We do not have to examine each step of the taxonomic ladder from species to genus to family of man to appreciate the increasing complexity of the animals. However, their increased biological complexity is not accompanied by a proportional increase or variability of lifestyle. Obviously, a primatologist distinguishes among the members of her gorilla or chimpanzee horde. They look and behave differently even to the eyes of amateur observers at a zoo. But one horde of apes does essentially that which all hordes do. In that sense, their conformity to type is only somewhat more varied than such lower mammals as hyenas or lions, or even the amoebas. This conformity makes it easier for the biologist to spot the abnormal members of his group.
When a raccoon ambles up to a larger predator like a human being in broad daylight, we know that its behavior is abnormal. It is not supposed to be active in the daytime hours, and it is recklessly approaching an animal that can and does hunt it. Life-endangering behavior is anomalous to most species. It is acting abnormally, and probably is sick in the physical sense of that word. This behavior is the sign of a rabid raccoon. When despite all the posted warnings, a human being approaches a dangerous bear in Yellowstone Park, we do not presume he is sick. We think of him as stupid. And to judge from the number of visitors killed or maimed by bears in the parks, his behavior is not that singular or unconventional.
It is the discontinuity of the human species from the rest of the animal kingdom, discussed in the previous chapter, that makes a judgment of sickness more problematic. More of our behavior is free of instinctual fixation. We are free to look differently, dress differently, live differently, in different climates and different terrain, and to behave differently in our daily activities. Since we spend relatively little time hunting for food these days—an activity that dominates the life of most animals—we are free to work rather than just labor to survive, and the work at which we spend the majority of our waking hours varies dramatically. We become accountants and acrobats, farmers and plastic surgeons, spending the majority of our time in wildly different pursuits.
For these reasons, we have been generous in setting the borders of normalcy for human behavior, allowing serious deviations from a standard before necessarily labeling the behavior as abnormal. In terms of emotional behavior, we accept the extrovert and the recluse as within accepted standards. All manner of nonconforming behavior is sanctioned. Even with something as primary to species survival as the sexual drive, we allow great latitude, sexually permissive communities coexisting with celibate ones. Nevertheless, since the beginning of recorded time, certain people and certain behavior have stood out. They are the outsiders, beyond the perimeters of the defined normal.
Sick Behavior
Early literature is filled with the strange and the exotic persons who even in those days were described as mad—people who were identified by their peers as having significantly departed from the wide landscape of normal human behavior. The madness was extreme and complete: like the madness of King Saul, poignant and terrible to behold; the frightful vengeance of Medea; Nebuchadnezzar, who “did eat grass as oxen, and his body was wet with the dew of heaven, till his hairs were grown like eagles’ feathers and his nails like birds’ claws.”28 Nebuchadnezzar’s appearance is an apt description of that of a deteriorated and neglected schizophrenic living on the streets of our major cities.
The assignment of the cause of such extreme behavior differs from culture to culture. Deranged people were considered cursed, enchanted, possessed by demons, or holy visionaries. In the case of Nebuchadnezzar, his behavior was perceived as a punishment from God, to whom he had dared compare himself. In some cases the behavior was seen as a gift and the eccentric viewed as a prophet. With the emollient influence of time we view Saint Francis dressed in rags and speaking to the animals differently from the way we perceive the homeless man dressed similarly and having his words with who knows whom. Until the eighteenth century, symptoms that today would be generally reserved for the insane were interpreted as special gift, a sign of the holy. Or they might equally be viewed as a sign of bewitchment, and the person would be destroyed as a henchman of evil, a witch or a warlock. The pathetic teenagers exploited by their mullahs to destroy themselves while destroying others will draw different evaluations from the Arab and the Israeli populations. And history will judge them differently, too.
These days we are unlikely to designate a deranged person as a saint or demon. Instead we designate the irrationality that defies normal human understanding as crazy. Crazy behavior is often animal-like and wantonly destructive (running amok), or simply a feckless and dangerous insensibility to self-interest. One sign that has been central to an assessment of mental illness in any individual is his wanton lack of interest in even the basic need for food and shelter, the cardinal essentials for survival.
Almost from the beginning of modern society, a concept of insanity was a clearly entrenched standard in most countries. The Bethlem Royal Hospital in England—Bedlam—was commissioned specifically for the care and confinement of the mentally ill sometime around the year 1400. And the appreciation that the insane ought not be held responsible for their actions goes back centuries. Nigel Walker, in his classic work, Crime and Insanity in England,29 cited the first case of a man actually freed by a jury for reasons of insanity, dating it back to 1505 (in tragic parallel to our times, the crime was infanticide). In all such cases, a clear line was drawn between “them” and “us.” Their behavior was grotesque and their actions beyond human understanding.
Coexisting with this humane and modern view of the insane was the concept of “possession” by dybbuks, devils, and demons. This was most dramatically evidenced by the infamous Salem witch trials of 1692. A parallel confusion exists in our minds today. Even in these days of enlightenment, when someone says to us, “You’re sick,” or says in relation to an action of ours, “That’s sick,” it is rarely stated in sympathy of our condition—an acknowledgment of our asthma or our cancer. It is certainly not an expression of support and compassion. It is the exact opposite of the traditional attitude toward sickness, which includes blamelessness for symptoms. It represents a severe moral condemnation, another way of saying “that’s disgusting and abhorrent.” This attitude is but one sign of a persistent ambivalence toward mental illness.
No real attempt at a scientific understanding of sickness, physical or mental, would emerge until the latter half of the nineteenth century. With a stunning burst of creativity, modern medicine was born in the research laboratories of Europe by such distinguished scientists as Pasteur, Koch, Ehrlich, Semmelweis, Wundt, Helmholtz, and Virchow. We began to understand the nature of physical illness and were on our way to discovering the cures.
Still, there was no concept of anything called mental disease, that is, disease of the mind, as distinguished from disease of the brain. Insanity was conceptualized in the same way as one viewed heart disease: as being a product of organ damage or system deterioration. And at that time this view was adequate. Most of the mental conditions that were recognized in the nineteenth century were actually the result of brain damage, a product of stroke, degenerative senile changes, or the damage wrought on the brain by late-stage syphilis, the leading cause of admission to insane asylums. It was easy then to view mental illness as brain disease. If liver functions failed, the liver was damaged. If thinking was disordered, there must be brain damage.
The body itself was envisioned in the same terms as other physical structures, a collapsing roof or a leaky cistern. Sickness was the product of wear and tear of age, a traumatic injury, or an invasive organism, such as the newly discovered bacteria. Since behavior was perceived as a product of the brain and peripheral nervous system, mental illnesses were called “nervous disorders,” and the physician looked for physical malfunctions in the nervous system to repair. In those early days, the behavioral abnormalities that concerned medicine and the courts were those at the extreme periphery of human conduct, those that would be described by laymen as cra
zy, lunatic, or insane. They were what we today would call the major psychoses. All that would change with the revolutionary work of Sigmund Freud at the beginning of the twentieth century.
Freud, a neurologist, was attracted to a series of conditions called “the hysterias.” Hysteria is not to be confused with the current usage of the word “hysteria” as in “acting hysterical,” that is, being overemotional. Hysteria, as it was understood in the nineteenth century, was an illness characterized by a physical symptom that had no demonstrable physical damage to the affected organ: for example, blindness with no damage to the structure of the eye or the optic nerve. Or more curiously, a symptom that could not possibly be explained anatomically. Such a condition was glove anesthesia; a patient would exhibit a hand numb from the wrist down. This is an actual impossibility, since the sensory nerves run in a linear track from the armpit to the finger, not in annular circles around the hand. Nerve damage would cause anesthesia in a line down the arm and into the thumb, let’s say, sparing the other fingers.
After years of investigation, Freud came to the startling conclusion that these “neuroses,” as they were called—literally nervous inflammations—had nothing to do with the status of nerve fibers but were products of psychological conflicts and the stress that they produced. This conclusion was a monumental departure from the prevailing medical model of disease formation. Freud dared to suggest that feelings and ideas as well as poisons, trauma, or invading organisms could cause disease. His audacious statement that “the hysteric suffers from reminiscences” infuriated a medical community that had finally achieved scientific legitimacy by locating the physical causes of disease in damaged organs. Freud was now saying that for certain diseases the causes were not physical and the organs remained undamaged. He paid in ridicule and censure.
Freud honored mental illness by applying to it the same rigorous standards of study that were then being applied to the burgeoning understanding of physical disease. He not only discovered the tools for understanding the human condition, but he applied those tools to the newly created field of mental illness. He created the equivalent of a physiology of mental illness. By that I mean that he carefully tracked the normal internal mental processes—the physiology of the mind, and looked for the distortions, the pathology, that lead to mental illness.
In the days before the discovery of the germ theory, diseases were labeled according to their symptoms. Patients suffered from fevers, agues, and chills. What was then described as the illness was often the visible manifestation of the body’s defense against the illness—the symptoms. A fever is an elevation of body temperature designed to enhance the chemical reactions brought into play to fight the offending organism—not yet identified. As any cook knows, heating increases the rate of chemical responses. The body “knows” this automatically.
The inflamed and ugly boil marks the entrance of a toxin, foreign body, or bacterial agent disturbing the integrity of a bodily tissue or function. The body responds to the attack with an immune response. It rushes white cells to the spot, increases the vascularity in the area to facilitate the delivery of blood elements that fight the invader, and ratchets up the heat to speed the chemical responses. A boil, when examined, is therefore red, hot, inflamed, and filled with pus. None of these is the “disease”—a staphylococcus infection—but a sign of the body’s defensive maneuvers against the invading microbe. The boil is a perfect “compromise formation” having elements of both cause and defense against the physical trauma. Freud suggested very similar mechanisms for psychic trauma.
In a somewhat grandiose attempt to find a universal theory—like Marx and Einstein—Freud evolved the Libido theory. This theory postulated the rather absurd idea that all behavior could be understood as an expression of the sexual drive and its vicissitudes. Unfortunately, Freud’s followers, the “Freudians,” tenaciously held onto these early concepts as though they were religious testaments. Eventually, this loyalty led to the increasing disillusionment with psychoanalysis as a treatment form and the demise of Freud’s reputation in current times.
Nevertheless, those psychoanalysts like me who abandoned the Libido theory continued to use the most basic Freudian principles of human motivation to analyze aberrant social behavior. We would accept the idea of internal conflict, but cast that conflict in terms of different and varied sources of psychic distress. Once liberated from the need to always see a sexual underpinning to psychological tensions, we found that conflict could be located in all sorts of internal desires. Psychic stress could be generated in all the various areas of aspiration and failure that occupy the human being in his daily life. A person could be conflicted by power, aggression, authority, anger, guilt, humiliation, or pride.
Internal conflict often arises from dependency. An analysis of the manipulated populations in Africa and the Arab world indicates that their emasculating dependency, not their poverty, drives them to genocidal hatred. Dependency forces us to inhibit and constrain our desires when they bring us into conflict with those on whom we are dependent. Someone enraged at a despotic authority figure is frustrated by his inability to express that hatred, particularly when that figure is a parent, an employer, a religious leader, or a despotic tyrant and his lackeys. Our rage and our fear of the consequences of releasing this rage create the kind of conflict that underlies much neurosis. For such rage to be released safely, it must be displaced to a neutral person or group in the environment with whom one can be angry without fear of the consequences. A scapegoat must be found.
Symptoms, such as the glove anesthesia of hysteria, are devices that facilitate living with conflict or avoiding despair. Failures and guilt can be—in the terms of psychoanalysis—“rationalized,” “projected” to others, “denied,” or converted into successes by “delusion formation.” All these strategies serve to make the unbearable present bearable by mitigating our own impotence in the face of the dilemma and our own responsibility in our humiliation.
Nowadays psychiatrists treat an array of patients who have no specific symptoms, but suffer from character and adjustment disorders, people now labeled “the worried well.” But in those early days of therapy, with its much more restricted definition of mental illness, a mental patient always presented with a symptom. Some symptoms were clearly in the realm of the mental, although some might be products of an underlying physical cause, such as brain damage. An example would be the memory loss or personality changes that are manifest with certain brain tumors.
The first of the purely mental symptoms to be identified were obsessions, compulsions, phobias, delusions, and hallucinations. And common to all of these was the fact that they were subject to rational analysis, they had “meaning.” They were not just random events. The awareness of an area of pathology that was in the mind rather than in an organ—the birth of mental illness—was the great transitional phase in the relatively new field of psychiatry.
One of the inquiries that served this transition, and will serve us in understanding scapegoating, was Freud’s discovery of displacement. This emerged from his early attempt to understand the phobias that seem ubiquitous in children between the ages of three and five, in his celebrated study of Little Hans.30 Displacement is an essential feature in the process of scapegoating, which is central to the psychology of the terrorist. The model established in this simple case of Little Hans is a paradigm for understanding the hatred that we see today.
Imagine the predicament of any five-year-old child beginning to establish his own identity by starting the process of loosening the bonds with his parents. He is terrified of his own anger with his parents and equally terrified by their potential responses, should he make his anger manifest. What can he do with his defiant rage? There is no way to win a power struggle with the parents. The child knows he is smaller and vulnerable to their retaliation. He cannot win this battle. But the thought that he might win is even more frightening. The parents are the strong protectors needed to shield him from the dangers of a hostile and
unpredictable world. A power struggle with the parents is always lost, particularly when the child is allowed to win.
The classic way of handling such aggressive impulses and the anxiety that ensues is to displace it to an imaginary figure, a ghost or a scary animal like a dray horse or a wolf. Animal displacements are particularly wonderful. All that is needed to control the anxiety is to avoid the source of danger. One cannot avoid one’s father at this age, but how many wolves is a little boy likely to meet in his daily activities within his house? If the danger were with horses, the danger was outside. One could feel safe only at home. Ironically, this last statement summarizes the condition of most phobias. Displacement and avoidance are the defense mechanisms that are offered to explain all phobias. And phobics characteristically tend to remain—or retreat—to the safety of their homes.
The case of Little Hans was a landmark discussion of the general problem of how human beings attempt to handle the existential anxiety that is the inescapable product of the human condition. One normal way of handling our anxiety is to displace it. Direct it at some controllable cause, other than the true and inescapable one. This displacement is practiced by all of us in our daily activities. It is a central mechanism of bigotry and hatred. When the real oppressors are too terrifying or powerful to confront, find a safer population toward whom you can direct your hatred.
Freud utilized this and other cases to explain the formation of symptoms in general. He believed that analyzing the symptom would direct the physician to the underlying causes. He stated that each symptom contained a symbolic representation of both the cause of distress and the attempted resolution. He labeled symptoms “compromise formations,” meaning that they were a compromise between a dangerous feeling and the defense against the impulse. The neurotic behavior was designed to protect ourselves or our standing in our own eyes. It is a model that lends itself to understanding aberrant social behavior as well as hysterical paralysis.
Hatred Page 9
