Monday, April 8, 2013

"Pathophobia": On Freedom, Sickness, and Being Human

Suicide has been in the news again. I pray for the Warrens, and entrust the soul of their son Matthew to the infinite mercy of God.

I know very little about Rick Warren's work as an evangelical minister or his famous books. It doesn't matter. He's a human being, and a father. His wife Kay is a human being, and a mother. Along with thousands of other people, I sent them each a tweet expressing sympathy and solidarity. It won't reach them personally, but that doesn't matter. Solidarity is in the heart, and the human heart is the original "social network" and remains the only one that's necessary; the one that gives value to all communication. Twitter has some value, if it can be used to express a work of mercy.

I wish I could say I'm surprised and shocked by suicide, but I'm not. The awful fact is that it happens all the time.

It happens to "nice" people. It happens to people who "look normal" on the outside. It happens to good people, loving people, admirable and heroic people. I'm quite sure that you know and love people who struggle with impulses toward suicide or lesser forms of self-inflicted personal harm.

And I cannot stress this point enough: These are "regular" people! I'm not just talking about "crazies" here. I'm not just talking about people in straight jackets, people living in the streets, drug addicts, sociopaths, or terrorists. I'm not just talking about people like Monk who are always straightening picture frames and arranging the food on their plate, or people who are generally considered "weird," or even people who have especially melancholy temperaments.

I'm talking about your friends, neighbors, children, parents, spouses, teachers, students and co-workers. I'm talking about people who may be active in your parish, who volunteer for stuff, and - yes - I'm talking about your priests, your good and holy priests (who have never harmed anyone or stolen anything, who have nothing to hide and no reason to feel this way). 

Often suicide can be prevented (which is one reason why we should try the best we can to take care of people suffering from mental illness, and why we should pray for them). But there are times when it just seems to devour a person like an implacable monster.

We have to keep fighting the monster, and never allow ourselves to get discouraged even if it appears that the monster has won.

It is never good for a human person to end his or her life. But there are various ways that this can occur, and so it is important to be as clear as possible about the context of such an event.

Anyone who knowingly and freely chooses to kill themselves commits a serious sin against the loving God who gives life, and whom we must always trust, no matter how desperate or painful our circumstances. Suicide is never the answer. It is not "death with dignity" in the face of a terminal disease or any other problem. To choose suicide is always wrong, and to help someone else commit suicide is always wrong. Of course, we cannot judge another person's heart, and we know nothing about what might transpire in that final moment. We continue to hope and pray for the person, knowing that God's mercy can still work miracles at the moment of death, even while we recognize the evil and destructive nature of this action.

However, with our increasing understanding of the complexities and subtleties of human pathology, we find it likely that many instances of self-inflicted death are not chosen as such. Rather, they are obscure events of human behavior that are driven, in part or perhaps entirely, by a relentless disease that results in a neurological breakdown. It seems that mentally ill people can become altered in their brain functioning to the point where their judgment and freedom must wrestle with deeply distorted perceptions and impressions of themselves and their environment.

There is something truly dramatic about this struggle. Human freedom is called into play, as it is in any other sickness or suffering. It has its triumphs and its failures, which may be invisible to us and even to the person who fights in the darkness. No doubt, the Enemy of the human race is involved as well. The one whom Jesus calls "a murderer from the beginning" will make trouble wherever there is an opening for it. Those who accompany a mentally suffering person should "put on the armor of God" and use the weapons of prayer and sacrifice, and of course the sacraments.

But do not underestimate the devastating force of the diseases that afflict the brain--this most delicate organ of the human body that we have only begun to understand.  The human being is a unity of the spiritual and the material, of soul and body. Human knowing and loving work within the context of sensation and images. Even though they are spiritual, they draw from and are expressed in bodily reality, and to this extent they are "dependent" on the brain. This is obvious when we consider the fact that we cannot perform significant acts of human responsibility when we are asleep. Our capacity to understand can be hindered and distorted by a brain injury, or by alcohol or other chemical substances that interact with brain functioning.

Clearly, then, diseases of the brain can impair human judgment and even bring about substantial disability. Given the brokenness of a human nature affected by original sin in so many ways, it would be amazing if there were not a wide spectrum of problems in the functioning of the body's most complex and intricate organ.

How do we heal a sick brain? How do we keep our brains healthy? These questions make it clear that medicine, like life itself, is primarily an art. Medicine makes extensive use of science, but ultimately it must be practiced on a particular human person. Moreover the brain is not isolated; it is an integrated part of the whole organism of the body, and shares in its vicissitudes. The art of medicine continues to develop in this area, along with all the arts that constitute healthy living. Our world has the potential to accomplish much that is good for human health and well being, for opening new vistas and bringing healing to human places that are difficult to find and burdened with indescribable suffering.

But lets get rid of the stigma of "mental" illness. Once and for all. It doesn't help anything.

There is no real reason why a brain ailment should be considered more shameful than a heart ailment or a liver ailment. The difficulty is that it has more direct and pervasive effects on human behavior, and is therefore more invasive of human interiority. Moreover, we have no illusions of control here; our remedies are fragile and temporary, and the causes and cures elude us.

The symptoms of a brain illness make it clear to us that our humanity consists in the union of soul and body. What afflicts the human body afflicts the human person. This makes us afraid. It makes us want to distance ourselves. It tempts us to isolate the sufferer, because otherwise we might have to look at him or her and see the reflection of ourselves, and our own suffering.

Here is a challenge for our culture that no one wants to confront. Here is a form of discrimination that everyone practices and no one denounces. In a sense, its very much at the root of our common problem. One might even coin a sociological term of reference for it, although its not likely to catch on:


Pathophobia. The fear of suffering. The dread of suffering. The full scale flight from suffering, or the cover up of real suffering with fake solutions, and then the marginalization of those whose problems we cannot pretend to have solved.

But the fear only grows. We need the audacity of humility. We need to acknowledge that the human project is cracked at its foundation. None of us can fix it. But humility frees us to hope for a renovation, nonetheless.

We must see that we are all small and broken and we feel endangered by the world, and by each other. And yet we aspire to an endless life. We are afflicted in every way, and yet we aspire to live in the image and likeness of God.

Let us direct this aspiration, and let it be shaped into the recognition and supplication of the One who corresponds to our dignity and our need. And let us take care of one another. Let us be compassionate and merciful to one another.