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personal responsibility & mental illness

Posted by anovagrrl on April 26, 2004 at 06:50:17

In Reply to: Oldtimers? posted by Jesse H on April 22, 2004 at 13:20:00:

Some people with brain diseases don't know what they're doing when they're in a psychotic state. However, brain disease impacts judgement, insight and reasoning to varying degrees, so that the "don't know what I'm doing" mental state is an end-point that describes a very, very small proportion of behavior that can be linked to a brain disease.

It is possible to have a behavioral health disease--and alcoholism is considered such a disease--and know that your behavior is hurtful to yourself and others. Still, such a person acts against his/her own best interests and "does the thing s/he would not" (as Paul might put it.) This striving of the flesh against the spirit is considered compulsive behavior, and there are medications & therapies that can help a person get his/her compulsive behavior under control. Prayer also helps some people overcome some forms of compulsive behavior in certain circumstances, but we know from clinical trials that the appropriate medicine and therapy helps more people more often more quickly in more situations than any other intervention.

If Berg did in fact have Borderline Personality Disorder, this doesn't mean he didn't know right from wrong. It means that his perceptions of reality were very distorted at times by black and white reasoning, particularly when he was feeling stressed. There were also times when his insight into his own behavior was extremely poor. There were times when his mental state was in such turmoil, times when he was so overcome with anxiety and fear that he behaved in very destructive ways. He would have rationalized his behavior as being OK because his reasoning capabilities were limited by his distorted belief system about what constitutes reality. Because alcohol use was "OK" in his particular belief system, he found it helpful (in the short run) with getting his anxiety under control. Unfortunately, this self-medication reinforced his cognitive distortions.

Please note: The prisons are full to overflowing with people who have diagnosable brain diseases like BPD. The presence of a brain disease does not in and of itself absolve a person of responsibility for obeying the laws of man and God.

If anything, a diagnosis and increased knowledge of brain disease requires taking responsibility for one's health and behavior. However, remaining ignorant about brain disease comes with a certain advantage. If you don't have a disease, then there's no point in seeking help, is there? Or, if you choose to believe that all physical illnesses have a spiritual cause, then why seek a physical remedy for something that originates in the spiritual realm?

It may be easier to understand Berg's responsibility for his mental state and related behavior as a matter of demon oppression or affliction with a foul spirit, such as Abraham. However, the same principle of personal responsibility and free will applies to people with brain diseases. That is, we each have a moral responsibility to take care of our behavioral health; if we choose not to take responsibility for our health, then we have to live with the consequences of that decision--regardless of whether that decision is based on lack of knowledge, distorted perceptions, irrational beliefs, or even lack of access to appropriate care.

There were very serious consequence to Berg's decision not to seek appropriate treatment for his alcoholism--his most obvious symptomatic behavior. If he had gone into treatment for his addiction, he would have had to confront the underlying anxiety that warped his personality structure (egotism) and the irrational beliefs on which he rationalized so much of his behavior. It's hard to maintain the claim that you're God's chosen, end-time prophet if you take responsibility for the fact that you can be an irrational person due to your faulty neural functioning. I would argue from experience that there are many saintly people in this world who have brain diseases. However, these saintly people have taken responsibility for their behavioral health and do not use their condition as an excuse for bad behavior and bad choices.

If it is possible to be a kind, loving, grace-filled person with a brain disease, it is equally possible to be an evil person with a brain disease. Berg's choice to interpret his alcoholism primarily as a problem of self-will rather than a fairly well understood physiological process involving "broken" neural synapses and inadequate metabolism had an extremely serious consequence. Berg is remembered as a monster. There are people who curse his name and all that he stood for. Regardless of the fiction that Zerby perpetuates, Berg's historic legacy is not one I would wish for myself or anyone else, for that matter.