Discussion Group Report

"The basic difference between what are socially considered to be bad and good people is not one of kind, but one of degree, and of the ability of the bad to translate dark impulses into dark actions," says Robert I. Simon, the Director of the Program in Psychiatry and Law at Georgetown University School of Medicine in his book with the same title as this article. "Bad men such as serial sexual killers have intense, compulsive, sadistic fantasies that few good men have, but we all have some measure of that hostility, aggression, and sadism. Anyone can become violent, even murderous, under certain circumstances. Our brains are wired for aggression, and can short-circuit into violence.

"There are dragons, and no one can run from them for very long." Sticking one's head in the sand or retreating into various addictions can be as painful or more disabling than the original dragons/problems. Psychiatrists aim to empower their patients by helping them to discover alternative, more problem-solving techniques. Autonomy and responsibility for one's own life replace previous helplessness and destructive repetitions.

We must all struggle with the dark forces. In the Middle Ages, ecclesiastical thinking held that aggression and violence were caused by foreign, evil spirits besetting an individual. Now those of us who ascribe aggression and violence to sickness fall prey to the same flawed perception of man as did those earlier clerics. The great majority of violence and mayhem in this world is done not by the mentally ill but by individuals and entire societies not considered to be sick, at least not by any known measure of mental illness. Many among the Nazi executioners went home after a day of exterminating women, children, and old men and resumed quite comfortable and normal lives in the bosoms of their families. We must stare our own demons in the eye and learn to control them. The grand catastrophes of mankind and the evils of our everyday lives reveal that the greatest danger comes from denying that there is a beastly part of our humanity. Much of life's work and play involves the necessary channeling of aggressive impulses, which permits us to take responsibility for our actions by facing and acknowledging all our feelings.

There is substantial agreement among professionals on the general aspects of what constitutes good mental health. Healthy people like and accept themselves, do not depend excessively on others for approval, and are not severely wounded by others' criticism. A solid, integrated sense of self, neither grandiose nor despised, exists with relatively continuous, reasonably pleasant memories. Healthy people do not have to diminish other people to maintain a positive self-view. They acknowledge and accept personal shortcomings, and seek help from others when it is needed. They have internalized loving, nurturing parental figures who provide sustenance during times of crisis and inner support at times of failure (I would add to Simon's observation that those who did not have such parents may find such support from important other people in their environment). They intrinsically reject suicide as a solution to life's vicissitudes. There are values and standards that throughout life provide them with a moral rudder. These people are fair and adaptive, not harsh and punitive or cruelly and unbendingly righteous. Present is a clear but reasonably flexible sense of right and wrong. In the face of human suffering, healthy persons do not insist on compliance with trivial formalities. They accept guilt when appropriate without experiencing panic or immobilizing depression. Their consciences work in harmony with other aspects of the personality and are not full of holes that permit acting out destructive behaviors inconsistent with their value systems.

Their value systems emphasize proficiency at their work while aiming at realistic goals. They have no debilitating perfectionist or pie-in-the-sky goals that guarantee failure. They value cooperation and collaboration with others and enjoy competition but not by humiliating their competitors. Life is not a dog-eat-dog struggle but a positive challenge. Psychologically healthy persons enjoy their relationships with others. They can place appropriate trust in others as well as be trustworthy. Support and empowerment of friends and acquaintances is their hallmark. They curb feelings of envy and jealousy in deference to the importance of maintaining friendships. They do not desire domination of others. They esteem other persons in their own right and appreciate that we all must bear the vicissitudes of the human condition. They seek no personal advantage. While healthy people pursue their own self-interests, they do so with empathetic regard to the consequences their own actions might have on others. They each maintain good personal boundaries, knowing where he or she stops and another individual begins. They feel regret or guilt if others are unnecessarily hurt by their actions. They do not shift blame to others. Healthy persons can accept the darker side of their humanness. They can enjoy childish pleasure but at the appropriate time and within measure.

Strong indicators of emotional health are the abilities to withstand anxiety without falling apart or launching into drastic action; to delay gratification and tolerate frustration, when appropriate; to think before acting; to modulate impulses; to sublimate basic impulses. Healthy persons can love, that is, value and care for another person. Feelings of jealousy, anger, hate, and rejection are tempered by an overriding concern for the person who is loved. Sexuality in a relationship is empowering through a mutually loving, physical, and mental exploration of one another. The emphasis is less on finding the right person than being the right person. Work is a source of creative emotional growth and psychological refreshment rather a primary way of obtaining or maintaining self-esteem. It is folded into a broader fabric of life rich in sustaining relationships, recreation, hobbies, and spiritual quests. Healthy individuals can experience awe, joy, and wonder in relation to the world. Emily Dickinson wrote, "To live is so startling it leaves little time for anything else." They find a sense of fulfillment and are not beset by regret and bitterness. Reality is perceived reasonably clearly and is harmoniously melded with the pleasure principle. They can accept professional help with their emotional problems. William Sloane Coffin succinctly stated, "I'm not okay, you're not okay, and that's okay."

"It is our human condition to struggle against the dark demons," says Simon. "It is the undaunted human spirit that strives to harness these demons in the pursuit and fulfillment of our human destiny."