BB3: Sally Satel: Individual Flourishing and the Mental Health Industry

This is the 13th in a series of posts on presentations given at Beyond Belief 3: Candles in the Dark"

You can find a list of all Atheist Ethicist blog postings covering Beyond Belief 3 at the Introduction post

And I would like to encourage you to give a contribution to the Science Network, who makes these presentations available for free.

Sally Satel rose to speak about the relationship of the mental health professional to human flourishing.

She started off her talk by looking at the reasons people seek mental health professionals, linking those reasons to the pursuit of human flourishing.

She included such things as:

• Symptom relief - depression and anxiety "because those limit human potential significant."

• Change behavior.

• Obtain insight and self-understanding.

• Because they know that they are sabotaging themselves.

She also spoke about her own role as a part-time worker in a methadone clinic. She looked at the question of whether there is any sort of incompatibility between human flourishing and the use of medication in order to obtain such a state - such as the use of methadone by opium addicts.

She admitted that the drugs were a crutch. However, she denied that there is any relationship between the use of a drug to obtain flourishing and flourishing itself.

Her claims were made against the belief that a person who used some drug (e.g., Prozac) to influence the brain could not obtain the flourishing of somebody who did not use such a drug. She compared the state that a patient may be in with medication with the state that the patient would be in without the medication and gave the argument, "It is better than the alternative."

Yet, better than the alternative need not be good. A financial setback where an individual loses half of his wealth might be "better than the alternative" of losing everything. However, it is still not as good as losing nothing.

So, the question still comes up whether a person who obtains a state of "human flourishing" through the use of some sort of medication can have as good a life as a person who uses no medication.

There is absolutely no reason to think that the use of medication is, in itself, a detraction from the quality of a person's life.

When we eat or drink, we ingest chemicals because those chemicals are useful to maintaining particular body functions. We put iodine in salt to prevent some physical problems, vitamin-fortify breakfast cerials, take vitamins. Even breathing is an ingestion of a chemical that helps the body to function better than it would have functioned without oxygen.

There is nothing about the ingesting of chemicals that is, per se, something incompatible with flourishing.

The only argument that can be given against medication is that it involves the ingestion of chemicals that people generally do not use. It is an argument that only makes sense under the assumption that "natural" has some sort of intrinsic value. However, intrinsic values do not exist. Any claim that what is "natural" is (intrinsically) better than what is "unnatural" or "not natural" is false. There is no useful measure of value to be found in this area.

Satel then went on to look at the impact that the mental health industry itself might have on helping - or, actually, on hindering people from obtaining human flourishing. She argued that, with respect to some problems such as Post Traumatic Stress Disorder, the reaction of the mental health industry might have a strong negative influence on the patient.

She illustrated her point with the story of an Iraq War soldier who applied for and obtained the status of 100 percent disabled as a result of injuries he suffered during the war. According to Satel, this was a disservice to the individual soldier because it confirmed the view that he would no longer be a functioning member of society. The award of total disability becomes a self-fulfilling prophecy. The patient can say, "See, this proves that I am now incapable of doing anything productive with my life - the military said I am totally disabled."

The general concern about this specific story is for mental health professionals to learn to recognize when they are contributing to a problem, rather than dealing with a problem. Where people come to the health professionals to improve "human flourishing" (whatever that is), the health professionals need to be concerned with the possibility that they are locking in states that will get in the way of flourishing.