Sick or Sinful?

"Psychiatrists since Freud have been busy doing for man's morals what Darwin and Huxley did for his pedigree." complained one of Britain's most respected economists and sociologists last week. This may or may not be progress, but to Economist Barbara Wootton, now a magistrate in London's juvenile courts, it presents a serious problem. In Twentieth Century she writes:

"The fact that the tiresome child, the lawbreaker and the unhappy lover now pass through [the doctors'] consulting rooms implies the belief that people in these predicaments are, or may be, ill. The concept of illness expands continually at the expense of the concept of moral failure . . . The significance of this question of who is sick and who is sinful can not be laughed off as 'merely semantic' . . . No verbal tricks with definitions will alter the practical consequences, in our culture, of drawing the boundary between health and illness in one place rather than another . . .

"Who, in fact, amongst the many who get into messes deserve to be fussed over as invalids and who should be required . . . to carry for themselves the responsibilities of normal healthy men and women . . . ?

"The conclusion seems inescapable that a large proportion of these people are 'treated' by the doctor just because they are tiresome or unhappy . . . Only by grotesque mental gymnastics can they be made out to be ill in any other sense. In fact, the stealing, bedwetting, bad-tempered children whom, as magistrates, we refer for psychiatric treatment, are diagnosed as sick by their very stealing, bed-wetting and bad temper. But what can we say about the parents of these children, some of whom also consent to receive 'treatment' for themselves? In what sense can they be said to be mentally sick? Must we accept as proof of their illness mere failure to cope with such unmanageable offspring?

"Plainly, the distinction between the mentally sick on the one hand and the sinful (or the miserable and the muddled) on the other, is getting shakier and shakier ... Hence the dilemma: either our psychiatrist must be spending his time upon those who are not really ill at all ... or our conception of mental illness must be much too narrow, and needs to be widened to include pretty well everybody who is in trouble of any kind."

Professor (of social studies) Wootton gave no pat prescription for resolving the dilemma, but confided: "For my own part I must confess that I can never listen to panegyrics of mental health as smooth personal adjustment without being haunted by the ghost of that most misfitting of all misfits--Florence Nightingale. Had that astonishing woman been born of this generation, must we suppose that a Child Guidance Clinic would have put an early stop to all her nonsense?"

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