Normality Does Not

Equal Mental Health

 Also from Steven James Bartlett
The Pathology of Man: A Study of Human Evil
Reflexivity: A Source Book in Self-Reference
When You Don’t Know Where to Turn: A Self-Diagnosing
Guide to Counseling and Therapy
Self-Reference: Reflections on Reflexivity (co-edited with Peter Suber)
Conceptual Therapy: An Introduction to Framework-Relative Epistemology
Metalogic of Reference: A Study in the Foundations of Possibility
VALIDITY: A Learning Game Approach to Mathematical Logic
As editor of these books by Paul Alexander Bartlett:
Voices from the Past – A Quintet of Novels
Sappho’s Journal
Christ’s Journal
Leonardo da Vinci’s Journal
Shakespeare’s Journal
Lincoln’s Journal
 Normality Does Not
Equal Mental Health
The Need to Look Elsewhere for Standards
of Good Psychological Health

Steven James Bartlett

Copyright 2011 by Steven James Bartlett
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, except for the inclusion of brief
quotations in a review, without prior permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Bartlett, Steven J.
Normality does not equal mental health : the need to look elsewhere for standards
of good psychological health / Steven James Bartlett.
p. cm.
Includes bibliographical references and index.
ISBN 978–0–313–39931–2 (hard copy : alk. paper)— ISBN 978–0–313–39932–9 (ebook)
1. Mental health. 2. Psychology, Pathological. 3. Creative ability. I. Title.
RA790.5.B345 2011
362.2—dc22 2011015147
ISBN: 978–0–313–39931–2
EISBN: 978–0–313–39932–9
15 14 13 12 11 1 2 3 4 5
This book is also available on the World Wide Web as an eBook.
Visit www.abc-clio.com for details.
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Dedicated to those who are willing to see things differently,
who may therefore lead the way to better people.
Einstein was once asked, “What can we do to get a better
world?”
He replied, “You have to have better people.”
—Quoted in Wynne-Tyson (1985/1989, p. 422)
 Contents

Preface xi
Acknowledgments xiii
A Note on Conventions xv
Introduction xvii

Part I. Normality and Mental Health 1

Chapter 1. Questioning the Standard of Normality: Steps to a

More Effective Understanding of Mental Health 3
From the “Banality of Evil” to the “Evil of Banality” 6
The Dispositional Pathology of Psychological Normality 11
Psychological Normality Is Not Mental Health 13
Positive Illusion and Resistance to the Pathology
of Normality 16
Where We Might Go from Here 18
Toward a More Effective Understanding
of Mental Health 23
Mental Health as Exception to the Rule 27
A Preliminary Conclusion 29

Chapter 2. The Psychology of Definition in Psychiatric Nosology 31

The Need for a Psychology of Definition 33
The Purposes of Definition in Psychiatric Nosologies 34
Stipulative Definitions as Sources of Authority 36
Real Definition and Reification 38
viii Contents

Defining Mental Disorders into Existence 40

The Dysfunctional Nature of the Psychology of Definition 41
Choices in the Interpretation and Recognition of Disease:
Physical Pathology and Mental Disorder 43
The Psychology of Symptom Clustering 45
Psychiatry’s Inflationary Ontology 49
The Concept of Mental Illness Is No Myth but the Result
of Dysfunctional Thought 51
The Psychology of Resistance to Idiopathic Disease 53
Do Internal Malfunctions or Dysfunctions Underlie
Psychiatric Syndromes? 54
The Psychology of Definition and Claims to Truth 56
The Next Step in Reification 58
Intelligent Science and Stopgap Definitions 59
To Summarize 61
Is Nosology Essential to Effective Clinical Practice? 64

Chapter 3. The Abnormal Psychology of Creativity and

the Pathology of Normality 70
The Abnormal Psychology of Creativity 71
The Inner Turmoil Thesis 73
Who Is Harmed? The Ascription of Pathology 75
The Situational Thesis 76
The Psychopathology of Normality 79
The Psychiatric Plight of the Artist 82
Afterword 84

Part II. Psychology During a Collapse of Culture 87

Chapter 4. Acedia: When Work and Money Are the

Exclusive Values 89
Work and Cultural Bankruptcy 91
The Symptoms of Acedia 95
Acedia: Moral Failure or Psychiatric Disorder? 97
Treatment of Work-Engendered Depression 100

Chapter 5. Barbarians at the Door: A Psychological and

Historical Profile of Today’s College Students 102
What Higher Education Meant 103
The Degradation of the Ideal of Higher Education
as a Result of Democratic Values 104
Contents ix

The Self-undermining History of Higher Education

in America 107
The Pathology of Narcissism 113
Barbarity as a State of Mind 119
The Mediocre Population, the New Barbarians 120
The New Dark Age, Already in Progress, and the
Disappearance of Higher Education 122
Sobering Reflections 124

Chapter 6. Psychology, Culture, and the Demoralization

of University Faculty 127
The Nature of Career Burnout 129
The Concept of Situational Depression 131
The Situation in the Liberal Arts 133
Situational Depression of Faculty in the Liberal Arts 137
Adjustment Disorders and the Liberal Arts 138
Treatment for Liberal Arts Demoralization 141

Part III. Beyond Long-standing Facts 145

Chapter 7. The Psychology of Abuse in Publishing: Peer Review

and Editorial Bias 147
Gag Orders through Time: Socrates, Savonarola,
Copernicus, Bruno, Galileo 152
Religious Belief, Imprimatur, the Inquisition, and the
Index Librorum Prohibitorum 154
Sedition, Treason, Censors, and Censorship 156
Academic Freedom versus Peer Review and Editorial
Tampering 157
Running Afoul of the Belief Systems of Peer Reviewers
and Editors: Varieties of Abuse in Peer Review and
Editorial Tampering 159
The Psychopathology of Peer Review and Editorial Bias:
Blocks to Creative Research 167
Obligations to Which Peer Review and Editing
Must Answer 170
A Code of Conduct for Peer Reviewers and Editors 172
Removing the Psychological Obstacles Erected by Peer
Review 173
Conclusion 174
x Contents

Chapter 8. The Psychology of Mediocrity: Internal Limitations

That Block Human Development 178
A Brief History of a Mundane Trinity: Mediocrity,
Mediocre, Mediocracy 183
Past Attempts to Understand the Psychology of
Mediocrity 186
Mediocrity as a Set of Traits 191
The Major Defining Traits of Mediocrity 195
“People Who Aren’t Real” 209
Resistance to Acknowledging Individual Differences
in Abilities 211
The Epidemic of Mediocrity 213
Mediocrity: Arrhostia or Spandrel? 215
Traits of Excellence and Superiority 216
Rejecting Normality as a Standard of Mental Health 220
The Transmission of Mediocrity 224
“A Room of One’s Own”: The View from the Third Floor 226

Chapter 9. Normality, Pathology, and Mental Health 233

The Romanes Principle 234
Two Promising Directions and Two Kinds of Pathology 237
Creating Mental Disorders by Ballot 240
Psychological Resistance to the Abandonment
of Psychological Normality as Mental Health 241
Psychological Primitiveness 244
Iatrogenic Effects of Psychiatric Labeling 247
Afterword 248

Part IV. In Retrospect 251

Chapter 10. The Reflexive Turn in Psychology 253

The Economics of Human Emotion 253
The Psychological Dynamic of a Dark Age 256
Subordinating Mundane Reality 258
Practical Implications 262
Idealism That Is Not Hopeful 265

Appendix I. An Apology to Lovers of Humanity? 267

Appendix II. Practical Speculations, or Speculative Practices 269
Appendix III. The Distribution of Mental Health 273
References 277
Index 293
 Preface

“Normal is good, abnormal is bad” is an unquestioned refrain of conven-

tional wisdom in such varied areas as child-raising, elementary and higher
education, peer-reviewed publications, the evaluative judgments of soci-
ety, and understanding the psychology of creative individuals—and, when
translated and clothed in slightly more sophisticated attire, it is the basis
for much of the diagnostic framework of contemporary psychiatry and
clinical psychology. The general equation of psychological normality with
good mental health, and of psychological abnormality with mental illness,
together express an uncritical bias that favors what is humanly typical and
socially and politically desirable. This equation has had far-reaching con-
sequences, consequences that affect humanity and human culture far
beyond the diagnostic confines of psychiatry and clinical psychology.
To examine this issue and certain of its major and sometimes wide-
ranging ramifications is the central purpose of this book. Its rationale is
to pick up the discussion where two psychologist-authors, Abraham
Maslow and Thomas Szasz, left off: Maslow directed attention to the
characteristics of “self-actualizing” people in an effort to delineate ways
in which they exemplify a better and higher degree of mental health than
is to be found among the typical, psychologically average population.
Maslow was a pioneer in recognizing the need to raise the criteria used
to define positive psychological health from conventionally applied stan-
dards to a higher level.
Szasz approached human psychology from a different perspective. He
opposed the diagnostic labeling of contemporary psychiatry and clinical
psychology because their conception of “mental disorders,” in his view,
expresses the not-so-hidden agenda to force people to conform to social
and political interests. Szasz’s criticism of DSM-inspired labeling led
xii Preface

him to characterize its alleged “mental disorders” as so much ideologically

motivated “mythology.”
In their challenges to contemporary psychology and psychiatry, neither
Maslow nor Szasz apparently thought to question whether the widespread
presumption—that psychological normality should be used as a standard,
a baseline, for good mental health—is deserved. Normality Does Not Equal
Mental Health is the first book to do this.
To that end, the book moves beyond Maslow and Szasz by seeking to
show, first, that psychologically normality cannot serve as a justifiable stan-
dard in terms of which to distinguish good from dysfunctional mental
health; second, that today’s “mental disorders” are not so much a matter
of “myth” but of conceptual and empirical error; and, third, that we are in
need of revised and revitalized concepts of mental health and the treatment
of human psychological problems, both of which the book formulates.
Where Maslow intuitively pointed to positive characteristics of “highly
developed” people, the book’s purpose is to show why it is necessary to look
elsewhere, beyond psychological normality, for acceptable standards of
positive mental health—because if we fail to do this, we mistakenly base
our conception of good psychological health on the model offered by
the inherently limiting and often destructive psychology of normality.
Where Szasz saw “mythological thinking” in the creation of today’s rap-
idly inflating lexicon of mental disorders, the book’s purpose is to show that
the majority of claims concerning such “mental disorders” involve funda-
mental conceptual errors and a disregard for scientific standards of validity.
This is not a matter of directing attention to vested social and clinical inter-
ests expressed in the language of myth but of showing such claims to be
wrong because, first, they conflict with scientific standards of evidence and
conceptual coherence, and second, and more importantly, they are mis-
guided in holding up as a standard of good mental health what we should
by now know to be frequently dysfunctional and indeed pathogenic.
The unexamined presumption of psychological normality as a desirable
standard of good mental health has infiltrated a wide variety of contexts,
including the psychology of definition in psychiatric nosology (i.e., the
definition of ‘mental disorders’ in the DSM), the psychology of higher
education, the psychology of creativity, the psychology that impairs
human cultural development, the psychology of peer review, and the
internally limiting psychology of mediocrity, which has been studied
almost not at all. The book shows how the equation of psychological nor-
mality with good mental health goes wrong in the real world and how it
does this is a wide variety of contexts. In place of that unsatisfactory stan-
dard, the book offers a constructive, positive conception of good mental
health and outlines how psychotherapy can be redirected to foster it.
 Acknowledgments

One of the few advantages of growing older is the privilege of looking as

far back as a short human lifespan permits. And looking back, I can’t help
but see a strong thread of iconoclasm that stitches together the fabric of
reflections begun more than four decades ago. As I suspect the reader
already knows, iconoclasm isn’t generally encouraged by our teachers
and mentors, but in this respect I’ve been lucky in my life that a number
of original thinkers, people who did not resist a fresh look at ingrained
patterns of thinking, gave me their personal and professional encourage-
ment.
As it is now routine good taste to make clear at this point: none of these
people should be held responsible for what each may inadvertently have
done as a result of his generosity. Even so, I want to thank the following
individualists for their guidance and for the breadth of their perception
and compass of their minds: Melvin Calvin, Nobel Laureate in chemistry
of the University of California at Berkeley, for his warm encouragement
in connection with my search for new antibiotics; Thomas N. Fast for his
generous guidance and free run of the microbiology lab at the University
of Santa Clara; William Altus, of the University of California, Santa Bar-
bara, for his insightful direction as my interests in pathology grew to
include psychiatric pathology; and Robert M. Hutchins, founder and direc-
tor of the Center for the Study of Democratic Institutions, for having
been persuaded that through my writing I would contribute to what, in
the introductory volume of the Great Books of the Western World, he called
“The Great Conversation.” His scope of perception, intellectual sharp-
ness, generous humanity and spirit, and statesmanship in the nearly for-
gotten meaning of the word I miss very much. I am also indebted to
Gabriel Marcel for making it possible for me to study with Paul Ricoeur
xiv Acknowledgments

at the Université de Paris; to Paul Ricoeur, whose wide span of interest and
scholarly knowledge, along with his intellectual fearlessness and creative
capacity, made it possible to turn what is so often an intellectually hum-
drum dissertation experience into the development of a method and
approach that I continue to develop; and to C. F. von Weizsäcker, director
of the Max-Planck-Institut in Starnberg, Germany, for his support of
research that underlies a few of the chapters in this book.
These men had one admirable quality in common: They were suffi-
ciently at home in a noncompartmentalized openness to free inquiry not
to be intimidated by it. They were sufficiently secure, both personally
and intellectually, not to be threatened by critical thinking and the icono-
clasm that is its natural result.
I also wish to thank Thomas Maloney, clinical psychologist in Clayton,
Missouri, who became a true colleague and good friend. I owe much to
him, and now to his memory, for his willingness to provide me with a
practicum as his cotherapist.
I want to express my appreciation to Debbie Carvalko, Praeger’s senior
acquisitions editor in psychology and health, and to Praeger’s editorial
board for their intellectual openness and interest in fresh ideas and new
directions of inquiry that challenge the status quo, qualities that are highly
valued but increasing rarities among publishers at a time of conservatism
and conformity.
Most especially I’m grateful to the significant people in my personal
life: to my wife, Karen Bartlett, for her love, friendship, and faithful
encouragement over the years; to my mother, Elizabeth Bartlett, poet;
and to my father, Paul Alexander Bartlett, novelist-artist. In this less than
the best of possible worlds, no one could possibly have had parents who
offered a more culturally rich upbringing in which the values of intellec-
tual courage and honesty, independence of mind, and compassion were
foremost.
 A Note on Conventions

In the course of this book we’ll encounter a variety of natural human

psychological propensities to believe without adequate justification. One
of these is to mistake words for the things we believe they represent. For
example, we can be lulled into believing that because we have a name for a
psychological disorder such a disorder must exist. To avoid misplaced belief
it is essential to distinguish two fundamentally different uses of language.
To do this I use a convention drawn from semiotics, or the theory of
signs, to make clear when so-called “autonymous” or “indirect reference”
is made to a word, phrase, or other symbol and to distinguish this from its
ordinary use. This convention reminds us to be aware when reference is
made only to words themselves as opposed to what they mean or what
we believe they designate.
When reference is made to a word, phrase, or symbol itself, single
quotes (also called inverted commas) are placed around it; they’re also
used to set off a quote within a quote. Double quotes are reserved for
direct quotations and to draw attention to words employed in an impor-
tant way, or words used in an odd, exaggerated, or illogical fashion that
stretches their usual meaning. To illustrate this practice: ‘five’ contains
four letters, in contrast to Einstein’s wise maxim, “to keep doing the same
things unsuccessfully is insanity.”
Whenever feasible I’ve used gender-neutral language in this book. In
infrequent passages where it would be repetitive to the point of ridicu-
lousness to use ‘he or she’ and its variants, I’ve followed the equitable con-
vention proposed by Charles Murray (2003, p. xiv) to use the author’s own
sex as the choice of third-person singular pronouns.
Chapter endnotes have been kept to a minimum; most provide explana-
tory details.
This page intentionally left blank
 Introduction

The range of what we think and do is limited by what we fail to notice.

And because we fail to notice that we fail to notice there is little we can
do to change until we notice how failing to notice shapes our thoughts
and deeds.
—Goleman (1985, p. 24)

“I like to believe _____” is a phrase that has often caught my ear in discus-
sions with others. It’s been a long time since I’ve been able pass over the
phase in innocence. Now I flinch when I hear it. During the past four dec-
ades the focus of much of my research has been the psychology of belief;
from this experience the deeply rooted connection between what we like
and what we believe has impressed itself on me. The beliefs we embrace,
as I see again and again, express what we prefer to think. History unfortu-
nately makes it all too clear that what we like to believe all too often turns
out simply to be wrong.
If we chose, we could make this very human disposition a focus of
study. We would then examine the psychology underpinning our often
passionate commitments to beliefs, ideas, principles, paradigms, and all
the other ingredients that make up the approaches, methods, and theories
which, in one way or another, we like better than others and to which we
give our allegiance and defend with sometimes confounding hardihood
even when confronted by contrary evidence (and sometimes especially
then!).
For better or worse, we are emotionally defined organisms whose
choices as to what to believe and what not to are motivated in large mea-
sure by a relatively simple psychology of reinforcement, security, and
comfort. Conventional thinking is the way average people think, not
xviii Introduction

because the majority just happens to think that way but because conformity
with convention gratifies many people in terms of reinforcement, security,
and comfort.
Unfortunately, what we like to think, what we prefer to believe, can be
false, misleading, and at times harmful precisely because we resist putting
our ideological preferences into question. It is now common practice to
refer to “belief systems,” and this is appropriate since beliefs are built on
beliefs, layer upon layer, in interdependent, integrated ways that form sys-
tems that possess a dynamic of their own—resistant to change, chame-
leonlike so as to accommodate to varying environments of fact and
fashion, and structured so as to protect and defend those systems, much
as the human immune system is organized to withstand and fight back
when challenged by a pathogen.
The fortitude and obduracy of systems of belief are their strength but
also their downfall. Conservative thinking—adherence to and defense of
conventions that are dominant at any particular time—therefore auto-
matically brings with it a limited field of vision and a self-chosen myopia.
If any blame can be laid for periods of slowed, nonexistent, or retrograde
intellectual and scientific development, for periods of uncreative, sluggish,
and at times imperceptible growth, that blame can be placed both on the
natural human unwillingness to call into question beliefs that apparently
have served well enough in the past and on the deeply entrenched disincli-
nation to step outside of the preferred category set. Individuals who are
willing to do these things tend to be few, and they should expect to meet
correspondingly deeply rooted resistance, which of course indeed they
have throughout the past.
As a consequence of the psychology of belief, when we look at the his-
tory of science we see that its most basic concepts and presuppositions are
often the least examined. They form the basis for all else in scientific
thought, so that in their very mental activity scientists make habitual use
of them. This results in it being all the more intellectually difficult and
challenging to place them in the light of day. Since they serve as the fun-
damental, core conceptual vocabulary of scientific thought, they resist
critical examination, because for a scientist to do this, he or she believes,
often incorrectly, that those very concepts and presuppositions must be
used.
It can be hard intellectual work to find ways of stepping back or out of
the habitual reference frame, and if necessary to develop new concepts and
flexible ways of thinking that make it possible to render basic concepts and
presuppositions explicit enough so they can be thought about without
being themselves used in the process.
Introduction xix

Unfortunately, when efforts like this are made, practitioners of a disci-

pline very naturally often feel that one must step into an altogether differ-
ent discipline—into “philosophy” or “metatheory”—which is then judged
to comprise a separate area of study, one that can safely and conveniently
be ignored by the scientist when his or her paradigm, tools of thinking,
and habitual approach are made objects of explicit critical evaluation. This
reaction has led to an unnecessary and undesirable compartmentalization
of science and a divorce of science from “foundational questions” that
are held at arm’s length and encapsulated as alien—as just so much pure
theory entirely divorced from practice.
As a result, the critical examination of the conceptual foundations of
science is often disconnected from science and considered to be a distinct
discipline, so that responsibility is transferred to philosophy of science or
perhaps to epistemology studied within cognitive science. This has served
both as an excuse for scientists to shift the responsibility for their concep-
tual clarity to others and as a source of encouragement for philosophers of
science and epistemologists to take on such metathinking without the
requirement of firsthand competency in science.
Such a separation of a discipline from an examination of its basic beliefs
and concepts is ill-conceived and, indeed, limitative and destructive. If
critical examination of the plans for a bridge or for space shuttle construc-
tion were divorced from actual bridge and shuttle engineering, bridges
would much more frequently collapse and space shuttles disastrously fail.
It is long past due that we should make the self-reflective critique of a sci-
ence an integral and integrated part of scientific activity and part of the
responsibility of any science for its own development.
This is not a book about philosophy of science or about epistemology,
which is often assigned these tasks of reflective criticism. Like epistemol-
ogy, much of the book’s focus is on extremely basic questions, and its
goals are similar: to improve our understanding, to make clear what it is
that we actually understand and can know, and in this process to correct
and avoid conceptual confusions.
But the approach used here is not epistemological but rather thor-
oughly psychological. In some of the chapters, my purpose is to challenge
conventional thinking in psychiatry and clinical psychology, and to this
end I’ve intentionally resisted the tendency to “philosophize” about psy-
chology from an external standpoint disconnected from psychological
study. I do not approach a critique of basic concepts and presuppositions
of clinical psychology and psychiatry from outside but situate the discus-
sion and the evidence provided from within, applying the observational
framework and tools of psychology from inside. And so in some of the
chapters I am interested in the psychological basis of much that
xx Introduction

psychiatrists and clinical psychologists think and do. This reflexive or self-
referential use of psychology is natural for human beings to engage in,
since we are ourselves reflective organisms, capable of self-awareness and
self-criticism. At the same time, such a reflexive, critical turn of psycho-
logical thought back upon itself is what psychologically focused self-
criticism, if it existed, would set as its subject matter and goal.
In other chapters, I also use the standpoint of clinical psychology and
psychiatry to understand aspects of the present human situation, and in
these chapters, where there is no intent to engage in presuppositional
criticism, still we will push against the confines of established convention.
In both ways it is my conviction that we cannot become aware of our
limitations unless we make the boundaries of our beliefs and thinking
explicit, and to do this we must of course exceed those boundaries and
step beyond what the past has allowed.
This book is about our usually unexamined, underlying, and indeed
profoundly rooted psychology. A wide range of interconnected purposes
will concern us. They include:

• A radical standing on its head of the view that psychological normal-

ity is equivalent to mental health, and therefore good;
• A revision of our understanding of mental health in a way that
changes both our conception of mental disorders and, correlatively
and perhaps surprisingly, also our understanding of the psychology
of creativity;
• A discussion of seldom-recognized psychological problems brought
about by two intertwined phenomena: (1) an epidemic of work and
materialism that has led to an incapacitating mental disability of val-
ues and resulting widespread cultural impoverishment and (2) the
associated collapse of a genuinely higher education that has led to
demoralization among university faculty who are profoundly com-
mitted to that rapidly vanishing ideal;
• A long-avoided examination of the psychology of peer review and
editorial bias;
• A detailed study of the psychology of mediocrity, which acts as a
powerfully limiting force that hinders individual and group develop-
ment; and
• The formulation of revised and revitalized concepts of mental health
and the treatment of human psychological problems.

In the coming chapters we will discover, often at the very heart of each
of the above issues, strongly entrenched commitments to the dominant
and unquestioned belief that psychological normality must serve as a gold
Introduction xxi

standard for good mental health. Contemporary psychiatry and clinical

psychology base their conception of mental health on the baseline stan-
dard of psychological normality. This supposition has come to be
accepted uncritically, has become habitual and fundamental to current
clinical theory and practice, and lies at the core of the psychiatric classifi-
cation system of the DSM, which has become today’s diagnostic authority.
This is the first book to question the equation of psychological normal-
ity and mental health. In the chapters ahead, I propose to weigh the evi-
dence and, using strict logic and compelling analysis, to challenge the
current paradigm of mental health theorists and practitioners. It will be
my intention to show how the presumed standard of normality has come
to play a basic role in a surprisingly wide diversity of contexts. The broad
and yet focused compass of the study seeks to make evident how this
unquestioned presumption has come to permeate contemporary con-
sciousness, often in unrecognized and well-disguised ways.
Throughout this book, as readers can immediately foresee, a variety of
toes—that is to say, beliefs—will inevitably get stepped on. But I try to do
this in as gentle and understanding a way possible, but also with directness
and without equivocation, inviting readers to share in the intellectual
adventure of sampling directions in psychology that may be new to them.
In writing this book it has been my sustained conviction that little good
comes from shielding ourselves from critical thinking, and even less
comes from adherence to beliefs simply because we like them, beliefs that
we defend in the name of political or disciplinary correctness. Iconoclasm
need not be felt as a threat: it can be freeing, indeed intellectually a source
of playfulness and pleasure as we become unstuck from conventional cat-
egories and from social, political, and professional attitudes that serve
mainly to narrow our field of vision while giving us a bad case of near-
sightedness.
There is an underlying, unifying thread in the discussions that follow,
and that is a willingness to examine a group of important psychological
problems and subjects from a psychological perspective. This kind of
self-referential approach from within psychology is unconventional and
likely to be new to readers. It is intended to encourage—and indeed it pre-
supposes—a certain intellectual flexibility and openness.
 PART I

Normality and Mental Health

This page intentionally left blank
 1

Questioning the Standard of Normality:

Steps to a More Effective Understanding of
Mental Health

[Y]ou . . . talk about the truth, which turns out to be nothing but what
you like to believe.
—George Bernard Shaw (1934, p. 182)

Psychological normality has remained one of the last as well as one of the
most central unexamined presuppositions of current psychiatry and clini-
cal psychology. With few exceptions in the literature, psychological nor-
mality has served as an unquestioned standard of mental health while the
same standard has been used to equate deviations from normality with
mental illness. This opening chapter reviews some of the most compelling
reasons to question that understanding of mental health and of the
psychological problems that many people experience and outlines an
alternative theoretical and therapeutic framework that offers promise.

To continue thinking unchallenged is, ninety-nine times out of a hundred,

our practical substitute for knowing. . . .
—William James (1904/1958, p. 69)

Presuppositions held uncritically can powerfully impede the growth of

any branch of learning. Because of the tenacious and obstructive nature
of unexamined assumptions, it has often been an intellectually, politically,
and sometimes religiously difficult project to place the prevailing beliefs
of the day in question before the dispassionate eye of reason. Intrepid
souls who have insisted on doing this have often been harshly rewarded
4 Normality Does Not Equal Mental Health

for their pains, for unexamined assumptions are often closely tied to
vested disciplinary interests, while attempts to question those assumptions
are apt to run aground on the shoals of what is perceived to be counterin-
tuitive, in conflict with establishment belief, and therefore seen literally to
be “para-doxical.”
One of the central assumptions of both the practice and theory of tradi-
tional psychiatry and clinical psychology is almost never discussed in the
literature, and even more seldom is it questioned. Let us agree to step
back to get an unobstructed view of this core assumption by means of a
short, fictitious allegory, pretending for a few moments that we are visit-
ing an alien planet populated by a humanoid life form. We on the visiting
team are professional psychologists; our observations are described in the
following report to be sent back home:

We see that the planet’s population has well-defined psychological charac-

teristics that include a long history of very frequent wars, genocides, revolu-
tions, and acts of terrorism. In all of these deadly quarrels the vast majority of the
population has been enthusiastic to participate and can be aroused to engage in
mass killing with little needed explanation or justification from their leaders.
We find that violent conflicts bring the majority diverse forms of emotional
gratification and stimulation. But we also find that there is sometimes a very
small minority, averaging less than 1 percent of the adult population, who
possess a strong aversion to harming or killing others.
During infrequent periods of peace, as well as during periods of chronic
deadly conflict, the majority’s overwhelming preference in entertainment is to
watch, read, and hear stories in which the plot revolves around violence and
murder and to watch athletic contests that are violent. Our psychological
testing, moreover, has shown that the majority will—without compunction
and under no duress—inflict severe suffering and death on their unknown
fellows merely if instructed to do this by those they consider to be authorities.
The population is never at a loss to fill the ranks of its military, police, prison
guards, or public executioners. If left unsupervised, their military, police, and
prison personnel exhibit a pronounced tendency quickly to become violently
and maliciously abusive toward their designated enemies or prisoners.
We also find that the inhabitants of the planet take their beliefs with
extreme seriousness, so much so that violent outbreaks of prejudice and hatred
are a daily occurrence. More than this, we find that, again, the majority of the
population receives emotional gratification from inflicting suffering and
death on those whom they see as significantly different from themselves,
whether because of distinguishable physical features, behavior, or beliefs.
Their emotional responses to such signs of difference—expressed in the form
of disrespect, ridicule, hatred, and persecution—give the majority satisfac-
tion, and this helps to perpetuate the cycle.
Theirs is a beautiful planet with a rich variety of many forms of life.
However, the humanoid population proliferates without any thought to
Questioning the Standard of Normality 5

ecological balance or intelligent judgment concerning the optimal population

that the planet is capable of supporting and refuses to think about curtailing its
population growth—in fact this topic is taboo in public discussion. As a result,
the steadily encroaching humanoid population is extinguishing many
thousands of irreplaceable species each year and is responsible for the largest
species extinction in their world’s geological history. At the same time, the
uncontrolled population explosion is causing rapid climate change, which we
can see will predictably accelerate and lead to worldwide suffering, famine,
refugee migrations, resulting deadly conflicts, desertification and deforesta-
tion, the spread of toxic waste, further species extinctions, and a domino effect
of these and related catastrophic yet avoidable consequences.
Two psychological characteristics stand out for us in observing this
population: First, the majority express strong disapproval, offense, or denial
if any of the above observations are brought to their attention. They are very
proud of their various national groups and of their social, political, and
religious institutions, and exhibit pronounced signs of narcissistic injury if
their own psychologists (for they also have them) or our own team members
share the foregoing observations with them.
Second, they are also deeply and rigidly committed to a conception of
mental health based upon what they judge to be “psychologically normal.”
The majority are, by definition, psychologically normal, for by this they
understand what is statistically average and hence the norm; those who
deviate from psychological normality are considered aberrant, and for the
aberrant their psychologists have developed a voluminous and detailed
taxonomy to label specialized variations of deviation from psychological
normality. Those who are so labeled are invalidated and stigmatized by
their societies and tend to become social outcasts or involuntary inmates in
mental institutions.
It is compellingly obvious to all of our team members that what the
inhabitants understand by “psychological normality” is synonymous with the
psychological description we have given above—of a form of life that, despite
evident signs of intelligence, receives important and addictive emotional and
cognitive gratifications from the many ways in which they choose to cause one
another, as well as other forms of life, harm, suffering, and death. From our
vantage point, their psychology of mental health and disease is a paradigm
case of tragic irony, for it is founded on their central and misplaced use of the
standard set by their own psychological normality, which has embedded
within it the destructive emotional and cognitive predispositions we have
already characterized. From our standpoint, we cannot judge their
psychological normality to be other than pathological, for the normal,
average psychology that characterizes the majority of their population results
in harm that is unmistakable throughout the planet and observable in their
private domestic lives, in bullying and mass killings in their schools, in their
abuse-prone system of justice, in their social, religious, and political conflicts,
and even in their preferred kinds of entertainment.
We initially believed that it would be possible to share our conclusions
constructively with their psychologists, who at least have been able to
6 Normality Does Not Equal Mental Health

recognize what, to us, are unmistakable pathological characteristics of the

general population. However, when we have pointed out that their
psychology is based on a dysfunctional standard, on a yardstick for mental
health that implicitly legitimates planet-wide pathological affective and
behavioral patterns, their psychologists take the same sort of narcissistic
offense as does their own lay population when observations are expressed
that they don’t like.
As a result of our visit and the observations our team has made, as
behavioral scientists we conclude that the majority, as well as the planet’s
own psychologists, are on a self-defeating, self-destructive path, heading in a
direction about which we cannot be optimistic. Their own idealized con-
ception of mental health, based as it is on a standard imbued with pathology,
shows no promise for development unless an altogether different standard of
mental health becomes evident and persuasive to the population. For this,
their psychologists would need—again paradoxically for them—to study
their own very small minorities that are to be found within the overall
population, specialized groups that appear to be free from the pathologies of
normality that characterize the majority.

FROM THE “BANALITY OF EVIL” TO THE “EVIL

OF BANALITY”
The foregoing observations of another planet would be distressing
indeed if they were applied to our own human world without a pacifying
sugar-coated translation. Were the foregoing psychological observations
to be published about the human species, we should anticipate that many
people, even many behavioral scientists, would take offense or choose
denial, preferring to relegate to silence what they do not want to believe.
And yet, despite our predictable response to views that we find unpalat-
able, there has been some progress in the direction of reaching an honest
human psychological self-understanding.
One of the first steps was taken when the meaning of the phrase ‘the
banality of evil’ underwent a quiet change from the time that Hannah
Arendt used it as a subtitle for her well-known book Eichmann in Jerusalem
(Arendt, 1964). Most readers may not know that, surprisingly, Arendt
used the phrase only once in her book, and only at its end, employing
the phrase without discussion, definition, or explanation. Readers
acquired a sense of the meaning of the phrase from context, but the mean-
ing they derived in this way was not what Arendt herself appears to have
had in mind.
Years later, more than two and a half decades after Arendt died, her col-
league Jerome Kohn collected together some of her essays and published
them under the title Responsibility and Judgment (Arendt, 2003). In one of
Questioning the Standard of Normality 7

her essays, Arendt made clear what the phrase was intended by her to
mean—namely, the inability of many people to think:

Some years ago, reporting the trial of Eichmann in Jerusalem, I spoke of

the “banality of evil” and meant with this no theory or doctrine but something
quite factual, the phenomenon of evil deeds, committed on gigantic scale,
which could not be traced to any particularity of wickedness, pathology, or
ideological conviction in the doer, whose only personal distinction was
perhaps an extraordinary shallowness. However monstrous the deeds were,
the doer was neither monstrous nor demonic, and the only specific
characteristic one could detect in his past as well as in his behavior during
the trial and the preceding police examination was something entirely
negative: it was not stupidity but a curious, quite authentic inability to think.
(Arendt, 2003, p. 159, italics added)

The equation of “banality of evil” with “a curious, quite authentic inabil-

ity to think” is far from what most readers today associate with the banal-
ity of evil. Certainly most people are unaware that any sort of incapacity to
think was involved in Arendt’s view.
The phrase “banality of evil” has instead come to name, contrary to
Arendt’s stated intent, precisely the theory or doctrine according to which
many people who perpetrate monstrous acts of atrocity are recognized
to be psychologically normal; indeed, much of the factual reporting in
Eichmann in Jerusalem bears this out. Once Arendt’s thesis has been for-
mulated in this way, it is plausible to find that thesis residing implicitly
in the passage quoted above, when Arendt refers to “evil deeds . . . which
could not be traced to any . . . pathology.”
The “banality of evil” has evolved into the doctrine which claims that
many people who perpetrate evil are generally not psychopathological but
rather are psychologically normal. Studies that have appeared since Arendt
died, such as Browning’s Ordinary Men: Reserve Police Battalion 101 and the
Final Solution in Poland (Browning, 1992) and Zillmer, Harrower, Ritzler,
and Archer’s The Quest for the Nazi Personality: A Psychological Investigation
of Nazi War Criminals (Zillmer et al., 1995), have succeeded in bringing
together strong evidence for the banality of evil understood in this sense.
Arendt’s focus was a specialized population, the Nazi leaders, in which
she found abundant evidence of human evil. She, and now others since she
wrote, have in different ways supported the contention that many of the
Nazi leaders, as well as Nazi soldiers and functionaries, were by and large
psychologically normal people. However, Arendt did not undertake a
much expanded analysis, not of special groups of war criminals, but of
the population at large, in order to study in the psychologically normal
majority the prevalence of highly destructive pathologies.
8 Normality Does Not Equal Mental Health

There is a very considerable difference, one which cannot be overem-

phasized, between finding that a specialized group of people who have
committed atrocities are psychological normal, and finding, as our ficti-
tious visiting team found on an alien planet, that the majority consisting
of the psychologically normal have a predisposition to inflict harm and
suffering on others in a way that can be characterized as pathological.
There is clearly a very large difference in the range of application of these
two divergent claims. The “banality of evil” has a very limited range of
application; “the evil of banality,” in contrast, includes most of the human
population. In the latter, more inclusive framework, Arendt’s work is his-
torically significant, but it does not support the stronger and more embrac-
ing thesis. That more encompassing thesis may appropriately be called “the
evil of banality,” for such a thesis would locate the source of much of human
psychiatric pathology in the psychological make-up of the psychologically
normal person (see Bartlett, 2005, p. 315, and Bartlett, 2008).
I don’t intend in this chapter to attempt to support this thesis, for to do
this would require a book-length study, which now exists (Bartlett, 2005).
Here, as introduction to what follows and for readers unfamiliar with that
study, it may be helpful to summarize briefly its approach and some of its
conclusions, since it is on this foundation that I want to raise the question
here whether psychological normality should continue to be used to
define mental health. I do not of course presume that readers should be
persuaded by the conclusions that are merely summarized here, for the
relevant evidence cannot be presented in a single chapter. Nonetheless
some explanation of why I have chosen to go strongly against the prevail-
ing current should be given. Certainly readers have a right to a brief
explanation of an author’s previously argued position when the author
builds upon his or her past research.
Throughout its development, the science of pathology has accepted
without question a homocentric bias that reserves the application of the
clinical-diagnostic label ‘pathogen’ to nonhuman agents, such as disease-
producing bacteria, viruses, or more recently discovered prions. But the
concept of pathogenicity does not of itself dictate an exclusionary applica-
tion to other-than-human forms of life. In The Pathology of Man (Bartlett,
2005), I argued the case expressed by the title, identifying and seeking to
explain in psychological terms pathologies for which the human species,
and by inclusion the psychologically normal human majority, are respon-
sible. There are unfortunately many such pathologies. They include a
varied and psychologically rewarding palette of emotional and cognitive
gratifications provided by vicarious or direct participation in violence
and hatred; by ideological rigidity and absolutism, obedience to perceived
authority, prejudice and persecution, sheer self-defeating stupidity and
Questioning the Standard of Normality 9

low levels of moral development, and their many sequelae in genocides,

terrorism, and wars; by school, domestic, social, and political bullying; by
publicly approved imprisonment, torture, and executions; by an uncon-
strained proliferation of the human population to its own detriment and
the detriment of many other forms of life, the unquestioned placement of
human interests above those of all other life forms on the planet, the
enforced subservience of nonhuman life to human wishes and convenience;
and by the resulting devastation of global biodiversity. (On the psychology
of human ecological destructiveness, see Bartlett, 2006.) The list of human
pathologies does not end here.
Central to human pathology is human resistance to an awareness of it.
“Denial” would be an understatement, for the forces that stand in the
way of humankind’s reflective consciousness of the psychological and eco-
logical malignancy of the species are incredibly strong, tenacious, and
self-preserving.
As a result of human recalcitrance to acknowledge our own pathology,
in the history of behavioral science, and in particular in the history of psy-
chology and psychiatry, almost no effort has been made to gain an under-
standing of human pathology that has its roots in normal—as opposed to
abnormal—psychology. Primarily among psychiatrists there have been a
few notable exceptions, including Menninger, Fromm, Peck, Milton
Erickson, and others whose observations are discussed in Bartlett (2005),
all of whom have had the courage to recognize the pathological
constitution of the ordinary person who so often is a willing participant
in inflicting suffering, death, and destruction. But despite the work of
these few researchers, psychology and psychiatry have doggedly reserved
the term ‘pathology’ exclusively for application to individuals and groups
judged to be abnormal, that is, whose psychology deviates from the norm.
This, as Bartlett (2005) attempts to show, is short-sightedness in the
extreme.
My purpose in giving this preliminary overview is to center our atten-
tion on the important role that the standard of normality has played in
traditional psychopathology. Psychological normality has served as the
fundamental arbiter in the diagnostic judgments that psychiatry and
clinical psychology have made when identifying psychiatric pathology.
Nosologies of mental disorders have traditionally given center stage to
psychological normality as a core criterion of mental health, in relation
to which deviations from such psychological normality are judged to con-
stitute psychiatric illness. A vaguely formulated, idealized conception of
the “psychologically normal person” has been incorporated into diagnos-
tic judgment. It has usually taken the form of a loosely understood,
amalgamated construct formed from the statistical average in a society’s
10 Normality Does Not Equal Mental Health

population in conjunction with the psychological and behavioral charac-

teristics which that society judges to be typically acceptable. For as long
as psychiatry and psychology have sought to be scientific, various alterna-
tive constructs of this kind have been proposed and equated with the emo-
tional and cognitive constitution of the “mentally healthy person.” Such a
“psychologically normal” and hence “mentally healthy” person is believed
to exemplify the traditionally accepted signs of psychological health, such
as the abilities to care for oneself and for others, to be comparatively happy
or contented, to maintain stable and productive human relationships, and
to find satisfaction in work or creative activity.

We need to make a terminological digression at this point: Over the years,

psychology and psychiatry have found themselves mired in a confusing
multiplicity of definitions of the term ‘normality’, which I cannot discuss
at length here but which nonetheless should be mentioned since these
many definitions form an implicit historical backdrop for our discussion.
These definitions include normality considered as the statistical average
(among the earliest in the last century to focus upon this were Hacker,
1945 and Redlich, 1952); normality as adjustment (Wile, 1940); normality
as optimal functioning (applied to physical health, e.g., by Hacker, 1945);
normality linked to social desirability and conformity (e.g., Reider, 1950;
Szasz, 1970/1997; Bolton, 2008); normality as personality integration
(e.g., Hacker, 1945); normality as the expression of stage of evolution
(e.g., Millon, 1989; Wakefield, 1992); and normality defined in terms of
multiple factors, which in different combinations include those previously
mentioned, along with mental efficiency; diverse utopian ideals; the
pragmatic distinction between normality and mental illness, defined as
what clinicians treat; individual adaptive strength; integrity of personal
meaning; and so forth (representative examples include Jones, 1942;
Sabshin, 1967; Offer & Sabshin, 1966/1974, 1984, 1989; Buck, 1992;
Wood et al., 2007; Bolton, 2008).
Since we cannot venture into this historical jungle of often conflicting
conceptions of normality, I ask readers to accept, for our purposes here,
a much simplified, intentionally fuzzy, and hence flexible understanding
of the phrase ‘psychological normality’. What I will mean by ‘psychologi-
cal normality’ is the set of typical and socially approved characteristics of
affective, cognitive, and behavioral functioning, a set of characteristics
derived from the reference group consisting of the majority in a society’s
population and relative to which clinicians understand “deviations from
Questioning the Standard of Normality 11

normality” and hence “mental disorder.” I use the term ‘normality’ in its
commonly accepted meaning of ‘customary’ and ‘typical’, and ‘norm’ in
its ordinary meaning of ‘an authoritative standard’. Finally, I distinguish
the term ‘normality’ from terms like ‘normative’ and ‘normativity’, which
suggest stipulative and usually ethical injunctions.
With these preliminary comments behind us, let’s continue the main
discussion.

THE DISPOSITIONAL PATHOLOGY OF

PSYCHOLOGICAL NORMALITY
I’ve used the phrase ‘the evil of banality’ to place the doctrine that we’ve
come to associate with Arendt in deliberate contrast with the more encom-
passing claim that psychologically normal people are predisposed, when
the situation is right, to inflict harm on others and often on themselves in
the process. In this chapter, when I speak of “predispositions” or “propen-
sities” what I mean is that, with the exception of many criminals, bullies,
and other people who have already behaved violently or abusively, the
majority of psychologically normal people are “sleepers”—that is, they are
dispositionally inclined, when the situation is right, to aggression and
destructiveness. Their patterns of thought and behavior are to be under-
stood dispositionally, that is, in the conditional sense that, if an adequately
provoking situation arises, then the behavior that results will tend to be
malignant: they have a pathogenic willingness to inflict harm, which
remains latent until an appropriate situation arises. Such a situation may,
for example, come in the form of war, ideological conflict, unrestricted
power over others (as in an inadequately supervised prison), narcissistic
injury, or in many other ways. Such “adequately provoking situations”
unfortunately, as we know, arise with great frequency and prevalence.
Various psychiatrists, psychologists, ethologists, sociologists, anthro-
pologists, and historians have recognized this dispositional propensity or
predisposition of psychologically normal people to manifest aggressiveness
and destructiveness. Among them, Freud, Jung, Menninger, Fromm,
and Peck have emphasized this; quantitative historians Quincy Wright,
Sorokin, Rashevsky, and Richardson came to the same conclusion, as have
ethologists Lorenz and Eibl-Eibesfeldt as well (see Bartlett, 2005, Part
II). It is both legitimate and appropriate for us to apply the term ‘pathology’
to this deeply rooted human predisposition.
Should we come to recognize that “psychological normality” is inher-
ently pathogenic, that is, predisposing the majority of typical, normal
12 Normality Does Not Equal Mental Health

people to harm others and often themselves as well, then it would seem
that we come up short, without reliable bearings in terms of which to
orient diagnostic study—without, in other words, possessing an agreed
upon, objective standard of reference in terms of which to identify human
pathology and to understand what constitutes good mental health.
Hannah Arendt’s concept of “the banality of evil,” as it has come to be
understood, rests upon an unquestioned acceptance of psychological nor-
mality as a standard of mental health. We may quickly see that this is the
case: implicit acceptance of this standard has understandably led research-
ers who are sympathetic with Arendt’s view and who wish to build upon it
to wonder how “psychologically normal people,” who should be mentally
healthy by definition, could possibly perpetrate such appalling, terrible acts
of atrocity as we routinely see when human beings engage in violent con-
flicts, genocides, terrorism, or torture. The very fact that our adherence to
the standard of psychological normality, intended to identify the mentally
healthy, would lead to a state of such surprise and perplexity over what
causes human evil should alert us that something in our theoretical orien-
tation is fundamentally wrong.
What is wrong is misplaced emphasis. Psychological normality, far
from comprising a reliable base from which to judge psychopathology, is
essentially pathogenic and can serve as no useful standard for mentally
healthy functioning. The very fact that only a tiny minority in any popula-
tion will resist authority and refuse to kill others in wars that they are
enlisted to fight—usually without adequate proof from their leaders that
such wars are just or necessary—should tell us that average, majoritarian,
psychologically normal people cause great harm. If the long human
history of wars, genocides, deadly quarrels, imprisonment, torture, and
executions is not enough, and if we need controlled experiments to reach
the same conclusion, the now amply reproduced Milgram experiment
(Milgram, 1974) and Zimbardo’s prison experiment (for a retrospective
analysis and update, see Zimbardo, 2007) show how the majority of
psychologically normal people do and will, in fact, behave.
If our intent is to understand the psychology of people who resist
inflicting suffering and death upon others, then we should look not to
psychological normality as a standard of mental health but decisively in
another direction: we should feel a need to understand the psychology of
those who resist perpetrating harm, who are capable of thinking critically
for themselves (which, we are reminded, was Arendt’s original concern),
and who have a level of moral and intellectual development that, in a com-
parative sense, “immunizes” them from participation in human pathology.
(For the groundwork for such a study, see Bartlett, 2005, Chapter 12,
Questioning the Standard of Normality 13

“The Psychology of Those Who Refuse to Participate in Mass Murder”

and “Those Who Actively Resist.”)
Arendt’s conception of the banality of evil has not led us to question the
central role in psychiatry and clinical psychology of the standard of nor-
mality, with reference to which psychopathologies are identified and
judged to be disorders that are deviations from normality. However, were
we, on the contrary, to recognize the evil of banality, we would already be
halfway toward realizing the purpose of this volume, namely to challenge
the appropriateness, usefulness, and effectiveness of employing what is
merely normal as an arbiter of what is desirable in mental health.

PSYCHOLOGICAL NORMALITY IS NOT

MENTAL HEALTH
The standard of health advocated by the yardstick of normality has
become so habitual, so deeply ingrained in our mental health nosologies
and therapeutic outlook that to question it can seem not only counterintui-
tive but to court the ridiculous and extreme. Certainly a statement becomes
true the more it is repeated and never contradicted. And the standard of
mental health that equates psychological normality with healthy mental
functioning has remained unquestioned for a very long time.
One of the first to equate normality with sanity, and deviations from
normality with mental illness, was Benjamin Rush (1746–1813), dean of
the Medical School at the University of Pennsylvania and physician gen-
eral of the Continental Army; his portrait is on the seal of the American
Psychiatric Association. Dr. Rush defined sanity and insanity in the fol-
lowing terms: “Sanity—aptitude to judge things like other men, and regu-
lar habits, etc. Insanity a departure from this” (quoted in Szasz, 1970/
1997, p. 141). For Dr. Rush, social conformity is synonymous with mental
health, and social nonconformity with mental illness. In the two interven-
ing centuries since Dr. Rush made his diagnostic pronouncements the
standard of mental health set by conformity with the psychological norms
of everyday society has remained exempt from serious challenge by main-
stream psychiatry and clinical psychology.
Has the standard we have created by placing psychological normality
on a pedestal become so imperious, so solidly embedded as an undeniable
premise of modern psychiatric diagnosis, that as psychologists and psy-
chiatrists we are incapable of thinking without it? Even if we should be
persuaded that normal psychology can be correlated with pathological
predispositions to prejudice, hatred, violence, and insensitivity to the suf-
fering of others when they are dehumanized, conjoined with emotional
14 Normality Does Not Equal Mental Health

gratification when those we see as our adversaries are harmed—even if we

should be persuaded that normal, average people can readily be persuaded
to become puppets of destruction, what would be accomplished by recog-
nizing that pathology lies so close to home, and is not confined, as we
would more comfortably prefer, to the smaller population of those whom
we now label as mentally aberrant? This is an important question to which
we shall return a little later.
Thomas Szasz has repeatedly emphasized that the labeling of persons
as mentally healthy or as diseased is crucial to psychiatric practice. Psychi-
atric labeling is in and of itself an “act of social validation and invalida-
tion” (Szasz, 1970/1997, p. 267). Psychiatric labeling sanctions society to
set the limits on an individual’s acceptability to his or her community. It
sets the boundaries within which people are expected to conform in their
attitudes toward others and themselves through their behavior, their pref-
erences, and how they think and feel. Although this should hardly need to
be said, it is important to express the following as explicitly as possible:
When we make the standard of mental health synonymous with psychological nor-
mality, we automatically validate normal psychology and invalidate deviations
from it. It makes good sense to do this as long as the standard of mental
health we accept is not synonymous with a psychological predisposition
to cause harm. At a theoretically fundamental level, theories of disease
recognize that identifying a condition as a pathology means that we recog-
nize that it causes harm—principally to the afflicted person or to others to
whom he or she relates, or to both (for a detailed analysis see Bartlett,
2005, Part I). As in the extraterrestrial allegory with which I began this
chapter, it is a tragic irony when what we embrace as mental health coin-
cides with a propensity to cause harm. To use psychological normality as
an arbiter of good mental health is to import pathology in our efforts to
differentiate health as opposed to disease.
This point of view is, to be sure, a hard pill to swallow. It was hard
enough to be faced with the banality of evil—to be forced by evidence to
acknowledge that terrible atrocities are often committed by psychologically
normal individuals. It has taken a great deal of carefully marshaled evidence
to convince us that this is the case, and yet we do still, almost in a reflex
arc, continue to look for reassuring signs of “abnormal psychology” in
perpetrators of brutal criminal acts.
Now, to be faced with a need to accept the preponderance of evidence
for the evil of banality—evidence that establishes that psychologically
normal people are predisposed to harm others and often themselves in
the process—this is considerably more taxing, and few scholars and
researchers in behavioral science have been willing to consider the human
species in this light. So that the skeptical reader may see that this
Questioning the Standard of Normality 15

understanding of human psychological normality is not as far-fetched as it

might at first seem, here are a few examples of mental health professionals
who in the past have reached similar conclusions:
Psychiatrist Milton Erickson wrote:

It is time that society—particularly its psychologists and psychiatrists—

takes a realistic view of the nature of undesirable and destructive human
behavior and the extent to which, under stress or without stress, the
individual, the group or an entire society can be led to enact it. . . . [N]o
effort is made to investigate scientifically the extremes to which the normal,
the good, the average, or the intellectual person or group will go if given
the opportunity. . . . (Erickson, 1968, p. 278)
[N]ormal and average human beings can be manipulated into inhumane
behavior. . . . [T]he need is great to study the normal man from this aspect
rather than continue to regard such behavior either as incomprehensible or
as evidence that the person involved is somehow aberrant, abnormal and
atypical. . . . (p. 279)

In a parallel way, psychiatrist K. R. Eissler (1960), in a case study of sol-

diers judged to be “psychologically average,” came to this conclusion:
“In spite of a general consensus by the whole community that they are to
be regarded as prototypes of normality, the psychiatrist finds himself pro-
fessionally obliged to view these very men as specimens of significant
psychopathology” (p. 69). Eissler went on to explain: “The general result
pointed to a negative rather than a positive statement, namely, the fact
that [a soldier’s] efficiency is possible in spite of psychopathology and that
quite possibly even that which is arbitrarily called normality is a special in-
stance of psychopathology. If so, what the specific nature of that psychopa-
thology is has escaped our knowledge” (p. 71, italics added). His paper
concludes by saying: “Thus this paper may be taken as an attempt at
trying out the operational value of the concept of the psychopathology of
normality” (p. 94, italics added).
Also dating back to the 1960s, Daniel Offer and Melvin Sabshin’s book,
Normality: Theoretical and Clinical Concepts of Mental Health (1966/1974),
questioned the assumption that psychological normality is free of pathology:

[I]t is possible that the major impetus of this approach will be the
redefinition of the borders of pathology to include a much wider range of
phenomena heretofore omitted. It is also possible, of course, that out of
such developments . . . new ideas going beyond the broadened definition of
pathology will develop. Whatever the new direction, it is clear that much
more attention will be paid to the normal part of the spectrum than has
been in the past. (p. 9)
16 Normality Does Not Equal Mental Health

[A] person who labels himself “normal” and is also labeled “normal” by
others is far from being free from psychopathology, and indeed may be
quite neurotic. (p. 33)

Psychologist Arthur G. Miller, reflecting on what we’ve learned from the

obedience experiments, proposed what he called the “normality thesis”:
“The basic argument is that people who would not ordinarily be described
as unusual, deviant, sick, mentally ill, or pathological are capable of com-
mitting acts of unrestrained violence and evil” (Miller, 1986, p. 184).
My point in citing behavioral scientists like Erickson, Eissler, Offer,
Sabshin, and Miller is to ask that we reflect on the justification and desir-
ability of making “mental health” and “psychological normality” synony-
mous. That they are not is a matter that is not hard to decide
empirically, merely by reviewing human history, although we recognize
that a willingness to be persuaded by the dismal facts about normal human
propensities is still not common among behavioral scientists or the
general public.

POSITIVE ILLUSION AND RESISTANCE TO THE

PATHOLOGY OF NORMALITY
As far back in time as recorded history permits us to look we find evi-
dence that people have sought to make the difficulties of life more accept-
able and emotionally satisfying through recourse to the illusions of myth,
the hopes of religion, and the security of systems of social ethics. Despite
the evidence provided by history of the human need for such beliefs, for a
long time traditional psychology embraced the view that to be mentally
healthy a person should be realistic, “in touch with reality,” that is, among
other qualities, to be nondelusional about one’s place in the world and
about what one can realistically expect from life. But in the past few deca-
des, the pendulum has swung the other way, affirming that “positive illu-
sions” play a central role in a healthy, satisfying life. Indeed, the
propensity to hold positive illusions has now become tantamount to being
psychologically normal and hence mentally healthy. “A substantial
amount of research testifies to the prevalence of illusion in normal human
cognition” (Taylor & Brown, 1988, p. 193). “[T]he healthy mind is a self-
deceptive one” (Taylor, 1989, p. xi). “[D]eparture from reality is not
harmful, on the contrary. This finding allows us to presume that greater
misperceptions of reality are not associated with maladjustment. . . .
[I]nflated self-deception is not synonymous with poor adaptation” (Gana,
Alaphilippe, & Bailly, 2004, p. 63).
Questioning the Standard of Normality 17

In this trend, three general types of illusion have occupied researchers:

distortions of reality that enhance self-esteem, illusions that support and
maintain the conviction of personal efficacy, and distortions of reality that
encourage optimism toward the future. All of these have been linked to
psychological normality and hence to what contemporary psychiatry and
psychology believe constitutes mental health: “These three illusions, as
we have called them, appear to foster traditional criteria of mental health,
including the ability to care about the self and others, the ability to be
happy or contented, and the ability to engage in productive and creative
work” (Taylor & Brown, 1988, p. 204, italics added).
This recent reversal, from asserting the central role of realism and
“reality testing” in the mentally healthy person to emphasizing the impor-
tance of positive illusion, has explicitly linked self-delusion with psycho-
logical normality while retaining psychological normality as the standard
of mental health. Some researchers have, however, acknowledged that
positive illusions can be harmful and destructive, as when an individual’s
positive illusion that his or her set of beliefs is superior to those of others
results in prejudice, persecution, and violence: “Faith in the inherent
goodness of one’s beliefs and actions may lead a person to trample on
the rights and values of others; centuries of atrocities committed in the
name of religious and political values bear witness to the liabilities of such
faith” (Taylor & Brown, 1988, p. 204). These authors go on to acknowl-
edge that “[t]he preceding argument is not meant to suggest that positive
illusions are without liabilities. Indeed, there may be many” (p. 204).
With even a modest awareness of history and of the current world sit-
uation we should be prepared to acknowledge that there are in fact a very
great many such liabilities that come from a predilection to engage in illu-
sional thinking, liabilities that pose threats to our species’ and to our
world’s well-being. They should make us hesitant to associate the average,
psychologically normal person’s propensity to engage in illusion—a pro-
pensity exercised throughout human history and now recognized in social
psychological research—with genuine mental health.
The social psychology of positive illusion has generally focused on
individual psychology. But what is true on an individual level is also in this
case true on a collective level. Stubbornly entrenched, collective positive
illusions that magnify group self-esteem and the conviction of the group’s
effective control and that promote a collective delusional optimism about
the future are not only counterproductive but serve as obstacles if we are
realistically and responsibly to face and solve the problems for which our
species is responsible. To take only one example, which has become
“politically hot” even to mention: There are now some 300,000 human
babies born into the world each day. This means that each week, 2 million
18 Normality Does Not Equal Mental Health

come into the world, adding to the world’s human burden that must
ideally be fed, housed, educated, and enabled to lead healthy and mean-
ingful lives. Many will subsist in the world’s rapidly growing slums of
830 million people today, expected by the United Nation’s division UN
Habitat over the next two decades to swell to 2 billion—enough people
living in slums to populate present-day China one-and-a-half times over.
Despite Al Gore’s admirable efforts to educate the public and its political
leaders about the need to take concrete, significant steps to avert climate
catastrophe, his book (Gore, 2006) contains only two pages that refer to
the burgeoning human population, while in the section of his book
devoted to “what you can personally do to help solve the climate crisis”
(pp. 305–321), the suggestion “have few or no children” is conspicuously
not included. Systematic avoidance in discussing the overwhelming need
for intelligent human population management is the expression of posi-
tive illusion gone awry.1
The potential ecological disaster that has begun to intrude on our con-
sciousness needs to be seen realistically, not through the rose-tinted lenses
of collective positive illusion and optimistic denial. And yet, even to sug-
gest this is to tilt against windmills. It is important that we recognize—
again realistically—how fundamentally important positive illusion is to
our species, to its homocentric bias, and to its preference for optimism
toward the future even when this is based on illusion. And we need to rec-
ognize what is central in our conception of mental health and psychiatric
pathology, that psychological normality has achieved its unquestioned
status as the standard of mental health without adequate study, justifica-
tion, or evidence.

WHERE WE MIGHT GO FROM HERE

If we were to accept the main points raised in the foregoing discussion, it
would be hard not to feel that the deck is stacked against the suggestion that
we look beyond psychological normality for an appropriate mental health
standard. The prevalence of human pathology, of human denial of that
pathology, and of the unrelenting force of human illusion together would
seem to make the challenge such a proposal faces close to insurmountable.
Earlier in this chapter, I raised the question, “What would be accom-
plished by recognizing that pathology lies so close to home, and is not con-
fined, as we would prefer, to the smaller population of those whom we now
label as mentally aberrant?” Let me now try to respond to that question.
Two principal purposes would be realized by acknowledging the pathology
of normality: First, we would no longer remain in a state of denial concerning
Questioning the Standard of Normality 19

normal psychology. We would see it as it is, recognizing its so often realized

potential for aggression and destructiveness—to cause harm, which is, after
all, the central meaning of pathogenicity. Second, we should be motivated
to redefine mental health in a way that does not import into our understand-
ing of the functioning of the mentally healthy person the very psychological
constitution that has, in so many ways, caused people, their families, their
societies, their nations, and other forms of life such a great deal of harm.
Critics of such a proposal will be quick to ask, “Just how then do you
propose to understand mental health and psychiatric disorder if the stan-
dard of psychological normality is discarded?” This is a fair question,
and in the space available here I’ll try to sketch how it might be answered.
But before proceeding, after the grim tone of the foregoing discussion, it
may help our mood to inject some humor—humor which at the same time
isn’t altogether tongue-in-cheek:
Psychiatrist Louis E. Bisch many years ago thought rather poorly of the
psychologically average. To say this is to probably to overstate his affec-
tion for normality, for he wrote: “The great, great majority of the people
who make a nation, who make a world, are normal . . . even if it be a low
normal, just about missing moronity or falling upon the bottom levels of
adolescence” (Bisch, 1936, p. 17). He bravely defended his antipathy
toward normality: “What this country needs is not more normals—not
even the exceptionally fine ones—but more neurotics; neurotics who are
glad of it; neurotics who have the courage to stress their individuality
and sensitiveness and make it outstanding and telling” (p. 28).
Bisch was not afraid of political incorrectness; he boldly claimed: “to be
normal is nothing to brag about! When I study normals and compare them
with neurotics I wonder sometimes whether to be normal is not something
to be ashamed about” (p. 32). We might be reminded of the definition of
‘abnormal’ given by Ambrose Bierce—“Not conforming to standard.
In matters of thought and conduct, to be independent is to be abnormal,
to be abnormal is to be detested” (Bierce, 1946/1989, p. 189)—and his
definition of ‘mad’—“Affected with a high degree of intellectual indepen-
dence; not conforming to standards of thought, speech and action derived
by the conformants from study of themselves; at odds with the majority;
in short, unusual” (p. 300).
Bisch saw in neurotics a collection of potentially affirmative traits that
tend not to be found in the average, psychologically normal person.
“What [well-meaning persons] do not realize is that the child who later
becomes neurotic is different, consequently does not fit in, because
he has been born with potentials for development that are greater
than, and unlike, the average. Remember he is not neurotic at birth, only
supercharged and hypersensitive. His neurotic reactions appear only
20 Normality Does Not Equal Mental Health

later” (p. 45). To be a neurotic in this sense is, he felt, something of a

privilege (p. 180). If his humorous yet serious book were taken to heart,
some of the unproductive stigma, shame, and alienation associated with
neuroticism might be lifted. And would this be such a bad thing?
However, to turn from this lighter thought, there are, as I see the situa-
tion we face, two main directions in which mental health theory might
develop. For both there are good grounds to believe that they are thera-
peutically promising. Both avoid the misplaced emphasis traditionally
invested in psychological normality as a standard of mental health, and
both are more realistic as well as accurate in their understanding of human
psychological problems. If we were, if only for the purposes of a thought
experiment here, to suspend reliance upon psychological normality as a
standard for mental health, the following are two potential directions for
future development that open to psychiatry and clinical psychology. They
are not mutually exclusive but complementary; they can be employed
fruitfully together.
The first seeks to understand mental health in terms of special, smaller
populations that exhibit signs of healthy, benign—nonpathogenic—
mental functioning, that is, in terms of identifiable marks of good mental
health that can be distinguished and freed from the context of pressure
to conform to the majoritarian larger population. I cannot develop this
suggestion in detail here, but instead offer a few examples by way of illus-
tration. If we accept that the human propensity to engage in deadly quar-
rels, manifested so often throughout human history, is far from being an
expression of good mental health, we might do well to consider a special
group whose psychology has been little studied: the population of consci-
entious objectors. It would be potentially enlightening to study their
degree of moral development and their capacity for autonomous thought
and behavior as contrasted with the general population. Instead of relying
upon the general population’s normal psychology as a criterion of mental
health, we could learn how individuals function on a psychological level
who are able to resist the pressures of authority, who are able to think
critically for themselves (à la Arendt), and who have the courage to respect
and act upon their own sense of individual autonomy. Such a person
would share in important ways characteristics identified by Maslow
(1970, 1971) in his paradigm of a “self-actualizing individual,” which
offers a seldom-to-be-found, detailed model of positive mental health that
avoids reliance upon a standard of psychological normality.
The suggestion that we establish one viable locus for good mental
health in the psychological constitution of conscientious objectors will
surely strike some readers as unexpected and perhaps tug at the bounda-
ries of credibility. And yet I wonder if the surprise or incredulity they
Questioning the Standard of Normality 21

may experience may not be a reflective aftertaste of contact with the

counterintuitive, which, given the history of psychiatry and clinical psy-
chology, is an altogether understandable and even predictable reaction.
It has become so habitual to equate psychological normality with good
mental health that to question the equation and then look to a special
group, such as conscientious objectors, for defining signs of good mental
health can indeed run counter to prevailing beliefs and hence feel
paradoxical.
There are without question other conceivably appropriate loci in terms
of which to understand good mental health and by means of which we
should be able to broaden our conception of beneficial, well-functioning
psychology. To mention a few other examples, one could study the psy-
chology of those who have developed compassion to a high degree (e.g.,
Buddhist and yoga practitioners, as in Walsh & Shapiro, 1983), of those
who have highly developed aesthetic sensibility (e.g., artists, sculptors,
and poets, as we’ll discuss in Chapter 3; see also Bartlett, 2009), and of
those who have cultivated impressive cognitive abilities of concentration,
discipline, synthesis, and creative thought (original thinkers in such fields
as mathematics, music, philosophy, natural science, etc., as in Simonton,
1994 and Andreasen, 2005). From an integrated study of such special
groups of people selected because they exemplify fully functional, healthy,
benign cognitive and emotional abilities, we should be able to integrate
into a clear and cohering whole what genuine mental health means and
then make use of what we have learned to establish a set of enlightened
and effective criteria of healthy psychological functioning.
As should be clear, the resulting conception of mental health would not
coincide with “psychological normality,” nor would we make recourse to
a standard of psychological normality to define mental health.
A second approach, which again can be employed in conjunction with
the first, involves a return to an individualized, human-centered, nonregi-
mented, nontaxonomic understanding of psychological problems—dis-
pensing with technically structured algorithmic catalogs of constructed
diagnostic codes. Such an approach was proposed by psychiatrist J. H.
van den Berg. He developed an approach to clinical psychiatry that he
called phenomenological psychiatry (van den Berg, 1955, 1972, 1980; de
Konig, 1982). It avoids standard psychiatric classification and diagnostic
pigeonholing and instead seeks to help individuals through nonjudgmen-
tal support of the patient by the therapist, support that is situated from a
phenomenological standpoint that recognizes the reality and legitimacy
of the patient’s own experience.
From this perspective, a therapist helps patients less through interven-
tion and more through collaborative understanding (my way of putting this,
22 Normality Does Not Equal Mental Health

not van den Berg’s). Van den Berg observed in many of his patients that
their inability to live effectively and at peace with themselves was at the
root of their psychiatric problems. Psychiatric treatment can be effective,
he found, when the therapist helps the patient to improve the degree to
which he or she is able to accommodate, without inner conflict, to his or
her own personal needs, interests, and values as these are expressed in
the individual’s “life-world,” the patient’s world of experience. Therapeu-
tic self-acceptance does not necessarily adjust the patient to the needs and
expectations of prevailing society, but it does often help the patient adjust
to himself or herself so as to establish a healthy congruity and integrity.
Although van den Berg did not formulate his approach in these terms,
one can describe his approach as seeking to help people find appropriate,
to them acceptable, ways to adapt to their experienced environments.
Recognizing that van den Berg’s European-phenomenological
approach has not been in keeping with prevailing American clinical tastes,
it may be worth mentioning in passing that Alfred Adler offered a related
perspective that considers many psychological difficulties to be expres-
sions of “problems of living” (see, e.g., Adler, 1924 and the collection of
his work in Ansbacher & Ansbacher, 1956). Adlerians understand that
they are treating an individual’s discouragement in life rather than forms
of mental “sickness.” Adlerian therapy uses encouragement tailored to
the individual’s self-understanding and view of the world. Like van den
Berg, Adler did not pathologize human problems as varieties of mental ill-
ness, but rather observed that such problems comprise challenging emo-
tional and behavioral difficulties in life, blocking people in their efforts
to realize themselves. Many of the problems that Adlerian therapists seek
to treat are therefore considered by them to be characteristic, naturally
occurring problems of living, problems that are part of life. Adler and
his followers have endorsed an approach to therapy that seeks, somewhat
like van den Berg’s, to understand and help the patient in essential relation
to his or her perceived total environment.2
As with the first approach suggested above, which derives an under-
standing of mental health from a study of special groups, it is important
to note that van den Berg’s and Adler’s conceptions of mental health do
not rely upon the application of a standard of psychological normality.
Both ways of understanding mental health that I’ve outlined in this sec-
tion reject the technical classification mechanism of psychopathological
diagnosis; both approaches turn away from traditional psychiatric diag-
nostic criteria that derive their meaning from deviations from psychologi-
cal normality and a constructed nosology of mental disorders. Instead,
one approach seeks to understand healthy mental functioning through a
study of specialized groups chosen both because their members do not
Questioning the Standard of Normality 23

cause harm and because they posses identifiable abilities to function espe-
cially well. The second approach seeks to help people on an individualized
basis to reach an improved level of self-understanding, self-acceptance,
and integration within the framework of their perception of their environ-
ments and to learn to function effectively in their own terms. Neither
approach aims to proselytize or inculcate in patients the behavioral goals
and cognitive values of majority society; they do not aim to adjust patients
to conform with what is perceived to be psychologically normal. Neither
approach leads to a stigmatization of “deviations from normality,” since
deviation from psychological normality is no longer an indication of men-
tal illness. Individuals who are seen to be in need of therapy are not iden-
tified due to their deviation from normality and the fact that their
symptoms satisfy conditions specified by diagnostic algorithms that are
themselves based on the benchmark of normality. The people who need
and may profit from therapy are rather those who experience impairments
which, most especially from their own points of view, are harmful and
undesirable.
In summary, both approaches are open to a recognition that psychiatric
pathology afflicts psychologically normal populations that include the
majority of people. Neither approach seeks, implicitly or explicitly, to
import into diagnostic classifications or into the practice of therapy an
endorsement that psychological normality is a core criterion of mental
health. One approach establishes a locus of psychiatric health in individ-
uals who function exceptionally well and nonpathogenically in one or
more aspects of their cognitive, affective, or behavioral lives. The other
seeks to help patients develop a foundation for their own effective func-
tioning from within, without social indoctrination or socializing goals.

TOWARD A MORE EFFECTIVE UNDERSTANDING

OF MENTAL HEALTH
To give up the exclusionist standard of normality in psychiatry and
clinical psychology is no small thing. To develop and apply an alternative
theory of mental health and of psychological pathology that does without
such a standard requires the majority of clinicians to revise their under-
standing of pathology, mental health, and therapy. We should need
to look in a different direction from the one in which we are accustomed
to look.
From the standpoint of current psychiatric diagnosis-centered thought,
if we were to try to define its presupposed concept of “mental health”—
which is seldom attempted—we’d get something like this: Mental health
explicitly presupposes psychological normality, and implicitly it calls for
24 Normality Does Not Equal Mental Health

an absence of perceptible mental dysfunction (as in Offer & Sabshin, 1989, pp.
405–17). And yet mental health, like physical health, is a good deal more
than a state of not having a disease: genuinely good health is not just not
having anything manifestly wrong with you. Positive physical health
derives much of its meaning from the optimal functioning of the body—
as exemplified and most fully attained by those who are in excellent physi-
cal condition, and who epitomize a realizable ideal. The concept of
‘excellence’ here is important for it emphasizes the need to have a clear
appreciation of the high end of the spectrum, and not just the mean.
Excellence connotes distinction of quality, superiority of merit, worth,
development, or attainment; it is what the ancient Greeks had in mind
when they spoke of aretē: its central meaning was excellence as evidenced
in an individual’s ability to reach the highest level of performance in any
arena of human capacity. Optimal is a derivative and subordinate concept,
and yet one which relies upon a grasp of what excellence consists in.
‘Optimal functioning’, as I propose to use this phrase here, has a more rel-
ative meaning that seeks to take into account the limitations of the indi-
vidual, which may not permit him or her to achieve true excellence. An
individual functions at an optimal level—for him or for her—when he or
she functions as well as possible given individual limitations. In contrast,
an individual functions at a level of excellence when, in comparison with
others, the level of attainment reached is truly superior. It will be impor-
tant later on that we recognize this distinction between ‘optimal’ and
‘excellent’.
Although we are not accustomed to thinking in these terms, what
would it be to be in excellent (or optimal) psychological condition? The
customary equation of mental health with psychological normality, per-
haps coupled with not having any noticeable mental problem, fails to tell
us anything significant about excellent (or optimal) psychological func-
tioning.
Modern psychiatry and clinical psychology, although putatively pro-
posing to help people reach a state of genuine mental health, have devel-
oped no clear understanding of excellent mental health, with few
exceptions. One exception is provided by research concerning the nature
of human intelligence. Intellectual intelligence, understood as a measur-
able degree of excellence in cognitive functioning, has been studied with
more success and specificity than has more comprehensive psychological
functioning.
In the evolution of our knowledge of human intellectual intelligence
perhaps the most significant development has come about as a result of
the widened range of abilities that we have come to recognize to express
forms of intelligence. We’ve learned that there are many forms of
Questioning the Standard of Normality 25

cognitive intelligence—verbal, spatial, quantitative, comprehension

ability, memory, imagination, ability to think critically, and so forth. This
multifactorial—or as Guilford (1967, p. 467) preferred to call it, multidi-
mensional—understanding of intelligence has given us a richer and more
detailed explanation of what it is to be intellectually intelligent. In study-
ing the varieties of intellectual intelligence, we have looked not simply at
normal functioning but at their expression in individuals who possess those
abilities to a superior degree. In this way, we have derived a sense of what
excellence means in connection with verbal ability, spatial relations skills,
calculation, memory, and any of the other cognitive skills that together
create a composite description of outstanding cognitive functioning.
Excellence is a realizable, nonfictitious ideal; it is a construct created
through the study of individuals who manifest certain skills to the highest
degree.
We have not yet reached a similar, widely accepted, composite under-
standing of identifiable, special “abilities” or other characteristics which,
when taken together, would tell us what excellence in psychological health
means. A few psychologists and psychiatrists have sought to focus study
on highly developed people who exemplify excellence in psychological
health: Fromm emphasized the “autonomous person”; Rogers, the “fully
functioning person”; Jung, the “individuated person”; and, with the great-
est descriptive detail, Maslow identified a large group of psychological
characteristics possessed by “self-actualizing” individuals, who are
“psychologically healthy, psychologically ‘superior’ people” (Maslow,
1971, p. 6; cf. also Maslow, 1964, 1970).
A level of excellence in psychological health is clearly a broad and
inclusive concept, embracing qualities of person, dispositions, and a range
of skills, including such intellectual abilities as we have already men-
tioned. A few efforts have been made to distinguish and study on their
own certain of the extra-intellectual “abilities” that would play a central
role in a more comprehensive account of excellent psychological func-
tioning as envisioned here. There are, for example, social abilities that are
often desirable in healthy social interaction. Nearly a century ago, E. L.
Thorndike (1920) proposed that there is a special kind of “social intelli-
gence” distinct from intellectual intelligence, which he characterized as
“the ability to understand and manage people” (p. 275). A few years later,
Charles E. Spearman (1927) noted that some people have the ability
to create within themselves a vicarious experience of the thoughts and
feelings of others by analogy with their own experience; Spearman, too,
recognized that this ability is the expression of a variety of intelligence.
Others, including Bruner and Tagiuri (1954), Taft (1956), and Eysenck
(1998/1999), have emphasized skills that can be subsumed under the same
26 Normality Does Not Equal Mental Health

heading of social intelligence. (For a more detailed discussion see Bartlett,

2005, pp. 278ff.)
Complementing such social abilities, and overlapping with them, are
emotional skills that are involved in accurately perceiving one’s own emo-
tions and those of others. Salovey and Mayer (1990), Gardner (1983/
1993 and 1993), and Goleman (1995) have grouped such skills under the
heading of “emotional intelligence.”
A third variety of nonintellectual intelligence is moral intelligence, which
had not previously been studied and which I have characterized in terms
of a set of specific dispositions and skills. They include a psychological
aversion to participation in behavior that harms others, a fully functioning
capacity for empathy, a well-developed sensibility that is expressed in
normative weighing tied to aversion that a morally intelligent person feels
when confronted by typical human aggression and destructiveness, and a
strong moral conviction that bridges skills in moral reasoning with com-
mitment to act accordingly. (For a more detailed elaboration of the con-
cept of moral intelligence, see Bartlett, 2005, pp. 277–80 and passim.)
These are a few examples of skills and dispositions that shed light on
how excellence in psychological functioning can be understood—without
recourse to the inappropriate standard of normality. There is clearly a
need, although it is not often acknowledged, to identify the essential fac-
tors of outstanding psychological health. Were we to acquire such an
understanding of psychological health by studying specialized expressions
of mental health, we should be able to bring together a composite under-
standing of what genuine mental health means. We need to learn what it is
for both cognitive or intellectual skills and the nonintellectual skills men-
tioned here to be realized in individuals to a degree that expresses
excellence of individual development or attainment. This would enable
us to formulate a realizable ideal, a standard, a set of criteria that tells us
what genuine mental health entails. We should then appreciate that mental
health is a good deal more than conformity with psychological normality, and a
great deal more than absence of mental illness.
Such an approach would extend and build upon the way in which
human intellectual intelligence has to date been successfully studied,
namely by consolidating multiple factors that represent different forms
of cognitive intelligence. The current emphasis of psychiatry and clinical
psychology has unfortunately been on identifying and distinguishing
mental disorders rather than understanding mental health. To reach an
effective and clear understanding of mental health, we need to be able to
consolidate what we now know, and have yet to learn, about the best in
human beings when they think, feel, and behave to a fully developed
degree.
Questioning the Standard of Normality 27

MENTAL HEALTH AS EXCEPTION TO THE RULE

The phrase ‘psychological normality’ has attained the secondhand status
of habitual stock expressions “tossed,” as Clifton Fadiman has said, “on the
scrapheap of popular misuse.”3 ‘Psychological normality’ is a phrase so
widely used and intuitively comfortable as to have become second nature
in current thinking. It is hard to loosen the grip we have on it, and it on us.
In this chapter I’ve argued two general claims: First, the notion of
psychological normality, far from throwing light on the nature of mental
health, has become a habitual way of referring at one and the same time
to psychological characteristics which are socially approved and which
are generally invariant across a broad population.4 Second, and more
importantly, the concept of psychological normality has come to function
wrongly and inadequately as a standard of mental health. The justification
for this second claim rests on several more specific observations:

(a) Typical and socially approved characteristics of affective, cognitive, and

behavioral functioning very frequently are pathogenic, as we’ve
noted earlier.
(b) Genuine mental health therefore needs to be understood in the con-
text of a range of nonpathological emotional, cognitive, and behav-
ioral characteristics and abilities. To formulate criteria of excellence
of functioning with respect to these abilities requires that we study
and develop a clearer understanding of what it is to be a highly
developed person from the standpoint of psychological health.
(c) Clinical practice, if it is to avoid the imposition of an inappropriate
standard of psychological normality, must center its attention on
helping individuals to optimize their own mental health within the
context of highly individual life situations.

And, finally, as a corollary to (c):

(d) The idea of normality is the result of a selective process of averaging,

thereby suppressing an awareness of individual variation by choosing
to ignore it through abstraction and generalization. A well-
developed concept of mental health, on the contrary, requires
compatibility with the significant variation to be found in real indi-
viduals, whose psychological functioning cannot adequately be
understood in terms of a generalized rule or norm but rather
requires a clinician’s awareness of their uniqueness as persons
who have unique life situations and sources of personal meaning. It
follows from the perspective of the individual that there is no one
28 Normality Does Not Equal Mental Health

univocally defined way for all individuals to be psychologically healthy

but many individual paths to mental health. Depending upon the indi-
vidual, his or her circumstances, and his or her sources of meaning in
life, certain abilities, dispositions, and qualities of person will be essen-
tial to that person’s optimal functioning and others less so.

To recognize the truth of the above propositions is not to embrace a

vague multiculturalist generality incapable of practical, individual applica-
tion. Although mental health as I propose we understand it encompasses a
wide range of individual variability, it is a conception that encourages
therapeutic approaches designed to be sensitive to individual needs and
perceptions. At the same time, and on the most fundamental level, such
a theory of mental health expressly (1) defines and affirms specific criteria
of healthy mental functioning that are nonpathogenic, and which, as a
consequence, (2) has no use for a univocal standard of psychological nor-
mality in terms of which mental health is assessed.
The current understanding of mental health does not accomplish these
ends. The one-size-fits-all adherence to the standard of psychological
normality not only bases our understanding of mental health on a dys-
functional and destructive model, but is all too frequently a cause of
shame and stigmatization for those upon whom DSM labels are affixed.
Furthermore, stipulating that mental health is synonymous with psycho-
logical normality can plausibly cause many individuals—and here I liter-
ally mean genuine individuals who are exceptions to the norm—to
become psychologically dysfunctional. This happens because they are
labeled dysfunctional both by clinicians and as a result by their society
and are so treated, and because labeling them as having mental disorders
often creates inner obstacles—of self-disparagement, alienation, isolation,
and a self-fulfilling prophesy of “illness”—obstacles to their effective
functioning as the individuals they are. We’ll look in more detail at the
psychology of such individualists, who are often artists, poets, writers, or
sculptors, in Chapter 3, and will return to consider the destructive conse-
quences of diagnostic labeling in Chapter 9.
As I’ve argued, adherence to the standard of psychological normality is
fundamentally flawed. The identical conclusion—that average, psycho-
logically ordinary people hold rigidly to beliefs and have an emotional
constitution such that, when the situation is right, they will inflict harm
on others and often themselves—has been reached from a variety of disci-
plinary points of view by many researchers in psychiatry, psychology,
ethology, sociology, anthropology, and history (Bartlett, 2005, Part II).
They have reached mutually reinforcing negative conclusions about the
psychology of normal people. None of these researchers, however, has
Questioning the Standard of Normality 29

yet advised that we should replace psychological normality as a standard

for mental health, although this conclusion has been staring us in the face
for a long time.

A PRELIMINARY CONCLUSION
There are three compelling reasons why psychological normality
should not be equated with psychological health: the factual disposition
of the psychologically normal person to feel, think, and behave in such
harmful—that is, pathogenic—ways as have been outlined here; the
strong recalcitrance of the psychologically normal population to pay
attention to, much less acknowledge and then make intelligent choices
based on, the evidence of their own harmful predispositions; and the
deeply rooted willfulness with which psychologically normal people em-
brace illusions about themselves, others, and the future.
It would take us a meaningful step forward should we be willing to
replace our defective, dysfunctional standard of mental health with a
new understanding of what mentally healthy functioning involves. Genu-
ine mental health might then be understood as involving, to mention
some of the main factors, general cognitive, social-emotional, and moral
intelligence that incorporates compassion, aversion to violence, moral
conviction, unwillingness automatically and uncritically to obey author-
ity, self-discipline, and the ability to think and make choices autono-
mously. All of these make up important ingredients essential to mental
health. It follows from this understanding that mentally healthy individ-
uals are fundamentally exceptions to the rule. Most of our human popula-
tion continues to have an inherently dysfunctional set of emotional and
behavioral dispositions. A standard of mental health that assumes psycho-
logical normality to be a central criterion of mentally healthy functioning
is fundamentally mistaken, hence misguided, and does not serve the con-
structive interests of our as well as other species.
In summary, in this chapter I’ve proposed: (1) the criteria which we use
to define mental health should promote thought, feeling, and conduct that
do not result in harm; (2) these criteria should take into account excellence
of functioning derived from a study of special groups whose members
excel in certain mentally healthy respects; and (3) on an individualized
level, these criteria should be applied by clinicians in a manner so as to
promote the individual client’s or patient’s optimal functioning. The stan-
dard of psychological normality does not fulfill these requirements. What
we should wish to adopt as a standard of mental health is the exception to the
rule in the sense developed here, the exception to what is and has been the
human norm. The normal has failed us as a species, and rather miserably.
30 Normality Does Not Equal Mental Health

To continue to employ the standard of normality is not only a mistake, it

fosters the continuation of our species’ destructive propensity.

NOTES
1. Population biologist Paul Ehrlich recently made the observation: “Even
though virtually every environmental and social problem nationally and globally
is exacerbated today by continued population growth, the topic of human num-
bers is absent not only from policy discussions in the United States but also
largely from public discourse” (Ehrlich & Ehrlich, 2008, p. 207).
2. It is interesting to note that this, too, was the conception of beneficial
therapy proposed by one of psychiatry’s most outspoken critics: “[t]he possibility
of helping the client accept his existing inclinations with greater equanimity, to
help him value his own authentic selfhood more than his society’s judgment of
it.” (Szasz, 1970/1997, p. 172).
3. An expression used by Fadiman in the course of an oral presentation at the
Center for the Study of Democratic Institutions in Santa Barbara during the aca-
demic year 1969–70.
4. In the literature there has sometimes been an unfortunate confusion and
unconscious blending together of two distinct concepts: normality, on the one
hand, versus normativity, on the other. The statistical average, what is typical in
a population, is clearly very different from an endorsement of values, which
expresses normative preferences. This problem permeates some discussions, con-
fusing the issue (as we find, for example, in Freides, 1960). This confusion prob-
ably has its base in the fact that the traditional standard of psychological
normality has functioned as a norm in both ordinary senses of that word: as a
standard it selects what is typical in a population as a basis for judgment, and then
to this it adds an evaluative preference for what is thereby identified as typical or
normal. These two senses need to be disengaged from one another since we can
obviously refer to average characteristics of a population without valuing those
characteristics.
 2

The Psychology of Definition in

Psychiatric Nosology

Contemporary psychiatry has sought to adhere to an essentially medical

conception of pathology in its definition of mental disorders. This chapter
looks closely at the psychology that underlies the largely successful attempt
of psychiatry to persuade us that the medical paradigm validly applies
to psychological conditions judged to be harmful and disabling. The
psychiatric conception of pathology—that is, medical psychopathology—
is, however, not the only way in which psychological pathology can be
understood. Later chapters discuss psychological pathology that is not
conceptualized along medical lines. But in this chapter we’ll look specifi-
cally at psychiatric pathology, pathology as it is understood from a medical
standpoint.
Underlying the formulation and endorsement of psychiatric nosologies
is the little-studied psychology of definition of mental disorders, comprising
both the psychology of nosologists who seek to define and classify mental
disorders as well as the related psychology of supporting clinicians,
institutions, drug companies, and the larger society. The psychologically
normal predispositions that come into play are seldom recognized and
are responsible, as we shall see, not only for certain flawed judgments
embedded in current psychiatric nosology but also for the way mental
disorder definitions are frequently misconstrued by clinicians and by the
wider society. By recognizing this fundamentally normal psychology we
gain a clarified understanding of the nature of definition in psychiatric
nosology and see that mental illness and the majority of mental disorders
are frequently not what we allow ourselves to believe.
This is but one instance in which our uncritical acceptance of and sub-
mission to psychologically normal limitations lead us astray. We shall
meet a variety of others in future chapters.
32 Normality Does Not Equal Mental Health

[N]o problems of knowledge are less settled than those of definition, and
no subject is more in need of a fresh approach.
—Abelson (1967, p. 314)

[B]y the content of their field, psychiatrists are the least well equipped to
confront the issue of defining [the fundamental concept of] normality.
—Murphy (1979, p. 414)

[T]here ends up being, so far as I can see, no stable reality or concept of

mental disorder; it breaks up into many, quite different kinds. . . . I would
have settled for one clear proposal as to what mental disorder really is, but
couldn’t find one.
—Bolton (2008, p. viii)

These three quotes, spanning four decades, represent a few of many sim-
ilar comments which have been made in the literature and which highlight
the conceptual confusion and lack of theoretical integration that we con-
tinue to face in psychiatry and clinical psychology. This state of disorder
in our concepts and how we apply them has evidently been brought about
in large measure by the rapid increase in the number and theoretical com-
plexity of approaches to psychological therapy. The greatly expanded
range of choice offered by the diversity of theories and methods of
psychotherapeutic treatment can be nothing short of overwhelming, espe-
cially in the context of widespread disagreement as to how practitioners
should go about making intelligent, justifiable decisions given the many
alternatives and their possible combinations. 1 On the most elemental
level, conceptual confusion in current psychiatric nosology has come
about due to the great variety of distinct, overlapping, and sometimes
incompatible definitions that have been proposed for such central terms
as ‘normality’, ‘mental disorder’, and ‘mental health’.
In addition to these sources of theoretical complexity, ambiguity, and
resulting turmoil, there is a hidden dimension that has been responsible
for a substantial amount of avoidable confusion, a dimension that has been
universally neglected throughout the literature. That hidden dimension
concerns the psychology of definition in psychiatric nosology. By this I mean the
psychological predispositions that lead nosologists as well as many others
in the mental health profession to lose control over self-critical, deliberate,
intelligent understanding of what they are doing when they define concepts
central to psychiatric or psychological diagnosis and treatment.
The phrase ‘the psychology of definition’ may suggest several hypotheses:
(1) that we mistakenly consider the process of definition to be simple,
The Psychology of Definition in Psychiatric Nosology 33

straightforward, and well-understood; (2) that definition brings into play

psychological propensities of which most of us tend not to be aware; and
(3) that these psychological propensities, if clearly and self-consciously
understood, would help us to control them and thereby gain a significant
measure of conceptual clarity and theoretical integration, in the process
lessening much of the conceptual turmoil that encumbers current psychia-
try and clinical psychology. The purpose of this chapter is to show that
these three hypotheses are true specifically in the context of definitions of
mental disorders.

THE NEED FOR A PSYCHOLOGY OF DEFINITION

Controversies from the careless employment of terms ought to be
impossible, and they can be prevented mainly through the agency of
Definition. Well-defined words, clearly understood and intelligently
expressed meanings, are a sort of panacea for the thinker; and, in propor-
tion as we approach the ideal here or recede from it, we may expect accu-
racy and progress in thought or deterioration and confusion.
—Davidson (1885, p. 2)

It is a psychological fact that the human mind thinks, and thinks among
other things about logical matters including definitions; and the
adequate investigation of this must be both psychological and logical.
—Robinson (1950/1962, p. 14)

A great proportion of essential human affairs rests on definition. How

much an insurance company will pay for a particular property or medical
claim depends on definitions set forth in one’s insurance policy or contract.
How much a court may provide in settlement of a lawsuit or how many
years it may sentence a person to prison equally depend on definitions.
How votes are to be counted in an election similarly rests on definitions.
What percentage of a forest can be logged may depend on the definition
of ‘old growth’. And, of course, definitions of ‘mental disorders’ determine
how patients or clients are diagnosed and treated, to what degree they may
ultimately be stigmatized by diagnostic labeling, whether a person can be
involuntarily confined to a mental institution, and whether the perpetrator
of a crime will be judged mentally incompetent to stand trial. The majority
of debates over pressing human interests and ideologies have definitions at
their core.
Definitions are of many kinds. Some stipulate that a word or phrase is to
have a certain meaning, as we often encounter in legal documents and in
mathematics. Some definitions state that a word has a certain customary
meaning, as we find in dictionaries, which offer definitions through
34 Normality Does Not Equal Mental Health

synonyms. Some definitions offer an informative analysis or explanation

(e.g., “DNA is composed of any of various nucleic acids that serve as the
molecular basis of heredity, are localized in cell nuclei, and are constructed
of a double helix (etc.).”). Many definitions mix together claims that have to
do with wholly different contexts, as we often find in definitions that are
advanced with the desire to persuade others to accept them. (Defining at
what stage and under what conditions a human embryo is to have the legal
rights of personhood is a good example, blending ethical, religious, scien-
tific, and legal definitions.)
The remainder of this chapter focuses on the particular kind of defini-
tion that is found in psychiatric nosologies and on how such definitions
are interpreted and understood by mental health professionals, drug
companies, social and legal institutions, and the surrounding society.
As we shall see, even the specialized variety of definition that we find in
psychiatric nosology performs varied functions, which bring about mis-
conceptions and distortions to which the human psychology of definition
is vulnerable.

THE PURPOSES OF DEFINITION IN PSYCHIATRIC

NOSOLOGIES
The definition and classification of mental disorders has today become
synonymous in the United States and increasingly in many other coun-
tries with the American Psychiatric Association’s series of Diagnostic and
Statistical Manuals of Mental Disorders, but the DSM is only the small, cur-
rently perceived promontory of a sprawling historical mainland of com-
peting psychiatric nosologies. Karl Menninger, Martin Mayman, and
Paul Pruyser (1963, pp. 419–89) give a concise yet detailed digest of many
of the psychiatric nosologies formulated over the past two millennia, from
primitive diagnostic classifications to those offered by the ancient Greeks
and Romans and subsequently supplemented and repeatedly modified
during the Middle Ages, Renaissance, and in the centuries since. Their
introductory comment places the swinging pendulum of fashion or para-
digm revision in perspective: “From simple beginnings there have been
eras of tremendous expansion, with the inclusion of many [disease]
entities, and—as now—eras of return to greater simplicity.” (p. 419). This
was more than four decades ago; since that time, the DSM, published
since 1952, has undergone revisions that have expanded the number of
diagnostic definitions from 106 mental disorders identified in the 128
pages of the first edition to 368 disorders defined in the 943 pages of the
2000 edition, DSM-IV-TR. —This has certainly not been the “return to
greater simplicity” envisioned by Menninger, Mayman, and Pruyser!
The Psychology of Definition in Psychiatric Nosology 35

During its long history, psychiatric nosology has in varying degrees been
committed to several definite and broadly inclusive purposes: to define
mental illness and its specific forms; to describe manifestations of mental
illness so they can be identified in a reliable, uniform way despite subjective
differences of practitioners; to arrive at insight into the nature and causes of
mental disorders; and to organize these definitions, descriptions, and
explanations in a systematically integrated and comprehensive taxonomy.
In this chapter, we’ll be concerned in particular with the first three of
these purposes, which concern definition, its descriptive elaboration, and
etiology.
Historically, the role of definition in the formulation of psychiatric
nosologies has had several concrete purposes intended to support
and contribute to the realization of the broader purposes just mentioned.
Definitions of pivotal diagnostic concepts are intended to allow mental
health practitioners to communicate efficiently and effectively with one
another—so that they, as a group, achieve an adequate degree of consen-
sus about what they are referring to in a manner that is as clear, unam-
biguous, and specific as possible. However, such definitions are not
intended to be mere conceptual creations unanchored in reality but are
intended to refer to actual symptoms2 and known causes of individual, dis-
tinct forms of real mental illness. In the latter sense, diagnostic definitions
may throw explanatory light on how and why individual forms of mental
illness arise. Further, in an additional capacity, definitions of mental
disorders are intended to function as coordinative rules, today often
expressed in the form of diagnostic algorithms, in terms of which practi-
tioners can reliably link an identified disease with a specified symptoma-
tology, family and patient medical history, the course of a disorder, its
likely outcome, and so on.
Diagnostic definitions are formulated, then, for the primary purposes
of efficient, effective, clear identification of real “disease entities”; beyond
these purposes, they serve others that are less immediately evident, among
them that the definitions propounded be judged to be authoritative and
that they, as a result, be persuasive. Diagnostic definitions are implicitly
intended to establish authority and credibility.
Definitions, as we’ve noted, come in many forms, and so far we’ve men-
tioned a few of these. They have names: There is stipulative definition, for
specifying how important terms are to be understood, either by equiva-
lence with synonymous terms (word-word definitions), or by reference
to things (word-thing); both of these are called nominal definitions. Then
there are word-thing definitions that have empirical content that may be
true or false, and may, as we’ve already seen in the example of DNA, offer
an informative analysis or explanation, called real definitions.3 Further, as
36 Normality Does Not Equal Mental Health

we’ve noted in connection with diagnostic algorithms, there are so-called

coordinative definitions that establish relationships between the terms of a
theory and the phenomena the theory is intended to be about (e.g., Reich-
enbach, 1965, Chap. IV). And then there are what we might call the
“meta-purposes” of definition, that is, to serve the function of authoritative
persuasion.
With this short summary of the types of definition encountered in psy-
chiatric nosologies, we turn to consider the psychology that underlies
their formulation and implementation.

STIPULATIVE DEFINITIONS AS SOURCES

OF AUTHORITY
Humpty Dumpty was adamant in claiming that the meanings of words
were the meanings that he chose that they should mean. This is stipulative
definition in a nutshell. It differs from the lexical variety of definition that
we find in dictionaries; that variety describes how people have used a word
or phrase in the past, which is the history of word use. Definitions are
stipulative when they decree how a word is to be used from now on, which
is the future. Stipulative definitions can be laid down for purely formal
purposes, as is done in mathematics and in a formal system of logic, or they
can be propounded for practical purposes, as we find in law. Stipulative
definition is also found in psychiatric nosology, as one main variety of
psychiatric definition; there is another we shall discuss in the next section.
In both law and psychiatric nosology, stipulative definitions serve an
intended role as arbiters of endorsed or acceptable future usage and prac-
tice. Those who formulate such definitions consider themselves and want
others to consider them to be credible authorities whose judgment in these
matters should be respected and followed in the future. When the defini-
tions they advocate are widely accepted, their authority and credibility
increase; a self-reinforcing cycle is established that lends further authority
and credibility to their future stipulative definitions and revisions of past
definitions. As further stipulations are made and these are accepted, the
degree of recognized authority continues to increase.
In other words, stipulative definitions of this kind are inherently legisla-
tive: they are not statements that are true or false, but are rules of usage that
are recommended or urged. Stipulatively defined terms, when they are
accepted, become a group-endorsed, socially correct vocabulary in terms
of which both the future usage of those terms and practice in accordance
with their definitions are to adhere.
The Psychology of Definition in Psychiatric Nosology 37

To call for proof of stipulative definitions is inappropriate because, as

we have noted, such definitions are not statements of fact that can be
shown to be true or false. The stipulative definitions found in psychiatric
nosologies are often misinterpreted to consist of statements that are true
about the world, but in fact they are legislated choices that are true or false
statements in appearance only; in actuality they are announcements or
decrees made by the recognized authorities of the time that certain sets
of rules should be accepted. To wish to “prove the stipulative definitions
of a nosology” is to misuse the word ‘proof’: One cannot prove that rules,
which are agreed-upon conventions, are true of the world. One cannot
prove that the Celsius temperature scale or the metric system is “true.”
Rules cannot be true or false; they can only be accepted or rejected—use-
ful in connection with a certain set of purposes or not useful. What is at
issue when we consider the definitions set forth in a nosology are the
choices made by those who enact the stipulative definitions of the nosol-
ogy, coupled with the choices made by those who accept and then imple-
ment those definitions. The history of psychiatric nosologies is a history
of how such choices have changed over time.
In nonscientific language the meaning of most words is ambiguous,
since most ordinary, nontechnical words can be used in different senses.
In science, ambiguity and resulting vagueness tend to be undesirable,
and for this reason stipulative definition can serve an important function,
ensuring that colleagues in a discipline are all talking about the same thing
when they use the same word. From the standpoint of psychiatric diagno-
sis, it is desirable that mental health practitioners reach mutually support-
ing, consistent evaluations of patients, and here agreed-upon stipulative
definitions are important; such agreement is what we mean when we refer
to the “reliability” of diagnosis.
When the number of specialized kinds of disease or disorder that are
named and classified by a nosology increases or decreases, when the stipu-
lated definitions of those forms of illness shift and frequent revisions are
made, we need to be alert to the active role of stipulation. The psychology
that characterizes human legislative activity is an expression of the psychol-
ogy of persuasion, recognized in those whom we accept as experts when
they seek the power of authority and credibility. The psychology of persua-
sion, on which rhetoric in its traditional meaning rests, is therefore at the
core of the formulation and acceptance of definitions of mental disorders
in psychiatric nosologies. As we shall see, stipulative definitions of this kind
frequently lead to inappropriate and indeed fallacious inferences concern-
ing the nature of what is defined, contributing to the conceptual confusion
we have remarked on. This, too, is a psychological matter.
38 Normality Does Not Equal Mental Health

REAL DEFINITION AND REIFICATION

Writers from Epictetus on have noted that what a person thinks is real is
usually more important than what is real, which is just another way of
saying that a person’s construction of events will psychologically chan-
nelize his processes.
—Sechrest (1977, p. 234)

Real definition plays a major role in science. Real definition is part of

the process of obtaining and expressing new knowledge of things. It has
a long history from the time of the ancient Greeks to the present. Real
definition was understood by Aristotle to be a statement of the essence
of a thing, and two millennia later this remains the goal of natural and
behavioral science. Real definition seeks to express important facts about
an object of reference, from which other true propositions about that
object can be deduced or otherwise related. Einstein’s definition of ‘simul-
taneity’ or psychiatry’s definition of ‘mental disorder’ alike intend to fulfill
this purpose. Unlike stipulative definition, real definition is believed to
communicate not merely conventionally agreed-upon meaning but real
information about things. In other words, real definitions are believed to
be empirically descriptive and hence to be true or false.
Real definition, then, by virtue of its intended purpose, purports to be
about what is real, contrary to a definition that is a pure conceptual con-
struct and has the status of a fiction. We recognize that the definition of
‘unicorn’ is not a real definition, nor are the definitions of ‘point’ and ‘line’
in Euclidean geometry. Real definitions implicitly or explicitly assert real
existence and hence imply existential propositions.
It is sometimes difficult to know whether a definition refers to what is
real or fictitious. Here psychology comes decidedly into play. British
mathematician and philosopher Alfred North Whitehead (1925)
described what he called “the fallacy of misplaced concreteness,” the error
of believing that what is only abstract exists physically. Whitehead’s name
for this conceptual mistake may be more descriptive than the more com-
monly used name ‘reification’, derived from the Latin facere, meaning
“to make,” and res, meaning “thing,” which when both are brought
together means “converting something that is purely an idea into an
object believed to exist.” Both ‘misplaced concreteness’ and ‘reification’
are names for the fallacy of believing that a construct, a purely hypotheti-
cal idea, refers to a real physical entity.
Misplacing concreteness or reifying are not mere parlor-game fallacies
of logic but are fundamental to the psychologically normal human
constitution. The propensity to believe that many of the things we define
must be real expresses one of a variety of forms of “conceptual pathology”
The Psychology of Definition in Psychiatric Nosology 39

that I have studied elsewhere (Bartlett 1971; 1975; 1976; 1982; 1983; 2005,
Part III). The human disposition to reify has often been expressed in the
history of science: In physics, appeal was made to the concepts of a luminif-
erous aether and of phlogiston in order to provide for a substantive, real
medium in space that could carry light waves and for the “fiery substance”
released during combustion. In medicine, similar reifications were made
through the concept of bodily humors, miasma, and vital force or by
stethoscope inventor René-Théophile-Hyacinth Laënnec’s (1982, MS.
2186 [III]) principe vital. And of course reification is pervasive in ideologies
and religions (the nation is partially reified in its flag, gods and goddesses
are reified by systems of religion and mythology, etc.). It is practically
impossible for most people to refrain from believing that what appears to
be a real definition or description actually refers to things that exist.
The tendency to reify is deeply engrained in the human psychologically
normal propensity to engage in what I have elsewhere called “projective
misconstructions.” Expressed in compressed form, a projective miscon-
struction occurs when we believe that that to which we refer is indepen-
dent of the very conditions that render such reference possible (Bartlett
1971; 1975; 1976; 1982; 1983; 2005, Part II). For our purposes here, this
is a theoretically abstract way of saying several simple things at once: when
we formulate definitions that we misconstrue to be real definitions, we are
often led to build on these, making further statements that we take to be
true, when in fact on a very basic level we do not know what we’re actually
referring to and talking about, and yet nonetheless insist that we do and
that what we’re talking about is real. To engage in projective misconstruc-
tion in the context of our present discussion is to be caught by the delu-
sional power of definition, that is, to believe that our seemingly real
definitions refer to empirical realities. In psychiatric nosology, this takes
the form of believing that what is authoritatively defined as a “mental dis-
order” corresponds to “a distinct and real disease entity.”
Once a purported illness has been defined, a psychological shift to reifica-
tion often takes place: after a nosologist has stipulated a disease definition,
it is a psychologically normal tendency to transform the definition, with-
out giving this shift reflective thought, into a judgment that a correspond-
ing object, a “real disease entity,” exists with the defined properties.
Definitions that purport to be real definitions carry with them, often in
disguise, existential propositions that claim that what has been defined is
empirically real. A name is given to a disease, its symptomatology is
described, and then a leap of misplaced concreteness frequently takes
place that results in an unquestioned acceptance that a “disease entity”
exists: a “mental illness” or “mental disorder.” Let us look at this psycho-
logical shift in greater detail.
40 Normality Does Not Equal Mental Health

DEFINING MENTAL DISORDERS INTO EXISTENCE

Like the personifications of the religions, these [disease] entities offer
certain advantages as transition stages for untrained reasoning, but from
the scientific point of view they are unacceptable.
—German physician and bacteriologist Ferdinand Hueppe (1852–1938)
(quoted by Faber, 1923/1930, pp. 191–92)

As we have seen, stipulative or legislative definition can be a great aid to

effective, efficient communication. It also has its disadvantages, for many
legislative definitions are easily mistaken for real definitions, which, unlike
stipulative, legislative definitions, can, as we’ve noted, refer to empirical
realities and communicate information about the world. All definitions of
course communicate information, but only some definitions formulate
empirical claims to knowledge, which can be true or false. We’ve seen that
stipulative definitions are not true or false but rather express an authorita-
tive request or insistence that they be adopted. Stipulative definitions in a
nosology express judgments that certain choices should be made—most
especially choices that specify which medical conditions we should con-
sider harmful or disabling and how those conditions are to be understood
in terms of sets of symptoms, family and patient history, the course of a dis-
ease, its prognosis, and other factors. In short, some definitions that appear
to be real definitions are only that in disguise, camouflaging the fact that
they express evaluative choices in favor of the shared allegiance of an expert
group that wishes to persuade others to adopt the same choices. But beyond
such misleading definitions, there are other disease definitions that success-
fully function as genuinely real definitions: They combine stipulation with
empirical description and indicate how observable symptoms are associated
with underlying physiological pathology, often recognized or confirmed by
laboratory tests, as is common in physical medicine.
The history of both psychiatry and physical medicine attests to the
frequency of change in the choices expressed by nosologies: In recent dec-
ades within psychiatry, we’ve witnessed a succession of modifications,
reclassifications, indecision, and controversy in diagnostic choices con-
cerning, for example, homosexuality, mathematics disorder, masochistic
personality disorder, caffeine intoxication, posttraumatic stress disorder,
nightmare disorder, perileuteal phase dysphoric disorder (a.k.a. PMS),
depression, intermittent explosive disorder, pathological gambling, alco-
holism, learning disorders, kleptomania, attention deficit disorder, sibling
relational problem, autism, conduct disorders, and eating disorders—and
the list could of course be lengthened. Some diagnostic judgments about
“disorders” thought to be real are now considered to be dead wrong, for
instance, masturbation and female orgasm.
The Psychology of Definition in Psychiatric Nosology 41

In physical medicine, perhaps more extravagant and outrageous in

hindsight, we have seen diseases come and go, as in the case of physician
Samuel Cartwright’s (1851) discovery of drapetomania (the disease causing
slaves to want to abscond) and dysæsthesia æthiopsis (the disease causing
slaves to destroy property); or going back a little further in time, of physi-
cian Benjamin Rush’s 1792 discovery of Negritude, “the disease of being
black” (Reznek, 1987, pp. 17–18). When, with the clarity that looking
back permits us, such putative “diseases” are recognized to have been dis-
guised evaluations that promoted the social or political correctness of the
times, we can see that these seemingly real definitions of disease were
actually definitions that aimed to persuade. As Robinson (1950/1962),
whose work was not concerned with psychiatric matters, asked in one of
the few books wholly devoted to cataloguing varieties of definition,

What is the value of persuasive definition? The habit of evaluating things is

presumably ineradicable from human nature, and certainly desirable. The
habit of trying to get other persons to share our own valuations is equally
ineradicable and equally legitimate. What is hard to decide is whether
persuasive definition is a desirable way of trying to change people’s
opinions. The argument against it is that it involves error and perhaps also
deceit. The only persons who are influenced by a persuasive definition, it
may be said, are those who do not realize its true nature, but take it to be
what every real definition professes to be, a description of the objective
nature of things. A persuasive definition, it may be urged, is at best a
mistake and at worst a lie, because it consists in getting someone to alter his
valuations under the false impression that he is not altering his valuations
but correcting his knowledge of the facts. (pp. 169–70)

Robinson notes: “This . . . form of real definition is a moral or evalu-

ative appeal misrepresented as a statement of fact, and gaining force from
its pseudo-scientific character. The general pattern of this [is] . . . exhorta-
tion and appeal and moral judgement masquerading as science” (p. 167).
However, we would be thrown off course if we were to accept that persua-
sive definitions are, as Robinson suggests, of themselves error-inducing and
deceit-causing. It is not the definitions themselves that are responsible but
the psychologically normal propensity that willingly, and indeed often will-
fully, insists that our conceptual constructs correspond to physical realities.

THE DYSFUNCTIONAL NATURE OF THE PSYCHOLOGY

OF DEFINITION
We have seen how stipulative definitions that appear to be or are mis-
taken to be real definitions often lead to existence claims. Again, it is
42 Normality Does Not Equal Mental Health

important to stress that the fault for this mistake is not simply attributable
to clumsy or inarticulate language but rests with psychological propensities
that are normal, pervasive, and expressed in many aspects of life—in poli-
tics, religion, mythology, literature, and the history of many disciplines. It
is certainly not a mistake confined to the way we construe definitions
in psychiatric nosology. We use words to point, and it is psychologically
normal to succumb to the belief that that to which they point is real. What
J. R. R. Tolkien called in a nonfiction essay the reality consistency of litera-
ture (mentioning the New Testament as an example) touches precisely on
the psychological facility we have of endowing with imagined, projected
reality whatever is portrayed sufficiently well in words to create in us a
sense of its “inner consistency of reality” (Tolkien, 1965, p. 47).
Legislative definitions—especially when they are enacted by panels of
experts in which the full faith of a profession is invested and when they
are set forth in a well-developed, detailed, descriptive system of disease
classification—can easily exercise a powerfully persuasive influence over
its professional audience and, in a psychological domino effect, also over
the general public. This is especially true if that audience and the public
are psychologically predisposed to engage in “projective misconstruc-
tions”—specifically if they are predisposed to misplace concreteness and
reify the diseases stipulatively defined by the authorized nosology. This
is, to be sure, most likely to happen when many of the stipulatively defined
diseases are not known to have organic origins and are instead understood
primarily in terms of sets of symptoms. We shall look more carefully into
this aspect of psychiatric disease definition later.
When normal human psychology supports and indeed promotes the
delusional reification of stipulated definitions it becomes dysfunctional,
for to equate what is purely a construct and hence fictitious with what is real
is delusion, while to recognize delusion is to acknowledge that cognitive
failure has occurred. In the context of psychiatric nosology, when stipulated
definitions of “mental disorders” inappropriately lead to their reification as
real “disease entities,” nosology similarly becomes dysfunctional.
We need to take this statement out of the abstract framework of nosol-
ogy and to place it within the framework of the people who are directly
and indirectly affected—psychiatrists, clinical psychologists, social work-
ers, their patients or clients, pharmaceutical and insurance companies, the
courts, the political system, and the wider society. When we do this and
find our feet firmly planted on the ground, it is hard to avoid the strong
impression that group delusion must be at work when definitions are
constructed by panels of experts, then are agreed upon and ratified, then
are given official endorsement as diagnostic rules by today’s psychiatric
community (recall once again that rules are not true or false), and then are
The Psychology of Definition in Psychiatric Nosology 43

misconstrued by psychiatrists themselves, and subsequently by much of the

rest of society, as “true statements” about real diseases.
Is this, however, what actually happens? Are all “mental disorders” that
are stipulatively defined by contemporary psychiatric nosology no more
than theoretical fictions? Does the concept of “mental illness” lose medical
meaning as “real disease” because of the propensity of human projective
psychology to reify? Surely, it is natural to think, not in all cases. At this
point, we need to make explicit what the stipulative definitions of today’s
psychiatric nosology in fact refer to.

CHOICES IN THE INTERPRETATION AND

RECOGNITION OF DISEASE: PHYSICAL PATHOLOGY
AND MENTAL DISORDER
In matters of definition there is no right or wrong.
—Hardin (1982, p. 138)

Stipulative definitions and the lexical definitions that we find in dic-

tionaries are not dictated by reality, but, as we’ve noted, they express
conventions: the stipulative variety lay down conventions that are
intended to serve an author’s or a group’s purposes in the future; the
lexical variety describes conventions that language use in the past has fol-
lowed. Definitions of either kind reflect choices that could have been
made otherwise if human purposes had been different. Empirical reality
does not prescribe the definitions human beings have chosen for their
words that we find in dictionaries, nor do facts determine what we recog-
nize as disease. Farmers judge that the blight that attacks corn or potatoes
is most certainly disease, yet

if man wished to cultivate parasites (rather than potatoes or corn) there

would be no “blight,” but simply the necessary foddering of the parasite-
crop.. . . Outside of the significances that man voluntarily attaches to
certain conditions, there are no illnesses in nature.. . . The fracture of a sep-
tuagenarian’s femur has, within the world of nature, no more significance
than the snapping of an autumn leaf from its twig: and the invasion of a
human organism by cholera-germs carries with it no more the stamp of
“illness” than does the souring of milk by other forms of bacteria. . . . [I]f
some plant-species in which man had no interest (a desert grass, let us say)
were to be attacked by a fungus or parasite, we should speak not of a
disease, but merely of the competition between two species. The medical
enterprise is from its inception value-loaded; it is not simply an applied
biology, but a biology applied in accordance with the dictates of social
interest. (Sedgwick, 1973, pp. 30, 31)
44 Normality Does Not Equal Mental Health

There are, however, levels of choice. The medical definition of disease

does not involve the degree of freedom that we often see in the stipulative
definitions of mathematics or law or that we recognize in the dictionary
definition of a word where a choice is recorded, indicating that someone,
at a certain time, chose to associate the sound or symbol of a word with a
certain meaning. Historically, the prototypical medical definition of disease
has been derived from physical medicine, which claims that the presence of
disease is made evident through its symptomatology (as noted earlier, here
taken to include both the symptoms the patient is capable of reporting as
well as the signs observed by the treating physician). We are reminded that
a symptom is a physical or psychological phenomenon that is believed to
arise from or accompany a presumed disease and to constitute an indication
of it.4 The prototypical medical understanding of disease claims that symp-
toms are the consequence of underlying pathology and that the main goal of
medical treatment is to detect and eliminate that pathology.
The medical theory of disease distinguishes various types of organic
disease ranging from disease caused by an infectious agent to environmen-
tal disease, nutritional disease, metabolic disease, autoimmune disease,
genetically based disease, and so on. (cf. Bartlett, 2005, Chapter 1). A spe-
cific and clear schematic concept of physical disease is expressed by the
Systematized Nomenclature of Pathology (SNOP), which seeks to stand-
ardize nomenclature for diagnostic pathologists and to assist pathologists
in classifying laboratory specimens. SNOP defines a physical disease in
terms of four fields: the part of the body affected (“topography”), struc-
tural changes that result from the disease (“morphology”), the cause of
the disorder (“etiology”), and functional manifestations (“function”). For
each field, a four-digit code is assigned, the first digit designating the sec-
tion of the field and the subsequent digits specifying subdivisions (College
of American Pathologists Committee on Nomenclature and Classification
of Disease, 1965). The Systematized Nomenclature of Medicine
(SNOMED) is similarly organized, being an extension of the SNOP.
SNOMED uses the four fields of the SNOP plus three additional fields
consisting of a disease classification field, a procedure field for administra-
tive records, and an occupation field for occupational record keeping
(College of American Pathologists Committee on Nomenclature and
Classification of Disease, 1979).
There is a significant—literally, a substantive—difference between such
an evidence-based, physical definition of disease and the definition of
‘mental disorder’ or ‘mental illness’. Psychiatric nosologies throughout
history have been influenced by their love affair with the model offered
by physical disease, but the definitions of physical disease and mental dis-
order have in general diverged very considerably.
The Psychology of Definition in Psychiatric Nosology 45

If we were to take the medical model of physical disease as an ideal stan-

dard in defining disease, then several criteria of definition follow. In order
for a medical definition of an individual disease to go beyond stipulative
definition, it would need to accomplish all four of the following things:
(1) the definition must identify a disorder that is judged to result in disabil-
ity or harm either to individuals themselves who are afflicted with that
malady, to their society, or to both; (2) it integrates the description of the
disease within a systematic framework of classification of other known dis-
eases; (3) it specifies conditions under which the disease is observable by
enumerating physical, behavioral, cognitive, and affective symptoms and
signs that serve as indications to the physician and to the patient of the pres-
ence of the disease; and (4) the definition describes the separately specifi-
able conditions, states, or physiological pathology known to give rise to
the characteristic symptomatology of that disease.5 Emphasis must be
placed on the phrase “separately specifiable,” for it is here that a medical
definition of physical disease is anchored in what we might, if it were not
such a mouthful, call “extrasymptomatological reality.”
In other words, we must have these two different contexts of reference—
stipulative definition plus empirical confirmation of pathology—in
order for a defined disorder or disease, whether in psychiatry or in physi-
cal medicine, to have more than symptomatological status. Unless a
mental disorder is to be equated with a set of symptoms, condition 4 must
be satisfied. However, as we shall soon see, the great majority of mental
disorders in fact have been identified and reduced only to sets of symp-
toms (commonly supplemented by individual and family history and
by assessment of the course of the purported disorder and of its likely
outcome).

THE PSYCHOLOGY OF SYMPTOM CLUSTERING

A disease without physical findings is an anomaly.
—Stempsey (1999, p. 190)

Symptom-complexes cannot pass for diseases.

—Hungarian neurologist Eugen Jendrassik (1829–1891) (quoted by
Faber, 1923/1930, p. 183)

A “syndrome” is a group of symptoms that occur together and are used to

identify a state or condition judged to be medically undesirable. Nearly all
purported “mental disorders” are syndromes, that is, their definitions are
symptom-based and fail to meet the last condition (4) above. The term
‘syndrome’ is at the core of the definition of ‘mental disorders’ that we
46 Normality Does Not Equal Mental Health

find relatively unchanged in the DSM-III-R (1987), DSM-IV (1994), and

DSM-IV-R (2000):6

[E]ach of the mental disorders is conceptualized as a clinically significant

behavioral or psychological syndrome or pattern that occurs in an individual
and that is associated with present distress (e.g. a painful symptom) or
disability (i.e. an impairment in one or more important areas of func-
tioning) or with a significantly increased risk of suffering death, pain,
disability, or an important loss of freedom.. . . Whatever its original cause,
it must currently be considered a manifestation of a behavioral,
psychological, or biological dysfunction in the individual. (American
Psychiatric Association, 1994, p. xxii, italics added)

This is intellectually honest language that places the word ‘syndrome’

alongside its nontechnical synonym ‘pattern’, for the perception of pat-
terns plays an important role in the definition of disease. Before 1980,
when DSM-III was published, “syndromes” were implicitly regarded as
being “proper sets,” that is, they were generally understood in terms of
well-defined symptom sets, each symptom of which was necessary, and
all symptoms taken together were sufficient, to determine the presence
of the disorder in question. Since then, a tolerance for less well-defined,
“fuzzy” syndromes has developed so that often no set of symptoms is
jointly sufficient to define a particular disorder. We now typically find
psychiatric disorders defined in terms of multiple symptoms, a specified
minimum number of which must be satisfied in order for a patient to be
considered correspondingly “disordered.”
There are several recognized problems with such a symptom-based
approach to defining mental illness: one is that the same symptoms are
frequently found in patients who are judged to have different disorders,
another is that a patient may have a mixture of symptoms that are consid-
ered to belong to several different disorders, still another is that a single
patient may have symptomatology that satisfies the definitions of two or
more mental disorders (so-called “comorbidity”), and still another is that
two patients with the same diagnosis may have different sets of symptoms
(“heterogeneity”). These problems, which together we’ll call “problems of
diagnostic haze,” when coupled with the psychology of pattern recogni-
tion that we’ll look at in a moment, make symptom-based definitions
of mental disorders inherently prone to uncertainty about the status of a
syndrome as a disease or disorder in itself. This naturally leads to doubt
whether the diagnostic criteria stipulated by a definition of a mental disorder
refer to distinct “disease entities” and whether such definitions themselves
are well formulated.
The Psychology of Definition in Psychiatric Nosology 47

Fever and depression are examples: A fever can be a symptom of an ill-

ness, but is not itself a distinct disease, for fevers may accompany many
diseases. Similarly, depression can be associated with various psychiatric
conditions—some 60 percent of general psychiatric patients show symp-
toms of depression, more than 40 percent of those diagnosed with anxiety
disorders, and 30 to 70 percent of those judged to have a personality
disorder (Beutler & Malik, 2002, p. 257). The incidence of depressive
symptoms is, in other words, not neatly delimited, and this fact leads to
suspicion that depression is not a specific “disease entity,” not a specifiable
“real mental disorder” in its own right, but a human psychological state
that has “a nonspecific etiology, an irregular course, and no specific treat-
ment” (p. 265). Depression, in this sense, is like the nonspecific symptom
of physical pain; the “emotional pain” of depression can accompany many
psychological conditions. It was therefore natural for Beutler and Malik
to conclude: “If this is true of the most frequently diagnosed and most
problematic of the mental health disorders, by extension one must be con-
cerned about the very nature of the assumptions underlying the DSM
itself” (p. 265).
It is evident that here, in the recognition and naming of symptom
patterns, several human psychological propensities are deeply involved.
The sets of symptoms that are grouped into syndromes are commonly
and graphically referred to by nosologists as “constellations.” Certain
elements of the psychology of perception, involving a subject’s interests
and purposes, underlie the definition of constellations. It is easy to see this
in connection with constellations of another sort, the astronomical
“objects” we see on a starry night. Pattern recognition plays a leading role
in the form that perceived clusters of stars come to take—once we are
instructed what to look for—whether Orion, Cassiopeia, or the seven
Pleiades. The psychology that is part of this process of clustering has not
been studied in connection with the construction of nosologies, but that
it plays a leading part is evident.
When as children we played “connect the dots,” the game would be
time-consuming indeed were it not for the numbering of the dots. The
greater the number of dots (in analogy here with symptoms), the greater
the number of possible patterns (in analogy with syndromes). To come a
little closer to the real world, consider a three-dimensional group of
numerous but unnumbered dots, and consider how many different patterns
can result from connecting them with straight lines. If arbitrarily curved
lines are allowed instead, the number of patterns explodes infinitely. If we
bring in the dimension of time, the potential number of patterns quickly
becomes dizzying. Although at this point we are on a fairly high level of
48 Normality Does Not Equal Mental Health

theoretical abstraction, we should quickly see that, on a specific and con-

crete level, the clustering of symptoms can occur as a function of many var-
iables, some of which have been the object of discussion and at times
contention in the psychiatric literature: namely, to what extent definitions
of syndromes are a function, for example, of social, political, religious,
moral, and commercial interests (e.g., Laing, 1960; Szasz, 1957/1961 and
1970/1997; Scheff, 1966/1984; Breggin, 1994; Stempsey, 1999; Beutler &
Malik, 2002; Sadler, 2002; Schiappa, 2003; Bartlett, 2005, Part I; Cooper,
2005; Sadler, 2005).
With respect to both kinds of constellations, of stars or of symptoms,
selective human choice is involved in the patterns we recognize. The clus-
tering that we sometimes say we “discover” and sometimes say we “create”
can be understood in terms of selective interest, for nature provides no
lines of categorical division, just as the map lines that define counties,
states, and nations are not determined by nature but are chosen and legis-
lated. As Stempsey (1999, p. 99) expressed this, “our descriptions of these
[symptom] constellations are in an important sense socially constructed.
We have a choice as to which clusters of phenomena we see as constitut-
ing a disease, and which we choose to interpret as background noise.”
As we’ve noted, by ‘symptoms’ we include behavior, affective and
physical states, and cognitive activity, whether reported by the patient or
observed as signs by the clinician. These phenomena are highly individ-
ual, related to the individuating context of a patient’s life history and
ongoing experience. Depending on the criteria by which these phenom-
ena are sorted and placed in symptom clusters, they can be grouped in
essentially innumerable ways.7
It might be appropriate to single out and name this open-ended human
propensity that clusters symptoms in diverse ways. One might be tempted
to name it the “Endless Multiplication of Syndromes Principle,” were it
not for the fact that it itself constitutes a syndrome, a collection of charac-
teristic psychologically normal dispositions. And so perhaps we may call it
the “Endless Multiplication of Syndromes Syndrome” (EMSS). By nam-
ing the EMSS I want to underscore that we need to take seriously that
“endless multiplication” is really at issue, for there is, in principle, noth-
ing—psychologically or logically—to halt it. We shall see that psychiatry
does not, like physical medicine, have available an “empirical brake” that
can reign in runaway syndrome multiplication.
The psychology of symptom clustering is also involved in the phenome-
non of diagnostic filtering. In much the same way as the constellation of
Orion leaps out—a clear pattern detaching itself from its starry back-
ground—as soon as you know what to look for, so do the diagnostic classifica-
tions learned by clinicians define, in both main senses of this word, how
The Psychology of Definition in Psychiatric Nosology 49

they are likely to perceive their patients’ behavior and psychological symp-
tomatology. Human beings cannot make observations outside of a frame of
reference that reflects adherence to some group of conceptual commit-
ments, however basic these may be. The conceptual commitments with
which a clinician evaluates a patient are generally those that are advocated
by the nosology he or she has been taught, and these, in turn, of course
can sometimes be further influenced by prevailing nonclinical values such
as diagnostic expedience (using DSM codes to meet insurance payment
criteria, etc.).
Diagnostic filtering extends beyond a clinician’s perception of patients:
it serves to check or limit the scope of what he or she is able to see or is
able most easily to see. As Malik and Beutler (2002) expressed this meta-
phorically, “the very success and widespread use of the DSM model of
diagnosis may have the unintended side effect of constraining us to work
within a less-than-optimal system of diagnosis, a situation analogous to
that of expending considerable time and resources in the ascent of a single
mountain, while neglecting to explore the possibility that even higher
peaks may exist nearby” (pp. 7–8). They concluded: “[T]he longer diagno-
sis is determined according to the DSM, the fewer opportunities there will
be for the exploration of alternatives” (p. 9).

PSYCHIATRY’S INFLATIONARY ONTOLOGY

Those groups of symptoms which are [called “diseases” by my colleagues]
are metaphysical abstractions which by no means represent a constant
unchangeable morbid condition, and which we cannot be certain of find-
ing in nature. They are factitious entities (entités factices), and all those
who study medicine according to this method are ontologists.
—French physician François-Joseph-Victor Broussias (1772–1838)
(quoted by Faber, 1930/1978, p. 48)

Such a view which takes abstract concepts for things, implying their actual
existence and at once treating them as entities, is called ontology. . . . [T]o
the ontologist the assumed disease is a dogma; the group once collected,
it becomes a concept, an entity.
—German physician and psychiatrist Carl Reinhold August Wunderlich
(1815–1877) (quoted by Faber, 1923/1930, pp. 66–67)

As human needs and vested interests change, it is to be expected that so

will the choice of symptom sets, for what human beings regard as harmful
or disabling behavior, affect, or cognitive function is subject to very
considerable change with time. Hence, correspondingly harmful “syn-
dromes” of these phenomena can be expected also to multiply without
50 Normality Does Not Equal Mental Health

end, along with, as we shall see, their correspondingly reified “internal

dysfunctions.” Diagnosable “patterns” will change, sometimes inflating
and sometimes contracting in number, but open-ended definitional
change in psychiatric nosology is formally assured as well as being guaran-
teed by the psychologically normal human predisposition to recognize
patterns in experience that fit, or conflict, with perceived needs and inter-
ests. As long as “mental disorders” are equivalent to free-floating stipulated
syndromes, uncorrelated with an empirical basis that can be tested and
thereby be confirmed or disconfirmed, they will remain on the historically
primitive level of mere beliefs subject to the vagaries of changing fashion,
changing interests, and values ever in flux.
Henrik Wulff has divided disease into four types: disease defined in
terms of symptoms, syndromal disease, anatomically defined disease, and
causally defined disease. He has argued that symptom diagnoses are used
to describe “the most primitive form of disease entity” (Wulff, 1976,
p. 67), with syndromes occupying the next level of scientific development.
As an example, he gives chronic diarrhea, which could come from ulcera-
tive colitis (a syndrome), cancer of the colon (an anatomically defined dis-
ease), or lactase deficiency (a causally defined disease).
Similarly, J. G. Scadding has described scientific progress in medicine
in terms of a “ladder of taxonomic knowledge” (Scadding, 1990, 1996).
The first rung of the ladder corresponds to disorders that physicians were
able to understand only in terms of symptomatology. This level of medi-
cal knowledge is the most elementary and forms a starting point for future
needed work. Scadding situates the majority of “psychiatric disorders” on
this primitive stage of development. As scientific medicine progresses, the
discovery of structural anomalies replaces the rudimentary and informal
descriptions of syndromes; this occurred, for example, when the structural
knowledge of tubercles replaced exclusive reliance on the syndromal
description of tuberculosis. As scientific medicine progresses further, a
third rung in the ladder of knowledge is reached when evidence of physi-
cal pathophysiology or of disorders of function becomes available. Finally,
the top rung of the ladder is reached when medicine comes to understand
the etiology of disease, which occurred when the tubercle bacillus, Myco-
bacterium tuberculosis, was discovered to be the origin both for the morbid
structure it causes and for a resulting failure of physiological functions.
From this evaluative-historical perspective, medicine advances not
when syndromally defined disorders explode in number, as they have in
psychiatric nosology during the past several decades, but when etiological
explanations are found for diseases that previously had been defined on
the elementary syndromal level. As physical medicine has gradually been
able to detect identifiable pathology at the root of what were previously
The Psychology of Definition in Psychiatric Nosology 51

described only as free-floating syndromes, it has made significant, solid

progress.
In contrast, the history of psychiatric nosologies shows little signs of
such progress. Few of the syndromally defined “disorders” in the most
recent edition of DSM can be associated with an empirically verifiable eti-
ology (e.g., Houts, 2002, p. 44). R. L. Spitzer, who has played a central
role in recent DSM revisions, estimated that more than 200 of the “disor-
ders” listed in DSM-III (it listed 265) would not have been included had
the criterion of empirical support from the research literature been
applied (Spitzer, 1991; Houts, 2002, p. 53). And since Spitzer published
this admission, syndrome multiplication has continued as more than 100
additional alleged “mental disorders” have been added to the DSM, nearly
all of these also lacking an empirical basis.
The globally influential International Classification of Diseases (ICD-10)
shows a similar inflationary trend. Where the previous edition, ICD-9,
contained only 30 categories for mental disorders, the new standalone vol-
ume, ICD-10 Classification of Mental and Behavioural Disorders: Clinical
Descriptions and Diagnostic Guidelines, devotes 100 categories (some still
unused) to mental disorders, of which some 90 percent of those listed have
no known organic basis.
This recent exuberance for recognizing and naming new syndromal
disorders stands in conflict with the precepts of disease theory urged by
the most eminent of nosologists of the past two centuries. Emil Kraepelin
(1856–1926) understood mental illness in essential connection with asso-
ciated organic pathology, course, and outcome. When there was an
absence of knowledge of the etiology of a purported mental disorder, he
fell back upon symptom-based definitions. Kihlstrom (2002), recognizing
the importance of Kraepelin’s basic medical objective, has urged: “[W]e
can honor Kraepelin not by repealing his principles, but by reaffirming
them—by moving beyond symptoms and diagnosing mental illness in
terms of underlying pathology. For Kraepelin, diagnosis by symptoms
was a temporary fallback, to be used only because diagnosis by pathology
and etiology was not possible” (p. 297).

THE CONCEPT OF MENTAL ILLNESS IS NO MYTH

BUT THE RESULT OF DYSFUNCTIONAL THOUGHT
It is important not to equate the need for an observable physical etiol-
ogy, for an empirically established origin of stipulated symptom sets, with
a simplistic and dogmatic preference for the paradigm offered by physical
diagnosis. For it is not simply that a preferred paradigm may be in view,
52 Normality Does Not Equal Mental Health

but something a good deal more central: that is, the need for symptom
sets to be correlated with a detectable, underlying disorder or dysfunction. This
is needed, not purely in order to honor Kraepelin’s ideal nor to satisfy the
antipsychiatrists’ complaint against the use of “mental illness” as a “meta-
phor” or “myth” (Szasz, 1957/1961, 1970/1997), but in order for the psychol-
ogy of definition to be nonarbitrary and not merely stipulative. This is an
important fact, and it distinguishes “the myth of mental illness” from “a
concept of mental illness that results from psychological misconception.”
The first is a matter of metaphor or analogy that has gone astray, while the
second is a matter of dysfunctional thinking. Szasz’s anti-mental-disorder
position was correct, not for the surface reason that mental illness labeling
is mythical or metaphorical but because the human psychology of defini-
tion has become dysfunctional, that is, it has resulted in delusional reifica-
tion of mental illness by means of constructed definitions, stipulated,
agreed upon, and ratified by today’s psychiatric community, with no con-
firmable basis in empirical pathology, and then systematically miscon-
strued by psychiatrists themselves and then by the rest of society as
referring to real diseases.
In order for the psychology of definition in psychiatric nosology to rise
above the arbitrariness of symptom clustering, it is essential to find a basis
for any alleged “mental disorder” in empirically detectable pathology. It
should be clear how psychologically easy it is, in relation to whatever
may be the dominant social, political, and, indeed, monetary interests
at any time, to select forms of behavior and ways of feeling and thinking
that are perceived as undesirable, to cluster these into symptom sets,
and then deceptively to designate the resulting reified syndromes “mental
disorders.”
Contemporary psychiatric nosology, as expressed in the DSM and the
ICD (implicitly included in our discussion from now on), has not been
blind to the need we are discussing: Although it may take some sympa-
thetic interpretation to see it this way, the DSM appears somewhat half-
heartedly and dimly to have recognized that, if a stipulated syndrome is
to be an indication a “real mental disorder,” this requires that an observ-
able inner disorder, a detectable harmful inner dysfunction, a verifiable
pathology, actually exist. But, unfortunately, in nearly every instance of a
purported, DSM-classified “mental disorder,” this necessary link with
reality has gone begging; the failure to establish such a link tends largely
to be ignored; and DSM-coded syndromes are then taken to name real
mental disorders—by clinicians; their patients; medical, legal, and social
institutions; and the surrounding society. The endless ramification, com-
bination, and recombination potential, for which the psychology of symp-
tom clustering is responsible when there is no detectable underlying
The Psychology of Definition in Psychiatric Nosology 53

pathology, makes “the reality of mental disorders” a contemporary empty

fiction—to paraphrase Robinson—clothing an evaluative appeal in
pseudoscientific dress (1950/1962, p. 167). The fiction arises not because
the concept of mental disorder is “metaphorical” or a “myth” but because
without empirical anchoring definitions of alleged mental illness can only
be stipulative, legislated, and promoted with the goal to persuade. Defini-
tion within any legitimate nosology must be more than this.

THE PSYCHOLOGY OF RESISTANCE TO

IDIOPATHIC DISEASE
This moral idiopathy, which neither proceeds from nor depends on any
other disease, . . . this itch for seeing memorable places . . . is peculiarly
English.
—The New Monthly Magazine (XXXIX, 1833, p. 129)

As in the quote above, it becomes very easy—often too easy—to label as

“idiopathic disease” any phenomenon for which we do not know its cause.
A disease is said to be “idiopathic” when, so far as we know, it arises by
itself and is not symptomatic or the result of another disease. This is a
lexical definition of the word ‘idiopathic’; the definition states what a
common usage has been in the past. The definition I’ve given is a para-
phrase of the main definition in the Oxford English Dictionary; in medical
contexts it is often expanded to include a phrase like “arising from an
obscure or unknown cause,” reflecting another psychologically prevalent
predisposition, the need to postulate underlying physical causes, which
we’ll look at briefly here in the guise of resistance to idiopathic labeling.
Concerning the symptom-based definitions that the DSM contains—
the majority that do not have a known etiology—could we reasonably
say that they are “idiopathic” in nature, insofar as current knowledge is
concerned? To suggest, if Dr. Spitzer’s estimate, noted a few pages back,
is brought up to date, that somewhere in the general neighborhood of
300 of the 368 presently recognized “mental disorders” are “idiopathic
clusters of symptoms”—to suggest this would certainly not gladden many
psychiatric hearts. And to suggest further, given the shifting sands of fash-
ion, taste, and perceived need, that these syndromes or patterns can and
no doubt will in the future be rearranged into varied and alternative clus-
ters, this surely would also not please. There is an unmistakable psycho-
logical resistance in taking what one has believed to be a “real disease
entity” and downgrading it to the medically shabby level of a mere
“idiopathic syndrome” with no fixed identity and an obscure, or merely
presumed, cause.
54 Normality Does Not Equal Mental Health

One of the clearest expressions of this resistance can be found in the

recently published book by Allan V. Horwitz and Jerome C. Wakefield
(2007), which contains a preface by Dr. Spitzer. He tips his hat to critics
who “have been suspicious of the very notion of a mental disorder,” and
goes on, in a revealingly stark, candid, and telling disclosure, to praise
Horwitz and Wakefield because they “recognize the DSM’s contributions
and accept its assumption that there are genuine mental disorders in the
strict medical sense” (pp. vii–ix, italics added). This is an important admis-
sion; indeed it is central to the psychology of definition in psychiatric
nosology. For some decades, Dr. Spitzer has been a prominent organizing
force as the DSM has undergone multiple revisions and updating. If any-
one should know what the psychological status is of the claim that mental
disorders are genuinely real, it would be Dr. Spitzer. And yet he tells us
that this, the very core of a nosology, the very fabric out of which it is
stitched, is actually no more and no less than an “assumption,” which he,
presumably, was persuaded to make for reasons rooted in our subject,
the psychology of definition. Or was this just a slip of the pen?
That doesn’t seem likely. The two authors, Horwitz and Wakefield,
also make the same candid admission: “Because of the role that diagnosis
has in so many areas of our lives and the assumption that a diagnosis repre-
sents a genuine medical condition, confusing depressive disorder with
normal sadness should not be taken lightly” (p. 22, italics added).
Toward the end of their book, they remark: “It is now generally accepted
that there are genuine medical disorders of the mind” (p. 225, italics
added). —Do we then, in vicious circularity, assert the existence of
genuine mental disorders because they are “generally accepted assump-
tions”? This was the way of the aether, phlogiston, bodily humors, and
in psychiatry of Negritude, Homosexuality, and the other phantom
pathologies that also for a time gained alleged existence as “genuine
medical disorders.” Only on the basis of refutable or confirmable
evidence of an “underlying dysfunction,” can it make sense to claim that
a disease is real.

DO INTERNAL MALFUNCTIONS OR DYSFUNCTIONS

UNDERLIE PSYCHIATRIC SYNDROMES?
It isn’t my intention to pick on Horwitz and Wakefield, but their book
is recent; it is up to date; and it exhibits much of the psychology of defini-
tion that this chapter is about; it is therefore instructive to turn to. Any
critical observations I express here are directed not so much toward their
book as toward the prevailing psychology of contemporary psychiatric
The Psychology of Definition in Psychiatric Nosology 55

nosology. Here are a few sample passages that I suggest we put at arm’s
length and examine critically:
The authors state: “Because [depressions without cause, so-called mel-
ancholia] . . . were not proportional reactions to actual events, such condi-
tions were assumed to stem from some sort of internal defect or dysfunction
that required professional attention” (p. 6, italics added). Note here the
explicit role of assumption.
They go on to say: “By depressive disorders . . . we mean sadness that is
caused by a harmful dysfunction (HD) of loss response mechanisms. According
to the HD definition, a collection of symptoms indicates a mental disorder
only when it meets both of two criteria. The first is dysfunction: something
has gone wrong with some internal mechanism’s ability to perform one of its
biologically designed functions. Second, the dysfunction must be harmful”
(p. 17, italics added). Note here that the existence of this “internal mecha-
nism” is again a presumption, thanks to a definition that says it must exist.
Following this claim, the authors accept the following stipulative defi-
nition: “Endogenous depressions by definition arise in the absence of real
loss, and so are almost always due to internal dysfunctions” (p. 18, italics
added). We need to ask whether it makes sense to claim that endogenous
depressions can reasonably be thought to arise as a result of definitional
requirements, for this is what the authors seem to be telling us—so that
the assumption made by the stipulated definition, that an “internal dys-
function” must be involved, comes, through reification, to be equated
with reality. And so it is natural to ask, “What is it about the psychology
of psychiatric definition that impels one to believe that behind any syn-
drome certain ‘internal dysfunctions’ must exist?”
Not to beat a horse that may already be gasping its last, suffice it to
mention that the authors repeatedly refer to “internal dysfunctions” with-
out any confirmable empirical referents whatsoever. The claim is made
repeatedly in various forms that depressive conditions are maintained
“by some internal dysfunction and thus are likely to be disordered” (pp. 210; also
20, 22, and passim). This is stipulative insistence that such dysfunctions
exist, as the authors’ preferred definitions would have it.
The DSM itself fares no better (nor does the ICD). Earlier in this chapter
in the section “The Psychology of Symptom Clustering,” I quoted the def-
inition of ‘mental disorders’ found in several editions of the DSM. The last
sentence in that passage read as follows: “Whatever [the syndrome’s] origi-
nal cause, it must currently be considered a manifestation of a behavioral,
psychological, or biological dysfunction in the individual” (italics added).
Why “must” it be considered a manifestation of a dysfunction? Have we
learned that all (most? any?) symptom sets that we happen to cluster
together and judge at any particular time to be harmful and undesirable,
56 Normality Does Not Equal Mental Health

are necessarily the manifestations of real dysfunctions in the individual?

Contrast this barefaced and unjustified assumption of the very thing that
is in need of empirical evidence with the way physical medicine confirms,
for example, through a patient’s blood analysis, that he or she has TB.
We cannot evade the conclusion that it is the psychology of definition
as it is deployed in contemporary nosology that is responsible for the mis-
perceived necessity that there exist a dysfunction in the individual patient.
Today’s nosologists, like many in psychiatry’s history, are psychologically
induced to claim that corresponding to a definition of a mental disorder—
one which has been legislated and enacted by a powerful professional
body perceived as a source of authority—is a real disease.

THE PSYCHOLOGY OF DEFINITION AND CLAIMS

TO TRUTH
An examination of the psychology of psychiatric definition shows that
it is no accident that the majority of definitions of mental disorders, as
found today in editions of the DSM and the ICD, are construed to be true
statements. Yet, as we have seen, such definitions are first and foremost
prescriptions that aim to persuade others that what is stipulated and legis-
lated should be accepted as diagnostic rules, and rules, we are reminded,
are never true or false; they are only conventions, some of which have a
value, and others of which do not. The definitions of psychiatric nosolo-
gies get into trouble when nosologists include descriptive content in their
stipulated definitions. It is a psychologically normal characteristic for
diagnosticians and other clinicians to construe this descriptive content,
which typically enumerates behavioral and psychological symptomatol-
ogy, as referring to the real world in a true or false manner. But, in fact,
this is a psychological deception.
When a mental disorder is stipulatively defined in terms of sets of
symptoms, then an individual will be judged to have that putative disorder
when he or she exhibits the corresponding set of symptoms. The diagnos-
tic judgment that is involved will be asserted to be “true,” and true by vir-
tue of the definition with which the patient’s symptoms are associated! That
judgment is necessarily true because it asserts nothing more than a tautol-
ogy! Here is the way another author expressed much the same point:

The key issue is this: What is the basis for claiming that when A is broken,
the result is C, the observed set of behaviors? For this type of argument to
be valid, we would need independent evidence that the hypothetical
statement “if A were broken, C would be the expected result” was in fact
true. . . . For most of the mental disorders listed in the modern DSMs, we
The Psychology of Definition in Psychiatric Nosology 57

have no such evidence. (Certain organic brain syndromes and substance

use problems may be the only exceptions.) The fact is, without such
independent evidence for a causal relationship between the broken
hypothetical mechanism and the observed behavior, this line of reasoning
is tautological, entirely circular (Houts, 2001; Houts & Follette, 1998).
(Houts, 2002, p. 43)

But instead of recognizing this fact, the diagnostician believes that he or

she has made a statement about the patient’s real mental condition and
further believes that this statement is verified by virtue of the patient’s
symptoms. But this is a far cry from what “verification” means in empirical
science, for it is not verification at all: We are simply caught in a defini-
tional circle in which we can’t lose! There is no way for the diagnostician’s
application of his or her definition to be disconfirmed.
A basic criterion of the truth or falsity of statements in science is
their falsifiability. If a scientific proposition cannot, even in principle, be
falsified—if no test could possibly show that the proposition is false—then
we reject the notion that the proposition has a proper place in science.
Scientific statements, which can be tested empirically and potentially
shown to be false, are contrasted with essentially metaphysical statements,
which are held, with great intellectual recalcitrance and fortitude, to be
true—no matter what the empirical facts may be.
We have seen how the definitions of mental disorders are thought and
believed to entail statements about the real existence of those disorders
and even about the existence of unknown yet nevertheless vigorously imag-
ined and propounded dysfunctions that are claimed to be involved in or to
underlie them. In what sense are these statements that assert existence falsi-
fiable? It might be tempting to resort to some hoped-for future by saying,
“Well, yes, there is a problem here, but maybe these alleged disorders will
at some future time be shown to come from an underlying empirical path-
ology.” But that won’t do: it simply begs the question and legitimates what-
ever nosological phantoms we happen to feel like postulating.
Could we somehow stretch our imaginations in some Procrustean way
so as to conceive how it would be possible, today, to falsify these assertions
that mental disorders are real, and similarly do this for the conjectured
corresponding inner dysfunctions? If your mind works at all like mine, it
is too much of a stretch to consider falsifiable that which on the surface
looks like an empirical belief but has no basis whatever in evidence in
the empirical world.
Our powers of imagination aside, we here face a “conceptual pathology”
of the kind alluded to earlier: we seek to refer to what, in principle, we simply
cannot successfully refer to in the context of present knowledge, and yet we
58 Normality Does Not Equal Mental Health

nonetheless insist that we do, and claim to know what we’re talking about. It
can be difficult indeed to break through a systematically held, psychologi-
cally motivated delusion of this kind, whether it is found in an individual
patient or is shared by a professional community of many thousands.

THE NEXT STEP IN REIFICATION

Within the framework of the psychiatric definition of mental disorder,
the psychology of “faculties” is making something of a comeback, but in
slightly disguised form. In the many centuries since Aristotle distin-
guished the nutritive, perceptual, and intellectual faculties, numerous
other human faculties have been recognized—and then reified into exis-
tence—in the form of such “faculties of the soul” as hungering, feeling,
knowing, reasoning, judging, perceiving, remembering, and so on.
Each of these “faculties” was presumed to exist as the generating source
of the corresponding activity. We may have thought that this old “faculty
psychology” had seen its last in nosologies of the nineteenth century, but
it is back in vogue to assert the existence of similar “internal mecha-
nisms”—now in order to support the presumed existence of disease enti-
ties. This has happened largely, it is reasonable to suggest, because it has
not been possible to substantiate with empirical findings the insistent
belief that there simply must be an identifiable etiology that lies behind
today’s purely symptom-based psychiatric diagnoses and disorders.
Here is an example of this kind of dysfunctional thinking. To explain
the etiology of alleged mental disorders, Cooper (2005) reasons: “Plau-
sibly there are mental mechanisms that are not under our conscious control.
. . . When something goes wrong with such mechanisms the behaviours
produced might well be involuntary and yet mentally caused” (p. 40, my
italics). Kihlstrom (2002) keeps reification company with Cooper.
Although he recognizes that diseases in physical medicine are now most
often not primarily diagnosed on the basis of symptoms but rather on
the basis of laboratory tests that serve to detect ongoing pathology, for
psychiatric disorders Kihlstrom believes instead in the existence of under-
lying “mental modules . . . specially geared to perform a particular cognitive,
emotional, motivational, or behavioral task. . . . [T]he linguist Noam
Chomsky has often referred to these modules as mental organs” (Kihl-
strom, 2002, p. 294; italics added in the first sentence).
In such empirically unfounded claims we see a combination of two of
the widespread psychological predispositions that we’ve described: reifi-
cation plus tautological verification of the “truth” of stipulative defini-
tions. These psychological predispositions culminate in a view like
Kihlstrom’s view: “Attention deficit disorder may involve damage to a
The Psychology of Definition in Psychiatric Nosology 59

module that focuses attention, leaving modules that disengage or shift

attention intact. . . . [A]utism results from a specific deficit in a particular
mental module, called the theory-of-mind mechanism. . . . [T]he others are
an intentionality detector, an eye-direction detector, and a shared atten-
tion mechanism” (pp. 295–96). As we have seen, once misplaced concrete-
ness gets started, there is no holding it back! Reified “mechanisms,”
“modules,” and “geared” devices proliferate ad libitum!

INTELLIGENT SCIENCE AND STOPGAP DEFINITIONS

Instead of debating alternative ways of handling information about
symptoms, we should be moving beyond symptoms to diagnosis on the
basis of underlying pathology.
—Kihlstrom (2002, p. 290)

We have seen how definitions of disease can be very different in physical

medicine and in psychiatry. When I have pointed to psychologically based
ways in which psychiatric definitions of disease are lacking, this is not due
to an unalloyed and exclusionary admiration for the approach that has been
successful in physical medicine. What I hope to communicate is the need to
understand what the two different approaches to definition yield in terms
of our understanding of pathology. Definitions of disease in physical medi-
cine often have lexical, stipulative, and empirical components: unless a
totally new disease has been discovered or new knowledge has come to
replace old, disease labels tend to be consistent with established, that is,
lexical, usage. Yet there is, in addition, agreement among practitioners as
to what they will, at least in the foreseeable future, stipulatively understand
a given disease label to mean. But most importantly, by virtue of requiring
confirmation of a real disease independently of its symptomatology, physi-
cal medicine permits statements to be made that are informative, empiri-
cally confirmable, and not tautologically true by definition.
The majority of psychiatric definitions of “mental disorders,” however,
do not meet the scientific standard of falsifiability; although they contain
descriptions of symptom clusters, they do not communicate empirical
knowledge of pathology but rather an intent to establish consensus agree-
ment to designate those symptom clusters as if they were symptoms of an
underlying but as yet unknown pathology. As Stempsey (1999, p. 175)
observed in connection with physical medicine:

Mere descriptions of symptoms are . . . generally not looked upon as

definitive diseases, but merely problems to be further elucidated. However,
sometimes symptom diagnoses are seen as definitive. Dermatology offers
60 Normality Does Not Equal Mental Health

many examples. The old joke defines a dermatologist as a doctor who tells
you in Latin what you just told him in English. There is a kernel of truth in
this. A patient may present with a greasy, scaly red rash, and go away with a
diagnosis of seborrheic dermatitis. A patient with an itchy rash might enjoy
some psychological comfort (or distress) in having a diagnosis of eczema
rather than just a rash. However, this type of symptom diagnosis per se tells
virtually nothing about such things as cause and prognosis,which usually are
the point of making diagnoses in the first place. [italics added]

In this, Stempsey is in agreement with Wulff (1976), who judged, first,

that syndromes are only and at best preliminary, tentative, and indeed
primitive means of designating possible disease processes; and, second,
that syndromes must wait for a satisfactory explanation that may—or
may not—be forthcoming through eventual knowledge of etiology. The
Centers for Disease Control endorsed this view in connection, for exam-
ple, with the series of syndrome definitions of AIDS that it has formulated
over the years. The CDC called its evolving definitions of AIDS surveil-
lance definitions, to emphasize that the intent behind its syndromal defini-
tions has been provisional, to provide a basis for planning and
prevention. Tentative surveillance definitions are what we might call
“stopgap definitions”: they express a medical commitment to shift from
a syndromal definition to an empirically based etiological definition as
soon as this can be accomplished.
The same degree of conceptual modesty and honesty has been
expressed by the American Rheumatism Association when it enacted a
new syndrome-based definition of rheumatoid arthritis: The ARA speci-
fied seven criteria, stipulating that at least four of these must be satisfied
in order for a diagnosis of rheumatoid arthritis to be made. Here is what
the ARA nosologists noted about their definition: “Disease criteria which
are descriptive reflect our current understanding of these disorders. Eluci-
dation of specific pathogenetic mechanisms may at some point permit
classification to be based directly on disease biology. However, these
new criteria for RA will necessarily serve to improve understanding, clas-
sification, and comparability to patients with rheumatoid arthritis until
other methods of achieving this purpose are available” (Arnett, Edworthy,
Bloch, et al., 1988, p. 323, italics added).
The ICD follows a similarly modest and honest wait-and-see approach
that is self-avowedly provisional in its comments relating to “mood
disorders”:

[I]t seems likely that psychiatrists will continue to disagree about the
classification of disorders of mood until methods of dividing the clinical
syndromes are developed that rely at least in part upon physiological or
The Psychology of Definition in Psychiatric Nosology 61

biochemical measurement, rather than being limited as at present to

clinical descriptions of emotions and behaviour. As long as this limitation
persists, one of the major choices lies between a comparatively simple
classification with only a few degrees of severity, and one with greater
details and more subdivisions. (World Health Organization, 1994, p. 13)

Medical definitions of physical disease are not considered complete

until their etiology is known. A set of free-floating symptoms that in the
future may or may not be found to be associated with a disease does not
designate a disease today; at most it has the status of an unanswered ques-
tion or a hypothesis. A symptom-based definition of alleged disease is sim-
ply preliminary, and when no “underlying pathology” is empirically
known, such symptom-based definitions need to be taken with a grain of
salt. We then need to be alert to the potential for such definitions to be
misconstrued as though we know that they refer to “real disease entities,”
as though we know that these symptoms occur due to a “breakdown,”
“dysfunction,” or “disorder” in the individual, despite having no empirical
evidence whatsoever for this.
If psychiatry is to take seriously its status as part of medicine, the pro-
fession cannot afford to acquiesce in a psychology that promotes poten-
tially capricious symptom clustering and its empirically unjustified
transformation into assumed or asserted reified dysfunctions and corre-
spondingly reified disease entities. DSM, instead of being regarded as an
authoritative “diagnostic and statistical manual of mental disorders,” must
be recognized as a provisional listing of forms of behavior and psychologi-
cal symptoms that may or may not eventually be found to be the result of
basic, empirically observed pathology. Seen from this perspective, DSM
may be thought of as setting before us a highly speculative and substantial
research project for the future. For many clinicians it may serve to offer
provisional surveillance definitions, but in no way, with the exception of
the relatively few organic brain diseases it now includes, should DSM be
construed as meaning what its title claims.

TO SUMMARIZE
Kraepelin’s [nosology] . . . arbitrarily set up disease entities in the
absence of substantiating empirical data, and subordinated empirical
analysis to the practical problems of prognosis.
—Menninger, Mayman, & Pruyser (1963/1967, p. 468)

The most damaging error in the psychology of definition is the confu-

sion of words with things. With respect to psychiatric nosology, there has
62 Normality Does Not Equal Mental Health

been abundant and widespread confusion of this sort due to the role
played by seven psychological propensities that we’ve analyzed. To sum-
marize, they are: (1) Nosologists selectively cluster observed symptoms
in terms of stipulated patterns that are linked to forms of individual harm
and disability, while neglecting to acknowledge the fact that such cluster-
ing without empirical reference to confirmable pathology is unscientific
and arbitrary. (2) The recognition of such patterns often reflects a psycho-
logical dynamic involving various kinds of individual and group-endorsed
motivations and interests—social, political, religious, moral, monetary,
and so forth. The resulting clustering of allegedly harmful or disabling
symptoms then provides a channel for three interrelated forms of
delusional projective thinking: (3) Clusters of symptoms are given, so to
speak, an “ontological promotion” to the clinically recognized status of
syndrome constellations. With no anchor in empirical pathology, (4)
these are then construed as necessarily involving internal disorders or dys-
functions that underlie them, and a presumption is made concerning their
reified existence. (5) A nonfalsifiable claim is then made that a terminus
for this snowballing process exists in the form of a reified “disease entity.”
The psychological propensity to look for confirmation of the “truth” or
“validity” of a nosology’s stipulative definitions of disorders is then free to
be exercised through (6) the circular, no-lose mechanism of tautological
verification. Finally, (7) the diagnostic categories that have been stipula-
tively established by nosologists are internalized by them and by clinicians
who accept and advocate the nosology, resulting in the phenomenon of
diagnostic filtering, a predisposition that is then transmitted, spread, and
perpetuated by supporting social, pharmaceutical, insurance, political,
legal, and other interest groups.
This psychology of definition underpins psychiatric nosology and yet
has been virtually ignored for centuries. Stipulative definitions have sys-
tematically been misconstrued to be real definitions that are “true” thanks
to a psychology of reifying projection and tautological verification that
has dominated psychiatric nosology and has remained safely out of sight,
implicit, and unquestioned.
Toward the beginning of this chapter, I proposed to show that three
hypotheses are true: (1) that we mistakenly consider the process of psychi-
atric definition in nosology to be simple, straightforward, and well-
understood; (2) that such definition brings into play psychological propen-
sities of which most of us are not conscious; and (3) that these psychological
propensities, if clearly and self-consciously understood, would help us to
control them, gain a significant measure of conceptual clarity and theoreti-
cal integration, and in the process lessen much of the conceptual confusion
The Psychology of Definition in Psychiatric Nosology 63

that encumbers current psychiatry and clinical psychology. I have done

what I can within the confines of a single chapter to show that the first
two hypotheses are true. In connection with the third, I’d like to offer
several observations.
We have taken note of a number of serious deficiencies that accompany
a symptom-based psychiatric nosology such as the DSM or the ICD. It
may be useful in retrospect to assemble them together: First, as we’ve
seen, purely symptom-based stipulative definitions of psychiatric disor-
ders fail to have a basis in evidence of pathology. Second, due to the
related heavy reliance upon a changeable psychology of pattern recogni-
tion in clustering symptoms, there is an intrinsic arbitrariness that besets
nosology; this makes it easy for stipulative syndrome and disease defini-
tions to shift with prevailing interests, whether these are social, political,
medical, monetary, or other interests. Third, symptom-based definitions
of mental disorders represent a rudimentary, immature, or at the very
least provisional stage of medical knowledge, given that they fail to
express knowledge of the origins of disease, the main point of diagnosis.
Fourth, symptom-based definitions draw attention to the fact that we are
uncertain whether there exists or does not exist an explanatory, originat-
ing pathology in the form of an empirically detectable dysfunction or state
of disorder. Fifth, such definitions routinely provide a medium in which
the psychologically normal human propensity to engage in misplaced
concreteness or reification can be enthusiastically exercised without criti-
cal oversight. Sixth, symptom-based definitions of mental disorders lead
to the interrelated problems of diagnostic haze mentioned earlier in this
chapter, which result from the lack of distinctness of syndromes and their
diagnostic designations and the conceptually untidy tendency of these to
overlap. And last, not previously discussed, is the fact that symptom-
based definitions of disease fail to be useful in detecting so-called
“lanthanic” disease, that is, disease that is present but has not developed
sufficiently to be expressed in the form of symptoms (Feinstein, 1967,
p. 145; Bartlett, 2005, pp. 40, 68, 179, 284). Lanthanic disease is of course
of major diagnostic importance, as we can see from the emphasis placed
upon early detection through mammograms, colonoscopies, pap smears,
prostate-specific antigen (PSA) and routine blood tests, and other labora-
tory and imaging procedures.
Given these many drawbacks of symptom-based diagnosis and disease
definition, and accepting the fact that at present the majority of alleged
psychiatric disorders have no known etiology, it is natural to ask whether
a psychiatric nosology as we know it is truly essential to effective clinical
practice today.
64 Normality Does Not Equal Mental Health

IS NOSOLOGY ESSENTIAL TO EFFECTIVE

CLINICAL PRACTICE?
There are no diseases, only sick people.
—Old medical aphorism

Earlier we noted how the conceptual commitments embedded in a

nosology can lead to diagnostic filtering, that is, to perceive, habitually
and reflexively, the patterns defined by one’s nosology in the symptoma-
tology of one’s patients and to be limited by the nosology’s diagnostic
vocabulary so that, in a Sapir-Whorf-like way, the category set of the
nosology determines, or at the very least constrains, one’s perception of
clinical reality. There is, furthermore, a secondary result of nosology that
also is unfortunate, and it applies equally well to physical as to psychiatric
medicine. That is the tendency for clinicians to treat diseases instead of
individual people, a complaint commonly expressed by the antipsychia-
trists. When the focus of treatment is the “disease entity” rather than the
afflicted patient, we once again face the human proclivity to reify, for
human maladies are never encountered in some metaphysical state of exis-
tence independent of individual persons who are sick or injured. If any-
thing, human diseases are abstractions from sick people, and not the
other way around. The psychology of definition in psychiatric nosology
has the following unintended and unwanted consequence—again, a result
of misplaced concreteness: The diagnostic code becomes the object of
clinical, social, and reimbursement attention, while the individual person
recedes into the background. For many clinicians, the diagnostic label
has become more important than the person.
Although the DSM has only been around for one lifetime, its spread of
influence has been enormous. The DSM didn’t exist when Tolstoy was
alive, but he understood the nature of such power and sway:

Morally the wielder of power appears to cause the event; physically it is

those who submit to the power. But as the moral activity is inconceivable
without the physical, the cause of the event is neither in the one nor in the
other but in the union of the two.
Or in other words, the conception of a cause is inapplicable to the
phenomena we are examining. (Tolstoy, 1869/1952, p. 687)

It is not that the DSM in and of itself is the powerful cause of its spreading
influence, but that we have participated willingly in allowing its concep-
tual commitments to influence us deeply and pervasively. As participants
in submitting to its persuasive authority we have approved the nosology
ratified by its committees, not on the basis of empirical evidence but on
The Psychology of Definition in Psychiatric Nosology 65

faith—faith that its stipulative definitions of symptom clusters refer to

genuine illnesses named by the nosology; faith that these are the result
of unknown but pathologically confirmable mental disorders; and faith
that the stipulative definitions of mental disorders in turn designate real
disease entities, that is, distinct diseases that are caused by real internal
dysfunctions to be found in individual patients. At this time, unless we
are referring to organic brain disease, belief in the reality of “mental disor-
ders” defined in this way is clearly a matter of blind and baseless faith, not
science.
We need to be persuaded by this conclusion, increasingly hard though it
is at a time when the reified nosology of the DSM continues to develop rap-
idly by accretion and the habit of diagnostic compliance establishes more
and more reality consistency for us. For readers who are persuaded by this
conclusion, what then? Is there effective clinical practice beyond the DSM?
To answer this we need to be reminded of the larger clinical world that
lies beyond that of the framers and advocates of the DSM. To mention but
a few of the clinical approaches that eschew nosology, there are behavior
therapists who focus on individualized symptom amelioration and who
for this reason often do not find classificatory diagnosis useful; clinicians
who are psychoanalytically oriented and who wish to put diagnostic label-
ing behind them; person-oriented therapists, followers of Rogers, Adler,
Maslow, Kelly, and others; phenomenologically or existentially oriented
clinicians, such as psychiatrist J. H. van den Berg and psychologist Rollo
May; to be sure, the antipsychiatrists, including Laing and Szasz; and of
course there are others.8 All of these groups of clinicians have advocated
both a “return to the individual” and a recognition that the majority of
the problems and suffering that people bring to psychiatrists, clinical psy-
chologists, and other mental health professionals are not, at least insofar
as we possess empirical knowledge today, appropriately treated in terms
of the paradigm of physical medicine.
Earlier in this chapter, I made a few brief observations concerning
psychological resistance to the default label ‘idiopathic’ when psychiatric
syndromes with no known etiology are in view. My purpose in introduc-
ing this generic label should be clearer now in retrospect: The term ‘idi-
opathy’ heralds from the Greek idiopatheia, which breaks down into idios,
meaning “proper” or “peculiar,” and pathein, meaning “to suffer.” An “idi-
opathic syndrome” from this etymological point of view would then be
something like “a set of symptoms expressing the suffering of an individ-
ual.” If we want to strain at the halter of medical terminology and insist
on using the nomenclature of disorders, an “idiopathic psychiatric disor-
der” would amount to “the individual symptomatology expressed by a
person who is in psychological distress.”
66 Normality Does Not Equal Mental Health

Horwitz and Wakefield (2007, p. 115) observed that the DSM “gives no
criteria for distinguishing symptoms of mental disorders from those that
are nondisordered problems in living.” The psychology of definition in
psychiatric nosology supports this conclusion but regards it as tentative,
recognizing that such criteria may yet evolve in the light of future empiri-
cal findings, perhaps in neuroscience.9
In the meantime, effective clinical treatment for symptoms that express
psychological distress has been the focus of the variety of approaches
mentioned above, none of which considers psychologically based symp-
tomatology to be more than just that—expressions by an individual who
is in need of symptom alleviation, much as a patient in physical pain may
need the assistance of a specialist in pain management. For syndromes
that have no known etiology, alleviation of symptoms is often the best that
can be hoped for. If such syndromes are considered to be truly idiopathic
in the individualized sense of the word, then an intellectually honest and
scientific conception of psychological distress will avoid diagnostic
categorization for all but organically based disorders and diseases for
which there is compelling etiological knowledge.
For other forms of psychological distress, harm, and disability, some
readers may be willing to lend a new and perhaps somewhat differently
attuned ear to a wait-and-see perspective, perhaps similar to the following
overall assessment:
Contemporary psychiatric nosology is basically flawed. It has sought to
identify and classify increasingly many overlapping and often indistinct
varieties of harmful or disabling behavior and psychological response that
people have to life. In the process of establishing a nosology, the psychol-
ogy of which this chapter has described in some detail, psychiatry has
imposed a medical frame of reference, usually without empirical justifica-
tion, upon difficulties that people experience in living. But unless empiri-
cally confirmable disorders and diseases are in view, the difficulties that
people encounter in living are highly individual in nature and dependent
upon context; individual sensitivities; life goals; personal values; age;
physical, marital, social, and financial health; and the many other factors
that affect, complicate, and individualize life. Unless such difficulties are
traceable to organically based pathologies, however much they may cause
discouragement and suffering, harm, or disability they are inappropriately
treated if they are judged to be medical in nature—not because of a “myth
of mental illness” or an inappropriately forced “metaphor” but because the
psychology of definition in psychiatric nosology has for a long time been recogniz-
ably dysfunctional, engaging in stipulative definition that has been systematically
misconstrued to be real definition and fostering a projective mentality of reifica-
tion that has no place in modern science. Such dysfunctional thinking is
The Psychology of Definition in Psychiatric Nosology 67

characteristic of the common, pervasive, and indeed psychologically nor-

mal human propensity to engage in what I earlier termed projective mis-
constructions. They occur whenever we believe that we can
meaningfully claim to trespass beyond the boundaries of what we can
meaningfully think and assert. What then results are metaphysical fic-
tions, the products of delusional thinking, not science.
To be sure, there are numerous kinds of harmful or disabling psycho-
logical and behavioral difficulties that people experience in the course of
their lives. Those that are known to be medical in nature should be appro-
priately treated. The others, when we lack sufficient knowledge that
shows them to be medically based, should be dealt with outside the medi-
cal model as compassionately and honestly as we can. What we have
learned from the psychology of definition in psychiatric nosology is that,
in the absence of knowledge of etiology, a palliative approach to alleviate
harm and disability is desirable, while a diagnostic approach, which places
on people mental disorder labels for which there is no empirical basis,
continues to fall victim to a dysfunctional psychology that has dominated
psychiatric nosology for many centuries.

Writing about the APA’s first 128-page 1952 edition of the DSM, which
we recall listed a mere 106 disorders, Menninger and his co-authors had
this to say: “The carefully prepared booklet has the merit of containing
working definitions of terms and descriptions of syndromes. It is, we are
assured, shortly to be revised—let us hope in the direction of simplifica-
tion” (Menninger et al., 1963/1967, p. 478).
As the DSM continues to expand in keeping with the EMSS (the Endless
Multiplication of Syndromes Syndrome), we would do well to remember
Menninger’s wise counsel, to simplify in the interest of scientific unifica-
tion. An awareness of the psychology of definition in psychiatric nosology
warns us of the need to embrace Newton’s motto, “hypotheses non fingo”
(“I do not make hypotheses”), as well as Occam’s Razor (to refrain from
multiplying entities beyond necessity)—in short, to accept responsibility
for science that is undertaken intelligently and with intellectual modesty,
admitting into the category of “real disorders” only those that have met
the dispassionate criteria of empirical evidence.

NOTES
1. The recently published book on the nosology of depression by Horwitz and
Wakefield (2007) reflects the present situation: The authors stress the importance
68 Normality Does Not Equal Mental Health

of awareness of the conceptual confusion in current psychiatric nosology and the

need to reduce that confusion. They point to “conceptual challenges” that face
psychiatry (p. 194) and to the existence of “conceptual problems” that need to be
solved (p. 168), express the need for “conceptual analysis” (p. 112), refer to “con-
ceptual errors” (p. 26) that need to be avoided, remark on “the need for greater con-
ceptual clarity” (p. 193), refer to “logical problems” (p. 212) and “semantic
confusion” (p. 225) that are involved in diagnostic definition, and so forth. The
authors repeatedly direct attention to conceptual issues in psychiatric nosology that
require attention but instead are disregarded.
2. To avoid repetitive language, I will not always make explicit the conven-
tional distinction between “symptoms” and “signs,” the former reported by the
patient/client, the latter observed by the psychiatrist/clinical psychologist. When
I refer to “symptoms” both are to be understood.
3. For a more comprehensive and detailed inventory and discussion of general
types of definition, but without application to psychiatric nosology, see Robinson
(1950/1962).
4. As soon as we begin to use the medical concepts and terminology of ‘symp-
toms’ and ‘syndromes’, we admittedly are already biased in terms of our choice of
frame of reference. To call a behavior, affect, or cognitive phenomenon a “symp-
tom” is already to presume that it indicates something other than itself, that it points
toward some pathogenic source. As we shall see, this presumption already expresses
certain of the psychological predispositions that typically come into play in psychi-
atric definition.
5. This medical understanding of physical disease is now well established. In the
1950s René Dubos (1959, p. 183) formulated a “doctrine of specific etiology” that
many disease theorists have built on since, according to which disease is understood
in terms of four components: a cause (typically a pathogen), a con-
sequent lesion, uniform and unvarying symptoms, and a confirmed expectation that
injury to health or death will result.
A comment concerning the first of these components is order. Etiology, the
study of the causes of disease, is understandably complex; we need to be wary of a
naı̈ve or oversimplified conception of causality, a subject we cannot consider in
detail here. In connection with disease, there is usually no “decisive cause” in the
genesis of a pathology, which is instead almost always multifactorial, involving the
total state of the organism, its susceptibility to illness or injury, its genetic or consti-
tutional predisposition to disease, and other factors. This subject would take us far
from our present concerns.
6. Outside of the U.S., the International Classification of Diseases and Related
Health Problems is widely used. The ICD-10, like the DSM, defines mental disor-
ders in terms of symptoms: “The term ‘disorder’ is used throughout the classifica-
tion, so as to avoid even greater problems inherent in the use of terms such as
‘disease’ and ‘illness’. ‘Disorder’ is not an exact term, but it is used here to imply
the existence of a clinically recognizable set of symptoms or behaviour associated
in most cases with distress and with interference with personal functions. Social
deviance or conflict alone, without personal dysfunction, should not be included in
mental disorder as defined here” (World Health Organization, 1994, p. 5, italics
added). Note the italicized phrase, which serves the same purpose as the more
The Psychology of Definition in Psychiatric Nosology 69

obvious assertion of inner dysfunction made by the DSM in the quote that follows
above in the text.
7. Readers familiar with set theory and number theory will immediately rec-
ognize that infinitely many disjoint sets of symptoms can be constructed from
the universal set of all symptoms. Hence there is, on a set-theoretical basis alone,
no criterion that can “promote” any one symptom set, or any finite number of
such sets, to a privileged position of syndromes that are “real” or “most valid.”
From a strictly formal point of view, this is enough to undermine the claim that
“syndromal diseases” are in any sense more than conceptual constructs.
8. In the history of physical medicine, there have been many researchers who
have similarly resisted thinking of diseases as objects, who have advocated a focus
on the individual patient, among them physicist-physiologist Hermann Helm-
holtz, Friedrich Gustav Jacob Henle, Emil DuBois-Reymond, Ottomar Rose-
nbach, Theodor Schwann, Rudolf Virchow, Carl Wunderlich, and others.
9. Already one can see an emerging tendency among neuroscientists to make
the central presumption that is questioned in this book: In comparing the brain
functioning of “psychological normal” individuals with those who exhibit a spe-
cific psychological symptom constellation, differences in brain function are some-
times observed. When such differences are noted, it becomes immediately
tempting, again, to assume that “dysfunctions” have been identified in the nonnor-
mal patients.
 3

The Abnormal Psychology of Creativity

and the Pathology of Normality

Psychiatry and clinical psychology face a little-recognized dilemma in

understanding and treating creative individuals. On the one hand, it is well
established that extremes of mood among the creative are often valued by
them, and hence they may resist treatment for what are conventionally
diagnosed as affective disorders, and discontinue prescribed medication.
On the other hand, it is not well understood that many of the putative
disorders ascribed to creative individuals are the result of their justifiable
response to widespread but seldom-recognized pathologies found in the
normal population. Understanding the interplay between these two horns
of the dilemma can help mental health professionals appreciate the need
to be especially circumspect and reflective in their diagnostic classification
and treatment of mood extremes among creative people.

A significant but as yet not entirely self-conscious change is occurring

within psychiatry. While contributors to the rapidly proliferating diag-
nostic categories of mental illness continue to identify and vote in new
disorders for inclusion in perennially updated editions of the DSM, other
researchers are beginning to question and even erode psychiatry’s largely
unquestioned belief in the desirability of providing customary treatment
for certain routinely classified mental disorders.
This countermovement within psychiatry has branched in different
directions; all but one of these have occurred quietly and been given scant
attention in the literature. Explicitly critical opposition to the diagnostic
pronouncements of the DSM has come from several divergent lines of
study. The main ones are these: Most widely known has been the skepticism
and downright rejection of “mental illness” as a legitimate medical category
The Abnormal Psychology of Creativity and the Pathology of Normality 71

of disease by Thomas Szasz (e.g., 1957/1961), Thomas Scheff (1966/1984),

and others. Less well-known has been a second line of psychiatric thought
pioneered by J. H. van den Berg (1955, 1972, 1980), whose “phenomeno-
logical psychiatry” avoids standard psychiatric classification and diagnostic
pigeonholing and instead seeks to help individuals through nonjudgmental
support of the patient by the psychiatrist, support situated from a phenom-
enological standpoint that recognizes the reality and legitimacy of the
patient’s own experience. A third line of study by the present author
(Bartlett, 2005) is characterized by a reversal of diagnostic classification,
turning away from traditional psychiatric diagnostic criteria that derive their
meaning in terms of deviations from psychological normality to a distinct
variety of socially focused study. Such an approach recognizes that a wide
range of psychological pathologies afflict psychologically normal popula-
tions that include the majority of people and establishes a locus of psychiatric
health in those individuals who are exceptional in their predominant psychol-
ogy, who do not have the pathologies that afflict the psychologically normal,
and who may be at variance with standards of psychological normality.
In this chapter, I bring together the empathic and clinically noncatego-
rizing approach of phenomenological psychiatry with my own studies that
have directed attention to the pathology of majority, psychologically nor-
mal populations. This integration of these two very distinct approaches
offers a new perspective for understanding the psychology of creative
individuals. While their difficulties in living have sometimes benefited
from careful and penetrating study, they have still failed to be adequately
understood by psychiatry, as well as by clinical psychology to the extent
that the latter has accepted, wholesale, the diagnostic categories formu-
lated and promulgated by psychiatry.

THE ABNORMAL PSYCHOLOGY OF CREATIVITY

Psychiatry has studied the temperament of creative individuals compara-
tively little. One of the most detailed studies was published by Kay Redfield
Jamison (1993; cf. also Goodwin & Jamison, 1990, Chap. 14; Andreasen,
2005), in which she observed that

the idea of using formal psychiatric diagnostic criteria in the arts has been
anathema, and, in any event, biological psychiatrists have displayed
relatively little interest in studying mood disorders in artists, writers, or
musicians. Certainly those in the arts have been less than enthusiastic about
being seen through a biological or diagnostic grid. Those in the best
position to link the two worlds—scholars of creativity—only recently have
begun to address the problem. (Jamison, 1993, p. 3)
72 Normality Does Not Equal Mental Health

Adding to the reluctance of psychiatrists to study the psychology of crea-

tivity has been the intrinsically fuzzy, amorphous, elusive nature of crea-
tivity itself, making it difficult for researchers to know and to pin down
exactly what they are referring to. It is a challenge to examine a phenome-
non that, by its very character, exists in an area where attempts to define
creativity can be limiting, inadequate, or simply mistaken. I therefore
make no attempt to define creativity and through a definition delimit it,
but will a little later instead refer to some of its psychological roots in
observable characteristics of creative individuals.
An understanding of the psychology of the creative has been dominated
by the unquestioned application of medical-diagnostic categories that
derive their meaning and value relative to a baseline of psychological nor-
mality (see Chapter 1). That is, psychopathology has been understood in
terms that have equated harmful deviations from psychological normality
with pathology. The “harm” involved is either harm to the patient or
harm as perceived by his or her surrounding society, or both.1
Unfortunately, the situation with respect to creative individuals is not
clear cut. The lack of “enthusiasm” on the part of creative individuals
toward diagnostic labeling mentioned by Jamison is, as we’ll note later,
sometimes well warranted by their own experience. There also can be a
justifiable resistance by the creative to clinical treatment—despite the over-
whelmingly high incidence rate, greatly disproportionate to the baseline
normal population, of what clinicians recognize as depression, cyclothymia,
manic depression, psychosis, and suicide among many artists, writers, poets,
sculptors, composers, mathematicians, and other creative thinkers.
Many creative individuals resist diagnostic labeling and treatment for
what seem to them to be compellingly good reasons: First, creative people
who are historically aware may justifiably resist mental illness labeling:
They may remember that many thousands of people were executed during
the Holocaust precisely because the label of mental illness was placed on
them, and in the United States many thousands more were involuntarily
sterilized due to the same judgment.
Second, from the standpoint of creative individuals, the heights and
depths of mood can be valued in and of themselves. What psychiatrists
routinely consider to be affective disorders can, for such creative people,
be the lifeblood of creativity. We’ll consider this perspective below, under
the heading of “The Inner Turmoil Thesis.”
Third, it is not clear that deep depression, the extreme variations of
mood in cyclothymia and manic depression, and even suicide, constitute,
for many creative people, unwarranted or undesirable moods or choice.
The potentially valuable nature of a life experience that possesses rich
emotional intensity and range, as experienced by creative individuals,
The Abnormal Psychology of Creativity and the Pathology of Normality 73

has, as we will see, led some clinicians to propose a category of “advanta-

geous psychiatric disorders.”
Fourth, it has been unappreciated by researchers who are concerned
with clinical aspects of creativity that extreme moods experienced by the
creative are frequently situationally induced, that is, are understandable
involuntary responses of creative individuals to their environment. The
creative face numerous challenges and suffer considerable ordeals that
are unknown to the psychologically normal and that to a meaningful
degree are likely to be unintelligible to them. We consider this topic later,
where I refer to it as “the situational thesis.”
Last, there is an identifiable “constitutional predisposition” shared by
many creative artists, writers, poets, composers, and other creative people,
that plays a central role in their emotional responses to other people, to
the world in which they must work, and to society generally, and this,
too, must be taken into account since it forms the basis for their reactions
to their life situations.
As we consider each of the above subjects in what follows, to avoid the
monotony of a one-phrase-vocabulary, I’ll often use the term ‘artist’ to
mean any individual with pronounced creative abilities and temperament,
unless the context limits the intended reference.

THE INNER TURMOIL THESIS

Norwegian painter Edvard Munch, who was hospitalized several times
for psychiatric illness, remarked: “A German once said to me: ‘But if you
could rid yourself of many of your troubles.’ To which I replied: ‘They
are part of me and my art. They are indistinguishable from me, and it would
destroy my art. I want to keep those sufferings’ ” (quoted in Stang, 1979,
p. 107). Writing about Munch’s claim, Jamison (1993, p. 241) noted:

This is a common concern. Many artists and writers believe that turmoil,
suffering, and extremes in emotional experience are integral not only to the
human condition but to their abilities as artists. They fear that psychiatric
treatment will transform them into normal, well-adjusted, dampened, and
bloodless souls—unable, or unmotivated, to write, paint, or compose.

There is no doubt that negative moods and the power of mania can
sometimes make positive contributions to creative thought. But such
moods do not of course of themselves produce it, or every sufferer from
abnormal mood intensity and swings would show signs of creativity. Yet
it is typical of anyone who engages in creative work to feel excited, elated,
perhaps euphoric or ecstatic, to feel increased self-confidence, the mental
74 Normality Does Not Equal Mental Health

efficiency of speed combined with focused concentration, zest, perhaps

expansiveness and heightened mental clarity. And, in a parallel fashion,
unhappiness, profound sadness, and grief can no less be the inner partners
to creative effort, as novelist Herman Melville, who suffered from severe
variations of mood, commented: “The intensest light of reason and
revelation combined, can not shed such blazonings upon the deeper truths
in man, as will sometimes proceed from his own profoundest gloom.
Utter darkness is then his light, and cat-like he distinctly sees all objects
through a medium which is mere blindness to common vision” (Melville
1852/1995, p. 242).
Melville lived before empirical studies showed that a moderate degree
of depression can serve as an aid in reality checking, for perceptions and
beliefs while in a depressed state can be more realistic than while in a more
normal mood (cf., e.g., Dobson & Franche, 1989; Sackheim, 1983; Taylor
& Brown, 1988). In other words, we now know empirically that Melville’s
poetically expressed observation at times can hold true.
The often beneficial yet potentially destructive peaks and troughs of
mood have been called by some psychiatrists “advantageous psychiatric
disease” (e.g., Jamison, 1993, p. 235). Yet, from the standpoint of the
general theory of disease (cf. Bartlett, 2005, Part I), such a phrase is a con-
tradiction in terms: if a condition qualifies as a “disease,” it must be
responsible for bringing about harm, rather than advantage or benefit.
To call the intense and sometimes destructive moods of artists “advanta-
geous” without substantial qualification is misleading. A more accurate
picture requires that we accept the two prongs of a true diagnostic
dilemma, for they are incompatibilities that cannot be fused:

There is a great deal of evidence to suggest that, compared to “normal”

individuals, artists, writers, and creative people in general, are both
psychologically “sicker”—that is, they score higher on a wide variety of
measures of psychopathology—and psychologically healthier (for example,
they show quite elevated scores on measures of self-confidence and ego
strength). (Jamison, 1993, p. 97 see also note on pp. 300–301, where more
than a dozen works supporting this result are cited.)

Despite many avowals by artists of the high worth of melancholy and

elation, we need to be reminded that we should take their claims with cau-
tion, knowing full well how many creative souls end their lives in misery,
impoverished both financially and mentally, often in suicide. For example,
Ludwig (1992) found that some 18 percent of poets have committed
suicide, while artists have two to three times the rate of mood disorders,
psychosis, and suicide as the normal population, and the rate of involuntary
The Abnormal Psychology of Creativity and the Pathology of Normality 75

hospitalizations of artists, writers, and composers is six to seven times that

of normal controls. Similar incidence rates have been borne out by various
other studies (e.g., Juda, 1949; Andreasen, 1987 and 2005; Jamison, 1989).
It follows that any serious scientific attempt to understand the psychology
of creativity must avoid the temptation to romanticize the extremes of cre-
ative moods, for they evidently can be associated with very serious and
destructive consequences. There is unquestionably a point, for many
artists, when the pit of depression or the high pitch of mania can come to
interfere with and wreck the very creative spirit that the artist believes these
make possible. A point can be reached when many artists recognize, on
behalf of themselves and their art, that they must seek clinical treatment.
It is important to emphasize this fact and not lose sight of it in the discus-
sion that follows.

WHO IS HARMED? THE ASCRIPTION OF PATHOLOGY

A danger exists from the opposite direction, that of insisting, unilaterally,
that society is harmed by those who are identified as “affectively disor-
dered.” Who precisely was harmed when Sylvia Plath took her life—as did
poets Thomas Lovell Beddoes, John Berryman, Barcroft Boake, Paul
Celan, Thomas Chatterton, Hart Crane, John Davidson, Tove Ditlevsen,
Sergey Esenin, John Gould Fletcher, Adam Lindsay Gordon, Randall
Jarrell, Heinrich von Kleist, Vachel Lindsay, Vladimir Mayakovsky, Cesare
Pavese, Anne Sexton, Sara Teasdale, Georg Trakl, and Marina Ivanovna
Tsvetayeva, and writers Romain Gary, Ernest Hemingway, William Inge,
Malcolm Lowry, Yukio Mishima, Gérard de Nerval, John Kennedy Toole,
and Virginia Woolf, and composers Jeremiah Clarke, Peter Warlock, and
Bernd Alois Zimmerman, and painters and sculptors Ralph Barton,
Francesco Bassano, Franceso Borromini, Edward Dayes, Vincent van
Gogh, Arshile Gorky, Benjamin Haydon, Ernst Ludwig Kirchner, Wilhelm
Lehmbruck, Jules Pascin, Mark Rothko, Nicolas de Staël, Pietro Testa, and
Henry Tilson (from Jamison, 1993, pp. 249, 267–70)? Surely—one can’t
help but ask—surely not only society, and often, of course, their
families, but foremost is it not the creative person who is “harmed” by
suicide—and if not by that, then hasn’t ‘harm’ lost its meaning?
Yet it is exactly when the patient denies that his or her condition is expe-
rienced as harmful (even should creative life end in suicide), while at the
same time society resolutely imposes its standards of “mental correctness,”
that we come to have Holocaust exterminations of “mental patients” and
involuntary sterilization programs in the United States. In The Pathology
of Man (Bartlett, 2005, Part I), I discuss the main competing theories of dis-
ease and advance a general, unified theory of disease. From that standpoint,
76 Normality Does Not Equal Mental Health

I’ve argued that any judgment to the effect that a condition constitutes a
disease—that it qualifies as a genuine pathology—is intrinsically
framework-relative. This is not to say that such judgment is subject to rela-
tivism, for a disorder that an individual experiences as harmful does this as a
matter of self-confirming experienced fact. However, “harm” must be
understood contextually: there is harm to the individual—as felt and judged
by him or her to constitute harm—and harm as judged by the society
in which he or she lives. They do not always coincide. In the case of the cre-
ative artist, they often do not. To put the matter rather bleakly: the depres-
sion, mania, cyclothymia, and even suicide of the artist will frequently be
judged harmful by society but yet at times not by the artist. When the
patient and the treating psychiatrist are in disagreement that harm is
involved, we are left in a position where it would be ridiculous as well as
therapeutically wrong to force the application of diagnostic standards of
psychopathology without stopping in our tracks and pausing to reflect.
For there are other issues that must be taken into account.

THE SITUATIONAL THESIS

To bring forth immaterial things, things partaking of spirit, not flesh, we
must be jealous of spending time or trouble upon physical demands,
since in most men, the soul ages long before the body. Mankind has been
no gainer by its drudges.
—T. E. Lawrence, The Seven Pillars of Wisdom

By “the situational thesis” I mean the claim that the alleged “psychopa-
thology” of creative people needs to be understood in the context of their
struggle to exist in, cope with, and resist pressures to adapt to, the world
of the psychologically normal.
From a phenomenological point of view, an individual’s “situation”
must be understood in relation to his or her values, sensitivities, and aes-
thetic and creative skills, as these are expressed in the individual’s experi-
ence. It is important that we keep clearly in mind that these realities
together form a dynamically interrelated group in terms of which the
artist’s experienced situation in life is defined. We are not able within
the span of a chapter to enter into this subject in great detail, but we none-
theless need a framework to understand what is at issue here.
It is a familiar truism that creative people are “more sensitive” than the
psychologically normal, but this fails to capture the fact that the experi-
enced world of the creative person can be qualitatively different from nor-
mal experience in a variety of ways. First, frequently the artist feels a sense
of passionate commitment to his or her art for no extraneous reason: for
The Abnormal Psychology of Creativity and the Pathology of Normality 77

some artists, it is not money or fame that fires the drive to create (though
he or she may also want these); the need to create is simply there, for no
other reason than itself; it is an intrinsically meaningful and important
goal in and of itself. Second, the artist’s “sensitivity” may encompass a
host of characteristics and skills. The creative person may, for example,
be greatly more sensitive to any undesirable disturbance from the physical
and human environment: Proust’s pronounced sensitivity to noise comes
to mind. Yet such “sensitivities” may also be tied to skills: Turner’s ability
to feel intensely the beauty of a sunset, or Shakespeare’s to feel the tragedy
of life. These are aesthetic skills, both in terms of the acute responsiveness
of an artist to his or her subject and in terms of the ability to communicate
that heightened aesthetic response. And last, there is the creative individ-
ual’s ability to go beyond the bounds of established thought and practice
in his or her field of endeavor and to offer new and original insights and
approaches.
By creative sensibility what I have in mind is the following group of inter-
related values, heightened sensitivities and vulnerabilities, and skills in the
context of lived experience: (1) passionate commitment to creation as an
intrinsically meaningful process and end in itself; (2) sensitivities to the
artist’s environment that can jeopardize or foster creative work; (3) skills
of aesthetic awareness and communication; and (4) the capacity to break
free from the confining ruts of the customary and established patterns of
thought and practice of the time. These are all sources of meaning in
which the creative individual’s experience often differs qualitatively from
that of the normal population.
There are some truths which, as psychologist George Romanes would
nod in assent, do not require supporting statistical studies.2 One of these
is the undeniable truth of the plight of creative individuals in most coun-
tries in the world—the still insufficiently appreciated, grueling lives of
many poets, independent writers of literary fiction and scholarly nonfic-
tion, painters, sculptors, composers, independent basic scientists and
mathematicians, and others. Few parents of modest means are unable to
anticipate the challenge their children would face if they decided upon
the creative life. Unless they are the rare, lucky exceptions, it will be a seri-
ous challenge for the creative to make ends meet and to live, often never
fitting in, within an industrialized society whose values displace virtually
all else but exclusively materialist interests.
The average person has no idea of the investment purchased by per-
sonal sacrifice, toil, long hours of intense concentration, and love poured
into an artist’s creations. Yet, sustained by an inner need to create, the
artist does what he or she must, and yet must somehow try to cope with
what is often perceived to be a brutish encompassing society that does
78 Normality Does Not Equal Mental Health

not understand artistic sensibility and the care required to bring beauty
into the world—and does not wish to. The artist can suffer from a variety
of situational depression that has yet to be named and classified by the
DSM. The painter must deal with tight-fisted opportunist art dealers,
galleries that claim half or more of the proceeds from an artist’s sales,
and consumers of art whose main criterion is whether a painting will
match the color of the sofa; the writer must cope with the closed-
mindedness and short-sightedness of publishers whose main concerns are
word count, page count, printing cost, list price, and market appeal—
frequently at the expense of literary or scholarly merit; the composer,
sculptor, architect, and poet alike must peddle their wares, often to the
deaf ears of publishers, patrons, contracting businesses, and a small and
fickle “literary-cultural” market. The potential, and the real, disappoint-
ments are legion, the frustrations immense, and the toll on life energies
frequently depleting and demoralizing.
Consider the following credo for the living of one’s life advocated by
novelist Hermann Hesse, who himself experienced wide swings of mood,
was hospitalized, and attempted suicide:

I consider reality to be the thing one need concern oneself about least of
all, for it is, tediously enough, always at hand while more beautiful and
necessary things demand our attention and care. Reality is that which one
must not under any circumstances worship and revere, for it is chance, the
refuse of life. And it is in no wise to be changed, this shabby, consistently
disappointing reality, except by our denying it and proving in the process
that we are stronger than it. (Hesse, 1925/1954, p. 67)

The creative person who has taken the meaning of this passage to heart
and bases his or her life on such an outlook is almost guaranteed very sub-
stantial hardships. The hardships are likely to be of two different kinds:
those experienced in order to “earn a living” and those encountered if
and when one is immersed in living a creative existence. Often, in the lives
of creative individuals, the first set of hurdles has to be cleared before the
artist—rarely—acquires the financial independence to tackle the second.
Virginia Woolf described the first set of hurdles in writing about her past
life:

[W]hat still remains with me as a worse infliction . . . was the poison of fear
and bitterness which those days bred in me. To begin with, always to be
doing work that one did not wish to do, and to do it like a slave, flattering
and fawning, not always necessarily perhaps, but it seemed necessary and
the stakes were too great to run risks; and then the thought of that one
The Abnormal Psychology of Creativity and the Pathology of Normality 79

gift which it was death to hide—a small one but dear to the possessor—
perishing and with it myself, my soul—all this became like a rust eating
away the bloom of the spring, destroying the tree at its heart. (Woolf, 1929,
p. 64)

The second group of hurdles will concern us in the next section.

“Situational depression” is a phrase not yet in common use. As most
readers will be aware, clinical psychology and psychiatry often construe
depression in different ways. Biologically focused psychiatrists believe
depression results from biochemical imbalance and should therefore be
treated primarily with medication. Some clinical psychologists urge that
psychotherapy should comprise the main approach; other psychologists
claim that depression is not a “disorder” at all, but an expression of “prob-
lems of living” (e.g., Adler and his following). Still another group claims
that depression is a justifiable emotion, warranted by a situation that
causes a person pain (e.g., Greenspan, 1988; De Sousa, 1987).
This last approach to depression has yet to be fully developed. To
date, relevant studies fall mainly under the heading of the psychology of
career burnout, where conditions in a person’s work environment—when
considered in relation to that individual’s temperament, values, and
outlook—can be linked causally with ensuing depression. We require a
different framework in which to understand the challenges which cre-
ative individuals experience in their efforts to deal with the surrounding
world.3

THE PSYCHOPATHOLOGY OF NORMALITY

[T]o write a work of genius is almost always a feat of prodigious diffi-
culty. Everything is against the likelihood that it will come from the
writer’s mind whole and entire. Generally material circumstances are
against it. Dogs will bark; people will interrupt; money must be made;
health will break down. Further, accentuating all these difficulties and
making them harder to bear is the world’s notorious indifference. It does
not ask people to write poems and novels and histories; it does not need
them. It does not care whether Flaubert finds the right word or whether
Carlyle scrupulously verifies this or that fact. Naturally, it will not pay
for what it does not want. And so the writer, Keats, Flaubert, Carlyle,
suffers, especially in the creative years of youth, every form of distraction
and discouragement. A curse, a cry of agony, rises from those books of
analysis and confession. “Mighty poets in their misery dead”—that is
the burden of their song. If anything comes through in spite of all this,
it is a miracle, and probably no book is born entire and uncrippled as it
was conceived. (Woolf, 1929, pp. 89–90)
80 Normality Does Not Equal Mental Health

Most closely allied to the situational awareness of the artist’s experience

that is advocated here is an approach to situational depression consider-
ably different from psychological studies of career burnout. Such a situa-
tional understanding of the artist widens the acknowledged causal basis
of depression beyond an individual’s immediate work environment to
encompass the society at large. For some people, whose sense of personal
identity, life commitments, cultural values, and creative sensibilities place
them at odds with their predominantly anti-intellectual and noncultural
society, a more specialized variety of depression can result, and it may well
have been the mood that Virginia Woolf, who committed suicide, felt
when writing the above passage.
We’ll explore certain of the ramifications of such depression in Chap-
ters 4–6 in Part II of this book. In these chapters I reconsider the ancient
Scholastic idea of acedia and place it in a twenty-first-century context as
the name for a diagnostic category that includes a group of mental impair-
ments that together result, for many people, in a mental incapacity for cul-
ture in its original meaning of cultus. Our later discussion of acedia is
directly relevant to the focus here on the psychology of creative individ-
uals, so a few words about it are in order.
As we shall see, the Scholastic meaning of ‘culture’, now largely lost,
subordinates mundane and mediocre concerns to a source (not necessarily
religious) of higher value. The Scholastics regarded some values as
“higher” because they bestow upon everyday life a significance that tran-
scends the workaday world. In the same sense, higher education was called
higher because its aim was to encourage cultivation, specifically the culti-
vation of nonuseful things, having nothing to do with utilitarian pursuits,
nothing to do with skills needed to get a well-paying job.
To cultivate such concerns requires leisure—not leisure in the sense of
idleness or taking a vacation, but leisure in the sense of an individual’s
capacity to become aware of a source of meaning that goes beyond the
mundane world of everyday preoccupation. Leisure in this meaning
was an attitude of mind, of silent affirmation, of active contemplation. To
have the capacity for leisure requires that a man or woman affirm his
or her own sense of identity, apart from a role as father, mother, worker,
or consumer.
To be incapable of this is acedia. In a few words, acedia is an inability to
see reality in other than mundane and mediocre ways; it is an inability to
perceive reality as it can be transformed through an awareness of “higher
values.” When this transformative capacity is lost, the minds of people
are blunted and they begin to suffer from a disability of values. Acedia is
just such a disability, as we shall see in greater detail later on. (For further
discussion, cf. Bartlett, 1990, 1993a, 1993b, 1994a, 1994b.)
The Abnormal Psychology of Creativity and the Pathology of Normality 81

In the context of the psychology of artistic or creative sensibility, which

is the appropriate focus for a psychiatric understanding of creativity, acedia
is a widespread disability that afflicts the psychologically normal, with
whom the artist must, often reluctantly and out of necessity, deal. In the
next chapter, we’ll see how the prevalence of acedia in today’s college stu-
dents can lead to a form of burnout among university faculty. The situa-
tional basis of the variety of demoralization that affects many artists is
similarly to be found in the cultural wasteland that exists, to speak nonme-
taphorically, between the ears of the majoritarian psychologically normal
and in the society they make up. We often find in the autobiographical
writings of creative individuals expressions of loneliness, isolation, and
alienation from the normal world. To understand this feeling and the
negative mood that results from it is to empathize in a basic way with the
“life-worlds” of many “struggling artists,” whose struggle is directly attrib-
utable to obstacles placed in their way by the psychologically normal,
which Virginia Woolf commented on.
Psychological normality has had many unquestioned legitimators—for
this is what psychiatrists do when they accept and apply, wholesale, the
classification system of the DSM. There have been those, however, who
have had the courage and the cognitive capacity to “reframe,” to step out-
side the boundaries of familiar categories and to recognize the very real
pathologies that are inherent in the psychologically normal constitution.
In the history of behavioral science, and in particular in the history of psy-
chology and psychiatry, little effort has been made to study pathologies
that afflict not the aberrant neurotic or psychotic individual or social
group but the greater population of the psychological normal. Yet, on
the odd occasion, an author such as Trigant Burrow (1953/1968, p. 25)
will occasionally remark: “a grave error is committed in aligning the usual
or average behavior with healthy behavior.”
To undertake a study of such “universal pathologies” requires that we
focus on the evil of banality, a phrase now familiar to readers, and not the
considerably more restricted “banality of evil” proposed by Hannah Arendt
(1964). I have sought to advance our understanding of a wide range of path-
ologies that afflict the psychologically normal population in The Pathology of
Man: A Study of Human Evil (2005). There, I’ve argued that these pathologies
of normality have largely been ignored or denied, yet an awareness of the
central role that they play in human behavior is essential to our understand-
ing of the psychology of war, genocide, the Holocaust, terrorism, obedi-
ence to authority, human ecological pathology, moral stupidity,
and cognitive delusion, each of which areas the book explores in detail. A
number of the world’s leading psychiatrists and psychologists have long
urged the need for such a study—clinicians mentioned in Chapter 1,
82 Normality Does Not Equal Mental Health

among them Freud, Jung, Menninger, Fromm, and Peck; also quantitative
historians Quincy Wright, Pitirim Sorokin, Nicholas Rashevsky, and
Lewis Fry Richardson; ethologists Konrad Lorenz and Irenäus Eibl-
Eibesfeldt; and others.
The “situation” in which many creative individuals find themselves in
the real world of uncreative, psychologically normal people needs to be
understood more effectively by psychiatry and clinical psychology—
understood, that is, in a more empathetic way that recognizes the impor-
tance of situating a therapist’s viewpoint phenomenologically from within
the perspective of creative individuals, to see the world from the individ-
ual’s standpoint so he or she may be helped in ways that are appropriate.
There is a need to question the categories of mental illness that psychiatry
applies to the artistic temperament,4 and also a place for the detachment
and perspective that can come from humor. Earlier I quoted from psy-
chiatrist Louis E. Bisch, who has offered such a desirable blend of humor
and seriousness in his all-but-forgotten book about neuroticism. Readers
will recall that it was Bisch who exclaimed, “to be normal is nothing to
brag about! When I study normals and compare them with neurotics I
wonder sometimes whether to be normal is not something to be ashamed
about” (Bisch, 1936, p. 32). Relevant to the viewpoint of artists who strug-
gle against the psychologically normal world, Bisch quoted then well-
known American author Joseph Hergescheimer, who made this comment:
“Normal people are almost invariably without minds or imagination. In
the main they are extremely stupid. They are, frequently, widely esteemed
and often occupy places of power, grow rich, but they have never pro-
duced an elevated written line” (Bisch, 1936, p. 31).

THE PSYCHIATRIC PLIGHT OF THE ARTIST

I began this chapter with the observation that psychiatry and clinical
psychology face a dilemma when it comes to diagnosing the extremes of
mood experienced by many creative people. Often the depths and heights
of artistic mood can be destructive: to the artist, to his or her marriage and
family, to professional relationships, and in the end even to the artist’s
own creative resources. As we have seen, the same intense moods and
mood swings can, however, also be vital to an artist’s capacity to create.
But to go beyond these surface observations, it is important to note that
clinical studies of creativity have almost always stopped short of anything
approaching a phenomenological understanding of the world as experi-
enced by the artist. There has therefore been little psychiatric or clinical
psychological effort to comprehend the situational nature of the despon-
dency into which creative people can sink, depression that at least some
The Abnormal Psychology of Creativity and the Pathology of Normality 83

of the time, and perhaps more often than we might imagine, is due to the
inroads upon their artistic sensibility for which coarse-featured, mundane,
and mediocritizing human social reality is responsible. From the artist’s
own perspective, creative life is very often an ordeal primarily because of a
world that is dominated by the presence of the psychologically normal, dominated
by the physical and culturally deficient environment these people pro-
duce, by the superficial values they subscribe to, and by the frivolous
interests they advocate. (For further analysis see Bartlett, 2009.)
And here again, psychiatry and clinical psychology have so far failed to
take seriously the case that needs to be made on behalf of the artist—
to recognize what for many highly creative people is the very real, dead-
ening, creatively destructive pathology of the everyday world and of the
everyday people who populate it. The obstacles placed in the way of the
artist by a human environment consisting often of a psychologically
normal family and normal friends, normal acquaintances and business
relations, and a psychologically normal encompassing society are
seldom appreciated and factored into a psychiatric understanding of
the creative.
What typically happens is that a clinically alleged, and sometimes real,
pathology of creativity meets the very real and soul-grinding pathology of
normality, and in the encounter it is usually the artist who fares the worst.
The conflict is usually thrust involuntarily upon the artist. As Bryron wrote:
“I recollect, some time [ago], Madame de Staël said to me in Switzerland,
‘You should not have warred with the world—it will not do—it is too strong
always for any individual.’ . . . I perfectly acquiesce in the truth of this
remark; but the world has done me the honour to begin the war” (quoted
in Jamison, 1993, p. 178). In a similar vein, Santayana (1920, p. 185)
observed of artists that “their unhappiness consists in the sense of their
unfitness to live in the world into which they are born.” Landau (1980,
p. 496) concluded that “artists are people who prefer the open condition
of perpetual maladaptation.” Hermann Hesse (1973), speaking autobio-
graphically, wrote: “my attempts to adapt myself to the standardized
world . . . remain . . . fruitless” (p. 159), and then reflected in more detail:

Are you, mad poet . . . , really mad? Are you sick, suffering so from life that
often you scarcely want to go on living, simply because you have neglected
to adjust yourself to reality “as it once and for all happens to be”?
And once more, although I was prepared to think realistically even at my
own expense, I was compelled to reply as I had so often replied before: No,
you are a thousand times right in your protest against this miserable “world
as it once and for all happens to be,” you are right even if you die strangling
on this world instead of accepting it. (Hesse, 1973, p. 213)
84 Normality Does Not Equal Mental Health

Unfitness, maladaptation, warring with the world—they all reflect a state

of conflict between the creative individual and a world populated by the
psychologically normal.
In reviewing studies of what the majority of clinicians judge to be the
abnormal psychology of creativity, we see an overlooked path that brings
us to a new perspective on the psychology of normality, for we see that,
from the artist’s point of view, normality itself can be replete with its
own pathologies, pathologies of normality that can contribute signifi-
cantly to what psychiatrists of creativity have construed to be psychopa-
thologies afflicting the artist. In this, if the observations expressed here
are right, there is clearly considerable irony and tragedy. There is good
reason to approach creative individuals both with a more circumspect,
reflective, self-critical yardstick than psychiatry and much clinical psy-
chology have been accustomed to apply, and with an increased intention
and ability to empathize with the predicament of the artist who must cope
with a psychologically normal world.

AFTERWORD
As we have noted, the psychology of creative temperament has received
comparatively little attention within psychiatry and clinical psychology.
Much of the reason for this, I suggest, is that clinicians have failed to rec-
ognize that many creative people are different in important ways from
psychologically normal people and that, therefore, diagnostic classifica-
tions that use normality as a baseline become questionable and even inap-
propriate when applied to the artist. The so-called “artistic temperament”
brings with it values, attitudes based on them, and choices in behavior that
often do not coincide with those of the psychologically normal popula-
tion. We recognize that artists frequently do not bow to the same noble
truths as the common person: Creative people can be less nationalistic,
considering themselves “citizens of all countries and patriots of none.”
They may be less inclined to participate in herd warfare, genocides, ter-
rorism, obedience to authority, group-endorsed ideological commitment,
bullying, environmental destruction motivated by financial greed (see
Bartlett, 2002), and similar acts. But because few psychological studies of
the artistic temperament have been made, the foregoing are observations
and conjectures based on personal and anecdotal experience not yet statis-
tically substantiated. The paucity of psychological studies of artists is
certainly also due to the fact that they comprise such a tiny minority and
most especially because, as we have seen, they tend in important respects
The Abnormal Psychology of Creativity and the Pathology of Normality 85

to be sufficiently “different” that “normal” psychiatric diagnostic catego-

ries may fail to apply.
The approach to creative individuals proposed here can be expected to
meet a certain amount of resistance. Like all socially applicable disci-
plines, psychiatry and much clinical psychology are influenced by con-
formist needs and pressures to adopt prevailing politically correct
beliefs. Among these, at the present time, is the widespread political belief
among many psychiatrists that all patients should be treated equally or
“the same.” For such psychiatrists, this means that a uniform system of
reliable diagnostic classification ought to be applied to each and every
patient—to do otherwise would be tantamount to recognizing that indi-
vidual difference at times should override the application of diagnostic
categories defined with reference to a standard of psychological normal-
ity. This would not be “egalitarian,” and it would also place a heavier
responsibility upon the psychiatrist when treating highly creative people,
requiring the clinician to think in highly individualized terms outside of
the customary, symptom-based DSM classification framework.
The artist can be exceptional in ways that put him or her at odds with
prevailing normal society. A psychiatrist who wishes to treat creative indi-
viduals in a manner that is genuinely appropriate to them must be willing
to accept an open-minded, “differential,” even “discriminating” approach
to psychiatric treatment. But to do this in an honest and fitting way, the
psychiatrist is compelled to accept a form of psychiatric elitism that recog-
nizes that some people require “special” treatment, unconventional diag-
nosis, and empathic understanding that recognizes them to be
exceptions. This is not easily accommodated by an algorithmic, nondis-
criminatory, and impartial diagnostic classification system as currently
embodied in the DSM, blind as it by definition must be to the needs and
values of creative individuals who are exceptions to the norm.

NOTES
1. For the role of harm in pathology, a detailed critique of theories of disease,
and the elaboration of a unified theory of disease, see Bartlett (2005, Part I).
2. More than a century ago, psychologist George Romanes defended the the-
sis that there are certain meaningful and factual observations about the world that
do not stand in need of experimental confirmation from empirical science
(Romanes, 1883, 1888, 1895). He did not disparage experimental evidence, but
he recognized that certain kinds of knowledge are possible, especially in psychol-
ogy, which do not require experimental validation. We in America especially,
with our unbounded drive for experimental substantiation of all observations
86 Normality Does Not Equal Mental Health

however obvious, need to be reminded of this wisdom from the past, as I’ll seek to
do again in a later chapter.
3. Authors who have made contributions in this area include Pines and Aron-
son (1988) and Bartlett (1990, 1993a, 1993b, 1994a, 1994b).
4. It should already be clear that I see no validity or legitimacy in medical-
diagnostic labeling when it comes to psychological problems that cannot be
traced to underlying organic dysfunctions. However, in Bartlett (2009) I consider
one diagnostic category seldom associated with creative people, which, if we
absolutely must have a diagnostic category to apply to them, might, with a little
stretching, serve as a close-to-accurate description, and that is “adjustment
disorder.” For the DSM definition of this disorder and further discussion in other
contexts, see Chapters 4 and 6 of this book.
 PART II

Psychology During a Collapse of Culture

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 4

Acedia: When Work and Money Are the

Exclusive Values

In the last chapter, I urged that a psychologically accurate and clinically

appropriate understanding of many creative people requires that we
recognize the individualized way in which an artist relates to the world—
taking into account the creative individual’s sensibilities and sensitivities,
how he or she derives a sense of meaning from life and creative work,
how the artist reacts to contact with the “normal world” that frequently
is unresponsive to the efforts of originality, and related factors. Such a
perspective seeks to acquire a situational understanding of the creative per-
son and sees psychological problems of the artist as inherently a function
of the individual person in relation to a highly individualized context of
interests, needs, sources of meaning, and challenges to these.
In Chapter 1 of this book I questioned the psychiatric standard that
equates normality with mental health, and in Chapter 2 I sought to make
clear how the psychology of definition results in a distorted and unsatis-
factory conception of mental disorders. When readers combine the
conclusions of both chapters in their own minds, it should make good
sense that the DSM’s decontextualized and symptom-based diagnostic
criteria utterly miss the mark when it comes to the kind of situational
understanding of psychological problems advocated here.1
In this chapter2 I want to extend this discussion by examining a certain
widespread psychological disability that remains virtually unrecognized
and undiscussed. We have seen how a contextually sensitive understanding
of the creative individual’s “situation” vis-à-vis the psychologically normal
world can involve a “mismatch” between self and world, resulting in much
of the debilitating struggle against the world that typifies the lives of some
artists. I now want to turn to a different, more inclusive frame of reference
that focuses upon not the small population of the highly creative but rather
90 Normality Does Not Equal Mental Health

the general population, which again we’ll consider in a situationally relative

way. Here, rather than a mismatch, we’ll look at the highly adaptive rela-
tionship of submission and compliance that has become established
between our society’s majority—workers who are consumers—and their
highly industrialized, commercially driven society. Like the highly creative,
today’s worker-consumer can experience difficult psychological problems,
but they are of an altogether different kind. The particular problem that
will concern us here may be called “work-engendered depression.”
There has been a general failure among mental health theorists and
social psychologists to understand what brings about depression of this
kind. Yet the condition is increasingly prevalent in highly industrialized
societies, where an exclusionary focus upon work, money, and the things
that money can buy has displaced values that traditionally exerted a liber-
ating and humanizing influence. Social critics have called the result an
impoverishment of the spirit, a state of cultural bankruptcy, and an inca-
pacity for genuine leisure. From a clinical perspective, the condition has
been diagnosed as widespread narcissism and obsessive work. But this
misses a great deal.
Acedia, a concept developed by the psychologically astute Scholastics
but now virtually forgotten, can throw explanatory light on the origin of
this form of depression.

Clinical depression at present is treated in two main, often mutually sup-

portive, ways: by drug therapy and by psychotherapy. Psychotherapeutic
treatment may involve any of a large number of alternative approaches,
ranging from psychoanalysis to cognitive therapy to behavior change.
A few of these therapeutic approaches focus special attention on the central
role of a person’s attitudes and values in both the genesis and the ameliora-
tion of depression.
These psychotherapies include Alfred Adler’s individual psychology
(1912/1926, 1924, 1929/1964), George Kelly’s personal construct theory
(1955, 1956/1978), Viktor Frankl’s logotherapy (1955, 1959), and Albert
Ellis’ cognitive therapy (1961, 1973, 1975). A therapist who subscribes to
any of these ways of implementing psychotherapy will, to speak in inclusive
terms, treat depression by attempting first to make explicit, and then work
to strengthen or change, the patient’s or client’s most basic, relevant atti-
tudes about living. In this perspective, depression is believed to be the result
of a fundamental mismatch between a patient’s beliefs and values, on the one
hand, and the realities and goals with which he or she must deal, on the
other. Such a state of affairs, it is claimed, brings about chronic frustration,
Acedia: When Work and Money Are the Exclusive Values 91

emotional suffering, and potential demoralization. More specifically, these

theories of psychotherapy claim that clinical depression is brought about by
a group of “basic mistakes” in perceiving the world (Adler), by a self-
defeating or self-confounding way of construing the world (Kelly), by
an inadequate or unrealized framework of meaning (Frankl), or by an irra-
tional set of expectations (Ellis).
Adler, Kelly, Frankl, and Ellis, among others, situate psychotherapy
within the personal framework of meaning or the internal logic and belief
system of their individual patients. Their psychotherapies can be likened,
in varying degrees, to forms of phenomenological psychology, which
began with Brentano (1924, 1925, 1928) and reached perhaps its most
direct and explicit development in the phenomenological psychiatry of
J. H. van den Berg (1955).
The locus of depression for these essentially phenomenological theo-
ries is wholly internal. According to them, depression is born and main-
tained thanks to an internal dynamic that renders a person vulnerable to
demoralization and despair. Here, Adler, Kelly, Frankl, and Ellis refuse
to apply the category of disease to psychological disorders: their clients
are not “sick,” for they believe there is no “disease” there to be treated;
the problems they face are problems of living. This was also Thomas
Szasz’s (1957/1961) view and the basis for his criticism of medical psy-
chiatry: it frequently reifies problems of living into varieties of illness, as
we saw in Chapter 2. In doing this, it makes what philosopher Gilbert
Ryle called a “category mistake” and falls victim to Whitehead’s “fallacy
of misplaced concreteness” (which we also saw in Chapter 2). Mistake or
fallacy, thinking goes astray when we assert the existence of what has only
the rank of phantom pathologies.
In this chapter, we look at a variety of depression first studied by the
medieval Scholastics. Their frame of reference resembles that of phenom-
enological approaches to depression, but unlike them it suggests that a per-
son’s attitudes and values do not directly give rise to the form of depression
with which they were concerned. Instead, the Scholastics observed that this
variety of depression is, we might say, negatively defined by a person’s values
and belief system. It arises, they claimed, due to the exclusionary nature
of the set of values to which a person is committed: it results, that is to say,
from what his or her attitudes neglect or omit. In other words, this type of
depression is, as we will see, brought about by a deficiency of values.

WORK AND CULTURAL BANKRUPTCY

The societies of the highly industrialized countries are now firmly in
the grip of an obsession with work and its product, money. Work has
92 Normality Does Not Equal Mental Health

always been a condition of living, but in the last half century work
has become so central in our preoccupations that other values have been
displaced.
A single-minded and exclusive focus upon work and the monetary value
of time form a social environment in which we increasingly see a certain
manifestation of depression. It is a variety of depression whose genesis
we’ve failed to understand clearly and which we have been unable to
appreciate for what it tells us about ourselves.
Few concepts drawn from medieval moral theology have direct bearing
on the diagnostic vocabulary of the DSM. Acedia is no exception. It is a
simple idea, one that was apparently not hard to grasp at the height of
the Middle Ages. Yet today, though it is still an uncomplicated notion,
the meaning of acedia is so remote from our modern daily cares and pro-
fessional concerns that it is hard to understand. But effort here is worth-
while, if only to help us gain a broader and perhaps a more humane and
contextual understanding of depression.
In highly industrialized societies like those of western Europe,
America, and now China, the values that have come to supersede all others
are money, material comfort, and financial security (the assurance that the
first two values will be safely satisfied in the future). The lives of the
majority of people in these societies are defined and controlled by a pro-
nounced and single-minded, obsessional concern to acquire and then to
remain in a well-paying job. What frequently results is a condition that
medieval moral theologians called acedia.
The medieval Schoolmen understood acedia as the cause of an exclu-
sionary focus on the world of work and material gain. In this, they have
been followed by Josef Pieper, one of few contemporary thinkers who
has given attention to acedia.3 My interest in this chapter, however, is in
the reverse, psychologically important relationship, that is, how an ethic
of work and consumption for their own sake leads to acedia. What I exam-
ine here is one direction of influence that leads from a narrowly limited
preoccupation with work and money to acedia; a complete account would
take into consideration the interaction that occurs between the two. Each
encourages and helps to perpetuate the other.
According to the Scholastics, acedia is the state of mind that comes
about when a person has lost his or her capacity for leisure. This seems
straightforward. But what they understood by ‘leisure’ (significantly, they
used the Latin word ‘scola’ from the Greek ‘skole’, the origin of the English
word ‘school’) is no longer familiar to us today. In their view, a certain inca-
pacity to experience leisure develops and becomes firmly established in
people whose scope of awareness has become impaired. It is an incapacity
Acedia: When Work and Money Are the Exclusive Values 93

whose existence contemporary industrial society is able to recognize only

with considerable difficulty.
The values of work and money, like the limited cares of any exclusive
preoccupation, blind its adherents to alternative values. They narrow the
scope of a person’s concerns; he or she becomes wholly and short-
sightedly absorbed in immediate gratification and in worry over ensuring
future gratification. When this happens, medieval theologians recognized
an “impoverishment of the soul.” Studies of work-related depression in
“career burnout” have pointed to a similar erosion and depletion of per-
sonal meaning (e.g., Pines & Aronson, 1988; cf. Rohrlich, 1980), but fail
to profit from the insight offered by the medieval understanding.
The logic of usage that underlies the meaning of acedia is alien to us to-
day: A logician would say it is “three-valued,” whereas our customary
logic is bivalent, recognizing only the two “values” of truth and falsity.
In a two-valued logic, a term has one opposite, its negation. In a three-
valued logic, a term may have two “opposites,” each being the contrary
of the other.
Today, we recognize two extremes: On one side, we locate work and
the desirable traits that we associated with it, such as diligence, industry,
competitiveness, ambition, and so forth. On the other side, we situate
leisure, having time on one’s hands, being idle, even lazy—in short, having
time away from work. Time away from work is useful to the extent and,
we now increasingly believe, virtually only to the extent, that it serves as
a restorative that, after the usual two weeks for an American, enables a
man or a woman to return to money-making work with renewed energy
and zeal.
It is impossible to understand acedia in this context. To understand the
medieval conception, we need to think in three-valued terms: Work, dili-
gence, and industry make up one extreme. Idleness, laziness, and time free
from the demands of work make up another. And leisure, in the special
meaning the Scholastics associated with the concept, is separate from both
of these.
In this three-valued context, acedia in the medieval view is an inability
to experience leisure. Leisure, as it was then conceived, is opposite to
work, but it is also, as we’ll see, opposite to idleness or laziness, to merely
having time on one’s hands. Idleness is of course contrary to work, while
leisure is the contrary both of idleness and of work.
In our bivalent attitude toward work, not only do we fall victims to
acedia, but we cannot realize that this has happened to us. This is not ver-
bal trickery, but a psychological reality we should be able to appreciate if
we will bear with the three-valued medieval view a little longer.
94 Normality Does Not Equal Mental Health

Leisure meant something specific to the medieval mind. It was not

synonymous, as we’ve said, with idleness or taking a vacation. Leisure was
instead associated with culture, with the cultivation of the spirit, with cultus.
What is at stake in this conception of “culture” has a radically different
meaning than we find in such phrases as “corporate culture,” “the culture
of the New York Giants,” or “U.S. culture.” These uses of the word
‘culture’ are diametrically opposed to the Scholastic conception. In the
Scholastics’ religiously based standpoint, the human capacity for leisure
was one with the ability to be spiritual, to be conscious of the self as a divine
creation, to cultivate spirituality within, and to accept one’s place in a uni-
verse that contains both matter and “higher values,” those that transform
one’s daily life and suffering. Leisure, however, as we shall see in a moment,
need not be tied to a religious perspective in order to maintain its capacity
to elevate.
The values that the Scholastics thought were higher bestowed upon
everyday life a significance that transcends the workaday world. In the
same way, higher education was called higher because its aim was to
encourage cultivation, specifically the cultivation of nonuseful things.
The ends of “higher education” had nothing to do with utilitarian
pursuits, nothing to do with the acquisition of the technical, social, or
other skills necessary to get a well-paying, secure job. Genuinely higher
education, as we shall see in more detail in the next chapter, was devoted
to those things that are of value “in and of themselves,” as it was then
commonplace to say.
Leisure, then, was an attitude of mind, an attitude of silent affirmation,
of feeling at one in a world in which a person is and cannot but be at
home, from birth and throughout his or her life. This form of “letting
go” is not inactivity. Leisure is active contemplation, enjoyment, and
appreciation of being and of being oneself. To be capable of leisure
requires that a man or woman affirm his or her own sense of identity apart
from a role as worker, father, mother, or consumer. To be incapable of
this is acedia.
Acedia, in short, is an inability to see reality in other than mundane and
mediocre ways. It is an inability to perceive reality under the guise of the
transformation that “higher values” make possible. During the Middle
Ages, these values were rooted in religion—as it happened, in Chris-
tianity. But higher values need not be Christian or even theistic. Reality
can be transformed by myth, by poetry, by music, art, philosophy, by
abstract theoretical research that has no practical application in view, or
by imagination. When these powers of transformation diminish or are
lost, the minds of the people are blunted, and they begin to suffer from a
disability of values. Acedia is just such a disability.
Acedia: When Work and Money Are the Exclusive Values 95

THE SYMPTOMS OF ACEDIA

In the impoverished state of mind brought about by an exclusionary
obsession with work and its financial rewards, acedia leads to despair—
to an unwillingness and an inability to be fully and richly human. It is a
state of mind without hope, a condition of demoralization that is an
impasse to realizing one’s full human potential.
The Scholastics realized that despair is a block to growth: in the words
of Saint Paschasius Radbert, despair “closes the door” (1857–1866, liber
II, caput VI, 2). As with the meaning of leisure, the medieval meaning of
despair is more comprehensive than is ours today. It is not sadness or grief
but a barrier that stands between the man or woman who is slave to the
world of work, and higher values. It handicaps a person’s ability to trans-
form the mundane, to see beyond and to apprehend what stunted, medi-
ocritized people cannot see or appreciate.
The overemphasis of our society upon work and purchasable things has
exactly this stunting effect. Our perspective becomes foreshortened:
“greater” and “less than” are reduced to inconsequentialities. The great
no longer stand out, the ordinary encompasses all, and indifference and
indiscrimination replace the respect that we once bestowed on the
extraordinary. We see this in the insistent, exaggerated tendency to make
everyone a “hero,” to consider everyone a “winner,” to “leave no child
behind,” and to praise every performance with a standing ovation
and frenzied cheering. This histrionic and indiscriminate mindset is the
product of a psychology that opposes differentiation—the ranking of
levels of natural endowment, talent, and attainment—and so loses the
capacity to tell and to respect the difference between excellence and the
commonplace.
Aquinas identified the other members of acedia’s family, the psychologi-
cal sequelae of this self-imposed narrowing of the human outlook. They
are the filiae acediae, the partners and companions of despair (Aquinas,
1269–1272/1949, Vol. II, 4; and 1265–1273/1921–1925, Part II of the
Second Part, Ques. 35, Article 4, answer to the Second Objection). They
spell out, with greater clarity and in more detail than the DSM, what
work-engendered depression means in human terms.
In addition to despair, acedia leads to what Aquinas called evagatio men-
tis, an uneasy restlessness of mind that expresses itself in

• inquietudo—or inner restlessness;

• verbositas—a need for the distraction and stimulus of unbridled,
mindless talk;
• instabilitas loci vel propositi—instability of place or purpose;
96 Normality Does Not Equal Mental Health

• curiositas—an unfocused, unanchored, indiscriminate surface interest

in any and all things; and
• importunitas—the urge to scatter oneself in many pursuits.

In addition to despair and restlessness, the symptoms of acedia include

• torpor—repudiation, indifference toward, and neglect of higher values;

• pusillanimitas—antagonism toward higher values;
• rancor—resentful rebellion against those who represent and seek to
cultivate higher ends; and, finally,
• malitia—the pure malice that reflects a deliberate choice in favor of
evil and a deep-seated commitment to hatred for whatever may be
capable of elevating human beings above the trivial, the fatuous,
the superficial.

We observe the first three of these—restlessness, the need for distrac-

tion, and instability—in frenetic activity, in the exaggerated and fanciful
degree that people wish to persuade others, including themselves, that they
have successful, meaningful lives in proportion to the degree that their
calendars are filled, in the amount of multitasking they pride themselves
in being able to handle and with which they are infatuated for the distract-
ing stimulation it provides. When every minute of the day is overbooked in
advance, frenzy erects a natural barrier to the possibility of leisure. Inner
restlessness and the need for distraction are evident in the public’s infatu-
ation for the distractions of emotionally gripping violence and drama and
for the adrenalin stimulation gained from extreme sports and thought-
dampening loud music. We see instability of place and purpose in the fre-
quency with which Americans move, change jobs and careers, and change
marriage partners. Frenzy, restlessness, and the need for emotionally rivet-
ing distractions foster superficial interest and the scattering of the self
among many pursuits. It’s plausible, if a few medieval Schoolmen were
alive today, that they would see the accelerating proliferation of attention
deficit hyperactivity disorder (ADHD) as yet another, complementary
expression of the same condition—and understandably so, since a society
dominated by frenzy, distracted attention, and the craving for stimulation
can be expected to encourage just such characteristics in its children.
The second set of symptoms of acedia expresses attitudes toward
“higher” values—ranging from indifference to such values, to neglect,
repudiation, rebellion, hostility and even hatred that is expressed when
the victim of acedia is confronted by those who represent values pur-
ported to “elevate,” values that are claimed to raise a person above the
normal level of mundane living. These symptoms of opposition to higher
Acedia: When Work and Money Are the Exclusive Values 97

values are expressed in anti-intellectualism, anti-elitism, and an embrace

of a thoroughgoing, undifferentiated cultural relativism and multicultur-
alism, from the standpoint of which there is no “higher” and no “lower.”
Together, the psychological dispositions enumerated by the Scholas-
tics form a set of overlapping and mutually reinforcing symptoms. The
nine characteristics of acedia promote an agitated, unstable, distracted,
and essentially mediocritizing attitude toward living and the purposes of
life, the psychology of which we’ll examine in detail in Chapter 8.
The list of the symptoms of acedia could easily stand as a psychological
profile of industrial society: the medieval terms have their unambiguous
correlates in the tense restlessness, angry rebelliousness, embrace of medi-
ocrity, intellectual lethargy, and demoralization that permeate much of
our society.
Acedia is, then, a condition that can appropriately be called a disability
of values. Higher values are amputated, and yet the amputee is adamant
that he or she is sound of mind and body. The dynamic of the person’s
inner world reinforces this belief. His or her monadic universe becomes
self-encapsulated; it is the autistic world of narcissism.4
Many who are trapped in this self-imprisoning world of sterile work
and trivial pursuits are unhappy—unhappy to the point of clinical depres-
sion. Some are unable to sustain their hollow drive to work and consume,
and collapse in fatigue, despair, and perplexed disillusionment. Clinical
psychology is inclined to say of them that they have acquired a certain dis-
order of adaptation, and more specifically that they have developed an
inhibition to continue working, to which we’ll turn our attention in a
moment. They are the most evident casualties of a work and consumption
ethic gone mad.

ACEDIA: MORAL FAILURE OR PSYCHIATRIC

DISORDER?
The psychological result of a society obsessed with work and material-
ism surrounds us. Acedia is boredom and despair. It takes the form of rest-
lessness and outbursts of impulsive rage and violence. It is an unrecognized
form of depression in the face of the monotony and sterility that has
permeated the industrialized world, a world in which art, poetry, music,
philosophy, and even pure theory and contemplative living have for the
majority become no more than distractions and momentary relief from an
obsessive compulsion to work, shop, and accumulate things; these distrac-
tions offer no more than temporary escape, time out, from a complete
absorption of mind and energy in frantic work, the craving for distraction,
98 Normality Does Not Equal Mental Health

and the acquisition of things. The disorder we face today might, a century
and a half ago, have been called the result of a spreading “moral failure,”
sustained by a loss of hope before an all-consuming epidemic of work and
materialism.
Current psychiatric nosology does not have a place for an expression like
‘moral failure’, which went out of fashion with the nosology of the influen-
tial English psychiatrists D. H. Tuke (1827–1895) and J. C. Bucknill
(1817–1897). I’d like to mention their work briefly here, since it can serve
as a bridge between the Scholastics of long ago and the present. Bucknill
and Tuke (1858/1879) proposed a detailed classification of mental
disorders. Their catalog of forms of mental illness included what they
called “lesions of the intellect”; such “lesions” included cognitive impair-
ments that they associated with corresponding “moral deficiencies.” These,
Bucknill and Tuke claimed, were analogous to forms of intellectual
deficiency, but instead have to do with deficiencies in the “moral sense”
(Bucknill & Tuke, 1858/1879, p. 243). They carefully distinguished vari-
eties of “moral insensitivity,” “moral idiocy,” and “moral insanity” in an
effort to direct clinical attention to deficits or disabilities that can develop
in people and cause them to lose sight of a more inclusive value-focused
perspective. It was such a perspective that they had in mind when they used
the term ‘moral’; and it was to develop and strengthen that perspective that
they sought to provide appropriate “moral treatment.” As they character-
ized it, this was, on a most fundamental level, therapeutic education
intended for the individual person; its purpose was humane and liberaliz-
ing. We will continue this theme in Chapters 5 and 6, in connection with
the psychological objectives of liberal education.
Moral treatment had already been in vogue at the time; Bucknill and
Tuke did not originate this approach. It connoted a kinder, more sympa-
thetic treatment of the mentally ill—certainly long overdue and much
needed—and it emphasized the importance for physicians to be genuinely
compassionate as persons.
The fact that Bucknill and Tuke chose to focus a portion of their psychi-
atric attention on so-called “moral” matters should not prejudice us today
against them, despite the widespread aim of contemporary psychiatry to
be value-neutral. Bucknill and Tuke, after all, were not as “soft” as might
appear; they were among the first psychiatrists to make the unqualified
claim that all mental illness must be organic in origin. Their work has influ-
enced the development of psychiatry through passages like this:

All disease, therefore, in our opinion, is organic. Not only is this so with
diseases which often come under the common observation of the
physician . . . but mental and nervous diseases also, of every kind and form.
Acedia: When Work and Money Are the Exclusive Values 99

Not a thrill of sensation can occur, not a flashing thought or a passing

feeling can take place without changes in the living organism; much less
can diseased sensation, thought or feeling occur, without such changes;
changes which very frequently we are not able to detect, and which we may
never be able to demonstrate, but of which we are, nevertheless, certain.
(Bucknill & Tuke 1858/1979, p. 495)

Today, psychiatry has moved away from the “moral dimension” that
concerned both the Scholastics and psychiatrists like Bucknill and Tuke.
We have come to believe that this is a sign of progress, to go beyond
metaphysics and to make a decisive turn away from religion. Is it therefore
possible, in terms of contemporary psychiatric concepts, to make much
sense of acedia? Is there a diagnostic classification in terms of which we
can situate and understand the depression and related symptomatology
we’ve been discussing?
It is both significant and ironic that contemporary psychiatry has estab-
lished a category in which, with some stretching, it is possible to accom-
modate those who, overcome by the barrenness of a world of total work
and material acquisition, become conscious of its depressive nature and
feel the sapping effect of its superficial, frivolous, and empty gratifications.
This is the “disorder” that the DSM calls “adjustment disorder, with work
inhibition.” It is the closest that our current classification of psychological
disorders comes to acknowledging, albeit very indirectly, the potential
contributing role to human suffering of an exclusionary focus on work
that is out of control. The DSM diagnostic description is all too short
and not especially enlightening:

The essential feature of this disorder is a maladaptive reaction to an

identifiable psychological stressor. . . . The maladaptive nature of the
reaction is indicated . . . by impairment in occupational (including school)
functioning. . . . [T]he predominant manifestation is an inhibition in
work . . . occurring in a person whose previous work . . . performance has
been adequate. Frequently there is also a mixture of anxiety and depression.
(American Psychiatric Association, 1987, code 309.23, pp. 329, 331; in
APA, 1994 and 2000, absorbed under code 309.9)

“Adjustment disorder, with work inhibition” is a diagnosis that perhaps

reveals more about contemporary psychiatry than it does about the
correspondingly labeled patient. The label expresses psychiatry’s
assumption that engagement in the world of work is normal, adaptive,
and desirable and that a person who isn’t able to be engaged in work,
due to “an identifiable psychological stressor,” must be afflicted with a
“disorder of maladaptation.”
100 Normality Does Not Equal Mental Health

Here again we find blinders put firmly in place thanks to the presump-
tion that conformity with what is judged to be normal will lead to positive
mental health. With some help from the Scholastics, we can, however,
make some constructive progress beyond this limited perspective. It is
clear that a life of total work and consumption, along with its resulting
cultural impoverishment, can come to be felt as a severe and self-
undermining source of stress. When it does, and as seen through the lens
of the Scholastics’ acedia, work-engendered depression results.

TREATMENT OF WORK-ENGENDERED DEPRESSION

There is indeed, as Thomas Szasz (1957/1961) has protested, a tempta-
tion for society to justify its prejudices through its classification of psycho-
logical disorders. In a society that believes in the critical value of universal
work, leisure in the sense developed here—beyond minimal, regular
restorative vacations, which we accept as we do the need for the other type
of regularity—inevitably is felt to be a contrary value. In our devotion to
utility and technology we can find no room for culture in its root meaning.
Leisure and idleness are therefore equated, and in that equating we
have allowed nonutilitarian values, the antidotes to mediocrity, to slip
away.5 Because of our loosened grip on higher ends we live in a time when
“culture” is glorified as a kind of trivial pursuit (exemplified with pride in a
book such as Hirsch’s (1987) Cultural Literary: What Every American Needs
to Know). In this social context, not only is work-engendered depression
promoted, but finding a cure for it is made all the more difficult.
There is a certain naı̈veté and charm about the views of the medieval
theologians; certainly their outlook fit a society very different from ours
today. The responsibility fell to men and women in this distant past to
try to articulate how people should live in order to live in the best way
possible. To do this in a reasonable and convincing fashion, they needed
first to have a vision of the meaning of human life. This they did possess,
often to a religiously dogmatic fault. Yet perhaps it takes such excess to
persuade people who would otherwise have no other criteria with which
to distinguish “higher” from “lower” and who would otherwise live in a
mundane, one-dimensional world.
Treatment for work-engendered depression requires a meaningful pre-
scription for living. It requires the cultivation of values beyond utility that
can balance an unbalanced and now altogether normal obsession with
jobs, money, and things. Therapy for work-engendered depression cannot
be effective as long as acedia is identified with idleness, as long as we con-
strue depression due to the aridity of work without end as an undesirable
Acedia: When Work and Money Are the Exclusive Values 101

maladjustment away from a desirable state of psychological normality, as

an “adjustment disorder, with work inhibition.” To treat the variety of
depression that is acedia, we need to relinquish our fast hold upon the val-
ues that constrain us to lives devoted to serving Mammon. As clinicians,
we need to lift the blinders from our own eyes in order to help our clients
and patients overcome the debilitating blindness that our work- and
dollar-obsessed society has produced in them.

NOTES
1. As Robert L. Spitzer recently commented, “DSM’s . . . criteria specified the
symptoms that must be present to justify a given diagnosis but ignored any refer-
ence to the context in which they developed” (Horowitz & Wakefield, 2007, p. viii).
2. An earlier discussion of the subject-matter of this chapter was published as
an article, “Acedia: The Etiology of Work-engendered Depression,” in New Ideas
in Psychology 8(3), 1990, pp. 389–96. The account provided here is revised,
updated, supplemented, and the focus changed to fit the context of this book.
3. I am indebted in this analysis to several authors, principal among them Josef
Pieper, who, while in his nineties, corresponded with me in connection with
research for this chapter. See Pieper (1948/1963, 1977/1986), Jünger (1934),
and de Grazia (1962).
4. On the willful self-confinement of clinical narcissism, see Bartlett (1986a).
5. We examine the neglected psychology of mediocrity in Chapter 8.
 5

Barbarians at the Door: A Psychological

and Historical Profile of Today’s College
Students

Modern psychology at its best has a questionable understanding of the

soul. It has no place for the natural superiority of the philosophic life,
and no understanding of education.
—Allan Bloom (1987, p. 121)

During turning points in history, colleges and universities act as micro-

cosms in which we can sometimes see with particular clarity forces that
are less perceptibly at work in the larger society.1 We face such a turning
point today. The values that used to define higher education have been
pushed aside to make room for others that emphasize vocational educa-
tion and the making of money. In the process, not only has the nature of
higher education itself changed but so has what we as a society value.
Educators generally see this as a shift away from a traditional concep-
tion of higher education in which the liberal arts were central to a more
contemporary approach that responds to the dominant role technology
has come to occupy. Yet it is more than this; it is not an isolated phenome-
non confined to education. The quiet revolution that has occurred in the
education offered by our colleges and universities is a symptom of basic
and far-reaching change not only in America but in other highly industri-
alized nations as well. The international emphasis on vocational education
is a regressive change that marks, as we shall explore, the reestablishment
of a primitive view of humanity and of a fundamentally barbaric attitude
concerning the purposes of living. In the process, as we shall see, the stan-
dards that once defined the objectives of higher education have been low-
ered to accord with society’s judgment that the average, the ordinary, and
the normal should instead be the central concern of university education.
Barbarians at the Door 103

The progressive deterioration in American higher education, which has

become particularly acute during the past four decades, has been inevitable.
It has come about as a result of commitments that took deep root in the
fresh American soil of social and educational policy nearly two centuries
ago. On the foundation of these commitments, American higher education
has grown: At first its growth was stunted, then became warped, and now it
has withered. The historical process described in this chapter has been
accompanied by a process of psychological deformity that has culminated
in an epidemic of narcissism and its moral counterpart, barbarism.
As we review the history and underlying psychology, we’ll find that its
past has made the atrophy of American higher education unavoidable,
while narcissism and barbarity have spread because they are appropriate
responses to the psychological forces that animate that history.

WHAT HIGHER EDUCATION MEANT

Higher education is essentially an ideal, an ideal associated with a group
of values that for many centuries were thought both to make individual
men and women better people and to enrich humanity. Central among
them were these two:
First, it was thought that certain intellectual and artistic pursuits have
an intrinsic importance to human life. They have no special utilitarian
purpose, they do not satisfy particular social needs, they do not tend to
bring financial affluence or material comfort, yet they are essential to a
fully human life. They are of value in and of themselves, without connec-
tion to external gain or vocational advancement.
Secondly, it was accepted that there are comparatively few individuals
who are well suited to these pursuits. Only some possess the personal
qualities of intelligence, discipline, dedication, and interest to cultivate
them. It was nonetheless believed to be important to the well-being of a
civilized society that some people devote their lives to intrinsic values of
this kind. It was believed that among the students of higher education
are some who are destined to become scholars, scientists, poets, artists,
and religious leaders: men and women who can offer to others experiences
of a distinctive kind that lead to a freer, higher, and richer level of con-
sciousness. The world of pure theory, any genuinely aesthetic encounter,
contemplation and meditation—these are experiences that can liberate a
human being; they are the experiences that, it was believed, express
human nobility and excellence.
They lead to habits of mind and of practice that transcend the workaday
world; their importance is wholly intrinsic, for they open doors to an
104 Normality Does Not Equal Mental Health

altogether different level and quality of living. Their cultivation elevates

humanity as a species, not only those who are members of its elite—
provided that one sees humanity as a brotherhood in which those who
devote their lives to higher values add to the measure of each. For this rea-
son, when the ideal of higher education was current, even the common
worker felt a sense of respect for the liberal arts, however far removed from
them his or her own toil might be. This respect expressed a framework of
understanding and of values in which life could be situated and lived with
dignity and meaning. The average worker had a sense of place in the world,
a world in which some learning was clearly “higher” and some “lower.”
Culture and leisure for the few: these are essentially the traditional val-
ues of higher education. It is a now rapidly disappearing objective, this
cultivation of the liberating arts by a small minority who possess the
required interests, abilities, freedom from everyday work, and leisure.
These are values not of our time, clearly out of place and out of pace with
contemporary society.
Our response to an ideal—through allegiance that is given or is
withheld—is a psychological event. It is within this psychological, value-
laden context that we should look for an understanding of what today’s
college students, and their faculty, care about, what they value, and what
they don’t. This psychological substructure is, as we will see, responsible
for the decline of higher education, a subject that has been much discussed
but as yet not examined in terms of its underlying psychology.

THE DEGRADATION OF THE IDEAL OF HIGHER

EDUCATION AS A RESULT OF DEMOCRATIC VALUES
Materialism, among all nations, is a dangerous disease of the human
mind, but it is more especially to be dreaded among a democratic people
because it readily amalgamates with that vice which is most familiar to
the heart under such circumstances. Democracy encourages a taste for
physical gratification; this taste, if it becomes excessive, soon disposes
men to believe that all is matter only; and materialism, in its turn, hurries
them on with mad impatience to these same delights; such is the fatal
circle within which democratic nations are driven round.
—Alexis de Tocqueville, Democracy in America

American society today believes that there are three interlinked truths: (1)
opportunity should be equal for all, (2) equal opportunity will yield equal
results, and (3) equal education for all equalizes opportunity and therefore
brings about equal results (van den Haag, 1974). This myth of egalitarian-
ism has very little to do with democracy.
Barbarians at the Door 105

Dewey tried to place the myth in its proper place:

Belief in equality is an element of the democratic credo. It is not, however,

belief in equality of natural endowments. . . . The very fact of physical and
psychological inequality is all the more reason for establishment by law of
equality of opportunity, since otherwise the former becomes a means of
oppression of the less gifted. . . . [W]hat we call intelligence [is] distributed
in unequal amounts. . . . The democratic faith in equality is the faith that
each individual shall have the chance and opportunity to contribute
whatever he is capable of contributing and that the value of his contribution
be decided by its place and function in the organized total of similar
contributions, not on the basis of prior status of any kind whatever.
(Dewey, 1949, p. 60, italics added)

Individual variation is a condition of evolution; it is also the spice of life.

Fortunately, we are not all the same. Our intellectual and practical skills as
well as our interests, aptitudes, capacities, and abilities differ. But miscon-
ceived democracy based on the myth of egalitarianism is precisely an attack
on individual variation and hence on individuality. In our zeal for equality
of opportunity, we have mistaken democracy for a commitment to con-
formity and uniformity, a commitment that elevates normality so that it
becomes a desired standard, in the belief that only when men and women
are homogenized is there real and assured equality: one person is then as
good as any other as an interchangeable part in the social machine, and
democracy and communism find a common point of contact.
The main psychological force that leads to this veneration of equality
by advocates of democracy is their manifest fear of superiority, fear of
the discriminatory entitlements that it is natural to bestow upon men
and women who, in different respects, are our superiors.
In America, the only evidences of superiority that we will comfortably
tolerate are in sports, in the accumulation of monetary wealth, in military
success and rank, and in show business. Celebrities in these areas do not
threaten egalitarianism because the common person is persuaded that he
or she, too, could accomplish such things, if circumstances were right—
that is, if the proper opportunities were assured, and possibly if he or she
possessed the requisite physical capacity. Natural physical superiority can
be forgiven in a democracy, perhaps because it has close and familiar ties
with physical labor, which levels differences.
But, if we advance a step further, we tread on thin ice: the performances
of outstanding fine artists, and here I am referring to virtuoso perfor-
mances of classical music and ballet, though they are physical in nature,
reveal a superiority of accomplishment that is too distant from what the
majority can aspire to. Such displays of attainment are intimidating for
106 Normality Does Not Equal Mental Health

this reason and, as we will see, for another as well, because of the disquiet-
ing addition of the ingredient “culture.”
The step from athletic proficiency to intellectual superiority puts us in
a markedly different universe of uneasy values. To be tolerable in our
egalitarian democracy, intellectual superiority must be excused, disguised,
and brought down to a commonplace level. The only intellectuals who are
really acceptable in America are those with dirt under their fingernails,
who speak like any Joe, who possess no unusual qualities of personal dis-
tinction, who would, in short, just make good drinking buddies. An article
about Bill Bennett, secretary of education for the Reagan administration,
is typical: “He holds a B.A. and Ph.D. in philosophy and a J.D. in law,
plays a deadly serious game of touch football and is a former rock-band
guitarist who is at home with Plato, Shakespeare and Thomas Aquinas.
The cozy world of academia never blunted his street smarts; the privileges
of his education did not make him an elitist. . . . [H]e not only read classics
in Latin, but played on the school’s winning football team” (Evans &
Novak, 1988, p. 106). Bennett’s higher degrees can be once forgiven
because he played football, and twice forgiven because he played “on a
winning team.” In short, Bill is really an all-American guy even if he does
have a few degrees.
Similarly, Nobel Laureate in physics Robert Feynman was democrati-
cally acceptable because he could play a mean rhythm on the bongos,
could handle himself in a fist fight in the men’s room of a bar, made quips
that entertained the press, and joined a Stockholm students’ ceremony
for Nobel Prize winners by making frog noises and jumping backward
(Grobel, 1986).
The confused equation of democratic equality of opportunity with
egalitarianism, particularly during the past 40 years, has led, as we shall
see, to a society that prefers the blindness of indiscrimination to the risked
sins of discrimination, to a society that favors laxity in its educational
expectations and that unquestioningly neglects and repudiates values not
closely linked with financial aggrandizement.
The history of higher education and the history of culture and civiliza-
tion to which it is linked are made up of two kinds of change: we can dis-
cern some patterns that, for a time—and perhaps a long time—endure,
while many quickly pass. One of the most fascinating challenges for the
social psychologist and the historian is to understand the reasons for this
difference between the momentary and the comparatively enduring,
between the ripples of fads and significant turns in the river.
As we examine the internal dynamic of higher education, we will see
that its history has made two interrelated consequences inevitable: the
deterioration of the schooling that American higher education can offer
Barbarians at the Door 107

and the spread in our society of pathological narcissism and of its result,
barbarism. This dynamic is strong and self-reinforcing, so much so that
there are convincing reasons to believe that the social and psychological
phenomenon of barbarism is here to stay, perhaps for a long time.

THE SELF-UNDERMINING HISTORY OF HIGHER

EDUCATION IN AMERICA
In a single year, America spends more upon higher education than all the
people of the world, throughout history, had spent upon the higher
learning down to the time of the Second World War.
What generosity, how indiscriminate, how ineffectual!
—Russell Kirk, Decadence and Renewal in the Higher Learning

From the perspective of the 1830s, the young American republic was
enlightened and intelligent compared with Europe. So it seemed to
French social critic Michael Chevalier in his study of American society,
Society, Manners, and Politics in the United States. Speaking of the France
of his time, Chevalier says:

Examine the population of our rural districts, sound the brains of our
peasants, and you will find that the spring of all their actions is a confused
medley of biblical parables with the legends of gross superstition. Try the
same operation on an American farmer and you will find that the great
scriptural traditions are harmoniously combined in his mind with the
principles of moral and religious independence proclaimed by Luther, and
with the still more recent notions of political freedom. (Chevalier 1838/
1961, Chap. 34)

In retrospect, the schooling offered by American higher education at the

time Chevalier wrote supports his judgment. Consider the work still
required of freshmen at Oberlin in 1877: The first term, they studied Livy,
Xenophon’s Memorabilia, Greek prose composition, and algebra. The
second term, Horace, Lusias, Greek prose composition, and solid and
spherical geometry. The third term, Cicero’s De Senectute, Herodotus,
German, and more geometry.
This solid, no-nonsense curriculum that trained both mind and moral
sensibilities was quick to give way before pressures that would mock
Chevalier’s observations. Some of these pressures greeted the Oberlin
freshmen virtually upon their graduation: The forces of change were
already at work in the 1840s as increasing numbers of Irish peasants and
workers came to this country. The influx of the many thousands kindled
the fear in America that unless determined steps in educating the
108 Normality Does Not Equal Mental Health

immigrants were taken, the settlers would bring with them the seeds of
European class conflict and despotic government. As a result of the per-
ceived or imagined threat to the tender new American democracy,
reformers like Henry Barbard and Horace Mann argued on behalf of
national compulsory education, schooling for everyone.
This was to be the first nail to be driven into the cross-in-the-making
for “higher” education. From this time on, education in America, includ-
ing the so-called higher education offered by its colleges and universities,
would succumb to a succession of policies that in time would corrupt aca-
demia from within.
Consider. The task of educating the incoming tide of immigrants was
above all intended to initiate the settlers into American ways, and so the
emphasis of education quickly became nonacademic. By the turn of the
century, the schools stressed manual training and vocational education.
Their aim was to produce useful Americans: efficient workers and politi-
cally enlightened citizens. Education in America henceforth would serve
the interests of social management.
By 1908, the National Education Association was urged (by a group of
businessmen) to include industrial and commercial subjects in elementary
schools. Since 70 percent of elementary school students never went on to
high school, the best schooling for them ought to be, the NEA pro-
nounced, “utilitarian first, and cultural afterward” (Callahan, 1962, p. 10).
By 1910, public insistence became more widespread that education
should not emphasize academic subjects, the ingredients of “a gentleman’s
education.” Manual and industrial training were the needs of the day.
Why the protest? Because the American public was incensed at the high
rate of failure of its children in schools that still provided academically
oriented programs of study. The democratically minded public discerned
that higher education must be disassociated from “culture.” The interests
of the normal population would need to be met.
A second nail was hammered into place. Education would march to the
drum of “manpower training.” The interests of American industry would
increasingly subvert the academic values of higher education. The college
curriculum devoted to mathematics, the classics, languages, grammar, his-
tory, and rhetoric was transmuted into the baser metals of vocational edu-
cation, citizenship, health science, homemaking, commercial English,
secretarial skills, and accounting—all valued because of their practical
utility. “Culture” was to become more and more of an afterthought until,
in its original, liberal, and liberating meaning, it occupied no place in the
minds of American educators.
It is important to observe that not only did the content of education
change at this time but, at least of equal and perhaps of greater
Barbarians at the Door 109

importance, so did its tenor: rapidly disappearing was the sense of reverence
that characterized the teaching, and the learning, of the older curriculum.
This reverence was not transferred to commercial subjects; instead it
evaporated. The shift away from a higher learning devoted to culture
was in fact, as we can now see clearly in looking back, a shift away from
contact with values capable of eliciting reverence. The values of careerism
and acquisition of money took their place, but reverence was a thing past.2
We will return to this subject later on.
In keeping with America’s democratically inspired hostility toward
social classes, American educators were mulish in their commitment to
the integral high school: they rejected the European model that routed
some students to universities and others to vocational and technical
schools. Democratic equality, the educators felt, was opposed to any form
of schooling that discriminated between students who were “college
material” and those who were best served through job training. The
enthusiastic populace, in their celebration of equality, had discovered
anti-elitism, and this mindset drove a third nail in place.
The period from 1910 until the Second World War was one of con-
solidation. College and university policy makers became more heavily
entrenched in dissociating higher education from culture and in enforc-
ing a democratic, anti-elitist integration of manual laborers, tradesmen,
professionals, and intellectuals in the schools. Belief in the value of
universal compulsory education soon spilled over into the belief that
everyone should go to college and, most importantly, that college should
be useful.
Professor George Boas at Johns Hopkins was a glaring example.
During World War II he argued: “If training men in trigonometry and
physics and chemistry, to the detriment of the humanities, will win the
war, then for God’s sake and our own, let us forget our Greek, our Latin,
our art, our literature, our history, and get to business learning trigonom-
etry and physics and chemistry” (Kirk, 1978, p. xix).
During the same period, demoniacal Harry Hopkins was especially
eager to enlist higher education:

Every college and university should be turned into an Army and Navy
training center. The women, too, should remain in college only while they
are being trained for their part in the war effort.
High school hours should be shortened so students will have more time
to work, especially on farms. . . . I can see no reason for wasting time on
what today are non-essentials such as Chaucer and Latin. A diploma can
only be framed and hung on the wall. A shell that a boy or girl helps to
make can kill a lot of Japs. (quoted in Kirk, 1978, pp. xix–xx)
110 Normality Does Not Equal Mental Health

Once the war had been won, thanks to these and other more final sacri-
fices of youth, others had still to be made.
Colleges across the country were flooded with war veterans who,
regardless of their academic abilities, were encouraged to enroll under
the GI Bill. Enrollments blossomed. New buildings were thrown up.
Unfortunately, in a few years, once the GIs were graduated, the schools
were left holding expanded facilities and overstocked faculties, which had
to be filled and supported, respectively. The emphasis of higher education
therefore turned to “recruiting” replacements for the departing soldiers.
To justify their recently expanded “physical plant” and to maintain their
now longer payrolls, the schools were forced, or they felt that they
were, once again to put academic standards aside and to engage in attracting
students.
In 1957, the Soviet Union put its first manned satellite into orbit. The
Eisenhower administration was alarmed. In 1958, the National Defense
Education Act accordingly was passed. Funds were appropriated and dis-
tributed to colleges and universities across the country. Teacher training
and foreign language programs were given special attention, because the
government associated them with national defense.
Here, then, the fourth and last nail was driven into higher education’s
cross. It was to be a nail of an entirely different sort. It was what general
systems theorists call “recursive,” since it comprised a self-perpetuating,
or self-reinforcing, element in the “system” of higher education. On the
one hand, the departing GIs left universities hurting for students; on the
other, the government decided to fund the expansion of higher education,
adding to the need to find new students. A self-cycling snowball effect was
set into motion, one that evades efforts to control it, and one that develops
a mind, or more accurately a mindlessness, of its own. As we shall see, this
recursive phenomenon was to recur in different forms in the more recent
history of higher education in this country. In conjunction with the other
three nails that have crucified higher education—the convictions that
higher education should be universal, that the education offered should
be useful and not “genteel culture,” and that higher education should be
opposed to intellectual elitism—a system with an extremely stable internal
dynamic resulted. It is self-perpetuating, and it is highly resistant to
efforts to change it.
Caught with a host of student vacancies to fill, colleges and universities
in the early 1960s found the public outcry that everyone has a right to be
in college very agreeable. The challenge posed by the student recruitment
problem was met by making higher education easier and more entertain-
ing to students. The gates to academe swung so widely open on their
Barbarians at the Door 111

hinges that the catchy and candid phrase “open admissions” was added to
the advertising vocabulary.
Other events reinforced this trend. There was the civil rights move-
ment of the 1960s, followed by black power. They heightened our
democratic sensitivity to minorities and the handicapped. Social con-
sciousness was expanded and equal opportunity education resulted.
Colleges and universities embraced a family of nonintellectual functions,
ministering to the diminished self-esteem of the poor, the disadvantaged,
the handicapped, and the downtrodden minorities. Higher education
responded to its new calling by becoming social counseling and therapy
for its students.
In 1965, Congress granted $848 million to subsidize higher education.
Funds were suddenly available for further physical expansion, for the train-
ing of more teachers, and for substantial student financial aid in the form of
scholarships and loans. The upshot was that virtually anyone could attend
college, without regard to aptitude, preparation, or dedication.
In 1969, the Carnegie Foundation for the Advancement of Teaching
asked the Nixon administration for greatly increased funding. Four billion
dollars were appropriated in 1970. By 1976, funding would run in excess
of $13 billion.
The Vietnam war added another log to the self-fueling blaze. Legions
of students enrolled in universities to avoid the draft. In response, faculty
whose social consciences were disturbed by the war eased their academic
demands on students who, if they received the lower grades they merited,
would become cannon fodder. At the same time, the clamoring students
insisted that higher education respond to their personal demands for rel-
evance and subjective gratification. The “new courses” that resulted,
designed to pacify, lowered standards still more.
The offerings of “higher education” now included such tantalizing
attractions as Electronic Existentialism (the “philosophy” of rock groups)
and Philosophy of Physical Education, which wormed their way into the
pabulum curriculum that offered bachelors’ and graduate programs in
Food Distribution, Packaging, Agricultural Journalism, Ice Cream and
Wine Making, and courses in the then-burgeoning, vague new field of
“Communications.” From LaMaze Methods for La Leche Mothers to
Death and Dying and Hostel Management, the curriculum offered a
womb-to-tomb varied diet, not intellectually nutritious.
During the decade of the 1980s, leniency and anti-intellectualism
spread more quietly. Declining numbers of students pushed standards
lower still, as colleges and universities scrambled to attract even less
qualified students to fill their classrooms and wallets. Programs in classics,
112 Normality Does Not Equal Mental Health

foreign languages, and even theoretical science dried up and disappeared.

As a mass, students and the vast majority of their teachers turned from the
more serious and demanding academy, its receding image lingering
faintly in the haze, to the radiant, freshly polished idol of financial aggran-
dizement.
This trend strengthened even more during the 1990s and the first
decade of the new century as a menu of university degrees was and con-
tinues to be advertised, showcasing the lifetime income each degree can
be expected to net. During this period university research in “pure sci-
ence” has been transformed and harnessed to the financially rewarding
interests of such fields as engineering, materials science, nanotechnol-
ogy, computer science, biotechnology, and telecommunications.
Universities now pride themselves on the number of new patents they
register each year and the number of spin-off companies their faculty
and students establish.
Attending college is now no more and no less than the most direct road
to material gratification. Mass education is America’s springboard to
economic development. The university has relinquished its control
to the marketplace. Higher education knows that it now pays only lip
service to culture: its real purpose is to cater to students who want, more
than anything else, to make money. Students and their parents now com-
monly apply a two-step decision process in choosing a university: the
costs of attending name-brand private institutions are compared with
those of less expensive state universities, and the totals are then compared
with the projected dollar value of the two varieties of degrees once the
student has diploma in hand and enters the workplace. (Money Magazine
recently ran a feature article that, without a shadow of shame, does
exactly this.)
This situation has been a necessary consequence of our history. From
the time of the migration to America more than a century and a half ago,
education in America, as we have seen, has been forced to respond to pub-
lic demands that it be useful and responsive to the real world of practical
and ultimately financial affairs. Its foundation was universal, leveling,
compulsory education. Next came the dissociation of higher education
from culture, from the essentially contemplative nature of the traditional
higher learning that inspired a feeling of reverence. Elitism, most espe-
cially cultural elitism, which would select university students on the basis
of their intellectual and creative abilities, was then declared the enemy of
the equality-sensitive republic. History has trapped education in a system
of self-reinforcing feedback that has turned colleges and universities
across America into cafeterias for careerism, with moneymaking heralded
as the supreme value.
Barbarians at the Door 113

This is the heritage of American higher education. We turn now to

look at its underlying psychology.

THE PATHOLOGY OF NARCISSISM

No patient I have ever encountered is free of narcissistic problems. At
least a third of our patients have this as the leading psychopathology,
the central one, the nuclear one around which the tide has to be turned.
People argue with me and say it must be two-thirds. Has this always been
so, or is this something recent? Is it only that our attention has been
sharpened so that we diagnose it more, or is it indeed increasing? I do
not know the answer to that but I believe that it may be on the increase,
and the question is, “Why?”
—Heinz Kohut, The Kohut Seminars on Self Psychology and Psychotherapy

In the past century there have been three main psychological consequences
of the history we have traced, each contributing to bring about the next.
After two world wars against totalitarianism, Americans have been
conditioned to feel a reflex arc enmity toward authority. Complete
authority embodied in the state is totalitarianism, but authority also
extends to the discipline we require of our children and fellow adults, as
it does to the values to which we adhere and to the standards of conduct
and competence that we respect.
In their rejection of authority, Americans overgeneralized, and they
rejected much: values, standards, and discipline were weakened, loosened,
rendered vague, or shelved.
When the experience of children, or of adults, is freed from the regulat-
ing effects of authority, life takes on a quality of arbitrariness. We come to
think of laws and standards as mere conventions; our outlook becomes
culturally relativist, tentative, multiculturalist, and ever subject to doubt,
reappraisal, and relegislation.
At the same time that American society and most of the free world
acquired this antipathy toward authority born of a fully justified fear of
its political consequences, the traditional sources of balance in human val-
ues began to find themselves in trouble: religion, the classical heritage,
and philosophy lost their capacity to elicit genuine reverence. Respect
for higher education and for its professors, the transmitters of this cultural
tradition, began to deteriorate.
Rejection of authority and loss of respect for the standards affirmed by
tradition led to a second psychological consequence: a spreading attitude
of leniency that was camouflaged as tolerance—leniency in the home, in
the courts, in corporate and governmental affairs, and, of course, in the
schools, which concern us here.
114 Normality Does Not Equal Mental Health

At the height of the 1960s, a pamphlet published by Stanford’s first-

year students, called Freshmen Voices: Student Manners and Morals, gave
eloquent testimony:

Our morals, or lack of morals, show our increasing conviction that there is
nothing absolute or dependable in this world, that nothing is real and no
purpose is valid unless we make it so and believe in it. There is no God, or
if there is, the code that people attribute to him is only an invention of man.
There is no country in itself worthy of patriotism, unless its ideals coincide
with what we personally feel is just. And since Nuremberg, we even feel that
a person must decide whether the laws are good and should be followed, or
bypassed because they contradict what he believes are right.

The period of the 1960s is of special interest to social psychologists

because it shows us how children who have been brought up in an atmos-
phere of indulgence and leniency will turn in anger on their society to
express their pent-up resentment that the guideposts for meaningful living
had been stripped away. The children of the 1960s were looking for the
authority that had been withheld from them, even if it were only an
authority they could challenge:

No one ever firmly said “No!” As tiny children are said to court
punishment, that they may learn definitely what is permitted and what is
not, so the college generation of these years probed again and again for
solidity, but encountered only flabbiness. Without vice there is no virtue;
without folly there is no wisdom. The rising generation could not discover
virtue or vice, wisdom or folly: only the phrase of empty consolation: “Do
your own thing.” Without authority, the world was meaningless. (Kirk,
1978, p. 71)

The loss of firm and respected sources of human values together with
the epidemic of leniency led to a third psychological consequence. Clini-
cal narcissism, believed by many clinicians to be a disorder of the self they
increasingly find in their clients, goes considerably beyond self-
absorption. We will refrain from taking a leap to reification, discussed in
Chapter 2, and stop short of making narcissism a form of “mental illness.”
It is, however, as we shall see, an appropriate response to certain of the con-
ditions that have come to make our society what it is.
Freud mentioned narcissism only in passing, and in a sympathetic con-
text: “[A] person who is tormented by organic pain and discomfort gives
up his interest in the things of the external world, in so far as they do not
concern his own suffering. Closer observation teaches us that he also with-
draws libidinal interest from his love-objects: so long as he suffers, he ceases
Barbarians at the Door 115

to love” (Freud, 1914–1916/1957). Narcissism in Freud’s sense is induced

not only by physical pain but by chronic illness and disability and by the
loneliness and incapacity of old age. Natural narcissism of this kind is tun-
nel vision brought on by suffering from which there is no escape.
Clinical psychology’s description of narcissism has broadened from this
early basis in an effort to understand a specific variety of pathology of per-
sonality called “narcissistic personality disorder.” Central to its study has
been the work of Heinz Kohut and Otto Kernberg (especially Kohut,
1971, 1977; Elson, 1987; Kernberg, 1975, 1980, 1984). The pathology
of narcissism is most effectively understood if we appreciate both how a
person develops the condition and why it has been considered to be a dis-
order or illness.
Clinical narcissism, which I’ll refer to simply as “narcissism” from here
on, is often thought to arise as a result of a childhood trauma that drives
the child to build rigid fortifications to protect against further pain. In
time, these defenses wall the person off from others.
Alternatively, it has been suggested that narcissism comes about in
reaction, or as a result of subjugation, to the twisted unreality of a “schiz-
ophrenogenic parent.” The child attempts to insulate himself from the
parents’, most often the mother’s, confused and conflicting demands,
expectations, and distorted style of communication, and isolates himself
in a world of his own.
A third hypothesis has gained wide acceptance. It claims that narcissism
develops when a child is raised without “confirming” or “mirroring” expe-
rience. Again, it is usually the mother who plays the dominant family role:
When she is herself self-absorbed, she sees her child as an extension of
herself, and so does not really respond to the child at all, but only to her
own projected needs. Typically, the child experiences an alternately suffo-
cating and cold or indifferent mother. The father often is absent, physi-
cally or emotionally; he either is just not there but, for instance, is
always at work, or else he distances himself from the family and remains
emotionally uninvolved. The result is a child whose early needs for accep-
tance and affirmation as a separate and unique person fail to be satisfied.
The child then develops a set of symptoms associated with a deficient
sense of self.
Writing in the 1960s, before the diagnostic vocabulary of narcissism
had been honed, psychologist Salvador Maddi observed:

All you need to develop a premorbid identity is to grow up around people

in significant relationship to you who value only some aspects of you, who
believe in social roles and biological needs as the only defining pressures
116 Normality Does Not Equal Mental Health

of life, and who are either afraid of active symbolization, imagination, and
judgment, or see no particular relevance of these processes to living. Have
these significant people act on their views in interactions with the child,
and he will develop a premorbid identity. (Maddi, 1967, p. 324)

Before we look at the symptoms that characterize narcissism, it is worth

noticing that the three explanations of the condition agree on one thing:
that the early experience of the child leads him or her to erect barriers to
further pain. This self-isolation is at the heart of the disorder.
If one were to make a composite portrait of the narcissistic personality
from the work of its main contributors, it would look like this:
We are first struck by his or her intense preoccupation with the self.
Behind this surface aspect of self-absorption, his (or her, understood
throughout) feelings are blunted; his perception of the world is flat and
monotonous. He is driven to seek stimulation, “to make life feel real,”
and so tends to wear masks, to lie, to deny, to blame, and wish for power
and infallibility. Megawatt rock music fills his need for a bombardment
of noise that can drown out or mask the dullness he feels, what Russell
Kirk has called “the tyranny of the auditory nerves”: “[T]he scholar’s lamp
. . . glows uncertainly in the blast of cacophony. . . . Within nearly all the
dormitories and fraternities of the typical American campus, cacophony
triumphs insanely” (Kirk, 1978, p. 213).
The narcissist tries, in short, to compensate through excited hyperac-
tivity and self-stimulation for a feeling of inner depression, apathy, and
deadness. Because of a feeling of purposelessness, he seeks comfort in con-
formity. His “chameleon personality” yearns to be “just like others”; only
then does he feel affirmed, stable, real. He receives emotional support,
social company, and stimulation from being “wired in” at all times
through social networking, e-mail, his cell phone, and other devices.
And of course he is attracted to the famous. He seems to gain a
strengthened sense of self and personal value through the admiration he
directs toward celebrities, whom he sees as extensions of himself. Our
society’s celebration of the celebrity originates here. But the mirage can-
not be sustained: Celebrities “have more” than he does. Their lives are
therefore fuller, more real. Like Envy in Doctor Faustus, he asks, “Why
shouldst thou sit, and I stand?” He yearns for the trappings of affluence,
for affluence encourages the unexamined life.
External demands are an unwelcome drain on his energy, and so he
evades personal accountability and the judgment of others. As a student
and later on in life, he seeks the path of least resistance and, best, the path
that can distract and entertain. He wants less work, but even more he
wants to evade judgment of its quality.
Barbarians at the Door 117

His psychological world is painfully confined to immediate experience.

He cannot appreciate what came before the self—that is, history—or what
will come after him—the world he will leave to his descendents. For him,
history and the future do not exist as realities; he needs to have the “story”
of history portrayed to him in the present tense to make it feel real. He
cannot reconcile the demands of the fleeting moment with the sometimes
vaguely imagined permanent things that require an attention and care that
transcend his cramped world.
Enduring personal relationships—friendships, love affairs, and mar-
riage—demand more than he can give. His substitute is a mania for elec-
tronic gadgets and in particular an infatuation for the latest electronic
means to fill his time with shallow socializing and the exchange of trivia.
His sense of self never solidifies and integrates; the earth moves beneath
his feet and he is constantly unsettled by the demands of new experience.
More than anything else, he is driven by the desire to be accepted and
admired by his peers. He therefore invests his emotional energy in exter-
nal appearances, extensions of himself. He focuses on money and on
career, the two yardsticks that our society esteems as measurements of
personal worth. Career advancement and monetary success are expressly
public ratifications of a person’s value. The narcissist hopes to find per-
sonal affirmation in the public spectacle of material success.

These, then, are some of the main characteristics of narcissism. They

describe a condition that most psychologists today judge to be dysfunc-
tional, a “disorder of the personality.” In Chapter 2, I raised a group of
objections against the inflationary trend in psychiatry that reifies mental
disorders. Reflective readers may therefore want to know how the concept
of pathology may be applied within the framework of clinical psychology
and at the same time steer clear of an extravagant ontology that populates
reality with mental illnesses thought to be disease entities. While many
psychologists today consider extreme, clinical narcissism to constitute a
“mental illness” à la DSM, my intent here is rather to refer to a psycho-
logical condition that constitutes a harmful functional impairment—an
impairment that does not postulate or assert any type of organic dysfunc-
tion, disorder, or breakdown of an inner “psychic mechanism.” From this
standpoint, to call narcissism pathological is to apply a heuristic concep-
tion of problem solving and not a concept of psychiatric nosology: When
I refer to narcissism as a “pathology,” “disorder,” or “dysfunction,” this
language is intended to draw our attention to a specific set of undesirable,
harmful functional shortcomings of narcissistic individuals. To be
118 Normality Does Not Equal Mental Health

psychologically impaired is not necessarily in any sense to suffer from a

disease or illness.
But in analogy to physical illness (and this is expressly an analogy—that
is, only a metaphor), to be functionally narcissistic is both incapacitating
and socially and culturally contagious. Narcissism constricts a person’s
world, undermines his or her personal relationships, and forces him or
her into a partial and embittering existence that can never satisfy a hunger
for individual acceptance and confirmation. The narcissism that affects
America is a disability that constrains a person to perpetual dissimulation,
to living a life pretending that a shallow existence of social mimicry and
material acquisition is full. And like certain other emotional impairments,
narcissism is contagious—that is to say, a narcissistic mother or father will
tend to recreate in the upbringing of a child the very conditions that
emotionally isolated the parent.
We have traced the outlines of nearly two centuries of the history of
higher education in America and sketched a portrait of clinical narcissism.
The connections between the two are unmistakable: Our society’s history
has favored egalitarian homogeneity. It has removed culture from the
public’s consciousness and appreciation as a result of its single-minded
devotion to utility. It has vigorously opposed cultural elitism, which is,
despite its unfortunate association with unnecessary snobbery, a public
expression of a scale of values with a clearly defined sense of “higher”
and “lower.”
Not very long ago, Americans and Europeans, like any civilized people,
realized that the spectrum from philosopher to menial laborer revealed
something important about human life and about the values that make
living worthwhile. The distance separating the contemplative from the
manual life was conceived not in terms of a leveled range of human abil-
ities, as it is now, but it expressed a hierarchy in which reverence for cer-
tain values was natural and meaningful. Culture has ceased to be an axis
mundi. We have yet to find another that gives men and women direction
in living. In place of culture, we have placed well-paying jobs, and even
here we are loath to recognize that some ways of amassing money are
inherently more meaningful than others. And yet, “working as a brain sur-
geon is almost certainly more meaningful than working as a salesman of
used cars” (Pines & Aronson, 1988, p. 138, who argue that our society’s
failure to legitimize such discriminations is at the basis of much career
burnout).
When the sense of reverence and respect to which I refer is lost, higher
education, on the one hand, is brought low; on the other, narcissism is
made to spread. Higher education in which the word ‘higher’ is drained
of meaning reinforces on the social level the same phenomenon that
Barbarians at the Door 119

American family life brings about on an individual level. Our sham educa-
tion takes neglected children who know only leniency and produces sham
people—narcissistic, incomplete people who are handicapped for life by
their schooling and by a society committed to mediocrity, as we shall see
in Chapter 8, none of which can satisfy the narcissist’s emptiness.
If we shift our perspective from psychology to human judgment, we
realize that narcissism is ultimately barbarism.

BARBARITY AS A STATE OF MIND

In the space of two or three generations, enormous stretches of the
“Judaeo-Christian tradition” . . . have passed into oblivion. The effective
loss of cultural traditions on such a scale makes talk of a new Dark Ages
far from frivolous.
—Christopher Lasch, The Culture of Narcissism (1979, pp. 260–61)

To call a man or woman a barbarian is to indict him or her for lack of

civilization, for lack of cultivation, for lack of culture. Barbarity is more
than the poverty of a loincloth—clothes, at least, have evolved—it is a
state of mind. The ancient Greeks and Romans used the term to deprecate
men and women outside their civilization who lived in primitive condi-
tions but, in particular and more importantly, to name those with no sym-
pathy for and comprehension of culture.
As we saw in the last chapter, culture is linked to cultus, to a public sense
of respect and admiration, if only from a distance, toward a source of value
that lies beyond the satisfaction of immediate human wants and needs.
Culture is free from practical considerations: To be cultivated is to pos-
sess a refinement that puts mundane reality in its place, in perspective. It
is, in a sense, to have one’s head in the clouds while walking on the earth.
It is an attitude; it does not derogate the importance of practical things—it
is important to emphasize this—but neither is it their servant.
Culture is humanity’s link between a world of mortality, finitude, work,
and everyday cares, and a world of freedom from these burdens. Cultus
refers to the capacity to step beyond the immediate and the mundane.
Divine worship makes it possible for people to take this step, as do the lib-
erating arts—philosophy, literature, fine art, music, and pure theoretical
research.
Those for whom this world of freedom from utility does not exist are
trapped in barbarity. Their shrunken sphere of concerns is limited to the
satisfaction of immediate biological needs and desires. The only growth
of perspective that can be expected of them is that they may develop an
anxiety concerning the future satisfaction of those same immediate needs
120 Normality Does Not Equal Mental Health

and wants. The result—“the barbarian with a pension plan”—is no more

of a contradiction in terms than is “a squirrel that stores nuts.” Neither
the store of nuts nor the pension elevates.
Barbarity is an impoverishment of mind. It is an exclusive preoccupa-
tion with material gratification. It is a blindness to the feelings and
autonomy of others. It is a lack of sensibility. And it is all that follows from
these: savagery of manners and a desire for stimulation—the excitement of
violence and sex, alcohol and drugs, and a sufficiently loud throb in music
to permeate and exhilarate a dulled consciousness.
It isn’t necessary for us to translate this meaning of barbarism to a
higher level to see that today’s college students, as a group, exhibit all of
its defining characteristics. But then, outside of the ivy-covered walls, so
does most of the society at large.

THE MEDIOCRE POPULATION, THE NEW BARBARIANS

Mediocrity, as we shall see later on, often takes the form of an intellec-
tual impairment. The medieval Scholastics would have called it a state of
impoverishment of the soul, an ignorant or willful confinement of vision
that glorifies the trivial, the fatuous, the superficial.
In the last chapter, we saw how the medieval moral theologians identi-
fied an impoverishment and illness of the soul, which they called acedia.
The mediocrity and social mediocracy in view here are manifestations of
just such a psychological impoverishment. Modern psychology does not
yet include mediocrity among its clinical categories, yet there can be no
doubt that it is a stultifying and infectious disorder that permanently dis-
ables. Mediocrity is a blindness not of the eyes but of the mind, and in par-
ticular of that part of the mind in which our special cares and sympathies
take up residence. Mediocrity is a disability of values, as we shall see in
greater depth in Chapter 8.
The blindness of mediocrity is reflexive, that is to say, when men and
women have this blindness, they cannot, for their very blindness, see that
they are blind.3 The world of their cares is hermetic, exclusionary of all
that does not gratify consumption, provide an adrenaline fix, or act as a
soporific. In short, for the mediocre, culture does not and cannot exist.
If we extend the diagnostic vocabulary of clinical practice to include
mediocritized consciousness, today’s disjointed pieces of the puzzle of
higher education become easier to fit together. Assembled, they might
look like this:
American education is controlled by an egalitarian distortion of democ-
racy that flattens individual differences and glosses over distinctions.
American family life is driven by the themes of money and career. They
Barbarians at the Door 121

feed parental narcissism, which widens the emotional distance to children

who are raised in an atmosphere of neglect and permissiveness. Family dis-
cipline and its social equivalent in the justice of the courts are fumbling
affairs of leniency rationalized as tolerance. Caught in this web of laxity,
indiscrimination, and materialism, the young, by the time they are ready
to enter college, have established within themselves a mental fixity born
of fear and disorientation that is strikingly narcissistic in its monadic self-
encapsulation, in its fear and resentment of authority, and in its conformist
rigidity and intellectual lassitude.
The result is the high-tech barbarian: rude, without appreciation for
culture, crude in his tastes, raucous in his behavior, enthralled by the loud
pulse of his music, and devoted to the accumulation of megabucks and the
amassment of the shining baubles of tawdry affluence. The world of the
new barbarian has no place for the ideal of higher education.
As with today’s minorities, the handicapped, the disadvantaged, and the
deficient, we are tempted to situate the barbarity of college students
within a framework of egalitarian charity. We contentedly locate the fail-
ure of individual responsibility in these three areas: environment, hered-
ity, and disease. The first serves to dilute individual incapacity and
deficiency by spreading them thinly over a culpable environment: in this
way, we environmentalize undesirable traits. The second, heredity, allows
us to geneticize those traits when they will not abide reduction to environ-
mental causality. The third, attacked by antimedical psychiatrist Thomas
Szasz, allows us without misgiving to label as a “disease” what doesn’t fit
society’s proprietary interests.
And so where once we had criminals, bad students, and censurable
behavior, we now identify groups of the socially handicapped, culturally
disadvantaged, and functionally impaired. We talk of “high-risk students”
when we mean those who will probably flunk out or drop out. “Attention
deficit disorders” reach epidemic proportions. Every sort of individual
shortcoming—in aptitude, sensibility, critical judgment, alertness, man-
ners, intellectual, aesthetic, or moral intelligence (Bartlett, 2005)—is
euphemistically labeled and “democratically” excused. Depending on the
nature of the diagnosed affliction, special therapists are needed to cope
with the newly identified impairments and disorders.
No one is constitutionally unable to do anything any more.
We live in an age that, in these dissimulating and camouflaged ways,
denies the existence of individual variation, repudiates unequal endow-
ments, and so balks at acceptance of individual limitations. Like medioc-
rity itself, this denial and dishonesty are reflexive, for they perpetuate a
cycle in which laxity is the rule and no one is responsible. This of course
fuels the new barbarism.
122 Normality Does Not Equal Mental Health

THE NEW DARK AGE, ALREADY IN PROGRESS, AND

THE DISAPPEARANCE OF HIGHER EDUCATION
Mediocrity and the rejection of individual accountability are vicious
circles that theoretically can be cut, but it is too late for this. The only
institutional solution that could stanch the tide is to place responsibility
on college students and on their universities: that is, to brick up most of
the breached doorway and to restrict passage to the comparatively few
who are qualified and motivated, directing the rest to vocational schools.
It would mean a reinstatement of curricular requirements and the detrivi-
alization of higher degrees.
What is missing in our institutions of higher learning and in our homes
reflects our opposition, born of a hyperexcited enthusiasm for social
equality, to any semblance of elitism. This is an irony, for it is just what
we lack that causes our pain. What is missing, ultimately, is that particular
species of elitism, of hierarchical valuation, that goes with a recognition of
values whose origin is suprapersonal. When right and wrong, better and
worse, beautiful and ugly are meaningful in their own right, when we real-
ize that not all is attributable to the subjective, relativist, multicultural
eye of the beholder, higher education can get on with its proper task of
cultivating and communicating culture, leaving the marketplace to take
care of itself.
The elitism that we lack out of fear of social differentiation is identical
to reverence for culture, reverence, that is, for certain values that give
meaning to the phrase ‘higher learning’ by putting the world of daily cares
in perspective. Without the vision of these higher and fragile things,
meaningful living degenerates into crass and disoriented barbarism.
When these higher values elicit our respect, a derivative respect is born
automatically toward those who transmit culture to us. Only when this
basis of respect is established can we appreciate and consciously choose
the genuinely “higher” learning they represent.
This is elitism, in the original meaning of the Latin eligere, to choose. It
is not antithetical to democracy, but it is incompatible with a society
whose indiscrimination has set it adrift in a cultureless sea of narcissistic
self-aggrandizement.
The myth of egalitarianism stands in the way of a reawakening of cul-
ture. Openness, homogeneity, and indiscrimination have impassioned,
narrowed, and impoverished our society; not only will the equality-
obsessed majority not question its commitments to devaluation, its mem-
bers possess the blindly willful pride of narcissists. “Quarry the granite
rock with razors, or moor the vessel with a thread of silk; then you may
hope with such keen and delicate instruments as human knowledge and
Barbarians at the Door 123

human reason to contend with those giants, the passion and pride of man”
(Newman, 1852/1960, p. 91).
And besides, it would be too expensive. Our universities, which have
grown fat on open admissions, grade inflation, 4 and usurious mass-
printed degrees, will resist any effort to restrict the hoards flowing
through their doors.
The economic momentum is too great to countenance change away
from “universal higher education,” the oxymoron that names the great
travesty of academia. Individual merit exacts too many costs, and the
material benefits are simply not there. To oppose mediocrity, one would
need to fly in the face of misguided democracy’s fear of cultural discrimi-
nation. To resist the ever-increasing momentum is simply too much to
expect.
The deck is stacked against the ideal of higher education. We have dis-
carded the natural elitism of unequal ability. And we have discarded the
nonutilitarian values of the artes liberales; they have been squeezed out in
a fervent embrace of money, utility, and homogeneity.

Fads are momentary preoccupations; an age, however, endures for a long

time. What is it that accounts for the difference between the transitoriness
of a fad and the lingering character of an age?
On the most fundamental level, what appears to be responsible is the
presence or absence of reflexivity, the recursive, self-maintaining charac-
ter of a system that enables it to endure.5 Both a fad and an age have an
internal dynamic. The dynamic of the one lacks equilibrium; it quickly
burns out. The dynamic of the other is self-reinforcing and so is self-
perpetuating. A fad is transitory because the values and behaviors it excites
do not feed back into and diffuse throughout those of an entire society. An
age endures precisely because the opposite is true: A society’s values and
the activity of its members achieve a self-regulating homeostasis that
maintains itself more or less efficiently. Lacking this, its reflexive ineffi-
ciency, like friction in a perpetual motion machine, ultimately brings it
to a stop, and when that happens a new age begins.
The barbarians at the doors of our colleges and universities are not an
aberrant and passing phenomenon. They are the symptom, not the cause,
of a self-reinforcing period of history in which a psychology of narcissism,
mediocrity, and indiscrimination; a mythology of egalitarianism; the rais-
ing of normality to serve as a gold standard of desirability; a denial of indi-
vidual accountability; and a base focus on work and money have combined.
They have combined in a remarkably self-supporting, self-reinforcing way.
124 Normality Does Not Equal Mental Health

The dynamic of this interplay of forces suggests the birth of an age, not a
passing fad. Only other, stronger forces can perturb its equilibrium, as
wars, plagues, and overpopulation do.
The barbarians at the door have now overrun the colleges and univer-
sities of America. The same has happened in other industrialized coun-
tries. Higher education is history. The ideal remains, but the human
response has died with only a murmur.

SOBERING REFLECTIONS
At this point, I want to return to the basic claim made in the Introduc-
tion to this book, that people prefer to believe what gives them gratifica-
tion and equally prefer to reject what does not. We should add to this
that the strength of rejection goes up very considerably when confronted
by ungratifying and downright unpleasant beliefs! We’ve come face to face
in this chapter with a group of observations that many people—according
to those very observations—simply do not like because they conflict with
the current, conventionally preferred values of industrialized society. For
many people, the strength of the perceived conflict is decidedly unpleas-
ant. The psychology of human belief being what it is, we should expect
many people therefore not to want to believe such unpleasant observa-
tions and to hurry to reject them.
There are different ways to reject propositions that we don’t like. One
way is to ignore them and go on with our usual lives, retaining our beliefs
and practices unchanged. Another is to get mad, feel that we’ve been
offended, and reject the offending propositions not because they’re not
true but because they’ve given rise to offense. A third and very common
way to reject what we don’t like is to summon up in our minds reasons
for dismissing the unacceptable propositions, reasons that we very
single-mindedly believe to be good, compelling ones—that we don’t
intend to give up, come what may.
Ignoring what we don’t like condemns it to silence. Taking offense
gives us an excuse to reject what we dislike, with no other needed justifica-
tion than the offense taken. Holding beliefs intractably despite challenges
to them is the ultimate defensive dodge, one that is typically exempted
from rational confrontation when the believer claims they are based on
“faith” or “gut feeling.”
Underlying all three of these intellectually dishonest responses is, very
frequently, a deeply rooted opposition to propositions that, if we should
accept them to be true, would take away from us a more cheerful, optimis-
tic view of things. To put the matter directly: we are, most of us, equipped
Barbarians at the Door 125

with a mental “circuit-breaker” that kicks in if our need for optimism is

short-circuited. It is, to speak diplomatically, “as though” most people
cannot bear to live with the real truths about their human condition and
so seek refuge in optimism, in the “positive illusion” discussed in Chapter
1. Optimism sugarcoats unpleasant reality so as to make it more palatable.
As Nietzsche expressed this in his Birth of Tragedy (1992, p. 18), such
avoidance borne of a need to maintain illusion is “morally speaking, a sort
of cowardice.”
Unfortunately, such a self-protective circuit breaker is not adaptive;
rather than fostering an accurate perception of reality, it results in denial
and illusion. It is, however, an effective means to defend and preserve
our existing beliefs. It blocks unbiased processing of new information that
conflicts with what we prefer to belief and helps us to continue to believe
what we like, unimpeded. Unhappily, when we face a challenge that
requires a change in our beliefs in order to emerge from a dead-end situa-
tion, constructive mental functioning that is subject to such circuit-
breaking is fated to fail. One cannot escape from a blind alley if the mind
shuts down whenever confronted by a dead end. We have, for some time,
been facing just such a dead end and critical challenge in connection with
higher education.
If the observations I’ve made in this chapter are accurate, we face an
impasse concerning the future of higher education. Because of the critical
importance of higher education to humanity’s future, this impasse poses
perhaps the most important challenge in the world (foreseen in precisely
these terms by Robert Hutchins, 1952, p. 17). But the situation is not a
pretty one, and the facts and observations I’ve brought together in this
chapter are a thorn to optimism. Further, they are expressed here in
much-needed, direct, no-nonsense language—in just the sort of
optimism-deflating propositions that, for many people, are likely to cause
their mental circuit breakers to kick in, bringing to a halt their ability to
think dispassionately.
There is no easy solution to this. The best that I, and I think any
author, can do is to encourage the reader to be reflectively aware of his
or her reflexive way of reacting to the propositions this chapter has
affirmed. There is no shorter route to intellectual honesty than self-
knowledge.
If the situation facing higher education indeed does not inspire hope,
then at least we have accomplished something in understanding that situa-
tion more clearly. To paraphrase Hutchins’ point of view in this context,
by understanding the psychology and history of higher education as we’ve
sought to do, we may not feel at home in the world of practical affairs in
the sense of liking the way of life we find about us, but we will feel more
126 Normality Does Not Equal Mental Health

at home in the world in the sense that we understand it more clearly

(Hutchins, 1952, p. 4).

NOTES
1. An earlier discussion of the subject matter of this chapter was published as
an article with the same title concomitantly in the Netherlands in Methodology
and Science 26(1) (1993), pp. 18–40 and in the United States in Modern Age 35(4)
(Summer 1993), pp. 296–310. (Readers consulting the latter publication should
see the journal’s “Note to Our Readers” printed in Vol. 36(3), p. 303.) The
account provided here is revised, updated, supplemented, and the focus changed
to fit the context of this book.
2. An annual survey conducted by the University of California at Los Angeles
and the American Council on Education very unambiguously supports this fact.
Over the past 40 years, UCLA researchers have studied some quarter of a million
entering college students. During the 1960s and early 1970s, when asked why
they wanted to go to college, the majority of students said they felt a need to
become “an educated person” and develop “a philosophy of life.” But starting in
the 1990s, there was a significant shift: the majority of students then began to
claim that their main reason for attending college was to make “a lot of money”
(see Sax et al., 1998). Not coincidentally, as a reminder of the harm resulting from
acedia, examined in the previous chapter, this degrading of values has occurred in
conjunction with a major increase among college students of psychological diffi-
culties, including depression and suicide.
3. This was Newman’s description of the self-inflicted blindness of religious
dogma, referring to Catholics’ views of education in England during the first half
of the last century (Newman, 1852/1960).
4. To cite one example: UCLA receives more freshman applications than any
other university in the United States, some 50,744 applicants in November, 2006.
The average GPA—note that this is the average GPA—of the incoming class for
the year 2007, was 4.30 (UCLA Magazine, October 2007, p. 12), a veritable reduc-
tio ad absurdum of inflationary grading policies, still flourishing without check.
The following belief has now achieved near-universal acceptance: the belief
that the great majority of children deserve “high” recognition for their alleged
superior abilities. One should be reminded of the dictum, rejected by Freud, credo,
quia absurdum—I believe because it is absurd (Freud 1930/1952, p. 786).
5. Reflexivity is a separate and fascinating subject unto itself. See Bartlett
(1987 and 1992).
 6

Psychology, Culture, and the

Demoralization of University Faculty

Work was for him, in the nature of things, the most estimable attribute
of life; when you came down to it, there was nothing else that was esti-
mable. It was the principle by which one stood or fell, the Absolute of
the time; it was, so to speak, its own justification. His regard for it was
thus religious in its character, and, so far as he knew, unquestioning.
—Thomas Mann, The Magic Mountain

Without work all life goes rotten. But when work is soulless, life stifles
and dies.
—Albert Camus (quoted in Rohrlich, 1980, p. 231)

In Chapter 4, I described a form of depression engendered by acedia, a

pervasive psychological deficit in the industrialized countries of the world
that has resulted in society-wide cultural impoverishment.1 In Chapter 5,
I turned to examine the psychological and historical background that, in
the United States and other Western industrialized countries, has led to
the cultural impoverishment of higher education and to a resulting nar-
rowing of outlook and mediocritization of its students. Although we’ve
looked at society-wide cultural impoverishment and the decline of higher
education separately in these chapters, we need to be reminded that they
clearly are not phenomena independent of one another, for they affect
each other mutually.
In our effort to understand the psychology of a society and its higher
education, both of which emphasize work and money to the exclusion of
consciousness of and respect for culture in its classical meaning, there is
a third important part of the picture that remains to be considered: the
psychology of university faculty, for it has been upon the shoulders of
128 Normality Does Not Equal Mental Health

university professors, in particular liberal arts professors, that the respon-

sibility has rested to communicate the values of culture to their
students. The wider society has been severely disabled by the accelerating
dissolution of cultural awareness and esteem for culture, and college stu-
dents have, in a parallel way, been rendered culturally disabled by a system
of higher education and by a society in which the meaning of ‘higher’ has
been lost. These two phenomena have had an unexamined effect upon
those who serve as the living memory and transmitters of culture: univer-
sity faculty, to whose psychology we now turn.

Social psychologists hope to take notice of potentially significant changes

in cultural values and their effects in personal life while these changes are
still subtle. During the last four decades, a gradual trend in higher educa-
tion and, in particular, in higher liberal arts education, has been a source
of concern among people who recognize the influence of the present upon
the future of the university. Some of this attention has been directed
toward expressions of discontent and high levels of stress among liberal
arts faculty. The informal descriptive name for this phenomenon has been
‘faculty burnout’, which designates a part of more general research relat-
ing to career burnout.
A good deal has now been written about career burnout, less about dis-
illusionment among university faculty, and still less about the specific
problems experienced by liberal arts faculty. Most of the more general
research dealing with stress in the academic world has held that faculty
burnout is due to the gradual erosion of a usually young professor’s ideal-
ism in an environment lacking in gratification. The reasons given for this
lack of gratification are multiple. In general they tend to fall into two cat-
egories: the frustrating blocks that young faculty often encounter when
they wish to bring about changes in the way higher education is managed
and offered to students, and the general absence of direct recognition and
approval received by younger faculty from their administrations and older
colleagues. Burnout among specifically liberal arts faculty has been viewed
from this perspective, emphasizing the frustration felt by young, idealistic
faculty who don’t receive the acceptance and appreciation they need to
sustain them. Without attempting to discriminate problems experienced
by faculty in different areas of study, this point of view has been applied
in a generic way to burnout experienced by faculty in a wide range of dis-
ciplines. There has been no attempt to study the specific psychology of
faculty demoralization in the liberal arts, which, as I suggest here, is sub-
stantively different from burnout in other professions.
Psychology, Culture, and the Demoralization of University Faculty 129

This chapter seeks to widen our understanding of the psychology of

faculty demoralization by focusing on its occurrence in the liberal arts.
The demoralization of liberal arts faculty in higher education today is a
phenomenon that is not on a par with career burnout in other professions.
The frustration of youthful idealism and the absence of sufficient, direct,
and personal appreciation from one’s senior colleagues and from superi-
ors in the college bureaucracy do certainly wear down young liberal arts
faculty. But the demoralization that they, as well as many of their older
colleagues, feel is more than this.

THE NATURE OF CAREER BURNOUT

Career burnout, inside or outside of the academy, is fundamentally
connected with the human need for meaning. When a person’s work sup-
ports and strengthens the perception of meaningfulness, those who are
highly motivated will excel; but when their work detracts from and even
undermines their ability to find meaning in what they do, burnout is only
a matter of time. Burnout is not the same thing as work stress, depression
from overwork, or alienation, though it usually involves these. One of the
clearest general descriptions of career burnout has been given by Ayala
Pines and Elliot Aronson:

Burnout is formally defined and subjectively experienced as a state of

physical, emotional, and mental exhaustion caused by long-term
involvement in situations that are emotionally demanding. The emotional
demands are most often caused by a combination of very high expectations
and chronic situational stresses. Burnout is accompanied by an array of
symptoms including physical depletion, feelings of helplessness and
hopelessness, disillusionment, and the development of a negative self-
concept and negative attitudes toward work, people involved in work, and
life itself. In its extreme form burnout represents a breaking point beyond
which the ability to cope with the environment is severely hampered. (Pines &
Aronson, 1988, pp. 9–10)

The study by Pines and Aronson suggests that there is a psychological

profile which is often typical of people who experience career burnout.
More than does the average person,

• they tend to be idealistic, in that they expect their work to give their
lives a sense of meaning—“burnout most often happens to people
who initially cared the least about their paychecks” (Pines & Aron-
son, 1988, p. 53);
130 Normality Does Not Equal Mental Health

• they tend to be especially caring about their work and its value,
sometimes so much so that they regard their work as a “calling”; and
• they are often highly motivated to achieve, in a way that goes beyond
routine high achievement, due to a strong and unquestioned belief
that success in one’s discipline is closely associated with one’s worth
as a human being.

People with these qualities tend to burn out when their work environment
has these characteristics:

• It frustrates, and may completely block, their aspirations. The frus-

tration they experience, given their high expectations and need for
meaningful work, soon erodes their spirit.
• Their work offers minimal personal rewards in the context of ines-
capable stresses that cannot be lessened or changed.
• Their work load is excessive, or else work itself does not provide suf-
ficient challenge because they are overtrained and do not feel well
utilized.

When their work comes to have little or no meaning and the stresses of
work day after day outweigh its rewards, burnout becomes inevitable. As
mentioned in the above quotation, Pines and Aronson have found that
the victims of career burnout experience one or more of the following
forms of exhaustion or depletion, which we can distinguish as:

• Mental exhaustion: difficulty concentrating, impaired creativity,

and negative attitudes toward one’s self, others, one’s work, and life
generally
• Emotional exhaustion: feelings of helplessness in situations they
cannot control, entrapment, and depression
• Physical exhaustion: chronic fatigue, lowered resistance to illnesses,
headaches, neck and back pain, eating disorders, and problems in
sleeping

Unfortunately, the unreflective tendency among the majority of mental

health practitioners is automatically to pursue a course of treatment that
encourages the person to adjust to the existing work environment. Pines
and Aronson’s study opposes this tendency by emphasizing that the major
causes of burnout reside in the work environment itself. Their outlook
is hopeful, even if unrealistic: “Since we view environments as more
amenable to change than persons’ personalities, we prefer to direct our
Psychology, Culture, and the Demoralization of University Faculty 131

efforts to work environments” (Pines & Aronson, 1988, p. 79). They

believe that it is the work environment that must be changed, rather than
the individual:

How individuals perceive the cause of their burnout and attribute the
“blame” has enormous consequences for action. If they attribute the cause
to a characterological weakness or inadequacy in themselves, they will take
a certain set of actions: quit the profession, seek psychotherapy, and so
forth. However, if they see the cause as largely a function of the situation,
they will strive to change the situation to make it more tolerable, a totally
different set of remedial actions. . . . [O]ur work has made it clear that, in
the vast majority of cases of burnout, the major cause lies in the situation.
(Pines & Aronson, 1988, p. 5)

It is not my purpose to pull the pendulum to one side in this individual

versus environment debate. However, it is important to underscore the
fact that traditional psychological treatment for career burnout, in its
one-sided focus upon individual adjustment, tends to avoid placing
responsibility upon the environment.
When career burnout is most severe, the individual becomes clinically
depressed and may then benefit from some variety of treatment. However,
if, indeed, career burnout is to a great extent situationally caused then
treating clinically depressed individuals who have become burned out in
their careers exclusively by means of individual adjustment therapies is
likely to be both inappropriate and, as we will see, potentially injurious
to them.
This is especially true of the burnout of faculty in the liberal arts, as the
remainder of this chapter attempts to show.

THE CONCEPT OF SITUATIONAL DEPRESSION

Of the theories advanced to explain depression, among those least in
vogue among clinicians is the theory of situational depression. To claim
that depression is situational is equivalent to blaming the environment
for an individual’s suffering. This directly conflicts with the individual
adjustment bias of psychiatry and most current theories of psychotherapy.
Because the majority of psychologists, psychiatrists, and social workers to-
day believe that clinical depression, often associated with serious career
burnout, is an illness that has its causal basis in the individual, the treat-
ment that is favored by them seeks to change the person—specifically atti-
tudes or other mental and emotional dispositions, or neurochemistry, or
all of these. The alleviation of depression, in this view, is a matter of
132 Normality Does Not Equal Mental Health

treating the individual—by helping the person better to adjust to his or

her environment. The help that is offered seeks to adjust individual atti-
tudes and biochemistry until a more compatible, comfortable fit between
individual and environment is accomplished. Seen from this point of view,
clinicians serve the purposes of social adjustment, normalization, and con-
ditioning: They help people to continue to carry on with their conven-
tionally endorsed social roles and responsibilities.
So-called “life events research” has been more sensitive to the situa-
tional relationship between an individual’s depression and his or her life
goals, values, perception of obstacles, hopes for success or expectation of
failure, and so on. From this point of view, Klinger (1975, 1977) and
Nesse (2000) have observed that depression can serve to motivate a person
to find a way out of blind alleys, to give up unreachable goals, and to
become free from a sense of entrapment in a destructive situation. In this
sense, Klinger and Nesse proposed that depression can be adaptive
because it may serve as a healthy defense against circumstances that are
harmful and demoralizing. However, such a situational understanding of
depression, which claims that an individual’s depression is attributable to
or largely due to outward circumstances, is relatively infrequent among
clinicians; others who have given a nod in that direction include Brown
and Harris (1978) and Bowlby (1969–1982, Vol. 3, pp. 254–56).
We should expect that a situational view of depression would be more
the province of the social psychologist, who is less directly involved in
the treatment of individuals. But even here, situational depression is a
concept with comparatively few adherents, perhaps because environmen-
tal causes of depression are, Pines’ and Aronson’s optimism notwithstand-
ing, much less easily changed than may be the attitudes and biochemistry
of a particular person. In addition, it can be complex and potentially prob-
lematic to evaluate the therapeutic effectiveness of environmental changes
in alleviating an individual’s depression, due to the absence of compara-
tive experimental controls.
In terms of the question of whether its origin is situational or individ-
ual, studies of the phenomenon of career burnout have been both moder-
ate and ambivalent. The majority of researchers who have studied it
describe burnout and its treatment in individual psychological terms,
although they occasionally and vaguely allude to environmental sources.
As yet there has been virtually no clarification of the fundamental ques-
tions: to what extent burnout among faculty is a problem due to differing
individual sensitivities and to what extent it is contextual. Certainly a
more balanced and comprehensive knowledge of burnout requires a better
understanding of its situational basis.
Psychology, Culture, and the Demoralization of University Faculty 133

THE SITUATION IN THE LIBERAL ARTS

I consider reality to be the thing one need concern oneself about least of
all, for it is, tediously enough, always at hand while more beautiful and
necessary things demand our attention and care. Reality is that which
one must not under any circumstances worship and revere, for it is
chance, the refuse of life. And it is in no wise to be changed, this shabby,
consistently disappointing reality, except by our denying it and proving
in the process that we are stronger than it.
—Hermann Hesse (1925/1954, p. 67)

Readers may recall this quotation from Hesse in Chapter 3, relevant there
in connection with the psychology of creative people. I’ve quoted Hesse
again here because his words are also applicable in a discussion of the psy-
chology of classically oriented liberal arts faculty, as we’ll see.
The point of view advanced in this section is phenomenological, a
point of view that is fundamentally one of descriptive, definitional logic
rather than empirical observation derived from consensus taking. I take
for granted as obvious that the nature and goals of the liberal arts can be
interpreted in many ways; but my purpose here is to show how, given a
traditional, classical conception of the liberal arts, burnout among faculty
who hold that conception within the context of today’s universities is a
phenomenon that is to be expected, is understandable, and, ironically,
should be judged as a sign of mental health on the part of the affected indi-
viduals. These consequences follow, I submit, strictly from the inner logic
of descriptions of the experience of these individuals. But the consequen-
ces are essentially human, not merely logical, and they bring pronounced
human suffering with them. The purpose in developing the perspective
that follows is to provide a clearer context in which the victims of liberal
arts demoralization can understand and accept themselves, and in terms
of which their sometimes puzzled colleagues and administrators perhaps
may acquire a deeper measure of empathy and support for their plight.
And, too, it is my hope that you, the reader, will gain a richer and more
concrete, person-centered understanding of what “culture” means to a
small and specialized population for whom liberal arts values are central.
For this purpose, it would perhaps be helpful if you will agree to sus-
pend (or bracket) your own conception of the nature and goals of the
liberal arts (if your idea of these differs) and, for the purposes of argument,
to consider with as much intellectual sympathy as you can summon the
human sequelae of the stipulative descriptions that follow. These stipula-
tions make clear to you what I presuppose is experienced by the small
group of university professors in question:
134 Normality Does Not Equal Mental Health

There is a population of faculty in the liberal arts who, sometimes with-

out self-conscious analysis, see themselves and their discipline in classical
terms—that is, they hold a clearly defined set of beliefs about the funda-
mental purposes of liberal arts study and perhaps a slightly less well-
formulated concept of their role in its teaching and scholarship. Among
their beliefs are likely to be found convictions similar to the following:
The liberal arts, or artes liberales, are, both in kind and in value, essen-
tially distinct from the servile arts, or artes serviles, in certain ways.

• The servile arts are mundane and of a chorelike nature, concerned as

they are with the impermanent worldly trappings of monetary suc-
cess and practical effect. The liberal arts, in contrast, intend to liber-
ate the individual from the concerns of the practical, material
universe and to open for him or her dimensions of human experience
that are qualitatively different.
• These dimensions of experience comprise a separate, distinguishable
universe of meaning, one perceived to be a source of the significance
of servile life. In this sense, the universe to which the liberating arts
provide access is hierarchically superior to the lower-order world
of servile pursuits. This is not a matter of marshalling objective and
empirical facts but, again, of stipulative, definitional logic. It has
the form, “If one understands the liberal arts in their classical mean-
ing, then the above perception is a psychological consequence.”
• In the view of the classical liberal arts scholar, human beings are
unequally endowed in both their practical capacities and in their
personal abilities to gain access to this second-order, higher reality.
Their practical capacities differ because of differences in personal
taste, inclination, and ability, as well as in their opportunities to
develop liberating skills. On the one hand, this can be a simple mat-
ter of individual preference, but it can also reflect a poverty of
opportunity to attend top-notch institutions of higher learning, to
acquire libraries of fine books, of musical recordings, collections of
art, and other expressions of culture, as well as the scarcity of time
to cultivate liberal pursuits. On the other hand, individual abilities
differ as a result of inborn talent; learned interest; discipline and
drive; and intellectual, moral, and aesthetic capability.
• Not infrequently, individuals who are particularly well-suited to
liberal arts study are ill-suited, or not suited at all, to other profes-
sions, just as the opposite is true. Like Thales, who, as legend has
it, fell into a well because his eyes were fixed on the stars, traditional
liberal arts scholars tend not to be adept do-it-yourselfers in the
material world; they tend not to fit the corporate mold; their
Psychology, Culture, and the Demoralization of University Faculty 135

psychological and personal profiles do not accord with the practical

needs of ordinary reality’s workforce.
• Partly as a result of their accurate self-assessment, some liberal arts
scholars feel drawn ineluctably to their chosen profession with either
something akin to a sense of mission or a more self-effacing accep-
tance that this is all they can do competently. Their sense of mission
relates to their perception that meaning in the transitory practical
world is ultimately derivative from an enduring universe of more
permanent realities.

These are some of the central convictions that define the perspective of
the classical liberal arts scholar. From the individual’s point of view, it is
inherently delimitative and judgmental. The lines of meaning are pre-
drawn for such a scholar; he (using the author’s gender, but ‘she’ is also
understood throughout) fits into a bipartite reality in a nonambidextrous
fashion: Where he can touch his finger to his nose with consummate skill
in a higher dimension, he often is completely at a loss in everyday life. On
the one hand he is endowed with a gift, and on the other is often the victim
of a disability. He can see in the world of the blind, but often blunders
blindly in the midst of those whose vision is mundane.
He is furthermore judgmental, since his perspective is essentially elitist
and nonegalitarian. For him, however, elitism and the natural rights of
humanity are not in themselves necessarily political issues or manifesta-
tions of personal arrogance, but facts in a life-world that is constituted as
it is. This is the province of phenomenological psychology’s descriptive
interest in the logos of the psyche, a concern to make explicit the regulative
principles of a particular, individual life-world. That there exists a higher
and a lower reality is as evident to the classical liberal arts scholar as that
automobiles emit pollution is to the person on the street. Here, empirical
studies with double-blind controls are simply irrelevant. Experienced
reality for the classically paradigmatic liberal arts scholar comes with
built-in indications of what is higher and what is lower.
Unfortunately for him, the political sensitivity of other men and
women is easily ruffled. His in principle innocent perspective, which pro-
vides the scholar with a sense of balance and orientation toward what for
him is most meaningful, is capable of being used against him by the politi-
cally driven. Elitism and a repudiation of egalitarian principles admittedly
can lead to overweening pride and abusive social evils, but this fact, with
its historical, political, educational, and highly emotional overtones, is
out of place in this discussion, where my intent is purely to describe some
central characteristics of the experience of the classically disposed liberal
arts scholar.
136 Normality Does Not Equal Mental Health

With this descriptive sketch before us, we turn to look at the work envi-
ronment as it is perceived by the traditional liberal arts professional. As we
saw in some detail in the last chapter, higher education in America has
changed considerably from the time of Newman, who had less to com-
plain of then. Josef Pieper has come and gone, Allan Bloom briefly stirred
a certain amount of dust, but in the end, education today, as we’ve seen, is
no longer “higher” in the meaning that traditionally was attributed to it.
The work environment of university professors has accordingly
changed, and it imposes restrictive boundaries on the efforts of the
classical liberal arts scholar. A single aspect of his environment affects
him most deeply: it is limited by the constricted values, interests, and
range of vision of the majority of his students, with whom he is in daily
contact. At the same time, the same shrunken perspective is often advo-
cated by his university administrators and many of his colleagues. Like
the creative individuals described in Chapter 3, he is impaired, as we shall
see, by the impairments of the normal world.
Contact with students comprises the main context for his professional
exertions, for it is their talk that fills his ears, their papers that occupy his
eyes, and their values and interests that in the end give him pause for
reappraisal. To understand the phenomenon of demoralization among
university faculty in the liberal arts, we need to consider dispassionately
what it is that the majority of students care most about, frequently to the
exclusion of all else. In Chapter 4, we examined the phenomenon of
“work-engendered depression,” a condition due to an exclusionary focus
upon work, money, and things. As we saw, many centuries ago such
depression was clearly acknowledged and comprehended with a remark-
able degree of clarity and was named ‘acedia’ by the Scholastics. Acedia
is no more and no less than a form of psychological malnutrition in which
an individual, or an entire people, has lost contact with the very realities
that concern the classical liberal arts scholar. These realities may be of
an intellectual, moral, or aesthetic kind; they may be highly theoretical
and ideal in nature; and as a result, they have the capacity to liberate a
man or woman from the confines of an empty dedication to the work-
place, social networking, shopping malls, and financial planning. We saw
that the culturally depleted universe of people who inhabit a world of total
work can lead to a variety of depression little understood today.
Industrialized societies that promote such depression through their
exclusionary emphasis on work and money correspondingly promote an
approach to college and university education that fosters a culturally
depleted mindset among its students, as we saw in the last chapter. During
the past 40 years of my professional life, it has been my repeatedly con-
firmed observation that, more than any other single group, college
Psychology, Culture, and the Demoralization of University Faculty 137

students exhibit the symptoms of acedia. As the decades have passed, these
symptoms have become more extreme, more pronounced, and more
prevalent. We recall that acedia serves as a barrier that stands between
the man or woman who is a slave to the world of work and money, and
higher values. It is an impairment preventing people from transforming
the mundane. The result is that their universe of concerns excludes all that
is not mediocre. Contact with culture, cultus, with the cultivation of liber-
ating arts, is lost, and with this loss has come a certain impairment of men-
tal abilities and an incapacity to cultivate leisure in the sense described in
Chapter 4.
Plausibly much of the fault for acedia does not lie with students them-
selves but with the society and with their families who have encouraged
and transmitted to them the incapacitating blinders they wear. And yet it
is the students themselves, who are the products of cultural disability,
who populate the classes of the classical liberal arts professor. The profes-
sor sees before him, day in and day out, legions of students who manifest
the symptoms of acedia. Most are young, but acedia has nevertheless
already taken firm hold in their minds, hearts, and vocationally compulsive
tunnel vision. The consequences upon the classically oriented liberal arts
professor are equally pronounced, for he is caught in the neverending
ordeal of the classically trained musician forced to perform before audi-
ences who are not receptive, and may be openly hostile, to classical music.
The values and skills that he seeks to impart, which define and open access
to a reality of a higher order, fall upon ears that have been deafened by loud
rock music and upon eyes dulled by the narrowed vision of university edu-
cation in the service of job acquisition whose purpose is moneymaking.

SITUATIONAL DEPRESSION OF FACULTY

IN THE LIBERAL ARTS
I have tried briefly to describe a certain type of individual, whom I’ve
called the classically inspired liberal arts professor and, as seen through
his eyes, his audience today. When the liberal arts professor is fully com-
mitted to his subject and to the values of its study, and when his audience
unquestioningly focuses on vocational and monetary values to the exclu-
sion of all else, the work environment of the professor can lead to situa-
tional depression of a particular kind. His environment stands in direct
conflict with his sense of self: His students are victims of a disease of the
spirit, acedia, an intellectual, moral, or aesthetic disability which blocks
them from cultivating the higher learning he would teach. Moreover, the
liberal arts professor is trapped by his work environment in the academy,
perhaps believing his teaching and research to constitute a personal
138 Normality Does Not Equal Mental Health

calling, on the one hand, while potential alternatives to his academic pro-
fession bring him face to face with the shortcomings he experiences in
“lower reality,” on the other.
This is the essence of a psychologically double-binding situation: the
liberal arts professor is damned if he does and damned if he doesn’t.
A well-acknowledged cause of depression is just this sort of entrapment
in a situation that brings deep pain and from which the only perceived
escape is itself severely painful.
Career burnout in other professions does not involve this complex
dynamic or the distressing and profound conflict both with one’s personal
sense of identity and with the conception of one’s role in the world.

ADJUSTMENT DISORDERS AND THE LIBERAL ARTS

Earlier in this chapter I referred to the tendency of mental health prov-
iders today to implement individual adjustment therapies in cases of
career burnout, and I mentioned in passing that individual adjustment
therapy for liberal arts professors can be injurious. I’d like to return to this
subject briefly.
The only DSM diagnostic classification that seems to apply to the sit-
uational depression of liberal arts faculty is “adjustment disorder, with
work inhibition,” a classification we also encountered in discussing the
psychology of the artist and the psychology of acedia. Here again is the
relevant DSM passage:

The essential feature of this disorder is a maladaptive reaction to an

identifiable psychological stressor. . . . The maladaptive nature of the
reaction is indicated . . . by impairment in occupational (including school)
functioning. . . . [T]he predominant manifestation is an inhibition in
work . . . occurring in a person whose previous work . . . performance has
been adequate. Frequently there is a mixture of anxiety and depression.
(American Psychiatric Association, 1987, code 309.23, pp. 329, 331; in
APA, 1994 and 2000, absorbed under code 309.9)

Two judgments embedded in this classification need to be made explicit:

first is the judgment that the condition constitutes a “mental disorder,” and
second is the claim that the disorder is “maladaptive.” These assessments
point to the likely treatment that situationally depressed liberal arts faculty
will receive if they seek psychological or psychiatric help.
If you the reader are willing to move beyond the limits prescribed
by the current classification of mental disorders, perhaps you’ll agree
that what certain liberal arts faculty experience today is most akin to
Psychology, Culture, and the Demoralization of University Faculty 139

demoralization rather than maladaptive mental illness. This demoraliza-

tion is a secondary dysfunction, to speak clinically, acquired as a result of
the long-term, inescapable exposure of these university professors to
acedia, both in their students and embodied in their administrations.
Morale is a matter of spirit, certainly of emotional and mental health.
When a situation is destructive to morale, it is destructive to an individ-
ual’s spirit, depleting the energy and desire to realize his or her human
potential.
As we’ve seen, the Scholastics believed that the despair to which acedia
leads has precisely this life-blocking effect. In much the same way, the sec-
ondary despair of the liberal arts professor is destructive of his potential; he
is caught in a work environment in which, in his perception, the members
of his student audience—his customers, in this market-oriented society—
are functionally impaired in the sense of being mentally handicapped (intel-
lectually, morally, or aesthetically) so as to be incapable of the cultivation
he aspires to encourage in them.
The demoralization of liberal arts faculty in question here is not a mat-
ter of mental disability; there is no impairment of mental faculties as there
is in the condition of acedia. There exist no directly applicable categories
in the classification system of psychotherapy with which to label this situa-
tional byproduct of acedia. Perhaps the closest is the disorder of demorali-
zation that Viktor Frankl called “noögenic neurosis,” his term for
existential frustration that occurs when a person’s will to meaning is
blocked (Frankl, 1955, 1959). The suffering that such frustration brings
is the result of a conflict between opposing values—in this chapter, the
conflict between the deeply rooted commitments of the liberal arts
scholar, understood as essentially absolutist, hierarchical, and elitist—
and the vocational, materialist, relativist, multiculturalist, and monetary
values that circumscribe the normal interests of the majority of his stu-
dents and usually also of his university administration.
Other than Frankl’s work, George A. Kelly’s theory of personal con-
structs offers a framework in terms of which liberal arts demoralization
can profitably be understood. Kelly’s therapeutic orientation, like the
approach of his contemporary J. H. van den Berg (1955), is phenomeno-
logically sensitive to the world as a person experiences or construes it.
Speaking of his clients, Kelly commented: “We have observed only that
they do what they do because their choice systems are definitely limited”
(Kelly 1956/1978, p. 121; see also Kelly, 1955). The choices open to a per-
son are a reflection, according to Kelly, of the individual’s personal con-
structs, of the “channels of thought” that he or she uses to construe
events. Kelly saw these channels as a maze that each person builds and
calls his or her own. “The labyrinth is conceived as a network of
140 Normality Does Not Equal Mental Health

constructs, each of which is an abstraction and, as such, can be picked up

and laid down over many different events in order to bring them into
focus and clothe them with personal meaning” (Kelly, 1956/1978, pp.
123–24).
Kelly would probably have portrayed liberal arts demoralization as
acute frustration over the narrowed choices that exist from the point of
view of the liberal arts professor. When all perceived alternatives are with-
out real hope, demoralization becomes inevitable, appropriate, and
understandable. For the classical liberal arts professor, the only alterna-
tives not destructive to the self are to continue to profess a set of values
to an otherwise-disposed and deafened audience or to leave the only work
environment suited to the kind of person he believes himself to be. It is a
dilemma of assured discontent.
‘Axiological demoralization’, if not such a mouthful, may come closer
to an accurate name for impairment due to the experience of incompati-
bility between an individual’s most cherished values and those that define
his or her environment. Mircea Eliade refers to the axis mundi of certain
primitive societies, which both anchors the meaning of the individual lives
of members of the society and gives direction to their activities.2 Axiologi-
cal demoralization is the experience of the loss of the power of an individ-
ual’s axis mundi to provide life with meaningful direction. Loss of religious
faith would be an example, when this loss leads to despair.
For professors whose axis mundi is the cultivation of liberating skills
and study, such axiological demoralization can assume the character of
clinical depression. Yet, because of the uncritical application of individual
adjustment therapies to alleviate depression, which I commented on ear-
lier, standard clinical treatment of axiological demoralization is likely to
be injurious to such a person.
The reason is straightforward: for anyone whose sense of purpose in
living, whose sense of personal identity and capacity for fulfillment, are
fundamentally tied to liberating skills and a vision of enduring, ideal, non-
material realities, adjustment to the workplace, when the academic world of
today is involved, is equivalent to destruction of self—literally a form of
self-mutilation: Huxley’s metaphor applies squarely here—that a person
should have his or her eyes put out in order to fit into a society of the
blind. This would constitute a destructive form of prescribed adaptation that
starts with a clinician’s perception of misfit between the professor and
reality and which then seeks to encourage a normalized, adaptive fit—in
the process undermining the individual’s source of life meaning.
The application of individual adjustment therapies leads to just such an
effect on those whose insight and enlightenment lift them out of the mun-
danity and mediocrity of the everyday world.
Psychology, Culture, and the Demoralization of University Faculty 141

TREATMENT FOR LIBERAL ARTS DEMORALIZATION

Strictly from a phenomenological point of view, two factors play a cen-
tral role in situational depression among liberal arts faculty: their claim to
a higher reality to which the rest of the world is now largely blind and the
resistance and even opposition to their values by students and university
administrators who are victims of acedia. Outside of the specialized con-
text of the liberal arts to which I’m referring in this chapter, it can be a
good deal more conspicuously objectionable when, in some countries,
psychiatry is used to label social dissidents—that is, those with politically
“maladaptive” attitudes—as “mentally ill.” Occasionally, a Thomas Szasz
will remark on the similarity closer to home. We live in a society that
has become ideologically hysterical about the evils of elitism and the need
for a homogenized populace that has been politically purified of standards
of cultural excellence. This is the social context within which the situa-
tional depression of liberal arts faculty is assessed and treated. It makes
sense that our society should be incapable of real sympathy toward the sit-
uationally based demoralization of liberal arts faculty. It is understandable
that in their response to prevailing social values that prescribe normality
as a standard, mental health professionals should classify the demoraliza-
tion of liberal arts faculty as a maladaptive mental illness. It is the expected
reflex of a society blind to liberating values.
If we take the idea seriously that faculty demoralization in the liberal
arts is neither maladaptive nor a mental disease, but instead regard it to
be a phenomenologically appropriate response to a destructive situation,
there are, unfortunately, few realistic alternatives for treatment available.
Pines and Aronson would prescribe changing the environment. But the
environment here is contemporary higher education itself, which, in the
perception of the classical liberal arts scholar, has lost the ability to dis-
criminate higher from lower and has succumbed to vocationalism.
Today’s anti-elitist, relativist, multiculturalist, equality-of-aptitudes
ideology offers no socially authorized niche for the liberal arts scholar.
His elitism is mistaken as arrogance, his avowal of “higher-order realities”
is misconstrued as seditious, and his acceptance in his students of unequal
abilities, talents, levels of motivation, discipline, and interest is misinter-
preted as a rejection of democratic principles.
From the edge of this precipice, the outlook is grim, for the liberal arts
scholar is no more and no less than an anachronism, and for many, an
undesirable anachronism. He or she is simply irrelevant to the social order
and to the values of the day.
Given that the dynamic of the current social and educational mindset is
strongly self-sustaining and resistant to change, as we saw in the last
142 Normality Does Not Equal Mental Health

chapter, plausible treatment options for the variety of depression experi-

enced by the liberal arts scholar are few. Two that do not fundamentally
compromise the scholar’s values and role in living come to mind: The first
alternative is to cultivate an essentially private monasticism within the
academy, viewing his or her life and work as preserving liberal arts values
for a possible future when genuine culture may once again become pos-
sible. But walling oneself off is an alienating path to take, and because of
its alienating character is a questionably helpful treatment for a depressive
condition.
The other alternative—as with any instance of situational depression in
which the environment cannot be substantially changed—is to leave the
destructive situation that leads to demoralization and to cultivate scholar-
ship outside of the academy. To do so requires an inner capacity to moti-
vate oneself to liberating ends, despite of the mediocritizing and practical
obsessions of lower reality. And yet it may be the only true path open that
can permit the liberal arts scholar today to maintain his intellectual,
moral, and aesthetic health free from despair. Although this choice
involves physical distancing from the academic world, for some it may
be significantly less alienating than the first alternative, because exposure
to the pathology of acedia is reduced.

Liberal arts demoralization is the Huxlean epiphenomenon of the general

disintegration of idealism. The values that sustained classical idealism,
and the men and women who gave their lives for it, are rapidly disappear-
ing in our consciousness. The increasingly few scholars in whom classical
liberal arts ideals remain alive and whose morale has been ground down
by a corrosive environment may want to recall Russell’s counsel:

Let us admit that, in the world we know, there are many things that would
be better otherwise, and that the ideals to which we do and must adhere are
not realized in the realm of matter. Let us preserve our respect for truth,
for beauty, for the ideal of perfection which life does not permit us to
attain, though none of these things meet with the approval of the
unconscious universe. . . . In action, in desire, we must submit perpetually
to the tyranny of outside forces; but in thought, in aspiration, we are free,
free from our fellow men, free from the petty planet on which our bodies
impotently crawl, free even, while we live, from the tyranny of death. Let us
learn then, that energy of faith which enables us to live constantly in the
vision of the good; and let us descend, in action, into the world of fact, with
that vision always before us. (Russell, 1957, pp. 109–110)
Psychology, Culture, and the Demoralization of University Faculty 143

NOTES
1. An earlier discussion of the subject matter of this chapter was published as
an article, “The Psychology of Faculty Demoralization in the Liberal Arts: Burn-
out, Acedia, and the Disintegration of Idealism,” in New Ideas in Psychology 12(3)
(1994), pp. 277–89. The account provided here is revised, updated, supple-
mented, and the focus changed to fit the context of this book.
2. Presented by Mircea Eliade in a symposium at the Center for the Study of
Democratic Institutions, Santa Barbara, April, 1970. Relevant works include
Eliade (1949 and 1963).
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 PART III

Beyond Long-standing Facts

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 7

The Psychology of Abuse in Publishing:

Peer Review and Editorial Bias

It has always been true, and it is now more than ever, that the path of
wisdom for a young scientist of mediocre talent is to follow the prevail-
ing fashion. Any young scientist who is not exceptionally gifted or excep-
tionally lucky is concerned first of all with finding and keeping a job. To
find and keep a job you have to do competent work in an area of science
which the mandarins who control the job-market find interesting. The
scientific problems which the mandarins find interesting are almost by
definition, the fashionable problems. . . . It is no wonder that young scien-
tists who care for their own survival keep close to the beaten paths. . . .
Our Institute here [Princeton’s Institute for Advanced Study] is no
exception. When I first came here as a visiting member thirty-four years
ago, the ruling mandarin was Robert Oppenheimer. Oppenheimer
decided which areas of physics were worth pursuing. His tastes always
coincided with the most recent fashions. Being then young and ambitious,
I came to him with a quick piece of work dealing with a fashionable prob-
lem, and was duly rewarded with a permanent appointment.
—Physicist Freeman Dyson (Roberts, 2006, pp. 268–69, quoting
Dyson, 1992, emphasis added)

The emphasized words in this quotation might well serve as a point of

entry into the psychology of peer review and editorial bias. But, as we shall
see, “tastes” and “fashions” are only surface phenomena that come to light
in a psychological inquiry into the ways in which peer reviewers and edi-
tors often judge manuscripts submitted to them for publication.
Peer review and to a lesser extent editorial bias have been subjected to
considerable discussion in the literature, some positive, some overtly criti-
cal. Generally there is consensus on three things: (1) peer review of publica-
tions has become the “gold standard” in scientific, academic, and scholarly
publishing, in spite of the fact that (2) virtually no serious qualitative or
148 Normality Does Not Equal Mental Health

data-based studies have been made to establish, when compared with pub-
lications not subject to peer review, that those which are peer reviewed are
“better,” “more reliable,” “more valid,” “more accurate,” and “more
important contributions” to significant advances in any discipline, and
(3) for the foreseeable future, peer review is here to stay. (See, e.g., Enserink,
2001; Roy & Ashburn, 2001; Marsh, Bond, & Jayasinghe, 2007.)
The struggle between proponents and opponents of peer review has
been anything but quiet. During the past quarter century, hundreds of
papers and several books have been published that have, from a multitude
of perspectives, endorsed or criticized peer review, in the process often
including the behavior of editors. The sheer numerousness of complaints
makes evident that these gatekeepers to publication have not been
accepted or tolerated with equanimity. If one takes only a fraction of the
published complaints at face value, one is compelled to recognize that
peer review and editorial bias must be afflicted by serious inadequacies
that at times result in unacceptable unfairness and intellectual suppres-
sion. These complaints have, among others, included the following alle-
gations (which I mention only as sample allegations and as background;
the majority will not be the main subject of examination here):1

• Peer review has come to dominate journal publishing and grant

administration, with a nearly total investment of belief on the part
of those concerned, despite the dearth of critical, hard, empirical
studies of the extent to which peer review may—or may not—ensure
quality and encourage—or suppress—innovation.
• Peer reviewers have frequently been found (by critics) to be incom-
petent and to lack formal training in the review of manuscripts;
much of the time they are chosen from younger and less experienced
faculty, scholars, and scientists, who are least qualified to serve as an
expert author’s “peers.”
• In evaluating manuscript submissions there is little agreement in the
judgment of reviewers, less than would be expected by chance.
• Many authors find that peer reviewers’ criticisms are irrelevant to
their manuscripts’ intent and content.
• A host of prejudicial factors can play a central role in peer reviewers’
judgment, such as the professional paradigm or ideology they em-
brace; their political and social biases; professional jealousy or vested
interest in protecting their own turf (status, reputation, research
approach, and results); favoritism toward graduates of their own
alma maters, toward colleagues from other institutions they admire,
and toward authors who are already well-known; and so on.
The Psychology of Abuse in Publishing 149

• Some peer reviewers seek to gain one-upmanship for their own pro-
fessional status and research by undercutting an author’s work.
• Peer reviewers make frequent mistakes in their evaluations, with lit-
tle accountability since their identities are generally hidden.
• Peer reviewers tend to reject more clearly written, more simply
stated papers in favor of those that are poorly written and clothed
in the trappings of technical sophistication; as a result, obscure writ-
ing tends to be rated more highly than an author’s scholarly or
research competence.
• Peer review is costly (time-consuming for authors and reviewers,
sometimes also a source of expense) but is between inefficient and
meaningless since the majority of papers rejected by one journal’s
peer reviewers tends to be published anyway by their authors else-
where, often in their original form.
• There are numerous examples of important, innovative contribu-
tions that were rejected outright by peer reviewers, including papers
that later received Nobel Prizes and papers that became the most
cited articles of all time; for instance, Einstein was so enraged by
peer review in the Physical Review that in protest he subsequently
refused to publish there. (For other examples, see Martin et al.,
1986, p. 274; Horrobin, 1990, pp. 1440–41.)
• Reviewers tend to be biased against negative results and to give pref-
erential treatment to submissions that positively bear out what they
already believe.
• An extremely small minority of journals has established appeals pro-
cedures for authors who complain of the low quality of peer review.
• Approximately half of authors who engage in “dialogue” with
reviewers get their papers accepted.
• Peer reviewers are often unable to detect fraud.
• Many peer reviewers as well as editors tend to be “neophobic” when
innovative work is concerned (Garcı́a, 1981, p. 149); papers that lay
some claim to being “interesting” tend to be rejected by peer
reviewers in favor of papers whose approach is familiar and
establishmentarian.
• Peer reviewers tend to focus on the negative in their reports and give
little to no attention to the positive features of submissions.
• Peer reviewers often engage in “mean-spirited,” “overly caustic,”
derogatory evaluations of authors’ submissions; peer review provides
“an avenue for professional nastiness,” for “sadistic” abuse (e.g.,
Holbrook, 1986; Fine, 1996; Levenson, 1996; Rabinovitch, 1996;
Hadjistavropoulos & Bieling, 2000).
150 Normality Does Not Equal Mental Health

• Over time, a discouraging pattern of response of this kind can of

course undermine the confidence and “submission tolerance” of
many authors, disabling their research motivation, and at its worst,
ultimately silencing them and causing them to withdraw from intel-
lectual exchange, blocking professional development and potentially
original work.
• Editors who oppose an author or his or her paper may intentionally
send the paper on to peer reviewers known to hold views antagonis-
tic to the author’s; similarly, editors may give preferential treatment
by selecting reviewers whose viewpoint ensures acceptance.
• Some authors have complained of peer reviewers who engage in pla-
giarism: stealing unpublished ideas and/or the research approach of
authors whose work has been sent to them for review; there have also
been complaints by authors against reviewers who allegedly delayed
publication of authors’ work when it competes with their own (Row-
land, 2002).

This is a fairly long and still incomplete list of complaints that com-
plainants have sought to document and justify. From the sheer length of
such a list and the serious nature of the allegations, we should reasonably
be persuaded—at the very least—of the need to find a more direct route
through the maze, to bypass the impasses created by the many vocifer-
ously expressed objections, which tie us up in rhetoric and argument,
argument and rhetoric that over the past two decades and more show no
sign of abating or of reaching any definite conclusion.
In evaluating the practice of peer and editorial review it would be a step
in the right direction if we can get beyond matters of mere belief. One way
to get beyond conflicting opinions in this area is to study the underpinning
psychology of peer review and editorial bias. Such a study, as we shall see,
shows us unequivocally how weak, inadequate, and at times manifestly
unacceptable are the prevailing means routinely used to arbitrate the
quality of works submitted for publication.
Despite the plethora of publications that examine peer review, it is sur-
prising that none has taken this focus. Martin, Baker, Manwell, and Pugh
(1986, p. 4) is unusual even in mentioning this topic and then immediately
places an examination of “psychological motivations” to one side, prefer-
ring to pay attention to other things. More recently, Frey (2003, p. 208)
has noticed that no one has offered “any theory about the behavior of
referees . . . [n]or is there any well-worked out theory on the behavior of
editors.” He cites Laband and Piette (from Gans, 2000, p. 119), who state
“to our knowledge, no widely accepted theory of editorial behavior has
ever been articulated.” To be sure, for it to be “widely accepted” it must
The Psychology of Abuse in Publishing 151

first be articulated, and apparently no one has (if anyone has, it hasn’t suc-
cessfully passed the gatekeepers to publication). This stands before us as
a gap to be filled. Let us therefore look at the emotional and cognitive
factors that can play a determining role both in the recommendations of
peer reviewers to publish or not to publish manuscripts and in the related
decisions and text-modifying interventions of editors.
After devoting four decades to the study of the psychopathology and
epistemology of belief, it has become abundantly clear to me that the vast
majority of the decisions that people make, in whatever context they make
them, are determined largely by belief rather than knowledge. We are a
species ruled by our preferred beliefs, and they predispose and control us
to an extent that we seldom fully recognize or appreciate.
Adherence to belief is often rigid and recalcitrant to change. Like
highly rigid commitments of any sort, inflexible adherence to belief can
result in pathology, for strict, blind, or unyielding adherence to belief
can, in many situations and contexts, become harmful—that is, destructive
and dysfunctional and hence pathological.
In this chapter, my concern is to identify and describe some of these
unrecognized pathologies of belief that are destructive in today’s accepted
publishing practice and that are especially dysfunctional in their capacity
to block the publication of creative, original research.
Having reached more than the halfway point in this book, readers will
likely have developed a sharpened vigilance to some of the ways in which
obeisance to the gold standard of psychological normality influences
human beliefs, preferences, and judgment. To avoid a needless frequent
repetition of the same refrain, I encourage you to share in some of the
reframing initiative: to continue implicitly in the background to frame
the ensuing discussion in terms of the habitual and uncritical priority
given by the normal population to the fashions, paradigms, and discipli-
nary interests that form the normal status quo—all of which arise and
are maintained as a consequence of the high regard invested by the
psychologically normal majority in what it judges to reflect its own traits,
tastes, and systems of belief.

It is usually thought that “prepublication restraint”—that is, censorship of

writing before it can be published—no longer exists to any great degree in
the United States or, for that matter, in educated, industrialized countries
of the West. But this is indeed far from the case. Peer review and the deci-
sions of editors erect an intimidating, sometimes demoralizing, and often
impenetrable wall to authors whose opinions, ideas, research approaches,
152 Normality Does Not Equal Mental Health

and research results conflict with the status quo of prevailing, preferred
beliefs. Peer and editorial review, by definition, serve as “prepublication
restraints”: that is their intended and stated purpose, in the presumed ser-
vice of ensuring greater quality, accuracy, and validity in publications. But
that intention, because it has become so diffusively absorbed in our
habitual practice, masks a psychology that has long gone undetected and
unanalyzed, a psychology that has, once we have made a decision to con-
sider it, obvious shortcomings and realized potentials for abuse.
These potentials for abuse are what this chapter is about. It seeks to
show how the abuses that conventional prepublication restraint lead to
are manifestly dysfunctional—so much so that it is appropriate to call
them symptoms of a specific form of psychopathology that we have
allowed to go unexamined for too long, and to exist under the cloak of
respectability as the arbiter elegantiae of publication.
The abusive use of peer review and editorial judgment are sensitive
topics, with a potential to give unintended offense to some readers, peer
reviewers, and editors, and so it is important that we step back from the
emotionally distracting issues for a moment in order to appreciate the
larger historical framework within which peer review and editorial
decision-making have evolved. The resulting picture of publishing prac-
tice has some intrinsic interest of its own and will help us to gain distance
from the subject we wish to consider.

GAG ORDERS THROUGH TIME: SOCRATES,

SAVONAROLA, COPERNICUS, BRUNO, GALILEO
[I]t is not permitted to contrive new ideas to defend a conclusion or to
use a method of defense that entails new principles. This is a danger to
be avoided. I could give many examples to make it clear that, in regard
to conclusions, to principles, and to the method of defense, dangers arise
from variety, from novelty, and from doctrines that are less than solid.
—Claudius Aquaviva, S.J. (1543-1615), General of the Society of Jesus
(from Aquaviva’s letter of instruction to all Jesuits, which formed certain of
the grounds for Galileo’s later condemnation; Blackwell, 2006, p. 210)

We could not wish for more instructive—or sadder—illustrations of

prepublication restraint gone bad than in the cases of Socrates, Savona-
rola, Copernicus, Bruno, and Galileo. All five men were judged by their
contemporaries and professional peers, who sought to silence them or
change their published views, in three out of the five instances by putting
them to death. All five, in different ways, made contributions that we now,
with the improved vision of hindsight, recognize to have been major and
The Psychology of Abuse in Publishing 153

original. Here are five abbreviated case studies of peer review and editorial
tampering from long ago:

1. Socrates (c. 470 BCE–399 BCE), who has been called “the greatest
hero of freedom of thought” (Laurence Berns, in Cropsey, 1964), is
known for having chosen to accept the death penalty rather than
cease philosophizing and expressing his ideas publicly. When oral
presentation was the main way to communicate to the public, speak-
ing publicly was publication. Socrates represents one of the earliest
Western martyrs to fall before the power of censorship in the service
of orthodoxy.
2. Girolamo Savonarola (1452–1498) also challenged the preferred
beliefs of his contemporaries. He is known for his passionate social,
political, and religious criticism. When the Medicis were over-
thrown, Savonarola introduced what many historians regard as the
best democratic government Florence had every known. His success,
his political convictions, and the enmity of corrupt Pope Alexander
VI led to a papal gag order, which sought to prohibit Savonarola
from preaching. Despite his enlightened and original contributions
to Florence, Savonarola was brutally tortured, condemned in a per-
functory ecclesiastical trial, then hanged and burned.
3. Nicolaus Copernicus (1473–1543), the Polish astronomer who argued
that the planets revolve around the sun and that the Earth itself
revolves once a day in its orbit around it, was the victim of what I’ll
here call “editorial tampering.” He formulated his planetary theory
in De revolutionibus orbium coelestium libri vi (“Six Books Concerning
the Revolutions of the Heavenly Orbs”), not published until the year
of his death. It was greatly to influence his successors, Galileo,
Kepler, and Newton. But its publication was victimized by editorial
tampering: The task of overseeing the printing of De revolutionibus
in Nürnberg was turned over to overzealous Andreas Osiander, a
theologian who had tried to persuade Copernicus to represent his
theory as no more than hypothetical. With Copernicus living at a
safe distance, Osiander made changes in the book without the
author’s permission. Osiander furthermore had the presumption
and arrogance to add an unsigned “Letter to the Reader,” inserted
in the published work immediately after the title page, informing
the reader that the book described only hypotheses that made no
claim to truth. As if this were not enough, Osiander proceeded to
change the title of the book from the original “On the Revolutions
of the Orbs of the World” to “Six Books Concerning the Revolu-
tions of the Heavenly Orbs,” a change which he seems to have felt
154 Normality Does Not Equal Mental Health

would weaken the impression that the book described the real physi-
cal universe. Osiander’s editorial tampering did not come to public
light until Kepler exposed it in his Astronomia Nova of 1609.
4. Giordano Bruno (1548–1600) was an astronomer, mathematician, and
philosopher, several of whose theories were considerably ahead of
his time, among them his theory that the universe is infinite in
extent, that there are innumerable planets substantially similar to
those in the solar system, and that geocentrism is false and a quasi-
Copernican view right (Bruno developed his own version). He was
irritated by theological nit-picking, and advocated freedom of speech
and thought, for which he was excommunicated in a succession of
cities in which he tried to live in both Italy and Germany. He was
placed on trial in Venice and then in Rome, where the proceedings
dragged on for seven years. His judges demanded his unconditional
retraction of his theories. When Bruno claimed that he had nothing
to retract and did not understand what he was expected to retract,
Pope Clement VIII ordered his execution as an impenitent heretic.
Bruno’s tongue was bound in a gag—the cruelest and most literal
gag order in history—and he was burned alive.
5. Galileo Galilei (1564–1642) is well-known for his contributions to
astronomy, the physics of motion and strength of materials, and the
development of scientific method. He developed and gradually
improved his own version of the Dutch telescope, through which
he discovered, for example, four of Jupiter’s moons and the phases
of Venus. His discoveries strengthened his belief in the Copernican
view, for which the Church sought to silence him; later he was
brought to trial in what lives on in memory as an example of Church
narrow-mindedness and infamy, forcing Galileo in humiliation pub-
licly to retract his support of Copernican theory. It was not until
1992 that the Vatican finally expressed regret for its condemnation
of Galileo’s views.

RELIGIOUS BELIEF, IMPRIMATUR, THE INQUISITION,

AND THE INDEX LIBRORUM PROHIBITORUM
To be sure, institutionalized religion was responsible for the judgments
against Savonarola, Bruno, and Galileo (both the Protestant and Catholic
churches in the case of Bruno), and religious dogma was involved in the
execution of Socrates and in the editorial tampering that victimized
Copernicus. Religious beliefs were at stake (no play on words is intended)
so that the “peer review” of the time was dominated by religious commit-
ments and the zeal to defend them.
The Psychology of Abuse in Publishing 155

The Inquisition expressed the resulting mindset of rigid belief and an

associated aggressive intolerance toward those not in the fold and is
synonymous with many of the atrocities committed in the name of
Catholicism. The widespread but false view is that the Inquisition came
to a stop centuries ago, but in fact it survived in Spain until 1834, while
the term was not formally dropped by the Vatican until 1908, when the
congregation charged with maintaining the “purity of faith” was named
the “Holy Office.” This congregation was then again reorganized in
1965, and called the “Congregation for the Doctrine of the Faith,” which
persists today. Its task—still—is to promote orthodoxy.
In this context of belief paranoia, the Catholic Church developed its
own specialized form of prepublication restraint. Imprimatur, which
means “let it be printed,” was—and still is—required by Catholic canon
law. Before permission to publish, authorized by imprimatur, can be
given, a Church censor must judge that nothing in a work is offensive to
Church faith or morals; if the work passes muster, a stamp of approval in
the form of a nihil obstat is given (“nothing hinders [the work from being
printed]”).
The first “index” of prohibited books was published in 1559 by the
Sacred Congregation of the Roman Inquisition (a forerunner of the Con-
gregation for the Doctrine of the Faith). The Index Librorum Prohibitorum
(“Index of Forbidden Books”), listing books believed to be dangerous to
the faith or morals of Catholics, wasn’t discontinued until 1966. Before
this, canon law imposed two kinds of restraint on publication: the censor-
ship of books in advance of publication (a practice that continues today)
and the condemnation of works considered to be dangerous to Catholic
doctrine and faith. The Church focused enforcement efforts on the works
listed in the Index.
I end this section with quotations from the three peer reviewers com-
missioned by the Society of Jesus to examine and recommend for or
against the publication of a work by Melchior Inchofer, S.J., who was con-
sidered an authority at Galileo’s trial and strongly influenced its outcome.
Inchofer’s book was titled A Summary Treatise Concerning the Motion or
Rest of the Earth and the Sun, in which it is briefly shown what is, and what is
not, to be held as certain according to the teachings of the Sacred Scriptures
and the Holy Fathers (Rome: Ludovicus Grignanus, 1633). Here is how
the appointed peer reviewers judged this work, which we now realize
was science at its worst: “My judgment, therefore, is that this treatise is
beneficial and should be published, especially since I have found nothing
in it that is contrary to sound doctrine” (Fr. Luke Wadding, O.F.M.,
Commissary General of the Roman Curia). “Therefore we have granted
permission for it to be published . . . (Muzio Vitelleschi). “Let it be
156 Normality Does Not Equal Mental Health

printed” (Fr. Niccolò Riccardi, O.P., Master of the Sacred Apostolic

Palace; quotations from Blackwell, 2006, p. 106).
What I want to suggest here is the hypothesis that only the variety of
dogmatically defended orthodoxy has changed since Galileo’s trial and
not the underlying psychology of many peer reviewers and editors, to
which we shall turn in a moment.

SEDITION, TREASON, CENSORS, AND CENSORSHIP

When we look at the extremes to which the adherents of beliefs will go
in the defense of their preferred opinions, we see that the many strategies
they have used to silence their opponents possess a common psychological
dynamic: in the political arena, the condemnation of sedition and treason
and the enforcement of censorship manifest a state of mind characterized
by defensiveness arising from insecurity that closely mimics parallel attempts
in organized religion to control beliefs and their expression. Sedition is a
crime against a state by encouraging opposition to it, whether through
speech or writing. English common law made it a criminal offense to pub-
lish seditious writing or to express seditious speech. Treason is closely
related: in the United States, treason is considered to be any act of war
against the country or any act that supports the beliefs of its enemies.
Sedition involves expression; treason, action.
Censorship, in its application to publishing—our focus here—means
prepublication control or, to put this more directly, publication prevention,
often termed “prior restraint” in law. At issue in this context are restrictions
imposed by censors that limit what is published and often the way in which
authors choose to use language. This is actively imposed censorship. There
is also self-censorship through passive acceptance of a prevailing set of
values, as when many authors today appear unquestioningly to presuppose
the validity of cultural relativism in formulating their results, or accept con-
straints of political correctness in views they advocate, or comply with
gender-neutral uses of language even when doing this can force their use
of language to become ungrammatical and terminologically monotonous.
This is passively accepted censorship. Together, actively imposed and
passively accepted censorship limit what is published. One of the main con-
sequences of publication censorship is to create an atmosphere of anxiety,
fear, and resulting conformity in which authors can be blocked from pub-
lishing innovative work. It is this phenomenon—the blocking of innovative
ideas and approaches—that will particularly concern us later.
Censorship has been present for a long time in the history of book pub-
lishing. Freedom of the press has come about in large measure as a result
of incremental resistance against censorship. I cannot recount this history
The Psychology of Abuse in Publishing 157

here, which includes the role of the Stationers’ Company in England; cen-
sorship wielded by the Sorbonne in France; Frankfurt’s imperial censor-
ship commission; the notorious actions of the British Star Chamber;
Milton’s eloquent defense of freedom of the press in his Areopagitica, in
which he argued that there was no possible justification for censorship;
England’s Licensing Act of 1662; and the eventual abolition of censorship
by Sweden in 1766, by Denmark in 1770, and by Germany in 1848. The
French National Assembly of 1789 took the strongest position, still often
quoted: “The free communication of thought and opinion is one of the
most precious rights of man; every citizen may therefore speak, write
and print freely.”
Let us, however, pause with Milton for a moment. In his Areopagitica,
he urged acceptance of the principle that censorship blocks “a free and
open encounter”; it may sometimes block error, but there is, he believed,
a genuine positive good that comes from exposure to error, for this is the only
way that truth can be tested and strengthened—a principle basic to scien-
tific investigation. It’s likely that Milton would have opposed peer review
and editorial tampering because of the ways these forms of thought con-
trol in publishing can run aground, homogenize and normalize the uni-
verse of expressed ideas, and establish obstacles to creative research.
Suppression of publication still continues—worldwide—under the
guise of suppression of obscenity, libel, and opinions whose expression
might “endanger national security.” In this context, censorship has
become a way of blocking or forcing changes in writing that is judged to
subvert “the common good,” writing that can in various ways express what
in the history of publishing have been called “forbidden sentiments.”
The public’s freedom to contest political issues and government deci-
sions can of course lead to unrest and instability, which, while undesirable
in themselves, are usually transitory. But, in contrast, the history of cen-
sorship has shown us that the abusive nature of publication censorship,
in the form of prior restraint or postpublication sanctions, can be much
more serious by handicapping the long-term development of knowledge
and culture. This, too, as we shall see, applies, mutatis mutandis, to the
abuses of peer review and editorial control.

ACADEMIC FREEDOM VERSUS PEER REVIEW

AND EDITORIAL TAMPERING
In principle, academic freedom provides scholars with the liberty to
inquire into opinions, ideas, and theories that are unpopular at the time.
Rigid adherence to preferred beliefs by peer reviewers and editors can
effectively restrict the freedom of researchers to publish the results of
158 Normality Does Not Equal Mental Health

their inquiries and therefore can restrict exchanges among them and com-
munication to the public.
Academic freedom and peer review are seldom recognized to be in
potential conflict with one another. Academic freedom is generally under-
stood to provide for the unrestricted liberty of teachers and scholars to
study whatever subject or set of ideas or beliefs interests them and to com-
municate their research to others through publication and teaching with-
out interference from censorial controls; academic freedom equally
provides for the unrestricted liberty of students to study the subjects they
wish and to think freely and to develop and express their views. Peer
reviewers, when their judgments block the access of teachers and scholars
to publication, obstruct much that academic freedom stands for.
The values basic to academic freedom are thought to be justified by sev-
eral interrelated tenets: that education and the growth of knowledge are
most strongly encouraged when research, study, and publication are kept
free of control by the state, religious institutions, or any special interest
group. The judgments of peer reviewers routinely reflect their adherence
to the special interests of political, social, or religious bias, and when this
happens the control they exert undermines the values of academic freedom.
Ironically, the historical foundations for academic freedom were laid by
medieval universities in Europe despite the fact that their own professors
sought to exercise restraint upon and condemnation of the publications
of their colleagues when their manuscripts violated religious beliefs.
These censorious faculty colleagues were among history’s first peer
reviewers. Academic freedom and the freedom to publish have been
uncomfortable bedfellows for a long time.
Conflict between peer review and academic freedom can be most pro-
nounced in the humanities, where the lack of an accepted unitary method-
ology, the absence of a body of accepted results that is built upon
incrementally over time, and the proliferation of special interest ideol-
ogies characterize much of liberal arts research, teaching, and publication.
During the last century, for example, suppression of academic freedom in
the humanities has been much more widespread in the communist coun-
tries than it has in these same countries in mathematics and the natural
sciences, in which researchers have had more freedom of inquiry.
The explosive spread of obsessive sensitivity to “political correctness”
has also, as one would expect, affected work in the humanities to a greater
extend than in mathematics and science, in which discussions and research
results tend to be less immediately applicable to and influenced by inflam-
matory social and political issues. The adoption by many U.S. universities
of so-called “speech codes” during the last two decades of the twentieth
century has contributed to higher education’s and the general society’s
The Psychology of Abuse in Publishing 159

sensitization to political correctness and has provided many special inter-

est groups with deeply felt justification for their increased sensitivity to
offense in connection with ethnicity, race, religion, political persuasion,
gender, sexual orientation, ethnic language and grammar variants, and
general multiculturalism. There is now increasingly a wider and wider
spectrum of issues over which offense can be taken and therefore prepub-
lication restraint imposed.
The complex network of entangled sets of mutually exclusionary
beliefs, whose proponents are frequently hostile toward one another, is a
phenomenon that we see in the worldwide strengthening of ideological
fundamentalism, and this, perhaps ineluctably, has spilled over into the
highly specialized worlds inhabited by research scientists, academics,
scholars, peer reviewers, and journal and book editors. Like the strongly
entrenched believers of other special interest groups, researchers, aca-
demics, scholars, peer reviewers, and editors share a sometimes uncom-
fortable universe of discourse in which those seeking to publish run
afoul of the private censorship that some peer reviewers and editors seek
to enforce by limiting publication to an acceptable range of approaches,
ideas, persuasions, beliefs, writing styles, and choices of terminology.
The effect of such prepublication restraint is of course felt most keenly, as
one would expect, by writers who push the boundaries of acceptability, who
propose ideas and endorse beliefs that at the time are unconventional, and
who have been and remain the main contributors to intellectual progress. It
is perhaps most importantly for their sake that academic freedom to publish
needs to be assured, often in the face of beliefs rigidly held by peer reviewers
and editors. The question is whether this can plausibly be accomplished
given the psychological predispositions of peer reviewers and editors.

RUNNING AFOUL OF THE BELIEF SYSTEMS OF PEER

REVIEWERS AND EDITORS: VARIETIES OF ABUSE IN
PEER REVIEW AND EDITORIAL TAMPERING
[I]t would be useful to know the fates of daring proposals that failed to
make it through peer review. Were some vindicated with the passage of
time? How prescient were the peer reviewers in judging the promise of
the applicants? Were they better, let’s say, than . . . a lottery?
—Daniel S. Greenberg (1999, p. 2092)

Let’s consider an example of what can happen as a result of rigid adherence

to the preferred beliefs of editors and peer reviewers; it illustrates what did,
in fact, recently occur when an author submitted a manuscript that con-
flicted with peer review and editorial bias.
160 Normality Does Not Equal Mental Health

By way of background, we need to recognize that some 60 million

Americans serve as hosts to the brain parasite Toxoplasma gondii. In rats,
this parasite influences their brain chemistry so they are motivated to seek
out cats and so be killed; in this way the parasite can complete its repro-
ductive cycle in the cat. It has been hypothesized that toxoplasmosis infec-
tion may also result in changes in human behavior, some subtle, some
manifestly schizophrenic. Biologist Kevin D. Lafferty, for example, has
correlated high levels of human toxoplasmosis infection with elevated
levels of neuroticism in 39 countries.2
In the context of this research, parasitologist Jaroslav Flegr of Charles
University in Prague has suggested that the consequence of human toxo-
plasmosis infection may be to unbalance the sex ratio of newborn infants:
104 boys to every 100 girls is normal, but in women who have developed
high levels of antibodies to T. gondii, the ratio according to Flegr becomes
260 boys to 100 girls. One possible explanation for this effect, again
according to Flegr, is that T. gondii may suppress the mother’s immune
system so that the normal tendency of the maternal immune system at
times to resist the development of male embryos is neutralized; as a conse-
quence, more boy babies are born.
Flegr’s study ran into the prevailing, preferred beliefs of journal edi-
tors. He observed: “People don’t like the possibility that their behavior
and life are manipulated by a parasite.” What editors like to believe became
a block to the publication of Flegr’s original research. “Our present study
was rejected by eight journals” (Svitil, 2007, p. 14). His earlier study,
which showed that toxoplasmosis infection more than doubles a person’s
risk of having a car accident, ran into the same block to publication.
One could amass many of other anecdotal accounts of similar struggles
of authors to publish papers and books that run counter to prevailing pre-
ferred beliefs, but it isn’t my purpose here to assemble a catalog of the frus-
trating experiences of authors. What we need instead is to cast light on the
underlying psychological reasons for abuses in the publishing process.
Although the following proposition is easy enough to state, and easy
enough to recognize when stated, it is often ignored: The “significance”
of a paper can’t be judged intelligently in terms of its conformity with
existing tastes and prejudices. The current “gold standard” of peer review
has an unmistakable tendency to equate these, as can editorial tampering.
Let us see in psychological terms how abuses in publishing result. Peer
review and editorial bias can become abusive in a number of ways:

1. Emotional and cognitive gratifications of power and authority. It goes

without saying that peer reviewers and editors are aware that they
act as gatekeepers to publication and hence as gatekeepers to
The Psychology of Abuse in Publishing 161

authors’ job acquisition, salary increment, promotion in rank, job

retention, and professional and research standing, as well as the
funding of research grant and fellowship proposals. Furthermore,
the judgments of peer reviewers and editors can, in the end, make
or break a scientist’s or scholar’s reputation by limiting his or her
access to publication. Within this framework of easily implemented
power, which has virtually no oversight to check excesses, a wide
range of abuses has been mentioned in the literature, including
manifest discourtesy, rudeness, verbal abuse, slighting the signifi-
cance of a researcher’s results, professional snubbing, unsubstanti-
ated destructive criticism, and others (see, e.g., Enserink, 2001;
Nicholls, 1999).
2. Anonymity and malice. The abovementioned abuses are considerably
magnified, as one would expect, by what psychologist Philip
Zimbardo (2007) has called “the Lucifer effect.” When psychologi-
cally normal people are placed in positions of authority and power—
and most especially when their anonymity is protected, as the iden-
tities of peer reviewers usually are—an opportunity is created in which
abusive intent is magnified and the door is opened to its expression.
There is nothing like anonymity to give malice free rein.
3. From belief system defensiveness to psychosis. Peer review and editorial
authority have become authorized, legitimated roles in which it is
natural for peer reviewers and editors to seek to protect their own
professional positions, research results, and sense of disciplinary pro-
priety. The emotional investment in protecting these sources of per-
sonal and professional identity can range from defensiveness to a
form of belief system psychosis in which believed-in reality is mistaken
for the one-and-only “true” reality: turf protection can become delu-
sional identification, reflecting the same psychological dynamic that
we see in any rigidly held, exclusionary, self-enclosed system of belief
(Bartlett, 2005, Part III).
4. Emotional gratifications of the familiar. It is well established that people
find emotional security in the familiar and are threatened by the
unfamiliar. There is a gratifying sense of safety in which members
of the respective disciplines feel “at home” with colleagues who share
their disciplinary perspective; who use the same familiar approaches,
concepts, and terminology; who are drawn to the same research
problems; and who share many of the same beliefs. Peer reviewers
and editors are no different in this respect: it is understandable and
to be expected that the psychologically normal peer reviewer and
editor is emotionally rewarded by his or her decisions that preserve
the familiar and that serve professional self- and group interests
162 Normality Does Not Equal Mental Health

which have become comfortable and habitual. The emotional grati-

fication experienced in a research environment made comfortable
through habituation feeds back into the psychologically normal pre-
disposition to mimic and conform to the preferences, values, expec-
tations, and behavior of others. Researchers whose work does not
conform are less likely to be rewarded, as Dyson observed in the
opening quotation.
5. Resistance, recalcitrance, repugnance, and retaliation. These are the
“4 Rs” of peer and editorial review. They describe a peer reviewer’s
or editor’s range of negative response to manuscripts whose content
trespasses beyond the boundaries of acceptable belief. Resistance,
recalcitrance, repugnance, and retaliation have both intellectual and
emotional components. When some peer reviewers and editors are
confronted by opinions, ideas, beliefs, values, approaches, results,
and so forth that they do not like or that they do not believe satisfy
criteria of the conventionally acceptable, their response may be one
of intellectual and emotional resistance, in which the submitted
manuscript is passively blocked: a form-letter variety of rejection is
then sent to the author. Should the negative response be more
strongly felt, the peer reviewer’s or editor’s reaction becomes recalci-
trant: he or she is repulsed by the views advocated in the offending
manuscript, and then derogating behaviors of the sort mentioned in
item 1 can ensue. The same is true with the last two degrees of
response, repugnance and retaliation, which are more blatantly hostile
and aggressive, the last expressing a militant judgment against the
offending author, with punitive criticism against the author that
can spill over and be re-expressed in the peer reviewer’s or editor’s
own publications and communications with colleagues. It is impor-
tant to recognize that all 4 Rs give a peer reviewer or editor an oppor-
tunity, which he or she believes is professionally sanctioned, to
gratify defensive needs and at times aggressive behavior as well.
6. Self-aggrandizement—placing the reviewer’s “stamp” on a publication.
There can be a pronounced and unmistakable experience of self-
aggrandizement when an editor or peer reviewer requires “certain
changes” in an author’s submitted manuscript. As H. G. Wells
observed, “No passion on earth, neither love nor hate, is equal to
the passion to alter someone else’s draft” (quoted in Asimov, 1987,
p. 57). Some critics of current publishing practice have complained
of the petty, nit-picking mentality to which some editors and peer
reviewers descend (e.g., Greenberg, 1999). Some can only be “satis-
fied” if, before a manuscript is allowed to pass muster, they require
an author to make a certain minimal number of changes, perhaps
The Psychology of Abuse in Publishing 163

inessential, but still reflecting stipulations that please a micromanag-

ing mindset.
7. Jealousy and competitiveness. Critics of peer review have pointed to the
paradoxical and self-defeating nature of the current system of pub-
lishing, which relies on the opinions of “rival producers” (Albert,
1997, p. 822). It is indeed far-fetched to suppose that one’s research
competitors are likely to be sources of dispassionate evaluation of
research that might equal or surpass theirs. Jealousy is a strong moti-
vating emotion, sometimes sufficient to lead rivals to dismiss without
justification competing points of view, approaches, and research
results expressed in manuscripts they review. We see the same
phenomenon in authors who will intentionally “mis-describe” the
work of a rival author and mendaciously seek to subordinate that
work to a thesis they have been advocating for a much longer period
of time. This is the same dishonest ploy used by Robert Hooke
when he attempted to preempt Newton’s discoveries by claiming,
to paraphrase him, that “whatever is new in Newton’s work, I’ve
already done.”
8. Cheapening of authorship. The value of manuscript submissions has
changed over the past several decades as a result of an exploding gen-
eral population, the consequent explosion of the population of com-
peting scientists and scholars, and the resulting terrific explosion in
the number of publications produced annually. Three to four deca-
des ago it was common practice for a journal editor or book editor
to thank an author for his or her submission, to recognize the implied
compliment expressed by the author in choosing that particular jour-
nal or publishing house as a possible outlet for his or her publication.
Today, instead, authors have learned to express their gratitude to
publishers, as do interviewees for the privilege of having public atten-
tion bestowed upon them. The burden to publish or perish placed on
the rapidly proliferating population of younger researchers, in a
world in which publications are flying off the physical and electronic
presses in ever-increasing numbers, has brought with it a cheapening
of manuscript submissions and, by implication, a cheapening of
respect that was once believed to be owed to the research efforts of
authors. Just as life becomes cheapened by overpopulation, so do
manuscripts and their authors. This general inversion of values has
paved the foundation for many of the specific abuses enumerated
here.3
9. Editorial tampering. This is, I suggest, an editor’s, and less often a
peer reviewer’s, greatest sin. We saw it in connection with unauthor-
ized changes made in the opus of Copernicus; lesser authors also
164 Normality Does Not Equal Mental Health

experience it. Sometimes personal experience should not be con-

signed to silence, while some readers may be interested in an anec-
dotal story from the author: More than a decade ago, I submitted
an article to a well-known journal, and the paper was accepted.
Before its publication the editor sent me a proof copy. I read, in a
state of shock, a text that had become victimized by extreme editorial
tampering. The editor used his “privilege” to, let us say, “recharac-
terize” my results, apparently making them more palatable to the
beliefs that he liked. There was a good deal of this, enough so that
I immediately sent registered letters both to the editor and publisher
saying that, unless my original text was restored, I refused to author-
ize the publication of the paper. There was no answer to either letter.
Some time later, and despite timely objection well in advance of pub-
lication, I received author’s copies of the printed journal in which my
article was published—with all of the editor’s tampering intact. I am
not litigious by nature, but this was simply too much; I retained an
attorney who requested an appropriate resolution. The result? The
journal later published a statement, expressing regret for “numerous
and substantive changes and abridgments . . . to which the author had
not consented,” and offered to send readers upon request an offprint
of the text as it had originally been written. My attorney’s fee was
paid by the journal, a small satisfaction, since few readers, I feel sure,
ever bothered to request the text as originally written, and the phrase
“editorial tampering” was born in the author’s mind.
10. Expressions of the psychology of stupidity. The psychology of human stu-
pidity has been little studied in preference to study of its more attrac-
tive big brother, intelligence. The psychology of stupidity is,
however, an area of proper study in itself. Human stupidity is not sim-
ply an absence of intelligence; it is characterized by a distinctive set of
psychological predispositions, identified in Bartlett (2005). Many of
these play a role in the psychology of peer and editorial review since,
unfortunately, these characteristics are not rare in the population
nor even within the higher echelons of scientific and scholarly pub-
lishing. To make this listing of varieties of peer and editorial abuse
as concise as possible, only three of these predispositions will be men-
tioned here: There is, first of all, a strong source of human gratifica-
tion to be found in personal denials both of ignorance and of lack of
specialized knowledge and skills. Many of us resort to denials of this
kind in order to make ourselves feel better when we’re confronted
by people who far surpass us in areas in which we are bumbling
incompetents. We may simply deny their superiority, we overlook it,
we do not in fact seem even to notice it. This is a form of denial that
The Psychology of Abuse in Publishing 165

is part of human stupidity. Related to it is intellectual stubbornness

and the gratification that comes from pig-headedness. Such a person
can pat himself or herself on the back for fidelity to tradition, to
“established disciplinary standards,” and so on, and in the process be
patted on the back by like-minded colleagues. Such pats as these are
gratifying to receive, but they have an intellectually stultifying effect.
Third, and perhaps most importantly, peer reviewers and editors
can, on a fundamental level, lack the intellectual intelligence, skill,
and breadth of knowledge that are necessary in order to appreciate a
creative author’s original work. All of these expressions of the psy-
chology of human stupidity come with built-in gratifications that
maintain and preserve a self-limiting outlook. (For a detailed discus-
sion and analysis, see Bartlett, 2005, Chapter 18.)
11. The presumed equality of opinions. There is a strong psychological bias
today in favor of a presumption of the equality of opinions. It is a
bias that engenders hostility toward claims to “intellectual authority”
and resentment toward the recognition of elitist expertise. However,
the authors of many papers and books know far more about their
particular subjects than anyone else does, for many have spent long
periods of time—years, perhaps their whole professional lives—
dedicated to studying and advancing knowledge in their particular
specialized areas of research. Yet, when these authors submit their
work for publication, the general disfavor into which elitist expertise
and authority have fallen has prepared the state of consciousness of
peer reviewers and editors. Like innocents abroad, reviewers and
editors can be emboldened to critique and nit-pick in specialized
areas in which, to be realistic and to call a spade a spade, they know
little more than the crassest amateur. This problem is greatly com-
pounded when an author’s research embraces several different disci-
plines simultaneously, for then it becomes virtually impossible to
find, in any single peer reviewer, the qualifications, skills, and
breadth of knowledge that are necessary in order competently to
evaluate the author’s work.
12. Rejection of novelty. Advances in knowledge are often made as a result
of obsolescence of what was thought to have been known: old beliefs
succumb and are superseded. This can be an unpleasant and uncom-
fortable experience for anyone who has dedicated years of his or her
life to theories and results that are now threatened by someone’s
original, new approach. It is therefore natural to reject novelty and
“to do whatever may be necessary” to retain a grip both on the public
acceptability of the understanding one has struggled to promote and
on one’s own resulting professional status.
166 Normality Does Not Equal Mental Health

An even dozen is probably enough in this noncomprehensive description

of the psychological basis of abuses to which peer review and editing can
fall victim. These abuses obviously do not occur all the time, in connection
with every manuscript submission. We still don’t know how often they
occur, although authors dubious of the value of peer review continue to call
for serious, empirical study of the value and effectiveness of this publishing
mechanism. Marsh, Bond, and Jayasinghe (2007, p. 33) recently com-
mented: “Given the central importance of the peer review process to sci-
ence, there is surprisingly little evidence of the use of scientific methods
to evaluate the peer review process.” Enserink (2001, p. 2187) similarly
noted that there is “little evidence that peer review actually improves the
quality of research papers,” and went on to mention the need for journals
to “study their own practices with the scientific rigor they demand of their
authors—as should agencies that rely on peer review to dole out billions of
dollars in research money.” Greenberg (1999, p. 2092) observed:

It’s time for an evidence-based assessment of competitive peer review, the

clunky procedure enshrined in science for making choices about who gets
money and who sinks into oblivion. . . . The defenders have fallen back on
such tattered lines as “If it ain’t broke, don’t fix it” and, paraphrasing
Churchill on democracy, “It’s the worst possible system, except for all
others.” . . . [T]he merits of peer review remain remarkably unexamined,
despite complaints about nit-picking assessments, poorly qualified
reviewers, clique-ish bias, purloining of ideas, and aversion to risk. . . .
Peer review, however, is one of those subjects about which much is said
with certainty but little is known.

But we do—on the contrary—know a good deal about peer review and edi-
torial authority: specifically, we know a good deal about the underlying and
chronically ignored psychology of abuse that comes from a system in which
reviewers are allowed to hide behind masks of anonymity; are free, if they
wish, to engage in destructive and hostile criticism without restraint; and
are often chosen precisely because they are research competitors of the
author whose work is to be evaluated and hence are psychologically the least
well-suited to pass judgment because their judgment runs a high risk of
being prejudiced. Furthermore, we also know a good deal about the
dynamics of belief systems and the pathologies to which rigidly held beliefs
can give rise. It is plausible to suppose that peer reviewers and editors are
usually regular people, and that they are therefore subject to the same
shortcomings as the population of psychological normal people.
We do, in short, know enough to be able to predict and therefore expect
the abuses we’ve identified, even though there have as yet been no data-
based studies to tell us their prevalence. But other studies of the prevalence
The Psychology of Abuse in Publishing 167

among psychologically normal people of such phenomena as obedience to

authority, the “Lucifer effect,” participation in state-endorsed wars and
group-sponsored genocide, the contagious effect of group prejudice and
aggression, the emotional and cognitive gratifications of adherence to the
ideology of one’s group, and similar pathologies (Bartlett, 2005) would,
however, suggest that the abuses we’ve discussed are far from being rare,
and are indeed very common.
There are two remaining issues that I’d like to confront: the hypothesis
that the abuses to which peer review and editorial bias are subject consti-
tute, in a certain legitimate sense, “psychopathologies” in their own right,
and the suggestion that these abuses present obstacles to the publication
of original, creative research.

THE PSYCHOPATHOLOGY OF PEER REVIEW AND

EDITORIAL BIAS: BLOCKS TO CREATIVE RESEARCH
The lack of sound judgment among people who have the fate of science
and the lives of others in their hands is appalling. . . . The referee system
as currently constituted is a disaster. What is most disastrous is its built-
in bias against highly innovative work. The towering achievements of sci-
ence for the most part have their origins in brilliant individual minds.
These minds are exceptionally rare. The concept of peer review is based
on two myths. The first is that all scientists are peers, that is, people who
are roughly equal in ability. The second myth is that in those rare instan-
ces in which someone who is exceptional does appear, the ordinary scien-
tist always instantly recognizes genius and smoothes its path. No one who
knows anything at all about the history of science can believe for one sec-
ond in either myth. Most scientists are not the peers of the very best, and
most scientists follow the crowd when it comes to the recognition of bril-
liance. The concept of peer review is philosophically faulty at its core.
—Horrobin (1982, pp. 33–34)

[W]e must take seriously the possibility that we have traded innovation
for quality control. . . . The numbers of truly important, innovative
articles presented to an editor are small. Yet it is this tiny minority of
articles that is responsible for [advancing knowledge]. . . . It is my view
that innovation is so rare, so valuable, and so central . . . innovative
articles should be deliberately encouraged and more readily published
than conventional ones.
—Horrobin (1990, p. 1439)

[Peer review is an] . . . enormous waste of scientists’ time, and the abso-
lute, ineluctable bias against innovation.
—Roy & Ashburn (2001, p. 394)
168 Normality Does Not Equal Mental Health

In Bartlett (2005, Part I) I examined the main theories of disease in order

to identify, within the existing framework of the science of pathology, the
criteria that must be satisfied in order for the term ‘pathology’ to be applied
meaningfully to acknowledged signs of harm. The outcome of that discus-
sion was, in a few words, to recognize that a condition constitutes a pathol-
ogy if it results in perceived harm in the context of a set of desired purposes,
the attainment of which is impeded by the condition. In this sense, for
example, a medical patient is judged to be incapacitated by a certain pathol-
ogy when his physical condition undermines his ability to function as he
otherwise would and wants to be able to. In other words, to qualify as a
pathology, a condition must be judged to be harmful relative to a set of
goals. The concept of pathology has direct application in the context of
the psychology of peer review and editorial bias and occasionally has been
applied by a few authors, always in passing. Ziman (1982, p. 61), for exam-
ple, calls the unproved standing of peer review “a gravely pathological sit-
uation, calling for serious inquiry and radical remedy,” while Horrobin
(1990, p. 1441) refers to the suppression of innovation through peer review
as a form of “psychopathology” in which the “sophisticated behavior” of
“the most distinguished scientists” is “pathological.”
The vocabulary of pathology is bandied about with a good deal of free-
dom, often in applications intended to be only metaphorical. Here, we’re
not concerned with a metaphor.
Prepublication restraint has, as we’ve seen, been imposed for a variety
of explicit and alleged purposes: to protect religious or political ortho-
doxy, and in peer review and editorial decision-making to protect scien-
tifically or academically reputable publishing. Peer review and editorial
decision-making are not established with the explicit and specific end in
view of promoting original research. They are inherently conservative
mechanisms designed to further the goals of established scientific or
scholarly orthodoxy, which is to say, to normalize: to protect against what
we might call “secular blasphemy”—dissension from the current prevail-
ing dogma, school of thought, paradigm, and criteria of accuracy, validity,
and scholarship. Secular blasphemy, a.k.a. political incorrectness or disci-
plinary heresy, is the crime of dissenting from whatever is the current
dominant system of belief. ‘Blasphemy’ is the shapeshifting word that is
molded to suit the objectives of those who oppose criticism of or depar-
tures from the ruling authority’s orthodoxy of the moment.
Peer reviewers and editors are not umpires of the truth or falsity of doc-
trine; their role is to remain neutral. And yet, again and again throughout
human history, and continuing today under the guise of relativism, multicul-
turalism, deconstructionism, postmodernism, feminism, and their cohorts,
peer reviewers and editors will often—as it is indeed psychologically normal
The Psychology of Abuse in Publishing 169

to do—reflect in their evaluations of prospective publications their favored

tastes and prejudices, their ideological and disciplinary preferences, and then
will, like religious and governmental censors of times past and present, reject
or seek fundamentally to modify manuscripts that diverge from the ortho-
doxy they advocate. Like religious and government censors, they stand
guard before the gate to block the entrance of the “forbidden sentiments”
and “false doctrine” that have so threatened the dogmas of the past. All of
these are patterns to be expected; they are only human; we can predict these
behaviors from our knowledge of the underlying psychology.
And yet we realize that important contributions to the advancement of
knowledge in any discipline occur only as a result of the efforts of
researchers who are capable of extending, or of breaking free from, the
limits of existing understanding. When we see things from this perspec-
tive, the 12 predictable abuses to which peer review and editorial bias
can give rise will be seen to constitute nonmetaphorical pathologies that
can play a destructive, harmful role as obstacles to the goal of publishing
original, creative research.4
In Bartlett (2005, Parts II & III), a wide range of pathologies is studied,
pathologies that result in undebatable harm to countless people, from
individuals to entire societies, pathologies that have their basis in normal
psychology. Wars, genocides, obedience to authority, human ecological
pathology, terrorism, pseudospeciation, psychic numbing, devaluation
and dehumanization of others, moral stupidity, and cognitive delusion—
to name a few of the principal pathologies—are consequences of the
psychologically normal constitution. The theory of disease has usually
associated the term ‘pathology’ only with conditions that are aberrations
from normality, and yet there is solid empirical evidence, and solid back-
ing from leading disease theorists, that compels the recognition of pathol-
ogies so widespread as to be considered “universal,” afflicting the great
majority of people.
The abuses that I’ve described above to which peer review and editorial
bias are subject come about as a result of a psychologically normal
constitution that seeks, among other things, to defend cherished beliefs,
to defend personal and professional identity, and to defend sets of essen-
tially conservative values within territorially protected disciplines. The
conclusion we have come to and, I submit, the only rational conclusion
to be drawn from this discussion, is that peer review and editorial bias,
because they will express the psychologically normal constitution, cannot
be freed from the abuses to which they are subject. The potential
for abuse can only be minimized to some degree through intelligent over-
sight. A group of much-needed professional guidelines that might accom-
plish this will be proposed in a moment.
170 Normality Does Not Equal Mental Health

Christine Wenneras and Agnes Wold of Göteborg University, Sweden,

have called for “the development of peer-review systems with some
in-built resistance to the weaknesses of human nature” (see Morris,
1997, p. 1611). How are we to go about achieving this?

OBLIGATIONS TO WHICH PEER REVIEW

AND EDITING MUST ANSWER
As things now stand, most editors proceed in the following way in
processing a manuscript submission: They give it a general glancing over
and may reject it immediately if the manuscript is perceived to be unre-
deemable or inappropriate for that particular journal or publishing house.
If the manuscript passes this first level of inspection, it is passed on to a
small group of peer reviewers, who may or may not have been nominated
by the author. The author usually remains in the dark as to the identities
of the peer reviewers actually chosen by the editor. Once the peer
reviewers have read or at least considered the paper or book, their reports
are sent back to the editor, who then reads the reports and makes a deci-
sion whether to proceed further. He or she may decide to reject the manu-
script, request that “certain changes” be made, or, increasingly rarely,
publish the work as it stands. All of this seems straightforward. However
it is not, and there are crucial questions that sometimes are, but probably
often are not, asked in the process. Here is an imagined exchange between
Professor Naı̈veté, who asks the questions, and Professor Cynicismus,
who answers them:

Prof. Naı̈veté: Are the peer reviewers truly qualified to judge the
manuscript? Are they professionally competent to judge what is often the
work of an advanced specialist, or are they junior faculty whose research
experience and expertise are still in the embryonic stages? If the manuscript
involves multidisciplinary competence on the part of the author, can the
editor find peer reviewers with similarly broad competence?
Prof. Cynicismus: Two things are happening in the growth of
knowledge: the increasing specialization of experts and the cross-linking
of discoveries in different disciplines. As a result, authors who have the
training and professional backgrounds to span several disciplines at once
are at a concerted disadvantage when their writing is reviewed by peers who
are specialists in single fields. Yet the need for such cross-disciplinary
contributions now, more than ever in human intellectual history, is
unarguable. Reality no more has disciplinary divisions than does the earth
show the territorial borders of nations when it is seen from space. In my
experience in publishing numerous papers and books, the vast majority of
The Psychology of Abuse in Publishing 171

peer reviewers are not well-qualified to pass judgment; in fact, many are as
ill-equipped as fifth graders saddled with the responsibility to judge the
work of a graduate student. Their reports very often reflect ignorance of
the subjects and literature treated in a given manuscript, lack of the
requisite technical skills, and often, too, ignorance of the author’s prior
published work to which reference tends, explicitly or implicitly, to be
made, and yet their reports express a willful unwillingness to recognize the
limits of their own knowledge and competence.
Prof. N.: Are peer reviewers and editors dispassionate in their judgment?
That is, are their judgments free from bias that favors established practice
and theory; are their judgments open to innovative research that extends
boundaries, lays the groundwork for new areas of study, or offers new
paradigms for research?
Prof. C.: The emotional and cognitive outlook of many peer reviewers
and editors was summed up centuries ago in the following passages:
[A teacher or scholar] . . . is not free to devise or present a new doctrine
on his own initiative, unless it is supported by responsible and established
authors. . . . [I]t is most important, especially in grave matters, that we avoid
as much as possible opportunities of devising new opinions. (From a Letter
on Implementing the Ratio studorium and on Following the Teachings of
St. Thomas, from Claudius Aquaviva, S.J., to the Provincials, December 14,
1613; in Blackwell, 2006, pp. 215–16.)
Philosophy professors should not introduce any new questions, or any
opinion which is not attributable to some author, to those present who
are inexperienced. And they should not defend anything that is contrary
to the axioms of the philosophers and the common understanding of
scholars. Those who are prone to novelties, or who are too free in spirit,
should understand that they will without doubt be removed from the
office of teaching. (From “Rules for Philosophers on the Adoption of
Opinions,” Decree 41 of the Fifth General Congregation of the Society
of Jesus, November 3, 1593–January 18, 1594; in Blackwell, 2006,
p. 209.)
Prof. N.: Are peer reviewers and editors free from egotism, professional
pride, envy, and turf-preserving motivation, from the seductions of
anonymously wielded power, from the emotional gratifications of imposing
or injecting into a publication their own ideological, disciplinary, and
stylistic preferences, of pressuring an author to conform in his or her
writing style to the politically correct fashion of the time?

At this point, we need to take the last question away from Professor
Cynicismus and return to nonimaginary reality: given the psychological
likelihood of the publishing abuses identified in this chapter, we clearly
are in need of a set of guidelines that could, if followed, help to lessen
the psychologically based abuses of peer review and editorial bias. The
172 Normality Does Not Equal Mental Health

psychological potential for abuse in publishing is sufficiently great, suffi-

ciently predictable, and sufficiently harmful that, in consultation with
journal editors and book publishers, professional organizations should
begin serious discussion and pass resolutions on behalf of their members,
affirming a code of conduct similar to the following:

A CODE OF CONDUCT FOR PEER REVIEWERS

AND EDITORS

1. Journals, book publishers, and granting agencies expect peer

reviewers and editors to abide by professional standards of courtesy
and respect in reviewing the work of others.
2. Editors are responsible for reading peer reviewers’ reports prior to
relaying them to authors. Readers’ reports that are deliberately dis-
missive, hostile, offensive, use belittling or sarcastic language, or
make unsubstantiated statements will not be sent on to authors but
will be returned to the reviewers for revision.
3. Editors will respect the intellectual property of authors by refraining
from imposing upon an author’s text views or language that are not
the author’s own, unless authors give explicit permission for such
changes in advance of publication.
4. Peer reviewers will similarly respect the text of authors by refraining
from acting as copy editors, which is not their assigned job, and for
which they rarely have the expertise.
5. The same rigor must be used in the reports of peer reviewers and
editors as is demanded of the submitting author—in particular, the
use of appropriate literature citations by reviewers and editors to
support their statements.
6. Criticism should be constructive and balanced rather than destruc-
tive or aggressive.
7. Derogatory statements criticizing an author’s alleged misuse of the
English language are not acceptable.
8. Gender-neutral language may be encouraged, but in keeping with
guidelines formulated by the American Psychological Associa-
tion, the American Philosophical Association, and the National
Council of Teachers of English relating to nonsexist language,
these guidelines are intended “to be kept in mind” so that schol-
ars can “take special care to avoid giving needless and unintended
offense,” but are not intended as “any specific or compulsory set
of rules.”5
The Psychology of Abuse in Publishing 173

(The suggestion for such a code of conduct was made by Nicholls

[1999, p. 1853]. I have added to and paraphrased his text.)

REMOVING THE PSYCHOLOGICAL OBSTACLES

ERECTED BY PEER REVIEW
[T]he political question par excellence [is] how to reconcile order which
is not oppression with freedom which is not license.
—Leo Strauss (1988, p. 37)

Once one has made a decision to take into account the abuse-prone psy-
chology underlying peer review and editorial bias, it is natural to ask what
the world would be like if publication decisions were returned to editors
without the complex, laborious, time-consuming, and sometimes costly
mechanism of peer review. For it would seem that the most efficient way
to bypass the majority of the psychologically based abuses in publishing
that we have described is simply to give control back to editors so that they
can publish what they judge to be worthwhile. It is true that their judgment
is sometimes influenced by bias, but this limitation may simply be the mini-
mum “price of doing business” in this less than the best of possible worlds.
Proposals to discontinue peer review have been made, for example by
Roy and Ashburn (2001), who note that “most of the best-known scien-
tists such as Nobel laureates, regard peer-review as a great hindrance to
good science. . . . An enormous amount of the best science has been and
is being run without benefit of this rubric, as is the worldwide patent sys-
tem.” To the objection that no serious alternatives to peer review have
been proposed, their response is: “Nonsense. They have not only been
proposed but have been in regular use worldwide for a very long time.
The users include the world’s largest research agency, the U.S. Depart-
ment of Defense, and industrial research worldwide” (pp. 393–94).
Prepublication restraint—that is, censorship—has always been motivated
by the emotional need for security. In human history, its use has shifted from
societies gripped by religious paranoia to nations dominated by anxieties
over their national security, and now its use has been extended through the
growing ascendancy of peer review to safeguard disciplinary and profes-
sional security and to defend increased concern for political and disciplinary
correctness. The form of censorship embodied in peer review is believed by
many to be a necessity. And yet, as Albert (1997, p. 822) observed:

Without peer review, journals will almost certainly reject a small number of
papers that should have been accepted, and accept one or two that should
have been rejected. But this is what happens anyway. Peer review is
174 Normality Does Not Equal Mental Health

inadequate when it comes to spotting downright lies, so what we are really

talking about is not so much guarding the gates from evil as directing
traffic towards (and away from) various measures of goodness. . . .
Without peer review, [editors] will be forced to take decisions on their
own . . . on the basis of what they think will inform, stimulate, and entertain
their readers. They can still get advice from experts, but it will be on their
terms. Some of their subsequent decisions will be wrong, but a lot more of
them will be bold, and at least the priorities will be back in the right place. . . .
It could bring some of the passion and excitement back into science.

This is a reasonable point of view. The contrary belief has been rigidly
held for centuries, and should by now be recognized as dysfunctional,
expressing a true pathology of belief:

[T]he censors must be more conscientious. If we do not contain ourselves

within definite and accepted limits, we will face new threats and dangers
daily. There is no doubt that we dishonor ourselves when someone wishes
to proceed further when he sees that there is permission to hold something
about matters that require many distinctions and great acumen, and then
others do the same thing, with the result that nothing is ever seen to be
stable and uniform afterwards. (From a Letter on the Solidity and
Uniformity of Doctrine, from Claudius Aquaviva, S.J., to the Provincials,
May 24, 1611; in Blackwell, 2006, p. 211.)

CONCLUSION
Closed-minded peer review and editorial tampering are the main ways
that American authors experience censorship, unless they write about sen-
sitive military or political issues, or as Catholic clerics write about
Catholic doctrine. Being the victim of straightjacketing peer review or
editing provides authors with a firsthand, painful experience of what it is
like to be censored. Abuse directed toward what one has written can feel
like a personal attack, and in a sense it is precisely that, for one’s intellec-
tual property is an extension of the author’s self, of work he or she has cre-
ated on the basis of years of education, later study, research, effort, and
perhaps also original thought.
When peer review goes bad and editorial tampering takes place we
enter a microcosm of ideological recalcitrance and of the resistance of
human belief systems to novelty, a microcosm ruled by a dynamic of con-
servatism and pettiness that perpetuates prevailing beliefs to the exclusion,
as intellectual history often shows, of original, creative work that conflicts
with or appreciably extends the boundaries of preferred ideas and fash-
ions. In other words, tastes, dictated by prevailing fashion and coupled
The Psychology of Abuse in Publishing 175

with the specific abuses to which normal psychology is prone that we’ve
described here, become blocks to what are unconventional, new, and
potentially significant advances in knowledge, when peers and editors take
on the serious responsibility—at times in strong conflict with their own
self-interests—of judging another researcher’s work.
The healthy development of human knowledge and culture requires
iconoclasts, rebels, those of independent mind and spirit. Suppressing
and blocking creative research and publication is tantamount to choosing,
literally, to disable ourselves. The irony is that we do this as a result of
normal psychological predispositions which themselves qualify as dis-
abling pathologies.
In our legal system we have preferred to increase the risk of allowing
some of the guilty to go free rather than mistakenly punish the innocent.
The elimination of peer review could perhaps permit the publication of
some outlandish, inaccurate papers and books—which seem, in any event,
to appear regularly and unimpeded. We might do well to recall Milton’s
observation that positive good can come from occasional exposure to
error, enabling us to test and strengthen the reliability of what we believe
we know: DNA mutation errors are known to be essential to evolutionary
advances; the occasional slippage into publication of erroneous results
undoubtedly plays a similar role in the evolution of knowledge, helping
us to break free of unrealized constraints, to see things in a new light,
to question what we have not had the courage or incentive to question in
the past. Hysterical peer-review paranoia that “mistakes” may be allowed
to slip through the gates is greatly out of proportion to their dreaded
danger.
If we are willing to make a conscious, intelligent choice whether to
retain peer review or eliminate it, our decision will hinge on whether to
open the door a crack through which, perhaps, a few additional unaccept-
able works may find their way to publication, or whether to continue to
use a system predisposed to obstruct the publication of potentially impor-
tant creative work. If our wish is to advance human knowledge, it should
be clear which is the lesser of the two evils.
There is a recognized and legitimate need, prior to publication, for edi-
tors to be assured of an author’s qualifications—as these are made evident
in the quality of his or her research, and not to be confused with either
possession of a set of credentials or affiliation with a well-known institu-
tion. There is a need for editors to be assured of the satisfaction of a disci-
pline’s general standards of proof and evidence—and yet to remain open
to persuasion that these standards need to be amended or extended. Solid-
ity of scholarship should be assured—but not at the expense of curbing
176 Normality Does Not Equal Mental Health

future work by binding it in slavish adherence to what has been said and
done in the past.
Standards of professional certification, criteria of justification for
results, and breadth of information do admittedly change with time, and
mental space must be reserved to allow for this.

NOTES
1. Nearly every one of the criticisms in this list has its own body of literature;
to list references for each would take inordinate space here. My purpose in this
chapter is not to review the published literature relating to peer and editorial
review, and so I have kept references to a minimum. Readers interested in an over-
view and discussion of many of the individual criticisms of peer and editorial
review that I enumerate, and others as well, may find Campanario’s detailed
two-part paper (1998) useful and replete with citations; further relevant works
include: Albert, 1997; Armstrong, 1996; Bedeian, 1996; Brysbaert, 1996;
Enserink, 2001; Fine, 1996; Garcı́a, 1981; Greenberg, 1999; Hadjistavropoulos
& Bieling, 2000; Harnad, 1982; Hojat et al., 2003; Holbrook, 1986; Horrobin,
1982 and 1990; Jefferson et al., 2002a and 2002b; Kassirer & Campion, 1994;
Levenson, 1996; Lock, 1985; Mahoney, 1977, 1979, 1990; Mahoney et al., 1978;
Martin et al., 1986; Naftulin et al., 1973; Olson, 1990; Peter et al., 1983; Peters
& Ceci, 1982; Rabinovich, 1996; Rowland, 2002; Sharp, 1990; Starbuck, 2003;
Ware & Williams, 1975; Yalow, 1982; Ziman, 1982.
2. See Kevin D. Lafferty, “Can the common brain parasite, Toxoplasma gondii,
influence human culture?,” http://rspb.royalsocietypublishing.org/content/273/
1602/2749.full.pdf+html, accessed May 11, 2011. From the November 7, 2006,
issue of the Proceedings of the Royal Society, Biology, 273, 2749–2755. News release
available from the U.S. Geological Survey at http://online.wr.usgs.gov/ocw/
htmlmail/2006/20060802nr.html, accessed May 11, 2011.
3. The number of books and journal papers, and the number of newly estab-
lished professional journals, are both increasing exponentially, with a current
doubling time of about 15 years. There are at present some 30,000 journals pub-
lishing 600,000 papers a year (Rescher, 2006, pp. 49–50).
The doubling time of the human population is now about 35 years, so the
rate of proliferation of publications far exceeds the growth of the population.
The result is a devaluation of publications and authorship, since the value that
people place on a product or work of any kind is inversely proportional to its
commonness.
Due to this explosive, exponential growth in what is published it is not sur-
prising that the likelihood that any given paper will not be cited in future publi-
cations is rapidly increasing (Rescher, 2006, p. 52). The pebbles one casts are
perceived to be smaller and smaller, the lake larger and larger, while the ripples
that are made by cast pebbles disappear faster and faster. The work of authors,
the “pebbles” they create and toss, comes naturally and proportionately to be
cheapened.
The Psychology of Abuse in Publishing 177

4. On the conflict between the psychology of creative thinkers and the psy-
chology of the normal world, see Chapter 3 in the present volume and Bartlett
(2009).
5. Quoting from the “Guidelines for Non-Sexist Use of Language,” originally
published in the Proceedings and Addresses of the American Philosophical Association 59
(3) (February 1986), pp. 471–82, and revised and reprinted as a separate report in
2001, and which was based on earlier guidelines of the American Psychological
Association and the National Council of Teachers of English.
 8

The Psychology of Mediocrity:

Internal Limitations That Block Human
Development

Psychology, as a field, has lots and lots of data, but we don’t have very
many good ideas.
—Dennis Proffitt, Chairman, Dept. of Psychology, University of
Virginia (Jacobs, 2009, p. 48)

One of the last remaining—and it would seem passionately postponed—

frontiers of behavioral and cognitive science is the investigation of internal
limitations of human psychology, limitations that act to block individual
and social development. This area has been a lifelong interest with me.
In earlier work, I examined

• Internal limitations of this kind that stand in the way of the meaning-
ful use of many concepts basic to scientific and to everyday thought
(which I’ve called conceptual pathologies: Bartlett, 1971; 1975; 1976;
1980; 1982; Bartlett & Suber, 1987; Bartlett, 1992; 2005, Part III);
• Internal limitations that are at the core of the psychology of normality
and that result in pathology (called pathologies of normality: Bartlett,
2005, 2006, 2009);
• Psychological constraints that block the ability of people to learn
from past mistakes and to improve their individual, social, and envi-
ronmental conditions, condemning people to vicious circles of
repetitive, self-destructive thought and behavior (a crucial but
entirely neglected area of study, the psychology of stupidity: Bartlett,
2005, Chap. 18);
The Psychology of Mediocrity 179

• Handicapping deficits that limit people to a low level and quality of

consciousness, conduct, and outlook that are inherently barbaric
(Chapter 5 of this book and Bartlett, 1993a, 1993b);
• Limitations that impede individual and group consciousness of culture
(familiar to readers of this book in the form of acedia: Chapters 4 and 6
of this book; also Bartlett, 1994a, 1994b);
• Internal psychological limitations that block the continued survival
of the world’s rich diversity of species as a result of an intransigent
human psychology of heedless reproduction and environmental
exploitation (Bartlett, 2006 and 2005, Chap. 17); and two more
specialized forms of limitation:
• Internal psychological limitations that obstruct the constructive
development of the discipline of philosophy (Bartlett, 1986a,
1986b, 1989); and
• Internal psychological limitations that block the human recognition
of animal rights (Bartlett, 2002, 2007).

All of these limitations are internal—that is, intrinsic—to normal

human psychology, and serve variously to slow, to impede, and at times
effectively to halt the advance of human knowledge. These limitations
obstruct the development and cultivation of human sensibility, which
would otherwise lessen human aggression and cruelty and encourage the
broadening and deepening of human compassion. At the same time, many
of these limitations are destructive because they block positive, construc-
tive relationships between individuals, between societies, and between
human and nonhuman species; and because they are devastating to the
environmental conditions necessary not only to sustain life but to make
humane, uncrowded, and aesthetic living possible. The majority of these
internal psychological limitations function exceedingly well in an obstruc-
tive capacity because they remain unrecognized, but more often because
their recognition by professional psychologists and psychiatrists and the
wider public is strongly resisted and subject to widespread denial thanks
to individual and group vested interests and ideological commitments.
In the academic world and in the popular consciousness, the study of
“internal limitations” has become familiar only in the field of mathematics,
where the discovery of a growing family of theorems of formal limitation is
judged by many mathematicians to have been the most important advance
in that discipline during the last century. Theorems of formal limitation
are proofs of what mathematics cannot, in principle, attain; they are
informative results that exhibit the intrinsic limitations of formal systems.
Theorems of formal limitation do not describe psychological limitations
of mathematicians but rather limitations that are inescapable because
180 Normality Does Not Equal Mental Health

they are internal and intrinsic to the subject matter itself of formalized
mathematics.1
The “internal psychological limitations” that have captured my interest
over the years are similar in kind to the formal limitations of mathematics
but yet are specifically different. Both varieties of internal limitation, the
formal and the psychological, are reflexive in nature. First, such limitations
are built into the very fabric of each subject matter, arising as a consequence
of the nature of each; and, second, they are discovered and made evident
through studies that make reflexive use of the means provided by formal
systems themselves, in the case of mathematics, and through investigations
that similarly make reflexive use of human psychology, in the case at hand:
tools of mathematics are used in order to demonstrate intrinsic limitations
in the use of those very tools, and human psychological abilities are relied
upon to make evident the limitations of those very abilities. In both these
cases, the means of discovery, the tools of analysis, have had to be devel-
oped from within the subjects studied, which is to say, self-referentially.
An account of the nature and role of self-referential analysis would take us
beyond the scope of this book (see Bartlett & Suber, 1987; Bartlett, 1992);
suffice it here to say that the psychological limitations I am referring
to can be studied by human beings only in a self-referential manner, that
is to say—and as cognitive scientists and epistemologists would express
this—reflexively: we are forced to make use of the means offered to us by
our own human psychology in order to study it, and hence when I speak of
internal limitations this phrase has a literal and concrete meaning which
asserts that a very large portion of the human population is internally limited
by the psychological limitations mentioned in the bulleted list above.
The varieties of internal psychological limitation that appear on that
list are, in different ways, restrictive and handicapping in a sense some-
what parallel to that in which customary psychiatric diagnostic categories
are considered to be restrictive and handicapping to those to whom they
are thought to apply. But this parallel is a matter of analogy only. Readers
will by now be aware of some of my reasons for rejecting psychiatry’s con-
cept of “mental disorders.” The justification for this rejection, as
expressed in previous chapters in this book, rests in large part on the deci-
sion to dismiss psychological normality as a valid or enlightened standard
of mental health.
The internal psychological limitations that I’ve listed affect the very
great majority of people and are so widespread as to be contrasted rather
than compared with conventionally accepted DSM diagnostic categories,
which, on the contrary, are intended to identify and sort out from the
general population special groups of “mentally disordered” individuals.
Despite this essential difference, psychiatry and clinical psychology have
The Psychology of Mediocrity 181

sought to find therapeutic ways to reduce or eliminate the cognitive, affec-

tive, and behavioral obstacles that hinder people psychologically, that
cause them distress and disability, that handicap their abilities to reach
their personal goals in life. In this general sense, to speak of “internal lim-
itations” within the framework of clinical psychology, as I shall do here, is
to make use of an historically appropriate descriptive phrase, while
emphasizing that its application is extended beyond a medically narrow
conception of psychological disorder.

In this chapter, I continue the study of internal psychological limitations by

examining a wholly neglected area of normal human psychology, the psy-
chology of mediocrity. Mediocrity, in its multiple forms of expression, is, as
we shall see, yet another kind of internal psychological brake that halts both
individual and social development. This topic has been so seldom men-
tioned, much less studied, in the literature that it will not take us long to
review what has been written about it, which we’ll do a little later.
During the second half of the twentieth century and continuing this
trend today, psychiatry and to a lesser extent psychology have been strongly
affected by the success of physical science. In taking physics as a model of
scientific success, psychiatrists and some psychologists have come to
believe that scientific success requires an unemotional neutrality toward
values. This interpretation has been reinforced by psychiatry’s wish to step
beyond any lingering shadows of the value-loaded moral psychology that
had been advocated a century and a half ago by Bucknill and Tuke (1858/
1879) and by their fellow nineteenth-century practitioners—who, it is
relevant to remember, inaugurated a much-to-be-appreciated kinder and
more sympathetic understanding and treatment of the mentally ill than
had previously been the case.
The resulting current fashion, which we now dignify by calling it a
“paradigm” and which has been embraced by psychiatry and empirically
focused psychology during the past six to eight decades, has sought to
emphasize experimentally and behaviorally focused investigation that
aims to be purely descriptive, empirically based, and most especially value
free. In this framework the preferred paradigm seeks to identify and
formulate law-like regularities that govern the psychology of human
emotion, cognition, and behavior so as to explain, predict, and gain
control over these components of the human psychological constitution.
But this external clothing of psychiatry and empirical psychology,
which aims to give the appearance of value neutrality, is only a
gossamer-thin outer layer, masking the stubborn persistence of—and
182 Normality Does Not Equal Mental Health

indeed the unavoidable need for—value judgments whenever good mental

health is differentiated from its lack. As we have seen in earlier chapters, it
is an inexorable fact that recognition of disease requires for its very pos-
sibility and meaningfulness a context, a framework, in terms of which
normative evaluations can be made—in other words, a frame of reference
that enables us to distinguish desirable health from undesirable pathology.
And so whenever we recognize a condition, a set of symptoms, a disposi-
tion, a personality structure, or another construct to be pathogenic, we
depend upon a prior acceptance of certain values that determine what we
hold to be desirable, in opposition to conditions that we seek to combat,
ameliorate, or cure.
In this chapter, we shall examine a set of human traits that, in an
unusual and until now unrecognized sense, constitute a widespread
pathology—characteristics that are perceived to be manifestly undesirable
from the standpoint of a normative frame of reference that is seldom
applied and is often neglected. It is, as we shall see, a frame of reference
for judgment that is most often resisted with extreme hardihood and
rigidity by current psychological theory and practice. This way of looking
at and understanding psychological matters arouses uneasy suspicion,
opposition, and often obdurate resistance among psychiatrists and many
clinical psychologists because (1) it is explicitly and unashamedly based
upon a specific set of values that stand apart from those that are conven-
tional and popular, and (2) it is fundamentally opposed to current diag-
nostic standards that equate psychological health with psychological
normality.
Readers who have followed the discussion to this point are by now
familiar with the author’s Socratic bias. It underlies the following discus-
sion, and so that bias will be repeated: If we cannot abide questioning
our most fundamental assumptions, then of course we’re fated to be held
captive by them, and what we are capable of seeing and thinking will be
correspondingly limited.
My use of this recurring word ‘limited’ is central to what follows. My
purpose in this chapter is to describe and discuss a set of human traits that
are essentially limitative in the sense that they comprise, in a variety of
ways, traits that stand in the way of the individuals who posses them, traits
that block individual and social development by limiting what people can
become conscious of and hence appreciate and cultivate. These traits
are blinders, constraints, and shackles that straightjacket and confine the
individuals who possess them to a partial, impoverished experience of
reality. At the same time, they are traits that impede human psychological
development and all that this means, including social, political, and,
perhaps most significantly, human moral development. The traits that
The Psychology of Mediocrity 183

I examine are limitative in both of these senses: They bar the development
of both individuals and their societies.
I use the word ‘moral’ intentionally but with some misgiving since the
word is easily associated with the pulpit. But I use the word here not from
any pulpit but in the same sense in which it is valid to speak of ‘the moral-
ity of medicine’, when by this phrase we intend to point to the explicit val-
ues of combating disease and disability, of seeking to avoid and alleviate
suffering, of using the knowledge and means that medical science offers
to make human life better. ‘Better’ is at the forefront of morally loaded
words, but it is unavoidable as soon as we articulate reflectively the pur-
pose of medical treatment: to resist and combat pathology in an effort to
achieve better health.
Psychology is no different from physical medicine in this respect: it,
too, aims to improve human life, on both an individual and social level;
and it, too, rests upon an implicit morality that seeks to resist and combat
pathology. And, as I seek to show in this chapter, the morality that moti-
vates us to oppose pathology leads us to recognize one of the most
destructive and handicapping of human pathologies, the stubbornly and
almost totally neglected psychology of mediocrity.
The study that follows provides a descriptive psychology of mediocrity,
which forms part of the psychology of individual differences. In any science
we must begin with description, proceed to taxonomy, and then finally to
explanatory or etiological analysis. As H. J. and M. W. Eysenck noted,
“No dynamic analysis is possible without a descriptive framework, and the
concepts provided within this framework are the stepping stones to a more
dynamic analysis and understanding” (Eysenck & Eysenck, 1985, p. 7).
Alternatively, William James and many continental psychologists have
called this phenomenological psychology. My purpose here is to describe
certain of the most fundamental characteristics of the psychology of medi-
ocrity so that they can be readily identified and named. This chapter
provides a descriptive framework and offers the basis for a taxonomy. But
first our discussion will benefit by a brief historical introduction.

A BRIEF HISTORY OF A MUNDANE TRINITY:

MEDIOCRITY, MEDIOCRE, MEDIOCRACY
These three words, proudly self-ascribed by some groups or applied to
them in passionate condemnation by their critics, can mean much or little,
as we choose. Their dominant meanings have undergone the most
extreme changes over time, much like the quaint and today greatly over-
used word ‘egregious’, which used to underscore the exemplary standing
out or apart from the vulgarity of the common crowd (e + greg = apart
184 Normality Does Not Equal Mental Health

from the flock or herd). But this word—that had once expressed an
affirmative judgment that one is distinguished by virtue of distinctiveness
from one’s group—is now, in a politically correct about-face, used to
imply an outraged judgment against this very thing, expressing sotto voce
an affront should anything or anyone have the temerity to stand out from
the herd—and those who do are subject to censure. Such temerity is “sim-
ply egregious,” that is, outrageous, hence an appropriate target for indig-
nation. Here we find one of those insightful, enjoyable (to lovers of
language), and telling radical transformations of vocabulary that can dis-
close much about ourselves and specifically about our psychology.
The three words in our vocabulary that are used to refer to ordinari-
ness, the average, the median, commonness, commonplace, normality,
and the social dominance of dullness and triviality—that is, the trinity
formed by ‘mediocrity’, ‘mediocre’, and ‘mediocracy’—have over the cen-
turies also experienced a striking change in the fashion of usage and public
intent.2 The meanings associated with these words have migrated from
one end of the spectrum of acceptability to the opposite end, cultural con-
demnation. As we shall see, they are now in the process of bouncing back
again toward their original point of departure.
It was not long ago that ‘mediocrity’ was used to name a golden mean,
an ideal situated contentedly between extremes, to be valued as a goal, to
be prized when achieved, to be regretted when out of reach. But with
the passing of a few centuries, ‘mediocrity’ became a label for the
second-rate, the undesirably common, middling, and ordinary and,
in the distasteful sense, a label for the simply rude, unsophisticated, and
vulgar, a word for the uncultivated, the unexceptional, the tawdry, the
uninspired, and the nondescript.
And now, the historical course of this trio of words is reversing, as is
unashamedly promoted by such books as The Happy Mediocrity, or Embracing
Your Inner Mediocrity, or even You Take the High Road and I’ll Take the Bus:
Celebrating Mediocrity in a World That Tries Too Hard.3 This “celebration of
mediocrity,” as we’ve seen in various forms elsewhere in this book, is real,
nonmetaphorical, and actively pursued in an assortment of complementary
ways—on the most general level, through adherence to the values behind
which the greater society rallies, and in the specific context of higher educa-
tion, through the content it communicates, the standards it sets, the educa-
tional ends it establishes, and the social and political purposes to which it
is harnessed.
‘Mediocrity’ is the English residuum of Old and Middle French, which
gave rise, from 1300 to the mid-1500s, to médiocrité, which meant an
intermediate state, moderation, and moderate fortune. Hobbes, in 1650,
assured his readers that it was “[t]he common Opinion, that Virtue
The Psychology of Mediocrity 185

consisteth in Mediocrity and Vice in Extreams” (De Corpore Politico). In

1681, J. Flavell’s Method of Grace continued to propose that “A mediocrity
is the Christians [sic] best external security.” Even in 1878, Thomas
Hardy’s Return of the Native still promoted the view that a well-
proportioned mind’s “usual blessings are happiness and mediocrity . . .
enabling its possessors to find their way to wealth, to wind up well.”
Despite this proud emphasis on the comforting superfluities of medioc-
rity, an opposing current began during part of the same period. In 1589,
Thomas Nashe would claim: “Which makes me thinke, that either the
louers of mediocritie, are verie many, or that the number of good Poets,
are very small.” By 1669, the word was beginning to point unwaveringly
toward a specific meaning—sheer lack of talent and distinction. William
Congreve in 1694 would comment, “[m]ethinks he wants a Manner . . .
some distinguishing Quality . . . he is too much a Mediocrity, in my
mind” (Double-Dealer, II). Here began the second life of the adjective
‘mediocre’—to mean an average, unexceptional level of mental ability,
skill, endowment, or achievement; and it would soon come to mean even
less than this level of attainment.
During the same period, the French became more inclusive in their
construction of ideas, turning from the adjective to the noun and using
‘les médiocres’ in 1658 to denote people. Soon ‘mediocre’, in French
and in English, began to imply qualities justifying disparagement, to
be contrasted with excellence and superiority. So that by 1987, the
October 15 issue of Cambridge’s Weekly News noticed that “[t]oo little
thought and understanding of the audience has produced a new high in
mediocrity.”
And so to say of something or someone that it, or he or she, is “medio-
cre” came to express a judgment concerning the quality or merit—from
indifferent to downright bad—of the thing or of the person. The adjective
was predicated of the perceived low quality of many works of art, music,
theatre, and literature; of many levels of ability, education, cultivation,
or knowledge; and of many people in terms of their mental competence
or other accomplishments. Nehru, in a 1945 letter to Gandhi, would then
write, “A few out of the books they send are good, most are mediocre”
(Two Alone), a twentieth-century refrain of Thomas Jefferson’s 1813 com-
ment that “[t]he Latin versions of this passage by Buchanan and by Johns-
ton, are but mediocres” (Oct. 12 letter in his Writings).
As for the application of ‘mediocre’ to people, in 1884 Sir Richard
Harrington observed: “The mediocre . . . always form numerically the
largest portion of every profession” (Law Times 77(393), p. 2), and then
in 1903 added: “The result would be a kind of nightmare of the mediocre,
a universal Brixton” (The Speaker, Oct. 17).
186 Normality Does Not Equal Mental Health

By 1991, the fault-finding m-adjective flowed unselfconsciously off the

tongue: “What emerges is a stream of sad litanies to the mediocre and the
ephemeral” (Time Out, Nov. 5). The critical, judgmental application of
‘mediocre’ and ‘mediocrity’, not just to things and individual persons but
to groups of people, meshed well with this usage, and so the third member
in our mundane trinity, ‘mediocracy’, was given room to grow.
The word ‘mediocracy’ may have come into English existence cloned
from the French ‘médiocratie’, applied in 1869 to refer to political power
in the hands of the mediocre. By July 1876, the Atlantic Monthly would
also use it: “The day which brought the news of the fall of Fort Sumter
saw the overthrow of the mediocracy.” A century later, psychologist Hans
Eysenck would use it in the context of a psychological critique of the
human majority:

The conscious cultivation of a mediocracy, in which the bright, the

original, the innovators, the geniuses are held back in order to spare the
mediocre the spectacle of outstanding success is to me an abomination. . . .
Compassion for the halt and the lame, bodily and mentally, is right and
good; it is the hallmark of an advanced civilization. But we must take care
that it does not exceed what is right and proper, and lead to the suppression
of high intellect and great merit. Even the able have their inalienable right,
and a society disregards these at its peril. (Eysenck, 1972, p. 219)

This description of the lexical history of the three m-words is an appro-

priate point of departure; from here on we shall leave lexical definition
and seek, instead, a real definition4 for these terms, that is, an empirically
based description of the psychology of most people, putting to one side
the historical changes of fashion that stipulate that these words should
be defined in certain customary ways.

PAST ATTEMPTS TO UNDERSTAND THE

PSYCHOLOGY OF MEDIOCRITY
As I’ve already mentioned, few researchers in psychology have studied
the phenomenon of mediocrity. To my knowledge, only three book-
length studies that purport to do this exist; all three works are in Spanish
and have not been translated into English. Why Spanish-speaking authors
have been attracted to the topic, which has failed to capture the attention
of researchers in other countries, is an interesting question to which I have
no certain answer. My guess is that the societies with which these authors
were familiar were stratified; the social conditions with which they were
most familiar were hierarchical, with clear-cut divisions been lower-class
manual laborers and the educated and more cultivated upper class.
The Psychology of Mediocrity 187

Societies in which stratification is an explicitly accepted fact of life may

perhaps encourage researchers to attend more consciously to the phe-
nomenon of mediocrity since, as we shall see later, the recognition of
mediocrity is facilitated when a society perceives individual differences
clearly (sometimes with excessive stereotyping), without distortions cre-
ated by a politically rigid system of belief in universal equality. In a similar
way, mediocrity tends to be swept under the carpet or simply ignored in
a society, such as that of the United States today, in which the act of
acknowledging the fact of individual differences often arouses great hostil-
ity. Weighing these two opposing factors—the acceptance of individual
differences by some societies and the ideological opposition of others to
such acceptance—it may be fair to say that the latter inhibits the study of
mediocrity at least as powerfully as the former fosters it.
The first of the three books about the psychology of mediocrity was
written by José Ingenieros (1877–1925), who, despite having been born
Giuseppe Ingegneri in Palermo, Italy, studied, lived, worked, and published
in Argentina under the name for which he has become well-known. He was
educated as a physician; he specialized in psychiatry and criminology;
the majority of his book-length publications are works in psychology and
psychiatry. Ingenieros was the founder of the Argentine Psychological
Society and later of the Revista de Filosofı́a, which reflected his interest in
philosophical studies, for which he is also recognized.
In 1910, Ingenieros gave a series of lectures on the psychology of char-
acter, which were collected together and published in his book El hombre
mediocre (“Mediocre Man”). The interest that this work aroused was noth-
ing short of astounding, as we look back from a vantage point a hundred
years later. It is hard to imagine today that a work about the psychology
of mediocrity could excite such interest: His lectures were first published
in 1910–1911 by La Nación in Buenos Aires, then published by Archivos
de Psiquiatrı́a y Criminologı́a in 1911, and then were published in book
form by the Madrid publisher Renacimiento. For the first edition, in
January, 1913, 10,000 copies were printed; only two months later, this
was followed by a second edition of 10,000 more copies (Ingenieros,
1913/1957, p. 7). The book has subsequently been published in a number
of additional editions and by several publishers. This gives an idea how
much attention the topic of the psychology of mediocrity attracted at that
time and how neglected, in comparison, it has become today.
El hombre mediocre consists of only about 200 pages. It seeks to describe
mediocrity but easily gives contemporary readers the principal impression
that the author is engaging in a catharsis and polemic against the psycho-
logical characteristics of the common person. The book can tax one’s
patience; it is unequivocally repetitious and monotonous in its deprecations
188 Normality Does Not Equal Mental Health

of mediocrity. But there is a central and significant purpose: to underscore

how mediocrity acts as a restrictive block to human development. In this
context, “catharsis” and “polemic” are understandable when readers realize
that they are expressions of Ingenieros’ impatience over humanity’s deeply
entrenched, stubborn disregard and denial concerning a major psychologi-
cally disabling condition which, as we shall see later on, there is good reason
to judge to be a form of pathology.
Ingenieros recognized that mediocrity possesses an underlying psy-
chology that is distinctive and in need of explication because, he claimed,
it constitutes a critical block to human evolution. Although his description
of that underlying psychology is fragmentary and incomplete, what he
does say offers a beginning that is worthwhile to consider.
For Ingenieros, mediocrity is fundamentally a psychological incapacity
for ideals (in much the same way as we saw that acedia is an incapacity for
culture in Chapter 4). This incapacity, according to Ingenieros, is tied to
the mediocre person’s impoverished personality or character. An individ-
ual’s personality or character is the basis for distinguishing one person
meaningfully from another; personality and character are basic constitu-
ents of a person’s individual identity. Ingenieros calls both the psychologi-
cal incapacity for ideals and an undeveloped sense of self “mediocrity.”
Ingenieros refers to the mediocre as “the obtuse” (los obtusos) because
“the narrow horizon [el estrecho trecho horizonte] of their experience consti-
tutes the forceful limit of their minds” (Ingenieros, 1913/1957, p. 34). He
therefore refers to the “obtuse imagination” of the mediocre, which con-
fines them to a limited, partial, and impoverished reality, the result of
their limited capacity to have ideals.
Although there is not space here to summarize Ingenieros’ conception
of mediocrity in great detail, I’d like to draw attention to a set of claims
that he makes about mediocrity and its study which are central and which
I’ll amplify and supplement later on. First, Ingenieros accepts the factual
inequality of individuals: individual differences, whatever their ultimate
causes, are real and must be taken into account. He agrees with Plutarch’s
observation that “animals of the same species differ among themselves less
than some men from others,” and with Montaigne’s that “[t]here is more
difference between this and that man than between that man and that
beast, which is to say, that the animal of highest excellence is closer to
the less intelligent man, than this man is to another man who possesses
stature and greatness” (Ingenieros, 1913/1957, p. 34).
Second, as a consequence of the reality of individual differences, people
vary a great deal, and in their variation, some—and they are rather few—
possess a meaningful degree of individuality, a uniqueness of character
that is their own, which differentiates them from the mass of other people.
The Psychology of Mediocrity 189

In contrast, mediocre people seek to blend with others, to be like them,

and so they are: members of an indistinct, undifferentiated mass. In con-
trast, genuine individuals, often those who are creative, possess singular
personalities that serve to differentiate them and give them distinctness
and identities of their own. The mediocre do, of course, believe that they
have their own individual personalities, but when observed closely, their
personalities are seen to be insubstantial, insignificant, and, as Ingenieros
expresses this, they simply dissolve away.
Third, because of the imitative psychology of the mediocre, they suffer
from a form of “mental myopia” (p. 62) and are incapable of creating their
own ideals, which is precisely what people who develop their own sense of
personal identity are able to do; Ingenieros judges such people “superior”
in contrast to the mediocre.
Fourth, because mediocrity is threatened by superiority, mediocre peo-
ple will often go out of their way to resist and block the efforts of those
who are superior in ability or attainment.
Fifth, the psychology of mediocrity is “contagious.” Despite his train-
ing as a physician, Ingenieros did not develop this idea drawn from his
background in medical pathology, but perhaps he had in mind the fact
that mediocrity brings with it undeniable emotional gratifications, as we
shall see later, which attract many people and lead them to embrace it.
Sixth, mediocrity is most at home in a life filled with routine, a fully
scheduled existence. The mental life that fits such an existence is similarly
routinized; decisions and judgments are facilitated and made a matter of
habit through prejudice, stereotyping, and adherence to conventional
beliefs, all of which save people the need to think. The mediocre hold
their prejudices stubbornly: “their prejudices are like nails: the more they
are hit, the deeper they are embedded” (p. 60).
Much of Ingenieros’ understanding of the psychology of mediocrity is
captured in these six observations. Although his book can be diffuse and
repetitive, sympathetic modern readers can perhaps see how each of these
six observations relates to Ingenieros’ general claim, that mediocrity is an
obstacle to human development. He recognized as an inescapable fact that
people vary as individuals, that the many copy one another and that some
few develop unique, significantly differentiating personal identities. He
observed that these few form the world’s great, the eminent, the creative—
individuals who are able to develop their own values and standards and live
according to their own principles. Mediocrity stands as an obstacle to such
development and therefore stands in the way of human evolution.
The significance of Ingenieros’ study of the psychology of mediocrity
perhaps lies mainly here, that he recognized mediocrity to be what I’ve
called an “internal psychological limitation,” one that drags down the best
190 Normality Does Not Equal Mental Health

that humanity can be, that prevents each mediocre person from develop-
ing a genuine sense of self, and, in a society dominated by the mediocre
and their mental myopia, that limits and obstructs the future development
of the species.
The second book, also in Spanish, purportedly also about mediocrity,
was written by Francisco Álvarez González (1986), El reto de la mediocridad
(“The Challenge of Mediocrity”). Álvarez González (1912–), like Ingen-
ieros, was born in Europe (in Madrid) but spent most of his life in South
America, teaching in Bolivia and Ecuador, with a short period in Costa
Rica. He was trained in jurisprudence and then in philosophy, studying
with Manuel Garcı́a Morente and José Ortega y Gasset. He made philoso-
phy his career.
El reto de la mediocridad tells us extremely little about the nature of
mediocrity; in fact, despite the book’s title and its 423-page length, medi-
ocrity as such is seldom discussed. The book is primarily a series of com-
plaints about society and is a rambling, philosophically unfocused
description of social and political conditions that the author dislikes.
Álvarez González mentions collective human stupidity (estupidez generali-
zada) in Chapter 2, but does not throw light on the phenomenon. The
closest we get to anything informative about mediocrity is that it consists
of “absence of imagination” (pp. 93 and 423), a claim similar to Ingen-
ieros’ but adding nothing to the discussion. I’ve chosen to mention the
book at all for the simple reason that it will come up in any multilanguage
search for works about mediocrity.
The third book dealing with mediocrity is Luis Camacho Naranjo’s
(1992) Ensayo sobre la mediocridad (“Essay on Mediocrity”). Camacho
Naranjo is a professor in the School of Philosophy at the University of
Costa Rica. His Ensayo is a short work, a monograph, which, despite its
brevity, reflects a serious interest in understanding mediocrity principally
from the standpoint of its social psychology. He identifies certain of the
social conditions that foster mediocrity, for example, fundamentalism,
dogmatism, and lack of openness to ideas. Unusual in the scant literature
about mediocrity, Camacho Naranjo raises but does not answer the ques-
tion whether there may be a biological basis of mediocrity, distinguishable
both from the social conditions that foster it and from the personal defi-
ciency that manifests it (p. 52). He bravely writes of the calidad of the
person—his or her worth or value as a person—which echoes the language
of Konrad Lorenz and Abraham Maslow, as we shall see later.
Mediocrity, for Camacho Naranjo, needs to be understood primarily as
a phenomenon that affects individuals and not purely as a negative
judgment of contemporary society (p. 29). He makes clear that the recog-
nition of mediocrity is relative to an overall context of valuation, of grades
The Psychology of Mediocrity 191

of value, in terms of which we make judgments (pp. 34–35). From this

point of view, the Peter Principle helps to explain how people can be
expected to rise in the ranks of their job or profession until they reach a
level at which their performance is incompetent, and then, because they
can advance no further, they remain there. As a result, the world falls
to the hands of the mediocre, a world in which nothing works correctly
(p. 62). Excuses for mediocrity multiply: the mediocre evade personal
responsibility, attributing shortcomings and failures to the system or
institution in which they live and work, but they are quick to claim credit
for any successes and attribute these to their own personal abilities (pp.
56–66). Mediocrity brings about a decline in creativity, behavior becomes
routinized, and the way is paved for political repression and totalitarian-
ism (Chapter IV).

Together, these three Spanish works share in the observation that

mediocrity is a psychologically limiting phenomenon: for Ingenieros,
and even for Álvarez González, mediocrity is a deficiency—an incapacity
for ideals and an impoverished personality or a deficiency of imagination.
Camacho Naranjo situates mediocrity in a social-political context, recog-
nizing that mediocrity occurs on the individual level, infusing a society
with incompetence, absence of personal responsibility, and a readiness to
dissimulate through excuses for failure. The result is a society in which
creativity declines, facilitating increased repression and loss of individual
freedom.
These three books also share a pattern of observation that is inherently
multifactorial, identifying multiple, differentiable human traits, all of
which express internally limiting characteristics of human psychology.
We shall attempt fill out this picture in a more inclusive and unified way
in what follows.

MEDIOCRITY AS A SET OF TRAITS

The study of individual differences in the organism, and their interaction
with stimuli and responses, is an integral part of scientific psychology,
and central to it. Identical stimuli are perceived and reacted to differen-
tially by a bright person or a dull, an extravert or an introvert, an emo-
tionally unstable or stable person. To find the laws according to which
this may happen, and to isolate the major dimensions along which we
can classify people, seems to me a fundamental and critically important
part of psychology.
—Eysenck (1990, p. 195)
192 Normality Does Not Equal Mental Health

Readers will recall the distinction between lexical and real definition in
the discussion of the psychology of definition in Chapter 2 of this book. It
would be easy to resign oneself to an arbitrary multiplicity of different
lexical definitions of the terms ‘mediocrity’, ‘mediocre’, and ‘mediocracy’,
and dismiss the range of choice as purely semantical. It is more challeng-
ing and constructive to establish real definitions for these words, defini-
tions subject to empirical verification or falsification. My interest here is
to describe real and specific psychological deficiencies that can severely
limit a wide variety of human abilities, sensitivities, predispositions, tastes,
values, motivations, choices, preferences, goals and the means selected to
achieve them, and even styles of execution in thinking, feeling, perceiving,
and in reflecting about these. There are identifiable forms of mediocrity in
connection with any of the foregoing, and, in general, whenever we make
evaluations in terms of a scale of value, it is possible to distinguish a lower
mediocre range of the scale from a higher range.
In the history of modern psychology, two principal concepts of medi-
ocrity have been suggested. One is the identification of normality with
mediocrity, as was done a long time ago by Wile (1940, p. 225): “A central
tendency principle establishes normality as mediocrity.” The other, more
evaluative, was recommended by Francis Galton:

The meaning of the word ‘mediocrity’ admits of little doubt. It defines the
standard of intellectual power found in most provincial gatherings, because
the attractions of a more stirring life in the metropolis and elsewhere, are
apt to draw away the abler classes of man, and the silly and imbecile do not
take part in the gatherings. Hence, the residuum that forms the bulk of the
general society of small provincial places, is commonly very pure in its
mediocrity. . . . Hence we arrive at the undeniable, but unexpected
conclusion, that eminently gifted men are raised as much above mediocrity
as idiots are depressed below it; a fact that is calculated to considerably
enlarge our ideas of the enormous differences of intellectual gifts between
man and man. (Galton, 1869/1978, pp. 31–32)

Galton used a ranking system that has become standard in contemporary

discussions, the Gaussian or bell curve. As Galton put it,

the numbers of men in the several classes in my table depend on no uncertain

hypothesis. They are determined by the assured law of deviations from an
average. . . . It will be seen that more than half . . . is contained in the two
mediocre classes . . .; the four mediocre classes . . . contain more than four-
fifths, and the six mediocre classes more than nineteen-twentieths of the entire
population. Thus, the rarity of commanding ability, and the vast abundance of
mediocrity, is no accident, but follows of necessity, from the very nature of
these things. . . . (Galton, 1869/1978, p. 31)
The Psychology of Mediocrity 193

What Galton meant by the terms ‘mediocre’ and ‘mediocrity’ evidently

encompasses the largest portion of the human population, and in this
I shall follow him, in contrast to Wile’s equation of mediocrity with the
human average. It is not the average per se that we have in view here,
but the great majority, who, taken together, as we shall see, make up the
population of the mediocre.
More than any other country, the United States has held, often hysteri-
cally, to an irrational, empirically false prejudice against the recognition of
individual differences. The country’s political commitment to social
equality has unreasonably spilled over into an unwillingness to recognize
individual differences, except perhaps physically—in sports. Diversity of
cognitive, emotional, and moral intelligence, variety in literary, artistic,
and general aesthetic sensibility, and the presence in individuals of a wide
range of traits of personality—all have been resisted topics in American
normalized psychology, and often their study has been passionately con-
demned, demonstrated against, and brought to a halt by the American
public.5 This ideological commitment to social and political equality has
obstructed research concerning individual differences, and, as a logical
consequence, it has stood in the way of constructive progress in designing
an educational system responsive to real differences between one person
and another.
From the time of Roman physician Galen’s proposal that there are
four basic types of personality, the sanguine, melancholic, choleric, and
phlegmatic, the psychology concerned with defining traits of personality
has, despite American resistance, nevertheless become more discriminating
and sophisticated (e.g., Eysenck, 1967; Eysenck & Eysenck, 1985). But in
spite of this progress, our recognition of individual characteristics that are
responsible for significant differences between individuals and between
groups is still fragmentary and partial because what we are prepared to
see and study continues to be limited by ideological bias.
Numerous alternative personality inventories have now been developed,
but none seeks to measure the identifying marks of mediocrity that concern
us here. Given the major role that these gravely limiting traits have had and
will continue to have in human development, this state of affairs should
strike reflective readers as not only surprising but undesirable.
Most of the empirically based study of the psychology of individual
differences has used factor analysis to identify fundamental traits and
dimensions (see Thomson, 1939, and Burt, 1940, works that have played
a historically influential role). Factor analysis begins with measurements
of different variables whose degrees of intercorrelation are quantified;
it ends with the extraction of a small number of preferably independent
factors that are intended significantly to reduce the number of sources of
194 Normality Does Not Equal Mental Health

variance that must be taken into account. Factor analysis ideally con-
denses the number of variables to a minimal number of common factors
and then determines each factor’s relative contribution. This can be a
great advantage, for example, to psychometrists by providing a minimal
conceptual vocabulary shared by researchers. In formalized mathematics,
much the same motivation leads mathematicians to expend considerable
effort to obtain minimal sets of axioms for which it is possible to prove
that each axiom is independent of the others and necessary to its formal
system.
J. P. Guilford was a pioneer in the factor analysis of temperament; he
sought to identify the major factors in terms of which personality varia-
tions can be understood. Guilford’s factors comprise such traits as level
of general activity, restraint, ascendance (leadership or submission), soci-
ability, emotional stability, objectivity, friendliness, thoughtfulness, per-
sonal relations, and masculinity (Guilford, 1936, 1975; Guilford &
Hoepfner, 1971). More recently, Eysenck has sought to show that with
but three major superfactors—extraversion/introversion, neuroticism,
and psychoticism (each encompassing multiple subordinate factors)—an
identifying personality profile for any given person can be developed
(cf. Eysenck & Eysenck, 1985).
However, a disadvantage accrues to a minimal conceptual vocabulary.
We know in color theory, for example, that only the proportions of the
three primary colors need to be specified in order to identify any color
combination, which can be represented by an ordered set of numbers that
quantify the contribution of each of the primary colors. This is in fact
how computer graphics software specifies individual colors and how paint
stores are able to mix custom-tinted paint to match a color sample. But if
one is a fine artist, it can be much more useful—that is, more informative
and practical—to be able to refer to viridian, raw umber, Naples yellow,
ultramarine blue, Vandyke brown, and other pigment colors by name.
For the purposes of human communication, and for the purposes of rich-
ness of description, it is often of value to have more than a minimal concep-
tual vocabulary. In such a context, we care less about the independence of
specific factors and more about the adequacy of a description in communi-
cating convincingly and fully what is in view. Such is the case here.6
It will not therefore especially concern us when describing traits that
are basic to the psychology of mediocrity whether they are independent
or may overlap, or whether these traits comprise a unique minimal or
complete set. To be realistic and as we’ve already noted, the psychology
of mediocrity has not evolved to a point where psychometric tests for
mediocrity have even been proposed, much less designed and imple-
mented. We do not have statistical data concerning intercorrelated traits
The Psychology of Mediocrity 195

of mediocrity to subject to factor analysis. Until we do, the best and

indeed the only way to proceed is by way of description, using a concep-
tual vocabulary that is adequate but certainly not minimal.

THE MAJOR DEFINING TRAITS OF MEDIOCRITY

The renowned factorists of human abilities, Spearman, Thomson,
Thurstone, Burt, and others, all were interested in identifying factors that
represent primary abilities of the mind. Here, in contrast, my interest is in
identifying certain of the primary disabilities of the human mind, to which
very little attention has been given.
The description of major traits of mediocrity that follows is a general
inventory of traits that typify mediocre people. Not all of these traits need
be found in a given person for him or her to be considered mediocre; my
intention is to direct attention to different and sometimes overlapping
ways in which people manifest mediocrity.
We begin with a manifestation of mediocrity which it is natural to asso-
ciate with cognitive skills as measured by IQ: intellectual mediocrity. Intellec-
tual mediocrity, however, unlike the abilities that comprise cognitive
intelligence, consists of a set of psychological limitations that constrain an
individual’s willingness, motivation, and ability to utilize his or her avail-
able cognitive intelligence. Although we associate intellectual mediocrity
with absence of cognitive ability, there is certainly no direct one-to-one
correlation between high cognitive functioning and freedom from intellec-
tual mediocrity, for some of the most intellectually mediocre are to be
found among individuals with high IQ. Intellectual mediocrity is decidedly
not confined to those of average or low IQ, as shown in Figure 8.1.
Intellectual mediocrity can take many forms, ranging from outright
anti-intellectualism to an individual’s low reading level and choice of
reading; the low value placed by the person on learning generally and on
higher education in particular; the individual’s choice of occupation and
occupational goals; habitual daily concerns, interests, and activities; and
lack of both critical thinking abilities and the willingness to apply those
he or she may have.
As will become clear, mediocrity in its many forms produces corre-
sponding varieties of poverty of mind, and here intellectual mediocrity is
particularly obtrusive. The poverty of mind to which intellectual medioc-
rity contributes is at once experiential and functional: the intellectually
mediocre person experiences the world in a flat, one-dimensional,
conceptually impoverished way, and is functionally deficient in those
intellectual skills he or she uses. Each deficiency of course worsens and
196 Normality Does Not Equal Mental Health

Figure 8.1
Venn diagram showing plausible interrelationships and combinations among
psychological normality, abnormality, high intelligence, creativity, and medi-
ocrity. In order to suggest the continuity of transition from psychological
normality to abnormality, these two areas are shown as partially overlapping.
The diagram does not seek to represent the relative sizes of the populations
involved.

interferes with the others. Ingenieros and Álvarez González saw aspects of
this when they wrote of an incapacity for ideals and a deficiency of imagi-
nation, but intellectual mediocrity encompasses a good deal more than
this. When one compares the experience and intellectual abilities of a
peasant with those of a mature, well-educated person, someone who has
devoted much of his or her life to intellectual development through depth
and breadth of reading and thinking, we may begin to conceive of the two
opposite ends of this standard of personal development.
As we continue to describe the psychology of mediocrity, it is central to
recognize that we need to maintain sufficient distance from our subject
matter to make unbiased description possible. I will not be concerned here
to consider how or why individuals and their groups come to be limited by
the psychology of mediocrity, or to protest that life is often not fair. It is
tempting, particularly at a time when a bias toward environmentalist
The Psychology of Mediocrity 197

egalitarianism is dominant, to rationalize or offer excuses (as discussed by

Camacho Naranjo) for the limitations of mediocrity. We are reminded
that the study of the psychology of mediocrity has not reached a point
where it is possible in an intelligent and empirical fashion to explain it in
terms of biological, familial, social, or other causes. Before we can begin
to determine the sources of the defining characteristics of mediocrity, we
first must know what it is we are referring to, and this is the task of system-
atic description.
The poverty of mind due to intellectual mediocrity is often accompa-
nied by destructive kinds of resistance or opposition to those who excel
intellectually. This phenomenon is not limited to plain-vanilla anti-
intellectualism but instead frequently includes outright resistance to
originality, rejection of creativity and novelty, and a wish to lower great
men. Mahoney’s (1979) study of the psychology of the scientist draws
attention, for example, to the concerted efforts Tycho Brahe made as a
lifelong opponent of Copernicanism to block its acceptance. Mahoney
points out this has happened many times: “Newton, Mendel, Galton,
Planck, Harvey, Lister, Pasteur, Darwin, Helmholtz, Einstein—each
experienced the intolerance of their peers, and sometimes the frustration
of being prevented from publicizing their views” (p. 357). The reasons
most frequently given for the opposition of peers to original work are, as
we saw in Chapter 7, the conservatism of peers, their vested interests, pro-
fessional jealousy, pettiness, and small-mindedness, the most literally
descriptive of these terms. But the opposition of peers to creative thinking
may more appropriately and informatively be described in terms of their
intellectual mediocrity, the self-confining poverty of intellectual outlook
that has so often impeded and sought to squelch the work of original
thinkers.
Closely related, and forming another side of intellectual mediocrity, is
the universal tendency of the mediocre to imitate one another. On a cog-
nitive level, imitation takes the form of unquestioning compliance with
prevailing conceptual paradigms, the use of the fashionable terminology
and writing style of one’s in-group, and of course intellectually uncritical
acceptance of current standards of political and disciplinary correctness.
Originality of thought of course conflicts with some and sometimes with
all of these forms of compliance and so engenders antagonism from those
whose intellectual mediocrity is dominated by imitation.
Intellectual mediocrity frequently is expressed in the subordinate form
of educational mediocrity, as vocational education is allowed to infiltrate and
take over what used to be genuinely higher education. We encountered
some of the central aspects of the mediocritization of higher education
in Chapters 5 and 6.
198 Normality Does Not Equal Mental Health

The intellectual mediocrity that has come to dominate much of today’s

higher education goes hand-in-hand with a recalcitrance to support high
attainment and the elitism of high ability. One of the most outspoken,
and little-heeded, commentators on such human resistance has been Nobel
Laureate in Physiology Charles Richet, who, in his (1919/c. 1925) book
appropriately titled L’Homme stupide (published in translation as Idiot Man
or The Follies of Mankind) wrote: “The more stupid and mediocre the
masses, the more mercilessly do they persecute those who are simple
enough to strive to mitigate their mediocrity and their stupidity” (p. 153).
This obstructiveness of the mediocre to original contributions will concern
us later.
Intellectual mediocrity includes other subordinate traits. Resistance to
culture is evident among people whose capacity to appreciate it is limited,
for example, to poster and folk art, pop music, primitive dance, and pulp
fiction. Such resistance to culture frequently is associated with an incapacity
for refinement—in manners, speech, and general conduct, as we shall see.
There is a close connection between intellectual mediocrity and the
inability and unwillingness to attain an effective level of critical reflection
concerning the dogma shared by one’s group. The cognitive and emo-
tional limitations that come from intellectual mediocrity make it easy to
be duped by a group’s ideological leaders. Unjustifiable wars and the com-
mission of atrocities are perpetrated by people who are deficient in the
capacity to reflect and to evaluate critically and competently beliefs to
which they are expected to subscribe.
Intellectual mediocrity leads, then, to a shallowness of views and to the
perpetuation of attitudes and behavior that have come to be habitual and
comfortable and that do not require the individual to expend effort in seri-
ous thinking.
Intellectual mediocrity is often accompanied by a fear of ridicule for
being different, for having the initiative to depart from group convictions.
As Cioran (1973/1998) noted, “A man who fears ridicule will never go far,
for good or ill: he remains on this side of his talents, and even if he has
genius, he is doomed to mediocrity” (p. 55).
A second major trait of mediocrity is emotional mediocrity. Emotional
mediocrity has to do with the preferred content of one’s affective experi-
ence. The emotionally mediocre person has a need for external stimula-
tion because his or her inner world of experience is limited and
impoverished. The need for stimulation can take many forms. It is com-
monly expressed in the person’s wish to be always occupied by external
sources of stimulation, and it is most often expressed in a desire for enter-
tainment that is violent and exciting on a primal level. Such need for
stimulation is linked, for example, to a love of war for the excitement it
The Psychology of Mediocrity 199

produces, for the emotionally gratifying sense of camaraderie that war

kindles, for the sharpened consciousness that danger arouses, and for the
sense of life purpose that the participants in war experience, often for the
first time (Bartlett, 2005, Chap. 9 and Chap. 14). In this sense, war is an
anodyne of mediocrity. War “first and foremost . . . gives to mediocre per-
sonalities an opportunity to increase their volume and weight by uniting
till all sense of mediocrity is lost. . . . It must be an entrancing experience”
(Lee, 1920, p. 285).
Emotional mediocrity is associated with low-level affiliative interests
and needs. The emotionally mediocre person is indifferent to the
second-rate quality—the mediocrity—of his or her friends, acquaintances,
and family. When expressed in this way, emotional mediocrity is a form of
emotional indiscrimination. Such emotional mediocrity is tied to social
mediocrity, which we’ll come to later.
Pride in mediocrity reinforces the self-constricting nature of emotional
mediocrity. The emotionally mediocre person tends to be proud of his or
her mediocrity. This is a self-reinforcing pride: the emotionally mediocre
individual pats himself on the back for his “down-to-earthness,” she
prides herself in being “one of the people,” he likes being mediocre
because mediocrity establishes limits that are comfortable, within which
undue effort is not required. These are limits that fit like old clothes—
habitual, loose, and unobtrusive in consciousness. “We must remember
that a man is not necessarily humble or even modest because has con-
sented to mediocrity. On the contrary, there is a sense of passionate pride
among the mediocre” (Finkielkraut, 1996/2000, p. 26). Sartre (1946/
1948) also observed this pride of the mediocre in their mediocrity, and
singled out the pride felt by anti-Semites, who magnify the perceived
value of being mediocre by creating for themselves what Finkielkraut has
called “an elite of the ordinary” (Finkielkraut, 1996/2000, p. 26). Pride
in mediocrity is now widespread, and can be seen in the enthusiastic cel-
ebration of ordinariness, the common, and the vulgar in its pejorative,
negative sense.
Jung, too, saw this: “Society, by automatically stressing all the collec-
tive qualities in its individual representatives, puts a premium on medioc-
rity, on everything that settles down to vegetate in an easy, irresponsible
way. Individuality will inevitably be driven to the wall” (Jung, 1964, pp.
228–29).
Nietzsche called this phenomenon “the personal arrogance of the self-
infatuation of the mediocre” (Nietzsche, 1954, pp. 618–19). He associated
such self-infatuation with human stupidity, to which we’ll turn a little later.
A subordinate trait of emotional mediocrity should be distinguished.
Resistance of the mediocre to those who succeed in developing their
200 Normality Does Not Equal Mental Health

individuality is part and parcel of emotional mediocrity. The pride of the

mediocre in their own mediocrity takes the form of opposition and often
hostility toward persons who have cultivated their own individuality, their
own identities apart from groups, their distinctness as persons. We recall
that Ingenieros referred to the mediocre person’s lack of a developed
personality. In terms of the degree of development of their personal iden-
tities, the mediocre are characterized by a uniformity that precludes genu-
ine individuation. Those who have been motivated to cultivate a sense of
personal autonomy constitute an emotional threat to the comforting com-
monality of mediocrity, as we’ll see in greater detail.
The third major trait of mediocrity is the aesthetic mediocrity of taste and
sensibility. Aesthetic mediocrity is, like emotional mediocrity, a deficiency
in the ability to discriminate: on the most superficial level it is typified
by the hearty chorus that “everyone is ‘a winner,’ ” any fireman, police-
man, or pilot doing his job is “a hero,” and all performances merit stand-
ing ovations accompanied by falsetto whoops, whistles, and shrieks of
the audience. Aesthetic mediocrity is characterized by a fervent and often
exclusive attraction for the primitive: in music, art, dance, film, sensation-
alist news, literature, and other forms of entertainment. The aesthetically
mediocre are limited in their capacity to appreciate cultural beauty. They
are blind to refinements of taste because they are deficient in the requisite
sensibilities.
Aesthetic sensibility is still a much-neglected area of psychological
research. One of the few psychologists to devote himself to its study was
Hans Eysenck, who early in his career did research relating to “experi-
mental aesthetics,” the study of good versus bad taste in painting, music,
culinary art, and so forth. He asked, “given that there is such a thing as
‘good taste’, do some people have better taste than others?” (Eysenck,
1990, p. 69). He found that this is indeed the case (and before Eysenck,
his mentor had confirmed the same thing: Burt, 1940, pp. 121–22).
Eysenck observed that people “differed in the degree to which they
approximated [an] objective measure of ‘good taste’ ” (p. 70). In the area
of “good taste” no less than in that of IQ, it is possible to formulate
clear-cut standards, devise tests for the requisite skills, and develop an
objective rating scale. And what is such “good taste”? Eysenck found that
judgments about the aesthetic merit of individual works of art were gener-
ally in agreement, and hence can be used to establish a standard of
judgment that is “objective” (p. 69). Of course, a knee-jerk objection to
the claim of such “objectivity” can be expected from an egalitarian-
minded critic, for whom relativism and “chacun à son goût” are persuasive,
and to which there is not space here to respond.7 The identification of
traits of mediocrity are, all of them, predicated upon a prior recognition
The Psychology of Mediocrity 201

of explicit standards of value, and when this recognition is absent, we’re in

a situation similar to that in which someone asks “how many meters long
is x?” and who then proceeds to deny the existence of any metric standard
of measurement.
Aesthetic mediocrity is, as we’ve noted, a form of indiscrimination. It is
an inability to judge aesthetic merit: the ability to judge such merit is what
aesthetic sensibility means. ‘Discrimination’ is now a word little used in a
positive sense; it has all but lost the meaning of a heightened and refined
level of individual taste and judgment that are capable of apprehending
distinction in the sense of the root Latin discrimen.

Discrimination, once a useful word with a praiseworthy meaning, is now

almost always used in a pejorative sense. . . . In everyday life, the ideology of
equality censors and straitjackets everything from pedagogy to humor. The
ideology of equality has stunted the range of moral dialogue to triviality. In
daily life—conversations, the lessons taught in public schools, the kinds of
screenplays or newspaper feature stories that people choose to write—the
moral ascendancy of equality has made it difficult to use concepts such as
virtue, excellence, beauty and—above all—truth. (Herrnstein & Murray,
1994, pp. 533–34)

The psychological incapacity to discriminate is fundamental to many of

the traits of mediocrity, as we’ve already seen and will continue to see in
connection with its other traits; indeed, discrimination is plausibly one
of mediocrity’s main superfactors, were we in a position to perform a sys-
tematic factor analysis. Certainly, in polar opposition to cultivated aes-
thetic judgment and taste, aesthetic mediocrity makes all too evident
how central is the capacity to discriminate.
Aesthetic sensibility, and at the other end of the scale, aesthetic medioc-
rity, have of course been recognized for millennia. In the Orient, for exam-
ple, Confucius contrasted the junzi ru (the noble scholar, assumed by him
to be a man) from the xiaoren ru (the common scholar), their difference
lying in the noble man’s sensibility that allows him to recognize the beauty
of ren (of being human), a sensibility that the “small man” (xiaoren) lacks.
“Here one may observe the radical difference between the two different
universes of junzi and xiaoren. One is awake to the beauty of ren, while the
other is not. . . . The junzi finds beauty in everything human (ren) and
accordingly takes pleasure in every expression of the human spirit, namely,
in human culture (wenzhang)” (Kim, 2006, pp. 112–13). In the West, aes-
thetic sensibility has been a central and once-revered topic threading
through the centuries from Sappho to Plato to Proust.
A century and more ago in the West, aesthetic sensibility was highly
valued and was accepted as relatively easy to detect in individuals based
202 Normality Does Not Equal Mental Health

on their expressed aesthetic preferences and judgments. Today—except in

specialized circles of connoisseurs of arts and letters and among the well-
educated—good taste, refinement of aesthetic judgment, and cultivation
have become divested of their meanings in a society frantic to assert the
universal individual equality of all abilities and therefore insistent upon
the relativism of individual taste. When it comes to matters of taste and
aesthetic judgment, there now exists no generally accepted understanding
of artistic, musical, or literary sensibility and no belief by the American
public and by that of other Americanized industrial countries that there
are any reliable standards of discrimination that can be relied upon. Sen-
sibility, taste, and aesthetic judgment have been heaped together in egali-
tarian fashion and dismissed as arbitrary, relative, and purely subjective.
This, in itself, is a conspicuous expression of the sway of mediocrity.
Ingenieros would again say it reflects the spread of an incapacity for ideals,
the inability to recognize nonarbitrary standards of excellence.
Given that “cultivation” has now but a tattered and faded meaning,
allow me to quote a short sketch drawn by violinist Yehudi Menuhin of
his wife, Diana Gould Menuhin:

Diana’s was a beauty—of mind and soul as well as body—which was the
result not only of gifts but of great cultivation, of human endowment
worked and disciplined within a tradition to the most refined and durable
expression. . . . [H]er upbringing was an interaction of disciplines, her most
priceless heritage a strength of selfhood which survived them all and
benefited from them. She had the discipline of the English family, whose
decorum never slackens, no matter what bombs overhead, no matter what
domestic upheavals within. She had the discipline of the ballet. . . . Seeing
the pure product, I knew it had been fashioned in the refiner’s fire.
(Menuhin, 1977, pp. 170–71)

At times, we need to be reminded of what is possible and is sometimes

realized by increasingly rare individuals.
A subordinate variety of aesthetic mediocrity is, perhaps surprisingly,
financial mediocrity. But financial mediocrity is simply another manifesta-
tion of taste, which it is fitting to consider under the heading of aesthetic
sensibility. People who express financial mediocrity in their thinking and
behavior demonstrate an overarching concern for money and what money
can buy. Those for whom life-in-the-pursuit-of-money dominates live a
one-dimensional existence of acquisition with no higher purpose that is
vital to their daily concerns. The financially mediocre are afflicted by a
narrowed outlook that offers little room for cultivation. Like other traits
that define the psychology of mediocrity, the financial variety is impover-
ishing, and it limits self-development. Harnessed to the acquisition of
The Psychology of Mediocrity 203

wealth, it paradoxically makes the people it afflicts poorer, limiting them

to a single mediocritizing dimension.
The fourth major trait of mediocrity is mediocrity of conduct. It can be
characterized in terms of (1) the general behavior of the mediocre, and
(2) their manners and lack of sophistication. In connection with the first
of these, the general behavior of mediocre people lacks discipline and is
conformist and narcissistic. Discipline here is the capacity to utilize one’s
time and energy in a manner resistant to external distraction and on behalf
of ends that are “higher.” Readers who have gotten this far in this volume
will already be aware of the intended meaning of this word, but for others
that may join the discussion late, expressed in abbreviated form, the term
‘higher’ refers here to values that are liberating in the sense of the artes
liberales—to values, that is, that enrich the human perspective and focus
attention on nonmundane matters. Mediocrity is characterized by an inca-
pacity to realize liberation of this kind and is therefore closely related to
acedia, discussed in Chapters 4 through 6.
The second characteristic that typifies the general behavior of the
mediocre, conformity, which we’ve already met in connection with intellec-
tual mediocrity and which was recognized by Ingenieros as basic to medioc-
rity, is the urge of people to copy one another’s forms of behavior—to
copy their common physical behavior, and most especially their overt
expression of conventional attitudes, group affiliation, patterns of response
to events, and so on. The third characteristic, narcissism, refers to the self-
absorption of the mediocre in the world of their narrowed concerns, inter-
ests, and pursuits; a detailed description was given in Chapter 5.
The manners and lack of sophistication of the mediocre make up a sec-
ond group of characteristics that typify mediocrity of conduct. Here, vul-
garity of language and of nonverbal behavior permeate the daily conduct
of the mediocre. There is an absence of refinement in language use (as
we shall see below in connection with linguistic mediocrity), an absence
of physical grace, a lack of polish and a crudeness in nonverbal communi-
cation, and often an unrestrained willfulness to engage in verbal and non-
verbal offense over trivial matters, the source of the various forms of road
rage, shopper’s rage, traveler’s rage, and related outbursts.
Mediocrity of conduct is closely associated with social mediocrity, the fifth
major trait of the psychology of mediocrity. Social mediocrity is often
expressed in the mediocre person’s choice of friends and acquaintances
and in the mediocre’s enthusiasm to maintain social relationships with
mediocre family members. As we have noted in connection with emotional
mediocrity, the mediocre person is commonly afflicted by various types of
indiscrimination. Social mediocrity involves one of these in particular,
social indiscrimination, a disposition encouraged by unquestioning
204 Normality Does Not Equal Mental Health

egalitarianism and the refusal to acknowledge individual differences. Social

mediocrity is evident in the mediocre person’s love for fellow mediocrity,
for the undemanding, warm, comforting, bland, mentally relaxing, enjoy-
able, and emotionally nonstressful herd experience. Social mediocrity is
typically exhibited in a low level of quality of conversation: idle chat and
prattle about trivia that resolutely exclude concern for “higher topics,” the
intelligent discussion of which requires a rich cultural experience, educa-
tion, individual cultivation and refinement, critical thinking ability, and
general mastery of language.
The socially mediocre frequently substitute celebrity mania for genu-
inely meaningful values. Their interests are aroused by the socially trivial
and fatuous. Their level of humor is immature and crude, emphasizing
reference to body functions, sex, violence, and Schadenfreude, pleasure in
the calamities that befall other people.
A sixth major trait of mediocrity is physical mediocrity, which refers to a
low level of care and management of one’s physical condition and health
and the health of others. The Greeks referred to physical aretē, the culti-
vation of excellence of the body and its functioning. Physical mediocrity
is its opposite. Physical mediocrity is characterized by obesity when not
due to a diagnosed physiological disorder, by the hypocritical pursuit of
dietary fads, by drug and excessive alcohol use, by the placement of a
lower value on adequate medical care in preference to material purchases,
and by avoidance of exercise and neglect of personal hygiene.
At a critical time of human overpopulation, widespread psychologically
based indifference to the physical consequences of adding further to the
population qualifies as yet another manifestation of physical mediocrity:
it is yet another expression of the inability to engage in reflective critical
thinking concerning human reproduction that results in the runaway pro-
liferation of the population. The choice to have children entails the fore-
seeable physical consequences of bringing more people into a world
already characterized by crowding and the consequent impoverishment
of the quality of the natural environment. In these senses, physical medi-
ocrity is not only typified by physically unhealthy living but is further
characterized by an uncritical, unthinking, and effusive infatuation with
the cult of pregnancy and the doting upon infants, by a mindless zeal
and unquestioned fanaticism in favor of the bearing and raising of chil-
dren, in oblivious disregard of the everywhere visible, physical effects of
a human population that crowds out other life forms, destroys the aes-
thetic beauty of the natural world, and poisons itself in the process.
In these ways, the lives of the mediocre are dominated by physically irre-
sponsible choices. Living responsibly, on a purely physical level, means
The Psychology of Mediocrity 205

living with an intelligent awareness of the consequences of one’s physical

choices, which include reproductive choices.
On a less globally consequential level, physical mediocrity is also typi-
cally expressed in the personal display by the mediocre of an exaggerated
lack of personal grooming and shoddiness of dress. We see that physical
mediocrity clearly overlaps aesthetic mediocrity, for these traits are clearly
not independent of one another. We see both intertwined today, for
example, in the young mediocre woman’s copycat conformity that gives
her voice a forced nasal, duck-like sound, jarring to the few who possess
aesthetic sensibility. Fashion rules the mediocre, and this is most espe-
cially seen in the choices they make in connection with their personal
physical characteristics.
Linguistic mediocrity is a seventh major trait of mediocrity. It refers to
mediocrity of expression, that is, to mediocrity of language use. Linguistic
mediocrity characterizes those who:

• Exhibit a poverty of expression due to an impoverished vocabulary,

through ignorance and lack of retention of the resources of language
that make articulate communication possible;
• Prefer this limited vocabulary because it is conformist and imitative.
Their shrunken vocabulary results in extreme limitation in their
expressive ability, and promotes a use of language that makes it most
suitable for the expression of elementary emotions, much less suit-
able for the communication of conceptual complexity, and least suit-
able for expression that is rich in imagery, figurative, original,
eloquent, or in any sense imaginative or evocative;
• Are ignorant of or disregard grammatical refinements of language.
Pitkin (1932) called this and the foregoing “linguistic stupidity”
(p. 174): “Most people are constitutionally unable to use language
in its higher refinements. They live at the mental level intermediate
between that of the primordial savage and the superior 1% of
modern mankind which has created the subtleties of grammar, rhet-
oric and style. . . . [W]e say the common man thinks, reads, and talks
in catch-phrases and slang” (p. 173);
• Are critically deficient in the reflective metaskills, the linguistic self-
consciousness, necessary for competent language use: for instance,
subject-verb agreement, distinctions between meaning and use of
such word pairs as ‘lie’ and ‘lay’, ‘effect’ and ‘affect’; today’s mindless
repetition of words and phrases such as ‘like’, ‘absolutely’, ‘y‘know’,
‘unprecedented’, and so forth; turning verbs into nouns, as in ‘a
repeat’, ‘a mix’, and similar manifestations of linguistic carelessness
206 Normality Does Not Equal Mental Health

and indifference. The general lack of reflective skills at issue here typi-
fies many of the traits of mediocrity. We shall come back to this issue
later;
• Communicate primarily through prattle that has no more lasting
value than momentarily excited air, using language principally for
the expression of trivia and limited to what is immediate and mun-
dane, without concern or interest in communicating about matters
of enduring significance or importance. Related to this is a defi-
ciency in temporal imagination, noted earlier in Chapter 5, which
takes the form of an inability to make descriptions of the past or
future feel real unless expressed in the present tense;
• Are averse to learning languages other than their native language;
who will raise a ridiculing eyebrow when a foreign word, name, or
phrase is pronounced correctly; who, as Bertrand Russell once said,
condemn to neglect whatever fails to be translated into their own
language; and who, through such choices and attitudes, express lin-
guistic provincialism.

In describing these characteristics of linguistic mediocrity, some readers

may have the impression that they merely reflect adherence to an intellec-
tually fastidious, grammatically pedantic, rigidly exacting set of standards
(and it is to be expected that some readers will feel this way about the
entire study of the psychology of mediocrity). In a sense, this perception
is correct—that is, it is tautologically correct from the standpoint such a
reader accepts—but it clearly is not ours here. It is not as though rules
of grammar and niceties of speech and writing are hallowed and revered
for their own sakes, but they are appreciated as signs of an active, edu-
cated, reflective, and disciplined mind, for these are among the qualities
that distinguish such a mind from mediocrity. As E. B. White expressed
this, “Unless someone is willing to entertain notions of superiority, the
English language disintegrates, just as a home disintegrates unless some-
one in the family sets standards of good taste, good conduct and simple
justice” (quoted in Roberts, 2009, p. C3). Certainly the recognition of
mediocrity, as it is described in this chapter, is only possible and meaning-
ful from the standpoint of a set of values that accepts the factual legitimacy
of what White calls “notions of superiority.” We shall return later to con-
sider this issue more explicitly.
Still another major trait of mediocrity is what we may appropriately call
mediocrity of way of living. Here, I refer to the physical living conditions
that the mediocre find acceptable, likable, and even preferable. The
mediocre often have low to nonexistent standards regarding the aesthetic
qualities of their physical environments and are comparatively insensitive
The Psychology of Mediocrity 207

to the presence of noise and crowding. They may have low to nonexistent
standards regarding their housing, interior decorating, and housekeeping.
They frequently have few standards that are deeply important to them
that concern the design of their neighborhoods and the architecture of
their towns and cities. They are accepting and tolerant of the degree to
which their work is routine and repetitive, of the amount of time that must
be given up to commuting, and of the quality and final significance of
working in and relating to their community. It is not that mediocre people
do not care at all about these things but these things are not for them
nonnegotiably important. Relatively few people are willing to undertake
fundamental change in their ways of living simply because they will not
or cannot tolerate conditions such as I’ve listed. All of the characteristics
that typify mediocrity of way of living involve taste and sensibility and
therefore involve an obvious overlap with aesthetic mediocrity described
earlier.
Moral mediocrity is the ninth major trait of mediocrity to which we turn.
Moral mediocrity is characterized by lack of individual autonomy—
specifically, an absence of the strength and independence to set one’s own
standards; an inability to develop, formulate, and commit to one’s own
principles; deficiency in critical evaluative ability; and insufficiency in the
combined capacity to stand alone in terms of one’s evaluative principles,
way of life, kinds of experience perceived to be meaningful, and life goals.
In the history of Western thought, Nietzsche has been the most vocal
in expressing the importance of rising above levels of moral mediocrity.
Through his “anti-mediocre morality” (a phrase used by Ingenieros,
1913/1957, p. 112: moral antimediocre) Nietzsche sought to fight back
against the mediocre’s “general war on everything rare, strange, privi-
leged, the higher man, the higher soul, the higher duty, the higher respon-
sibility, creative fullness and mastery” (Nietzsche, 1972, §212; also §62,
§202; 1956, p. xii). Nietzsche described and urged a “final stage of moral-
ity” in which “the individual acts in accordance with his own standard
with regard to men and things: he himself determines for himself and
others what is honourable and useful; he has become the lawgiver of opin-
ion” (Nietzsche, 1989, §94). Nietzsche had no politically correct qualms
about recognizing the substantial, real, and inherent distinction between
the many and the few, between the noble and the common, between the
great and the small (Nietzsche, 1982, §323; 1974, §3, §40; 1968, §984).
He emphasized the high worth of individual autonomy, of moral self-
sufficiency, and proclaimed that “greatness of soul” involves precisely this
kind of independence (Nietzsche, 1974, §55; 1989, Vol. II, §337; 1968,
§984; 1972, §§29, 201). In these passages Nietzsche notes that the individ-
ual who has reached this high level of morality is indifferent to the
208 Normality Does Not Equal Mental Health

opinions to which the mediocre comply and to moral standards which

they uncritically accept.
Today, of course, recognition of “nobility of soul,” of “the higher
man,” of “the higher duty,” and of “creative fullness and mastery” seldom
occurs—in fact, these phrases have lost all pretense of having any definite
meaning, and now, for most people, they seem quaint, antiquarian, and
when taken with any seriousness are, in an ideological reflex arc, dismissed
as unacceptably elitist.
In Bartlett (2005, Chapter 18), a detailed description is given of human
moral intelligence, to which interested readers are referred for a more com-
prehensive discussion than can be given here. Moral mediocrity involves a
deficiency in such moral intelligence, coupled with an in-built resistance
to the moral autonomy that preoccupied Nietzsche. The psychology of
morally mediocre people predisposes them to be strongly and rigidly
opposed to those who develop and cultivate moral autonomy. Here we
again encounter the familiar signature of mediocrity: a psychology of
internal limitation that hinders human development.
The tenth and the last major trait of mediocrity that will concern us is
absence of individuation. As we’ve seen, Ingenieros referred to the “lack of
personality” of the mediocre. In several contexts, we have encountered
their lack of discrimination. Both are involved here. The mediocre prefer
a state in which they do not feel different from others; they wish not to be
fundamentally different since this would erect a wall between them and
the comforting warmth of being just like the other members of the herd.
This intention to merge the mediocre self with the collectivity of the herd
is a deliberate internalization of mediocrity.

This is what constitutes the mediocre man and women, the immense
human majority: For the mediocre, to live is to give oneself to unanimity,
to permit customs, prejudices, practice, and subjects of concern to become
internalized. . . . Beneath the apparent indifference and lack of involvement
of the mediocre there always lies a secret fear of having to make decisions
for themselves. . . . They dissolve among the multitude. (Ortega y Gasset,
1957/1982, p. 214)

Hence, the mediocre are “indifferent’ in the two senses of this word:
they prefer not being different from others, and they prefer the tepid to
the hot or the cold, avoiding whatever goes beyond mediocre acceptabil-
ity. They dread and resist developing personal identities that would dis-
tinguish and differentiate them from everyone else and so render the
mediocre person recognizably alien to his or her fellows.

²
The Psychology of Mediocrity 209

At this point we need to gather together this trait-by-trait description of

the psychology of mediocrity. From a level of higher theoretical general-
ity, a level from which we can see the various defining traits of mediocrity
as they interact and combine to form the specific phenomenon under dis-
cussion, the 10 traits I have identified can be seen to be responsible for a
general mediocrity of values: They are values that determine and circum-
scribe the level of a person’s everyday consciousness. They determine
the objects that receive the person’s attention; they determine how his or
her life is shaped around these; and they determine how the person makes
decisions in a way that displaces or excludes attention to higher alterna-
tives. Such values that absorb the attention of the mediocre frequently
have to do with valuing money and things more than time, things more
than quality of experience, money and things more than higher realities,
imitation and herd commonality more than autonomy and the ability to
think reflectively and critically. Mediocrity of values is centered around
conformity and compliance and in particular around physical and ideo-
logical conformity, shared fashions, tastes, standards, reproductive drives,
and doctrinal beliefs. These values motivate the mediocre to gravitate to
the menial, the elementary, the undistinguished and hence unexceptional,
and therefore to the commonplace; the mediocre accordingly find their
most comfortable level of personal challenge and attainment on the hum-
drum level of ordinariness. And so the imitative and unremarkable iden-
tity of the mediocre renders them most contented when in subservience
to leaders who themselves share major traits of mediocrity with which
they can identify. The mediocre engage in a willful blindness that is both
mutually and individually comforting, a blindness that excludes from
awareness the experience of the unfamiliar that potentially could chal-
lenge, conflict with, or jeopardize accustomed, habitual states of con-
sciousness. As a result, the mediocre live within the boundaries of
limited horizons; they lack awareness of other dimensions that go beyond
the single dimension of their experience.8 In the next section, we shall
look at the way in which a constrained mediocritizing experience that
excludes consciousness of other “dimensions” is intrinsically limiting.

“PEOPLE WHO AREN’T REAL”

“I’m sorry, I certainly don’t want to offend you, but, in fact, for me you are
without reality. As you present yourself to me, you are without those con-
vincing characteristics that make what we perceive and experience, make
what happens, real. You exist, sir, that I cannot deny. But you exist on a level
that in my eyes lacks time-space reality. You exist, I might say, on the level
of paper, of money and credit, of morality, of laws, of intellect, of
210 Normality Does Not Equal Mental Health

respectability, you are a space-and-time companion of virtue, of the cat-

egorical imperative, and of reason, and perhaps you are related to the
Thing-in-Itself or to capitalism. But you have not the reality I find convinc-
ing in the case of every stone and tree, every toad, every bird. I can give you
my unlimited respect and approval, sir. I can doubt you or consider you
valid, but it is impossible for me to experience you, it is wholly impossible
to love you. You share this fate with your relations and worthy next of kin,
with virtue, with reason, with the categorical imperative, with all humanity’s
ideals. You are magnificent. We are proud of you, but real you are not.”
—Hermann Hesse (1973, pp. 153–54)

In Ingenieros’ El hombre mediocre there is a section entitled “Los

Hombres Sin Personalidad” (Men without Personality) where we find this
claim: “Considered on an individual level, mediocrity can be defined as an
absence of personal characteristics that make it possible to distinguish the
individual in his or her society” (p. 36). We saw earlier in this chapter how
“indiscrimination” and “lack of distinction” can contribute to the mediocre
person’s absence of a genuinely individuating identity. The mediocre are,
when considered singly as individuals or as members of the class of medio-
cre people, not “significantly different.” What does this mean?
In Bartlett (1971, Chapters 1.1, 2.3), I showed how the cognitively fun-
damental concept of an object of reference necessitates that such an object
possess an identity: possession of an identity is an inescapable prerequisite
for any entity. This was the unspoken basis, as I understand Hesse and
Ingenieros, of what both men had in mind: Mediocrity prevents people
from developing a degree of individuation that is genuinely meaningful,
that is significant, that distinguishes them from the masses of other simi-
larly undistinguished people. It is not, of course, that the mediocre are
utterly devoid of personal identity, but when compared with a more fully
developed person who can be distinguished from others by his or her indi-
viduating qualities, abilities, and attainments, the mediocre deliquesce
into a undifferentiated mass. As authentic individuals, the mediocre are
not fully real.
As Hesse might put it, the mediocre are nonentities: there is nothing in
particular that distinguishes them from others who are just as indistin-
guishable. To make such a claim is to understand the reality of a person
as a function of the level of the realities of which he or she is conscious, that
is, in proportion to his or her exercised capacity to attend to realities that
are “higher.” Twice before in this book, I quoted a passage that expresses
what I believe was Hesse’s personally defining outlook. That quote begins,
“I consider reality to be the thing one need concern oneself about least of
all, for it is, tediously enough, always at hand while more beautiful and nec-
essary things demand our attention and care” (Hesse, 1925/1954, p. 67).
The Psychology of Mediocrity 211

Those “more beautiful and necessary things” are, for Hesse and others like
him, “more real” than the mundane, the ordinary and common. As readers
have found presupposed in most of the chapters of this book, there is a
frame of reference in terms of which such levels of reality can be discrimi-
nated. We’ll discuss this presupposition more fully in what follows.
“People who aren’t real” is a phrase compatible with Hesse’s under-
standing of the world of mediocrity. The people who inhabit that world
are trapped on a level of reality that is—from a “higher,” “deeper,” “more
sensitive,” and “more cultivated” perspective—unreal: Their world lacks
dimensions; they are one-dimensional creatures, with a single, narrowed
consciousness that has little depth, little height, and little width. It is only
linear, on a single track, confined and impoverished.9
This observation is anything but new. Such “levels of reality” were
described in detail by Plato, and are basic to many stratified, hierarchical
descriptions of human experience. I use the term ‘description’ with a lit-
eral meaning in view: what is described is based on an empirical, matter-
of-fact account of what many, but not all, people experience. This is
empiricism in its most basic application to the contents of awareness; it
is descriptive phenomenology.
Plato wrote: “[I]n heaven, methinks, there is laid up a pattern of such a
city, which he who desires may behold and, beholding, take up his abode
there. But whether such a city exists, or ever will, is no matter; for he will
live after the manner of that city” (Plato, The Republic, Chap. XXXIV, ix.
591–2). This “higher level of reality,” which for the majority is not real
(just as these people themselves are unreal for the Hesses of the world),
can become the dominant and most real center of one’s concern, of what
one values, of one’s attention and care. It can then form one’s dominant
“mental space.” Seemingly bordering on metaphor, but yet not meta-
phorical, that space possesses more dimensions than the mental space
inhabited by the mediocre. It is a genuinely “extra-ordinary” space, and
access to it and the cultivation of it, on an experiential level, is what most
distinguishes the mediocre from those who are not similarly limited.

RESISTANCE TO ACKNOWLEDGING INDIVIDUAL

DIFFERENCES IN ABILITIES
It is in the most unqualified manner that I object to pretensions of natu-
ral equality.
—Galton (1869/1925, p. 12)

Unfortunately, even to give utterance to such observations as I’ve just

made concerning “levels of reality” is for many people today, just as when
212 Normality Does Not Equal Mental Health

Francis Galton wrote more than a century ago, objectionable and subject
to condemnation and intellectual suppression. In his justly famous Heredi-
tary Genius, quoted above, he admitted: “At the time when the book was
written, the human mind was popularly thought to act independently of
natural laws, and to be capable of almost any achievement, if compelled
to exert itself by a will that had a power of initiation” (p. vii). Later in his
book, he commented:

Our race is essentially slavish; it is the nature of all of us to believe blindly

in what we love, rather than in that which we think most wise. We are
inclined to look upon an honest, unshrinking pursuit of truth as something
irreverent. We are indignant when others pry into our idols, and criticize
them with impunity, just as a savage flies to arms when a missionary picks
his fetish to pieces. (Galton, 1869/1925, p. 189)

We recall that Ingenieros quoted Plutarch’s observation that animals of

the same species differ among themselves less than some men differ from
other men, and Montaigne’s opinion that there is more distance between
some men than between some men and animals (Ingenieros, 1913/1957,
p. 34). Galton’s study of genius bore out such judgments. He wrote: “To
conclude, the range of mental power between—I will not say the highest
Caucasian and the lowest savage—but between the greatest and least of
English intellects, is enormous. . . . There is a continuity of natural ability
reaching from one knows not what height, and descending to one can
hardly say what depth” (Galton, 1869/1925, p. 22).
Much more recently, psychologist Arthur Jensen ran painfully aground
on the most bitter resistance to an acknowledgment of individual differ-
ences, shouted in protest with a degree of impassioned hysteria almost
beyond belief by his professional colleagues as well as by the general pub-
lic. About the series of personal attacks and professional abuses he
endured, he wrote:

To a psychologist observing all these phenomena [of ill-treatment], the

question naturally arises as to why so many otherwise objective and
dispassionate intellectuals display such vehement moral indignation and
even zealous combativeness toward any explanation of human behavioral
differences. . . . We all feel some uneasiness and discomfort at the notion of
differences among persons in traits that we especially value, such as mental
abilities, which have obviously important educational, occupational, and
social correlates. There are probably no other traits in which we are more
reluctant to notice differences, and if circumstances force us to notice
them, our first tendency is to minimize them or explain them away. (Jensen,
1972, p. 55)
The Psychology of Mediocrity 213

A colleague of Jensen later commented that some people were unable to

consider individual differences dispassionately because they are commit-
ted to an unquestionable belief that unless it is true that human beings
are equal in abilities, a democratic society simply cannot succeed, there-
fore such equality must be a fact. He drew an analogy from religion: “If
there weren’t a Heavenly Father to sustain me in my agonies, I couldn’t
go on living; therefore God exists” ( Jensen, 1972, p. 57).
A diversity of individual abilities is a fundamental fact of our present
human reality. At this time, it is an inescapable given. Perhaps in the
future this fact can be replaced with another more to the majority’s liking,
but if our task is to describe the present human psychological constitution, we
are stuck with the facts; whether these facts turn out to be due largely to
genetics, or chiefly to environment, or to a certain contribution of both
is irrelevant insofar as the psychological description remains the same.

THE EPIDEMIC OF MEDIOCRITY

As we have seen, each major psychological trait of mediocrity is associ-
ated with psychological gratifications that cause mediocrity to be self-
constraining—that is, literally to limit the self of the person who possesses
that trait, preventing the individual from developing further, analogous to
the way in which a mechanical governor limits the speed of a motor: as the
motor rotates faster, the governor exerts more and more braking force.
We have recognized that there potentially exists a level of mediocrity cor-
responding to every imaginable ability, capacity, sensitivity, or sensibility.
Those forms of mediocrity that I have selected to describe are among the
most insidious and infiltrating, working their ways into the lives and con-
cerns of the majority of people. These traits of mediocrity enter a person’s
life often in unobtrusive ways, insinuating themselves into habits of think-
ing, feeling, and behaving that are essentially constraining, restricting
the mediocre person’s experience to the lowest levels that he or she
finds gratifying. In this sense, mediocrity can accurately be described as
contagious, a fact that Ingenieros also recognized.
A set of traits can become psychologically contagious—in a literal and
not a metaphorical sense—when those traits bring people deeply felt grat-
ifications of the kind this chapter describes; these gratifications, in turn,
encourage people to make them habitual. This is a contagious process that
results in addictive habituation. In Bartlett (2005, Chap. 7), I described
the contagion of “psychic epidemics” in which mass infection or mass
pathology occurs and to which rationality succumbs. Are we in the midst
of an unrecognized “epidemic of mediocrity”?
214 Normality Does Not Equal Mental Health

More than half a century ago, Jung observed that through such conta-
gion mental illness can come to afflict an entire society. It happens espe-
cially, according to Jung, in war. Discussing Germany’s part in World
War II, he wrote of the “mental contagion that threatened every Euro-
pean,” a nonfigurative kind of psychological infectiousness, an “all-
engulfing force of attraction” in which “each man clings to the next and
each drags the other with him” (Jung 1946/1967–1983, p. 230).
As this occurs, the capacity of people for independent and reflective
response is blotted out, their moral sense is diminished so that the larger
the social collective in which the mediocre person establishes his or her
identity, the lower its moral standards. “Any large company composed of
wholly admirable persons has the morality and intelligence of an
unwieldy, stupid, and violent animal. The bigger the organization, the
more unavoidable is its immorality and blind stupidity” (Jung, 1916–
1917/1967–1983, p. 153). “Hence every man is, in a certain sense, uncon-
sciously a worse man when he is in society than when acting alone; for he
is carried by society and to that extent relieved of his individual respon-
sibility” (Jung, 1946/1967–1983, p. 228).
During this process, capacities for individual thought and independent
response are wiped out. As they are lost, the individual’s moral sense (to
whatever degree it may exist) is dissolved, so that the larger the herd in
which the individual is absorbed, the less is moral restraint observed.
Actions that an individual would abhor when acting on his own initiative
and conscience then become commonplace: “[T]he greatest infamy on
the part of his group will not disturb him, so long as the majority of his
fellows steadfastly believe in the exalted morality of their social organiza-
tion” (Jung, 1946/1967–1983, p. 229).
It is important again to stress that in Jung’s judgment the pathology he
had in view is not a literary fiction but real: The infection takes place in
the minds of people, it sweeps away their capacities for individual, inde-
pendent thought and action, and it attributes ultimate importance to the
social herd. When the collective comes to assume ultimate significance,
then the contagion “puts a premium on mediocrity,” elevating the ordi-
nary, the mundane, the common, so that “everything . . . settles down to
vegetate in an easy, irresponsible way. Individuality will inevitably be
driven to the wall” (Jung, 1967–1983, Vol. 7, p. 153).
This phenomenon of contagion unfortunately is not confined to war
but is an everyday occurrence. The psychology of mediocrity is a magnet
for people who wish to be relieved of the burdensome responsibilities of
independent thinking, self-governing morality, and autonomous feeling
and behavior. The traits that characterize the psychology of mediocrity
The Psychology of Mediocrity 215

are among the most seductive, insidious, and subverting, working their
way into the lives and concerns of the majority of people.

MEDIOCRITY: ARRHOSTIA OR SPANDREL?

As I use it here, the word ‘arrhostia’ (derived from the Greek, meaning
“ill health”) refers to a normal condition or trend in development or evo-
lution that is recognized to be pathological.10 The other word, ‘spandrel’,
harkens back to the construction of the domes of Gothic cathedrals,
where triangular spaces below the dome came about as the unintended,
adventitious results of the way the dome was mounted on the surrounding
arches. Gould and Lewontin (1979) picked up the word and applied it to
accidental characteristics that fall between the cracks of natural selection
and confer no evolutionary advantage. Somewhat less descriptively,
Jensen (1972, p. 160) chose to call such conditions “polymorphisms.”
Hence, the question this section raises is whether the psychology of medi-
ocrity is simply a “spandrel” (or “polymorphism”) that bestows no advan-
tages upon human survival, or is instead an “arrhostia” that has become a
normal condition and acts as a pathology.
Readers will anticipate my answer to this question, since mediocrity has
been described in terms of traits that constitute functional impairments
that are inherently limitative for individual as well as to general human
development. From this standpoint, the psychology of mediocrity focuses
on a specific, pathological branch of human psychology, a branch charac-
terized by a group of self-perpetuating disabilities.
We should note that there is no necessary association between low levels
of ability, sensitivity, sensibility, and refinement, on the one hand, and the
mediocre’s willful determination to limit those who excel, on the other,
for—after all—the compliant and imitative worker ant performs an
obvious social function, and yet does not resist or attack either other
workers who excel in their jobs (if among ants “workers of eminence”
exist), or, hopefully, the preeminent queen. There is no necessity that
low levels of ability, sensibility, and the other characteristics described in
this chapter should take the form in people of hostility toward the new
and the different, or hostility toward supramediocre levels of attainment.
And yet among human beings this plainly does happen, and very often.
The psychology of mediocrity not only limits the individual development
of those who are mediocre but it would place fetters on others who excel,
and, when mediocrity becomes dominant in a population, it turns society
into mediocracy, obstructing its advancement.
216 Normality Does Not Equal Mental Health

Needless to say the mediocre serve many functions in human society

and fill many useful niches. Ingenieros recognized their socially important
role: much of social stability and functioning depends upon people who
fill the common ranks (Ingenieros, 1913/1957, pp. 45–48). Unfortunately,
the psychology that dominates them brings with it inherent limitation.
When the psychology of the majority of the human population involves
traits that handicap them in critical ways, we are justified in judging that
psychology to be to be pathogenic. In a better world, low levels of ability
and achievement in some people need not be associated with the deeply
rooted resistance that we see in the mediocre to their own self-
development and the development of others.

TRAITS OF EXCELLENCE AND SUPERIORITY

As we have seen, many of the traits of the mediocre set them in antago-
nistic opposition against those who possess superior abilities; have more
cultivated tastes; and show a higher level of education or manners, a
broader cultural awareness, excellence in linguistic competence, greater
originality, greater concern for physical health and for aesthetic physical
surroundings, heightened moral sensitivity and development of moral
autonomy, richer personal individuation, and freedom from conformity.
In all of these ways, we see the psychology of mediocrity sharply divided
from traits that define such qualities as excellence and superiority of abil-
ity, achievement, and sensibility.
The branch of psychology dealing with such positive traits has not been
as neglected as the psychology of mediocrity. It would take us beyond our
present subject to describe these characteristics in detail. Many have
already implicitly been named in the course of this chapter, often preceded
by the adjectives ‘higher’, ‘better’, or ‘superior’. There are different routes
that language provides to refer to these traits: we may choose to speak of
“levels of reality,” “dimensions” of awareness and concern, “higher” as
opposed to “lower,” “richness” as opposed to “poverty” of mind, an
“elevated life” in contrast to a life of mundanity. Proust (1913–1927/
1981, Vol. III, p. 698) spoke of having “another plane” in one’s life; alterna-
tively, we can refer to imagination that goes beyond selfishness, beyond
ordinary life and its attendant concerns, beyond routine, job, family, and
the mundane necessities that surround us on all sides; and then we encoun-
ter a willingness, even a need, to go against the tide.
But when such qualities are found in an individual person, and he or she
is called “superior” in certain respects, a rumbling of protest begins. The
taboo of individual differences reacts quickly in a prereflective reflex, and
then ideology comes into full swing. Nietzsche’s most deeply felt concern,
The Psychology of Mediocrity 217

I believe, was the creation of conditions necessary for genuinely superior

individuals to develop and achieve greatness. He believed that he foresaw
a future—which there is evidence to believe has become the present of
today—in which there could develop “a general war on everything rare,
strange, privileged, the higher man, the higher soul, the higher duty, the
higher responsibility, creative fullness and mastery” (Nietzsche, 1972,
§212, cf.§62, §202). He wished for a world in which the long-standing
dominance of the mediocre would be replaced by the ascendancy of peo-
ple of genuinely superior abilities. Like Galton, he did not hesitate to take
note of distinctions between the many and the few, between the common
and the noble, between the small and the great (Nietzsche, 1982, §323;
1974, §§3, 40; 1968, §984).
Nietzsche has admittedly received bad press, thanks in part to editorial
tampering with his writing at the hands of his sister and through the Pro-
crustean stretching of his ideas by the Third Reich. It does of course
require independent and clear-headed thinking to break free from such
associations that can prevent us from considering an individual’s thought
on its own merit. More recently, Konrad Lorenz and Abraham Maslow
have tried to do this. Lorenz (1940, p. 71) wrote of “the man of high
value,” “the fully superior person,” and “the fully valuable person” (Voll-
wertige). He had in mind many of the traits mentioned in this section
and was intellectually and emotionally at ease as an ethologist in accepting
the variability of human abilities. He saw no reason to suppress a recogni-
tion of the superiority of some people and urged appreciation and respect
for outstanding abilities and achievements when they are found in individ-
uals. (For more on this subject in Lorenz, see Bartlett, 2005, Chap. 10.)
Like Lorenz, Maslow also used the language of “superiority” in connec-
tion with the factual inequality of human abilities. Since for many people
Nietzsche has become “tainted,” and perhaps even Lorenz as well (because
of uncertainty concerning his early association with the National Socialist
environment of his time), I’d like to pause for a few minutes to consider
Maslow’s thoughts on this matter. Fortunately, he seems to have had no
potentially compromising political affiliations that we might hold against
him. Maslow is known as a humanistic psychologist with a gentle touch
and engaging style. It may surprise some readers that he was unreservedly
outspoken about the “superiority” of some people. One of his papers,
which is almost never cited—for obvious politically correct reasons—bears
the title “The Superior Person” (Maslow, 1964). Since this paper is appa-
rently little read, I’d like to quote some sample passages from it:

None . . . dares to lock horns with the problem which is so unpopular in any
democracy: that some people are superior to others, in any specific skill
218 Normality Does Not Equal Mental Health

or—what is more provocative to the democrat—in general capacity. There

is evidence that some people tend to be generally superior, that they are
simply superior biological organisms born into the world. . . . No society
can be really efficient unless its superior persons are preferred and elected
by the other people. (p. 10)

Maslow calls this a “delicate problem . . . docked by democrats” (p. 10).

He goes on to say, obviously without mincing his words: “[T]here must
be a good 10 percent of the population, at least, whom we simply tell what
to do and whom we care for as if they were pet animals. Our society has
never squarely faced the question of the objective superiority of some peo-
ple and the inferiority of others” (p. 10).
This topic—for constructive research or for public discussion—is
swept under the table: “It is permitted me to say in public what my weak-
nesses are, but it is certainly not permitted to me to say what my superior-
ities are. This is a real weakness in our society” (p. 10). He expresses the
observation: “The unselected differentiated population at large has a fair
proportion of very sick people, very incompetent people, very psycho-
pathic people, insane people, vicious people, authoritarian people, imma-
ture people” (p. 11). He then goes on to refer to the “constitutional
endowments” of individuals, which these facts reflect (p. 13).
Readers would expect that, in a paper bearing the title it does, Maslow
would tell us what the “superior person” really is, what main traits one
should expect to find in such an individual. In the paper from which I’m
quoting, he uses the phrase “psychologically healthy” to refer to the supe-
rior person, but we learn little more in this publication. But it would come
later. Maslow concluded his “superiority paper” with these words:

In an ideal society is seems very clear that people must be able to admire, to
choose, and to follow the superior leader with a minimum of antagonism
toward his superiority. I am stressing this because I am so aware of the fact
that real factual superiors tend to be strongly resented as well as admired,
and that therefore they are less apt to be chosen on the basis of a
democratic vote.
We must work out some better criterion for selecting leaders than
popularity. . . . The good society is impossible unless we develop the ability
to admire superiority. (Maslow, 1964, p. 13)

We do find a more fully detailed description of human superiority in

Maslow’s (1971) The Farther Reaches of Human Nature. There, he makes
a good deal clearer what he has in mind: a “small and selected superior
group” (p. 7) who share his now-famous trait: they are “self-actualizing,”
that is, they have developed what I’ve called moral autonomy (Maslow:
The Psychology of Mediocrity 219

“They do not get confused just because 95 percent of the population dis-
agrees with them” [p. 9]). They are “psychologically healthy” and hence
“psychologically ‘superior’ ” (p. 6); the “psychologically healthy” person
is the “more highly evolved” person (p. 96); they are “better cognizers
and perceivers” (p. 6); they have a “mission in life” that is meaningful
because of “principles which seem intrinsically worthwhile” and which
“are not abstract to the self-actualizing person; they are as much a part
of them as their bones and arteries” (p. 192). Such people are “our (fac-
tual) superiors,” and for this reason often they are abused by people who
are envious of them (p. 219). Superior individuals are more resistant to
the pressures of conformity and enculturation (p. 270). And the last char-
acteristic of self-actualizing people that I’ll mention from Maslow’s work
is that they are “more responsive to beauty” (p. 287).
Unlike Nietzsche and Lorenz, Maslow wished to be very specific about
these traits; in fact, he recognized that they can be defined operationally
and measured through psychological testing, as the Personal Orientation
Inventory (Shostrom, 1963) attempts to do. Maslow was intellectually
and emotionally relaxed, was secure in accepting the factual, wide varia-
tion in individual differences, and was no more hesitant to call one person
another’s “superior” with respect to specific qualities than he was to rec-
ognize that one person was taller than another. He accepted the unfair-
ness of unequal natural endowments: “Neither would it be fair that one
[child] is more talented or intelligent or strong or beautiful than another”
(Maslow, 1971, p. 224). He chose to study “remarkable human beings,”
and about them he wrote: “It was as if they were not quite people but
something more than people” (p. 42). Of the total population, perhaps
they make up “the healthiest 1 per cent or fraction of 1 percent”
(p. 92).11 And he recognized that some people will feel “deep conflicts over
the ‘elitism’ that is inherent in any doctrine of self-actualization—they are
after all superior people whenever comparisons are made” (p. 289).
What of the rest of the people, the majority? I don’t recall that he used
the word ‘mediocre’ to describe them, but he did use the phrase ‘less
evolved’ (p. 313). Despite the fact—which we may not like but to be real-
istic must accept—that the great majority of the population is stupid,
cruel to each other, and falls between shortsighted and blind (p. 288),
Maslow appears to have been hopeful: “[W]e must be very careful to
imply only that the higher life is in principle possible, and never that it is
probably, or likely, or easy to attain” (p. 326).
Others beside Maslow, Lorenz, and Nietzsche have tried to paint accu-
rate portraits of the superior person. As we noted in Chapter 1 of this
book, Fromm (1941, 1947, 1955) developed the concept of the “autono-
mous person,” Rogers (1961) the concept of the “fully functioning
220 Normality Does Not Equal Mental Health

person,” and Jung that of the “individuated person” (e.g., Jung, 1958,
p. 81; for a general discussion of such approaches, cf. Jahoda, 1958). What
was their motivation in studying the traits of human beings that make up
such a tiny minority? It is of course impossible to answer this question
about other authors without speculation, and so I’ll bring it home to bear
on myself: Why study the psychology of mediocrity? Certainly the frame-
work that I have presupposed in describing the major traits of mediocrity
is elitist in precisely the sense that it is elitist to identify and promote traits
of human superiority.
And so why do this? I gave my own answer to this question at the
beginning of this chapter: “to make human life better.” If we don’t recog-
nize and fully comprehend how major psychological traits that character-
ize the majority limit us, we will remain correspondingly limited and
unable to shake off our shackles. The traits that together contribute to
the psychology of mediocrity are compelling in their conformist attrac-
tions and in the gratifications they bestow, and so not only is it difficult
to focus attention on them in a climate of denial but difficult to summon
the willingness to repudiate them and then hopefully grow beyond them.

REJECTING NORMALITY AS A STANDARD

OF MENTAL HEALTH
In 1932, Columbia University professor in psychology and philosophy
Walter B. Pitkin, who studied with Edmund Husserl and Georg Simmel
at the University of Berlin and who was influenced by William James,
published a lengthy work with the intentionally ironic title, A Short Intro-
duction to the History of Human Stupidity. In that hefty volume, he wrote:

To select as a standard the present normal member of a social group strikes

me as itself evidence of imbecility. I should incline to reject normality in
the social sense altogether; for the entire social life of our age seems to
me . . . sickening in its innumerable deviations from good sense, the rules of
health, and the broader principles of human happiness. (Pitkin, 1932,
pp. 502–3)

As I’ve noted in the course of this chapter, the psychology of mediocrity

has been almost completely neglected. The same has been true of the study
of the psychology of stupidity, to which Pitkin sought to contribute. And
the same has been true of the study of the psychology of what I have called
“pathologies of normality” that characterize much of typical human behav-
ior. In Bartlett (2005, Chap. 18), an attempt was made for the first time to
identify major factors that combine to form the familiar phenomenon of
The Psychology of Mediocrity 221

human stupidity, one that psychology has failed to study as a disabling con-
dition with its own special traits and a dynamic not captured merely by
labeling it a deficiency of intelligence. In Bartlett (2005, 2006, 2008,
2009), similar attempts were made to fill what I consider to be a major
loophole in clinical psychology, to study characteristic traits of the normal
population that predispose people to engage in destructive thinking, emo-
tion, and behavior. And in this chapter, an equally broad net has been cast
in an effort to focus attention, again, on traits possessed by the majority
of the human population.
In terms of the purpose of this book, these three foci of study that I’ve
mentioned—human stupidity, pathologies of normality, and mediocrity—
are intended to serve a single main purpose, to encourage readers to begin
to doubt whether the largely unquestioned equation of psychological nor-
mality with mental health is desirable; whether this equation, in the light
of what we know about human behavior, is justifiable; and whether there
is not a more theoretically plausible, rationally valid, and empirically con-
vincing alternative model for good mental health.
In the course of his principal book on this subject, Maslow admitted:
“[W]e are confronted with the very saddening realization that so few peo-
ple make it. Only a small proportion of the human population gets to the
point of identity, or of selfhood, full humanness, self-actualization, etc.”
(Maslow, 1971, pp. 25–26). In addition to the most obvious reasons for
this failure, which include poor parental care, impoverished environ-
ments, dietary deficiencies and inadequate medical care, and—the bitter
pill for egalitarian environmentalists to swallow—intrinsic constitutional
limitation, there is another complementary perspective which we can, if
we choose, adopt, and that is heightened awareness of the role of the psy-
chology of mediocrity in holding people back. If readers come away with
anything from having read this chapter, I hope they will recognize some
of the main ways in which the traits of mediocrity serve to restrict the
mind, encouraging imitation, unreflective thought, a narrowed range of
concerns, and deeply vested resistance against novelty, originality, and
the recognition of eminence.
Such a recognition requires, as I’ve tried to underscore, a prior recogni-
tion of “higher standards” and perhaps of “higher orders or levels of real-
ity” (if one acknowledges the legitimacy of these concepts). It has not been
my purpose in this chapter logically to compel readers’ acceptance of such
“higher standards,” since this task isn’t one of logic but rather of sensibil-
ity, whose development cannot be compelled and perhaps not even
encouraged. And so the prior acceptance of “higher standards” has been
something I have no other alternative but to presuppose. Once presup-
posed, logically and empirically this follows: “From the point of view that
222 Normality Does Not Equal Mental Health

Table 8.1
Three varieties of internal human limitation.

Mediocrity—focusing Pathologies of Normality— Stupidity—focusing

attention on: focusing attention on: attention on:

limitative psychologically normal characteristics that involve

characteristics that characteristics that are a wide range of deficits
function as explicitly harmful, therefore and impairments, whether
self-chosen blocks to pathogenic intellectual, emotional,
development moral, or aesthetic

I have outlined, normalcy would be rather the kind of sickness or crippling

or stunting that we share with everybody else and therefore don’t notice”
(Maslow, 1971, p. 26). The mediocre typically share a great deal of
psychological normality among one another, while those who are not
mediocre share much less.
Mediocrity, pathologies associated with psychological normality, and
human stupidity are not coextensive but overlap in various ways, as shown
in the earlier Venn diagram. The following table may make some of their
interrelations clearer.
The distinctions suggested by this table are intended in part to allow us
to change the perspective of analysis, that is, to concentrate attention on
different areas of study and in part to denote specific populations. In this
chapter, I’ve described major traits of mediocrity in some detail; here, a few
words are in order in connection with the other two headings in the above
table. Pathologies of normality include a psychologically rewarding set
of emotional and cognitive gratifications provided by vicarious or direct
participation in aggression and violence, by ideological rigidity and abso-
lutism, obedience to authority, prejudice and persecution, sheer self-
defeating stupidity and low levels of moral development (with obvious
overlaps with mediocrity and stupidity), and their many sequelae in geno-
cides; terrorism; wars; school, domestic, social, and political bullying; pub-
licly approved imprisonment, torture, and executions; an unappeasable
appetite for human reproduction (another evident overlap, and there are
others); the unquestioned placement of human interests above those of all
other life forms on the planet; the enforced subservience of nonhuman life
to human wishes and convenience; and the resulting devastation of global
biodiversity. In addition and central to the subject of pathologies of normal-
ity is human resistance to an awareness of it. “Denial” would be an under-
statement, for the forces that stand in the way of mankind’s reflective
consciousness of the pathogenicity of the species are incredibly strong,
The Psychology of Mediocrity 223

tenacious, and self-preserving. (For a book-length analysis and discussion,

see Bartlett, 2005.)
The third category in the table, human stupidity, can be understood in
terms of the interaction of a group of affective and cognitive functions:

• Forms of behavior and thinking that are frequently known perfectly

well to be harmful and wrong
• Unstable and quickly forgotten knowledge of these forms of behav-
ior and thinking
• Frequently, deliberate evasion of facts

and it commonly involves the following:

• Suggestibility, gullibility, and intellectual laziness, especially in con-

nection with critical, independent appraisal and judgment
• Conformity in thought and feeling (overlapping with mediocrity)
• Disinterest in lessening stupidity itself and unwillingness reflectively
to recognize one’s own stupidity
• Willful opposition to clear thinking and a preference for reality-
denying fantasy
• Disinclination to deal with problems until they have reached crisis
proportions
• Inability to make the future or the past real, and hence a mental
inflexibility in which only what is perceived to be immediate is real
(again, shared with mediocrity)
• Projective thinking (for a more complete discussion see Bartlett,
2005, Chap. 18, especially pp. 286–88)

Understood in this way, human stupidity is both a pathology and a set of

characteristics pervasive among the psychologically normal population,
found to varying degrees in the majority of people.
We should immediately see that stupidity plays an implicit role in path-
ologies of normality, as do some of the traits of mediocrity identified in this
chapter (e.g., ideological myopia, social compliance, and conformity).
Recognizing cross-linkages and overlaps among psychologically limitative
traits is not inherently undesirable when these interrelations are informa-
tive. As I remarked earlier, at this stage of our knowledge of the psychology
of mediocrity it is not useful to become bogged down in sharpening our
pencils to determine the independence and theoretical completeness of
categories of classification. At present, a truly minimal conceptual vocabu-
lary consisting of the smallest number possible of major independent
224 Normality Does Not Equal Mental Health

trait-factors stands more of a chance of handicapping communication rather

than of increasing its effectiveness. But we should be self-consciously
aware that the three categories in the preceding table significantly overlap.

Among the many memorable maxims attributed to Einstein is the remark,

“To keep doing the same things unsuccessfully is insanity.” Using the
vocabulary of this chapter, we might say instead, “To keep doing the same
things unsuccessfully is stupidity; refusing to see this, despite adequate
cognitive ability, is mediocrity; and remaining in this unnecessary and
destructive cycle is most certainly pathology.”

THE TRANSMISSION OF MEDIOCRITY

We have already noted implicitly how the psychology of mediocrity
promotes its own transmission: since the mediocre gravitate to imitation,
they copy traits of mediocrity from others. And since many of these traits
provide emotional gratification, their transmission is virtually assured.
In making these claims, it is not necessary for us to become needlessly
embroiled in the debate whether such traits are biologically based or envi-
ronmentally promoted, in order to reach the assured conclusion that the
spread of mediocrity, once firmly established in a social group, is difficult
to contain. It has been argued that “human beings in our world today have
no more, or little more, than the absolute minimal intellectual endow-
ment necessary for achieving the civilization we know today” (Harlow &
Harlow, 1962, p. 34), and this “minimalist thesis” is probably also true
in the encompassing sense that takes into account not only intellectual
abilities but moral and aesthetic sensibilities that are the foundation of
the meaning of civilization.
Readers are no doubt familiar with the bell curve distribution of intel-
lectual ability, with a high bulge in the middle where most of the popula-
tion is concentrated and tapering to the opposing tails of the curve where
we find, at one end, those who are sorely impaired, and, at the other end,
those who excel. If one were to draw a curve to represent the distribution
of mediocrity, however, it would most plausibly look like only the right
half of a bell curve—as though the curve had been cut vertically down
through its center and the left side thrown away. Only in the progressively
slim right tail of the curve would be found those who are comparatively
free of the traits described in this chapter. (By way of comparison, see
the chart in Appendix III, which depicts the estimated overall distribution
of mental health in the population.)
The Psychology of Mediocrity 225

Biologically focused researchers in the area of cognitive intelligence—

such as Galton (1869/1925), Jensen (1972), Herrnstein & Murray (1994),
Eysenck (1998/1999), and others—have all voiced warnings of the predict-
able dysgenic tendency of any population in which, for whatever reasons,
the population of those with lower-level abilities increases disproportion-
ately in relation to the population of those with high-level abilities. We
are not yet in a position to determine the extent to which the traits of medi-
ocrity are genetically transmitted, and for purposes here we need not be. It
is enough in laying a purely descriptive basis to recognize (1) the very large
distribution and prevalence of mediocrity in human history, and (2) its very
large distribution and prevalence today. Recognizing both of these is enough
to remove any sense of surprise in observing (3) the increase in the incidence
of mediocrity in the past several decades. (These are central terms in the
theory of disease: The distribution of a disease typically relates to the extent
of its geographical diffusion; its prevalence relates to the proportion of
a population that has contracted the disease; and incidence refers to the rate
at which new occurrences of the disease develop during a specified period
of time.)
As readers are sure to be aware, we live at a time when the doubling rate
of the population is becoming shorter and shorter. To whatever extent
mediocrity is heritable or environmentally conditioned, we should expect
its contagious and internally limiting psychological traits to be expressed
in an increasingly prominent way as the human population continues to
double, with resulting crowding and the undermining of many of the envi-
ronmental and intellectual conditions that eminent individuals rely upon
for personal development, to which I will turn in concluding this chapter.
Harry and Margaret Harlow’s hypothesis, that people today have no
more or little more than the absolute minimal endowments needed to
attain our present civilization, becomes an urgent warning when applied
to the future. If my own observations during four decades of research in
this area are right, then we are already bemired in our own kind of Dark
Age—dark because the heavy atmosphere, fixated on “correctness” and
“normality,” resists critical questioning.
This observation isn’t idiosyncratic on my part, though it is not often
made.12 Lee McIntyre, for example, expresses much the same perception
in Dark Ages: The Case for a Science of Human Behavior: “Political ideology
is today doing to social science what religious ideology did to natural
science in the . . . Dark Ages. . . . Afraid of what we might find out about
ourselves, today’s academics have stood in the way of a science of human
behavior in precisely the same way that religious clerics attempted to stunt
the scientific revolution of Copernicus and Galileo” (McIntyre, 2006,
pp. xviii–xix).
226 Normality Does Not Equal Mental Health

Resistance to self-criticism is intellectually regressive and feeds the

internally limiting dynamic of an infectious, invasive, self-perpetuating
psychology of mediocrity that brings about a dark age. When a globally
distributed population doubles increasingly rapidly and is characterized
by a psychologically contagious mindset that limits that population to
one-dimensional concerns and thought, we have the ingredients for a
potentially long-lasting dark age, literally an Age of Mediocrity. The
future shape of such a world’s “half-bell-curve” of mediocrity would show
a swelling in the height of the bell as it comes to incorporate more and
more people, and a diminishingly thin tail to the right, as the comparative
size of the population of those who have been spared, or have freed them-
selves, from mediocrity dwindles.

“A ROOM OF ONE’S OWN”: THE VIEW FROM THE

THIRD FLOOR
I’ve described mediocrity as a pathology that essentially limits the
mediocre person, obstructing the individual from becoming—in impor-
tant, higher, ways—more than he or she is, a pathology that condenses
the person’s experience around narrowed concerns framed within a limited
horizon. It is a pathology that motives the person to associate with others
who are similarly limited, erecting mental and emotional barriers in the
mediocre person to recognizing, accepting, and wishing to affiliate with
others who are superior in any of numerous abilities, and erecting similar
barriers to ideas that conflict with those that are familiar, habitual, and
therefore preferred. My focus here has been on the nature of mediocrity
in limiting self-development, accompanied by observations of the effect
upon society when a majority of its members are mediocre. To conclude
this chapter, I turn to examine the reverse effects of a mediocre society
upon those whose preeminence of ability, moral and aesthetic sensibility,
and breadth of concerns place them outside the category of the mediocre.
In Chapter 3, I quoted briefly from Virginia Woolf’s A Room of One’s
Own. In that passage she commented on the “poison of fear and bitter-
ness” that the external—we would now say “mediocre”—world inflicted
upon her. The mediocrity to which she was exposed and which she could
not avoid felt soul-destroying to her, “like a rust eating away the bloom of
the spring, destroying the tree at its heart” (Woolf, 1929, p. 64). I went on
to discuss similarly severe difficulties set in the way of creative artists by a
society that we are now justified in characterizing as profoundly mediocre.
In Chapter 6, I described a variety of depression experienced by some
university faculty in the liberal arts, the result of their unavoidable contact
with students and university personnel who are afflicted with acedia, an
The Psychology of Mediocrity 227

impairment that is an incapacity for culture, and which we now can recog-
nize as an essentially mediocritizing disability.
In the present chapter, I’ve tried to provide a description of major traits of
mediocrity, and to do this have made use of what might be called a “two
worlds” or “two-storey” classification of human experience. Maslow
devoted much of his professional life to studying “remarkable human
beings,” and he wrote about them, as I’ve quoted earlier: “It was as if they
were not quite people but something more than people” (Maslow, 1971,
p. 42). In a nonfanciful and real sense, such remarkable people can be unlike
mediocre people in considerable and far-reaching ways: from their own
points of view, it can be very much as though they belong to another species.
And so I’ve talked about “higher standards,” “elevated lives,” and multiple
“orders” or “levels” or “dimensions” of experience, in contrast to the one-
dimensional scope of concerns that characterizes mediocre consciousness.
If we are prepared to recognize the existence of “people who are some-
thing more than people” (admittedly a big ‘if’ today), and if we are willing
to recognize the existence of “upper storeys” of human experience and
attainment that some human beings are able to reach (also a sizeable ‘if’),
then perhaps we can see, for such remarkable people whose mental space
includes levels above the mundane, how living among the mediocre can
be oppressive, discouraging, and depressing. This is a phenomenon simi-
lar to the predicaments of the artist and of university faculty in the liberal
arts, but it concerns a greater number of people, even though they still
make up a very small minority in relation to the total population.
The world of the mediocre is increasing, strengthening, and becoming
more dominant before our eyes, and as it does, the freedoms upon which
many of the exceptional have relied are vanishing. Mediocrity overrides
many of these freedoms: the freedom to develop one’s own ideas, princi-
ples, standards, and tastes without the tyranny of the restrictive judgments
of mediocrity; the freedom to coexist with natural beauty, unspoiled by
human crowding and the many forms of human invasiveness; the freedom
to think, work, and live without intrusive noise from increasingly loud and
inconsiderate neighbors and from the society at large (cf. Bartlett, 1987;
Hempton & Grossman, 2009); the liberty to pursue one’s aesthetic, cul-
tural, and intellectual interests in an environment not subject to intellec-
tual suppression, and hence the free ability to give expression to creative
conceptions, views, judgments, and theories, to publish with freedom
from editorial and peer mediocrity, in an intellectual and cultural environ-
ment that is uncrowded by mediocrity that competes with and often
willfully displaces genuinely original and significant work.
When the mediocre deprive these conditions from those who are supe-
rior in ability and sensibility, not only are the latter often blocked in their
228 Normality Does Not Equal Mental Health

development and creative work, the world losing in the process, but they
suffer on a personal level as a result. We find hints of this recognition in
Maslow:

Hospital staffs have learned the unloved babies die early from colds. Do we
need truth in the same way? I find that if I am deprived of truth, I come
down with a peculiar kind of sickness—I become paranoid, mistrusting
everybody and trying to look behind everything, searching for hidden
meanings to every event. This sort of chronic mistrustfulness is certainly a
psychological disease. So I would say that being deprived of truth results in
a pathology—a metapathology. . . .
The deprivation of beauty can cause illness. People who are aesthetically
very sensitive become depressed and uncomfortable in ugly surroundings. . . .
How much the ugliness affects you depends on your sensitivity and the
ease with which you can turn your attention away from the obnoxious
stimuli. To carry the point further, living in an unpleasant environment
with nasty people is a pathological force. If you choose beautiful and decent
people to spend your time with, you will find that you feel better and more
uplifted.
Justice is another [case in point], and history has given us plenty of
examples of what happens to people when they are deprived of it over a
long period of time. (Maslow, 1971, p. 193)

My concern here is with a range of emotion, attitudes, and critical judg-

ments of and by the very small minority of the nonmediocre, whose state of
mind and state of feeling about the rest of humanity is predominantly neg-
ative. Disappointment, discouragement, and depression felt by a small
number of people, because of restrictive and destructive traits of the larger
society in which they find themselves, is not unusual. History is full of
examples of the justifiably discontented. Recently, to mention one profes-
sional group, lawyers have expressed dissatisfaction and estrangement
due to what they perceive as a general decline in their profession. In the
1990s, a RAND study sponsored by the California Commission on the
Future of the Legal Profession and the State Bar showed that a majority
of attorneys despaired of the decline in the sense of integrity and honor of
their profession; half admitted they would not choose to become attorneys
in today’s world (McCarthy, 1994). A study by the Maryland Judicial Task
Force (2003) revealed the same kind of distress among attorneys in that
state, who feel that their profession has degenerated and given way to rude-
ness, impatience, and an atmosphere of verbal abuse. A further sign of the
inroads that mediocrity is making on professional integrity concerns pro-
fessional ethicists, whose testimony as experts is relied upon during judicial
proceedings in such issues as patient rights. Some among this very group of
people who are appointed to be experts in ethical decision-making have
The Psychology of Mediocrity 229

become discouraged over increasing paradoxical breaches of ethical integ-

rity by their ethicist colleagues, as explained by the title of a recent article,
“Moral Expertise: A Problem in the Professional Ethics of Professional
Ethicists” (Crosthwaite, 1995).
These are, however, only faint signs of the seriousness and magnitude of
the spread of mediocrity and of the powerful effect this has on the needless
struggle of the eminent, who cannot avoid contact with the mediocre
population that willfully, steadfastly, and with great stamina and commit-
ment will block their way. As Eysenck remarked:

Faced with such truculent opposition, unreasoning at best, vehement at

worst, creative people need personality traits that help them to cope with
such opposition. Such traits are not always approved of by the majority.
Persistence, bloody-mindedness, nonconformist behaviour, even asocial
and antisocial behaviour—these are some of the protective devices needed
by the creative person to cope with the obstacles society, and specifically
the society of his peers, throws in his way. If you want to be creative, you
might be prepared to fight; if you are a genius, the fight may be even more
deadly. Sometimes genius shuns the fight. Copernicus did not publish his
heliocentric theory till he was dying. Gauss did not publish his work on
n-dimensional geometry; he knew how it would be received. (Lobachevsky,
who was the first to actually publish his results in this field, was considered
insane, and banished to remote parts of Russia!) (Eysenck, 1998/1999,
p. 185)

To say of such remarkable people merely that “they suffer” as a result

of mediocrity would be an irresponsible understatement, for their work,
their lives, and that of their families are often painfully torn apart by the
self-assured and self-chosen limiting nature of mediocrity. In this light,
we should be able to appreciate and respect the superior person’s frus-
tration and anger over the prevalence of mediocrity—because it suffocates
him, with a capacity to prevent him from doing what he is convinced he
is here for. The mediocre person, in contrast, acquiesces in his acceptance
that large portions of his life must be spent in petty matters of daily exis-
tence, in competition and struggle with others, in time spent to defend
the narrowly perceived beliefs and interests of his group against others
who are equally small-minded, in laboring to rectify the stupidities and
incompetence of others, and so on. The mediocre person accepts such real-
ities of everyday living, and is not thrown off course and out of balance
because he has nothing higher that can be brought lower by them. But
the same mediocritizing life makes a world of difference to the superior
person. The anger and frustration he feels because of the intrusion of the
mediocre in his life are clearly defensive. They express the superior
230 Normality Does Not Equal Mental Health

person’s awareness that mediocrity is a threat to his life purpose, and that
he is forced to waste much of his life in dealing with, coping with, and
combating the persistent invasion of mediocrity in his experience.
Above the ground floor of the common, the everyday, and the mun-
dane, on which the mediocre live, think, and feel, there is a second floor
or order of reality on which the remarkable, the eminent, the creative set
their sights and establish what concerns them most. From a temporarily
rented room on the floor above that second storey, from which we may
have a view of the two floors below, we should be able to develop a more
sympathetic and supportive understanding of the great effort that out-
standing people must often summon—unnecessarily—not to develop
their abilities or to advance their work, but simply to survive successfully
amid mediocre people. The degree to which the mediocre stifle, obstruct,
and oppress, and of course fail utterly to support and encourage individ-
uals with unusual and invaluable capacity, talent, ability, and sensibility
is seldom recognized, less often appreciated, and virtually never explicitly
opposed, as one chooses to do once we realize that a condition constitutes
a widespread and handicapping pathology.

NOTES
1. The most thorough and clear discussion of the internal limitations of math-
ematics is still Jean Ladrière’s (1957) Les Limitations internes des formalismes,
a major 700-page work still unfortunately untranslated into English despite my
offer to do this in 1971. It was M. Ladrière’s belief that Anglo-American publica-
tions relating to the foundations of mathematics and the theory of formal systems
were considerably ahead of publications in Latin languages, and he therefore pre-
ferred to make the book available in French and in Spanish translation only.
2. My discussion of the history of use of these words relies in part on the
resources of the OED’s recently instituted detailed online search service.
3. Related to the appearance of this genre of reading is another recent telling
title, Idiot America: How Stupidity Became a Virtue in the Land of the Free, which
relates to the topic of the psychology of stupidity, discussed later in this chapter.
4. On the difference between lexical and real definition, see Chapter 2.
5. One of the most exaggerated examples of this kind of professional and pub-
lic protest took place in reaction to Arthur Jensen’s genetically focused research
on intelligence (Jensen, 1972); much the same thing occurred years later in con-
nection with similar research by Herrnstein & Murray (1994). There are,
unfortunately, many other examples.
6. Another way of expressing this is to see that while a purely theoretical ori-
entation can profitably emphasize minimal conceptual simplicity, a practical ori-
entation will often benefit from a useful, maximally rich vocabulary. Burt
recognized this when he wrote: “[T]he attitude of the practical psychologist
shows a curious contrast to that of the theoretical investigator. The theoretical
The Psychology of Mediocrity 231

investigator wants to describe a maximum number of tests in terms of a minimum

number of factors. The practical psychologist would rather aim at deducing a
maximum number of factors from a minimum number of tests” (Burt, 1940, p. 76,
his emphasis).
We gain still another reinforcement for this view by realizing that the fewer
the number of factors used to describe an individual, the greater the variability
that each factor must account for, and hence the less that we will actually know
about the individual. If understanding the individual is the therapist’s primary
goal, then limiting his or her therapeutic evaluation of the client to a minimal
number of descriptive traits will provide minimal information specifically about
the individual.
7. An adequate response requires a refutation of relativism, for which see Bartlett
(2005, Chap. 20).
8. Again, it is essential to underscore that the traits I have described charac-
terize people to varying degrees: few people possess all of the traits of mediocrity
to a maximal extent; most people possess a fair number of them; and very few
people have none at all. We saw how Confucius perceived “a radical difference
between the two different universes” inhabited by those who are awake to beauty
and those who are not. One of the disadvantages of a descriptive psychology of
traits is that it is easy to form the incorrect impression that possession of a cer-
tain set of traits by any given individual is an either-or proposition—in this
example, that the “two different universes” can be readily distinguished with
respect to any given person. But this is not always the case, for people possess
the traits we’ve distinguished to varying degrees, on a continuum. However, the
situation changes when we have entire classes of people in view. Then it makes
sense to distinguish between the large class of the mediocre and the small class
of the distinguished, cultivated, or eminent, and then it makes good sense to
speak of the “two different universes” that these people experience. It is impor-
tant, then, to be aware, on the one hand, of the continuity of degrees to which
individuals may possess traits of mediocrity, and, on the other, of the disjunct
nature of distinct populations. And so when I refer to “the population of the
mediocre” we should have in mind individuals who express traits of mediocrity
to a pronounced, typifying, degree.
9. We need to bear in mind that in expressing observations of this kind we’re
not deficient in compassion toward those of lesser ability or sensibility; but the
focus of our interest here is purely descriptive, to recognize psychological limita-
tions of which we are little aware.
10. This seldom-encountered word is sometimes used to refer to a condition
that only “resembles” or “simulates” a diseased condition, as in Henderson
(1960/1963, p. 43) and Knight (1948, p. 12). Here, I use it without this qualifica-
tion.
11. Maslow’s estimate of the rarity of such remarkable individuals has a proper
place within the panoramic perspective offered by Charles Murray’s systematic,
comprehensive study of human achievement. There, Murray studied the inci-
dence of genuine human eminence, which is truly rare. In his words: “When we
assemble the human résumé, only a few thousand people stand apart form the
rest. Among them, the people who are indispensable to the story of human
232 Normality Does Not Equal Mental Health

accomplishment number in the hundreds. Among those hundreds, a handful

stand conspicuously above everyone else” (Murray, 2003, p. 87).
12. A decline of civilization has been recognized from a variety of perspectives,
from Arthur de Gobineau’s Essai sur l’inégalité des races humaines (1853–1855), to
Nietzsche, Burckhardt, Spengler, Sorokin, and Toynbee, and pointed to most
recently by Charles Murray, who observed: “If the question is how much art and
science has been produced relative to the people who had a chance to produce
it, the West has been on a downhill slide since the end of the Renaissance” (Mur-
ray, 2003, p. 434). For studies of the decline of civilization, see also Brander
(1998) and Herman (1997).
 9

Normality, Pathology, and Mental Health

If the status quo is presented as natural and normal, then deviation or

criticism is by definition unnatural and abnormal. The definition of
abnormality thus depends on one of normality which is never itself ques-
tioned or justified.
—Cannan (1972, p. 253)

In the first chapter of this book, I quoted a few passages from psychiatrist
Louis E. Bisch, who, readers with good memories will recall, thought that
the psychologically average make a dismal model of psychological health.
He defended the important place in the world of nonnormal people “who
have the courage to stress their individuality and sensitiveness and make it
outstanding and telling” (Bisch, 1936, p. 28). He did not believe that the
world needs more “normals”; it rather needs more exceptional people,
remarkable people, people who are not, as we’ve seen in earlier chapters,
afflicted with acedia or are mediocre, barbarous, or stupid.
There are two ways we can take the similar recommendations of Bisch,
Fromm, Rogers, and Maslow. Either they are pointing toward unrealizable
ideal fictions or there is a need to reassess what we mean both by psycho-
logical health and mental disorder. To do this, there is no getting around
the need to remove the primary obstacle that has, with obdurate stubborn-
ness, blocked the way toward a more enlightened and realistic psychology
and psychiatry. The obstacle that I refer to is of course the equation of
psychological normality with mental health.
It is important to remind readers what I mean by ‘psychological nor-
mality’. Toward the beginning of this book, I affirmed an open and
accommodating understanding of the meaning of ‘psychological normal-
ity’, using this phrase to refer to “the set of typical and socially approved
characteristics of affective, cognitive, and behavioral functioning, a set of
characteristics derived from the reference group consisting of the majority
234 Normality Does Not Equal Mental Health

in a society’s population, and relative to which clinicians understand ‘devi-

ations from normality’ and hence ‘mental disorder’. I use the term ‘nor-
mality’ in its commonly accepted meaning of ‘customary’ and ‘typical’,
and ‘norm’ in its ordinary meaning of ‘an authoritative standard’.” In this
chapter, I continue to understand psychological normality in this sense.

THE ROMANES PRINCIPLE

In Chapter 3, I referred to psychologist George Romanes, who in his
own informal way defended the thesis that there are meaningful, factual
truths about the world that do not stand in need of experimental confirma-
tion by empirical science (Romanes, 1883, 1888, 1895). For convenience
let us call this “the Romanes Principle.” It expresses a point of view that
today borders on the heretical, given that we’ve become adamant in dis-
trusting virtually any claim, however obvious and factually based, unless it
has been subjected to double-blind, statistically sound, and replicated
studies. There is surely a place in science for caution, but not for thick-
headedness. Human history is already a readily available laboratory that is
able, in keeping with the Romanes Principle, to provide us with reliable
information about how human beings feel, think, and behave, and are likely
to continue in the same old patterns.
Here are some of the historically established facts that we should have
at our fingertips and at the forefront of our consciousness when we equate
psychological normality with mental health:

• Human history, as any schoolchild knows, has been dominated by

wars, revolutions, genocides, persecutions, and the varied brutalities
of martyrdoms, judicial executions, political assassinations and mur-
ders, imprisonments, torture, and the many other signs of human
aggression and self-destructiveness in which psychologically normal
people routinely have been and continue to be involved. In wars,
they play the role of active participants, nearly always uncritically
willing, indeed enthusiastic, to do the bidding of their leaders. The
ranks of the psychologically normal are never in short supply,
whether to serve as members of a country’s armed forces, to serve as
jurors whose decisions send others to imprisonment or a sentence
of death, to serve as public prosecutors, judges, wardens, jailors,
and public executioners, or in any other capacity to serve in the
defense of the ideology of their group. The willingness of the
psychologically normal to “serve” obediently in all of these ways
does not stand in need of further confirmation from empirical sci-
ence; history is more than enough. 1 (For those who would like a
Normality, Pathology, and Mental Health 235

detailed discussion and justification of all of these claims, a separate

book is required: see Bartlett, 2005.)
• The psychologically normal make up the great mass of the mediocre,
as the previous chapter made evident. The internal psychological
limitations to which this greater part of humanity is subject are
powerful and increasingly dominate and check the development of
the human population. We see this in the history of higher educa-
tion, the history of the liberal arts, and in evident changes in the pub-
lic’s level of consciousness of culture, literacy, aesthetic sensibility,
language competence, manners, and other expressions of taste.
• The closely related traits of acedia, barbarity, mediocrity, and
human stupidity taken conjointly, that is, adding the respective
groups together, designate the greatest portion of the human popu-
lation. At the same time, the dominant portion of this population is,
by virtue of the customary definition we are applying, characterized
by psychological normality. The total size of the population of indi-
viduals who fail to be psychologically normal and yet who exhibit the
characteristics of acedia, barbarity, mediocrity, or stupidity is, in
comparison, extremely small (the size of the set of the psychologi-
cally nonnormal is itself small).2
• In their thinking, beliefs, and attitudes, the psychologically normal
make use of a vocabulary of ideas and cognitive patterns that are per-
meated by forms of projective thinking that are self-destructive. It
does not take a sophisticated level of conceptual analysis to show
any historian or ethologist precisely this conclusion from the avail-
able record of human prejudice, ideological commitment, pseudo-
speciation (the willful propensity of human groups to identify, or
manufacture, group distinctions that give them a basis to differenti-
ate and distance themselves from other groups), and ethnocentrism
(a group’s insistence that it is special and uniquely good). (Again,
for a detailed discussion of these observations, see Bartlett, 2005.)

As human history has abundantly shown, the above are some of the typical
and socially endorsed ways in which typical, normal people think, feel, and
behave. And yet, despite these overwhelmingly indicting expressions of
psychological normality, psychiatry and much psychology persist in equat-
ing psychological normality with mental health! To do this is similar to a
pulmonary specialist who uses tubercular lungs as a model for pulmonary
health, or an oncologist who uses samples of cancerous tissue as a standard
of healthy tissue, or a cognitive scientist who finds in imbecility or demen-
tia a standard of fully functioning intelligence. And yet we do not and will
not see this. Using psychological normality as a measure of psychological
236 Normality Does Not Equal Mental Health

health is to use a defective measuring stick. Bisch tried humor to correct

this deeply rooted mistake, but his small readership probably only laughed,
and the point he sought to make has yet to be made.
It should go without saying that psychological normality is functional
in many ways, as we saw in connection with mediocrity, which also serves
its functions, many of them useful. But the pathology of normality has
almost always been neglected, evaded, or denied. 3 It is true that the
tubercular lungs of the still-living patient continue to perform a function,
as may cancerous tissue, or the imbecilic individual. But the functional
deficits that are involved far outweigh the functional advantages and make
evident to us that pathology is present and treatment needed.
It is difficult to learn from history: Each new generation has no memory
and so must depend upon education to transmit what can be learned from
the past. When education fails adequately to do this, and the psychological
constitution of people from generation to generation does not itself
undergo fundamental change, people can be expected to continue to
exhibit the same patterns. When it comes to the pathogenic traits of nor-
mality, psychology and psychiatry have not learned from human history.
As disciplines, they are not alone in their failure to pay sufficient attention
to evidence drawn from the past; however, they are unique in establishing
a standard of mental health that fully ignores that past.
Clinical psychology and psychiatry that are historically well-informed
would need to recognize that there is no brake or restraint in the psycho-
logically normal person to prevent him or her from engaging in behavior,
thought, and affect that are so typically normal as found in the above bul-
leted list. In looking as far back as we can see in the human historical
record, we see behavior, thought, and affect that are mediocre, stupid,
afflicted by acedia, barbarous, and self-destructively projective—exempli-
fying precisely such things as we find in the above list. These patterns con-
stitutive of the greater part of human history have become so familiar that
they are not only accepted and tolerated but have come to be ignored,
while at the same time psychological normality has been raised on a dais
of its own and then used to define and act as a standard of good mental
health. This is Kafkaesque absurdity; it is to turn reality on its head and
to mistake the typical but regrettable for the good and desirable.
Acedia, barbarity, mediocrity, stupidity, and projective thinking that is
self-destructive—all of these are ingredients of the normal psychological
constitution. It can only reflect shortsightedness and an unwillingness
to face the paradox at the core of the mental health disciplines for us to
continue to dig ever deeper the ruts in which we’re entrenched in our stub-
bornly persistent equation of psychological normality with psychological
health.
Normality, Pathology, and Mental Health 237

TWO PROMISING DIRECTIONS AND TWO KINDS

OF PATHOLOGY
As I see the situation we face, there are two main directions in which
mental health theory can constructively develop; they were introduced to
readers in the first chapter of this book. There are good grounds for us
to recognize that both are therapeutically promising. Both avoid the
misplaced emphasis traditionally invested in psychological normality as a
standard of mental health, and both are more realistic, more accurate, and
more insightful in their understanding of human psychological problems.
The first seeks to understand mental health in terms of special, smaller
populations that exhibit signs of healthy, benign—nonpathogenic—
mental functioning. Such special populations show identifiable marks of
good mental health that can be distinguished and pried freed from the con-
text of pressure to conform to the majoritarian larger population. Abraham
Maslow offers one of the best examples of this approach through the
detailed descriptions he has given of characteristics possessed by excep-
tional people, people who, as he put it, are “meta-motivated,” or who, as
I’ve expressed this, succeed in living a life above the mundane, an elevated
life, individuals whose awareness exceeds the boundaries of the common
limited horizon, who are morally intelligent, capable of independent critical
thought, culturally enlightened, aesthetically sensitive—who, in a word, are
truly “civilized.”
A second approach, which can easily be employed in conjunction with
the first, involves a return to an individualized, human-centered, nonregi-
mented, nontaxonomic understanding of psychological problems—
dispensing with technically structured, algorithmic catalogs of constructed
diagnostic codes and avoiding the theoretically ungrounded notion of
“mental disorders.” As noted earlier in this book, such an approach was
proposed by psychiatrist J. H. van den Berg; he called it phenomenological
psychiatry (van den Berg, 1955, 1972, 1980; de Konig, 1982). It opposes
standard psychiatric classification and diagnostic pigeonholing and instead
seeks to help individuals through nonjudgmental support of the client by
the therapist, support that is situated from an empathetic standpoint
that recognizes the reality and legitimacy of the person’s own experience.
Rogers expressed this well:

It is the counselor’s function to assume, in so far as he is able, the internal

frame of reference of the client, to perceive the world as the client sees it, to
perceive the client himself as he is seen by himself, to lay aside all
perceptions from the external frame of reference while doing so, and to
communicate something of this empathic understanding to the client.
(Rogers, 1965, p. 24)
238 Normality Does Not Equal Mental Health

Therapy offered from such a point of view consists in helping the individual
to deal more effectively with his or her own individualized situation in terms
that involve the person’s values, goals, competences, abilities, sensitivities,
and temperament. Successful living through self-adaptation becomes the
focus, rather than adaptation to the normal and normalized world.

In this way we could, if we chose, change the reference group in relation

to which we understand mentally healthy functioning from the population
of the psychologically typical and average to special, smaller populations
that demonstrate traits of psychological health. Alternatively, we can
choose to understand psychologically healthy functioning in highly indi-
vidualized terms. Both of the resulting conceptions of good psychological
health suggest corresponding and mutually compatible approaches to
psychological therapy, the first by enabling us to establish a set of ideal
standards of mental health and the second by recognizing that the psycho-
logical problems experienced by individual people are best understood
and helped on a situationally relative and individualized basis.
Were we to make either choice, or both, how should we then under-
stand pathology in the context of mental health?
There are, as I see this, two distinct psychological senses in which it is
meaningful and justifiable to call a condition a variety of pathology. In
Chapter 2, I made the case to restrict the meaning of psychiatric pathol-
ogy to confirmable organic disorder; this meaning of ‘pathology’, in itself
and as far as it goes, tends to be unobjectionable to both the medical-
psychiatric and the clinical-psychological communities (both of course
are not content with this but want to include varieties of pathology
beyond the organic). As readers will recall, I oppose the reification of
symptoms and syndromes into distinct “disease entities” that simply
reflect our predisposition to engage in projective thinking.
There is a second legitimate meaning of the term ‘pathology’ that I’d
like to introduce at this point, and will give only a brief sketch here of this
concept (for a detailed discussion, see Bartlett, 2005). Suppose that we’re
especially interested in cognitive intelligence as measured by IQ. If a per-
son’s IQ can be shown to be very considerably lowered, for instance by
dietary deficiency or an abusive home environment while he or she is a
child, it makes good sense to characterize this destructive lowering of IQ
as a consequence of pathology. There may or may not be evidence of
organic damage, of any physical “lesion,” but still it conveys useful infor-
mation to speak of pathology in this context. Our justification for using
this language is that we share an objective means for measuring IQ, and
Normality, Pathology, and Mental Health 239

more importantly, we base our judgment of pathology of the observed

desirability and preference to be given to a state of higher IQ. To attribute
individual pathology in the context of IQ, we need to be able to measure
or estimate a given individual’s IQ; to do this in an objective manner, we
must share the use of a common IQ standard and scale; and we need to
be convinced that an individual’s level of desired cognitive functioning
has been harmed.
In more general terms, the judgment that pathology is present in a
given individual is relative then to (1) an expert group whose members
share an agreed-upon standard and scale of value; (2) one or more ways
of establishing by formal measurement or informal appraisal, where on
such a scale, applying the given standard, an evaluative measurement is
to be located; and (3) an evaluative judgment, giving greatest weight to
the individual’s own judgment, that his or her level of desired functioning
has been harmed. When these conditions are met, we have established a
reference frame in terms of which we can meaningfully speak of “pathol-
ogy.” And, in this, we note that we do not projectively reify “disease enti-
ties” or go beyond empirical evidence.
To give another illustration, in my book The Pathology of Man (Bartlett,
2005), I examined a wide variety of human pathologies, including mental,
social, and conceptual, none of which are, at least at present, known to be
linked to verifiable organic dysfunctions. Such pathologies include
psychological gratifications obtained from hating, injuring, and killing
others; aggression against others for the sole reason that they are per-
ceived to be different; persecution of those whose beliefs differ from our
own; and so on. All of these can appropriately be called pathologies
because there is an informed, perhaps I should say “enlightened,” group
of people who agree that such acts are undesirable, and there are standards
of harm which they can apply to identify and rank the kind and degree of
pathology involved.4 Here again we note that calling such psychological
predispositions “pathological” does not entail any sort of projective reifi-
cation of disease.
In the present book, I’ve used the language of pathology to describe
varieties of harm that we can recognize as undesirable thanks to our pos-
session of the relevant standards, but the use of such language does not
imply that (1) we are referring to disease entities inferred or assumed to
lie behind complexes of symptoms, or (2) equate such pathology with
deviations from normality (see Chapters 2 and 3).
As far as I can see, the two concepts of pathology that I’ve outlined
above are the only two fundamentally distinct ways in which judgments
claiming that pathology is real (and not merely stipulated by definition)
can be solidly defended by psychiatry and clinical psychology. Earlier in
240 Normality Does Not Equal Mental Health

this book (Chapter 2), I described one of these ways through an analysis of
the traditional psychiatric concept of mental disorder; the result of that
discussion was to recognize that it is crucial for legitimate psychiatric
pathology to be correlated with a detectable organic basis.
The second variety of nonarbitrary pathology is the subject matter of
Bartlett (2005). There, diagnostic judgment rests on the solid basis offered
by the shared values of a specific reference group chosen because its mem-
bers possess traits of exceptional psychological health. As we have seen, our
recognition of pathology is essentially a matter of evaluative judgment and
hence is a matter of values. Our ability to recognize pathology, in the spe-
cific sense intended here, involves the “morality of medicine” or the
“morality of psychology.” I referred to the morality of medicine in the pre-
ceding chapter to emphasize that, in recognizing pathology, we intend “to
point to the explicit values of combating disease and disability, of seeking
to avoid and alleviate suffering, of using the knowledge and means that
medical science offers to make human life better.” With the meaning of this
kind of “morality” in mind, it will make good sense to some readers that the
reference group whose evaluative judgment is presupposed when the
“morality of psychology” is at issue consists of people who have what else-
where I’ve referred to as a high level of moral intelligence (see Chapter 1 of
this book, and in more detail Bartlett, 2005, Chap. 18). They are “extra-
ordinary” people; “remarkable” in Maslow’s sense; “egregious” in the root
meaning of that word: they stand apart from the crowd.

CREATING MENTAL DISORDERS BY BALLOT

The counsel men agree with is vain: it is only the echo of their own voices.
—George Bernard Shaw (1934, p. 184)

In contrast to the two concepts of pathology that I’ve just described, con-
temporary psychiatry (and clinical psychology to the extent that it has sur-
rendered to DSM-defined practice) has set down classificatory criteria
that define “mental disorders” through a complex, committee-driven pro-
cess that votes into existence those symptom clusters that are judged by
appointed committee members, now numbering more than a thousand,
to be undesirable, harmful, disabling, and then further judged to entail
psychological dysfunctions that express underlying “mental disorders.”
(Note that it has never taken a thousand physicians voting together to
decide that tuberculosis is a bona fide disease!) We need to dwell for a
moment on the inescapable psychological implication of this process:
Since large numbers of appointed mental health practitioners are
involved, it will follow, as a consequence of the law of large numbers, that
Normality, Pathology, and Mental Health 241

their preferences and the judgments to which they arrive will reflect the
statistical average as communicated by the vote of the majority.
“Ontology by plebiscite” is the result: psychiatry brings mental disor-
ders into existence through the casting of votes by increasing large com-
mittee groups. The result of this process is the creation ex nihilo of
“mental disorders” that seldom, as we have seen, have any known underly-
ing organic basis. At the core of this process is the unquestioned accep-
tance that psychological normality is equivalent to mental health. We
need to see that this core commitment is the automatic reflexive effect—
whether intended or not—of any plebiscite whose voting members sub-
scribe to the legitimacy of a process that stipulatively defines “mental dis-
orders” by the majoritarian preference of an exceedingly large group.
Here is the essential point: The uncritical acceptance of the standard
provided by psychological normality is not merely an unexamined
assumption of the dominant psychiatric nosology, it is a symptom of the
very process used by diagnosis-oriented psychiatry. The consequence of
seeing this is to realize that it is not enough for us to discard an unwar-
ranted and indeed historically absurd assumption that places normality
in the role of a standardized norm, but we must bring a halt to our toler-
ation of a professionally endorsed process that votes disorders into exis-
tence. As long as the majority vote of very large groups is the basis for
identifying pathology, the plebiscite’s choices will express their own aver-
age, and psychological normality will remain at the unquestioned center.

PSYCHOLOGICAL RESISTANCE TO THE

ABANDONMENT OF PSYCHOLOGICAL
NORMALITY AS MENTAL HEALTH
What I have proposed, argued, and defended in this book is undeniably a
hard pill to swallow, and it would be surprising indeed if there were not
very considerable and even unbudging resistance at the very thought of
swallowing it: “Psychological normality! —Why it is the expressed aim of
parenting, the implied goal of socialization, of public and private educa-
tion! It is thought to distinguish the innocent man or woman in the street
from the sadistic criminal, good citizens from evil perpetrators of atrocities.
It is always conveniently on hand to encourage socially approved behavior,
and to bring back into line anyone who strays from acceptability, with the
exclamation, ‘Why that’s just not normal!’ And psychological normality is
a defense when your reaction to events is questioned, for then you can
claim, ‘Why it’s what any normal person would think/feel/do!’ ”
And then there is the pride of the average person, who is proud of his or
her “ability” to “fit in”; to be “adaptable”; to hold a job, support a family,
242 Normality Does Not Equal Mental Health

and come to the defense of country in the name of patriotism; to serve

obediently when called upon to serve; to obey, conform, comply, and imi-
tate the models urged upon him or her by family, church, ethnic group,
school, professional association, and nation. It is a pride that is continuous
with the pride of the mediocre, which, as we saw in the last chapter, caught
the attention of Nietzsche, Jung, and Sartre. The pride in being psycho-
logically normal is an even more expansive pride: it expresses the narcissis-
tic self-importance in being typically human—a mere short step away from
species pride, a preemptive degree of narcissistic arrogance that is immune
to challenge and places the human species in a supervening take-whatever-
you-want role in relation to other species (Bartlett, 2002, 2007).
But psychological normality has come to mean much more than this
since it has been turned into a calcified, skeletal framework upon which
psychiatry, much clinical psychology and social work, and the supporting
mental health industry hang a rapidly growing collection of artificially con-
structed diagnostic labels that justify the business of providing mental health
services. The equation of psychological normality with good mental health
is implicit here, explicit there; it surfaces, and it goes below the surface; it is
sometimes visible, at other times not; but it is never seriously questioned.
To question it seriously is, first of all, counterintuitive. To think this
way runs against what we’ve been instructed to take for granted and hence
believe. It therefore feels absurd even to countenance the possibility that
mental health is not captured by the way everyday, average, and simply
normal people think, feel, and behave.
But to question the established standard of mental health isn’t just
counterintuitive; we don’t want to think this way! It would be psychologi-
cally unsettling; it would stand prevailing theory and practice on their
heads; we wouldn’t know which way is up! “Not only does this way of
thinking run counter to obvious vested interests,” the protestor com-
plains, “it is downright offensive to suggest that psychological normality
is fundamentally flawed, and flawed to such a degree that it involves real,
nonmetaphorical pathology. This is beyond audacious, it is outlandish,
and it probably bespeaks no more than a not very well camouflaged misan-
thropy on Bartlett’s part!”
But “misanthropy” plays no part in the medical science of pathology.5
When we see a condition that causes harm, suffering, and disability, not
merely to one person but to countless people, decade after decade, cen-
tury after century, there is no alternative but to recognize pathology.
And yet there will be many who will object to such recognition.
What we see in their protests and complaints is resistance, and it is
deeply seated, unyielding, obdurate, and resolute. I began this chapter
by listing numerous ways in which human psychology is subject to
Normality, Pathology, and Mental Health 243

internal limitation. Such internal psychological limitation is essentially

characterized by resistance to change: people who are psychologically
constrained in the ways I have described will predictably oppose and
defy any attempts to get them to develop beyond those constraints. So
much is this the case when we make the attempt to question the standard
of psychological normality that it is not clear that there exists a common
mental space in which a dialogue might occur. It is, I hazard to think, very
much like the conflict between the lover of classical music, on the one
hand, and the tone-deaf, primal-rhythm lover of rap and street dance, on
the other. To claim, as I have, that different levels of sensibility are
involved is already to presuppose what is at issue, but at least this sensibil-
ity thesis is honest, and the buck stops there. It is an honest thesis which,
I trust Romanes would see immediately, is true and in need of no further
evidential support, unless we wish to trace sensibility to another level—
perhaps, as is popular now, to the neurological.
I refer to “sensibility” once again because this is where intellectual hon-
esty realizes the matter must rest. Some of us recognize that our grim
human history has gone on long enough to warrant strong impatience
and frustration, so much so that we’re confident in claiming that the
psychological average is a sad and sorry thing, which we need, in the inter-
ests of humanity and of other species, to outgrow as soon as possible.
Others of us, and certainly the great majority of us, do not feel this way at
all, but on the contrary see a “nobility” in the struggles of Everyman, and
“true tragedy” in what we judge to be humanity’s entrapment in a vicious
but inescapable cycle of repetition of wars, genocides, persecutions, and
the rest. Those of the majority do not perceive the irony, and indeed, in
the current sense of this word, the “egregious” nature, of equating psycho-
logical normality with mental health. To see that irony requires that we
step back from the herd—“egregious” in the old, original sense of the word.
To perceive this fundamental irony is a matter of sensibility, taken in its
broad meaning that includes a degree of enlightenment and moral intelli-
gence that is uncommon.
But this claim, however candid it may be, is immediately subject to
politically correct ridicule, an expression of the deeply rooted resistance
I’m referring to. It takes this form: “To propose a standard of mental
health that has its basis in a rare capacity to comprehend human psychol-
ogy—a basis in an uncommon variety of intelligence and sensibility not
possessed by, and perhaps not even accessible to, the common man—
why that is elitism personified! It cannot be tolerated!”
This reaction is understandable. It bears out what this book has been
about. It is to be expected. But it is an unfortunate and indeed crippling
reaction.
244 Normality Does Not Equal Mental Health

If we are to be realistic, psychological normality is likely to remain

pretty much where it is: a presupposed standard by means of which the
larger society and its authorized mental health theorists and practitioners
will persist in judging that many aberrations from that baseline involve
“mental disorders.” They will make such judgments in a psychologically
normal, often intellectually mediocre, way, sometimes with stubbornly
stupid insistence, sometimes with signs of professional meanness that is a
sign of barbarity, and often resorting to distorted, projective thinking.
Normality will continue to live on in the whispered toasts whenever the
cocktail glasses of psychiatrists and insurers clink, for resistance to its
open-minded systematic criticism, to its empirically based questioning,
is simply too strong.
The predictable psychological obstacles that a paradigm change will
encounter has never been a deterrent to the hardy perseverance of anti-
establishment thinkers. In writing this book, “tilting at windmills” is a
phrase that has sometimes come to mind. I have felt that perhaps the most
that can be hoped for such a book is to knock, or at the very least to nudge,
the profession of psychiatry out of its DSM self-induced complacency.
This is what Kant also wanted to accomplish, but in connection with
“the dogmatic slumber” of philosophy. It is intellectually healthy to
engage in some knocking and nudging of this kind. Antipsychiatrists like
Szasz, Laing, and Scheff have protested that mental disorders are artifi-
cially created constructs that merely serve socially approved purposes.
But none of the antipsychiatrists has yet pointed to the fact that the standard
of mental health assumed and applied by psychiatry is inherently defective. Psy-
chiatry’s reliance upon psychological normality involves recourse to men-
tal health norms that have been derived from a population characterized
by pervasive, harmful, and disabling traits. Although in obvious ways the
average, majoritarian population is able to function, it is, for all that,
severely dysfunctional in psychologically critical ways. It is in our own
best interest to recognize this and to make whatever changes in our theory
and practice are required by that recognition.

PSYCHOLOGICAL PRIMITIVENESS
People who share traits of internal psychological limitation—charac-
teristics such as acedia, mediocrity, stupidity, barbarity, and projective
cognitive distortion—are, as a result of these internal limitations, comfort-
ably walled in. Their mental space or horizon is occupied by views that are
solidly shallow; their beliefs tend to be held with incredible hardihood
even in the face of contrary evidence. They are, furthermore, proud of
the tenacity with which they hold to their views and beliefs, and at times
Normality, Pathology, and Mental Health 245

most especially proud when they keep faith in their beliefs even when face
to face with the fact that they have no empirical evidence for them. Com-
fortably walled in, they therefore do not willingly reflect on their concerns
within a more inclusive frame of reference spanning eons—for example,
the reference frame of evolutionary history, or even the much narrower
frame of reference of the history of human civilization. But it is healthy
to do this, as we shall try briefly to do here.
We’ve seen in several chapters of this book how levels of human ability,
competencies, sensitivities, and sensibilities can be ranked or graded on
scales that discriminate “better” or “more advanced” from those that are
“inferior” and “less developed.” In Chapter 1, I referred to psychologists
and psychiatrists who have studied “highly developed people,” people
who exemplify excellence in their psychological health. We remember
that Maslow, for example, focused his research on the “more highly
evolved person” (Maslow, 1971, p. 96). Researchers who have focused
attention on such extraordinary people have often made use of concepts
relating to degree of development or evolution.
Little attention, however, has been directed in the opposite direction,
to describe the nature of the psychologically primitive. In many obvious
ways, the internal psychological limitations that I’ve described in this
book reflect psychological primitiveness. Acedia, an incapacity for higher
culture; mediocrity, defined by a varied set of rigidly constraining traits;
human stupidity, whose self-imprisoning dynamic dulls awareness and
blocks growth; barbarity, which opposes cultivation; and projective think-
ing, an apparent vestige of animism—all can appropriately be grouped
under the general heading of psychological primitiveness.
To classify an individual or group as “primitive” is to call attention to
his, her, or its little-evolved qualities that are signs of an early stage of
development. We have such concepts as “elementary,” “rudimentary,”
and “immature” to express this. But the notion of “primitive” includes
more than this: It is informative by telling us that the level of development
in view is still rough; it is unshaped and therefore coarse and crude, not yet
refined or polished. To be primitive is to be close to one’s animal origins,
to be “brutish” or “bestial.” Beyond this, primitiveness implies, on a level
of taste, manners, and sensibility, the presence of crudeness, incivility,
rudeness, and discourtesy (once civilization came to involve royal courts,
then it was called “uncourtliness”). Further, in terms of level of cultural
development, to be primitive is to be uncultivated, uncultured. And, on a
moral level, primitiveness means savagery, cruelty, cold-heartedness, and
therefore lack of empathy and compassion. These different meanings that
we associate with primitiveness relate directly to the varieties of internal
psychological limitation that I’ve described.
246 Normality Does Not Equal Mental Health

We can think of a “less evolved person” as someone who is primitive in

any or all of these ways: coarse, brutish, unmannered, tasteless, uncul-
tured, uncompassionate. To develop beyond the level of the primitive
has commonly required natural evolution over long periods of time. On
the much shorter—human—time scale, we rely on an individual’s natural
growth, parental training, and later education and experience to bring
about increased maturity, growth in sensibility, advancing knowledge,
and improved compassion. But unfortunately, to rely on these is more a
matter of optimism than assurance.
The concept of psychological primitiveness allows us to distance our-
selves from ourselves and to recognize that the different ranges of ability,
sensitivity, moral sensibility, and the other characteristics that I’ve exam-
ined in this book all lend themselves to being placed on a scale of develop-
ment that ranges from primitive to more highly evolved. When we situate
on a comparative developmental scale psychological traits that exemplify
greater individual development, and locate on the same scale traits that
characterize psychological primitiveness, we can take note of the very
large discrepancy, the very large gap, between the two. It is not a radical
or unreasonable thing that some members of the human species will, at
any stage of the species’ development, show signs that they are more fully
evolved than others. We identify such individuals as comprising an evolu-
tionary vanguard, whose psychological traits are more highly developed.
From such an evolutionary perspective, it would be unlikely that the
majority population of the average, the typical, the psychologically nor-
mal should possess characteristics that place them at the forefront of
human development. Throughout this work, I have pointed to remarkable
individuals, men and women who, in comparison to the psychological
normal, are mentally healthier and hence more highly developed in
psychologically important ways. I have also pointed to traits shared by
the psychological normal that show they are, again in comparison, defi-
cient and psychologically limited in ways that constrain them to their level
of deficiency. To observe these facts is, in part, to recognize that a diver-
sity of mental abilities, whether we have in view cognitive, emotional, aes-
thetic, or moral sensibilities, is a fundamental fact of nature.
Human health, whether we have physical health or mental health in
view, should therefore be understood in two conjoined ways: by identify-
ing what excellent health is as exemplified by those who show it to a fully
functioning degree, and by explicitly excluding from our conception of
good health internally limiting traits that prevent people from developing
to that fully functioning level. In psychology, approached from a develop-
mental or evolutionary point of view, our task then is to formulate a con-
cept of mental health that embodies both (1) a clear understanding of an
Normality, Pathology, and Mental Health 247

excellent level of psychological functioning and (2) an explicit understand-

ing of psychological pathology that informs us how people are prevented
from reaching that level of mental health.
Psychological normality should therefore play no role in framing an
effective and meaningful concept of mental health. Normality characteris-
tically involves traits of psychological primitiveness, while at the same
time it is internally limiting, blocking individual and human advancement.
If human development truly concerns us, individually and as a species, it
makes no sense to continue to identify human psychological normality
with mental health.

IATROGENIC EFFECTS OF PSYCHIATRIC LABELING

Clinical observations on the concept of normality reveal that to a certain
segment of our population the term has meaning as an extension and a
derivative of the concept of ‘good’.
—Reider (1950, p. 50)

In Chapter 2, I described the extent to which contemporary psychiatry has

indulged in an “inflationary ontology,” creating and then giving its stamp
of approval to an increasingly populous and crowded universe of “mental
disorders.” A widely recognized effect of such labeling is to stigmatize
people upon whom these labels are placed. As Reider remarked in the
above quotation more than half a century ago, there is a tendency to
equate “normal” with “good,” which is another way of expressing the
unquestioned thesis this book has opposed, the equation of psychological
normality with good mental health. Unfortunately, the authoritative pro-
nouncements of nosology-oriented psychiatry have a pronounced effect
on the beliefs of the society. Once our accepted professional authorities
elevate normality to serve as a diagnostic standard, society pads along
obediently and judges those who don’t meet the authorized diagnostic
standard to be aberrations from what is “good.” Immediately a source of
social stigma is created, a stigma that must be borne by those whom psy-
chiatry has labeled “mentally ill.”
Reider noted that psychiatric labeling has clear iatrogenic effects:
“[T]here are numerous instances of individuals who are worse for their
knowledge [of the diagnostic label placed on them by a psychiatrist]”
(Reider, 1950, p. 43). Reider’s intent, I believe, was to communicate the
extent to which a mental disorder label can do inner damage to the patient,
leading him or her to internalize the label of sickness derived from psychia-
try’s unquestioning application of the standard of psychological normality.
As we’ve seen in earlier chapters, the capacity to think critically, to weigh
248 Normality Does Not Equal Mental Health

socially and professionally endorsed beliefs in terms of the existence of

empirical evidence to support them, is found relatively rarely in the overall
population, and so it is not likely to be found in individual patients. Instead,
most succumb easily to diagnostic classification, and the way in which they
think and feel about themselves can be profoundly influenced by the labels
placed on them by those whom they believe to be authoritative and hence
trustworthy and hence convincing.
The conviction that one is “mentally ill” can have far-reaching and
undesirable consequences. That conviction can itself be disabling—
encouraging and sometimes compelling the diagnosed person to conform
to the criteria applied to him or her and, as a result, to exhibit in his or her
thought, affect, and behavior expectations to which such mental disorder
labeling leads.6 In other words, the application of conventional psychiatric
diagnoses can, when internalized by patients, assume the form of yet
another handicapping internal psychological limitation of the kind we
have studied in this book. Such internal limitation can be the inner result
of psychiatric labeling, which can in such people act not in a helpful,
therapeutic capacity but as an internalized, harm-producing, iatrogenic
pathology.
Beyond this, there is of course the well-known external stigma of men-
tal illness. As we have seen in different contexts, the psychologically nor-
mal are “primed” to react negatively to deviations from normality. The
psychology of mediocrity contributes to this reaction, as often also does
the psychology of stupidity. As a consequence, virtually no efforts are
made by the public to question or evaluate psychiatry’s rapidly inflating
catalogue of mental disorders, which they swallow wholesale. Beyond
the public, insurers are not in the business of asking fundamental ques-
tions, and so they also passively yield to and process without selective,
critical oversight whatever DSM diagnostic codes are duly submitted
to them. In this process in which ready credulity plays a central part,
“concepts of normality have become the morality” (Reider, 1950, p. 43)
advocated by the mental health industry.

AFTERWORD
In relation to the concept of mental health described in this book, it
would be fallacious logic to reason that if deviation from psychological
normality does not identify the mentally ill then deviation from normality
should be a sign of mental health. This consequence does not of course
follow. Individuals who are “more fully evolved” exhibit traits not typi-
cally found among the population of the psychologically normal, but it
should go without saying that the population of psychologically
Normality, Pathology, and Mental Health 249

nonnormal people, people who are psychologically atypical, includes

many who are neither remarkable in Maslow’s sense nor characterized
by other qualities I’ve described that typify exceptional people who have
reached a more advanced stage of development. Psychological normality
is not equivalent to mental health; but neither is psychological abnormal-
ity. This point cannot be emphasized enough, since it is an ingrained
tendency of human thinking to swing from one excess to its opposite.
The truth is usually to be found between extremes.
Vacillating between those extremes, there should come an equilibrium
point at which we recognize that psychological problems are not confined
to the psychologically abnormal or to the psychologically normal. Psycho-
logical problems show no preference in whom they afflict.
In Chapter 1, I distinguished between “optimal functioning,” which
takes into account the limitations of the individual, and “excellence of
functioning,” which indicates that an individual has reached the highest
level of performance, distinction, or development in connection with a
given ability. The two concepts of mental health proposed in this chapter
correspond to this distinction: Mental health in the sense of excellence of
functioning makes use of standards derived from statistically rare groups
of individuals who exemplify the highest levels of genuinely good psycho-
logical functioning. Mental health in this first meaning is not to be found
among those who are average, ordinary, normal.
In comparison, mental health understood in the sense of optimal func-
tioning is altogether relative to an individual’s “self-adaptation,” to his or
her self-acceptance and self-contentment in relation to the person’s spe-
cific life circumstances, values, abilities, and goals. This individualized,
relative level of mental health is by no means restricted to the more fully
evolved, but is attainable by an extremely wide and psychological diverse
population.
Both degrees of mental health share in the requirement that they be
free—comparatively free, for this is a matter of degree on a continuum—
from the internally limiting pathologies I have identified. To be psycho-
logically healthy as described in this book requires, whether for individ-
uals who have optimal psychological health or for individuals who in the
fullest sense have excellent psychological health, that they be compara-
tively free from the internally limiting mental dysfunctions we have dis-
cussed.
As remarked in Chapter 1, mental health is more than a state of not
having a mental disorder. To be mentally healthy is to be free from the
internally limiting traits that we recognize in the pathologies of normality,
mediocrity, acedia, barbarity, and destructive projective thinking, as well
as to have reached a level of psychological maturity which is either
250 Normality Does Not Equal Mental Health

optimally integrative for the person or reflects a high degree of excellence

of development that we find only rarely among similarly remarkable
people.

NOTES
1. Even so, behavioral science—in the form, for example, of the many-times-
replicated obedience experiments—tells us that the majority (at least two out of
three) of psychologically normal men and women will inflict harm on others in
simple obedience to the authority of their leaders. The Romanes Principle
applied in a casual review of history would lead us at least to this understated fig-
ure, without recourse to laboratory experiment.
2. Related to this observation, see the Afterword of this chapter and Appendix
III.
3. For a discussion of behavioral scientists who have been exceptions to this
rule, see Bartlett (2005).
4. The reflective reader will note immediately that in the two examples I’ve
given reference is made to an “expert group” or an “informed group” whose
judgment that pathology exists is subsequently relied upon. There is no way to
circumvent the need for a reliable source of diagnostic judgment, and here lies a
point potentially subject to theoretical contention: Advocates of the DSM plebi-
scite process will argue that a committee of a thousand should be accepted as
well-informed, impartial, and trustworthy. I have argued, in opposition, that we
should doubt its impartiality and knowledge, and hence its trustworthiness. As
discussed below in the main text, a consensus conception of mental health,
derived from such a large group of people, will automatically advocate adherence
to a standard of psychological normality. I’ve argued that such a committee—
given the typical or normal psychology that of necessity dominates its numerous
members, a psychology that underlies the definitions of its nosology (see Chapter
2 of this book) and that makes mistaken use of normality as a standard of mental
health—can be expected to make choices that are conceptually invalid and empir-
ically wrong.
5. See Appendix I.
6. Related to this unfortunate result is “illness of work incapacity,” a phrase
used by Hadler (2004, p. 141) to mean illness that is made worse by the need to
document it for legal or insurance purposes. This is quite different from “malin-
gering”: Hadler has in view illnesses that are in fact made worse by the pressure
placed on patients to prove that they have them.
 PART IV

In Retrospect
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 10

The Reflexive Turn in Psychology

We are most limited by conditions we choose to ignore.

—SJB

Relatively few clinicians have time for theory. Their clinical practice is
all-absorbing, so much so that the asking of psychologically fundamental
questions is indeed a luxury—if any time at all can be found for it. Theoreti-
cally focused psychologists and psychiatrists may have the time, but they are
usually busy applying and extending their own research. The incentive to
step reflectively back from a habitually employed theoretical standpoint is
rare and is probably most often found in philosophers. This is a pity, since
as soon as fundamental questions are relegated to philosophy, the implication
is that asking such questions is likely to be only speculative and obscure,
resulting in reflections that are abstract and conceptually complex, multi-
plying into infinitely debatable and inconclusive conjectures.
Philosophy’s generally bad reputation in these respects is, I believe,
well-deserved, and I do not propose in this chapter to wax philosophical.
On the other hand, I am convinced that psychiatry and clinical psychology
suffer from unrecognized theoretical disabilities which a concerted effort
in a reflective direction can serve to ameliorate. In this final chapter,
I invite readers to gain some distance from the content of the preceding
chapters and to look back reflectively, with a sense of perspective and
detachment, at the ground we’ve covered.

THE ECONOMICS OF HUMAN EMOTION

In the course of this book, I’ve described a variety of internal limita-
tions of human psychology—among these, acedia or the incapacity for
culture, traits of barbarity, pathologies of normality, the psychology of
254 Normality Does Not Equal Mental Health

mediocrity, and the distorting nature of projective thinking. My purpose

in studying these has been to serve a single main purpose, to motivate
readers to doubt whether the unquestioned equation of psychological
normality with mental health is desirable; to ask whether this equation,
in the light of what we know about human behavior, is justifiable; and to
consider whether there is not a more theoretically plausible, rationally
valid, and empirically convincing alternative model for good mental
health.
My approach in the previous chapters has been informally heuristic,
descriptive of ways in which men and women throughout history have
succumbed to internal psychological limitation, usually without knowing
this and virtually always without struggling against it. Each of the varieties
of human pathology I’ve described is associated with forms of psychologi-
cal gratification that cut off development beyond it. The psychological
pattern of forces, the dynamic, that we see in each form of pathology is
similar: there is an “emotional profit motive” that is deeply seated in most
people, which leads them to remain in a self-limiting and destructive
pattern of thought, emotion, or behavior, and to resist abandoning
that pattern. If an explicit “economics of human emotion” were to be
developed, we should find one of its main objects of study here, in the
human unwillingness to give up powerful sources of gratification that
attract and bind people to those gratifications and that create in them
incredibly strong resistance to relinquish them.
In parallel with economics, we should find a psychological application
of the “principle of economic scarcity,” which recognizes that investment
in one course of action tends to be exclusionary, eliminating consideration
of alternative courses of action. We see this in psychology in the all-too-
familiar phenomenon in which a person’s or group’s emotional invest-
ment in one alternative excludes all others. Each of the psychological vari-
eties of internal limitation brings people evident kinds of satisfaction that
very strongly encourage them to invest their beliefs and efforts in certain
directions—and, in accordance with the principle of economic scarcity,
to disregard alternatives that may potentially be open to them.
If you, the reader, will put these two “economic” perspectives together,
you may be willing to think in the context of a heuristic frame of reference
similar to the author’s. From that standpoint, we see that a study of the
psychology of varieties of psychological internal limitation has not, in any
serious measurable, quantitative fashion, even begun. There are, for exam-
ple, no psychometric tests to show how strongly predisposed a psychologi-
cally normal person is to inflict harm on others or to place himself and his
fellows in harm’s way simply to promote or defend his ideology. Nor
do we have any such tests to determine under what circumstances a man
The Reflexive Turn in Psychology 255

or a woman will engage in violence or atrocity, nor do we have any way to

anticipate in advance what degree of satisfaction or remorse the person
would later feel as a result. The same is generally true in connection with
virtually any human patterns of thought, emotion, and behavior typically
exhibited by the psychologically normal population, patterns that involve,
for example, aggression, destructiveness, envy, rage, laziness, or greed;
absence of compassion; a willingness to dehumanize others; species pride
and resulting environmental depredation; or, on a more specialized plane,
professional jealousy, backstabbing, and the struggle to block new and
potentially better ideas.
We see all of these phenomena in great profusion, and still we do not
know how to test an individual with any known method in order to dis-
close the likelihood that he or she will, under specifiable circumstances,
think, feel, or act in such ways. Similarly, in terms of the management of
society, we have no reliable standards with which to determine in advance
how a seemingly mentally healthy leader is liable to think, feel, and behave
once placed in a position of power.
Nor do there exist psychological tests that have been designed specifi-
cally to measure mediocrity and the extent of its heritability, nor the recal-
citrant stubbornness of stupidity, nor the incapacity for culture, nor the
predisposition to misrepresent reality through projective thinking.
As a result and on an individual level, quantitative data about these
internal limitations are lacking and will continue to be lacking as long as
a serious study of the subject is ignored and evaded. We are therefore
not yet in a position to know very much at all about such predispositions
when the highly individual, living person is in question. However, we do know
a great deal about all of these predispositions on the level of large groups.
For this purpose, a psychological study of history, as remarked in the last
chapter, provides more than adequate evidence that psychologically
normal people are, as a group, predisposed to engage in patterns of behavior,
thought, and emotion that are internally limiting, blocking individual and
species-wide development.
The evidence that shows this is substantial; indeed it is compelling
when there is firsthand acquaintance with its strength and breadth. That
evidence is not fully communicable within the confines of a single chapter
in a book. Perhaps it is in a full-length and detailed study (e.g., Bartlett,
2005), but perhaps not even there—except for those who are already
keenly aware of the weight of the evidence and need no reminders. There
is a sense in which an unfortunate dilemma besets the researcher who
ventures beyond our prevailing internal psychological limitations: either
to preach to the choir or to the impenetrable wall erected by the very
internal limitations that are in view.
256 Normality Does Not Equal Mental Health

Notwithstanding the inherent pessimism of this meta-remark, the most

promising basis on which future research can build given the present stage
of our knowledge of forms of internal psychological limitation is to identify
and discriminate principal traits that characterize internal psychological
limitations. And it is in relation to this task that I’ve tried to make a first step
through detailed description.

THE PSYCHOLOGICAL DYNAMIC OF A DARK AGE

Any application of the phrase “dark age” to the future of course sug-
gests gloom. When the phrase is used, as in Lasch’s (1979) The Culture
of Narcissism or McIntyre’s (2006) Dark Ages: The Case for a Science of Human
Behavior, it is in the context of cultural criticism and not, as here, in connec-
tion with specific ways in which human psychology acts to hold people
back in cognitive, emotional, moral, and behavioral patterns that are
humanly self-destructive. In Chapter 5, I described the way in which a loss
of the liberating spirit and liberating content of higher education lays the
groundwork for a new Dark Age. Other forces contribute, among them:

• The domination of such an age by acedia, an incapacity for culture;

• The suppressive effect of a system of intellectual prepublication
restraint in which an internally limiting psychology of peer review
and editorial bias can be expected significantly to block original
intellectual work;
• The role of the psychology of mediocrity in impeding individual and
collective human development in a multitude of ways; and, of
course,
• An uncritical approach in psychiatry and much clinical psychology
that is based on an equation of psychological normality with good
mental health.

Together, these forces reinforce one another and help to promote and
perpetuate an environmentalist-egalitarian, multiculturalist-relativist,
anti-elitist, anti-intellectual attitude toward higher education, higher
learning, individual attainment, and original thought. These are the
psychological ingredients needed for a dark age. We note that technology
is able to thrive in such a culturally depleted atmosphere; a dark age in
which there is more and more technological progress is not a contradic-
tion in terms.
A dark age is perpetuated by any society’s commitment to conformity,
conservatism, and conventionalism, all of which make it especially diffi-
cult, and sometimes unpopular, for people to question what they have
The Reflexive Turn in Psychology 257

not questioned before and may not have been willing to question. In such a
period, it is decidedly more difficult but all the more imperative for us to
examine our major premises and to be prepared, at least for a time, to
put preferred and comfortable beliefs to one side. “Imperative” does not
mean, however, that everyone is going to be enthusiastic about doing this,
especially when, as we saw in the last chapter, this means facing the chal-
lenge of a wholesale revision in established concepts of “mental health”
and “mental disorder.”
In contemporary psychiatry and much clinical psychology and social
work, the prevailing commitments to conformity, conservatism, and con-
ventionalism collaborate to support the belief that “adjusting the young to
their environment” is desirable and therefore should be an explicitly urged
goal not only by our families and educational system but by establishment
mental health services, where the routine therapeutic aim is to normalize
through the use of psychiatric medication and to encourage and produce
normality through the corresponding use of psychotherapy.
This mindset acts as a brake, a constraint, that blocks human advance-
ment. It checks individual development, deters original thought, discour-
ages creative efforts to achieve positive growth, and stands in the way of
paradigm change. We’ve seen this phenomenon in connection with the
psychology of definition in psychiatric nosology, in terms of the psychol-
ogy of the creative artist, the psychology of today’s college students and of
their liberal arts professors, the psychology of peer review and editorial
bias, and of course in discussions of the psychology of normality and
mediocrity. Brakes hold back a vehicle, a person, or a group from move-
ment or advancement—which is change. The internal psychological limi-
tations studied in this book are brakes of a certain kind: they impede
change, and they preserve and protect a variety of forms of cognitive,
affective, and behavioral disability.
As we have seen, there is an in-built brake in the psychologically nor-
mal population that holds its members back in typical patterns of pathol-
ogy. For the mediocre, the majority of whom are psychologically
normal, there are in-built impediments that prevent them from becoming
more than they are, as there are obstructions ready to hand that they place
in the way of those who would become better than they.
But there is more to the dynamic of psychological forces that bring
about a dark age. There is, as we’ve seen in chapters dealing with acedia
and barbarism, a growing antipathy toward culture in its liberating,
classical meaning; there is also a growing anti-intellectualism, a product
of intellectual mediocrity and a politically correct denial of the natural fact
of the inequality of individual abilities and sensibilities. There is a pas-
sionately rigid opposition to anything that smacks of elitism, and hence
258 Normality Does Not Equal Mental Health

an enthusiastic embrace of cultural relativism, multiculturalism, and the

rejection of standards that discriminate between higher and lower.
Irony is added to the human tragedy of this drama thanks to the success
of psychiatry’s nosology that has elevated psychological normality to
an unquestioned role as arbiter in distinguishing “mental health” from
“mental disorder.” In doing this, the psychiatric diagnostic system of clas-
sification has evolved into a habitually accepted theory and approach to
therapeutic practice that precisely embodies many of the internal limita-
tions that have occupied us in this volume.
We need to perceive the “larger picture” in which a multiplicity of
factors—that is, a substantial number of psychological predispositions
and traits—interact, reinforce one another, and together contribute to
an outcome that is deeply resistant to positive change. If it were the case
that only one, or two, or three such factors were at the basis of the major
psychological faults of the human species, the undesirable situation and
its possible remedy would be greatly simplified. But the contributing
factors are complex and they are numerous. They constitute major failings
in the psychologically normal constitution as it is at the present time.
It has been my intention in this work (1) to draw attention to certain of
these major faults, faults of which people, including mental health theo-
rists and practitioners, are generally oblivious and prefer to be; (2) to
remind us of what is most important in life, but what is rapidly being for-
gotten as liberating higher values recede into shadow and then potentially
into oblivion; and (3) to provide a more promising and solid conceptual
framework for subsequent work in clinical psychology and psychiatry by
eliminating obstacles to clear thinking. To accomplish these things, it
is essential that we clarify our fundamental concepts and question the
validity of our reasoning by means of them, for they form the basis of
theoretical psychology and hence the basis for the approaches to therapy
to which it leads.

SUBORDINATING MUNDANE REALITY

[E]ach morning, reality resembles more and more a nightmare.
—Jorge Luis Borges (1940)

In The Man in the Mirror of the Book: A Life of Jorge Luis Borges, biographer
James Woodall (1996) describes how Borges managed—always, through-
out his life—to “subordinate” events of the everyday world in order to
guard and cultivate more important things. Those “more important
things” are among those things that in this book I’ve called “higher.” This
is an expression of an ancient attitude found in Plato’s resort to allegory,
The Reflexive Turn in Psychology 259

in his effort to express what is not easily expressed in language, at least not
intelligibly to those who do not already understand. Here, I believe, is
one of the most articulate and intellectually honest expressions of this
difficulty, dilemma, and challenge:

That the world is a prison and our life and hope respectively are servitude
and release, is a universal image, powerful enough to be transformed into a
myth, and hence, to become imprisoning in its own right if it is nonsense or
is false. For then we will be held captive only by the belief in our captivity.
Plato’s version is the reverse of this. . . . According to him, our imprison-
ment consists exclusively of the fact that we are not aware of being in our
prison. So we cannot (logically) both be in this condition and know that we
are in it, and knowledge of our condition is instantly delivering, like a cure
for a disease which consists only in not having the cure. But deliverance is
complicated by the extraordinary difficulty of explaining to the prisoners, in
terms intelligible to them, that prisoners are what they are. For the
conditions which make self-understanding possible are incompatible with
the conditions they are in, and he who speaks of imprisonment to prisoners
must be regarded by them as a madman in his raving. For the bonds which
hold them captive are the boundaries of the understanding, and how are
we to bring the boundaries within themselves to make them understood?
The limits of understanding are not part of what is understood. (Danto,
1971, p. ix)

This, as I see it, is far from being a parlor trick in a logician’s fable; nor
is it simply an epistemological predicament (which it certainly is); but,
more importantly here, it describes a psychological impasse that owes its
existence to the widely varying psychological constitutions of individual
people. For some people, the bonds that hold them captive to rigidly
habitual patterns of thought, feeling, and behavior are undetectably felt.
For others, such as the creative artists described in Chapter 3, any shackle,
any sense of imprisonment, is felt keenly, sometimes painfully, and is
nearly always met with a spirit of defiance and rebellion. In contrast, the
majority of people show a pronounced inability to get beyond the impasse
hardened by their own internal limitations. For them, that they are inter-
nally limited is as imperceptible to them as a self-conscious sensation of
water probably is to a fish. The limitations of their understanding are
not, as Danto expressed this, part of what they understand.
I’ve tried to place a description of their main psychologically limiting
traits in more distinct relief than our usual acceptance of normality pre-
fers, and in this I’ve chosen a direct approach to communication rather
than allegory. I have tried not to mince words in formulating these
descriptions, since we gain nothing by vagueness and overcautious qualifi-
cation. If at times it may seem that I’ve indulged in overstatement, my
260 Normality Does Not Equal Mental Health

rationale is that when stretching the boundaries of understanding, clear

assertion that for some may be too bold is sometimes the only effective
alternative to allegory—or parable, poetry, or fantasy.
Psychiatric nosology has defined itself into its own sort of Platonic
cave, and its authoritative definitions of mental disorders have permeated
our society as though from a biblical source. Not only have its diagnostic
classifications assumed a reality of their own, but they have persuaded the
credibility of their creators, who are, in short, imprisoned within a prison
of their own devising.

The sum of what the prisoners know is shadows and images of things,
projected onto the cave’s wall. These compose reality for them. The
shadows are the touchstone of intelligibility of creatures in their
circumstances, for since shadows are all they know, no statement except
one about shadows will be meaningful to them. It is this which makes it
difficult, which perhaps makes it impossible, that they should know the
limits of their world or even that their world has limits, for how is the
expression “only shadows” to be made intelligible in terms which refer
alone to shadows? This is a statement made about reality from without, and
one who understands reality only from within cannot then know that he
does so. (Danto, 1971, p. x)

We might be reminded here of the linguistic relativity hypothesis of

Whorf (1956/1962) and Sapir (1949/1958). In its strong formulation, it
claims that speakers of a given language are internally limited by the per-
ceptual and conceptual discrimination capacities of their language. Whorf
and Sapir did not employ the concept I’ve called “internal psychological
limitation”; their concern was rather linguistic, suggesting that natural lan-
guages have boundaries that potentially circumscribe what its users do or
can experience. In contrast, Danto’s focus in the two passages I’ve quoted
has to do with the boundaries of human understanding. And in further
contrast with Whorf, Sapir, and Danto, my focus has a less broad compass
but a more explicit application, for I’ve had in view specifically the way in
which the contemporary psychiatric paradigm of mental health and men-
tal disorder is internally limited.
In part, I’ve attempted to show readers that such internal limitations are
actually operative by pointing to “levels or orders of reality” in comparison
with which everyday, mundane reality can be perceived as unreal, artificially
constructed, and lanthanic, that is, involving unrecognized pathology. To
make this step of meta-analysis, you must step up at least one rung on a lad-
der of progressive reflection. The last line of Philip Glass’s opera “Waiting
for the Barbarians” is: “I’m caught in an ugly and stupid dream.” The three
The Reflexive Turn in Psychology 261

concepts—“ugly,” “stupid,” and “dream”—all require that we take a step

back from or above the everyday standpoint. To make these judgments,
Glass presupposes that his listeners will be able to situate their thinking at
least one step removed from ordinary reality. So does Plato’s allegory of
the cave. So does Borges in many of the themes one finds in his writing, in
which the judgment is expressed that what we see is unreal and untrustwor-
thy, so much so that a step into reflective fiction must be relied upon—
to establish a level of reality that is higher because only within its borders
(daring to speak here for Borges) can we come to know what is true.
In a real and nonliterary, nonmetaphorical fashion, the same is true in
connection with our subject, the seemingly heretical proposal that
psychological normality is a bad, even monstrous, choice of standard for
human mental health. For many people, in order for them genuinely to
recognize the truth of this claim, a review of the supporting evidence will
always be insufficient—except for those who are already convinced or who
have a comparatively rare capacity for reflective disengagement from their
own habitual commitments. And this assertion, too, is no logician’s
sleight-of-hand, but it reflects the internally limitative human predica-
ment. Such a recognition requires, as a condition of its very possibility,
that a person be able to step beyond or outside the familiar and comfort-
able constraints of his or her experience. Not many people have the abil-
ity, much less the willingness, to do this. Psychiatrists, psychologists,
and social workers are no exception.
There are usually alternative routes to the knowledge that something is
the case. In this book, I’ve pointed to two routes. Each requires a reflective
turn by psychology, that is, a willingness to assume a reflective metastand-
point toward either or both of two concerns. These two concerns by this
point are well-known to readers. The first is the concern that the popula-
tion of the psychologically normal is far from being mentally healthy, and
the second is that much that is of great significance in human life goes
unnoticed and remains invisible to the average, typical man and woman.
Either recognition—that psychological normality is in many ways dys-
functional and destructive, and that “elevated living” possesses a wealth
of meaning in contrast to the poverty of mind of the psychologically nor-
mal—either recognition can, for readers with the requisite intellectual
receptiveness, provide a psychological foundation that allows them to sub-
ordinate ordinary reality. But, as Danto has expressed so well, this is a
demanding challenge. It is psychologically demanding for anyone who is
not already among the “converted,” for at this juncture most people will
run headlong into a face-to-face confrontation with their own internal
psychological limitations.
262 Normality Does Not Equal Mental Health

PRACTICAL IMPLICATIONS
You, the reader, have noticed the occasional appearance in this book of
such names as Plato, Hesse, and Borges—one man a philosopher, another
a novelist, and the third a writer of intellectual fantasy—all, no doubt,
idealists! As a result, you may have gotten the mistaken impression that
I’m urging a highly idealistic point of view that lacks practical application.
The perspective I’ve described is firmly rooted in a set of ideals, but in fact
they have very practical implications.
Having reached the end of this work, we should not hesitate to ask in
retrospect, “What, then, is the practical point of a descriptive psychology of
human pathology?” This is a legitimate question, to which I have these
answers: First, and in more general and deceptively simple terms, we need
to understand ourselves better if we are to learn how we might become
better. We need to take seriously Einstein’s observation with which this book
began, that if we are to have a better world, “you have to have better people.”
Second, if it is the case that built into the present psychological constitution
of most people are constraints that block their own development and further
stand in the way of the development of others, then we need to become fully
conscious of those limitations if ever we are to grow beyond them.
Both answers give the initial impression of vagueness and of lacking
useful application, so we need to move to the level of the very concrete:
the point of studying the psychology of human pathologies is ultimately
to provide us with an understanding of people that can be applied on such
practical levels as psychological therapy, education, and vocational guid-
ance. Earlier chapters in this book have directed attention to the need to
reevaluate the general equation of psychological normality with mental
health, to reassess the direction of human education, and to enlarge the
scope of values to which we are sensitive. These are practical and concrete
ends: Taking them seriously leads to a revisionary approach to mental
health and to the treatment of psychological problems, as we have seen in
earlier chapters. A serious commitment to these ends also leads directly, as
Robert Hutchins (1937, 1952) has shown, to a specific conception of higher
education and of specified content to be studied. Further, were we to take
these ends seriously, we should be able to develop a map in terms of which
to orient how we wish humanity to develop, and then seek practical steps to
achieve those goals. In much of this effort, there would be no need to
reinvent the wheel, for the work has already been done: it resides on the
shelves of libraries, in volumes that would need to be dusted off, expressed
in language that could tolerate some refreshening, but little more.
A serious decision to rethink where we should go from here requires
that we first understand with uncompromising honesty where we stand
The Reflexive Turn in Psychology 263

at the present time. The phenomenon of mediocrity needs to be taken

seriously as a warning, rather than a trivialist’s celebration. The psychol-
ogy of mediocrity is humanity’s ball and chain, whose mass and therefore
inertia are unappreciated and casually dismissed. A healthy recognition of
individual differences needs to be developed in conjunction with an
equally healthy affirmation of standards of good mental health in which
psychological normality no longer plays a central role. These, too, are
specific and concrete goals with applicability that does not require much
imaginative effort. There are obvious social and political implications if
we affirm the reality of individual differences. Education would need to
concern itself foremost with the encouragement and cultivation of excep-
tional individual merit and attainment, realizing that “no child left
behind” is a mistaken mythology that holds children back to a level of
mediocrity. We need to make human excellence the explicitly stated goal
of education; we should celebrate it: “Excellence exists, and it is time to
acknowledge and celebrate the magnificent inequality that has enabled
some of our fellow humans to have so enriched the lives of the rest of us”
(Murray, 2003, pp. 449–50).
From a clinical point of view, we should see that successful psychological
therapy is much more of an art than a science, given that the individual and
his or her individual circumstances, abilities, sensibilities, attitudes, values,
and goals must together be comprehended and taken into account through
the way a therapist responds and offers help to the person who is suffering.
Whenever the focus becomes concentrated on the individual, and universal
principles of etiology and symptomatology cannot be found, then science
must give way to art, for art deals with the individual, science with general-
izable and invariant principles. The practice of physical medicine also used
to be regarded as an art, and no doubt to some extent it still is, but it has
become less so as the many forms of laboratory testing facilitate diagnosis
and obviate a large portion of what used to be diagnostic intuition and
judgment.
As Norman Sartorius, director of the Division of Mental Health of the
World Health Organization, wrote in his preface to the ICD-10 Classifica-
tion of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic
Guidelines (World Health Organization, 1992, p. vii): “A classification is
a way of seeing the world as a patient in time.” This is eloquent but per-
haps too concise for a meaning that needs to be explained. Were clinicians
to “see the world as a patient in time,” what would this mean? I don’t pro-
pose to speak for Sartorius, but here are two interpretations: The first is
that we consider the world of humanity as a patient in need of therapy;
the second is that we consider each individual patient as an expression of
the world as experienced by him or her. The first is compatible with
264 Normality Does Not Equal Mental Health

concepts of mental health and psychological pathology that have con-

cerned us in this book, while the second is compatible with the highly
individualized approach that I advocate to help people who experience
psychological distress.
I do not really think Sartorius had these interpretations in mind (unless
he is more than a psychiatrist, but also a poet at heart!), and whether he
did or not isn’t relevant here. These two imagined approaches to “seeing
the world as a patient in time” do serve, however, to underscore their stark
contrast with the current attitude of diagnostic psychiatry: As we have seen
in some detail, the way that today’s diagnostic psychiatry “sees the world” is
heavily influenced by a projective psychology of reification that systemati-
cally misconstrues symptomatology as mental disorder, mistakes stipula-
tive definition in psychiatric nosology for real, scientific definition, and, in
this process, elevates psychological normality to serve as psychological
arbiter of good mental health.
The practical implications of “seeing the world as a patient in time,” as
I’ve no doubt extended and supercharged this phrase, can be as specific as
we choose. They can include, as I’ve mentioned, a revitalization of
psychological therapy, education, and vocational guidance—all with the
individual’s self-adaptation in mind and with a concerted attempt to
remove from the individual’s way obstacles that are placed there by the
internal psychological limitations I have identified.
The idealism expressed in this volume is not of the familiar variety that
is impracticable, for it does have clear and definite applications. But its
implementation is so daunting, affecting so much of human reality, as to
be felt impossible, perhaps indeed hopeless, and so it is tempting to judge
it as just so much “pure idealism.” This interpretation leads directly to
pessimism, which, very much like optimism, has its shortcomings. Hope
helps us to accommodate to a reality we know is undesirable; pessimism
can tie our hands as we wring them. Either way, our capacity to change a
reality we should no longer be prepared to accept can be disabled.
The fact that the practical implications of this approach are over-
whelming should not be confused with the notion that it has none: the
practical implications are legion. They extend to many critical areas of
human life, from the ethics of reproductive choice in a precariously over-
populated world to the values encouraged in children, the treatment of
criminals, the evaluation and appointment of society’s leaders, socially
approved attitudes toward violence generally and war in particular, and
the list could be made to go on indefinitely, each item on it reflecting
the need to reappraise values that have too long gone unquestioned.1
This, surely, is idealism, but it is not idealism without practical conse-
quences.
The Reflexive Turn in Psychology 265

IDEALISM THAT IS NOT HOPEFUL

Optimism makes reality more tolerable. When much of psychologi-
cally normal reality is unacceptable and no longer to be passively toler-
ated, optimism about that reality is difficult to summon. Should it be
summoned at all when we realize that it so often leads us to suffer on with
what is no longer bearable? Nietzsche thought poorly of optimism; in an
earlier chapter, I quoted his claim that, “morally speaking, [optimism is]
a sort of cowardice” (Nietzsche, 1992, p. 18). The sheer scale, the over-
whelming magnitude, of internal psychological limitation that one finds
in the average human population is cause enough to wring our hands.
To face human reality with eyes fully open and yet feel optimism Nietzsche
would condemn as cowardly denial. Hope can be a refuge sought out of
fear, an escape from an undistorted perception of reality. When human
pathology is so widespread as to be normal, the susceptibility of optimists
to accept intolerable conditions and so to tolerate them can itself reflect
a self-destructive form of pathology. In another work (Bartlett, 2005),
I describe “the pathology of hope,” which successfully brings about human-
ity’s willingness to tolerate its own worst failings.
The psychologically normal response is to adjust to the human environ-
ment as best we can, which in the end of course changes nothing. We call
this “adaptation”; it is socially desired; it is clinically desired. But adjust-
ment to a world increasingly afflicted by pathologies of normality is not
a goal to be wished. To revise an observation made by Robert Hutchins
(Mayer, 1993, p. 400): Our purpose is not to adjust to the world, but to
make it better; if we become maladjusted in the process, so much may this
be better for the world. To adjust to a world in which humanity’s internal
psychological limitations have reached the present level of conspicuous
domination is to become yet another victim of normalization. As we saw
in an earlier chapter, creative individuals have often been classified by cli-
nicians as maladapted, as misfits in relation to the world of normal
humanity. This has been their strength and their merit, as it has often
been their source of suffering, often in large measure thanks, as we’ve
seen, to the way normal society has treated them. (Just as surely, we of
course recognize that “maladaptation” is no automatic sign of an elevated
mind, nor of high attainment, nor of original capacity.)
The concepts of mental health and mental disorder propounded by
psychiatry’s consensus-based definition of truth reinforce rather than
grind down the blocks that obstruct human psychological development.
To urge that it be otherwise, to work toward that end, is—under the
psychological circumstances—unalloyed idealism, an idealism which does
not encourage tolerance of or adjustment to an unacceptable and
266 Normality Does Not Equal Mental Health

disappointing human reality, an idealism which has specific, direct, and—

predictably for the psychologically normal human majority—sometimes
unattractive and objectionable practical consequences.
Sir Richard Burton (1821–1890) was a rarity among scholars and world
explorers, for he combined both in a single man, the author of 43 volumes
describing his travels and some 30 volumes of translations, the first European
discoverer of Lake Tanganyika, and a linguist fluent in 25 languages which,
including dialects, amounted to a knowledge of 40 languages—in short, an
unusual man. Ensconced in a heavy scholarly section of notes appended to
his long narrative poem The Kasidah of Haji Abdu is the following observation:

To consider the world in its length and breadth, its various history and the
many races of men, their starts, their fortunes, their mutual alienation, their
conflicts, and then their ways, habits, governments, forms of worship; their
enterprises, their aimless courses, their random achievements and
acquirements, the impotent conclusion of long-standing facts, the tokens
so faint and broken of a superintending design, the blind evolution of what
turn out to be great powers or truths, the progress of things as if from
unreasoning elements, not towards final causes; the greatness and littleness
of man, his far-reaching aims and short duration, the curtain hung over his
futurity, the disappointments of life, the defeat of good, the success of evil,
physical pain, mental anguish, the prevalence and intensity of sin, the
pervading idolatries . . . —all this is a vision to dizzy and appall, and inflicts
upon the mind the sense of a profound mystery which is absolutely without human
solution. (Burton, 1894/n.d., pp. 58–59)

By now, we should have a firm grasp of the psychological limitations that

dissolve and explain much of this mystery. But whether it is utterly without
human solution remains to be seen. Certainly the internal psychological lim-
itations depicted in the present work highlight how difficult any solution
would be. The odds seem to be overpoweringly against any solution we might
be able reflectively to devise for ourselves; perhaps evolutionary or other
natural forces over which we have no control will intervene. But a decline of
hope, or the birth of pessimism, is not reason enough to give up the task.
William of Orange is reputed to have courageously uttered in the face
of overwhelming odds: “It is not at all necessary to hope in order to
endeavor, nor to succeed in order to persevere” (Rüstow, 1980, p. xxix).

NOTE
1. Additional practical implications are suggested in Appendix II.
 APPENDIX I

An Apology to Lovers of Humanity?

It is a strange thing that, in studies of medical pathology, authors do not

feel called upon to balance their analysis of diseases with praise of good
health, whereas the situation is entirely different when it comes to a
psychological critique of human psychological normality. Readers who
are defensive about “humanity” may feel that a work that studies such
things as “pathologies of normality” owes it to the humanistic spirit or to
species pride to offer a “balanced presentation”—by emphasizing how
good many people are, how good much of their behavior is, how much
beauty, truth, courage, and heroism humanity is responsible for.
From a psychological standpoint, such a defensive reaction to a study of
human pathology that is so widespread as to be normal constitutes both an
expression of denial and an attempt to take the sting out of a dispassionate
assessment of the psychologically normal population’s typical destructive
predispositions. Complaining that a study of human psychological pathol-
ogy skips over or does not take the trouble to emphasize human goodness
is counterproductive and encourages misplaced emphasis. We do not
identify, diagnose, and treat dysfunctional thought, emotion, and behav-
ior by citing counterexamples. The wish for a “balanced presentation” in
medical pathology would be seen as irrelevant as it is here.
Yet “irrelevant” is not the entire story: such a wish expresses an attitude
that hinders the attainment of the goal of pathology, to identify and then
treat harmful conditions. We are already ill-disposed to recognize “the
enemy within.” If we insist upon patting ourselves on the back—even,
and most especially, in the course of studying our gravest faults—we are
likely to miss the point.
There is nothing in a treatise on venereal disease that depreciates human
love by virtue of the fact that the treatise omits to mention and praise love;
similarly, there is nothing in a study of forms of psychopathology, which
268 Appendix I

hinder individual and general human development, that should be inter-

preted as universally depreciating exceptional human attainments,
creations, and exemplary conduct.
But beyond this recognition, there is a compelling need, as I’ve tried to
show in different contexts in this book, to accept that what is finest about
our species is not captured by the psychological constitution of the major-
ity. My own observations and those of others whose works are mentioned
in this volume suggest that, nearly without exception, extraordinary
achievement comes from an exceedingly small segment of the total human
population, which this book plainly honors. It should make good sense
even to the most ardent lover of humanity to acknowledge the following:
that serious opposition to the equation of psychological normality with
good mental health should not unnecessarily, irrelevantly, and counter-
productively be saddled with the task of praising the very subject in which
deeply seated and largely unrecognized pathology thrives.
 APPENDIX II

Practical Speculations, or Speculative

Practices

A shift in our chosen standard of good mental health, whether we call such
a standard a set of criteria, a measure, norm, benchmark, baseline, or
arbiter, has potential practical implications. This book, it should be clear,
is not a detailed practical engineering manual for social, political, or even
psychological reconstruction. Yet, in rereading the text, it struck me that
some readers might wish to have a few more concrete examples of how the
approach that is proposed in this volume can lead to practical application
and implementation. In a mere appendix, space for this is clearly limited,
but here are a few additional examples, some of greater import than others:

1. The most immediate implication of the shift to a new standard of

mental health as proposed in this book would be to undermine the
credulity invested by both the public and by mental health clinicians
in the plethora of “mental disorders” that are authorized by the DSM
despite the fact that most have no known organic basis. The majority
of the psychological problems that people encounter would then not
brand them as “mentally ill,” and they would be spared both the
internal and the external stigmata that so often result from current
diagnostic labeling. As I have proposed, such a change in clinical per-
spective leads to the recognition that psychological problems are
highly individual and require the highly individualized attention
and care of clinicians. In addition, I’ve advocated a thoroughgoing
revision in our criteria that are supposed to inform us what consti-
tutes fully functioning mental health. For this purpose we would
look not to the population of the psychologically normal but to
groups whose psychological traits are exceptions to the rule, whose
members express predispositions that, unlike those characterizing
270 Appendix II

the psychologically normal populace, are free from the pathologies

of normality, mediocrity, stupidity, and delusional projective think-
ing discussed earlier. These two practical implications for psychiatry
and clinical psychology have been foremost in my mind in writing
this book. But there are other practical implications that one might
visualize.
2. The recognition that the world is already greatly overpopulated by
our species, coupled with the acceptance that typical, psychologically
average people will not curtail their reproductive interests volun-
tarily, could lead (for instance) to an appropriate politically imple-
mented policy of increased taxation on families in proportion to the
number of their children (the very opposite of the prevailing tax
exemptions policy in the United States) or to differential taxation
so that taxes earmarked for the education and medical care of chil-
dren are paid only by families that actually have children—policies
that are clearly unlikely in the absence of crisis conditions. China,
of course, has applied a one-child policy, apparently with some suc-
cess, as well as with attendant problems; selective, directed taxation
might in time be more to America’s political taste. The looming
global problem of “simply too many people” has yet to be faced in
any intellectually honest and determined fashion. Once we establish
a new center of gravity for good mental health and stop enshrining
the norm of normality, we may be more willing to face the manifold
problems that are the consequences of excessive population.
3. The psychologically based analysis of higher education that I’ve
given leads directly to the need to elevate educational and discipli-
nary standards, the reinstituting of liberal arts and foreign language
requirements, and an intelligent, self-consciously undertaken public-
ity campaign that stresses the intellectual and cultural rewards of
higher education (and not the financial gains to be expected from a
vocational degree)—all of these accomplished within a framework
that acknowledges, respects, and encourages individual differences
among students in their levels of intelligence, sensibility, achieve-
ment, and other abilities. A corollary of these policies is the recogni-
tion that only a small percentage of students will excel in any given
area, and it is upon them that the future largely depends. Other pos-
itive and concrete policies relating to education would of course
include the permanent removal of sports from the province of higher
education and a distinction and separation between higher education
and career-oriented vocational training.
4. We recognize that the population of the psychologically normal com-
bined with that of the mediocre comprises a huge group of people
Appendix II 271

who are predisposed, under suitable circumstances, to think, feel, and

behave in well-established, predictable, destructive patterns. This rec-
ognition could lead to a deliberate program to encourage benign and
productive dispositions in their place. Here, specifically designed
education, political, social, and judicial policies are fundamental, as
is a fundamentally new approach to the theory and practice of clinical
psychology and psychiatry, as already mentioned.

I’ve given the above concrete examples not only to expand upon the few
mentioned in the text. They serve perhaps a more important function.
From a psychological standpoint, the reader’s reaction to such examples
can be enlightening, for he or she will immediately recognize that some,
perhaps all, may arouse such dismissive emotions as amusement, scorn,
mockery, or outright condemnation. If the reader will take note of his or
her reaction, and if it should be of this kind, it may well be symptomatic
of the very internal psychological limitations explored in this work. The
above list of examples runs afoul of popularity, that is, it runs counter to
or is abrasive to views supported by psychological normality. Such a list can
therefore act as a challenge, and therefore literally as an informative
affront, to norms that we take for granted. In reading such a list, a negative
reaction is very likely a symptom that habitual values have been scratched,
causing a tell-tale emotional itch. It is a reaction to which we need to pay
reflective attention and not simply scratch and then dismiss what we do
not like to believe, as we so often are prone to do.
This page intentionally left blank
 APPENDIX III

The Distribution of Mental Health

A book that critiques the standard of normality would be incomplete

without some mention of the “normal” distribution curve—the so-called
bell curve brought to public awareness by Richard J. Hernnstein’s and
Charles Murray’s book of that title, which examined the distribution of
intelligence. The normal curve is the quintessential expression of the idea
of normality: it presents in graphic form what we mean by average, by a
statistical mean, and it shows how the average tapers off into extremes
the more distant one gets from the mean. The bell curve for IQ, for exam-
ple, makes clear that the intelligence of the human majority is centered
around a mean IQ of about 100, and that, symmetrically, IQ drops off to
the left of that mean, and to the right it rises.
In the past century, human intelligence has been studied in great detail,
and numerous tests have been designed to measure it. In comparison, as
earlier chapters have shown, positive mental health suffers from lack of
precise definition, while definitions of mental disorders have largely been
unscientific and highly unstable.
As we’ve seen, mental health, like intelligence, is a multifaceted thing,
consisting of a varied group of individual abilities or skills, sensitivities
or sensibilities, attitudes or values, and predispositions to think, feel, and
behave. But unlike intelligence, psychometrists have yet to devise a quan-
titative measure to rank a person’s “mental health quotient” (we might call
it MHQ) as IQ does with respect to cognitive ability. As this book has
argued, genuinely good mental health—in other words, a high MHQ—
is not normal, and its distribution in the general population is extremely
skewed, as the charts that follow show.
We’re accustomed to referring to “positive mental health,” but not
explicitly to “negative mental health” (although we sometimes speak of a
person’s “poor mental health”). It can be an aid to clarity for us to think in
274 Appendix III

Figure AIII.1
Estimated Distribution of Mental Health in the Population

terms of these two polar opposites (Figure AIII.1). Doing this allows us to
represent graphically how mental health, understood in terms of the criteria
described in this book, is plausibly distributed in the general population. As
a suggestive approximation at this early stage before we can quantify
MHQ meaningfully, the two charts above depict curves that show the
estimated distribution of mental health in the general population. You will
immedi-ately see that although the estimated distribution of mental health
is repre-sented in the form of a normal bell-shaped curve, the
distribution of positive mental health is confined to the shaded right-
hand tail.
For readers unfamiliar with curves like the lower one, a few comments
are in order: The lower curve is called a cumulative distribution curve. In
relation to the upper bell curve, the lower curve allows us to read off the
percentage of the total population that corresponds to any point on the
bell curve. For example, the solid vertical line that splits the bell curve
symmetrically in two marks the zero standard deviation point, which in
Appendix III 275

both charts represents the mean level of mental health in the total popula-
tion. The point where this vertical line intersects the lower S-shaped
cumulative distribution curve allows us to read off from the left-hand
vertical axis of the lower graph that half (.5, or 50%) of the population is
at that level of mental health.
Below the horizontal axis of the bell curve is a range of italicized num-
bers, from 12 to +5, representing arbitrarily chosen equal divisions
above and below zero. These numbers are not intended to have special
significance, but serve only to divide up a range. What is significant, how-
ever, is the zero point through which the dotted vertical line has been
drawn. It marks the point, somewhere between 1 and 2 standard devia-
tions above the general population’s mean, at which an individual’s level
of mental health is judged to be comparatively neutral, that is, whose men-
tal health is balanced between characteristics that define negative and pos-
itive psychological health. (Someone who is one standard deviation above
the mean is at the 84th percentile; if two standard deviations above the
mean, the individual is at the 98th percentile; if three standard deviations
above the mean, the person is in the top thousandth of the population.)
The zero point through which the vertical dotted line is drawn has not
been chosen arbitrarily. We have a considerable amount of observational
and clinical data that supports a dividing line between positive and nega-
tive mental health at that point, between 1 and 2 standard deviations
above the mean level of mental health of the total population. Here in
an appendix I can only mention some of the sources the charts rely on.
There is strong evidence for the size of both the white and the shaded
sides of the top curve. For the size of the shaded righthand side, for exam-
ple, as quoted in an earlier chapter, Abraham Maslow (1971, p. 92) found
that only 1 percent or less of the population has what the upper chart rep-
resents as a high level of positive mental health. Lewis Fry Richardson’s
quantitative, psychologically focused studies of the statistics of war found,
as one indication of what I’ve called “moral intelligence,” that fewer than
1 percent of men called to military service in World War I refused on the
basis of conscience (Richardson, 1948, I, p. 151; see also Richardson,
1960a, 1960b, and Ashford et al., 1993). Similarly, historian Eric A.
Johnson (1999, p. 261) found that only about half of 1 percent of Germans
were willing to participate in any kind of resistance against the Nazi
regime. (For a fuller discussion of morally intelligent groups see Bartlett,
2005, p. 182). In earlier chapters we found similarly small minorities when-
ever we looked for fully developed moral intelligence, aesthetic sensibility,
commitment to higher values, and behavior consistent with these. But in
case the restricted size of these rough estimates may be unduly pessimistic,
the percentage of the population in the chart that represents people with
276 Appendix III

high degrees of mental health has been increased severalfold to err on the
side of generosity: but whether 1, 2, or 3 percent, or twice that, the group
remains a small minority.
There is considerably more evidence for the size of the normal majority
population that falls in the negative, unshaded, lefthand region of the upper
chart: there are, for the dispassionate mind, the convincing conclusions to
be drawn from human history, from Milgram’s (1974) and Zimbardo’s
(2007) studies, from the combined incidence of crime and violent psychotic
behavior, and from the evidence of the many normal pathologies of internal
limitation discussed in this book and in Bartlett (2005).
The vertical dotted line intersects the lower cumulative distribution
curve somewhere between the 94th and the 97th percentiles, as shown
by the horizontal shaded band. In other words, 94 to 97 percent of the
total population is represented by the white, unshaded area under the bell
curve, while only 3 to 6 percent of the population can be characterized,
applying the criteria of this book, as possessing genuinely positive levels
of mental health. These people are represented by the shaded portion
under the righthand tail of the bell curve.
This understanding of the distribution of positive versus negative men-
tal health may appear pessimistic, but it is important to realize that 3 to
6 percent of the world’s present population includes 210 to 420 million
people with genuinely positive levels of mental health, while in the United
States alone there are an estimated 9 to 18 million. Although not common
and not normal, positive levels of mental health are to be found in a great
many people.
At this stage when we have few ways to measure positive mental health
it would be idle to become bogged down in concern over precise percent-
ages. The two charts together place in relief the generally low—that is,
negative—level of “normal mental health” of the overall population, in
contrast to the relative rarity of genuinely positive mental health in the
much smaller population, those who are the exceptions to the rule. If a
picture is worth many words, the picture we see underscores the need to
question the dictum that to be normal is to have good mental health.
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 Index

Abelson, Raziel, 32 Adler, Alfred, 65, 90

abnormal psychology, 9, 14, 84 defining mental health without
abnormality, 249 standard of normality, 22
definition, 19, 233 problems of living, 22
as deviation from normality, 9, advantageous psychiatric disorders,
233. See also Normality, 73–74
deviations from as mental aesthetics, experimental (Eysenck),
disorder; Mental illness, as 200–201
deviation from normality AIDS syndrome definitions, 60
search for in criminals, 14 Albert, Tim, 173
academic freedom, 157–59 alcoholism, 40
conflict with peer review, 158 Álvarez González, Francisco,
acedia, 80–81, 89–101, 120, 127, 190–91, 196
136–39, 141–42, 179, 226, American Rheumatism Association,
235–36, 244–45, 249, 253, definition of rheumatoid
255–57 arthritis, 60
as disability, 94–95, 97, 137 animal rights, psychological
and mediocrity, 83, 94–95, 97 limitations that block, 179
and narcissism, 97 anti-elitism, 97, 109, 118, 122, 141,
opposition to higher values, 198, 208, 256–57. See Higher
education, anti-elitism in
96–97
anti-intellectualism, 80, 97, 111, 195,
symptoms, 95–97
197, 256–57
three-valued understanding of, 93
Aquaviva, Claudius, 152, 171, 174
adaptation, as clinical goal, 99, 132,
Aquinas, Thomas, 95
140, 265. See also
filiae acediae, 95–96
Self-adaptation
Arendt, Hannah, 6–7, 12, 81
adjustment disorder, 86 n.4,
Areopagitica (Milton), 157
97, 99, 101, 138. See also
aretē, 24, 204
Liberal arts faculty, burnout
among
concept of in good health, 24.
294 Index

See also Excellence, concept Boas, George, 109

of in good mental health Bolton, Derek, 32
Aristotle, 38, 58 Bond, Nigel W., 166
Aronson, Elliot, 86 n.3, 129, 131, 141 Borges, Jorge Luis, 258, 261–62
arrhostia, 215, 231 n.10 Bowlby, John, 132
artists, psychology of. See Creative Brahe, Tycho, 197
individuals Brentano, Franz, 91
Ashburn, James R., 167, 173 British Star Chamber, 157
Astronomia Nova (Kepler), 154 Broussias, François-Joseph-Victor, 49
attention deficit hyperactivity disorder Brown, G. W., 132
(ADHD), 40, 58, 96, 121 Bruno, Giordano, 152, 154
and acedia, 96 Bryron, George Gordon, 83
attorneys, distress over decline of Bucknill, J. C., 98–99, 181
profession, 228 Burckhardt, Jacob, 232 n.12
authority, resistance to, 12–13 Burrow, Trigant, 81
autism, 40, 59 Burt, Cyril Lodowic, 195, 230 n.6
autonomous person (Fromm), 25, 219 Burton, Sir Richard, 266
axiological demoralization, 140. See
Liberal arts faculty, burnout caffeine intoxication, 40
among Camacho Naranjo, Luis, 190–91, 197
axis mundi (Eliade), 140 Campanario, Juan Miguel, 176 n.1
Camus, Albert, 127
banality of evil (Arendt), 6–7, Cannan, Crescy, 233
12–14, 81 career burnout, 79, 93, 118, 128.
as inability to think, 7 See also Liberal arts faculty,
and unquestioned acceptance of burnout among
the standard of normality, 12 contributing work environment,
Barbard, Henry, 108 130–31
barbarity, 119–120, 235–36, 244–46, individual adjustment focus,
249, 253, 257. See also Higher 132, 138
education, barbarism and need for meaning, 129
belief symptoms, 129–30
ideological preferences, xviii Carnegie Foundation for the
pathologies, 151 Advancement of Teaching, 111
psychology, xvii–xviii, 124, 151 Cartwright, Samuel
what we prefer to think, xvii, 124, drapetomania, 41
160, 242, 257 dysæsthesia æthiopsis, 41
belief system psychosis, 161 category mistake (Ryle), 91
belief systems, xviii causality, 68 n.5, 121
Bennett, Bill, 106 censorship, 156–57, 173. See also
Beutler, Larry E., 47–49 Prepublication restraint; see
Bierce, Ambrose, definition of also Sedition; Treason
abnormality, 19 self-censorship and political
Birth of Tragedy, The (Nietzsche), 125 correctness, 156
Bisch, Louis E., 19–20, Centers for Disease Control, 60
233, 236 cheapening of authorship, 163
Bloom, Allan, 102, 136 Chevalier, Michael, 107
Index 295

Chomsky, Noam, 58 incidence, 72

Churchill, Winston, 166 resistance to treatment, 70, 72
Cioran, E. M., 198 as response to pathologies of
civilization, decline of, 232 n.12 normality, 70, 81, 226–30
clinical psychology, conceptual traditional treatment
confusion of, 32 approach, 72
cognitive science, xix sensitivities tied to skills, 77
cognitive therapy (Ellis), 90 struggle against normality, 82–84,
comorbidity, 46 89, 265
compassion, Buddhist and Yoga, 21
their experience qualitatively
conceptual commitments, 49
different, 76–77
conceptual pathology (Bartlett), 38,
creative sensibility, 77
57, 178. See also Projective
creativity, psychology of, 70–86.
misconstructions
See also Inner turmoil thesis
conduct disorders, 40
(Bartlett)
conformity, xviii, 116
advantageous psychiatric
Confucius, 201, 231
disorders, 73
Congregation for the Doctrine of the
Faith, 155 inappropriateness of DSM
Congreve, William, 185 classifications, 84–85, 89
conscientious objectors situational thesis (Bartlett), 73,
moral development, 20 76–79, 89
psychology, 20 cultural elitism, 112
constellations, as sets of symptoms, cultural relativism, 97, 258
47–48, 62. See also Syndromes culture, 94, 106, 108, 112, 118–19,
socially constructed, 48 122, 127–28, 133, 137
conventional thinking, xvii–xix, 256 original meaning, 80
Cooper, Rachel, 58 resistance to, 198, 257
Copernicus, Nicolaus, 152–54, 163, Culture of Narcissism, The (Lasch), 256
225, 229
creative individuals Danto, Arthur, 259, 260–61
clinical dilemma in treating, 70 Dark Age, conditions encouraging a
constitutional predisposition of, new, 122, 225–26, 256–57
Dark Ages: The Case for a Science of
73, 84
Human Behavior (McIntyre),
creative sensibility of, 77
225, 256
extremes of mood, 70, 72, 73, 82
Darwin, Charles, 197
intrinsically meaningful goals, 77
Davidson, William, L., 33
level of mental health, 74 De corpore politico (Hobbes), 185
maladaptation, 83–84, 265 de Gobineau, Arthur, 232 n.12
phenomenological understanding De revolutionibus orbium coelestium
of, 82 (Copernicus), 153
plight, 77–79, 259 de Staël, Germaine, 83
psychological difficulties de Tocqueville, Alexis, 104
differential clinical treatment decline of civilization,
required, 85 232 n.12
of famous creative people, 75 deconstructionism, 168
296 Index

definition. See also Psychology, of disease

definition denial of relativism in recognition
coordinative, 36 of, 76
of disease as value-based, 43, 182 distribution, 225
kinds, 33, 34 incidence, 225
lexical, 36, 43, 192 medical definition, 45
medical, 44 medical model, 45
nominal, 35 prevalence, 225
persuasive (Robinson), 41 disease entities, 35, 39, 46, 49, 53, 58,
real, 35, 38–39, 41, 61, 65, 117, 239. See also
186, 192 Reification; Projective
genuine vs. deceptive, 40 misconstructions
history of, 38 focus of treatment on, 64
role and nature, 33 disease, general theory, 74–76, 169
stipulative, 35–37, 40, 43 Doctor Faustus (Goethe), 116
as legislative, 36 doctrine of specific etiology (Dubos),
as rules of usage, 36 68 n.5
surveillance, 60–61 drapetomania (Cartwright), 41
to serve authoritative DSM diagnostic classifications
persuasion, 36 history of revisions, 34
definition of mental disorders, iatrogenic effects, 28, 247–48,
psychology of. See Psychology, 250 n.6
of definition of mental recent reclassifications, 40
disorders shame and stigmatization, 28, 248
depression, 40, 47, 55, 74, 80, 90–91, DuBois-Reymond, Emil, 69 n.8
101, 127, 131–32, 140 Dubos, René, 68 n.5
adaptive, 132 dysæsthesia æthiopsis (Cartwright), 41
Adler’s understanding, 91 Dyson, Freeman, 147, 162
Ellis’s understanding, 91 eating disorders, 40
Frankl’s understanding, 91 economic scarcity, principle of
as justifiable emotion, 79 applied to psychology, 254
Kelly’s understanding, 91 economics of human emotion, 254
negatively defined by editorial bias, psychology of. See Peer
Scholastics, 91 review and editorial bias,
in phenomenological psychology of
psychiatry, 91 egalitarianism, 105–6, 118, 141,
situational, 78, 80, 131, 137, 141 193, 197
situational entrapment, 138 myth of, 104–5, 122–123
as undesirable maladjustment, Ehrlich, Paul, 30 n.1
100–101 Eibl-Eibesfeldt, Irenäus, 11, 82
work-engendered. See Work- Eichmann in Jerusalem (Arendt), 6–7
engendered depression Einstein, Albert, 38, 197, 224, 262
Dewey, John, 105 Eissler, K. R., 15–16
diagnosis, reliability of, 37 psychopathology of normality,
diagnostic filtering, 48–49, 62, 64 15. See also Pathologies of
diagnostic haze, 46, 63 normality
Index 297

Eliade, Mircea, 140, 143 n.2 fallacy of misplaced concreteness

elitism, 104, 110, 112, 122–23, 135, (Whitehead), 38, 64, 91
141, 219, 243 falsifiability, as criterion of scientific
in psychiatric diagnosis, 85 truth, 57, 59
Ellis, Albert, 90 Farther Reaches of Human Nature, The
emotional intelligence (Gardner, (Maslow), 218
Goleman, Mayer, Salovey), 26 feminism, 168
Endless Multiplication of Syndromes Feynman, Robert, 106
Syndrome (EMSS) (Bartlett), Flegr, Jaroslav, 160
48, 51–52, 67 Frankl, Viktor, 90–91, 139
Ensayo sobre la mediocridad (“Essay on French National Assembly, 157
Mediocrity”) (Camacho Freshmen Voices: Student Manners and
Naranjo), 190–91 Morals (Stanford students), 114
Enserink, Martin, 166 Freud, Sigmund, 11, 82
epistemology, xix on narcissism, 114–15
equality of opportunity, confusion Fromm, Erich, 9, 11, 82, 219, 233
with egalitarianism, 106 autonomous person, 25, 219
Erickson, Milton, pathologies of fully functioning person (Rogers),
normality, 9, 15. See also 219–20
Pathologies of normality
Essai sur l’inégalité des races humaines Galen (of Pergamum), 193
(de Gobineau), 232 Galileo (Galilei), 152–56, 225
ethicists, distress over decline of Galton, Francis, 192–93, 197, 211–12,
profession, 229 217, 225
ethnocentrism, 235 Gandhi, Mohandas Karamchand, 185
etiological explanation, 50 Garcı́a Morente, Manuel, 190
etiology, 35, 44, 47, 50–51, 53, Gauss, Carl Friedrich, 229
58, 60–61, 63, 65–67, Glass, Philip, 260–61
68 n.5, 263 Goleman, Daniel, xvii
evil of banality (Bartlett), 8, 11, Gore, Al, 18
13–14, 81 Gould, S. J., 215
excellence, concept of in good mental Greenberg, Daniel S., 159, 166
health, 26, 216–20. See also Guilford, J. P., 25, 194
Aretē multidimensional understanding
Eysenck, H. J. and M. W., 183 of intelligence, 25
Eysenck, Hans, 186, 191, 194, 200,
225, 229 Hardin, Garrett, 43
Harlow, Harry and Margaret, 225
factitious entities (entités factices) harm. See also Pathology, understood
(Broussias), 49 as causing harm
factor analysis, 193–95 understood contextually, 76
practical disadvantages, 194–95, Harrington, Sir Richard, 185
223–24, 230–1 n.6 Harris, T., 132
faculty burnout. See also Liberal arts Harvey, William, 197
faculty, burnout among Helmholtz, Hermann, 69 n.8, 197
faculty psychology, 58 Henderson, Isabella, 231 n.10
Fadiman, Clifton, 27 Henle, Friedrich Gustav Jacob, 69 n.8
298 Index

Hereditary Genius (Galton), 212 Hooke, Robert, 163

Hergescheimer, Joseph, 82 hope, 266. See also Optimism
Herrnstein, Richard J., 225, 230 n.5, Hopkins, Harry, 109
231 n.10, 232 n.12 Horrobin, D. F., 167
Hesse, Hermann, 78, 83, 133, 210, Horwitz, Allan V., 54, 66, 67 n.1
262 Hueppe, Ferdinand, 40
life credo, 78, 133, 210 human species
heterogeneity of symptoms, 46 destructive dispositions, 5, 7–8
higher education dysgenic tendency, 225
aim of, 80, 94, 263 ecological destructiveness, 9, 18,
anti-elitism, 109, 118, 122 81, 169
barbarism, 103, 107, 119–20 narcissism, 242
conformity, 116 population explosion, 17–18, 30
culture and leisure for the few, n.1, 176 n.3, 204
104 psychological characteristics, 4–6
decline, 102–27, 136 Husserl, Edmund, 220
self-reinforcing dynamic Hutchins, Robert, 125–26, 262, 265
of, 110 Huxley, Aldous, 140
disappearance of reverence, 109,
112, 118, 122 iconoclasm, xxi
dissociation from culture, ideology, 148, 167, 201, 216, 225,
234, 254
108–9, 112
idiopathic disease, 53–54
and higher values, 94, 104, 118
idiopathic syndromes, 53–54, 65–66
history, 107–12
imprimatur, 155
intrinsic value, 103 Inchofer, Melchior, 155
leniency, 113–14, 121 Index Librorum Prohibitorum, 155
mediocrity, 119–23 individual accountability, rejection of,
narcissism, 103, 107, 113–19 121–23
natural elitism, 104, 112, 122–23 individual differences, 85, 105, 134,
normality the central concern of, 183, 188, 191–93, 246, 263
102, 105, 108, 123 opposition to, 95, 105, 121, 193,
open admissions policy, 111 211–13, 257
psychology of, 113–19 individual psychology (Adler), 90
rejection of authority, 113 individuated person (Jung), 25, 220
role of egalitarianism, 104–6, 120 inflationary ontology in nosology, 49,
role of GI Bill, 110 51, 247
shift to vocational education, 102, Ingenieros, José, 187–91, 196, 200,
108, 112 207–8, 210, 212–13, 216
Hirsch, Eric Donald, 100 inner turmoil thesis (Bartlett), 72–75
Holy Office, 155 Inquisition, 155
El hombre mediocre (“Mediocre Man”) intelligence, 238–39
(Ingenieros), 187–90, 210 distribution, 224, 273
L’Homme stupide (“Idiot Man or The emotional, 26
Follies of Mankind”) (Richet), moral, 26
198 psychology of, 24–26
homosexuality, 40, 54 social, 25–26
Index 299

intermittent explosive disorder, 40 lesions of the intellect (Bucknill and

internal limitations Tuke), 98
of formal systems, 179–80 Lewontin, R. C., 215
of human psychology, 178–82, liberal arts, 127–43
189–90, 235, 243–49, 253–66 distinguished from servile arts,
as result of psychiatric labeling, 134
248 liberal arts demoralization. See Liberal
International Classification of Diseases arts faculty, burnout among;
(ICD-10), 51 Psychology, of university
liberal arts faculty
James, William, 3, 183, 220 liberal arts faculty, burnout among,
Jamison, Kay Redfield, 71–73 127–43
Jayasinghe, Upali W., 166 elitism of, 135
Jefferson, Thomas, 185 individual adjustment therapies,
Jendrassik, Eugen, 45 destructive effect of, 131,
Jensen, Arthur, 212, 215, 225, 230 n.5 138, 140
Johnson, Eric A., 275 recognition of higher values, 135
Jung, Carl, 11, 82, 199, 214, 242 repudiation of egalitarian
individuated person, 25 principles, 135
as response to pathologies of
Kant, Immanuel, 244 normality, 136–41, 226–27
Kasidah of Haji Abdu, The situational depression,
(Burton), 266 137–38, 141
Kelly, George A., 65, 90, 139 treatment, 141–42
Kepler, Johannes, 153–54 Licensing Act of 1662 (England), 157
Kernberg, Otto, 115 life events research, 132
Kihlstrom, John F., 51, 58–59 Les Limitations internes des formalismes
Kirk, Russell, 107, 116 (Ladrière), 230 n.1
kleptomania, 40 linguistic relativity hypothesis, 260
Klinger, E., 132 Lister, Sir Joseph, 197
Knight, R. L., 231 Lobachevsky, Nikolay
Kohut, Heinz, 113, 115 Ivanovich, 229
Kraepelin, Emil, 51–52, 61 logotherapy (Frankl), 90
Lorenz, Konrad, 11, 82, 190,
Ladrière, Jean, 230 n.1 217, 219
Laënnec, René-Théophile-Hyacinth, 39 Lucifer effect (Zimbardo), 161, 167
Lafferty, Kevin D., 160, 176 n.2 Ludwig, A. M., 74
Laing, R. D., 65, 244
Landau, Jacob, 83 Maddi, Salvador, 115
lanthanic disease, 63, 260 Mahoney, M. J., 197
Lasch, Christopher, 119, 256 Malik, Mary L., 47–49
Lawrence, T. E., 76 Man in the Mirror of the Book, The
learning disorders, 40 (Woodall), 258
leisure, 80, 92–95, 100, 137 Mann, Horace, 108
distinct from idleness or laziness, Mann, Thomas, 127
93, 100 Marsh, Herbert W., 166
and higher values, 94 Maslow, Abraham, 65, 190, 217–19,
300 Index

221, 227–28, 231, 233, 237, intellectual mediocrity, 195–98,

240, 245, 249, 275 257
self-actualization, 20 linguistic mediocrity, 205–6
self-actualizing person, 25 major defining traits, 195–209,
superior people, 25 231 n.8
masochistic personality disorder, 40 mediocrity of conduct, 203
materialism, 121 mediocrity of values, 209
in democracy, 104 mediocrity of way of living, 206–7
mathematics disorder, 40 moral mediocrity, 207–8
May, Rollo, 65 as normality, 192–93
Mayman, Martin, 34, 61 one-dimensionality, 211, 227
McIntyre, Lee, 225, 256 as pathology, 183, 188, 213–14,
medicine, morality of, 183, 240 224, 226, 230
mediocrity, 119–23, 235 effect upon exceptional people,
as form of human internal 226–30
limitation, 181. See also physical mediocrity, 204–5
Internal limitations of human positive purpose of study of, 220
psychology social mediocrity, 203–4
mediocrity, psychology of, 120, undeveloped personality, 189,
178–232, 236, 244–45, 200, 208–11
248–49, 254–57, 263 Melville, Herman, 74
aesthetic mediocrity, 200–202 Mendel, Gregor, 197
anti-elitism of, 198, 208 Menninger, Karl, 9, 11, 34,
conformity, 203, 208–9 61, 67, 82
contagious nature of, 189, 224–26 mental disorders
deficiency of imagination, assumed nature of in DSM, 54
190–1, 196 blind faith in postulating, 65
distribution, 224–26 as coordinative rules, 35
educational mediocrity, 197 defined by ballot, 64, 70, 240–41,
emotional mediocrity, 198–200 250 n.4
epidemic of mediocrity, 213–15 definitions, 35
and equation of mental health distinct from that of physical
with normality, 182 disease, 44
factor analysis, 193–95 group delusion involved in, 42
financial mediocrity, 202–3 in DSM, 46, 55
functional utility, 236 in ICD, 68 n.6
historical and lexical background, failure to satisfy medical model,
183–86 45, 54, 59
as impoverished personality, 188. as free-floating stipulated
See also Mediocrity, syndromes, 50–53, 61
psychology of: undeveloped harmful dysfunction definition
personality of, 55
as incapacity for ideals, 188, 196 as historically primitive level of
incapacity to discriminate, 201, diagnosis, 50, 63
210, 258 idiopathic nature, 53, 65
Index 301

lack of organic basis, 51–52, 57, more than absence of mental

61–63, 238 illness, 26
not falsifiable, 57, 62 more than normality, 26. See
only legislated, 56 also Psychological
and problems of living, 66. See also normality
Problems of living as optimal functioning, 24, 27,
reification of. See Reification; 249–50
Projective misconstructions two promising approaches,
stipulative definition, 42–43 22–26, 237–40, 246–47
symptom-based nature, 45, 51, and individual variation, 27
58–59, 61, 63 open conception of, 27–28
resulting problems, 46 as optimal functioning, 29
as syndromes, 45 positive vs. negative, 273–76
tautological nature of diagnosis, traditional concept of, 10, 23–24
56–59, 62 mental health quotient (MHQ)
mental health (Bartlett), 273–74
as conformity, 13 mental health theory, promising
as excellence in functioning, 29 directions for development, 20,
as exception to the rule, 27–29 28, 246–47
equation with psychological mental illness. See also Mental
normality. See Psychological disorders
normality, equation with concept of
good mental health only legislated, 53
cause of dysfunction among as result of dysfunctional
creative people, 28 thought, 51–52, 56
good as deviation from normality, xi, 3,
consciousness of higher levels 5, 9, 10–11, 13–14, 22–23,
of reality, 203, 207, 210–11, 71–72, 234, 239
216 involuntary sterilization in U.S.,
criteria, 29, 216–20 72, 75
defined in phenomenological labeling during Holocaust, 72, 75
psychiatry, 21–23 as myth (Szasz), 51–53, 66
defined in terms of special stigma of, 5, 20, 28, 33, 247–48,
groups, 20–23, 29, 216–20, 269
237–38, 240 Menuhin, Yehudi, and Diana Gould,
defined without standard of 202
psychological normality, Method of Grace (Flavell), 185
Milgram, Stanley, 276
22–28, 65, 71, 139, 237–40,
Milgram’s obedience experiment, 12.
246–47, 263
See also Obedience to
distribution, 219, 231–32 n.11,
authority; Obedience
250 n.1, 273–276 experiments
as excellence in functioning, Miller, Arthur G., normality thesis,
24–27, 246–47, 249–50 16. See also Pathologies of
locus of, 71 normality
main factors, 29 Milton, John, 157, 175
302 Index

misanthropy, 242 as statistical average, 27

Montaigne, Michel de, 188, 212 normality thesis (Miller), 16
mood disorders, ICD remarks on, 60 Normality: Theoretical and Clinical
moral deficiencies (Bucknill and Concepts of Mental Health (Offer
Tuke), 98 and Sabshin), 15
moral intelligence (Bartlett), 26, 29, nosology, psychiatric, 31–69
208, 240, 275 application of Sapir-Whorf
moral treatment, 98 hypothesis, 64
multiculturalism, 97, 141, 159, 168, arbitrariness, 63
256, 258 by ballot, 64, 240–41, 250 n.4
Munch, Edvard, 73 clinical approaches that
Murphy, Edmond A., 32 eschew, 65
Murray, Charles, 225, 230 n.5, 231 conceptual confusions, 68 n.1
n.10, 232 n.12 deficiencies in current, 63, 66, 260
history, 34–35, 37
narcissism, 90, 97, 101 n.4, 103,
psychological propensities, 61–63
113–19, 121–23, 203
purposes, 35
explanatory hypotheses, 115
unscientific nature, 62
Nashe, Thomas, 185
National Defense Education Act, 110
obedience experiments, 16, 250 n.1.
National Education Association, 108
See also Milgram, Stanley;
Nazi leaders, psychology of, 7
Obedience to authority
Negritude (Rush), 41, 54
obedience to authority, 8, 12, 81, 84,
Nehru, Jawaharlal, 185
167, 169, 222, 250 n.1
Nesse, Randolph M., 132
Occam’s Razor, 67
neuroticism, its potentially affirmative
Offer, Daniel, 16
traits (Bisch), 19
Oppenheimer, Robert, 147
Newman, John Henry, 136
optimism, 17, 125, 264–65
Newton, Isaac, 67, 153, 163, 197
Nicholls, Robert D., 173 delusional, 17–18
Nietzsche, Friedrich, 125, 199, 207, pathology of hope, 265
216, 219, 232 n.12, 242, 265 Ordinary Men (Browning), 7
nightmare disorder, 40 organic disease, 44
noögenic neurosis (Frankl), 139 Ortega y Gasset, José, 190
normality. See Pathologies of Osiander, Andreas, 153
normality; Psychological
normality Pasteur, Louis, 197
definitions of, 10–11 pathological gambling, 40
deviations from as mental pathologies of belief, 151, 166, 174
disorder, 10–11. See also pathologies of normality, 6, 9, 23,
Abnormality, as deviation 70–71, 79, 81, 83–84, 169, 175,
from normality; Mental 178, 215, 220–22, 234–36, 239,
illness, as deviation from 242, 249, 253–55, 265, 276. See
normality also Internal limitations of
as distinct from normative and human psychology
normativity, 11, 30 n.4 Bisch, Louis E., 19, 20
elevation to role of standard, 105 Burrow, Trigant, 81
Index 303

characteristics of, 8, 9, 222–23 perileuteal phase dysphoric disorder

Eissler, K. R., 15 (PMS), 40
Erickson, Milton, 15 personal construct theory (Kelly), 90
Miller, Arthur G., 16 Personal Orientation Inventory (POI)
Offer, Daniel, and Sabshin, (Shostrom), 219
Melvin, 15 pessimism, 264, 266
and positive illusion, 16 phenomenological psychiatry
provoking situations, 11 (van den Berg), 21–22, 71,
purposes in recognizing, 18–19, 91, 237
philosophy of science, xix
258, 262–64
physical health, definition of, 24
resistance to, 16
Pieper, Josef, 92, 101 n.3, 136
pathology, 238–40
Pines, Ayala, 86 n.3, 129, 131, 141
conceptual, 239. See also
Pitkin, Walter B., 205, 220
Conceptual pathology
Planck, Max, 197
conditions for judging, 239 Plato, 211, 262
framework relativity of, 76, allegory of the cave, 258–61
182, 239 Plutarch, 188, 212
medical paradigm, 31, 61 political correctness, 158, 225, 243
multifactorial nature, 68 n.5 polymorphisms, 215
psychiatric, 31 Pope Alexander VI, 153
psychological meaning, 238–40 Pope Clement VIII, 154
reserving the term for positive illusion, 16
abnormality, 9 essential to being psychologically
resistance to awareness of normal, 16
human, 9 as harmful, 17, 125
science of, 8 and human population
understood as causing harm, 14, explosion, 18. See also Human
19, 76, 85 n.1, 117, 168–69, species, population explosion
239–40, 242, 244, 248 importance to homocentric bias, 18
universal, 81, 169 and mental health, 17
Pathology of Man, The (Bartlett), 8, 75, types, 17
81, 239 positive psychology, 216–20. See also
Peck, M. Scott, 9, 11, 82 Excellence, concept of in good
peer review and editorial bias mental health; Mental health,
abuses, 160–7, 256 good: as excellence in
belief system psychosis, 161 functioning
code of conduct, 172–73 recognition of higher
complaints concerning, 148–50 standards, 221
intellectual mediocrity, 197 postmodernism, 168
psychology of, 147–77 posttraumatic stress disorder, 40
psychology of stupidity, 164–65 prepublication restraint, 151–77, 256
psychopathologies involved in, prior restraint (in law), 156
167–70 presuppositional concepts, xviii
standard of psychological principe vital (Laënnec), 39
normality in, 151, 157, 175 prison experiment (Zimbardo), 12
304 Index

problems of living, 66, 79 justification for rejecting as a

highly individualized, 66 standard, 27, 29, 220–24,
need for palliative approach, 67 234–36, 254
reification of, 91 need to challenge as a standard,
Proffitt, Dennis, 178 13, 180
projective misconstructions not free of pathology (Offer and
(Bartlett), 39, 42, 66, 239, 244, Sabshin), 15. See also
264. See also Conceptual Pathologies of normality
pathology as pathological, 12, 222, 236, 242,
psychologically normal 257, 261. See also Pathologies
propensity, 67 of normality
vestige of animism, 245 as statistical average, 5, 9, 10
projective thinking, 62, 223, 235–36, traditional conception, 27
238, 244–45, 249, 254–55, 270. understanding mental health
See also Projective without this standard, 19–20,
misconstructions
23–24, 237–40, 247
delusional nature. See Projective
as unexamined presupposition, 3,
misconstructions;
13, 248
Conceptual pathology psychological primitiveness, 244–47
Proust, Marcel, 77, 216 psychology
Pruyser, Paul, 34, 61
of career burnout, 79. See also
pseudospeciation, 169, 235
Liberal arts faculty, burnout
psychiatry, conceptual confusion
among
of, 32
psychic epidemics, 213
of college students, 70–86, 102
psychological health. See Mental of definition, 54–56, 61–67, 264
health dysfunctional nature of, 41–42,
psychological normality. See also 66, 89
Normality of definition of mental disorders,
as both standard and norm, 30 31–69. See also under
definition of, 10, 233–34 Definition
as dysfunctional standard, 6, 29, main hypotheses concerning,
235–36, 244, 261, 265 32–33
promoting human of human ecological
destructiveness, 30, 255 destructiveness, 9
dispositional understanding of, 11 of mediocrity. See Mediocrity,
distribution, 235 psychology of
equation with good mental morality of, 183, 240
health, 16, 89, 100, of normality. See Psychological
233–36, 241–43, 247, normality; Normality;
249, 256–57, 264 Pathologies of normality
resistance to abandoning, of pattern recognition, 46–47,
241–44 50, 63
as gold standard of mental health, of peer review and editorial bias.
xxi, 9, 141, 151, 258 See Peer review and editorial
rejection of seen as elitism, 243 bias, psychology of
Index 305

of persuasion, 37 relativism, 141, 168, 256

reflexive or self-referential, refutation of, 231 n.7
xx–xxi, 253–66 Responsibility and Judgment (Arendt), 6
of symptom clustering, 63, 65. See El reto de la mediocridad (“The
also Psychology of pattern Challenge of Mediocrity”)
recognition; Endless (Álvarez González), 190
Multiplication of Syndromes Return of the Native (Hardy), 185
Syndrome (EMSS) Richardson, Lewis Fry, 11, 82,
unexamined assumptions, xx, 3 275
of university liberal arts faculty, Richet, Charles, 198
Robinson, Richard, 33, 41, 68 n.3
127–43. See also Career
Rogers, Carl, 65, 219, 233, 237
burnout
fully functioning person, 25
psychometric tests
Romanes Principle, 234, 250 n.1
for propensity to harm,
Romanes, George, 77, 85 n.2,
nonexistence of, 254
234, 243
of internal limitation, lack of, 255. Room of One’s Own, A (Woolf), 226
See also Internal limitations of Rosenbach, Ottomar, 69 n.8
human psychology Roy, Rustum, 167, 173
publishing, explosive growth of, Rush, Benjamin
176 n.3 definitions of sanity and
insanity, 13
Quest for the Nazi Personality (Zillmer
Negritude, 41, 54
et al.), 7
Ryle, Gilbert, 91
Radbert, St. Paschasius, 95
Sabshin, Melvin, 16
Rashevsky, Nicholas, 11, 82
Sacred Congregation of the Roman
real definition. See Definition, real
Inquisition, 155
reality consistency, 65
Santayana, George, 83
reality testing, 17
Sapir, Edward, 260
reflexivity, 126
Sartorius, Norman, 263–64
of internal limitations of human
Sartre, Jean-Paul, 199, 242
psychology, 180. See also Savonarola, Girolamo, 152–54
Internal limitations of human Scadding, J. G., ladder of taxonomic
psychology knowledge, 50
Reider, Norman, 247 Schadenfreude, 204
reification, 52, 63–66, 238–39. See also Scheff, Thomas, 71, 244
Fallacy of misplaced Scholastics, 80, 91–92, 95–97, 100,
concreteness 120, 136, 139
in ideologies and religions, 39 Schwann, Theodor, 69 n.8
of internal dysfunctions, 50, science, conceptual foundations
55–56, 58–59, 61–62, 65 of, xix
of internal dysfunctions by Sechrest, Lee, 38
neuroscience, 69 n.9 sedition, 156
in medicine, 39 self-adaptation, 238, 249, 264
in physics, 39 Shakespeare, William, 77
psychological shift to, 39 Shaw, George Bernard, 3, 240
306 Index

Short Introduction to the History of syndromes, 48

Human Stupidity, A (Pitkin), as constellations, 47–48, 62
220 no more than conceptual
sibling relational problem, 40 constructs, 69 n.7
Simmel, George, 220 choice of symptom sets. See
situational depression, 78–80, 131, Constellations
137, 141 definition, 45
social intelligence (Bruner, Eysenck, in DSM, 46
Taft, Tagiuri, Thorndike), function of vested interests, 48,
25–26 52, 62–63
Society, Manners, and Politics in the
with no known etiology, 66
United States (Chevalier), 107
as proper set, 46
Socrates, 152–53
Systematized Nomenclature of Medicine
Sorbonne, 157
(SNOMED), 44
Sorokin, Pitirim, 11, 82, 232 n.12
definition of physical disease, 44
spandrel, 215
Systematized Nomenclature of Pathology
Spearman, Charles E., 25, 195
(SNOP), 44
speech codes, 158
definition of physical disease, 44
Spengler, Oswald, 232 n.12
Szasz, Thomas, 14, 30 n.2, 65, 71, 91,
Spitzer, R. L., 51, 54, 101 n.1
100, 121, 244
Stationers’ Company, 157
Stempsey, William, E., 45, 59–60 mental illness as myth, 52
stipulative definition. See Definition,
stipulative Thales, 134
Strauss, Leo, 173 Thomson, Godfrey, 195
stupidity, psychology of, 164, 178, Thurstone, Louis Leon, 195
220–24, 230 n.3, 235–36, Tolkien, J. R. R., reality consistency, 42
244–45, 248, 255 Tolstoy, Leo, 64
characteristics, 223 Toxoplasma gondii, 160, 176 n.2
major predispositions, 164–65 Toynbee, Arnold, 232 n.12
as pathology, 223 treason, 156
Summary Treatise Concerning the tuberculosis, 50, 56
Motion or Rest of the Earth and Tuke, Daniel Hack, 98–99, 181
the Sun (Inchofer), 155 Turner, Joseph Mallord William, 77
“Superior Person, The” (Maslow),
217–18 universal pathologies. See Pathologies
superiority, 206, 216–20, 229–30 of normality; Pathology,
fear of in democracy, 105 universal
intellectual, 106
surveillance definitions, 60–61 van den Berg, J. H., 21–22, 65, 71,
symptom, 47, 68 n.4 91, 237
definition, 44, 48 defining mental health without
nonspecific, 47 standard of normality, 22
symptoms and signs, 68 n.2 Virchow, Rudolf, 69 n.8
syndrome multiplication. See Endless
Multiplication of Syndromes “Waiting for the Barbarians”
Syndrome (EMSS) (Glass), 260
Index 307

Wakefield, Jerome C., 54, 66, 67 n.1 work-engendered depression, 89–101,

Wells, H. G., 162 136. See also Acedia
Wenneras, Christine, 170 treatment, 100–101
White, E. B., 206 Wright, Quincy, 11, 82
Whitehead, Alred North, 38, 91 Wulff, Henrik, 50, 60
Whorf, Benjamin Lee, 260 divisions of disease, 50
Wile, Ira S., 192–93 symptom diagnoses as most
Wold, Agnes, 170 primitive, 50
Woodall, James, 258 Wunderlich, Carl Reinhold August,
Woolf, Virginia, 78–81, 226 49, 69 n.8
work ethic, 92. See also Acedia
work incapacity, illness of (Hadler), Zimbardo, Philip, 12,
250 n.6 161, 276
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 About the Author

STEVEN JAMES BARTLETT was born in Mexico City and educated

in Mexico, the United States, and France. He received his undergraduate
degree from Raymond College, an Oxford-style honors college of the
University of the Pacific; his master’s degree from the University of Cali-
fornia, Santa Barbara; his doctorate from the Université de Paris, where
his research was directed by Paul Ricoeur; and has done postdoctoral
study in clinical psychology. He has been the recipient of many honors,
awards, grants, scholarships, and fellowships. His research has been sup-
ported under contract or grant by the Alliance Française, the American
Association for the Advancement of Science, the Center for the Study of
Democratic Institutions, the Lilly Endowment, the Max-Planck-
Gesellschaft, the National Science Foundation, the RAND Corporation,
and others.
Bartlett brings to the present work an unusual background consisting
of training in pathology, psychology, and epistemology. He has published
15 books and monographs and many papers and research studies in the
fields of psychology, epistemology, and philosophy of science. He has
taught at Saint Louis University and the University of Florida and has
held research positions at the Max-Planck-Institut in Starnberg,
Germany, and at the Center for the Study of Democratic Institutions in
Santa Barbara. He is currently visiting scholar in psychology at Willamette
University and senior research professor at Oregon State University.