Badness and Mental Illness: Not the Same Thing

A reader asked me to comment on an article written by the mother of a would-be killer, a violent young person with no conscience whom the mother felt should be entitled to mental health services to correct his low character. My comments were as follows:

People who initiate harm against others and feel no remorse about it are not “mentally ill” in the same sense that a depressed, anxious or delusional person is. If you want to put it in psychiatric terms, you can — as Dr. Stanton Samenow did in his book “Inside the Criminal Mind” — refer to it as antisocial personality or, using the older term, ‘sociopath.’

The author of this sad passage is confused and lumps together two things: (1) psychological problems and (2) plain old badness compounded by psychological problems.

Every time there’s one of these awful events (going back at least to Columbine), people love to claim that “if only there were more free mental health services, these things wouldn’t happen” while they ignore the distinction between emotional problems versus a total lack of conscience or ethics of any sort.

Does it occur to people that a bad person doesn’t want therapy? From the criminal or violent perspective, wish fulfillment is an entitlement, at any cost. It’s a price others must pay, no matter how wrong or irrational. People unconcerned with virtue or reason are the last ones who would ever seek therapy. At best, they’d sit in a therapist’s or psychiatrist’s office and say what they think they’re supposed to say. To con, not to change, is the most you could ever expect of someone like this. It’s pure fantasy and ignorance, sheer magical thinking, to suggest that greater “access” to mental health services will do anything to alleviate killing. A greater willingness on the part of the nonviolent, and the innocent, to refuse to tolerate irrationality would go a long way to stopping violence. Therapy ought to help the innocent learn to stand up for themselves, not engage in the pretense that you can give a person a conscience who has no desire for one.

It seems that people are reluctant to label evil people what they are — evil — because they prefer to live in a world where they can pretend such things don’t exist. I’m a mental health professional and I’ve helped a lot of people over twenty-five years, but believe me when I say that bad people are just plain bad. They cannot be helped, and they don’t want to be. It’s their victims who are most often my clients, not the ones who perpetrate all the evil and abuse, and see no problem in doing so.

You cannot lump together being depressed or anxious with plain old badness. Emotionally troubled people almost always have a conscience and a sense of ethics. Sociopaths do not.


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