One “advantage” of working in psychiatry is getting a window into an otherwise invisible world of really miserable people.
I work in a wealthy, mostly-white college town consistently ranked one of the best places to live in the country. If there’s anywhere that you might dare hope wasn’t filled to the brim with people living hopeless lives, it would be here. But that hope is not realized. Every day I get to listen to people describe problems that would seem overwrought if they were in a novel, and made-up if they were in a thinkpiece on The Fragmentation Of American Society.
Alexander goes on to give details about the kinds of problems he’s seeing, and to point out why he thought maybe he’s seeing the worst people because he’s, you know, a psychiatrist, but how that just doesn’t pan out. More:
The world is almost certainly a much worse place than any of us want to admit. And that’s before you’ve even left America.
This is part of why I get enraged whenever somebody on Tumblr says “People in Group X need to realize they have it really good”, or “You’re a Group X member, so stop pretending like you have real problems.” The town where I practice psychiatry is mostly white and mostly wealthy. That doesn’t save it. And whenever some online thinkpiece writer laughs about how good people in Group X have it and how hilarious it is that they sometimes complain about their lives, it never fails that I have just gotten home from treating a member of Group X who attempted suicide.
This is also why I am wary whenever people start boasting about how much better we’re doing than back in the bad old days. That precise statement seems to in fact be true. But people have a bad tendency to follow it up with “And so now most people have it pretty good”. I don’t think we have any idea how many people do or don’t have it pretty good. Nobody who hasn’t read polls would intuitively guess that 40-something percent of Americans are young-Earth creationists. How should they know how many people have it pretty good or not?
Read it all. In my life, I have known some folks who to outsiders, were on top of the world. You want to see your cover model for White Privilege Quarterly? Them. And yet, they were profoundly miserable, and miserable for serious reasons. Their money and their social position did nothing to spare them from the pain of broken families, addiction, and on and on. I’ve also known more white working class and poor people who were just barely hanging on. Every time I hear some bigmouth black student at an Ivy or a costly liberal arts college talk about how oppressed they are because somebody microaggressed against them, I think about the people who live right here in my part of the world — black and white alike — who are suffering deprivation and dysfunction that would beggar belief of these elites.
On the other hand, some of these same people are probably happier, on balance, than these expensively educated elites, because they have a greater capacity for happiness, despite material deprivation. Funny, but a Harvard study last year found that two of the five happiest cities in the nation are in Louisiana: Baton Rouge and Lafayette. Corrupt, poor, hot, backwards Louisiana. Imagine that.
Can we really say that we have it better, on balance, now, than we did in the old days? Most people probably do, but how do we measure this? Yes, I would rather live today in a time of air conditioning and effective anesthesia than in the old days, and so would you. But there are many more kinds of suffering, you know. Perhaps people in the “old days,” whenever that is, did not perceive certain kinds of suffering to be as bad as we imagine it must have been, because they had greater spiritual and communal resources to help them bear it. As I’ve mentioned here before, my father told great stories about growing up in the rural South during the Great Depression. God, they were poor. If the only meat you have to eat many nights is squirrel, you are poor. But Daddy said very few people back then perceived themselves as especially poor, because everybody was in the same boat. Looking back on that time from the vantage point of today, they were suffering terribly. But that’s not how they saw it.
Anyway, I was moved by Scott Alexander’s reflection on the depth, complexity, and intensity of the pain he sees behind the well-groomed façade of his wealthy college town. Judge not, lest ye be judged is not just a high moral ideal, but the most practical wisdom.