Minds over monsters

In a TEDx Talk titled “The Most Important Lesson from 83,000 Brain Scans,” Dr Daniel Amen tells a story about how a nine-year-old boy violently attacked a little girl on the baseball field.

The boy had been drawing pictures of himself hanging from a tree and shooting other children. It was later revealed that the boy had a cyst in his brain. When the cyst was removed, his violent impulses and thoughts went away completely. He turned back into a sweet and loving little boy. The boy was Dr Amen’s nephew. Dr Amen points out that this was likely a Columbine or Sandy Hook (mass shootings at schools)waiting to happen.

Aaron Hernandez, a tight end for the New England Patriots, is infamous for murdering his friend Odin Lloyd. Hernandez was diagnosed with Chronic Traumatic Encephalopathy (CTE), and that diagnosis is used to explain his actions. Dr Ann McKee, a neuropathologist who studies CTE, said, “We can’t take the pathology and explain the behaviour, but we can say collectively that individuals with CTE of this severity have difficulty with impulse control, decision-making, aggression, often emotional volatility, and rage behaviour.” Both Dr Amen’s nephew and Aaron Hernandez are examples of chilling, yet hopeful, stories about how seemingly unexplainable and atrocious acts may have an underlying, explainable, medical cause.

Through a mental health lens

Personally, I find it encouraging that when people hear about something heinous and awful on the news, they say something like “That’s so sick that they did that.” If a person is sick, then maybe they can be cured. It’s encouraging that people want to be able to explain the awful things that human beings sometimes do to one another.

These people are trying to see the best in others. When people view bad, evil, or antisocial behaviour through a mental health lens, that’s what they are trying to do.

They believe that if the person had been raised properly or had received the right treatment, they wouldn’t have done those things. People have these beliefs because there is some compelling evidence for them. According to the Traumatic Brain Injury in Criminal Justice Project at the University of Denver Graduate School of Professional Psychology, some jails have up to 96 per cent of inmates with a history of at least one traumatic brain injury, or TBI.

While rates of TBI vary among sites, again, some view that statistic with a certain degree of hope. Outside of brain cysts and complex TBIs, we have data showing that people with bipolar disorder or a schizophrenia-related disorder are more likely to end up in jail. One study found that people with ADHD are more likely to end up in prison, which makes sense, because if you have poor impulse control, you are more likely to do something without thinking that might get you in trouble.

When someone commits a crime, I agree they deserve the best representation imaginable. If a mental health argument will help someone’s case, lawyers should make that argument. If mental health is a factor to consider in the outcome of a trial, it should definitely be taken into account. But does the tendency to explain away sins, mistakes, and crimes against society by pointing to mental illness end up confusing and obscuring the difference between behaviour we deem bad and mental illness itself? In other words, is there perhaps an inflation of the idea that mental illness and bad behaviour are correlated because lawyers will lean on the mental health argument if they can? If that’s true, then as a mental health culture, we need to be sure not to get seduced by the psychobabble (see box) around comparing and contrasting mental illness and acts we collectively wish to punish as a society.

Victims more than perpetrators

One major problem with the myth that people are not bad, just mentally ill, is that it implies that people with a mental illness are more likely to commit crimes, commit heinous acts, or get into trouble.

This is not just false — it is illogical. First of all, all dogs are mammals, but that doesn’t mean all mammals are dogs. Just because those who are in jail happen to have higher rates of mental illness or TBIs, that doesn’t mean those with mental illness or TBIs are more likely to commit crimes. In fact, a large body of data shows that people with mental illness are much more likely to be victims of violent crime than the perpetrators of it. In one study looking at violence and schizophrenia, it was shown that substance use was a better predictor than just having schizophrenia. In fact, alcohol is a key factor in most violent crime, regardless of your mental health status.

The idea that we can explain away bad behaviour through mental health is alluring because we don’t like to consider that we are all capable of terrible things. If someone hurts us physically, it’s somewhat comforting to think they have something wrong with their minds or brains. If someone hurts our feelings, it’s reassuring to consider that their agitation stemmed from a childhood wound or being overdue for an adjustment with their medication. It’s terrifying to believe that someone would hurt us soberly, consciously, and intentionally. That would mean people you trust — people you love —might be capable of a similar transgression. It’s even more intimidating to consider that you might be capable of doing things you believe are wrong.

Good and evil: A capacity for both

There are many perspectives about whether or not people are naturally good or bad. I believe that we all have the capacity for both good and evil. I am particularly fond of Carl Jung’s analysis, that accepting the fact that you are capable of absolutely horrible things is a mark of maturity. He argues that if you are aware of your capacity for evil, then you can keep an eye on it and conduct yourself in a good or moral fashion.

Jung believed that it is not a lack of capacity for bad behaviour that makes someone good; the people who can do bad things but choose not to are the ones who are truly good. Jung thought that people who delude themselves into thinking that they can never do anything that bad are the people who end up committing the most atrocious acts. He also thought that it was unfair to the people who consciously choose good over evil to label people who are incapable of doing bad things as the most moral, because they don’t have a choice in the matter.

I had a mentor tell me that in order to become truly masterful in the art and science of psychology, you need to think about deep and dark questions. You need to consider whether or not each and every person has the capacity to do bad things. In my opinion, these sorts of questions quickly leave the realm of psychology and touch on questions of philosophy and even theology. In philosophy, as in psychology, it’s vital to define your terms. I do not have a deep or concise definition of bad or evil that I can offer you to contextualise the ideas presented here. I do not think I need one.

If your thinking is that good and evil are totally subjective and do not exist, then you don’t agree with the myth by default. If evil doesn’t exist, then comparing mental illness to evil is a moot point. Furthermore, I cannot imagine a working definition of evil that would conflict with the larger point I am making: While mental and physical health might explain some behaviour we can classify as bad, it simply cannot explain all of it. To try to convince you otherwise would make me feel like I was trying to sell you a story rather than telling you the truth.

The author is a psychotherapist and writer whose content contextualises mental health misinformation, pop psychology facts and fallacies. Excerpted with permission from Psychobabble: Viral Mental Health Myths & The Truths To Set You Free, recently published by HarperCollins.