Malevolence and madness (conference day 1.5)

This is going to be a little bit like a work conversation, or one that I would like to have: it’s driven by the scripture and an anecdote. I was sitting in the opening ceremony of the conference and a colleague was describing a supervisee as malevolent: not just incompetent but actively evil and actively harassing.

So most psychiatrists believe in evil, because we see it, and differentiate it from madness. That was followed by a talk about neurophysiology, dopamine, the nucleus accumbans, pavlovian conditioning and how this all works in addiction. So we at times think of the brain — but we have to consider how the brain learns and how that affects us.

And today’s passage is about madness and demonic possession: the implication to any acute psychiatrist of the family coming to take someone is they are probably going to call you in right now.

Matthew 12:43-50

43“When the unclean spirit has gone out of a person, it wanders through waterless regions looking for a resting place, but it finds none. 44Then it says, ‘I will return to my house from which I came.’ When it comes, it finds it empty, swept, and put in order. 45Then it goes and brings along seven other spirits more evil than itself, and they enter and live there; and the last state of that person is worse than the first. So will it be also with this evil generation.”

46While he was still speaking to the crowds, his mother and his brothers were standing outside, wanting to speak to him. 47Someone told him, “Look, your mother and your brothers are standing outside, wanting to speak to you.” 48But to the one who had told him this, Jesus replied, “Who is my mother, and who are my brothers?” 49And pointing to his disciples, he said, “Here are my mother and my brothers! 50For whoever does the will of my Father in heaven is my brother and sister and mother.”

I’m going to refer to that cliche — Jesus has been accused of being the Lord of demons, and is now teaching about that… and the context implies that Jesus mother and brothers account him as crazy. Jesus does not refuse, but calls all his brothers — but the other half of the statement is in part aimed at them — whoever does my will is my brother and mother was said to his brothers and mother. In short: believe in me and what I say.

Which brings me back to Pavlov and Demons. We need to condition ourselves. We need to seek God and not the pleasures of this life, for we habituate to them and need increased stimulation to get the same thrill. This is why when we are apart from our beloved when we get back together it is so good… because it is now salient, new, and not just a habit. We need to choose good and shun evil. For many sins this is not a problem: but we all have sins that we find exciting, and there we need discipline. We cannot afford to be lazy.

But that alone will not suffice. If we have a habitual sin, and we all do, it will not go away. We have literally trained our bodies and brains to be excited and respond to that: these sins are often an excess of a normal desire: hunger leads to greed, love to lust, and ignorance of probability to gambling.

To deal with these, we need the grace of God. For we are not merely fallen by nature, but we deliberately break ourselves with chains of our own choosing. And here, those who struggle are on the side of the angels. Those who just act on instinct have less psychological distress… while they rejoice in their evil, and polish the chains of the slavery they have chosen.

But you can see that not in how they look or present — for the malevolent can perform extremely well if they know the rules of the game (and they normally do) — but in the breakage of others they cause. In the end, we are judged by the consequences of our lives.

By that measure, we all fall short. We all need grace. And Christ alone can deal with that: or we will find ourselves indeed in a worse place than we were before we had but temporary relief.