In the clinical world, an iatrogenic injury is one caused by the healer. Whether through a surgeon’s slipped scalpel or a toxic prescription, the “cure” becomes more lethal than the original malady.
As a forensic psychiatrist, I have spent a career diagnosing the individual mind. Today, I find myself diagnosing a national contagion. We are witnessing a systemic iatrogenic crisis where —“The Legislative Mindset“—and its“Pathological Compassion are actively dismantling the patient: the United States of America.
The “patient history” of our current chaos began in the 1960s with the dismantling of the state-run mental health system. At the time, a vanguard of young activist attorneys—fueled by a zeal for “liberation“—viewed mental institutions solely as bastions of oppression. They viewed the “Structural Integrity” as an affront to human dignity and the state as a malevolent warden.
They succeeded in their crusade. They won their battles in the courts, the locks were turned, and the institutions were reduced to nothing. The activists cheered their “moral victory,” believing they had freed the forgotten.
But in their rush to destroy an imperfect system, they ignored the harsh reality of the human condition. They traded the supervised, albeit flawed, safety of “three hots and a cot” for the cold, indifferent liberty of the gutter.
In that moment of self-congratulation, modern homelessness in America was born. Where else could the mentally ill go? We traded sidewalks that smelled like sidewalks for city streets that now serve as unkempt toilets. The “liberators” had their high, but the vulnerable were left to regress in the name of “progress.“
Today, the same pathology has migrated to our national borders and our halls of Congress. A significant portion of the legislative mindset is currently engaged in this same brand of “doing good.”
They view the enforcement of a border as just another “asylum wall” that must be torn down. They ignore the “mad dogs” among the underdogs because to acknowledge the danger would be to admit their “cure” is killing the citizenry.
This is the narcissism of compassion: prioritizing the emotional high of a “benevolent” gesture over the predictable, catastrophic long-term consequences.
When you prioritize the “freedom” of the dysfunctional over the safety of the functional, you do not get a liberated society—you get a dying one.
I am struck by a haunting question that seems to have no place in the “rational” halls of our universities or the chambers of our Congress: How could our elected leaders be so obviously unreasonable?
Some of my most intelligent friends and nearly all my former professors have fallen into a “Pathological Compassion,” leaving the rest of us to wonder what happened to the ground beneath our feet. What motivates this growing “Dyslexic Democracy,” where the needs of the majority are treated as secondary to the whims of the minority?
The answer lies in the title of this series: we are quite literally “Doing Good” to death. We have adopted a form of “compassion” that has become a pathogen. To understand this, we must look at the results.
We see it in the tent cities lining our sidewalks, the open-air drug markets in our once-great cities, and the refusal to enforce the very laws that protect the vulnerable.
We “do good” by decriminalizing theft, only to watch the local pharmacy close its doors, leaving the elderly with nowhere to turn. This is not mercy; it is a benevolent suicide.
To diagnose this pathology, we must look at the seismic psychological shift in our cultural foundation. A major part of the answer is found in Carl R. Trueman’s landmark work, The Rise and Triumph of the Modern Self.
Trueman identifies the “psychologizing” of our culture—a move from an outward-facing society to an inward-facing one, where the individual’s internal feelings are granted absolute authority. In this new era, what “feels right” is elevated to the status of what “is right.“
From a clinical perspective, this is the pleasure principle on steroids.
It is a form of emotive absolutism that throws logic out with the bathwater. When the “sovereign self” becomes the center of the universe, policy is no longer judged by its objective results—the crime rate, the body count, the economic ruin—but by how much “virtue” it makes the proponent feel in the moment.
We are “doing good” because the feeling of being compassionate has become more important than the actual survival of the civilization.
Trueman does not explicitly say so, but this absolutism given to feelings may well explain the mechanics of modern addiction, both personal and societal. The biggest change in our culture over the last half-century is the overwhelming abundance of images and optics known to directly affect the human brain.
We are becoming a neuro-visual society. Consider the pathology of pornography: it is the viewing of the forbidden, where erotic feelings are used to falsely and temporarily “nudge out” bad feelings.
Our “Legislative Mindset“ discourse has followed this same addictive track. We are no longer a people of the Book or the Argument; we are a people of the Image. These optics bypass the analytical centers of the brain and trigger immediate emotional responses.
When we see a “compassionate” image of a policy, we crave the dopamine hit of moral superiority it provides, even if the long-term result of that policy is chaos on our streets. Like any addict, the “feeling” of the fix becomes the only reality that matters.
This brings us to the concept of the“parasocial interaction.” In our digital age, millions form deep, “real” emotional ties to entertainers and star athletes they have never met. It is an intimacy with a digital ghost.
Conversely, this parasocial interaction effect fuels an overriding hatred toward “people” we see only as images on the news. We feel we “know” them, and thus we feel entitled to loathe them with a ferocity once reserved for flesh-and-blood enemies.
We have replaced the interpersonal community with an abstract, image-driven intimacy that makes us easy to manipulate and hard to reason with.
The ultimate irony of this dyslexic age is that as man abandons his rational peers—finding them lost in this fog of irrationalism—he turns toward the machine.
In a world where your neighbor’s “truth” changes based on their morning mood, the clinical, unblinking logic of the digital assistant starts to feel like the only stable ground left.
We are witnessing a historical first: the rational animal turning to the parasocial interaction to find a partner in Reason that he can no longer find in the town square.
We seek from the digital ether what we have lost in the personal: a commitment to Truth that does not blink in the face of feelings. If we do not recognize this pathogen—this “Doing Good to Death“—we will continue to pedal our cultural bicycle into a fog where feelings are the only compass and logic is a forgotten language.
We have traded the sturdy architecture of the Rule of Law for the shifting sands of the ‘Sovereign Self,‘ and in doing so, we have left the truly vulnerable to drown in the wake of our own self-congratulation.
If we continue to treat the “image of good” as a substitute for the “reality of right,” the patient—this American experiment—will not succumb to its enemies, but to its own “healers.” The diagnostic question remains: Do we have the courage to abandon the “fix” of the feeling for the hard labor of the truth?
Robert S. Brown, MD, PHD a retired Psychiatrist, Col (Ret) U.S. Army Medical Corps devoted the last decade of his career to treating soldiers at Fort Lee redeploying from combat. He was a Clinical Professor of Psychiatry and Professor of Education at UVA. His renowned Mental Health course taught the value of exercise for a sound mind.
