Recently, there was a post on By Common Consent which explored the potential mental illnesses George Albert Smith. My thesis chair penned a response to the post, drawing on some of his experience in psychology. He has consented to having his response posted here. Be aware: this is not a polished essay. Dr. Gantt is, so to speak, “shooting from the hip,” and as such, his arguments have not been revised, poured over, etc. Truthfully, this reads much more like a transcript of one of his classroom lectures (where he simply speaks his mind) than any of his published works. Without further ado, I turn the time over to Ed Gantt:
Recently, a dear friend of mine posted a link here on facebook to a blog post by Jonathan Stapley at By Common Consent, a popular Mormon blog. The brief post was on Mental Illness and the life and struggles of President George Albert Smith. Before reading further, it would be a good idea for you to check out the post. It’s pretty short and so won’t take much of your time.
Well, perhaps needless to say, at least to those who know me, I was much less than impressed by Shapley’s post, finding it misleading (though perhaps not intentionally so) in a number of ways. I was originally just going to let the whole thing pass. As a professor of psychology, I encounter things like this constantly and so long ago learned that I can’t respond to everything that is misleading and annoys me, I just don’t have the time or energy. I also wasn’t terribly keen on taking a controversial stand on a topic of deep significance and which hits close to home for a dear friend for fear of maybe giving some offense. However, when some other friends asked me what I thought about the post, and when I noted the overall adulatory response to the post in the comments section of the blog, I decided I had to put some thoughts down and at least be on record as quite strenuously objecting to the claims Stapley makes.
Please note that what follows is by no means an exhaustive analysis – there are a number of additional issues that could or should be treated but which I opted to skip. Neither is this as scholarly as it probably should be – I could make it so, but at the cost of increasing its inaccessibility to the general reader and at the cost of considerable time that I do not currently have.
There are, as I see it, a couple of key problems in the post that need to be addressed.
First, on fairly flimsy evidence, the author (Jonathan Stapley) is reading back into President Smith’s life a disorder whose diagnostic criteria is often so expansive and vague (purposely so – but that’s a different cynical point I won’t make here) that it is easy to see it wherever anyone wants to see it. This sort of thing is somewhat akin to those homosexual activists who wish to claim that Abraham Lincoln was gay because he occasionally shared a bed with other men (something that was, by the way, common in his time) and because he didn’t always get along swimmingly with his wife. If you want homosexuality to be pervasive, then you can find it everywhere you happen to look – no matter how unjustified the inferences.Same goes for mental illnesses.
Anyway, what the article that Shapley references actually shows – though almost no one will actually read it because they will just take the Shapley’s interpretation at face value – is that George Albert Smith was never a physically robust individual, very sickly, and had many medical problems of a persistent, frustrating, and exhausting nature. However, he was also a very energetic and active man who took his apostolic and family and communities duties very seriously and frequently overworked himself – thus exacerbating his physical maladies.His wife, too, suffered from numerous physical problems and was in need of much assistance with the family, something that her husband could seldom provide due to his extensive travels and other duties. This was , unsurprisingly, something about which he often felt troubled because of his inability to provide the kind of supporting presence he felt was needed and for which he was responsible. Further, the author of the Journal of Mormon History (Mary Jane Woodger) notes that George Albert was “Well known for his sensitivity and compassion, he too-easily took on other’s burdens. At one point he confided to a stake president, ‘Even when things are normal my nerves are not very strong and when I see other people in sorrow or depressed I am easily affected.’”
So, what we have is a man who is overworked, possessing a deep sense of obligation but not sufficient time or physical health to fulfill his obligations as well as he feels he should, who is also possessed of a deeply compassionate nature and, thus, acutely feels the pains and sorrows of others. That his energy would flag at times, perhaps even for long stretches, that he would often be saddened, pensive, frustrated, and emotionally exhausted is no surprise. However, to hastily diagnose the man as a depressive with a mental illness is to make a serious leap that quite probably misunderstands both the man and the disorder. If George Albert Smith was suffering from the mental illness of depression, then so was Jesus Christ and many other great and compassionate people. Just because one happens to be a poor wayfaring man of grief does not mean that one is a depressive.
In the end, it is much too much of a stretch backward in psycho-historical diagnostics to ascribe Elder Smith’s problems to “clinical depression.” Just because his case may look like modern clinical depression from 30,000 feet (so to speak) and from a century after the fact, does not mean that it was the same thing at all. Indeed, the journal article itself notes: “Of course, diagnosis becomes increasingly murky and uncertain, the further back in time one goes” (p. 127).
Interestingly, the author of the Journal article on President Smith’s “breakdown” spends most of the article citing contemporary physicians opinions on the apostle’s physical ailments. This is very tricky business and must be undertaken with considerable care and plenty of caveats. When Woodger does discuss the mental dimensions of the apostle’s case, she cites first an emergency room physician (Dr. Kirk Gilmore) for the diagnosis of depression. However, even more interestingly, Woodger states that while the physician cited felt certain that George Albert experienced depression, “he leans toward seeing it as ‘secondary depression’ caused by his lengthy ‘chronic illness’ and complicated by his ‘frail constitution’ and oversensitivity to diet” (p. 128). Further, she writes that Dr. Gilmore “discounts ‘emotional or mental illness’ because George Albert ‘was not irrational, hallucinatory, nor delusional” (p. 128). Yes, you read that right! The author who Stapley cites in his blog post as providing evidence that George Albert Smith suffered from depression in fact argues exactly the opposite.
A few pages later in the article, Woodger notes the appraisal of clinical psychologist Ford McBride, who suggests that “George Albert may have experienced a panic attack or a major depression” (p. 130). That’s a pretty big “may have” – but not a surprising one to get from a clinical psychologist when said psychologist has been asked to suggest a possible diagnosis of a person who lived a century ago and about whose particular case we have relatively limited information. Furthermore, Dr. McBride’s explanation of George Albert anxieties in terms of the causal presence of a “double-bind” situation (i.e., the harder he worked, the sicker he got, but the more he rested, the less work he got done and then the guiltier he felt about not getting work done) is really pseudoscientific and circular. In short, the double-bind explanation holds that our anxieties increase when we find ourselves in anxiety increasing situations. How, one might ask, might it be known that a person is in an anxiety increasing situation of the double-bind sort? Well, if that person’s anxiety is increasing would be the answer. See the circularity?
So, after reading Woolger’s article carefully, as well as having already studied George Albert Smith’s life and trials in some depth, I would say that what we are really looking at here is a person who was saddened and frustrated by his all-too-often inability, brought on by physical frailty and persistent illnesses, to perform the duties and responsibilities he felt he must perform. Coupled with a deep sensitivity to the needs and sufferings of others, this often left him feeling sad, inadequate, and worrisome. Such is not, however, depression as understood in psychiatric or psychological circles today. Rather than being evidence of pathology of any sort, it is wonderful evidence of normality, spiritual sensitivity, and basic goodness. It is a good thing when we do not medicate people for such things. I fear the day when compassion is reduced to pathology.
Now, onto my second, more philosophical concern with the post: The author’s much too confident assertion that “we live at a time when we can all safely view mental illness as a biological problem, like cancer, that needs to be treated.” Though offered as a statement of fact, such a claim is not, in fact, a fact, but in reality a highly controversial assertion for which there is only good evidence if you first assume to be true the very thing you are asserting to be true. That is, only if you first assume (as many in contemporary psychology and medicine do) that psychological events are really only biological in nature are you then certain that mental illnesses are primarily biological problems. The circularity of the reasoning should be obvious. That, however, is not the most serious problem here. The most serious problem is the notion that biology accounts for psychology. When one assumes that abnormal psychological events or states are in reality just the products or manifestations of biological events or states, one must then also equally assume that normal psychological events or states are in reality the products or manifestations of biological events or states. And, thus, in quite short order you have dismissed the reality of human agency, morality, and meaning. After all, if one is not responsible in any meaningful way for one’s depressive thoughts and feelings because they are the result of non-rational biological causes that are mechanical and deterministic in nature, and over which one can exert no control, then one is also not responsible in any meaningful way for one’s non-depressive thoughts and feelings because they too must be the result of non-rational biological causes that are mechanical and deterministic in nature, and over which one can exert no control. So, for example, if I feel that everyone I love really hates me and is disgusted by me, and those feelings and thoughts are really just the product of underlying brain states or some dysfunction in neurochemistry, then feeling that everyone I love also really loves me is likewise really just the product of underlying brain states or some dysfunction in neurochemistry. And, if that is the case (in both instances), then neither of those sorts of thoughts or feelings really reflects how things really are – they simply reflect something my brain happens to be doing, as series of thoughts and feelings it happens to be creating for me.
So, then, one might well ask: what status does my emotional, social, psychological life really have? Answer: Illusion. Nothing we feel or think is real or truly reflective of real relationships, meanings, or our active participatory involvement in the world. Rather, all our percpetions of such things are merely the byproduct of the underlying operations of the meat and chemicals that somehow are sufficiently complex and powerful to produce them in me. If my thought that God must hate me is really just a depressive symptom brought on by some neurotransmitters actions or absences in the limbic system of my brain, then the thought that God loves me and has answered my prayers is also just a non-depressive symptom brought on by some neurotransmitters actions or absences in the limbic system of my brain. Does God really love me or really hate me? Who knows? It doesn’t really matter anyway because your thoughts and feelings – whatever God’s thoughts and feelings might be – is simply determined for you by your underlying biological condition.
I was interested to see that the journal article makes mention of George Albert Smith’s famous dream in which he met his long-deceased grandfather, who asked him: “I would like to know what you have done with my name.” As most LDS acquainted with the story know, George Albert responded: “I have never done anything with your name of which you need to be ashamed.” Now, in the article, Woodger – as a presumably faithful Latter-day Saint – takes this dream at face value and does not in any way seek to explain it in terms of biology or psychopathology. However, the dream occurred to George Albert in 1909, in the midst of one of his “repeated sinking spells” (p. 140). Contemporary medical and psychological explanations would likely assert that the dream was either (1) nonsense generated by the random firing of synapses during sleep or (2) symptomatic of the man’s depression (because of his pathological obsession with being thought to be a good man, dutiful, responsible, and worthy). In the end, however, it doesn’t really matter which explanation is offered here, both of them reduce the dream, its contents, and revelational reality to nothingness, the meaningless byproducts of underlying brain functions. Elder Smith met no one, saw nothing, received no revelation whatsoever, on this model. Rather, he simply interpreted a bit of brain-dreaming that was either simply the product of normal brain functioning during the course of sleeping or the byproduct of a biologically based and induced depressive condition.
While the journal author does not – and presumably Shapley wouldn’t either – interpret the dream in either of these ways, not doing so simply reflects intellectual inconsistency and arbitrariness. If the brain is the source of our thoughts and feelings and dreams and disorders – then this powerful dream by Elder Smith is in fact meaningless. I am reminded of Ebenezer Scrooge’s initial response to the visitation of his former business partners Jacob and Robert Marley. Scrooge refuses at first to believe his eyes when the two ghosts appear, taking them to be hallucinations or a nightmare, explaining them by suggesting:”You may be an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of underdone potato. There’s more of gravy than of grave about you, whatever you are!” If the biological story of our psychology is, in fact, the way things are – as Stapley suggest, then George Albert Smith’s night time vision of his beloved grandfather had “more of gravy than of grave” about it. You simply can’t have it both ways. Either our biology is the source of our thoughts and feelings, dreams and disorders OR such things are better accounted for in some other way. You can’t with any logical consistency claim that our brains ONLY cause our disturbed thoughts and feelings and that something else is the source of all the thoughts and feelings we find acceptable. After all, how in the world would a brain know how to tell the difference and decide which is which, what is normal and socially acceptable and what is pathological?
Of course, this should not be taken to mean that brains and brain functioning, especially dysfunctioning, plays no role or has no consequences for our psychological and emotional life. Brains that are not functioning well, or which are damaged in some way, do in fact contribute to our experiences of ourselves and others. Brains, however, rather than being the causes of our thoughts and feelings, are better thought of as providing context and constraint on such things. That is, if my brain is not functioning properly, there are going to be constraints on my capacities and consequences for my experiences. A consequence or a constraint is not, however, the same thing as a cause. Indeed, it is exactly the opposite.For example, if my knees are broken, I cannot play ice hockey – or, at least, I cannot play it at all well. Knees are a necessary condition for the playing of ice hockey and a consequence of having damaged knees is an inability to do something I otherwise would be able to do (i.e., play hockey).
Brains are much the same in this regard. If my serotonin activity is very low, or I lack required levels of hormone production in my central and peripheral nervous systems, then I am going to have a very hard time being ecstatically joyous or energetic, or even just “feeling” normal. I just won’t have the basic energy to do or experience such things. That does not, however, mean that my lethargy and my feelings of being “down in the dumps” are caused by my serotonin levels. Rather, my serotonin levels and lack of proper hormone production leads to a general physical malaise that I am likely to interpret or understand as sadness or fatigue. And, if such things go on long enough, I might well start to understand my situation in terms of depression. I might even get so tired of feeling the way I do that I begin contemplating suicide. However, at no point did my brain or my hormones or my neurotransmitters cause me to think or feel any particular thought or feeling. It was, rather, my own active, agentic participation in my own experiences brought about my suicidal thinking and depressive misery.
Now, this does not mean, of course, that my interpretation was constructed out of “whole cloth” or is “merely subjective” nonsense that I am just making up. My interpretation of myself, my experiences, and relationships is very real and very much occurring in the context of my (perhaps dysfunctional) embodiment. Nonetheless, be that as it may, at no point is it logically justified to claim that my brain is the cause of my thoughts and feelings.It is, however, quite justifiable to say that as an embodied moral agent I am actively taking up and making sense of my experience –experience that has a profound and very real biological context.
At this point, I think it is absolutely central to state as emphatically as possible that in objecting to a biologically reductive and deterministic account of psychological events or states, such as depression, I am not in any way suggesting that the brain does not matter or is not involved in such things. It most certainly does and most certainly is. (I apologize if I am being slightly redundant here, but I am so often unnecessarily misunderstood that I want to be very clear – even at the cost of being somewhat repetitive.) My concern is that Stapley’s blog post parrots the overconfident assumptions of contemporary medicine, psychology, and scientific naturalism by suggesting that biological explanations of psychological phenomena, such as depression, are sufficient in nature – that is, that one only needs to appeal to biology to offer a complete explanation of mental illness, and nothing else really matters. This, however, is seriously flawed – though commonplace – reasoning. I would argue that biology matters to our psychological, social, and relational lives, but not exclusively. That is, biology is a necessary condition for psychological life – both normal and abnormal – but it is not sufficient to explain that life.
A quick example to illustrate my point: The human eye is absolutely necessary for vision.Without the eye, one simply cannot see anything at all. This does not mean, however, that the eye is the cause or source of vision. Eyes do not make us see things, but they are nonetheless absolutely required for us to see anything at all. Just because you have well-functioning eyes does not mean that you will be able to see something – you could for example have blindness originating in a dysfunction optic nerve. But, if you are able to see something, then you must have well-functioning eyes to do so. Similarly, then, one’s brain does not cause one feel suicidal or worthless (or, for that matter, ecstatically happy at the return of loved one who has been long absent). Nonetheless, one must of necessity have a functioning brain in order to feel suicidal or worthless, or to feel anything at all. Brains matter in deep and profound ways, they just don’t matter in the way that much of contemporary science, culture, and psychology think they do (i.e., as primary causal agents).
A further point that needs also to be emphatically stated here so as to avoid another common misunderstanding: Arguing for the central and inescapable role that moral agency plays in all human existence, in cases of so called “mental illnesses” and otherwise, is not the same as asserting that severe depression is just a matter of conscious, deliberative choice – as though one could cease feeling suicidal by consciously turning on the “happy switch.” To say that one has actively and participatorily engaged in the construction of one’s own depressive life and experiences is not to say that one was simply walking down the street one day and, after carefully weighing of the costs and benefits in a rational manner, opted to feel miserable. Likewise, it is seldom the case that one simply opts for happiness and “June and Beaver Cleaver” normality in one moment of free, rational choosing amongst alternatives. The story is obviously much more complex and multifaceted than that.
Nonetheless, agency and responsibility, as well as meaning and morality, play a key role in our active, agentic interpretations of our world, ourselves, our bodies, and our relationships. Further, our capacities as moral agents are not divorced from or in competition with our physicality and embodiment. Rather, to be a moral agent is to be an embodied being – and bodies have consequences. To say that (1) human beings are fundamentally moral agents capable of choosing, as well as actively participating in and constituting their worlds of meanings and experiences AND that (2) the brain is not the cause of our agency, our thoughts, our feelings, or our psychopathologies IS NOT to say that the body is irrelevant to our agency or that our ability to rationally deliberate and choose always reigns supremely over the conditions of our embodiment. Moral agency, intricately interwoven with embodiment, culture, and history, is clearly a matter of much more than simply the cognitive capacity to choose from a list of lifestyle alternatives abstractly presented to our intellect as though a series of items on a Chinese menu.
Given the above two qualifications, it is time for one final qualification: Criticizing biological accounts of mental illness and arguing that an understanding of human agency is vital to any viable understanding of human nature, normality, and/or psychopathology, does not mean that I think persons who are being severely (or even marginally) depressed are in any way “faking it” or aren’t really undergoing painful and powerful emotional, psychological, physical, and relational experiences. It is perfectly permissible to accept people’s actual experiences without adopting whatever indefensible explanation of those experiences happens to be currently passing for scientific truth. The theories we tend to generate in medicine and psychology, especially when informed by a naturalistic worldview, are highly objectionable, often patently false and misleading. Those who suffer, however, are our brothers and sisters and deserve our respect and most compassionate understanding. Of course, they only deserve that respect and compassion because they are so much more than their brains, they are eternal beings who are literally the offspring of a Heavenly Father who has imbued each of them with moral agency and given them a world of moral meaning, relational depth, and spiritual purpose in which to realize themselves as his offspring. I have no doubt that President George Albert Smith would have wholeheartedly agreed with this sentiment. I am not at all convinced he would have agree with the naturalistic assumptions and explanations of human life and suffering that have so taken hold of our science and our culture in these latter days.
There is much more that could and should be said about the issues I’ve raised here – e.g., the role of medication in the treatment of “mental illness,” the problematic nature of using the medical metaphor of “illness” to addressing the social, moral, emotional and spiritual problems of life, etc. – but that will need to wait for another time.
—Edwin E. Gantt, PhD
“Dr. Gilmore “discounts‘emotional or mental illness’ because George Albert ‘was not irrational, hallucinatory, nor delusional.” Wait–so all emotional and mental illness is characterized by behavior that is “irrational, hallucinatory, [n]or delusional”? That’s ridiculous. Plenty of people (I’d wager to say most people) with emotional and mental illnesses are not irrational, hallucinatory, or delusional.
“It was, rather, my own active, agentic participation in my own experiences brought about my suicidal thinking and depressive misery.”
I’m a bit worried about Gantt’s conclusion that people who struggle with depressive thoughts, etc. are personally responsible for how depressed they are. Do we really want to say that it’s George Albert Smith’s fault that he felt the depression and anxiety that he did? Surely there are important biological factors at play. The rather ironic thing here is that Stapley blamed Smith’s anxiety and depression (whether actual clinical diseases or not) more on natural and biological causes, while Gantt seems to be blaming them more on Smith himself.
Thanks for sharing Ed, lots of food for thought. Today’s concept of “Clinical Depression,” seems to me to be somewhat of a cultural creation. Fancy new names and ways to define something that is very basic to the human condition. By defining, labeling, and characterizing it in certain ways, it takes on a life of it’s own, and people begin living out the prophesies of their cultural diagnosis.
As a depressive myself (at least clinically diagnosed so), I find it comforting to find great company among prophets of the scriptures and church history. My favorite scripture is from the Book of Mormon: “Our lives passed away like a dream, we were wanderers, cast out from Jerusalem, therefore we mourned out our days.”
There is so much depression, sadness, and leaden sobriety in the scriptures, it makes me smile that we have such a cult of happiness in the church today. George Albert Smith’s condition fits in nicely with most of the Biblical prophets. Nothing particularly unique or special about it from what I’ve read. And those were depressing days in the church. Most of the church went inactive during that time. My own LDS ancestors lived lives of crushing poverty, and frequent despair, cast off, as they were, by Brigham Young, to remote and desolate locations to try and survive on their own.
I do appreciate Jonathan Stapley’s desire to try to cut down the “cult of happiness.” I’m all for that. But I agree that appealing to our culture’s current definitions of clinical depression to define past events is very limited.
Tim, I believe you skipped several paragraphs of Dr. Gantt’s comments.
Tim,
Reading this post, I got the feeling that for some, it’s going to all be reduced to finger pointing and who to blame. Your first comment didn’t disappoint, I suppose. But really, it is rather disappointing, because it seems like the tendency is to always argue and “win” in these cases and it’s sad to see a complex topic being reduced to two sides: blame your (defective) biology, or blame yourself. With the human tendency to naturally want to blame something or someone for everything, it’s not surprising, but still makes a conversation somewhat difficult I think.
Tim, I think one of Dr. Gantt’s central points is that modern society is in the habit of pathologizing vast swathes of otherwise normal human experiences. Unhappiness, sadness, sorrow, empathy, and anxiety are not illnesses, and not even so when we sometimes experience them persistently. This isn’t “blaming” George Albert Smith… it’s saying there’s no “blame” to pass around. If anything, Dr. Gantt is praising George Albert Smith for being willing to mourn with those that mourn, and for being troubled by mortal inability to respond fully to all those to whom his heart responded. That isn’t blaming George Albert Smith for his sadness and anxiety, it’s saying that sadness and anxiety are often not blameworthy or an illness, but a perfectly normal experience for good-hearted people.
And even during times where we do feel as if biological constraints keep us from feeling content and happy when we think we should, the way we interpret, respond to, and make sense of those experiences are well within our control. That’s not saying that biology plays no role in our experiences (something Dr. Gantt was careful to point out), it’s simply saying that our experiences are not solely the product of our biology, and that we can construe and interpret them in a variety of ways.
aka, interpreting them as a biological illness that needs to be cured is not a prior better than interpreting them as evidence of personal wrong-doing (many with depression berate themselves for perceived faults). Both somehow assume that sadness at the human plight and malcontent with our mortal constraints to help others are somehow wrong and need to be eliminated.
I appreciate that Edwin Gantt took the time to write some of his thoughts in reaction to my post. I’d like to make a couple of points and then ask a couple of questions.
This was my statement regarding George Albert Smith: “the new manual does not mention George Albert Smith’s lifelong struggle with what appears to be some sort of chronic depression and anxiety disorder. Instead it describes his health issues and years of convalescence as strictly physical maladies (which though technically correct, obfuscates the real mental illness component of his suffering).”
I tried to be vague as I am not qualified to diagnose Smith, and perhaps my language was too precise. I will say that my comments were based on more than Woodger’s article. Though I am not an expert on the documentation of Smith’s life, I am familiar with more sources than those outlined in the article. My comments reflect that broader context. You may still disagree with them emphatically. Gantt hints that he is familiar with this broader context as well, but it is not clear.
Gantt also suggests that his reading is a minority view in academia. I’m very interested in these broader critiques, and would appreciate being referred to any published versions of them. Is the idea that mental illness is not biological widely accepted?
My graduate training was not in this area of science, but it is my perspective that the understanding of biological mechanisms relating to mental illness are still very poorly understood and that cognitive science is still in the proverbial dark ages. Nevertheless, Gantt is right that I do generally take a naturalistic approach to diseases. I appreciate his emphasis on morality and agency, but it seems (and this may be the result of the informal nature of his post) that it doesn’t consider agency a vector. If that is a correct description, then I would disagree.
Lastly, I wrote the post in five minutes, and had I imagined that it would have received the traction that it did, then I would have likely been more careful in my descriptions.
Actually, I’m not sure Dr. Gantt’s analysis really affects Stapley’s conclusions at all — namely, that the topic of Pres. Smith’s life would have been an excellent opportunity — but alas, it was a missed one — for the manual to address mental health concerns among the Saints. I don’t think Stapley ever held himself out as an expert in the field, but seriously, how does Dr. Gantt’s missive here really alter the outcome?
Steve, if what Dr. Gantt says is true (that there is no real evidence of mental illness in George Albert Smith’s life, and the experiences we interpret as symptom’s of such are actually frequently normal experiences for good-hearted people), then using George Albert Smith’s life as a launching point for a discussion of mental health concerns may simply further perpetuate a misunderstanding of mental health (namely, that sadness, anxiety, discomfort, discontent are maladies to be cured, rather than normal experiences to be lived and learned from).
ldsphilospher, I’m working under the assumption that there is a normal curve which would generally describe the ability or propensity for people to feel sadness anxiety, discomfort and discontent (and I would add things like empathy). And I agree that these are all very important experiences. It is my opinion that George Albert Smith was outside that curve in several aspects. I am also under the working perspective that there are generally biological reasons that people fall outside the curve.
I’d also like to ask about the title of this post, namely the “pathologization of compassion.” I’d like to get some clarification on where that comes from. Let’s consider a hypothetical example of someone who suffered from polio at an early age and lived with constraints on his or her physical body was more compassionate for it. If we were to say that this person consequently had a great measure of compassion, would we be similarly pathologizing compassion?
J. Stapley, I think Jesus Christ was outside that average curve as well. Would you want to diagnose Him with depression as well? Would you want to refer Him to a counselor as well? Many people have experienced more sorrow, sadness, and anxiety than is average for their peer group. Just because one deviates from the norm, or experiences life as an outlier on the bell curve, doesn’t mean they are sick.
It seems to me that the question of whether Pres. Smith had what we would call a mental illness is a purely academic question, to be decided on its merits. But the passion against that proposition seems almost to make J. Stapley’s point about stigmatization: Heaven forbid that a past apostle/prophet be said to have had a mental illness lest it reduce his humanity, his noble character, and cause us to medicate away all our problems.
Jared, it has nothing to do with damaging his character. Having a mental illness would not lessen my opinion of George Albert Smith at all. My problem is with making the diagnosis based upon the described symptoms, which don’t sound at all like depression to me and more like the experiences of any ordinary, good person faced with suffering he wishes he could ameliorate. The problem is pathologizing basic human goodness. It isn’t bad to feel sorrow, anxiety, and distress at the plight of others and your inability to help them. It’s good, and to refer to it in the same way we refer to conditions we medicate is, I think, a travesty.
ldsphilosopher, I don’t think anyone has a real basis to evaluate the life of the Saviour from such a perspective (being God made him an outlier in many ways); so I don’t think it really relates to our conversation.
Your point about sickness and outliers is interesting. I think the bell curves are generally wide. But if someone is incapacitated, I generally associate that with a pathology of one sort or another.
Though I find it poignant, I also find the Catholic idea of Salvifici Dolores ultimately unsatisfying from a Mormon perspective (despite the long tradition of the imitatio Christi among our people).
It isn’t bad to feel sorrow, anxiety, and distress at the plight of others and your inability to help them.
I think we are in agreement ldsphilospher. I think we probably then only disagree over the historical record. I’m unaware of your familiarity with it, so I beg your pardon.
I like this quote from Spencer W. Kimball: “Being human, we would expel from our lives sorrow, distress, physical pain, and mental anguish and assure ourselves of continual ease and comfort. But if we closed the doors upon such, we might be evicting our greatest friends and benefactors. Suffering can make saints of people as they learn patience, long-suffering, and self-mastery. The sufferings of our Savior were part of his education.”
I wrote in more detail about it here: https://www.millennialstar.org/the-yellow-brick-road-syndrome/
Thanks for posting this, ldsp and Dr. Gantt.
ldsphilosopher,
“it has nothing to do with damaging his character”
I didn’t mean that the mere fact that he had a mental illness would damage his character. I meant that some of his anxiety, sadness, etc. could be attributed to the illness rather than his nobility of character.
That said, I am agnostic on whether he did, in fact, have a mental illness, and of course suffering can be a part of normal life. So, like J. Stapley, we probably agree. On the other hand, aches and pains are a normal part of life, but perhaps you would agree that if they become debilitating, it’s time to seek medical treatment.
Wow. And wow. I might take this post a little more seriously if the author had bothered to get Stapley’s name right.
Gantt seems to totally and woefully misrepresent anything either Stapley or Woodger wrote.
And I find it rather unsettling to have a professor of psychology at BYU write about the treatment of “mental illness,” with scare quotes around “mental illness.” His ideas sound more like Scientology than anything I’ve ever heard in the Church.
“Researcher,”
Questioning contemporary constructs and assumptions about mental illness shouldn’t unsettling. Rather, we should be unsettled when questioning prevailing assumptions becomes anathema and is ridiculed.
Also, I think you’ve haven’t read the right literature yet. Neal A. Maxwell gave a fantastic lecture about some of the ways that contemporary psychology and our assumptions about mental illness are wrong. Ezra Taft Benson is famous for saying, “The precepts of man have gone so far in subverting our educational system that in many cases a higher degree today, in the so-called social sciences, can be tantamount to a major investment in error.” LDS Psychologists just haven’t yet had the courage to stare down scientific convention and question central assumptions.
It is inconsistent for someone to condemn J. (and/or MJWoodger) for diagnosing “from 30,000 feet” and in the very next breath to announce his own diagnosis: “I would say that what we are really looking at here is a person who was saddened and frustrated by his all-too-often inability, brought on by physical frailty and persistent illnesses, to perform the duties and responsibilities he felt he must perform. Coupled with a deep sensitivity to the needs and sufferings of others, this often left him feeling sad, inadequate, and worrisome.”
Two observations.
1. Yes, we should exercise care making a diagnosis when we are this far removed. It is, however, relevant to know that Heber J. Grant referred to George Albert Smith’s condition as a mental problem and Abraham Smoot described it as a breakdown. Sure, they weren’t trained clinicians, but then neither is a psychologist, even one with a PhD. I think we should allow the opinion of Smith’s contemporaries to have at least some valence.
2. This breakdown, which resulted in treatment in a sanitarium, lasted for three years. For over 36 months, George Albert Smith was completely debilitated. ldsphilosopher, do you know anybody who can’t get out of bed for 3 years because he is excessively empathic? Do you think that is a healthy or desirable condition? If Gannt were a psychiatrist, I’d be interested to know what treatment he would prescribe, or if he thinks this is normal, and does not indicate treatment.
Gannt claims to be familiar with the details of George Albert Smith’s condition, and he may well be. However, since he didn’t deal with these details, it is impossible to know.
Thank you for adding this post to the discussion. Perhaps Stapley will write a follow-up post that draws upon the other sources he mentions in #8. All of this is helpful.
Mark, 25: Could you please provide the source for the info about Smith in a sanitarium as well as the quotes from Grant and Smoot? I would very much like to read more on that. Thanks.
It seems this whole debate is part of a larger one views are part of a growing concern that the medical and pharmaceutical industry have been over-zealously pathologizing depression, both because it is more profitable, and also as “a method of indoctrination into the pieties of American optimism, an ideology as much as a medical treatment,” in the words of Gary Greenberg, author of “Manufacturing Depression.”
Allen Frances, an editor for the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has a lot of ambivalent feelings about his industry’s continual redefining of mental disorders. http://www.wired.com/magazine/2010/12/ff_dsmv/all/1
BrianJ — D. Michael Quinn, The Mormon Hierarchy: Extensions of Power
As someone who has struggled with severe depression and anxiety for going on nearly four months, I can tell you, from personal experience, that depression and anxiety are real and, for me, sometimes debilitating. I went three months without any prescription medication. I reached a point where I realized that prayer, priesthood blessings, and happy thoughts were not sufficient to assist me out of my deep, dark hole. My ability to function today is due in part to medication prescribed to me by my primary care physician. I am thankful for modern medicine and what it has done for me.
Mark,
One day, I combed through the sources of one of D. Michael Quinn’s papers. I looked up his original sources. I read the works he read. And I never again trusted him as a scholar. He is incredibly adept at drawing conclusions and making them appear legitimate, based on the flimsiest of evidence.
What you say may or may not be true. I do not trust D. Michael Quinn as a source, though. I’ve combed through some of his work and do not consider it to be honest scholarship.
I am confused, ldsphilosopher, are you a philosopher or a pyschologist or a psychiatrist or some combination of the three or none of them at all? To disclose this would really help in the discussion. If a philosopher, are you so confident in your training in what I presume is philosphy to diagnose someone’s mental health? I am no philosopher but I have spent a good deal of time studying ancient philosophy, and if there is one thing that I have learned it is that one is best served by readily recognizing the limits of one’s knowledge.
So please disclose your training so that I and others can better assess the post and the ensuing comments. Thanks!
I am just finishing up a masters degree in theoretical and philosophical psychology.
ldsphilosopher, I share some of your reservations about Quinn’s tendency to see unwarranted connections and to arrive at shaky conclusions.
But my reservations do not extend to his honesty, and I do no think he makes up quotes.
Thanks, ldsphilosopher, that is what I wanted to know.
I don’t know who of these two is right, but it really doesn’t matter. What I take away from George Albert Smith’s health issues (mental, phsycal, both etc.) is that he was a human, plauged by troubles. For me it was good to see that even those in high posistions of leadership can have regular problems. I have family members who have struggled with mental illness issues, and I’ve been on anti-anxiety medicine myself a few times. I’ve never thought it was a sign of weakness, or unrighteousness or of a faltering testimony, but I know there are those out there that do think this way and are very unkind about it. Hopefully, one of the things we can all learn from President Smith is how to show more compassion and empathy to those that struggle and those that want to do what is right and good, but might not always have the physical capacity to do so. One thing that has always impressed me about Pres Smith is that despite his frailties, he kept on going as best as he could and put his trust in the Lord to carry him along.
ldsphilosopher and Dr. Gantt,
Is there such a thing as “clinical depression” where help from a psychologist or psychiatrist is useful? If so, how does one distinguish between clinical depression and long term melancholy?
Very interesting article, however, I much appreciated Stapeley’s article also. It was brief, opened up new ideas, furthermore it was clear that it was a thumbnail sketch. While I understand Gantt’s perspective and the point he was trying to make and that he is probably an experienced psychologist, he is clearly not a clinician, or psychiatrist. It is an interesting opinion piece though.
ldsphilosopher could you tell me your name so that I can acknowledge you as a scholar and not just a pseudonym.
“dsphilosopher could you tell me your name so that I can acknowledge you as a scholar and not just a pseudonym?”
I am not speaking for him, but why? This is the Internets, not some academic round table. I am sure that if he, or myself for that matter, wanted to tell us our names that we wouldn’t use a pseudonym. Not knowing who we are so that we can be free to say what we want without real world incrimination is the whole point. Or, to put it more directly, I don’t trust the Internets as a safe place to be out in the open with who I am, but its great to be open to what I think.
As for this argument, I too found little if any evidence to support that claim that Pres. G.A. Smith had clinical depression. Not that he wasn’t depressed as he was physically frail and had long periods of bad health. That can cause anyone to feel emotionally drained and depressed without hope. I think the point of this article and one that I agree with is that if one has depression (even for long stretches) that doesn’t mean its clinical. That more than likely means its normal in the situations we find ourselves. Put me down as another vote that modern psychology is obsessive about medicating normality when metaphorically a good swift kick in the head would be more appropriate.
“dsphilosopher could you tell me your name so that I can acknowledge you as a scholar and not just a pseudonym?”
I am not speaking for him, but why? This is the Internets, not some academic round table. I am sure that if he, or myself for that matter, wanted to tell us our names that we wouldn’t use a pseudonym. Not knowing who we are so that we can be free to say what we want without real world incrimination is the whole point. Or, to put it more directly, I don’t trust the Internets as a safe place to be out in the open with who I am, but its great to be open to what I think.
As for this argument, I too found little if any evidence to support the silly claim that Pres. G.A. Smith had clinical depression. Not that he wasn’t depressed as he was physically frail and had long periods of bad health. That can cause anyone to feel emotionally drained and depressed without hope. I think the point of this article and one that I agree with is that if one has depression (even for long stretches) that doesn’t mean its clinical. That more than likely means its normal in the situations we find ourselves. Put me down as another vote that modern psychology is obsessive about medicating normality when metaphorically a good swift kick in the head would be more appropriate.
Sorry for the double post. The first came up as an error so I didn’t know if it worked, and I had to change a few lines to get the second one posted.
Jettboy: So do you believe that such a thing as clinical depression exists, or do you deny it in all cases?
Also, do you oppose using medication to overcome depression if that depression is still “normal” as you call it? Why? Do you oppose all medications that are designed to alleviate “normal” human suffering?
Lastly, you say that you found “little if any evidence,” and yet several commenters here pointed to what should be considered as evidence (not conclusive, sure, but still evidence). Is it that you did not see those comments or is it that you saw them—i.e., “found” that evidence—but then dismissed it?
BrianJ,
You asked “Could you please provide the source for the info about Smith in a sanitarium as well as the quotes from Grant and Smoot?”
These sources (and others) will be detailed in ‘A Selected Chronology of George Albert Smith’ — being presented at LDS-Church-History over the next few months.
http://bit.ly/aboutldshist
“Lastly, you say that you found “little if any evidence,” and yet several commenters here pointed to what should be considered as evidence…”
Where? I didn’t see any evidence pointing. Just statements that evidence exists garsh darn’t and you better belv’ it!
Um, let me get two things out of the way first: Stapley, not Shapley. You can’t fix that??? Also, your use of the word “potential” is incorrect. I would use possible. Potential suggest a future problem.
This is my deal: I WANT him to have been mentally ill because it gives me some hope for myself. I’m not proud of it, but it’s the truth.
I learned from both posts; however, Dr. Gantt, I must say, if all they said in the lesson was “he struggled with his health, he was a kind and sensitive man and sometimes that got him down” I’d feel better about it. It’s the appearance that (once again) we’re hiding unpleasantness and sugar-coating a situation that really drives me nuts.
And again, not to mention all the crazy, sick and depressed women sitting in Relief Society who’d benefit from knowing they’re not the only ones.
(You wouldn’t believe how often I go the rounds with doctors who tell me I’m sick because I’m depressed. Possibly. But I think I’m depressed because I feel like crap most of the time.)
Why append PhD to your signature? It suggests that you’re not convinced by the logic of your arguments, and feel the need of an appeal to authority.
Mark B. JD
I don’t know why they append like that. We will probably never know.
Dr. David M. Morris (Ph.D.)
If I’d gone to college all those years, spent all that money, worked my tail off, I’d sign my name: Dr. Arlene Ball, Phd who studied at SUU, earned a 3.8 and wrote her doctoral thesis on how early childhood trauma affects physical health in later years while juggling life as said early childhood trauma affected sick person and is pretty cool since she’s a DOCTOR.
Or something like that.
Well, we really should go all British and include the name of the university (you know, LL.B., (Camb.)) so we know you didn’t get that PhD down at the Trade Tech.
Mark B. JD (UChicago)
Mark, not Mark B. and Brian J- You should read the article from JMH that Stapley links to in his post. Or ready my synopsis of it here. http://www.newcoolthang.com/index.php/2012/01/how-i-intend-to-teach-george-alberts-smiths-mental-illness/2953/
Smith was in a Sanatorium for 5 weeks as part of that three year period after his breakdown. Quinn plays fast and loose and cherry picks the quotes a bit.
Matt W, very nicely done. Thanks for linking that here.
Hey, but you know Stapley got the narrative right. And that’s all that really really matters isn’t it?
Brig
Jettboy, 42: My questions appear to have annoyed or upset you, or otherwise simply not been worth your time. That is unfortunate as they were sincere. I am preparing to teach the high priest group about depression and was interested in your viewpoint in case any of the high priests in my ward have similar views. I had hoped to incorporate any additional wisdom or insight into my lesson.
The whole subject upsets me BrianJ. I am tired of the very idea that the LDS Church doesn’t teach history as if hiding something. That is anti-Mormonism at its finest and I don’t care if it comes from the membership. The manuals teach what they need to teach. There comes a time when people of faith need to learn that there needs to be a wall of separation of Church and Academics. For instance, I really love Rough Stone Rolling and even well done Biblical Criticism even if half the stuff I disagree with, but they have no business used in Sunday School class or over the pulpit. Those who use them miss the whole point of religion. What is the point? To grow closer to God and not history, science, etc. They are important as individual studies, but not in a Church setting. Jesus didn’t come here as a teacher of the classroom or Roman learning, but of Righteousness. He didn’t use Plato, but the Scriptures and everyday life.
A side issue is that I might do a post on is that we have no business trying to be understood or find others who we can relate to; the point of the contention with this issue it seems. We are to understand God and Him only; conforming to His image and not He or others to ours. That is a revelation I had once when contemplating my own worth and place in the world. It occurred to me that is the wrong approach to life. We shouldn’t be trying to be like any mortals and certainly we shouldn’t care if others are like us (or if God is even like us). We should only care if we are what God wants us to be and what that is. Should I find someone who fully understands me I will be grateful, but in the end it will be inconsequential.
Finally, I kind of hinted at the answer to your questions. I see a lot of conjecture about depression from straight forward evidence of his physical frailty and sickness, but no concrete evidence of his mental state. I want pointed out “I felt sad, I felt sad, I felt sad yet again going on two years. There was no body ailments for the last –, but I still feel sad.” He was sick without doubt and I am sure it made him depressed even, but that is far from clinical depression. Its called life and when he wasn’t sick it doesn’t seem he was depressed.
Jettboy, I think those are good points. If GASmith had been even more obviously depressed and suicidal, the Curriculum department of the church would have probably left that out even then.
There is a stigma against mental illness among church membership, and the church may not want to challenge those stigmas if they might shake some people’s faith, even if it was more historically accurate.
Church curriculum is set at the standard for the weakest of the saints, presenting a clear, black and white world of happiness and prosperity resulting from commandment keeping. However, dig a little in the scriptures, and actually take them at face value, and you get totally blown away by the existential crisis inherent in them. Thankfully, we have the archaic language KJV and obscurity of the text to keep most of those crisis from ever reaching the surface in Gospel Doctrine class.
“With much wisdom comes much sorrow; the more knowledge, the more grief.” Ecclesiasties 1:18.
Jettboy, 52: I’m afraid that I don’t at all understand your comment—partly because you seem to argue against trying to be understood. I suppose I have to live with that if that’s your decision. Also, you only hinted (in comment #42) at the answer to my third question (in comment #40).
As far as Church manuals go, my questions have absolutely zero to do with them; my lesson is for the first Sunday for which there are no manuals. As such, I will happily bring into my classroom any books, philosophy, science, scripture, history, etc. that the Spirit directs—including any wisdom I might gain through blog discussions.
By the way, I don’t really care whether or not George Albert Smith was depressed since whatever his ailments were they are in his past; my concern is for the living members of my quorum, their families, and the families they home teach.
Some might say that Americans’ insistence on cheeriness and optimism is what’s pathological.
A pretty close friend of mine opened up one night and said he’d been struggling with severe depression for awhile. What helped him was to stop thinking of it as an illness or a psychological problem and to accept it as his earthly lot. A cross to bear–my words, not his, but he agreed that they described when he was getting at. When he accepted that, he said, he was still sad and gloomy a lot, but it was no longer as debilitating.
My view is that sadness is appropriate, since even Heaven weeps; that the insistence on being happy can edge over into tyranny at times; that we have got into some pretty murky area with our diagnoses of mental illnesses these days; and that the boundary between “biology” and mind/spirit isn’t as clear cut as we’d like in either direction.
I appreciate your comment, Adam.
Until anyone has experienced severe depression, it is easy to say: Just be happy! It is not that easy. Believe me…I have tried. I wish it were that easy.
Whether depression is a mental illness or not, I do not know, nor do I really care. My primary concern is getting back to the point where I feel ‘normal’ again, and remove the heavy burden of pain and sorrow that is on my shoulders, and in my heart.
Anonymous, nobody in this thread—I repeat, nobody—has suggested that people with depression “just be happy.” Rather, many of us are trying to say that it’s OK TO BE SAD.
Anonymous, 56: I have to agree with ldsphilosopher that Adam G (#55) did not say that depressed persons should “just be happy.”
I have to disagree, however, with ldsphilosopher and Adam G that “it’s okay to be sad.” Not because being sad is unnatural, or that we all need to be happy always, but because “being sad” is really not at what depression is—like saying to a Type I diabetic that “it’s okay to be thirsty.”
BrianJ,
what I said was that in the case of one individual I know, acceptance of sadness was a route to recovery from depression. Neither I nor my friend believe that sadness and depression are identical. I don’t think I said anything like that.
Adam G, 59: Thank you for clarifying your comment (#55). I read you the way I did because your second paragraph was about a specific friend, but your first and third were clearly general/universal statements. Thus, when you shared detail of what your friend said worked for him, it seemed you meant to use him as representative. Sorry for the misunderstanding/misrepresentation.
I can’t believe that history professor took it upon herself to diagnose President Smith with a mental illness. The lack of scholarship is amazing in the face of overwhelming evidence of true physical illness. I’m trying to link to this post at MM but I cannot figure out what I’m doing wrong. “I’ll be back.”