About This Episode

A philosopher examines the theological implications of mental illness and its treatment.

[You can listen to this episode of The PloughCast on Apple, Spotify, Amazon Music, Google or wherever you get your podcasts.]

James Mumford tells his own story of the philosophical inadequacy of much contemporary therapy, and asks: What if some of the philosophical presuppositions of materialist therapy actually end up making depression worse? Could it be that depression can be exacerbated by bad philosophy? And if so, how can we bring moral realism into our therapies in order to address the problem where it lies?

Peter, Susannah, and James then discuss recent findings about the effect of politics on mental illness. Recent studies have showed that young liberals have much worse mental health, in general, than young conservatives. They consider Jonathan Haidt’s proposed explanation of this phenomenon: that certain approaches to progressive politics encourage people to adopt disempowering and destructive habits of mind.

Finally, they consider the way that a holistic understanding of a person, as body, soul or mind, and spirit, can offer hints towards a better approach to therapy.

Recommended Reading

Transcript

Susannah Black Roberts: Welcome back to the PloughCast! I’m Susannah Black Roberts, senior editor at Plough.

Peter Mommsen: And I’m Peter Mommsen, editor-in-chief of Plough. In this episode, we’ll be speaking with James Mumford about his piece in our new issue, “The Mind in Pain.”

Susannah Black Roberts: Dr. James Mumford is a London-based writer and senior fellow at the University of Virginia’s Institute for Advanced Studies in Culture. His latest book, Vexed: Ethics Beyond Political Tribes, was published by Bloomsbury. Twitter: @JamesACMumford

Thank you, James, so much for coming on the podcast. What is your story?

James Mumford: Well, it’s lovely to be on the podcast, Susannah, and it was a great privilege to get to write for Plough Quarterly, which is a magazine and a journal I’ve admired from afar for a while. So the piece for Plough is called “The Mind in Pain,” and it was very cheery piece about the nature of depression, which is something that I’ve had for twenty years on and off at varying degrees of intensity, and I suppose it was trying to square – I am a Christian, and it was trying to square those two things, which seem at times vividly to be incompatible. I was raised in a charismatic evangelical tradition that, to use the one book title, believes that “God talks back” and has great expectation for the intervention of God, the still small voice, if not the blind flashing light on the road to Damascus.

There’s an expectation that God speaks and meets us in the dark night of the soul, and I was exploring really what it means when that doesn’t happen, when the overall impression is one of religious non-experience and how that can be squared with orthodox belief, and I found a lot of comfort at the end of the piece looking at different things that theologians down the ages have said about Matthew 27:46, “My God, my God, why have you forsaken me,” and the abandonment or dereliction of Christ.

And Calvin interestingly says that the fact that Jesus Christ, according to His human nature, does not experience . . . the classical theistic line is that he never loses the vision, the beatific vision. Calvin’s line is at the level of His human experience, it’s very important that he does experience the forsakenness of God and the silence of God, but He hasn’t done anything wrong.

And of course, there’s something unique about Jesus’ experience as He carries the sin of the world on the cross, and the Father looks away from Him. But if it was good enough for Calvin, it was good enough for me – thinking that there might be some interesting precedent in the fact that just because we don’t experience the consoling presence of God, or have episodes of intense depression, when things feel like the darkness seems to be pervasive, that doesn’t mean that God is absent or that there’s something wrong with my faith.

Peter Mommsen: Thank you, James. There’s something about your piece, “The Mind in Pain,” that clearly spoke to many, many of our readers, and it kind of made me chuckle because one of the lines that I remembered from your first draft, and it’s in the published piece as well, is there’s something about depression that defies communication. In a way, your article was – not a repudiation of that, but an attempt to convey the reality of it and then a Christian answer to it in a way that clearly many, many people found very helpful.

James Mumford: That’s encouraging. I think that that was definitely what I was trying to do in writing about literary and philosophical attempts like Elaine Scarry’s in The Body is in Pain, and also Conrad’s . . . “The horror! The horror!” The words that Kurtz says when he has this vision moments before he dies. We are not given the content of that vision, it’s almost as if in a language Conrad feels . . . there’s ellipsis because language you cannot carry and cannot endure the full weight of the chillingly nihilistic vision that Kurtz has, and so it was very instructive to draw on some literature as well.

Susannah Black Roberts: Yeah, and I also just found it incredibly relatable and comforting. Depression has not been particularly something that I’ve struggled with, but I have with OCD, which is more an anxiety disorder, and I also was kind of converted in the context of a very charismatic Vineyard church, which I think was also your background. Was that right?

James Mumford: Yeah.

Susannah Black Roberts: Yeah, and there is this common sense in the Vineyard of, to a certain degree, your perceptions are good theological information about what God is doing, and that can be really helpful if you need to make room for the Holy Spirit and for a more experiential Christianity, but if you’re struggling with something that’s mental health related, it can also be really, really bad advice because as the way that you described depression is it tries to give you information about the world. Kurtz is perceiving a kind of maleficent vision that is telling him that it’s true about the world, and one of the things that we have to do in the face of that if we’re Christians, is to say, “No, we have a better source of information about the world than our subjective experience.”

So for me, it’s really funny that you should have gone to Calvin because the times in my life where the Calvinists have been most comforting were when I was struggling really deeply with scrupulosity. So I would read John Bunyan, John Bunyan’s sort of account of his scrupulosity, which he didn’t think of as scrupulosity, he just thought of as this is what conversion is like, which I don’t think was the case. Anyway. Yeah, the Calvinists can be really helpful. So I just wanted to thank you so much for sharing. It is a certain amount of vulnerability that you take on when you’re putting something like that in public, and thanks for letting us be the ones to bring it into public, because I do think it’s massively helpful, massively for other people who are suffering from this kind of thing or similar.

James Mumford: Thank you.

Susannah Black Roberts: Yeah. You also wrote another piece for the New Atlantis, which is sort of a sister publication. I mean, that’s really presumptuous, we just like it, edited by our friend Ari Schulman. Do you want to talk a little bit about that piece? Because that was a bit of a different take.

James Mumford: Yes. So that piece was about my experience, an encounter with therapy in a psychiatric unit, in a secondary care facility, which I voluntarily admitted myself in 2017. And I was feeling pretty bad, pretty depressed, and I found that the therapy they gave us, which was partly group therapy, the group therapy was enormously helpful, but the lessons in psychotherapy that they gave or the exercises they gave us about how to sort of work one’s way out of depression, I paradoxically felt made the depression worse, and I was interested in why that might be the case.

The particular exercise I write about is one called Values Clarification exercise, which is obviously used in business outside of the therapeutic realm, but is used by acceptance and commitment therapy, which is a third generation behaviorist modality dreamt up by Steven Hayes at the University of Nevada. Basically the thinking is what you do is they give you this sheet. The psychologist handed out this sheet and on the sheet were this bizarre jumble of hobbies and virtues. It’s like “swimming,” “honesty,” “racket ball,” “moderation,” and we were supposed to circle the values we identified with, and then as part of his pedagogy, the psychologist sort of said, “Aha. Well, people have circled different things and what does that tell us?” And he answered his own question, because it was a circle of depressives who probably weren’t the greatest audience of him, and he said, “It tells us that we sometimes have different values, and what’s more, we disagree about our values sometimes, and therefore,” he said, and this is a direct quote, “Values are subjective. Morality is something,” he said, “Externally imposed by society, but values are subjective.”

So it was really quite troubling because I felt that one of the reasons that I found myself in that place, in acute psychiatric care, and I think other people in the world find themselves in those settings is because not just of because of faulty brain chemistry and the huge biological and genetic component to depression, and not just because of particular environmental circumstances, but we also find ourselves in trouble in terms of our mental health because of this existential dimension that we live in, a society that’s sort of lost the courage of its convictions perhaps, is unmoored from traditions and is post-Christian in many ways, and we have questions about whether there is meaning – I do – in those darkest moments.

So if people end up in that place thinking values are subjective and there is no truth and there is no meaning, and then they’re told as part of the supposed remedy that there is no truth and there is no meaning, obviously psychology becomes, as someone said of psychoanalysis, the problem of which it purports to be the cure.

Peter Mommsen: It was remarkable to me seeing in this acceptance and commitment therapy session that you describe just the way that therapy in a way is sort of at once denying the entire history of ethical philosophy, or at least most of it, and most of the world’s monotheistic religions. I mean, this is going to be good for you. And by the way, values are all subjective and we disagree about them. There was something darkly humorous about that.

James Mumford: Yeah, I’m afraid so.

Peter Mommsen: And I believe that you describe actually arguing a little bit with the therapist, and his response to you.

James Mumford: Because the other thing, I mean, I think there is something darkly humorous, you’re right. There’s also something bad-faith about it because one of the amazing things about the hospital I was in and the care I received was just how solicitous the practitioners were, the psychologists and the psychiatrists and the psychiatric nurses, and in little snippets of conversations with nurses in the corridor during moments when one is feeling particularly down or in group therapy from peer support and directly from psychologists and psychiatrists, you’re told constantly that you are someone who has worth and that that’s an objective fact about the world.

I think what they think is that that might have fallen out of view for you, your sense of your own objective value and preciousness because you’ve come to see yourself as unlovable for any host of reasons, but then in the intellectual implications of “values are subjective” is that we really should listen to your estimation of your own value, which is a very meager estimation, and so their practice of the care that they give based on the fact they believe objectively that you have value as a person is at odds with their preaching. They don’t preach what they practice.

Peter Mommsen: This seems to tie in with a discussion about depression in particular that’s been playing out just over the last few weeks, this sort of contrast between saying values are all subjective, but we’re telling you that your low self-value is not subjective, so you shouldn’t be depressed. There’s been quite a bit out there about the politics of depression, and Susannah, I think you’ve done a little workup on this.

Susannah Black Roberts: Yeah, I think I’ve probably read a bit more . . .

Peter Mommsen: Yeah, I think you have delved deeply into this. I’ve been much more of a surface follower of this, although I love reading Scott Alexander’s blog, so I did read his post.

Susannah Black Roberts: Yeah, and you, James had said that you hadn’t kind of run into this either, but I went into a deep rabbit hole on this. So apparently there was this recent study that came out that first Matt Yglesias and then Jonathan Haidt did a couple blog posts on . . .

Peter Mommsen: We will drop links.

Susannah Black Roberts: Yeah, we will drop links.

Peter Mommsen: OK, and big picture, Susannah, is that as probably most of our listeners know, mental health is not doing really good right now, and especially not for young people, and especially not for young women.

Susannah Black Roberts: Right, and that was the major headline, but the thing that Haidt and Yglesias found was that actually liberals were doing much more poorly in mental health than conservatives, and this was striking to the point that liberal men were doing worse in mental health than conservative women, and generally gender sort of trumps other kinds of differences in these kinds of things, and Jonathan Haidt had a theory about why this might be true, which got into something that he and Greg Lukianoff had talked about in their book, The Coddling of the American Mind, which argued that the political mindset that is advocated for as part of the ingredients of being a good person by many very progressive, particularly very young people, Zoomers, basically is an inversion of another therapeutic modality called cognitive behavioral therapy.

So CBT will say things like, “You can look at your own thought processes and notice cognitive distortions,” and then once you’ve noticed them, say, “Hey, that’s a cognitive distortion. I don’t necessarily need to think that way.” So some of these are mind reading, you’re ascribing to someone else something that they haven’t said, and it tends to be a very bad thing that they haven’t said, so you’re assuming that you know what they’re thinking. Or catastrophizing: you think of something very bad that might happen and you think it probably will happen. Black and white thinking, you think that there are just good and bad people in the world and everyone is either entirely good or bad, and all of those kind of tend to be things that are to a certain degree promoted by at least certain social groups among very liberal, very young progressives, and it struck these writers that that could be an explanation for why mental health kind of broke down this way according to politics, but you actually, in the book that you’re working on, say that you had a different take on CBT and I’m interested to hear about that.

James Mumford: Yeah. I mean, that is fascinating. Thanks for running through that, Susannah. I mean, I think to that point that there is something profoundly stoic about CBT and CBT’s founders, Ellis and Beck, both write about stoicism. And the political critique of stoicism is that it can be quietistic, and so it is interesting that if you’re very activist, then it makes sense why you’re going to care more about things in the world that you can’t necessarily control as much as you’d like to, and that might lead to more mental disturbances in the CBT language. So it does make sense of why the less people are into CBT, the more they might be more activist and also more liberal in that sense of . . . but I mean, my reading of that would probably be slightly more conservative, with a small c, in the sense that despite the foundation, which is so important to Jonathan Haidt, there is sort of among liberal Zoomers some of this existential malaise and this existential dimension of believing that despite how socially activist they are, they don’t necessarily know if there’s a foundation of meaning that can support some of our aspirations in the world.

And so alongside the activism is a nihilism, and I think that if that’s true, which is a big if, it makes sense of the why if and it’s true that nihilism is dispiriting and makes you feel more depressed, as it did in my experience, it kind of makes sense of the data in a different way.

Susannah Black Roberts: Just a little housekeeping before we continue with the rest of our discussion. Heads up – we have a new format! As opposed to each episode containing two segments, we’re switching to just one segment per episode. But you’re not getting any less content – rather than having six weeks on and six weeks off, we’re just going to be giving you an episode every single week. There’ll also continue to be PloughReads, audio versions of our articles, however, which you’ll be able to access through a different channel.

Peter Mommsen: And don’t forget to subscribe to this podcast on iTunes! We’ll be back with the rest of our conversation with James after the break.

James Mumford: But yeah, let me say what I’m writing about with CBT is on a slightly different note. Do you want me to go on?

Susannah Black Roberts: Yes, go on. Absolutely.

James Mumford: I think that one of the key questions is whether Ellis and Beck, as founders of CBT, did actually understand the stoic inheritance that they take, particularly from Epictetus, and there’s an interesting moment at the beginning of Ellis’s book where he runs together and conflates two quotations. One is the famous one from Epictetus, the slave who was a Roman, who then was freed and became a philosopher and was a great influence on Marcus Aurelius, and Epictetus says, “It’s not the events themselves, but our judgments of the events that cause us disturbances,” or words to that effect. So basically it’s our faulty cognition, our awry perceptions, that lead to our distress and depression and not what actually happens in the world, and they run together that quotation with Hamlet’s purely subjectivist line that “there’s neither good or bad, but thinking make it so.”

And that’s an intriguing moment, because whether Epictetus could be taken in that direction is a matter for scholars to dispute, it’s very clear that Shakespeare gives that line to Hamlet at that point in the play.

There are no moral facts. Events have only the moral valence that we give to them, the color that we impose upon them with from our own minds, and actually it deprives us of being able to name and apprehend and recognize evil as not just a faulty misperception of a perceived threat to us, but as something that exists in the world, and is there to be recognized and fought.

Susannah Black Roberts: So this is basically stoicism without any natural law, which is not stoicism.

James Mumford: Yeah, exactly.

Susannah Black Roberts: See, this is why I think that there’s room for another therapeutic modality that brings together stoicism, natural law theory, and Christianity, but that might be a discussion for another day.

Yeah, your reflection in your New Atlantis piece, which again, we will drop a link to, I thought was fascinating in that it was kind of my first . . . that kind of thinking, those kinds of questions were some of my first steps other than more childhood-like steps towards Christianity because while I wasn’t suffering from depression in any kind of biochemical way, it did strike me as very straightforward that if materialism was true and there was no such thing as right or wrong, there were no things that I ought to do and ought not to do, that kind of knocked my knees out from under me in terms of living according to my own sense of what I am and what I’m supposed to be doing in the world, and I think that the main reason that nihilism and the kind of existentialism that is an attempt to solve nihilism through this kind of life hack are unpleasant is because they’re not true.

They are untrue accounts of our own experience of reality, of reality itself, and so it feels bad because it’s a lie, and if we start a therapy that begins from no, there actually are things that are the case about you, and it’s pretty important that you know them and some of those things, it matters what you do, and you have responsibilities that you may not even choose, there are better and worse ways of living, and that is one-to-one connected to happiness. But you have to go after these things whether or not you’re happy because this is what you’re for. There’s something that you’re here for. You’re on a mission. That’s just, at least subjectively for me, a much happier way of living, it’s much more exciting, it’s much more joyful, and it seems bizarre to me to tell someone, “Choose your own values and then be happy about that.” That just seems totally alien to me.

James Mumford: Yeah, that’s so eloquently put. I think a much surer foundation would be one where therapists make room for and accommodate a moral quest for their clients, and they don’t think that they can embark on that quest instead of their clients or do it vicariously through their clients. Clients, people in therapy like myself, need to go on that quest to discover the good for ourselves, but at least it hasn’t been foreclosed to us from the beginning.

Susannah Black Roberts: And it is a matter of discovery rather than invention.

James Mumford: And it’s a matter of discovery rather than invention. Yeah, and I was really drawing and channeling a lot of Iris Murdoch in the piece, particularly her view that what it means to be a human being is the central method for vision rather than choice, and it’s what we see and how we perceive goodness when we see it, evil when we see it, and having confidence in our ability to see, and not just to arbitrarily choose one option or the other, which was the existentialism that she wrote about. She wrote a book on Sartre early on and then met Sartre in Brussels in 1946 and then moved away from existentialism, and by the time we come to these texts like The Sovereignty of the Good, in the ’70s or whenever that was published.

Susannah Black Roberts: For which we can all be grateful and we will drop an Iris Murdoch link in the show notes as well.

Peter Mommsen: There is one thinker, one therapist you reference, and I’d be curious just hearing you talk about him a little more. Viktor Frankl, who wrote this classic text Man’s Search for Meaning. Of course, an Auschwitz survivor, and a man who had obviously experienced real bad things, not imagined bad things, and then sought to take this search for meaning seriously. How helpful did you find Frankl?

James Mumford: Well, I would never say a bad word about Frankl because he was such a hero and he gets right the fact that a core part of our problem isn’t to deny the biological or the particular circumstances that lead people into depression, but he did see that our plight, our modern plight particularly, is an existential one, and he sees that very clearly, and he sees that without meaning we can’t be happy or that the happiness that we have if it’s not rooted in believing that we are for something bigger than ourselves will only be a superficial kind of happiness, and so for that, I think he’s a great guide.

Logotherapy, which is the therapy he invented, I didn’t personally find as satisfying because I was worried about certain voluntaristic aspects to it, i.e. a belief that we invent rather than discover meaning, and we are the ones to who create that meaning for ourselves, which the nice face of that is going to be something like we create our own values, but the nasty face and the flip side of the same coin is that if we invented our values, we can destruct our values and that they’re just constructions and fictions and it all becomes quite Nietzschean quite quickly. So I think we owe a huge debt to Frankl. Logotherapy doesn’t, in my view, fulfill and sort of meet the expectations of it that he sets on it.

Susannah Black Roberts: It doesn’t seem to me that it’s really solving the problem but it understands, it describes the problem.

James Mumford: That’s a much better way of putting it, yeah.

Susannah Black Roberts: Yeah, it describes the problem, but then it once again says, “Well, let’s just do an existentialism.” I wonder whether we could talk a bit about . . . so one thing that you mentioned was there is this residue of reality of biochemistry to all of this. One of the things that really freaked me out as a kind of young person who thought that if you were any kind of a non-materialist, you basically had to be a Cartesian dualist, and whomst among us has not had that misapprehension. I basically thought that . . . it totally freaked me out when I started taking Prozac and it worked, and I thought what does that mean for . . . does this means that I don’t have a soul? I’m just a brain, I’m just a body.

And what helped with that, again, so much of . . . I do think that there are great kind of strides that can be made in people’s mental health if they get better philosophy often, and what helped with that, which freaked me out for quite a while, was getting better theology really, and anthropology, Christian anthropology, and the sense that we are body-souls. In fact, the way that Saint Thomas talks about the interaction of our bodies and our immaterial intellects is something that actually would make sense of something like Prozac working. The three things that Saint Thomas prescribes for depression, have a snack, take a nap and take a bath. So just make sure you’re not hangry or tired, and then just kind of . . .

James Mumford: Angels that supply food to Elijah on Mount Horeb.

Susannah Black Roberts: Yeah, but there is this kind of understanding of the human person, of human anthropology in Christianity in particular, as opposed to in kind of Iris Murdoch, whatever it was that she was, that I think kind of solves and makes a lot of room for all kinds of different therapeutic approaches, including medication, including talk therapy, including lots of different things because we understand that we’re complicated body-soul creatures where there’re all these weird feedback loops. And in fact, virtue ethics basically gives an account of how it could be the case that in, for example, cognitive behavioral therapy, which has been helpful for me, you can make a choice of your will and your intellect, which then actually rewrites pathways in your brain bizarrely. So your mind is doing something to your brain, which doesn’t actually make sense philosophically under materialism, but a lot of modern therapy requires that it be the case. Have those kinds of considerations been things that you’re thinking about in your book?

James Mumford: They are now. You’re writing my book for me. No, you must claim proprietary ownership over those ideas. I’m in a dangerously listening mode, but I think that . . . I mean, the book I’m writing is no screed against medication despite the problems we know of over-prescription and also the somewhat great promises that are sometimes . . . things being over-promised for medication. I still have enough friends who are psychiatrists who respond to the very trenchant critiques of medication for mental illness and say, “Well, what would you like me to do to this man or to this woman that is so unwell that he or she is unable to function? The behavior is awry and dangerous,” and it would be bad faith for me, having taken various medications, to give that screed as well.

I don’t know if what you’re talking about is a sort of affirmation and materiality that we see in incarnational Christianity. If that’s partly what you’re talking about, then I think that there is something unique about that affirmation of the body and the importance of somatic wholeness and the ways that therapy and pharmacology can help to get at that, and secure that somatic wholeness. That’s not my quarrel, no.

Susannah Black Roberts: So what is your quarrel? What other aspects of this are you working on now that you’d like to bring out for the listeners, or what is the center?

James Mumford: Yeah, my quarrel is with subjectivism, what C. S. Lewis called the poison of subjectivism, and it’s difficult to know whether that is caused by the therapeutic as a syndrome, or whether it’s caused by it or whether it causes therapy to be the therapy that I encountered. So that’s one of the big questions I’m wrestling with, and Philip Rieff is such an important figure he is, but The Triumph of the Therapeutic from 1966 is still an invaluable contribution.

I think one last thing to sort of say would be how the problem with how we’ve come to understand moral development and the way we think about the education of children, that some moral development theorists beginning with Piaget and then moving on to Kohlberg, think that moral realism, as they put it, or this belief that there’s a right and wrong outside of ourselves bluntly, that transcends us and that we need to see or integrate ourselves with in order to be whole, that that’s part of the building blocks of reality, that is part of the fabric of the world – That moral realism is an infantile notion that is heteronomous and something that we grow out of.

Maturity is coming to realize that we are the source of moral rules, and that’s baked into how they understood the cognitive and moral development of children, which obviously has huge implications for how I think about raising my own children, how I think about education, and at its core is this same idea that our hands are going to be empty in terms of what we have to hand on to our children if we really believe that we are the source of the norms that we live by and thrive by.

Peter Mommsen: I mean, as a dad, I really love that insight. Of course, now I’ve got teenagers and if I were the source of the norms, I’m not sure how much convincing power they’d have.

James Mumford: Yeah, that wouldn’t be authority. Yeah.

Peter Mommsen: Thanks so much for talking with us.

James Mumford: All the best.

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