Diagnosis As Violence
The idea of diagnosis does not typically conjure images of violence. In theory, it shouldn’t. In reality, diagnosis necessarily constitutes violence if it fails to account for the diagnosticians’ epistemic limitations and conflicts of interest. Without humility and transparency, the reality of diagnosis manufactures consent for pseudo-solutions. Hidden in plain sight, this pandemic of misdiagnosis violates the interests and integrity of everyone it claims to help.
Trapped in Reductions
Imagine yourself as the elephant in the ancient parable with blind men groping your body parts, likening your trunk to a snake, your tail to a rope, your leg to a tree and your tusks to spears. Because they can’t see you, they can’t know you, and they can’t help but reduce you to something they know. They can’t help but misdiagnose you.
Now imagine these Blind Gropers (BGs) as stand-ins for all the diagnosticians whose advice you seek out and whose judgments affect your view of everything that causes avoidable suffering. They may include:
- Institutional and individual participants in healthcare, political activism, public policy and the entire ecosystem of advisory arts encompassing legal, financial, psychological, spiritual and philosophical counsel.
- Mainstream diagnosticians such as licensed physicians and lawyers, large investment firms, professional standard-setting organizations, elected officials and regulators.
- Heterodox thinkers, fringe-dwellers, psychics, shamans, astrologers, energy healers, life coaches and religious missionaries inviting you to join forces with them to bring about a messianic redemption.
- Total strangers who enter purely transactional relationships with you.
- Close friends and family whose connection with you extends far beyond a specific diagnosis or remedy.
Regardless of what connects you to them, BGs typically boil down their research to a problem and a solution, a diagnosis and a recommended remedy. However, unlike the blind men in the parable, most of your diagnosticians operate as self-interested economic agents in real-world institutions with faulty (and often woeful) governance and disclosure standards.
Your professional BGs may all claim to serve your best interests and to first do no harm, but the economic system rewards them for groping and guessing. By contrast, the system offers them much weaker incentives to study, mitigate and acknowledge the limits of their knowledge and the epidemiology of corruption in their ranks.
Outside the institutional arena, too, the informal advisers you find among friends and family are not necessarily motivated by your best interests. They may be seeking validation and attention, or they may want to maintain or disrupt an established power dynamic in the family, or prevent the disclosure of an explosive secret. Consciously or subconsciously, they too may be leading you astray.
Whether the real-life context is institutional or interpersonal, the metaphorical Blind Gropers don’t hesitate to use force or subterfuge, if necessary, so that they can keep groping and guessing. They do what they can to sustain the self-aggrandizements, denials, fabrications and other ways of bolstering the claim that the elephant is a snake, a tree, a rope, a fan, or a spear. In real life, this organized misinterpretation of reality results in normalized violence against you, your family, your community, your country, your world.
Masks of Reductionism: The Ignorant “They” and the Theory of “A Few Bad Apples”
Even the most high-minded interpretations of the parable of the Blind Men and the Elephant often lapse into the very sin the parable illustrates. They reduce this illustration of reductionism, confining the moral of the story to specific contexts. Such distortions obscure the systemic epidemiology of diagnostic malpractice.
Rather than foster the complete “ignorance of ignorance” that Alfred North Whitehead warned against, these distortions acknowledge the malignancy and say nothing about its metastatic complications.
In 1872, for example, the poet John Godfrey Saxe reduced the ancient parable of reductionism by tethering it to the context of “theologic wars” in which disputants “rail on in utter ignorance.”
This interpretation of the parable is high-minded in that it deciphers the elephant as a stand-in for God or the ultimate reality. From this dizzying interpretive altitude, Saxe projects the sin of reductionism onto the disputants in theologic wars. That means them and there; not me, not here. Thus, the warning about the pitfalls of reductionism not only got poetically reduced, but also projected onto the ignorant “others”.
But reductionist violations of wholeness don’t just occur in the minds and hearts of religious fundamentalists wedded to absolutist doctrines in the marketplace of ideological tribalism. These assaults against Reality unfold insidiously in countless day-to-day interactions in which unexamined assumptions about “problems” send relief-seekers into the arms of Blind Gropers whose epistemic limitations — not to mention psychopathologies — have not yet been exposed. This dynamic simmers imperceptibly behind numerous phenomena.
- The appeal of demagogues, con artists, cult leaders and Ponzi schemers peddling False Hope and False Fear.
- The scapegoating of minorities and the normalization of violence against them to protect the worldviews of normative majorities.
- The medicalization of normal suffering and the suppression of evidence about the adverse side effects of profit-generating treatments.
- Companies — public and private — destroyed by pseudo-solutions du jour (e.g., downsizing, empire-building acquisitions, etc.)
- Sleazy salesmen trained to sell you something even if you don’t need it, even if you can’t afford it, even if many of the claims about the product are false.
- Doctors running conveyor-belt practices that make a mockery of the very idea of diagnosis and treatment.
- Medical apparatchiks responsible for the Sodom and Gomorrah of reductionism known as the Diagnostic and Statistical Manual of the American Psychiatric Association (APA).
If you have thought deeply about the epidemiology of weaponized ignorance, this list of examples hardly requires elaboration. If you cling to the “a few bad apples” theory of violence-by-diagnosis, it’s possible that no elaboration will suffice. However, if you occupy the liminal space between these polarities, you at least recognize the glaring flaws in this argument:
“What’s the big deal about being told something you know is false? Where’s the violence in that? As the elephant in the parable, you know you’re not a tree or a spear.”
On the contrary, human beings are deeply vulnerable to the charms of falsehood. The imagery in the parable of the blind men molesting an elephant understates the gravity of its real-life correlates. Blind Gropers provide upstream justifications for downstream violence ranging from the trivial to the soul-searing and encompassing all major domains of human experience — physical, psychological, economic.
Discovering the Inner Blind Groper
Like Saxe, we all naturally direct our resentments at external manifestations of the BG syndrome. In mapping the epidemiology of blindness, we exclude the inner planes of unconscious ignorance. Thus, we create a Safe Harbor for what psychoanalysts call an “introject” of the ignorance that rains down upon us out there.
Disguised as a trusted adviser, this introject serves a single mission: to keep our attention focused outwardly, at the social sphere. That’s where we’ll find all our enemies and all our messiahs, the introject assures us. Our job, the argument goes, is to distinguish the former from the latter. In this labor of daily discernment, the introject is always eager to assist…but only on one inviolable condition: We must never turn our attention inward.
Carl Jung understood that this deal with the devil is both self-defeating and powerfully seductive. He encapsulated this tension of the opposites in his famous aphorism: “One who looks outside, dreams. One who looks inside, awakens.”
As long as we fixate on unmasking the reductionists “out there”, we can’t discover the inner Blind Groper, the introject. Until this discovery, we flee from the bondage of our afflictions to the Promised Land we envision, but we continually find ourselves in the wilderness of pseudo-solutions.
During my college years, the projections of my inner reductionist drew fresh fuel from my sociology curriculum. I was deeply moved, for example, by the history of Malleus Maleficarum (The Hammer of Witches), possibly the first diagnostic and statistical manual for disturbances of mental health. Published in 1486, the book outlined diagnostic criteria and treatment protocols for witches. Citing Exodus 22:18 — “You shall not permit a sorceress to live” — Malleus legitimized violence. It was one of the books that left me wondering “How could they [the ignorant ‘they’] go along with this insanity?”
For years after college, I habitually explained instances of such insanity as symptoms of “religious fundamentalism” or “ideological anachronism” or other isms supposedly designating the insanity’s point of origin. I felt that my disavowals of these falsehoods provided sufficient confirmation of my virtue. With my claim to virtue established, I couldn’t see what I couldn’t see — e.g., my private witch hunts and fundamentalisms.
The Evolving Cartography
No doubt, the psychoanalytic tradition deserves credit for incorporating the psyche into the evolving cartography of the terrain separating us from the utopian horizon. But, even with the added contributions from other giants of 20th century psychology, we are just starting to scratch the surface. And W.H. Auden’s immortal line — “We are lived by powers we pretend to understand” — stands uncontroverted, as it surely will remain.
As we traverse our epistemic chaos in 2020, we do not have any ready-to-download maps that meet the basic cartographic standard set by Alfred Korzybski. Our maps don’t even come close to matching the structure of our territory.
As a result, we inhabit the balkanized epistemology whose advent Terence McKenna anticipated a few decades ago. In this Tower of Babel, we can’t achieve a languageable consensus either about our current coordinates or our best course of action.
Without this consensus, and without the comfort of a stable institutional order, we still remember that, after our last passage through the same crucible we entered between 2016 and 2020, we proclaimed “Never again!” We also remember that, as addicts, we never stopped reaching for the next fix. There was always a minority to scapegoat, another moral failing to project onto others, another piece of propaganda to re-describe our personal and collective depravities. Importantly, there was always another dose of opium to numb the resulting pain and, of course, another false messiah in whom to invest our yearning for redemption.
Every addict knows this struggle well, but many of us also know that there is a road to recovery. Hard to find on most of our maps, this road begins where slogans end, where instead of proclaiming “Never again!”, we simply withdraw our consent…where we refuse to let another Blind Groper interpret our body parts for us.
This is where the evolution of our cartography ends. A discontinuity occurs. And we find ourselves in a hyperdimensional topology for which we have no language.
Several 20th century thinkers (e.g., Terence McKenna, Robert Anton Wilson, Marshall McLuhan, etc.) playfully experimented with various nomenclatures for this terra incognita. Their playful spirit harmonizes well with the climate of our new homeland, but to play well, we have to acknowledge, as Alice did in Wonderland, that “we are not in Kansas anymore!”
Co-opting Cartographic Malpractice: Victory Via Negativa
We’re not in Kansas anymore, but the Blind Gropers are still with us. Rather than resent them for their persistence, we can cultivate the skill of regarding them with gratitude. Indeed, without them, we would be hopeless in our quest for the utopian horizon.
The apparent contradiction is easily resolved. Computer hackers, for example, not only reveal the vulnerabilities in our security perimeter, they also create strong incentives for us to invest in security. Similarly, the Blind Gropers we allow into our lives teach us more about the shape of our wounds than than we learn from our best teachers.
By mapping our wounds, we reveal the path to our Promised Land. This revelation is, in part, a gift from our Blind Gropers, and they deserve our gratitude.
This is why, after the quote below popped up in my Twitter feed, I added Wendell Berry to my list of important contributors to our new cartography.
And the world cannot be discovered by a journey of miles, no matter how long, but only by a spiritual journey, a journey of one inch, very arduous and humbling and joyful, by which we arrive at the ground at our own feet, and learn to be at home.