I once had a very successful female patient named Susan, who was in her late 30's and was rising rapidly in her career; but who felt dissatisfied and fairly unhappy, not only in her career, but also in her personal life. In spite of her demonstrable capabilites, she felt inadequate and like she didn't deserve her wealth or status. Sometimes she felt like she didn't even deserve to live. Susan came to see me because she couldn't understand why she felt the way she did, and --unlike most of my patients--she didn't want medication. "Why can't I just be happy?" she wanted to know; so we proceeded to talk about her life to see if we could discover what might be going on.
Some weeks later, in a casual comment, Susan mentioned that she had never liked her younger brother when she was growing up. I looked up from my notes, surprised, because she had never mentioned her brother before.
"I didn't know you had a brother," I said. "Oh," she commented lightly, "he died. That's why I don't bring him up much."
Obviously she wanted to drop the subject, but I persisted. The brother who died was two younger than she was, and had died when he was 16.
"How sad for you and your family! That must have been terrible for you."
Susan shrugged. "It was a long time ago now," she said.
I considered whether I should pursue this further, since she clearly didn't want to talk about it. I asked her if it bothered her to talk about it.
"Not really."
"Could you tell me what happened to him?"
What followed was a dispassionate account of a family trip with the two parents in one car; and the patient and her brother in the other on their way to the family cabin in the mountains. The brother became tired, and went to the back seat to sleep. Susan, who was new to driving, misjudged a curve and went into it far too fast, causing her to lose control. The car slid off the road, and rolled over twice. My patient was uninjured because she had been wearing a seat belt. But her younger brother, sleeping in the back had been thrown from the car and died instantly.
I was stunned. This was serious stuff, and I knew it could be and probably was the origins of Susan's disabling guilt about her life. Yet the patient had never mentioned it in the weeks before as we had talked about her life, and seemed completely unaware that it could be linked to the very situation for which she had consulted me. Even now, while telling me the story, she sounded like a disinterested observer, rather than an intimate player in the drama she described.
"That must have been so awful for you," I said gently.
She smiled brightly at me. "Well, I guess I only did what every big sister really wants to do to an obnoxious brother!" Her laugh was rather forced.
"I suppose its natural for an older sister to feel very upset and angry with a rather trying younger brother--I have two of them, so I certainly know about that.... But I don't believe for a moment that you would truly want him dead or that you would deliberately kill him....it was just a horrible accident, wasn't it?"
She stared at me for a moment, then burst into tears, with great gulping sobs that went on for more than 15 minutes, as I tried to console her the best I could. Yes, the accident was her fault. She had made a mistake and it resulted in her brother's death. But she hadn't wanted him to die; and she hadn't deliberately gone off the road in order to make her childish and angry feelings toward him come true.
For years she had carried around the terrible burden of guilt about her brother's death, telling herself that she had killed him, feeling that her anger toward him made it deliberate. Her parents, grieving themselves, had never thought to absolve her of the accident.
As you might expect, her unhappiness with her life and her overwhelming feeling that she didn't have a right to live was tied to this traumatic incident in her life. What followed in the weeks after her revelation and sudden insight into her unresolved guilt and grief was the beginning of a cure for the inexplicable unhappiness she suffered in her life.
Her belief that she didn't deserve to live was tied up with her childish --and normal--sibling feelings about her brother. But what had sealed her fate was magical thinking--a belief that just because she had some negative feelings about him, those negative feelings had been responsible for the car accident. It was difficult for her to come to the realization that even if she had had uniformly positive and loving feelings toward her younger brother, the accident in which he was killed because she was an inexperienced driver would have still taken place.
With time, she moved from this dramatic insight, to accepting that, while she might have been a poor driver, she wasn't a murderer. And that also, if her brother had made other choices (e.g., used his seatbelt; waited for another hour to go to sleep; etc.)he too might have survived the accident. Some guilt was appropriate for her to deal with. But the life-destroying guilt she was experiencing was far more than she deserved.
Her insight actually gave her back her brother. Since the accident many years before, she had avoided thinking about him, and had psychologically banished all thoughts--both good and bad--about him from her life. For the first time in many years she could remember happy times with him, and finally appropriately mourn him.
Insight is a wonderful thing. The power or act of seeing into a situation and apprehending the inner nature or motivation of one's self--especially the why--can be extremely liberating, as it was for Susan. Only by being aware of these kind of hidden truths and inner motivations can a person gain control over them and correct the behavior that they generate.
But insight can also sometimes be devastating. Susan's insight freed her from a life of unhappiness and made her guilt over her brother's death much more bearable. But there are situations where achieving insight and understanding the motives behind one's behavior (as well as what one can and cannot control) can generate deserved guilt and shame. That is when such emotions can be productive and initiate a change in behavior for the good. While it is painful to acknowledge horrible truths--but truths nonetheless-- such understanding of one's self is essential for personal growth and normal personality development.
Interestingly, I thought of Susan when I was reflecting on the photos of Saddam Hussein in his underwear that were recently in the news; as well as his rage about it and his intent to file a lawsuit. At no time since he has been in custody, has Saddam expressed one iota of remorse or shame for all the murders and tortures he bears responsibility for; and I doubt that he has suffered a significant amount of guilt or shame because of them. When he looks in the mirror, he sees only a brave, heroic Muslim warrior, and not the pathetic human being he truly is.
Because of her insight and willingness to face her own inner truth, Susan demonstrated more integrity, honesty, courage and human decency than the former dictator of Iraq will ever be capable of.
Soon, Saddam will have his day in court. He will have lawyers arguing passionately for his lack of responsibility for the brutal deaths of literally thousands upon thousands of his own people. He will undoubtedly demonstrate the same arrogance and pride that beggared his people while making him a wealthy and powerful despot. Any suffering he is now experiencing; any shame or humiliation will not be due to the heinous crimes he has committed over the years, but only to the superficial wounds against his outward vanity and pride.
Saddam will never achieve anywhere near the personal growth and development that my young patient Susan was able to; because he is incapable of any real psychological insight into his own evil, malignant behavior. Nor is he capable of the inner courage required to look at yourself in the mirror and truly know the person looking back.
But then, that is what defines true evil, isn't it? The inability to acknowledge any degree of responsibility for their behavior; or to see clearly into their own souls. And that is the ultimate purpose of, and necessity for, Justice -- to impose insight; force awareness; and to reflect reality for those who refuse to look in the mirror.
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