The publicly traded corporation, as required by federal law, must put maximizing profit ahead of all other considerations. Thus:

It [the corporation] is self-interested, inherently amoral, callous and deceitful; it breaches social and legal standards to get its way; it does not suffer from guilt, yet it can mimic the human qualities of empathy, caring and altruism.

The federal government imposes constraints on corporations, and for good reason. Even with constraints, corporations violate the law in multiple ways: by committing the financial fraud that led to the global economic collapse of 2008 and by committing environmental crimes (the federal government collects billions of dollars in fines for corporate violations of environmental regulations).

The Supreme Court justices who decided in favor of Citizens United must have missed the movie. These justices removed an important part of the remaining limits that keep some of the most powerful people in our society minimally in check. Instead of constraint, supervision, and treatment – all reasonable options for dealing with people who need to be under the microscope – the Supreme Court decision allows corporations to do as they please. If it were shown that the Supreme Court was aware of the dire consequences of its actions, then the Therapist General ought to investigate and report on its pathologies.

The psychological profession has many wonderful tools for helping individual citizens and their families, but it barely recognizes psychopathy in larger groups.

Lawrie Reznek, a professor of psychiatry at the University of Toronto, argues that groups can have dangerous and destructive personalities. He points out that when a psychotic person lures another person into his or her delusion, it results in the clinical condition known as folie a deux, which is a form of madness shared by two people.

Reznek complains, however, that psychiatry has no diagnostic category for groups of people larger than two, despite the fact that some psychotics pull more than one person into their delusions. Remember the groups led by Charles Manson (Manson Family), Jim Jones (Peoples Temple), Marshall Applewhite (Heaven’s Gate), and David Koresh (Branch Davidians)? Those groups were larger than two people and they were clearly delusional and dangerous.

Reznek offers the term folie a culte to characterize groups of people in thrall to psychotic delusions. A delusion, in Reznek’s words, “is a belief, held with conviction, in the face of overwhelming contrary evidence.” Reznek makes an excellent case that psychiatry should offer treatment to delusional groups; but even though such treatment is desperately needed, it is near impossible to provide because of its sheer scope. Huge groups of Americans are in the throes of dangerous delusions.

How do we explain the fact that some of our political leaders reject or deny the scientific consensus on climate change and that many of their followers think that warnings about anthropogenic climate change result from a conspiracy? We have already observed what happens when such delusions are left untreated. We end up with a dysfunctional political discourse, a reckless disregard for human health and well-being, and attacks on science and intellectualism; none of those outcomes is good for our society’s well-being.

Why do we have so much dysfunction, delusion and misery in our society?

Freud – and other good mental-health professionals – would say that our denial, or our refusal to see the truth about the costs of our behaviors and experience actual grief about our condition, keeps us sick. Only by understanding and accepting the truth about our behaviors and their consequences can we hope to change ourselves for the better.

You must realize by now that I have no serious expectation that a Therapist General will ever become an executive office in the United States. But I hope that citizens will do this work themselves.

Every level of our country – city, state, region, and nation – should have citizen task forces investigating and reporting on the mental health status of our people, groups and institutions. Ordinary citizens can learn to be witnesses to the mental-health crises plaguing the nation, and they can learn to become a force for healthy changes.

Barry Mauer is an associate professor in the UCF Department of English. He can be reached at [email protected]. Column courtesy of Context Florida.