Last year, the Christian philosopher Dallas Willard died. In a lecture not long before his death, he discussed skepticism. The lecture was actually entitled What is Skepticism Good For? He opened the lecture by answering his own question with admirable brevity. Skepticism, Willard said, does two good and important things: (1) It undermines claims to illegitimate authority, and (2) it stimulates inquiry.
It's been very cold at my house lately. We are the captives of a weather anomaly that pushed a polar vortex which generally hovers somewhere over Baffin Island down across the continental United States, so in addition to deep snow that has been blown by this sub-zero vortex into mountainous drifts, the roads are more suitable for Nordic skis than automobiles. We've been staying indoors quite a bit. During that time, I have been indulging in a guilty pleasure, watching Law & Order reruns on TV. It's is also a masochistic enterprise, because when I do watch them, I find myself arguing with the television in the same way I remember my father cursing newscasters that he, likewise, continued to watch in spite of how they agitated him.
One of the features of that hoary series is that it highlights and even reenacts, albeit sometimes clumsily, a number of topical social debates. In addition to debates about social issues, there are constant tensions between the police and the lawyers, as well as the lawyers and the lawyers about the relative merits - in particular situations - of two opposing moral philosophies, one essential Kantian and one utilitarian. That is, one approach emphasizes the sanctity of the law as a universal standard (There is Kant's categorical imperative), the underlying logic being if we allow one exception, then every other exception might run through the breach. The process take precedence over the consequences. The other approach is that the end - in some cases - justifies the means (consequentialism). It's the outcome (the consequence) that trumps the process.
Maybe that's one reason I watch these stories, even when there are more insidious messages at work. This essential incompatibility between a duty-ethic and a utilitarian one embodies the theme of one of my favorite books about moral philosophy, After Virtue, by Alasdair MacIntyre, who demonstrates how these two antithetical approaches that thrive side-by-side in modern society prove that we live in an age of moral incoherence . . . and MacIntyre contends that that this incoherence can only be overcome by the investment of arbitrary power in a vast bureaucratic apparatus (which Law & Order portrays in "two separate but equally important groups; the police who investigate crimes, and the district attorneys who prosecute them."
It's like a more sophisticated form of the old TV series Dragnet ("just the facts, ma'am"), with the citzenry being more or less clueless, but fortunate enough to have these professionals standing between them and chaos.
Among the insidious characteristics of these programs is this valorization of the police, in ways similar to our worship of soldiers, as the armed sentinels standing between civilization (us) and chaos (them), the consistent portrayal of political activists as deviant zanies, and - of course - the implicit conclusion that, after all, even when it doesn't work justly, this investment of arbitrary power in a vast bureaucracy is necessary and good. My own characterization of these themes as "insidious" betrays my own skepticism about the underlying assumptions. But these tropes are in turn underwritten by sub-propositions, and one of them is the portrayal of "sociopathy."
It is this notion and its portrayal that I'd like to subject to the kind of skepticism that undermines claims to illegitimate authority and stimulates inquiry.
Until 1930, there was no such thing as a sociopath. The term was invented by Karl Birnbaum in 1909, but employed in its psychopathological sense in 1930 by George Everett Partridge, who applied the term - along with others - to "the legions of deviates" who did not conform to the norms accepted by professionals in early twentieth century Massachusetts. Partridge was a proponent of eugenics, who co-authored a tome called Genetic Philosophy of Education, in which he advocated teaching "the principles of eugenics" to all students in high schools and colleges. Partridge famously concluded that Jews, as a "race," are "neurotic," and medicalized "overindulged boys" as suffering from the "Jew complex."
In 1952, the American Psychiatric Association listed "Sociopathic Personality Disturbance" in the first edition of the Diagnostic and Statistical Manual of Mental Disorders, a manual that was prepared in cooperation with the National Committee for Mental Hygiene and psychiatrists with the United States Armed Forces.
The term "personality," defined as "the combination of characteristics or qualities that form an individual's distinctive character," first appears in its proto-modern form in 1795 in France as personnalité, which hearkens to its Latin root which means roughly "the quality or fact of being a person," but which takes on the additional suggestion of what makes one person distinct from another, or possessing a "distinctive character.". With Jung in the late nineteenth and early twentieth centuries, the notion of idiosyncrasy is introduced as something innate, "the supreme realization of the innate idiosyncrasy of a living being."
This use of innate is not suggesting genetic determinism as we presently think of it, but is shorthand for saying that no one person is exactly the same as any other. The idea of genetic determinism appears concurrent with the ideas of "scientific eugenics," alongside the idea that we can "measure" something called personality. Psychoanalysts around the time of Jung and Freud were trying to develop the theoretical basis for the study of personality understood as an intrapsychic phenomena, though their frame of reference was always social, including the standards upon which normativity was based. Freud, for example, took bourgeois Atlantic culture and phallocentrism as normative, and it was against these norms that he attempted to define the figurative notions of "disturbance" or "disorder" in the realm of the intrapsychic. Others, using similar and dissimilar norms, would then invent various ways of "measuring" personality.
There were challenges mounted to the emerging paradigm of mental "hygiene," renamed "mental health," which emphasized the intrapsychic aspect of these various "disorders" and obscured the social (or intersubjective) character of human practices, which were linguistically reduced to something called "behavior," in order to produce "behavioral science," the academic discipline that would articulate the means for these theoretical measurements. Feminist psychoanalysts, like Jessica Benjamin, were among the most powerful challengers of intrapsychic hegemony; but they remain sidelined in a society that has become ever more medicalized in those ways criticized by Michel Foucault.
Foucault worked for a time in a mental hospital and became interested in the history of "madness," which he spelled out in his 1961 book, Madness and Civilization. By historicizing "mental illness," formerly understood as madness (the opposite of reason), Foucault proves that both madness and its medicalized offspring, "mental illness," are culturally contingent, and not some asocial ahistorical reality. He shows an evolution in Atlantic metropolitan society from madness as unreason, to madness as moral failure, to madness as disease.The latter shift is what he called medicalization.
For a variety of politico-economic reasons, those deemed mad between the seventeenth and nineteenth centuries were confined en masse, along with vagrants and prostitutes and others considered deviant and-or unproductive. Once confined, they became available to doctors, who by the latter eighteenth century, who were increasingly supervising these confinement facilities, and who began using confined people as experimental subjects. This process gave rise to a new episteme which defined "madness" as a medical condition which could be "cured."
During my own recent engagement with Law & Order reruns, I also read an article by Luke Bretherton in ABC Religion and Ethics, called "Drug-fueled culture of control: thinking theologically about the legalization of marijuana," an unfortunate title that leads people to assume it is an anti-drug article until they read it. In fact, it was a theological reflection on the modern episteme of the body. Drugs were just one example of how the modern way of knowing the body is manifested in action. Bretherton prefaces his critique of the modern body with:
Drugs may be used both therapeutically and in an ampliative way to enable personal presence, either through healing the body, or enhancing personal relations. For example, the use of alcohol to promote conviviality is good in the light of the end of human being as communion with God and each other. Indeed, the use of wine to foreshadow the messianic banquet lies at the heart of Jesus's actions at the wedding feast at Cana. Conversely, when drugs militate against greater personal presence and a deepening of communal relations, then a line has been crossed between proper use and abuse. The line between the use of alcohol (or cannabis) to enable conviviality and being drunk (or stoned) is drawn at the point at which alienation and the sundering of personal relations sets in. We must always ask, when someone is using alcohol (or cannabis), whether that person is more or less physically, spiritually, emotionally and rationally present to others, and if they are, at what point does the drug in use inhibit both an individual's present ability, and their future capacity, for personal presence to God and others.
If readers stop here, they think they are reading an article about the virtue of moderation. But when you plunge deeper into the article, you find that he is criticizing a Cartesian and medicalized body, a far meatier (forgive the pun) topic than the question of drug legalization (which is the utter captive of those same discourses we see in Law & Order (Kant v. Bentham, individual rights v. optimized social utility, et al).
In order to develop a critical perspective on drug use it is necessary to discern how drug use conforms to central discourses within contemporary culture. My contention is that drugs are a form of technology and used as a means to "progress" out of what is viewed as the tyrannous imposition of nature. As such, drugs are a symptom of modern, technocratic approaches to nature. In short, drugs - as a technology - are central to Western society, and the way we approach drugs is characterized by seeing them as a means by which to manipulate the body according to our will.In a much earlier blog post, I unpacked Susan Bordo's critique of Descartes, to whom the origins of the medicalized body can in many ways be traced.
The use of drugs as a technology by which we make ourselves free becomes especially apparent when we look at the anxieties surrounding the spectral figure of the "addict." The state of being an addict - whether of heroin or nicotine or caffeine - is feared and socially proscribed because it is seen as being out of control, dependent on something, in a state wherein the body is not subject to the will. To be dependent on a drug is to deny the modern conception of freedom by making oneself subject to necessity. Such dependence constitutes a betrayal of deeply held modern beliefs about freedom and a retrenchment to barbarity.
Descartes separated mind from body in a decisive way. He called the two realms res cogitans, the mind, and res externa, the external. In his time, this is a tectonic discontinuity.
For the first time, the self - that is, the mind - was seen as something separate from the world, even one's own body. For the first time, we were conceived of as in a permanent state of voyeurism - peering out the window at what was going on outside. We became watchers instead of participants. The mind became the subject. All else became objects. We were ghosts in a machine.
It is this concept of the body, as subject to machinic correction, a thing to be optimized, that is at the heart of medicalization. This process corresponded to the centralization of society and the expansion of social control from center to margin, a development that accompanied the evolution of the modern nation-state. Where in earlier vernacular cultures the crazy person or the person who was distinct in other ways was simply a feature of the local society. X talked aloud to her self and Y was a drunk and Z reported peculiar dreams. In societies where centralized control was being expanded and consolidated, deviance was generalized and categorized and it was seen as a threat to order, to the "health" of the body politic, and so it was quarantined. Crazy people and drunks and debtors and scofflaws were segregated from society by incarceration.
And so, as the doctors gained access to large numbers of incarcerated people upon which to conduct their experiments, the doctors themselves became responsible for their categorization. And let's be careful not to retroject our notion of doctors as our scientific priests back onto the physicians of old. These men killed far more than they ever cured (and medicine now creates as many problems as it amelioriates, but that is another story).
Not long after these categories had been cooked up by the medical profession, a wave of immigrants landed in the United States from Southern Europe, and those ways in which they deviated from established Anglo-Saxon and Germanic norms was instantly pathologized. That pathologization corresponded to new theories of eugenics, and as a result, many of these new arrivals were committed to institutions, experimented upon, and involuntarily sterilized. By the time G.E. Partridge penned his theory of sociopathy, African Americans and Native Americans were being routinely subjected to compulsory sterilization; and women of color in the US were involuntarily sterilized well into the 1980s. Sterilization of women in color in prison in the US lasted until 2010 (and may still happen without public knowledge).
The category "sociopath" has also evolved in two directions: one medical and one popular. In the medical field, the idea has been dropped in favor of calling it a subset of psychopathy, i.e., antisocial personality disorder, "characterized by a pervasive pattern of disregard for, or violation of, the rights of others. There may be an impoverished moral sense or conscience and a history of crime, legal problems, impulsive and aggressive behavior." In other words, this medical condition looks exactly like the same people we normally call assholes, schemers, bullies, and crooks.
In the popular imagination, especially since the release of the enormously popular film, Silence of the Lambs, sociopathy has come to be associated with moral monstrosities like Hannibal Lecter, although I would argue that Lecter is a kind of Neitzschean Zarathustra figure slyly presented (he is actually strangely sympathetic). Perhaps Ted Bundy is closer to the popular mark when thinking of "sociopaths." In fact, the vast majority of people so diagnosed have no history of violence at all.
"Serial killer" - a term that conceals more than it reveals - is almost synonymous with sociopath on Law & Order, and that is because it has proven a successful film convention. These characters, real and imagined, have a grip on the popular imagination, because people are already fascinated with deviance, even if it is only to reassure themselves of their own normality. The "serial killer" is the best kind of deviant, because he (or she) is perfectly deviant, almost an ideal. That one line in Silence of the Lambs goes, "He's a perfect psychopath. It's so rare to capture one alive." The SK is a deadly miscreant, not a human but something disguised as a human that is rarely captured alive.
In more than one episode of Law & Order, the sociopath - in one episode a little girl, who the resident expert warns is already a "serial killer," a term the psychiatrist uses interchangeably with "sociopath," and - he further warns - she is incurable. She must be incarcerated for life for the protection of society. It is easy to forget, for some, while watching these shows, that the story itself is constructed. We are drawn into the logic of the story in a way that makes certain conclusions inevitable. We find ourselves saying, if there is a little girl like that (who in the story has murdered a little boy), then she should be locked up. And of course, if you accept the story as it is given, that is absolutely true. But this story and stories like it, including the far more skillfully told tales of Thomas Harris, featuring his brilliant Neitzschean anti-hero Lecter, are patently not true, and they never capture either the complexity or the banality of actual crimes, because those will not make compelling stories.
I am not only dismissive of the sociopathy-equals-killer notion (far more murders are committed in war or in passion than are committed by deranged people, who by the way are very unlike these fictional characters); I remain highly skeptical about the whole category "sociopath," even as it is renamed antisocial personality disorder in the DSM-whatever.
I say this at the risk of being misunderstood, because these questions are fraught with politics
Being a drunk was once understood as a moral failure and is now routinely called a disease (in 12-step meetings it is actually called "an allergy"), likewise other addictions, which raises some ethical quandaries. If it is a disease, how can we criminally punish drunk drivers, for example? We don't seem to be able to overcome our dual-mindedness about this. Would we punish someone for crashing a car during an attack of severe hypoglycemia? Might we punish them because they were too irresponsible to eat promptly after taking insulin?
Of course, we seldom realize that our quandary here is created not only by medicalization but by the law and by a culture where alcoholism thrives. Even the 12-steppers realize that there are social and psychological problems associated with a drug problem (often the inability to "fit in'). On the other hand, there are plenty of people who believe addiction is genetic, even though they wouldn't know a gene if it bit them in the ass. (Listen to Barbara Duden and Silya Samerski on the popular notion of genes.)
On issues of crime and punishment, as is prominently featured in Law & Order, especially during creative defenses in the courtroom, the question of culpability is thrown into question by environmental factors (childhood abuse, e.g.) which most of us do believe contribute to character formation, though at the same time we are loathe to let anyone off the hook when they err, especially if the err in ways that are hurtful to others. Medicalization is seen as a threat to criminal justice, something that might undermine the idea of personal responsibility.
This may actually be a false dilemma, even when it makes a good story, because medicalization (of sociopathy and every other "behavioral" or "personality" disorder) has actually functioned as a species of power not pardon.
As Bretherton indicates in his article on drugs, we are expected to manage our (proprietary, machinic) bodies. In one episode of Law & Order, a woman who refuses to vaccinate her children is shown to be responsible for a case of measles that kills another child. We have an affirmative duty, in the context of this story, to manage our bodies in accordance with modern medical protocols, as an imperative of citizenship.
Sociopathy, or antisocial personality disorder is diagnosed, according to the DSM as the occurrence of three or more of the following in anyone over eighteen years old:
failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
impulsivity or failure to plan ahead;
irritability and aggressiveness, as indicated by repeated physical fights or assaults;
reckless disregard for safety of self or others;
consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
Presumably the reason there is a cutoff age of eighteen is because these same actions and attitudes are actually common among children and adolescents. In fact, by this standard, there have been periods in my own life where I can honestly say that I exhibited at least three of these. Many of these actions and attitudes can be understood as something called selfishness, or (in the 12-step idiom, self-centeredness).
I had malaria once, persistent, drug-resistant malaria that gave me a five-month ass-whipping and dropped me down to 113 pounds at one point. I count malaria as a disease. They took blood from me.sometimes four and five times a day, to look for organisms in the blood (protozoa) which are known to be the cause of malaria. Five thousand years ago, on the other side of the world, people with malaria had similar protozoa in their blood which was causing them to have horrible headaches, high fevers, and chills. The etiology of malaria was discovered, but it existed all along. It was not culturally determined, even if how it was treated, understood, and suffered was.
"Failure to conform to social norms with respect to lawful behaviors" presupposes that such norms exist, as lawful behavior presupposes specific laws. Neither those norms or that law is comparable to the blood parasite that causes malaria. Norms and laws are culturally determined, and they do change from place to place and time to time, and not through process of natural selection.
Lewis Kirshner writes:
This transformation of the psychiatric subject seems close to placing the mentally ill into the category of defective persons— perhaps persons whose lives are not worth living. It reflects a system of thought in opposition to the traditional view of mental illness as a loss of reason, a process of inflamed emotions and imagination, which represents an existential possibility for every human being. In its modern version, this position regards psychiatric disorders as the outcome of a complex interplay between biological propensity, individual psychology, and social environment, and, conversely, posits "normal health" as a fragile achievement, responding to a number of crucial variables.
In response to my placing the Bretherton article on my facebook page, my friend Davin Heckman replied (citing Foucault again):
It is very interesting, especially if you read it against Foucault's discussion of "governmentality" (the modern progression of control from external, coercive forms to forms of imposed mental "correction" and culminating in the individual's embrace and regulation of the status quo through regulation of the most intimate aspects of one's being). Read this alongside the literature about "neoliberalism" and the shift towards an economy of mobile, autonomous, entrepreneurial individuals whose chief mode of political expression is their form of economic activity (consumption). While I am generally enthusiastic about keeping people out of prison for drug offenses, I think the enthusiasm for drugs of all sorts is just the reflection of this tendency of people to take on the "duty" of regulating even the most intimate aspects of their lives through consumption. There is no shortage of invented disorders that can be "treated" by spending money. It's just late stage imperialism. The British East India Company went around the world, finding new people, taking their labor and resources, establishing markets for the first corporations, and imposing control over populations. Now that the world is ringed by satellites, we send our anthropologists, our missionaries, our prospectors, our guns, and our bureaucrats into the hearts and minds of our own people… I really think that asking this question, what is "the good life" remains the most relevant.
Governmentality can be summarized thus:
Governmentality is a term coined by philosopher Michel Foucault, and refers to the way in which the state exercises control over, or governs, the body of its populace. Governmentality also refers to the way in which people are taught to govern themselves, shifting power from a center authority, like a state or institution, and dispersing it among a population. Govermentality can therefore be understood as how conduct is shaped, making "the art of governing" and embodied experience. According to Foucault, governmentality allows for the creation of “docile bodies” to be used in modern economic and political institutions.
The relationship between governmentality and the pop-sociopath of Law& Order is that the show, in addition to its featuring the ethical conundrums of modernity, serves as an ideological transmission belt for the status quo as represented by police and prosecutors (by bureaucratic authority). In doing so, and in doing so with characters that are witty, intelligent, and caring (as well as brave and capable of redemptive violence), the program - like most programs that valorize cops and soldiers (there is yet another "based on a true story"" SEAL flick out now, apparently) - rationalize certain forms of coercion and violence directed at certain outsiders who have been fictionalized into anti-ideal types in our social imaginary. The pop-sociopath is (implicitly, sometimes explicitly) genetically aberrant, often "incurable" (read: beyond redemption), which makes these fictionalized others legitimate targets of our disgust and hatred. Our belief in their existence puts us on the inevitable path of acceptance of authority as it is presently constituted.
People who don't manage themselves normally deserve to be hauled by the police before the courts. And monsters need to be quarantined.
In the same way, the Law & Order - Special Victims Unit series, which features the FBI's Dr. Huang - a psychological profiler - frequently suggests through the dialogue of "professionals" that sex offenders lack the capacity for rehabilitation (a claim that is patently untrue, but which allows us to think of certain kinds of law breakers as monstrosities, like the pop-sociopath). The sex offender and the sociopath are different species. (I don't know how many times I've heard on SVU that "rape is not about sex, but power," maybe the stupidest popular truism I know . . . one that makes a "rapist" a different species, and not a man.)
In another blog post one snowy day in the future, I will explain all the reasons I believe "criminal psychological profiling" to be bunkum on the order of money-printing machines, mine-salting, and Nigerian advance-fee email fortunes.
But back on topic . . . you know what? Our culture (bureuacratic individualist), our dominant ideology (acquisitive individualism), teach us to be exactly what we have pathologized in the notion of this so-called personality disorder - men are encouraged to take risks for the sake of risk (probative masculinity), deception is seen as legitimate as long as it is legal (advertizing), consumerism encourages us to want then to get what we want now, our high-velocity promotes jostling and irritability and impatience, our me-firstism promotes combativeness (and calls it self-assertion), our isolation into tiny nuclear families separated by the public-private dichotomy concentrates our concern inward and leads us to ignore outward, and our leaders tell us that killing, maiming, dispossessing, and displacing people afar is necessary to maintain our way of life.
Everything we are calling sociopathic or psychopathic or disordered is reproduced by our very milieu, and then we wonder why a few people take the next step. What we value above all is not care (we devalue that all the time), but obedience to authority, and so the elastic clause in this diagnostic standard is law-breaking.
Medicalization has thrown us off the scent, because "personality" as we understand it has nothing to do with "character," which is formed in communities and by traditions, and we are living in a society that pretends there are no such things (nay, celebrates breaking the person off from community and tradition as a form of liberation). Medicalization fits nicely with the disembodied and abstracted "individual" of liberal philosophy, because it denies the influence of collective life on the identity of the person and then reduces that person's actions and attitudes to an intrapsychic phenomenon that can be treated by the bureaucratic monopoly called medicine - which is in actuality a species of modern power.
For today, I will leave this post where it lays, and let others do with it as they will . . . Law & Order begins in ten minutes. (-: