Political psychiatry: a post-Watergate perspective or the revolution of falling expectations.

The social contract is a concept equally vital to philosophy and psychology in terms more relevant to this presentation, to politics and psychiatry. From the Hobbesian point of view, the contract has to do with the rights and responsibilities of different components and classes of society vis á vis one another. From the psychodynamic point of view, the social contract has to do with the way individuals relate to each other. Common to both perspectives is the implicit recognition that certain rules will be followed and that penalties will ensue when they are not, or, at the very least, that the prospect of penality will serve as a deterrent. These two notions of social contract converge in the actual regulation of our individual and collective behavior. Governance is impossible without trust in either the rules (more commonly known as the law, or the rule of law) or the people who administer them, whether parent, judge, or senator. Laws that are accepted and a corresponding "care that those laws are failfully executed" both are necessary to a good and just society. Perhaps I can demonstrate these concepts by paraphrasing the nobel Prize winning Japanese novelist who used as a title of his prize winning novel, The Sound of the Mountain. The tearing of the social fabric is the sound of loss of trust in our government, governors, and governance. If that trust is lost, it is but a step to loss of faith in self. For me, the test of these envolving concepts is their usefulness in predicting or at least in coping with the near future. To re-establish trust is our major task. My view may be too narrow and parochial, but I think it is more than coincidental that two of the groups under severest attack as untrustworthy are politicians and psychiatrists. The response of these two groups have some dramatic and meaningful similarities. In politics or, at least, in campaign rhetoric we are seeing fewer promises and more candor; mor emphasis on truthfulness, personal integrity, and character and fewer offers to solve difficult problems. In psychiatry, and somewhat in psychology and the other behavioral and social sciences, we see a demand to reduce the role of scope of the profession, particularly in dealing with "social issues," such as poverty and racism, which commentators and critics consider to be outside the proper sphere of competence and propriety. As a political psychiatrist, I am deeply concerned. In order to avoid the pitfalls of over-promising, we are overreacting; we are movinginto a trap that combines anti-intellectualism and anti-idealism. It can be summarized briefly in what I would call "the revolution of falling expectations." This is wrong. I protest. At the risk of being accused of hubris and hutzpah, I feel that nothing less than the best intellectual capacities and abilities and the deepest and widest experience are needed to deal with our problems in both politics and psychiatry...