Journal of Religion and Health, Vol. 13, No. 2, 1974
Editorial
Mental Health and Public Leadership When we w e r e quite y o u n g , t h e r e was a class o f p e o p l e w h o w e r e usually described as queer, n u t t y , o d d , t o u c h e d , lunatic, or even c r a z y . I f t h e y w e r e s u f f i c i e n t l y well p r o v i d e d f o r financially, t h e y usually lived at h o m e a n d were cared f o r b y o t h e r m e m b e r s o f t h e f a m i l y . S o m e strange living styles grew o u t o f this m e t h o d of caring f o r t h e m e n t a l l y ill. We recall o n e f a m i l y g r o u p o f t h r e e u n m a r r i e d elderly ladies. O n e r e m a i n e d at h o m e and n e v e r w e n t o u t o f the house. O n l y rarely a n d a f t e r careful p r e p a r a t i o n a n d w i t h e x t r e m e p r e c a u t i o n did she v e n t u r e o u t o f her r o o m . All her dishes and clothes had to be specially washed. N e v e r in a n y c i r c u m s t a n c e s did she see or t o u c h a n y b o d y f r o m t h e outside world. We saw her o n e d a y b y c h a n c e w h e n the d o o r t o her r o o m had b e e n m i s t a k e n l y left o p e n . I t was q u i c k l y closed b y the s e c o n d sister, w h o was, as it were, the p r o v i d e r f o r t h e f a m i l y . She ran a little s h o p in the village, w h e r e t h e n e c e s s a r y i n c o m e f o r the f a m i l y was earned. She also did the s h o p p i n g and t o o k care o f o u t d o o r a n d i n d o o r chores like c o o k i n g , housecleaning, w i n d o w washing, p o r c h sweeping, etc. She supervised the m a n w h o did t h e h e a v y w o r k . T h e t h i r d sister was t h e social, political, and religious p e r s o n . She r e p r e s e n t e d her t w o sisters at social events like parties, weddings, and funerals. She was f r e q u e n t l y seen at t h e library, t h e c o m m u n i t y center, t h e b a n k , a n d t h e stores. She did the f a m i l y b a n k i n g and k e p t t h e a c c o u n t s . T a k e n all t o g e t h e r , t h e t h r e e sisters m a d e u p one w h o l e , h e a l t h y , and r e a s o n a b l y well-adjusted p e r s o n . P e o p l e did a d m i t t h a t "Miss G r a c e " was a little odd. Aside f r o m t h a t , no c o m m e n t was ever m a d e , a n d c e r t a i n l y no d o c t o r was ever c o n s u l t e d . We lost t o u c h w i t h this f a m i l y g r o u p years ago and d o n o t k n o w h o w it finally t u r n e d out. O t h e r s w h o b e l o n g e d to t h e r a n k s o f t h e " o d d " were n o t so f o r t u n a t e . T h e y lived a l o n e as recluses or w a n d e r e d a b o u t a n d b e c a m e t h e o b j e c t s o f the cruel j o k e s o f little b o y s or t h e ridicule o f t h e p e o p l e , m o s t l y m e n , w h o h u n g a r o u n d t h e drug store or t h e fire station. I f t h e q u e e r and t h e o d d b e c a m e d e s t i t u t e or so e c c e n t r i c as t o a t t r a c t p u b l i c n o t i c e a n d c o m p l a i n t , t h e y 'were sent to the p o o r f a r m or in e x t r e m e eases, such as h a b i t u a l d r u n k e n n e s s or a n n o y i n g little girls or ladies, t h e y l a n d e d in t h e jail a n d e v e n t u a l l y e i t h e r in t h e prison or t h e s t a t e h o s p i t a l or insane a s y l u m , as it was called. I f t h a t h a p p e n e d , one s e l d o m saw t h e m again, and t h e y w e r e 79
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soon forgotten. A few remained around t o w n indefinitely and became village characters._ E v e r y b o d y knew t h e m by name. Their eccentricities were well k n o w n and harmless. T h e y added variety and a certain a m o u n t of amu s emen t and interest to small c o m m u n i t y life. Th at is the way it used to b e - n o t m uch more than half a century ago in thousands of small American towns. N o b o d y had heard of Sigmund Freud or the unconscious except a rare few. Most physicians had heard of psychiatrists, but regarded them as a peculiar kind of species not to be trusted if a n y b o d y was really sick. A ny w ay, t h e y cost a lot of m o n e y , and what did t h e y do for y o u but listen to y o u and talk to y o u ? A n y b o d y with any c o m m o n sense could do that, could he not ? Even in 50 years, with the rapid growth in the n u m b e r of psychiatrists, psychologists, and counselors, it is astonishing and depressing how little these widespread attitudes have changed. A person can have any kind of physical illness, be treated by a doctor, hospitalized, operated on, and restored to health w i t h o u t any question, but if he confesses that he has gone through a period of deep depression or emotional instability during which he has been hospitalized and treated b y a psychiatrist, this very fact carries with it a serious stigma that saps public confidence in him and may even make it impossible for him to hold a responsible position in the business hierarchy or even more so in political life. The Vice-President, Gerald Ford, recently had to establish the fact that he did not consult a well-known New York psychiatrist as a patient, and another vice-presidential hopeful, already n o m i n a t e d by his party, had to withdraw his candidacy because he admitted that he had been hospitalized and received psychiatric t r e a t m e n t some years before for depression and severe anxiety. It is, as we have said, astonishing how these ancient superstitions continue. Within the past year it has been revealed that the prosecution, in this case the United States government, arranged for the burglarization of the office of a psychiatrist who had been treating at one time Dr. Ellsberg, a man it was trying to convict of conspiracy. Luckily the burglary itself was so much m or e insane than anything Dr. Ellsberg could possibly have done that the judge quite properly dismissed the case. But it was another example of the fear and suspicion that so m a n y people hold for the idea that there are times when people need doctors of the mind and spirit as much as or m or e than t hey need doctors of the flesh, blood, and bones. Even more, the episode reflects the little-recognized fact that b o d y and mind are so inextricably connect ed that one is constantly acting on the other and that n o b o d y can treat one w i t h out treating the other. The tr u th is t hat the person who seeks help from a responsible professional source in a time of mental confusion or emotional instability is revealing his essential sanity rather than insanity, his fundamental strength rather than his weakness. It takes a considerable a m o u n t of courage and honesty to go to a professional person and say, in effect, " D o c t o r , I am perplexed and mixed up by the situation in which I find myself. I do n o t know what I ought to do or what decisions I have to make. Talking with y o u will perhaps help me see
Mental Health and Public Leadership
81
the situation m o r e clearly and m a k e a wiser j u d g m e n t . " He does n o t e x p e c t the d o c t o r to tell him what t o d o in detail. He e x p e c t s the d o c t o r t o listen objectively and empathically. He e x p e c t s him to help with the difficult process of discovering the causes o f the p e r p l e x i t y and o f outlining w h a t some o f the possible choices are. O b v i o u s l y the p a t i e n t m u s t in t h e end m a k e those choices for himself; b u t just as obviously, nearly a c e n t u r y o f p s y c h o t h e r a p y should have t a u g h t us t h a t t h e therapist can m a k e a positive c o n t r i b u t i o n b y helping the individual t o see h o w he got into the state o f p e r p l e x i t y where he n o w is, w h a t his realistic choices are, and h o w he can find the courage and energy t o take the m o s t c o n s t r u c t i v e path. When a p e r s o n submits himself to this difficult and searching process in a t i m e o f p e r p l e x i t y , or as he c o n t e m p l a t e s t h e u n d e r t a k i n g o f a h e a v y responsibility such as high political office, we see this act as an e x a m p l e o f strength , n o t weakness, o f responsibility, n o t carelessness. T h e irresponsible o n e is t h e o n e w h o simply assumes his o w n a d e q u a c y in all situations, hides his o w n fears and d o u b t s even f r o m himself, and insists o n bulling his way t h r o u g h , n o m a t t e r what. T h e p e r s o n w h o is n o t aware or dares n o t a d m i t t h a t he has weaknesses and d o u b t s is a d a n g e r o u s individual. He should n o t be e n t r u s t e d with high responsibility, for w h e n m o m e n t s o f p r o f o u n d and d a n g e r o u s decisions c o m e , he is likely to act in response to his o w n fears and his needs to prove his o w n sufficiency, r a t h e r t h a n the necessity o f doing t h e right thing f o r the c o m m u n i t y as a whole. We w o u l d suggest t h a t in the years and generations ahead it w o u l d be wise, even essential, f o r o u r c o u n t r y t o devise an extensive and w o r k a b l e s y s t e m t o evaluate the m e n t a l and e m o t i o n a l stability o f t h o s e w h o aspire to p o s i t i o n s o f leadership and high responsibility. N o t all p e o p l e are capable o f bearing these heavy e m o t i o n a l burdens. S o m e are brilliant innovators, b u t lack elements o f calmness and stability in times o f stress. S o m e are g o o d r o u t i n e workers, b u t lack imagination and daring. Others have m u c h imagination, b u t lack a sense of timeliness and realism. S o m e w a n t the o f f i c e and the public acclaim and fame t h a t go with it m o r e t h a n t h e y w a n t to serve the public g o o d . S o m e see the powers and responsibilities o f public life as an adversary p r o p o s i t i o n wherein it is essential, as o n e such p e r s o n r e c e n t l y p u t it, " t o screw o u r e n e m i e s " w h e r e v e r possible. T h e c o m m u n i t y as a w h o l e needs t o be p r o t e c t e d against p e o p l e like these and t o e n c o u r a g e and s u p p o r t the large n u m b e r s o f intelligent, highly responsible, and d e d i c a t e d m e n and w o m e n w h o t r u l y w a n t to serve the public g o o d and are at times driven a w a y f r o m the e f f o r t w h e n t h e y find w h a t a m a e l s t r o m o f plotting, conniving, and self-serving c o n f u s i o n public life has b e c o m e . It seems to us t h a t one o f the m o s t c o n s t r u c t i v e c o n t r i b u t i o n s t h e h e a l t h sciences c o u l d m a k e in the years and decades ahead w o u l d be to devise m e t h o d s o f finding, testing, and training m e n and w o m e n w h o have first o f all a d e d i c a t e d desire to serve t h e public g o o d and, second, the rational a n d c o m p a s s i o n a t e qualities of character, t o g e t h e r with the p a t i e n c e and imagination t h a t enable t h e m t o d o so, and, finally, t h e c o n t r o l o f their o w n
82
Journal of Religion and Health
power needs that enables them to use the power entrusted to t hem wisely and with a deep sense of moral responsibility. Of course the most difficult problem in establishing such a progTam of standard-setting and evaluation for public responsibility is the question of wh o will make these p r o f o u n d and complicated judgments about their fellow h u m a n beings. All of us are vulnerable and from time to time can be capable of prejudice and self-serving acts. People entrusted with this kind of responsibility assume a t r e m endous a m o u n t of power over the lives of others, more than most of us want. We see no immediate solution for this problem. It is as old as Plato's Republic. The ideal state should be governed by the wise and the good, but who will choose the wise and the good? So far, the best we can suggest is that the person who seeks c o m p e t e n t professional help in time of mental confusion and emotional stress is performing a brave and intelligent act. It should go into his record not as a sign of weakness, but of strength of character. Harry C. Meserve
Editorial
Mental Health and Public Leadership When we w e r e quite y o u n g , t h e r e was a class o f p e o p l e w h o w e r e usually described as queer, n u t t y , o d d , t o u c h e d , lunatic, or even c r a z y . I f t h e y w e r e s u f f i c i e n t l y well p r o v i d e d f o r financially, t h e y usually lived at h o m e a n d were cared f o r b y o t h e r m e m b e r s o f t h e f a m i l y . S o m e strange living styles grew o u t o f this m e t h o d of caring f o r t h e m e n t a l l y ill. We recall o n e f a m i l y g r o u p o f t h r e e u n m a r r i e d elderly ladies. O n e r e m a i n e d at h o m e and n e v e r w e n t o u t o f the house. O n l y rarely a n d a f t e r careful p r e p a r a t i o n a n d w i t h e x t r e m e p r e c a u t i o n did she v e n t u r e o u t o f her r o o m . All her dishes and clothes had to be specially washed. N e v e r in a n y c i r c u m s t a n c e s did she see or t o u c h a n y b o d y f r o m t h e outside world. We saw her o n e d a y b y c h a n c e w h e n the d o o r t o her r o o m had b e e n m i s t a k e n l y left o p e n . I t was q u i c k l y closed b y the s e c o n d sister, w h o was, as it were, the p r o v i d e r f o r t h e f a m i l y . She ran a little s h o p in the village, w h e r e t h e n e c e s s a r y i n c o m e f o r the f a m i l y was earned. She also did the s h o p p i n g and t o o k care o f o u t d o o r a n d i n d o o r chores like c o o k i n g , housecleaning, w i n d o w washing, p o r c h sweeping, etc. She supervised the m a n w h o did t h e h e a v y w o r k . T h e t h i r d sister was t h e social, political, and religious p e r s o n . She r e p r e s e n t e d her t w o sisters at social events like parties, weddings, and funerals. She was f r e q u e n t l y seen at t h e library, t h e c o m m u n i t y center, t h e b a n k , a n d t h e stores. She did the f a m i l y b a n k i n g and k e p t t h e a c c o u n t s . T a k e n all t o g e t h e r , t h e t h r e e sisters m a d e u p one w h o l e , h e a l t h y , and r e a s o n a b l y well-adjusted p e r s o n . P e o p l e did a d m i t t h a t "Miss G r a c e " was a little odd. Aside f r o m t h a t , no c o m m e n t was ever m a d e , a n d c e r t a i n l y no d o c t o r was ever c o n s u l t e d . We lost t o u c h w i t h this f a m i l y g r o u p years ago and d o n o t k n o w h o w it finally t u r n e d out. O t h e r s w h o b e l o n g e d to t h e r a n k s o f t h e " o d d " were n o t so f o r t u n a t e . T h e y lived a l o n e as recluses or w a n d e r e d a b o u t a n d b e c a m e t h e o b j e c t s o f the cruel j o k e s o f little b o y s or t h e ridicule o f t h e p e o p l e , m o s t l y m e n , w h o h u n g a r o u n d t h e drug store or t h e fire station. I f t h e q u e e r and t h e o d d b e c a m e d e s t i t u t e or so e c c e n t r i c as t o a t t r a c t p u b l i c n o t i c e a n d c o m p l a i n t , t h e y 'were sent to the p o o r f a r m or in e x t r e m e eases, such as h a b i t u a l d r u n k e n n e s s or a n n o y i n g little girls or ladies, t h e y l a n d e d in t h e jail a n d e v e n t u a l l y e i t h e r in t h e prison or t h e s t a t e h o s p i t a l or insane a s y l u m , as it was called. I f t h a t h a p p e n e d , one s e l d o m saw t h e m again, and t h e y w e r e 79
80
Journal o f Religion and Health
soon forgotten. A few remained around t o w n indefinitely and became village characters._ E v e r y b o d y knew t h e m by name. Their eccentricities were well k n o w n and harmless. T h e y added variety and a certain a m o u n t of amu s emen t and interest to small c o m m u n i t y life. Th at is the way it used to b e - n o t m uch more than half a century ago in thousands of small American towns. N o b o d y had heard of Sigmund Freud or the unconscious except a rare few. Most physicians had heard of psychiatrists, but regarded them as a peculiar kind of species not to be trusted if a n y b o d y was really sick. A ny w ay, t h e y cost a lot of m o n e y , and what did t h e y do for y o u but listen to y o u and talk to y o u ? A n y b o d y with any c o m m o n sense could do that, could he not ? Even in 50 years, with the rapid growth in the n u m b e r of psychiatrists, psychologists, and counselors, it is astonishing and depressing how little these widespread attitudes have changed. A person can have any kind of physical illness, be treated by a doctor, hospitalized, operated on, and restored to health w i t h o u t any question, but if he confesses that he has gone through a period of deep depression or emotional instability during which he has been hospitalized and treated b y a psychiatrist, this very fact carries with it a serious stigma that saps public confidence in him and may even make it impossible for him to hold a responsible position in the business hierarchy or even more so in political life. The Vice-President, Gerald Ford, recently had to establish the fact that he did not consult a well-known New York psychiatrist as a patient, and another vice-presidential hopeful, already n o m i n a t e d by his party, had to withdraw his candidacy because he admitted that he had been hospitalized and received psychiatric t r e a t m e n t some years before for depression and severe anxiety. It is, as we have said, astonishing how these ancient superstitions continue. Within the past year it has been revealed that the prosecution, in this case the United States government, arranged for the burglarization of the office of a psychiatrist who had been treating at one time Dr. Ellsberg, a man it was trying to convict of conspiracy. Luckily the burglary itself was so much m or e insane than anything Dr. Ellsberg could possibly have done that the judge quite properly dismissed the case. But it was another example of the fear and suspicion that so m a n y people hold for the idea that there are times when people need doctors of the mind and spirit as much as or m or e than t hey need doctors of the flesh, blood, and bones. Even more, the episode reflects the little-recognized fact that b o d y and mind are so inextricably connect ed that one is constantly acting on the other and that n o b o d y can treat one w i t h out treating the other. The tr u th is t hat the person who seeks help from a responsible professional source in a time of mental confusion or emotional instability is revealing his essential sanity rather than insanity, his fundamental strength rather than his weakness. It takes a considerable a m o u n t of courage and honesty to go to a professional person and say, in effect, " D o c t o r , I am perplexed and mixed up by the situation in which I find myself. I do n o t know what I ought to do or what decisions I have to make. Talking with y o u will perhaps help me see
Mental Health and Public Leadership
81
the situation m o r e clearly and m a k e a wiser j u d g m e n t . " He does n o t e x p e c t the d o c t o r to tell him what t o d o in detail. He e x p e c t s the d o c t o r t o listen objectively and empathically. He e x p e c t s him to help with the difficult process of discovering the causes o f the p e r p l e x i t y and o f outlining w h a t some o f the possible choices are. O b v i o u s l y the p a t i e n t m u s t in t h e end m a k e those choices for himself; b u t just as obviously, nearly a c e n t u r y o f p s y c h o t h e r a p y should have t a u g h t us t h a t t h e therapist can m a k e a positive c o n t r i b u t i o n b y helping the individual t o see h o w he got into the state o f p e r p l e x i t y where he n o w is, w h a t his realistic choices are, and h o w he can find the courage and energy t o take the m o s t c o n s t r u c t i v e path. When a p e r s o n submits himself to this difficult and searching process in a t i m e o f p e r p l e x i t y , or as he c o n t e m p l a t e s t h e u n d e r t a k i n g o f a h e a v y responsibility such as high political office, we see this act as an e x a m p l e o f strength , n o t weakness, o f responsibility, n o t carelessness. T h e irresponsible o n e is t h e o n e w h o simply assumes his o w n a d e q u a c y in all situations, hides his o w n fears and d o u b t s even f r o m himself, and insists o n bulling his way t h r o u g h , n o m a t t e r what. T h e p e r s o n w h o is n o t aware or dares n o t a d m i t t h a t he has weaknesses and d o u b t s is a d a n g e r o u s individual. He should n o t be e n t r u s t e d with high responsibility, for w h e n m o m e n t s o f p r o f o u n d and d a n g e r o u s decisions c o m e , he is likely to act in response to his o w n fears and his needs to prove his o w n sufficiency, r a t h e r t h a n the necessity o f doing t h e right thing f o r the c o m m u n i t y as a whole. We w o u l d suggest t h a t in the years and generations ahead it w o u l d be wise, even essential, f o r o u r c o u n t r y t o devise an extensive and w o r k a b l e s y s t e m t o evaluate the m e n t a l and e m o t i o n a l stability o f t h o s e w h o aspire to p o s i t i o n s o f leadership and high responsibility. N o t all p e o p l e are capable o f bearing these heavy e m o t i o n a l burdens. S o m e are brilliant innovators, b u t lack elements o f calmness and stability in times o f stress. S o m e are g o o d r o u t i n e workers, b u t lack imagination and daring. Others have m u c h imagination, b u t lack a sense of timeliness and realism. S o m e w a n t the o f f i c e and the public acclaim and fame t h a t go with it m o r e t h a n t h e y w a n t to serve the public g o o d . S o m e see the powers and responsibilities o f public life as an adversary p r o p o s i t i o n wherein it is essential, as o n e such p e r s o n r e c e n t l y p u t it, " t o screw o u r e n e m i e s " w h e r e v e r possible. T h e c o m m u n i t y as a w h o l e needs t o be p r o t e c t e d against p e o p l e like these and t o e n c o u r a g e and s u p p o r t the large n u m b e r s o f intelligent, highly responsible, and d e d i c a t e d m e n and w o m e n w h o t r u l y w a n t to serve the public g o o d and are at times driven a w a y f r o m the e f f o r t w h e n t h e y find w h a t a m a e l s t r o m o f plotting, conniving, and self-serving c o n f u s i o n public life has b e c o m e . It seems to us t h a t one o f the m o s t c o n s t r u c t i v e c o n t r i b u t i o n s t h e h e a l t h sciences c o u l d m a k e in the years and decades ahead w o u l d be to devise m e t h o d s o f finding, testing, and training m e n and w o m e n w h o have first o f all a d e d i c a t e d desire to serve t h e public g o o d and, second, the rational a n d c o m p a s s i o n a t e qualities of character, t o g e t h e r with the p a t i e n c e and imagination t h a t enable t h e m t o d o so, and, finally, t h e c o n t r o l o f their o w n
82
Journal of Religion and Health
power needs that enables them to use the power entrusted to t hem wisely and with a deep sense of moral responsibility. Of course the most difficult problem in establishing such a progTam of standard-setting and evaluation for public responsibility is the question of wh o will make these p r o f o u n d and complicated judgments about their fellow h u m a n beings. All of us are vulnerable and from time to time can be capable of prejudice and self-serving acts. People entrusted with this kind of responsibility assume a t r e m endous a m o u n t of power over the lives of others, more than most of us want. We see no immediate solution for this problem. It is as old as Plato's Republic. The ideal state should be governed by the wise and the good, but who will choose the wise and the good? So far, the best we can suggest is that the person who seeks c o m p e t e n t professional help in time of mental confusion and emotional stress is performing a brave and intelligent act. It should go into his record not as a sign of weakness, but of strength of character. Harry C. Meserve
