The Waning of the Spirit

Jubilee Book in Honor of
Shlomo Giora Shoham

The Waning of the Spirit

Jubilee Book in Honor of
Shlomo Giora Shoham

Editor

CHemi Ben NoOn

IDRA Publishing, Tel-Aviv

Table of Contents

Hebrew Section

Chemi Ben Noon -  Shlomo Giora Shoham’s friends and Their Contribution to the Collection

Chemi Ben Noon- Introduction

Chemi Ben Noon - The Waning of the Spirit?

Joseph Agassi - Quid facit, quid Juris: Truth and Justice, Science and Law

Achia Admoni and Shay Admoni - “No Wooden Horse, to Exist or Become Extinct”: 20 Years of Trojan Horse (1984-2003)

Yakir Aharonov and Avshalom Elizur - Time Saw it and Fled: Reflections on the Third Revolution in Modern Physics

Avshalom Elizur - In Search of Faithful Remembrance

Avi Elqayam - “I am the One that I Desire, the One I Desire is I”, The Love Poetry of the Crucified Poet al-Ḥusayn bin Manṣūr al-Ḥallaj

Jean Askenasy - Shlomo Giora Shoham, Nonagenarian

Raanan Ben-Tovim - Apologetics to Shlomo

Itzik Ben-Yair and Natti Ronel - Spiritual Jewish Criminology

Matityahu Gutreich - Towards a Hermeneutics of a Text by Chuang Tzu: What is the Language of Clowns?

Itzik Ben-Yair and Natti Ronel - Spiritual Jewish Criminology

Yitzhak Hadari - The Reciprocal Relationship between the Income Tax Ordinance and the Land Taxation Law

Igal Vardi - Ontological Revolt at the Meaning of Life – the “Tantalus Process” According to the Personality Theory of Shlomo Giora Shoham

Sagi Vardi - The Guide and the Apprentice

Yossi Ziv - Mysticism as the Limit of Rationality

Amicḥai Zilberman - A Possible Platform for the Oceanic Oeuvre of Shlomo Shoham

Yoav Igal - “The Home” and Inbuilt Uncanny

Rafi Yaakobi - School of Friendship – Learning to Change 

Adir Cohen - Literature and Thought Merge: The Literary Works of Bertrand Russell

Erez Casif - David Ben Gurion – Sisyphean Protagonist

Erez Casif and Igal Vardi - Personality of Politics – Shoham’s Personality Theory as a Tool for Analyzing the Political Domain

Moḥamed Kittany - “There is Nothing Better for a Man than to Deal Justly Unless it be to Love”

Yossi Lev - Alice – Through the Looking Glass: From Infancy to Adulthood

Shimon Levy - I, “I” and Not I – On Acting, Identity and Ethics

Mibi B. Moser and Shira Brik-Haimovich - Freedom of Speech and the Poland Holocaust Law

Ron Margolin - Shlomo Giora Shoham’s Approach to Myth: Conceptual Sources and Current Implications

Alon Mark - The Dialogue between Myth and Chaos in the Buddhist Tantric Tradition

Mordecai (Motti) Mark - The Trial of Solomon at the House of God. The Dilemma of Forced Psychiatric Hospitalization

Eyal Naveh - The Erosion of the Zionist Narrative in Israel Following a Two-Sided Attack on its Meaning

Zvi Amely - Because of the Expulsion from Eden, Thanks to the Expulsion from Eden

Juval Portugali - “It Turneth about Continually in its Circuit, and the Wind Returneth Again to its Circuits”

Aviva Fried - The Courage to Treat

Ghil’ad Zuckermann and Gitit Holzman - Language Revival, Social Justic and Mental Health

Moshe Zuckermann - The Artist and his Art

Giora Rahav - Foreigners’ Crime in Israel

Yinon Shivtiel - New Insights into the Study of Rock-Hewn Caves (Hiding Complexes) and Natural Caves (Refuges) in Galilee as Jewish Defensive Methods in Ancient Times

English Section

Macabee Dean - Shoham from a Long-Time Friend’s Perspective

Stefano Ferracuti and Gabriele Mandarelli - Informed Consent in Non-consensual Psychiatric Care, an Overview

Haim Hazan - The Insufferable Other: Dementia as a Modern Ghost Story

Gregory J. Howard - This Could Be a Best-Seller: A Dialogical Gift

Kalman J. Kaplan - Biblical Humanism and Suicide Prevention: Where Did the Greeks Go Wrong?

Paul Knepper - The Return of the Crime Museum

Arie Nadler - Intergroup Reconciliation and Victimhood: Social Psychological Dynamics

Yongjae Nam & Mahesh K. Nalla - The Effect of Childhood Violence Victimization Experiences on Dating Violence – The South Korean Experience

Graeme R. Newman and Pietro Marongiu - On Punishment

Robert T. Rubin - Fading Influence of Humanism in Medicine – Illusion or Reality?

Frank J. Tipler - Genesis Chapter One is a Fine Textbook on Modern Cosmology

Science and Spirituality Series

Series Editor: Prof. Avi Elqayam

Academic Board:

Prof. Shlomo Giora Shoham

Prof. Oded Maimon

Cover Art: Igal Vardi

Cover Design: Avi Elqayam

ISBN: 978-965-92711-4-6

Copyright 2019 by Idra Publishing ©

IdraPublisher@gmail.com

http://idra.org.il/

All Hebrew and English rights reserved. No part of this book may be used or reproduced in any manner whatsoever without the written
permission of Idra Publishing, except in the case of brief
quotations embodied in reviews.

Printed in Israel 2019

Macabee Dean

Shoham from a Long-Time Friend’s Perspective

Shlomo was born in Lithuania in 1929 and arrived in ‘Palestina’ in 1935.

My 60-year friendship with Shlomo started in the most conventional way. I was a reporter for the Jerusalem Post in the early 1950s. One day I looked up to see standing near me the equivalent of an American football bruiser. He was tall, strongly built, and closely resembled a British soldier from the Mandate period who had married an Israeli girl and stayed in Israel.

During the British Mandate, Shlomo was waved through British checkpoints without having to show identification. This enabled him to carry out several secret missions for the Jewish secret service. He described those days in his book, שכשל העד (The Failed Witness), published by Schocken.

In flawless Hebrew without the slightest foreign accent, Shlomo said: “I’m a law student at Hebrew University. I got a job as a news reporter for ITIM, the Israeli news agency. Can you teach me the basics of writing a news story?” (This turned out to be typical Shlomo: first get the job, then worry about how to do it.)

I explained the ‘hook’, something that would attract reader interest, then the journalistic Who, What, When, Where & Why. “Since you are writing for all the newspapers, keep to the facts. Never let your personal views and beliefs creep into your story. A journalist on each paper will rewrite your story to fit his paper’s policy and probably put his byline on your story.”

He quickly grasped the general principles. Then I added a personal admonishment: “Never try to change mankind. If celestial prophets like Moses, Jesus and Mohammed failed, and earthly prophets such as Lenin and Hitler failed, so will you.”

Shlomo failed to heed my advice.

Until this day, Shlomo is not only a criminal theorist, but once a week he meets with criminals and tries to change their way of life. These meetings, which have produced a remarkable 40% success rate, are patterned after Alcoholics Anonymous (AA) whose members meet regularly to seek the help of others in breaking their addiction.

On his 80th birthday, Tel Aviv University honored Shlomo with an evening of lectures. When the event ended, two former drug addicts climaxed the evening by rushing to him and embracing him for changing their lives.

Shlomo was a world-wide name in criminology at an early age. He had the unusual advantage of working in a field that included both native Israelis and the criminal law breakers in the streams of refugees arriving from dozens of countries. Many had been forced into crime to obtain bread to survive. Others found it difficult to adapt to life in Israel. They were not typical lawbreakers.

Each aliya had its own ‘crime pattern’. The huge Russian aliya, for example, brought drinking problems. The Polish tended towards trickery and financial crimes. The Moroccans brought the lovely Mimouna holiday, but they leaned towards violence and larceny as their patriarchal system disintegrated. The Egyptian aliya was probably the most law-abiding. It silently melted away into the existing populace.

During all these years, the melting pot of the school system, the pressure cooker of the army, Ashkenazi – Sephardi intermarriages, and the leniency of the judicial system combined to create a new breed – typical Israelis with their own pattern of crime.

Shlomo is a devoted family man. When his son Giora was a toddler, Shlomo used to toss his giggling boy into the air and catch him, saying “My King, my King.”

When Giora fell in the line of duty in the Yom Kippur war, Shlomo’s reaction was the same as King David’s when his son, Avshalom was killed (2 Samuel 19:1): “Would that I have died instead of you.” Shlomo not only held memorial services, he added Giora to his own name: Shlomo Giora Shoham.

His son Boaz is an agricultural genetic engineer. His daughter Yael is still seeking her future. His wife Ruth has a degree in the classics.

For a person who dealt with the harsh realities of life during his career, Shlomo is also a ‘Paradise dreamer’. This is the only explanation for the title of his book about his childhood and youth mentioned above, The Failed Witness, which was written decades after his early years.

Did he expect Israel to become the biblical Paradise? If so, he forgot the statement credited to Jabotinsky that “we demand the right to have our own villains, exactly as other people have them.” It seems that Israelis, as distinguished from Jews in the diaspora, became normal people at a blitzkrieg pace.

Shlomo was a university student whose ability to grasp the essence of journalism within a few minutes showed enormous intellectual potential. I was an American farm boy and a joyous university dropout. I thought I was stupid enough without studying such useless things like ethics and morality after WWII.

Why did we become life-long friends? I have no answers. Perhaps because he was a dedicated idealist and I was a confirmed cynic. We both understood the thought patterns of criminals. His experience included successful work with criminals. My experience included combat in Italy during WWII. None of us G.I.s ‘stole’ anything; we just ‘liberated’ things.

Both of us, he as a criminologist and I as a journalist, dealt mostly with the pathological side of mankind. We both needed a drinking companion. Many were the times we finished a cheap bottle of arak together. Because Shlomo inherited a family tendency to diabetes, he stopped drinking alcohol many years ago.

Why did we remain friends? Perhaps because he wanted to exchange bawdy jokes. His generated more laughter than mine. Perhaps because we thought differently. During the first eight years of my schooling in America, all my teachers were of German extraction. They indoctrinated me to believe that Germany’s achievements in all fields were the best in the world.

And in the pre-Hitler period this was true. Most German Jews thought this was true causing many to refuse to leave Hitlerian Germany. They left through the crematoria chimney.

Our different ways of thinking can best be shown by his plan to write a book about Adolf Eichmann. Shlomo asked me to join him and Ze’ev Avni in writing this book. Shlomo would be the specialist in diagnosing the criminal mind. I had covered the Eichmann show trial for the Jerusalem Post and had obtained the trial protocol in German. Avni, whose mother tongue was German, would interpret that trial protocol.

Avni had just finished a 12-year-jail sentence. He had been a Russian Communist spy, had infiltrated the Israeli civil service in Europe, and had gathered classified information about the activities of the Mossad for 15 years before arousing the suspicions of Isser Harel, then head of the Mossad.

We spent a morning once a week for several months discussing the theories upon which our book would be based. The plan fell apart due to our differences of opinion. Although Avni had garbaged his communist indoctrination, he felt that Eichmann was part of Marx’s theory of a working class uprising. Shlomo thought Eichmann was a human devil, the most evil person alive. I thought any ordinary person – I repeat, any ordinary person – could be brainwashed to honestly believe that his duty was to kill Jews who were Germany’s enemies.

Eichmann was far from a human devil. He was a party functionary who did nothing without signed orders – which his attorney produced in court. Moreover, Eichmann had personal contact with the Jews. The leading Nazis, from Hitler to Goring, Himmler, Goebbels, and so on kept themselves far distant from actual Jews.

(In my opinion, Eichmann was nothing more than a devoted SS officer zestfully carrying out his orders. Why was such enormous attention given to Eichmann? He was the last famous name – except for Dr. Mengele – of the German Nazis associated with the Final Solution. Hanging him would pave the way for Germany’s re-admission to the world’s ‘civilized Nations’. And Israel would benefit from German financial help to absorb the European Jewish refugees.)

After Avni was discharged from prison, Shlomo did everything possible to see that Avni became a useful member of Israeli society. Avni had studied psychiatry in prison and planned to work as a lay psychiatrist. Avni’s confession of his gradual rejection of communism is a masterpiece and rivals Arthur Koestler’s essay in the famous book edited by Richard Crossman, The God that Failed.

The same reasons that converted Avni to a communist also convinced a huge number of persons in all of the world’s countries to believe that Communism was the future. During the American-Russian Cold War, a hysterical witch hunt for communists in America took place.

Avni’s confession is an entire chapter of a 300-page study that Shlomo wrote during that period. It is entitled Beggars at the Gate dealing with “Studies in Personal Anomie.” The study is not even dated. Nevertheless, it has become a collector’s item.

Avni’s personality and his philosophy of life continues to fascinate Shlomo until today. How could a highly intelligent man, a learned man, believe that Communism was the wave of the future? How could so many Russian, American, French, Italian, and so on, learned intellects believe that any theory, no manner how brilliant on paper, could succeed without the use of secret police, physical and mental torture, and concentration camps?

Human nature, which has not changed in untold generations, could not be changed by a theory, by brainwashing. Nazism, at least, was based on human nature: kill, murder, rob, rape, steal, torture, enslave, and so on.

Shlomo saw the Final Solution as the most atrocious sin committed by mankind. Due to my pro-German education, I saw it as inevitable for two reasons. First, when Hitler assumed power, the Nazis and Communists were fighting bloody street battles. Hitler saw that creating virulent Anti-Semitism was the easiest way to reunite Germany and win the sympathy of nearly all Germans and much of Christianity worldwide, including the closet Nazi, Pope Pius XII.

Secondly, Hitler believed that the Germans, the Aryans, were a superior race. Hitler had to liquidate the Jews since the Bible named them God’s Chosen People.

Hitler is quoting as saying he preferred to sacrifice – to sacrifice, not to lose – three million German soldiers in three months, rather than four million in four years. By the same token, he was willing to wipe out all the Chosen People. And he nearly succeeded because both the Christian and Islamic world refused them entry.

It was the stupidest mistake Hitler ever made. The German Jewish scientists, who were the world leaders in atomic energy, fled to America where they built the first atomic bomb. Had they stayed in Germany, we would all be speaking German today.

Shlomo has one characteristic which, some say, is both a blessing and a curse. He is a compulsive writer. While writing one book, his mind is already churning out another. He publishes at least one and often two books every year.

He has written – and published – more than 100 books, not only in his specialty, criminology, but in philosophy, psychology, social science, and more. He has also written fiction and plays.

Shlomo goes to sleep early in the evening and wakes up early. When he takes a taxi to lecture in one of Israel’s colleges, he takes along a pad and writes with an old-fashioned fountain pen – not with a ball-point pen which other academics abandoned decades ago for a much faster computer.

Those who type fast often use the first word or idea their mind serves up. Those who write slowly by hand often use the second or third word or idea their mind delivers.

Shlomo does have a telephone at home. But he has none of the latest electronic gifts to humanity. He has no smartphone; no fax, no computer and no printer at home. However, he does read email at his office in room 03 of the Trubowicz building at Tel Aviv University.

Like academics at the turn of the century, he is an avid book collector. My wife’s father left a library of perhaps 800 learned books in French. Shlomo spotted a copy of the Encyclopedia Larousse and then rapidly picked up book after book.

“I want every one of those books for my private library.” He called up a moving company (founded by one his reformed friends) and the books were taken away a few hours later.

Years ago, I tried to verify that Shlomo was quoted as saying, “The only thing worth stealing is a good book.” I failed. Of course, the best source was Shlomo. But I didn’t think a criminalist of his statue would confess to having made such a statement.

For a short time, this placard was on the door to his home: “This home is clean enough to be healthy, and messy enough to be comfortable.” ‘Messy’ means to sit down one must remove books from a chair and place them on a table already bursting with books. He once piled book on book until he had a ‘Tower of Babel’.

Although Shlomo loves books, he is far from even liking publishers. I will not mention his opinion since some delicate souls may be reading this. In brief, he believes that many of them are worse than the worse criminals he is trying to persuade to abandon their life of crime.

His complaint is simple: No one buys his books. The main reason is that the publishers do not advertise them. They print his books because they add a ‘serious cultural tone’ to the publishing house. Publishers rarely take the effort to publicize such books. These publishers make their living from popular books, from ‘best sellers’ that disappear from the best seller list in a short few months.

Shlomo writes philosophical books, books that express his opinions and his thinking. His books appeal to a special type of intellectual who reads with a pencil in his hand, who argues with the author, and who fills the book with marginal notes. Shlomo does not write ‘best sellers’ that cater to the type of person who buys and reads a new best seller every month or so.

Shlomo writes serious books about ideas which fascinate him. Many of his books have been translated to other languages. But he fails to grasp that he is writing for a very limited and special group of people who, a hundred years ago, would constitute a ‘Shoham cult’.

There are thousands upon thousands of university professors and post-graduate students who have a much more serious complaint: they cannot find a publisher for their books.

Western civilization has become enslaved by electronic gadgets, ranging from radio and TV down to the latest smart phone which, many will agree, has dulled our minds and not enlightened us. Mass education (to keep youngsters off the streets and provide work for academics) has reduced many universities to the level of high school a century ago.

Shlomo had great hopes for his book, Moses, the Righteous Sky Gazer. An Egyptian acquaintance had discovered some new hieroglyphics which threw a different light on the life and activities of Moses. Why did Shlomo write a book about Moses? Tradition. Freud wrote Moses and Monotheism. Buber wrote Moses: The Revelation and the Covenant. Shlomo wanted to be part of that tradition.

A century ago, before radio, TV and smart phones, when religion was a more important part of the average person’s interests, this book had the potential to be a best-seller. But science has lessened that interest. Today, such books are bought mainly by librarians and theologians.

Is there any solution? Perhaps the universities should help publish and publicize books written by their professors and graduate students. Perhaps the universities should organize a convention to discuss the problem.

To sum up, the best description of Shlomo would be that of a European academic at the beginning of the 1900s. This was before the Wright Brothers flew their airplane in 1903, before Ford started manufacturing assembly line Model Ts in 1908, and before WWII changed the world for ever. Back then, at the turn of the century, continental academics aimed at a well-rounded personality. They mastered several languages.

In addition to Hebrew, Shlomo lectures in English, French and Arabic. (He learned French and Arabic at the Umm el Jamal prisoner-of-war camp run by the Arab Legion.) He also has a working knowledge of German.

In that far distant period, intellectual ‘salons’ reigned. They were a symbol of the time. Once a week, serious books and affairs, local and worldwide, were discussed in private homes. For a brief period, Shlomo held a ‘salon’ on his lawn to discuss the weekly biblical portion. During inclement weather, he moved the ‘salon’ inside. The participants had to clear the chairs of books.

Shlomo lectured many semesters in English at Harvard University on law, criminology, philosophy and Judaism and in French at the Sorbonne on Kabbalah, Gnosis and existentialist philosophy.

In those days, each student had a mentor. Shlomo had two: the late Attorney General, Haim Cohen, and Martin Buber. When Shoham was a law student, it was Haim Cohen who noticed Shoham’s interest in criminology and advised him to specialize in this subject.

Academics then enjoyed classical music and learned to play an instrument, as well as sing. Shlomo only listens to classical music. He has a large collection of fascinating medieval music.

He is also a sportsman. In his long past youth he used to go underwater fishing with a spear.

And he has a wide acquaintance with wines and cheeses. As befits a man with a robust appetite, Shlomo can list the pluses and minuses of many Israeli restaurants. (A major result of his appetite for good food and his propensity to buy more books than he sells is that he always has a fluctuating overdraft.)

He differs from other academicians because at the age of 90 – an age few active academics in any country reach – he is still a super active professor emeritus with a clear and active mind in a relatively healthy body.

If he continues at the same pace into his 90s, future generations will probably call him a ‘phenomenon’.

Stefano Ferracuti and Gabriele Mandarelli

Informed Consent in Non-consensual Psychiatric Care, an Overview

Introduction, legislative and clinical problems

Involuntary hospitalization or treatment of patients suffering from mental disorders is one of the main ethical issues, due to practical, juridical, ethical, and deontological implications in psychiatric care. Despite several attempts aimed at reducing or abolishing coercive treatments, clinicians still deem involuntary psychiatric treatments necessary at least as a last resort option in some cases. There is no legal international standard for involuntary hospitalization of mental health patients. The legal prerequisites for involuntary treatment vary in different jurisdictions (Dressing & Salize, 2004), however the clinical perception is that those patients who are treated involuntarily lack the ability to give valid consent / denial to treatment.

In several countries, involuntary psychiatric treatment criteria are linked to an evaluation of patients’ dangerousness for self or others (Steinert et al., 2014), while in others the focus is on the severity of the disease and the need for treatment, which must also be refused by the patient (Carabellese et al., 2012). Some countries (e.g., Denmark, Finland, Greece, Ireland, United Kingdom, Portugal) provide both criteria. Summarizing, two types of Mental Health regulation criteria for involuntary commitment exist: a) those requiring mental illness and danger, and b) those requiring mental illness and need for-treatment (Dressing & Salize, 2004).

In Italy, Spain and Sweden, the legal regulation concerning involuntary psychiatric hospitalization does not rely upon dangerousness nor on a capacity-based criterion. Specifically, three conditions are required: 1) the patient is suffering from ‘psychic alterations’ that need immediate treatment, 2) the patient refuses treatment, and 3) the patient cannot be adequately treated by other non-hospital-based means. This procedure allows both compulsory admission and treatment of patients, while in other countries (e.g., the Mental Health Act of England and Wales) involuntary hospitalization and involuntary treatment are regulated by distinct procedures. In Italy, two medical certificates are required (proposal and confirmation), the decision is issued by the city mayor, and verified by a judge. The maximum length of initial placement is 7 days, but it can be extended based on a medical decision certifying the persistence of the 3 criteria.

Among European Union Member States, the considerable inconsistency among different legislative and procedural details for compulsory admission has been pointed out (Dressing & Salize, 2004), as well as the need for cross-national harmonization of regulations. Moreover, it has been acknowledged that current mental health regulations might lack compliance with the principles of autonomy and self-determination of patients, and are inconsistent with the UN Convention on the Rights of Persons with Disabilities 2006 (CRPD) (Szmukler & Kelly, 2016). For such reasons a so-called ‘Fusion Law’ based on assessment of patient’s decision-making capacity (DMC) and patients’ best interest has been proposed (Szmukler et al., 2014).

Beyond differences in the legal framework for involuntary commitment, the abilities required for giving a valid informed consent / dissent to treatment are well recognized, and specific reliable clinical tools to measure such abilities exist (Appelbaum, 2007).

An increasing number of studies prove the existence of significant variability in psychiatric patients’ capacity to give informed consent in acute psychiatric inpatient settings. Initial results from a single-center study from our group unexpectedly showed that non-consensual psychiatric patients under a need for treatment based regulation might preserve treatment decision-making abilities (Mandarelli et al., 2014). Such data prompted us to further verify those results in a larger sample from different centers.

It is noteworthy that the diagnosis of a mental disorder is not a definite correlate of reduced or compromised mental capacity. Psychiatric inpatients do not necessarily perform poorer than medical inpatients in informed consent decision-making measures (Lepping et al., 2015), while significant within group variability has emerged in both groups of patients (Candia & Barba, 2011; Owen et al., 2013; Palmer et al., 2007; Raymont et al., 2004). Specific clinical characteristics are most often associated with lack or impaired capacity to consent to treatment (Aydin Er et al., 2013). Among these are excitement and positive symptoms (Cairns et al., 2005; Howe et al., 2005; Mandarelli et al., 2014; Owen et al., 2008), cognitive dysfunction (Jeste et al., 2006; Palmer et al., 2004; Parmigiani et al., 2016), impaired executive functioning (Mandarelli et al., 2012), and impaired metacognition (Koren et al., 2005).

Patients affected by mental disorders in acute phase are at greater risk of incapacity, as are those treated involuntarily (Catanesi et al., 2010; Howe et al., 2005; Kallert et al., 2008; Mandarelli et al., 2014; Okai et al., 2007; Owen et al., 2008). Little is known about the neurophysiological underpinnings of treatment-related decision-making, while an introductory fMRI study showed activation of specific brain areas during a clinical-research decision-making task (Eyler et al., 2007).

Despite these advances, research has not yet explained the actual degree of impairment of mental capacity to consent to treatment in psychiatric patients who are involuntarily hospitalized and/or treated due to an acute mental disorder. Nor have scholars yet explained the role played by psychopathological, diagnostic, and social features in this particularly vulnerable population. The two distinct legal prerequisites underlying involuntary treatment of people with mental disorders, i.e., need for treatment or dangerousness, also merit consideration with regard to capacity evaluations. It is conceivable that the evaluation of patients’ capacity to consent / dissent to treatment is more relevant in legal systems based on the need for treatment than in those based on dangerousness as a legal criterion for involuntary commitment.

Although from a legal point of view a patient is considered, according to a dichotomous view, competent of incompetent to give a valid consent / denial to treatment, there is initial evidence suggesting that there may exist residual autonomy and freedom of decision-making even in patients subjected to non-consensual treatment (Mandarelli et al., 2018; Mandarelli et al., 2014). The relationship between patients’ decisional capacity to consent to treatment, formal status, and clinical outcomes has been poorly investigated. Moreover, the factors underlying poor mental capacity remain unclear, especially in acute psychiatric coercive settings. Nor has research yet explained why and how mental capacity to make decisions about treatment varies widely in patients admitted voluntarily or involuntarily to a psychiatric patient unit for a mental disorder.

Instruments to assess consent

The tools developed for the assessment of the decisional capacity to consent are subdivided into those dedicated to treatment and those to research (Dunn, Nowrangi, Palmer, Jeste & Saks, 2006; Sturman, 2005). This differentiation is based on the different ethical and decisional assumptions underlying consent to treatment with respect to participation in experimental research, hence the need to evaluate somewhat different aspects.

Among the tools supported by greater empirical validity are the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) (Appelbaum & Grisso, 2001) and for Treatment (MacCAT-T) (Grisso, Appelbaum & Hill-Fotouhi, 1997).

The MacCAT-T is a semi-structured interview relying on a multidimensional capacity model. It investigates the patient’s understanding about the disorder’s main features and specific treatment, including potential risks and benefits. The MacCAT-T appreciating subscale measures the patient’s ability to acknowledge her/his medical condition and likely consequences of treatment options. The MacCAT-T reasoning subscale assesses the ability to manipulate the disclosed information about diagnosis and treatment in a rational and logical way, making assumptions on possible everyday effects of treatments, and comparing different treatment alternatives. Finally, the MacCAT-T expressing a choice subscale measures the ability to take and communicate a treatment-related decision in a clear and non-ambivalent way.

The MacCAT-T has proved reliable in assessing mental capacity in patients with severe mental disorders, including psychosis (Wang et al., 2017) and eating disorders (Elzakkers et al., 2018). No consensus exists on possible MacCAT scores associated with judgments of incapacity. However, some methods have been proposed for MacCAT-CR (Kim et al., 2007) and MacCAT-T (Mandarelli et al., 2018, 2014).

Psychiatric symptoms and consent

Several lines of evidence have highlighted an association between cognitive functioning and mental capacity, and that patients with cognitive dysfunctions present a higher risk of incapacity (Mandarelli et al., 2018, 2012; Palmer et al., 2004; Raymont et al., 2004). In patients presenting with severe psychiatric symptoms, as do patients hospitalized for acute treatment, psychiatric symptoms also appear to be negatively associated with decisional capacity (Cairns et al., 2005; Howe et al., 2005; Rutledge, Kennedy, O’Neill & Kennedy, 2008). The capacity to consent to treatment is a multidimensional construct encompassing several abilities (Appelbaum & Roth, 1982; Appelbaum & Grisso, 1998), all of which must be present to ensure competency, and can be differently impaired depending on the type and course of the mental disorder.

Cognitive dysfunction has been widely acknowledged as a factor of primary importance in both psychiatric (Carpenter et al., 2000; Dunn et al., 2007; Kovnick et al, 2003; Moser et al., 2002; Palmer & Savla, 2007; Palmer et al., 2004; Palmer & Jeste, 2006) and non-psychiatric samples (Raymont et al., 2004). Psychiatric symptom severity (Howe et al., 2005) and impaired meta-cognition (Koren et al., 2005) have also been linked to reduced ability to make informed decisions. In addition to individual features, multiple environmental factors may play a role in determining variability of patients’ capacity to consent to treatment or research participation (Jeste et al., 2007; Palmer & Jeste, 2006), including the complexity of disclosed information, type of clinical setting, and the quality of consent forms and disclosing procedures.

Evidence supporting the existence of a wide array of specific cognitive and neuropsychological alterations has been provided in patients suffering from schizophrenia (Barch & Ceaser, 2012; Mesholam-Gately, Giuliano, Goff, Faraone & Seidman, 2009) and bipolar disorder (Hellvin et al., 2012; Torrent et al., 2012). Alterations in working memory, verbal memory, information processing speed, attention, sensory processing and executive functioning have been reported in the early stages of schizophrenia and bipolar disorder (Barch & Ceaser, 2012; Hellvin et al., 2012; Mesholam-Gately et al., 2009).

Decisional capacity requires the intervention of multiple domains of mental functioning, most of which appear to rely on the concept of executive functions, such as will, inhibition, abstract reasoning, concept formation, prediction, and planning (Koren et al., 1998). Executive functions are also involved in cognitive set shifts and in learning new rules in accordance with varying environmental feedbacks, accounting altogether for the cognitive flexibility of the individual (Goldstein, 1990). Executive functions are considered to rely upon frontal-cortical areas together with other complex networks of frontal-cortical and subcortical circuitries (Leh, Petrides & Strafella, 2010).

Because all these features are encompassed by complex decision-making processes, such as those involved in informed consent acquisition, executive functions may intuitively be involved in this context, and executive-dysfunction might play a significant role in determining incompetency. Four studies reported an association between executive functions and consent process (Holzer et al., 1997; Mandarelli et al., 2012; Palmer & Savla, 2007; Schillerstrom et al., 2007) while one did not (Koren et al., 2005). Differences in methods and study samples may account for the lack of clear evidence. For instance, Koren and colleagues (2005) did not observe any correlation between executive functions investigated by the Wisconsin Card Sorting Test (WCST) and competence to consent to treatment. However, they did observe a role for meta-cognition. Conversely, another study (Holzer et al., 1997) found that incompetent patients scored significantly poorer than competent ones at the Executive Interview (Royall, Mahurin & Gray, 1992).

We enrolled a sample of acute psychiatric inpatients to investigate possible associations between executive functions and decisional capacity. Patients were recruited and evaluated through the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the 24-item Brief Psychiatric Rating Scale (BPRS) for the evaluation of the severity of psychopathology, the Mini Mental State Examination (MMSE) instrument for the evaluation of basic cognitive functions, and the Wisconsin Card Sorting Test (WCST), a well-established test for category generation, learning, problem solving and abstraction, i.e., the so-called executive functions. Patients with poor executive functioning performed worse in MacCAT-understanding, appreciation, and expression of a choice, compared with good performers. In addition, we found a strong association between learning abilities and informed consent decision-making, providing empirical evidence indicating possible cognitive enhancement strategies that may improve psychiatric patients’ competency.

More specifically, we observed that learning abilities, such as those investigated by the WCST learning to learn, play a significant role in consent decision-making. Partial correlation analysis, corrected for symptom severity and general cognitive functioning, revealed that good informed consent decision-making is associated with better executive functions performance, as measured by the higher number of WCST categories completed, percent conceptual level response, learning to learn, and, accordingly, lower error percentages and fewer attempts needed to complete the first category. The number of categories completed, a general measure of executive functioning, was mostly associated with the main informed consent features: understanding of diagnosis, risks, and benefits; appreciating diagnosis; logical consistency in reasoning; and expressing a choice. Accordingly, the number of attempts required to complete the first category, which expresses the intellectual level needed to understand the WCST sorting rule, was inversely associated with the measures of understanding and appreciation.

We did not observe an association between percent perseverative errors or failure to maintain set and competency, possibly due to type II error. We also verified the role effect of executive functions by using a dichotomic approach and comparing poor executive functioning patients with good performers, an analysis that confirmed a significant difference in all MacCAT-T subscales except reasoning. This finding was also unexpected since logical-reasoning, like that involved in complex treatment choices, is likely to involve executive functions. In interpreting this result, we must acknowledge that the majority of our acute psychiatric inpatients performed very poorly at reasoning, independently of executive functions performance.

The WCST learning to learn correlated positively with understanding of diagnosis and treatment risks and benefits, appreciation of diagnosis, reasoning logical consistency, and expressing a choice. We did not evaluate metacognition, a factor with initial evidence supporting a role in informed consent decision-making (Koren et al., 2005).

Consent in involuntary hospitalized patients

A systematic review (Okai et al., 2007) reported that unlike most psychiatric in-patients, those receiving involuntary psychiatric treatment tended to lack mental capacity. The few studies that have specifically evaluated treatment decision making capacity in patients who undergo voluntary or involuntary psychiatric treatment reported discrepant results, mainly owing to methodological problems including heterogeneous study samples and assessment methods (Bellhouse et al., 2013a, 2013b; Owen et al., 2008; Poythress et al., 1996). Some authors found no significant differences in treatment capacity between psychiatric patients admitted voluntarily or involuntarily (Poythress et al., 1996), while others found that an involuntarily-admitted subgroup scored worse on a scale measuring information understanding (Appelbaum, Appelbaum & Grisso, 1998). Yet others reported that a small sample of patients detained under the Mental Health Act 1983 lacked mental capacity to decide about hospital admission (Bellhouse et al., 2013a) and treatment (Bellhouse et al., 2013b). A study on a mixed sample of voluntary and detained in-patients using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), found that 43.8% of all in-patients lacked capacity, and 9.5% of detained patients had competence to consent to treatment (Cairns et al., 2005). Among clinical factors associated with incapacity the investigators identified the presence of mania, psychosis, delusions and poor insight (Cairns et al., 2005). In more recent years, Owen and colleagues found that 60% (95% CI 55−65) among 338 patients hospitalized in three general adult acute psychiatric in-patient units lacked mental capacity to make treatment decisions (Owen et al., 2008). Patients with mania or being detained had higher rates of incapacity.

We initially performed a study on a sample of voluntary vs. involuntary admitted patients in a psychiatric ward at Roma. We evaluated severity of psychopathology, basic cognition, and capacity to express informed consent. We confirmed the hypothesis that mental capacity to consent to treatment, as measured by a semi-structured clinical interview, differs significantly between in-patients treated involuntarily or voluntarily for an acute mental disorder. Involuntarily-treated patients as a group performed significantly worse than their voluntary counterparts in all MacCAT-T measures. Hence, using a multidimensional mental capacity framework, we showed that patients admitted involuntarily have a reduced capacity to give informed consent to psychiatric treatment. They appear less able than patients admitted voluntarily to understand and appreciate their own clinical condition and the risks and benefits of treatment. They are also less able to reason about it, or express a clear treatment choice. The effect sizes we found showed that patients admitted voluntarily and involuntary differ especially in appreciation, and differ less in the ability to understand treatment-related information. This result is not surprising since MacCAT-T appreciation pertains to the ability to apply information abstractly understood to one’s own situation, and refusal of treatment is crucial in the Italian civil jurisdiction on involuntary admission.

Notwithstanding the poorer MacCAT-T scores we identified in patients treated involuntarily, the two study groups showed great variability, particularly in MacCAT-T understanding and appreciation scores. Unexpectedly, as many as 30% of patients treated involuntarily understood the disclosed information about treatment well or extremely well. Most surprisingly, the same percentage of involuntary patients scored 3 or 4 at appreciation, thus indicating that they completely or almost completely acknowledged their medical condition as well as the consequences of possible treatment options. Even so, their reasoning abilities were severely impaired. More than half of the patients admitted involuntarily were judged incapable of rationally arguing about how psychiatric treatment or possibly no treatment affected their everyday life (Fig. 1). This unexpected intra-group variability probably depends on the multidimensional framework we used for evaluating capacity to consent to treatment (Appelbaum, 2007; Appelbaum & Grisso, 1988; Okai et al., 2007).

Differences in mental capacity to consent between voluntarily
and involuntarility hospitalized acute psychiatric patients

MacArthur competence assessment tool for treatment (MacCAT-T);
age and sex-matched

* p<0,05; ** p<0,001; p values by paired sample t test.

Fig. 1: Capability to consent to treatment

These data seem to confirm that lack of treatment-related decisional capacity is a common but by no means inevitable correlate of admission to a psychiatric in-patient unit (Cairns et al., 2005; Owen et al., 2008). Accordingly, in our study some involuntary patients understood all the essential information they received about treatment, yet they were treated involuntarily. We attribute their impaired capacity mainly to altered reasoning abilities. Conversely, within the voluntary study sample 17% patients agreed neither with their diagnosis, nor with the type of treatment they were receiving, as indicated by a score of 0 at appreciation, a feature presumably found in people incapable of giving valid informed consent. These findings support the suggestion (Owen et al., 2008) that mental capacity or incapacity to make treatment decisions cannot be presumed and may not overlap with capacity as measured by validated capacity assessments.

Conditional stepwise logistic regression analysis disclosed that involuntary treatment was associated with more manic symptoms. This finding emphasizes the role of psychiatric symptoms in determining incapacity in an acute psychiatric setting, as others have noted in non-forensic (Cairns et al., 2005; Howe et al., 2005; Owen et al., 2008) and forensic psychiatric samples (Rutledge et al., 2008). An important point in interpreting this result is that involuntary psychiatric treatment was decided before study recruitment, relying on a non-capacity based law. In the regression analysis we found no association between cognitive measures and voluntariness of hospitalization and treatment. Another possible explanation of this result is the possible prominent effect of severe psychiatric symptoms in acute psychiatric in-patients, such those we studied, which might largely override the possible effect of cognition in determining capacity levels. We selected involuntary patients according to the Italian civil jurisdiction since we wanted specifically to focus on those patients who needed treatment for an acute mental disorder in a real-world clinical setting.

In a second phase we designed a multi-center study of 131 acute non-forensic involuntary treated patients to investigate acute non-consensual psychiatric patients’ treatment Decision Making Capacities (DMC) in a representative sample from three distinct Italian regions. We identified patients with high or low treatment DMC. We also analysed to what extent diagnostic features and psychiatric symptoms were associated with mental capacity to consent to treatment. A significant variability in acute psychiatric inpatients’ degree of impairment in treatment DMC emerged. Decisional impairment was a common but not always unavoidable characteristic of patients compulsorily admitted to the acute psychiatric inpatient units, which is in line with previous initial research on smaller samples from single centres (Cairns et al., 2005; Mandarelli et al., 2014; Owen et al., 2008).

Twenty-two percent of the 131 patients scored >75% on every MacCAT-T subscale and were classified as having high treatment DMC. Schizophrenic and schizophreniform patients performed worst on DMC. The percentage of patients with high treatment DMC reached 32% among Bipolar Disorder patients and 42% among other diagnoses, such as personality disorders. The latter had an almost complete understanding and appreciation of their clinical condition and the risks and benefits of their treatment (or no treatment). They also had an adequate capacity to reason about their therapy and to express a choice (e.g., no hospitalization / treatment) in a clear and consistent way.

The result was surprising and has implications for researchers, clinical psychiatrists, and policymakers as it seems to imply that under the Italian mental health regulation, or a need for care regulation, a capable patient’s refusal of treatment can be overridden for reasons that deserve further consideration because they do not involve the patient’s understanding. A possible explanation is that a patient’s ‘best interest’ criterion is being applied according to which a capable patient’s refusal is being overridden. However, this does not comply with the principle of autonomy and with the ‘Fusion Law’ which requires lack of capacity and best interest criteria for non-consensual treatment. Another possible explanation is that physician decision-making included a danger criterion even though Italian law does not provide it, for example in case of actual suicide risk.

Finally, we should consider that patients’ treatment DMC could quickly change in an acute psychiatric settings. Even though we assessed patients within 3 days from admission, it could be possible that treatment DMC had significantly improved due to hospitalization and pharmacological treatment. Therefore, the patients’ DMC level assessed during this study could differ from the one displayed when physicians decided involuntary admission. This hypothesis deserves future studies aimed at investigating rapid changes in treatment DMC in acute inpatients since it also has implications under capacity-based mental health legislation.

The result of a poorer treatment DMC in patients affected by schizophrenia spectrum disorder compared to patients affected by bipolar disorder questions existing data indicating a minor role for diagnoses rather than symptoms. For example, Palmer and colleagues (Dunn et al., 2007) found no differences between long term illness outpatients affected by bipolar disorder and long term illness outpatients affected by schizophrenia in competence to consent to research, as measured through the MacCAT-CR. Howe et al. (2005) found no differences in MacCAT-T scores between acute psychiatric patients affected by schizophrenia, schizoaffective and bipolar disorder (manic / mixed phase). The results we report here suggest that schizophrenia spectrum disorder patients are at greater risk of impaired treatment DMC in acute coercive psychiatric settings.

Greater impairment of treatment DMC was associated with positive symptoms severity in the sample overall, acute mania in Bipolar Disorder patients, and cognitive impairment in Schizophrenia Spectrum Disorder patients.

Conclusions

In our opinion the validity of legal regulations for involuntary commitment in vulnerable populations should be tested with real world procedures. In a system where the involuntary treatment criterion is based on the principle of ‘need for care’, such as the one in Italy, forms of paternalism can be generated that compromise the freedom of patients. There is no doubt that the alternative based on the ‘social dangerousness’ poses even greater problems, but both solutions do not seem adequately respectful of the personal freedom of patients suffering from mental illnesses.

When involuntary procedures are based on the need for treatment criterion, the evaluation of capacity to consent / dissent should also be routinely performed in acute psychiatric settings. As is the case of psychiatric symptoms severity, the treatment Decision Making Capacities should be conceived as a clinical variable that can be measured to guide clinical decisions (e.g., involuntary hospitalization vs. acceptance of patient refusal) and to evaluate the degree of freedom of decision in mental health patients.

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Haim Hazan

The Insufferable Other:
Dementia as a Modern Ghost Story

‘Otherness’ has long become both a popular buzzword and a scholarly construct that occupies the center stage of cultural discourse regarding the categorization of ‘us’ and ‘them’, friends and foes, the familiar and the alien, the homely and the uncanny and, ultimately, the benevolent and the malevolent. From Emmanuel Lévinas’ other incarnated in the ‘face’ to Jacques Derrida’s messianic unreachable other, from Julia Kristeva’s notion of the other within us to Giorgio Agamben’s concept of the ultimate extra-cultural outcast embodied in one who can be killed with impunity but nevertheless not sacrificed, homo sacer in his terminology, the mythical image of the other is an indivisible, counter-dualistic compound of body and soul.

However, when an uncalled for split between the corporeal and the mental occurs, the cultural construction and conception of the other are gravely challenged as the schism questions commonplace ideas of life and death. The growing presence of the imagery of Alzheimer’s disease in the midst of the holistic ethos of modernity is a case in point for examining such insufferable eventuality.

Ethnographic accounts describe the practice of excommunicating and even killing the mentally malfunctioning elderly in some societies. Often described by their executers or abandoners as ‘the living dead’ or ‘not human but ghosts’, such discarded categories became the target of social assignation rather than victims of medical diagnosis. However, with modern nosology reigning supreme in identifying, treating and caring for the mentally incapacitated, the mark of Alzheimer’s has become a critical signifier of irreversible transformation in existential states as well as in social categorization.

For the anthropologist, therefore, Alzheimer’s disease belongs to the realm of metaphor, drama, social classification and cultural codes of inclusion and exclusion. In this sense it is the imagery of the condition rather than its medical properties that constitutes the core of anthropological concern with Alzheimer’s.

Viewed as a trope rather than a pathology, Alzheimer’s invokes a plethora of culturally contingent meanings from a denial of its impact and effect in India, as

suggested by anthropologist Laurence Cohen in No Aging in India, to challenging the nexus of the biologically determined and the socially symptomatic as maintained by anthropologist Margaret Lock in The Alzheimer Conundrum.

In the following I would like to dovetail with this approach by proposing that the omnipresence of the concern with Alzheimer’s is not just an offshoot of epidemiological variables, but also a result of public panic. This angst is generated by the terror of old age in a contemporary society where the life cycle has turned into a course ending in a deadlock, a threatening impasse.

Thus, the advent of Alzheimer’s implies a demarcation between culturally endorsed categories of humans and other kinds of dubious humanity. It erects an impenetrable divide between the biologically living and the socially dead. This insurmountable gulf embodies the illusion of temporary immortality in an era of inevitable mortality, wedging a false discontinuity along an unavoidable continuity. The preoccupation with Alzheimer’s, therefore, serves as a structuring device that separates the normal human from the disease afflicted non-human and the penultimate phase of life from the rest of it.

The very old on the brink of death indeed offer an intriguing testing ground for revisiting our western, midlife, neurotypical views. The voice and gaze of the very old, or rather their inaudible and invisible characteristics, defy our normative discourses of reason, causality, sense of purpose, well-being, and temporality. They also call into question the basic tenets of academic disciplines, such as gerontology and anthropology, which are supposedly geared toward comprehending the aging process as part of the human condition. Above all, they offer an opportunity to throw into relief the arbitrary limits of cultural configurations of narrated and enacted selves and ages.

The case of Alzheimer’s disease has become a major matter for public concern and is currently widely narrated in the mass media. It demonstrates the discrepancy between social exposure and personal experience, thus accentuating the inadequacy of cultural imagery to account for and to express incommunicable individual plights. This constitutes an insufferable daunting uncertainty that calls for either covering up or uncovering.

However, neither of these options are taken. Instead, this gap is minded by culturally spanning a twilight zone where old age is identified with its associated mental impairments. Hence, lay and professional alike freely refer to the very old, who are deemed cognitively and physically challenged, as possessing imputed “Alzheimer’s,” even though the clinical diagnosis can only be ascertained posthumously.

Thus, sociologist Jaber Gubrium’s discussion of the expert management of the blurred border between the “normal” and the “pathological,” the “old-timer” and “Alzheimer’s,” is a telling yardstick for scaling the old between “old people as people” or succumbing to the Alzheimerization of aging and society as labelled by some scholars. The trope of senility and dementia, as medicalized in Alzheimer’s disease, is indeed the demarcation line between including or excluding the aged in the canonized codex of culture and subsequently from anthropological debate.

This borderline position inherits the place of the dubious humanness attributed to the unbridled, untamable savage. “Alzheimer’s” as a tag for modern savagery is actually deemed as the antithetical pole to the civilized. The old time savage, who was exiled from anthropology as a politically incorrect concept, has become the popular, albeit abominable, savage old in contemporary culture, turning the discipline of anthropological gerontology into its banning agent.

The label of “Alzheimer’s” can in some cases reflect an overarching stereotype of old age as socially unaccountable and “beyond culture.” It is therefore a midlife metaphor for and an indication of the failure to introduce novel benchmarks for reappraising the life span, a failure to distinguish between the later phases of life not in sequential terms but via substantive criteria of the capacity to survive as mentally incapacitated in the age of reason. However, an emphasis on illness narratives, rather than on the medicalization of sickness, spells out a return to the subjective human voice of the person and the need to listen to it and not just to diagnose / construct the syndrome.

The metaphor of Alzheimer’s is enthrallingly depicted in literary critic John Bayley’s best-selling account of his late wife’s Alzheimer’s onset and progress. Bayley’s wife was Iris Murdoch, the eminent philosopher and writer, a paragon of word mastery and intellect. Her life is described by her widower as tossing between interchangeable contrasting episodes of then and now – lucidity and confusion, alertness and dimness. To illustrate the abyss of his situation, he recounts a simile by a friend in his position, who compared the caretaking of an Alzheimer’s-stricken beloved spouse to “being chained to a corpse.” Bayley repels the metaphor; midlife slanted anthropology and gerontology seem to live by it.

If very old age signifies a functional as well as an attitudinal departure from midlife linear temporality, then any definition of identity or self in terms of past-bound future orientations and choices is patently aborted. The resulting selfhood peculiar to the oldest old is therefore no longer lodged in the realm of temporal constructions of scripts of prospective options and opportunities, but in spatial ad hoc arrangements of making do under pressing constraints and present exigencies.

The potential loss of sense of self, incurred by that shift from living to existing, heralds critical transformations in identity, including abandoned gender distinctions, dissolved cross-generational bonds, disappearing adaptive alternatives, and silenced life-story narration. All these do not necessarily mean that self-conception among some of the old is rendered defunct, but rather that it becomes increasingly untenable to the non-aged listener as a reflectively anchored discourse. Thus, gerontologists are left with little choice but to consider the often malfunctioning, observable body as almost the only template for relating to the being-in-the-world of the elderly subject. This amounts to adopting a monistic mode of understanding old age through its performed corporality.

The very old person is thus turned into “barely alive” or a “living corpse.” Stripped of any symbolic embellishments, the very old, as a metonymic representation of death, impedes the anthropological pursuit of otherness in forms that can be reconstructed, negotiated, revoked, and re-inherited as one of “us” humans. Hence, the unadulterated old have no recognizable culture nor are they even conceived of as objects for veneration, sacrifice or sacred killing. Impacted in the cultural fiend of the savagery of Alzheimer’s, the very concept of old age cannot elude its devastating selfless trope.

Kalman J. Kaplan

Biblical Humanism and Suicide Prevention:
Where Did the Greeks Go Wrong?

In his influential book, The Closing of the American Mind, Allan Bloom (1987) bemoaned the decline of the humanities. For Bloom, philosophy professors have become obsessed with language analysis or logical positivism, disregarding important humanizing ethical and political issues. Literature professors have become obsessed with deconstructionism and skepticism of standards of truth, thereby dissolving all moral imperatives. Bloom argues that contemporary liberal education has failed, resulting in the inability of students to fashion a life of occupational success for themselves.

Yet, we must ask, following Martin Buber (1948), what exactly is “humanism”? In his seminal article, Buber makes a clear distinction between European Humanism and Hebrew Humanism While traditional European Humanism may derive largely from classical antiquity, Hebrew Humanism, for Buber, must ultimately derive from the Hebrew Bible. In my mind, at least, the Platonic vision concentrates on an abstract humanity (i.e., the idea of mankind) at the expense of the real person, while the biblical-rabbinic vision concentrates on each individual human being (i.e., each human being is created in God’s own image, Genesis 1:26-28).

As Frantz Fanon wrote bitterly in 1961,

Leave this Europe where they are never done talking of Man, yet murder men everywhere they find them, at the corner of every one of their own streets, in all the corners of the globe. For centuries they have stifled almost the whole of humanity in the name of a so-called spiritual experience.

In his insightful book of fifty years ago, the sociologist Philip Slater argued that “buried beneath every western man is a Greek – Western man is nothing but the narcissistic and disloyal Greek leader Alcibiades with a bad conscience, disguised as a plumber” (Slater, The Glory of Hera, 1968, p. 451). This observation becomes especially important in light of the warning of Lev Shestov, in his magnum opus Athens and Jerusalem (1937, 1966), against the seductive trend to read the Hebrew Bible through Greek lenses. “Is a man educated by the Greeks capable of preserving that freedom which is the condition of the right of understanding what the Bible says?” (p. 278).

Nowhere is this bias towards ancient Greek texts and thought more apparent than in the field of medicine. Despite the importance of ancient biblical civilization and the great involvement of Jews in medical science, it is striking how little biblical and Talmudic ideas seems to have influenced Jewish physicians, who seemed completely under the influence of the Greek physician Galen (Muntner, 1977). It was not until 1911 that a systematic presentation was published of Biblical views of various fields of medicine as well as mental disease (Preuss, 1971).

Perhaps the single most important distinction between a Greek and Biblical approach to medicine lies in their different approaches to treating a disease versus a whole person. This difference is dramatically illustrated in the contrast between the Hippocratic Oath (Edelstein, 1943) and the physician’s prayer attributed, perhaps incorrectly, to Maimonides (Golden, 1900).

For Hippocrates: (1) The physician is servant of the “art” or “nature.” (2) The “art” consists of three parties: disease, patient and physician. (3) The disease is the enemy, something to be combated by the patient along with the physician. (4) The physician is exhorted to do no harm. (5) The physician swears to neither give nor suggest deadly medicine to anyone.

Maimonides’ prayer is fundamentally different: (1) The physician has been chosen by God to watch over the life and health of his creatures. (2) He prays for inspiration from God for love for his art and for God’s creatures. There are three involved parties: God, the physician and the patient. (3) The disease is a beneficent messenger sent by God to foretell approaching danger and to urge him to avert it. (4) The physician has been chosen by God to watch over the life and death of his creatures. (5) The physician specifically prays to remove from his patients all destructive figures which may lead “God’s creatures to their death.”

The most important distinction for our purposes is the contrasting view of disease. For Hippocrates, the disease is the enemy and the fight of the physician is to eradicate the disease or to cure the symptom. The patient seems secondary to this. For Maimonides the physician must treat the person (God’s creature) and the disease or symptom can be seen as an ally warning the physician of danger to the patient and as a signal to avert it. This latter view resonates quite well with more modern views of disease, especially with regard to disorders of the immune system.

Although many of the pioneering psychotherapists in modern times have been Jewish, they have often ignored or actively disparaged the Hebrew Scriptures, thus explicitly or implicitly parroting a Greek view of man (Simon, 1978), including perhaps Freud himself. In answering a letter from Jewish historian / folklorist Alter Druyanov alerting him about the considerable similarity between his ideas and those of the early Hebrews, Freud stated: “I’m happy to learn of a competent reader of my book from so far a place. As far as I’m concerned however the similarity between my ideas and those of the early Greeks strikes me as much more salient.” (Rolnik, p. 56)

To be sure, a number of interesting thinkers in psychology have begun to develop a more Biblical and Jewish approach to mental health during the last few decades (e.g., Bakan, 1958; Caspi, 2011; Hazony, 2012; Rottenberg, 2005, 2016; Shoham, 2011; Yerushalmi, 1991), yet the anti-biblical bias remains in modern psychotherapy.

Over 60 years ago, Dr. Erich Wellisch, medical director of Crayford Child Guidance Clinic in Kent, England, called for a “biblical psychology,” arguing that:

The very word “psyche” [ψυχή] is Greek. The central psychoanalytic concept of the formation of character and neurosis is shaped after the Greek Oedipus myth. It is undoubtedly true that the Greek thinkers possessed an understanding of the human mind which, in some respects, is unsurpassed to the present day, and that the trilogy of Sophocles still presents us with the most challenging problems. But stirring as these problems are, they were not solved in the tragedy of Oedipus. In ancient Greek philosophy, only a heroic fight for the solution but no real solution is possible. Ancient Greek philosophy does not have a vision of salvation…There is need for a Biblical psychology (Wellisch, 1954, p. 115).

This article focuses on suicide, the ultimate outcome of a tragic and pessimistic view of life, in ancient Greek writings so dear to the humanities. M. D. Faber (1970) identifies some 16 suicides and self- mutilations among the 223 characters depicted in the 26 surviving tragedies of Sophocles and Euripides yielding a suicide rate of 7.2% (see Table 1). Applying Durkheim’s typology, most of Sophocles’ depicted suicides are egoistic, while most of the suicides depicted by Euripides are altruistic. Several of each are anomic. Table 1 applies Durkheim’s typology to suicides in Greek tragedy.

Table 1: Suicides in Greek Tragedy

Character

Gender

Source

Method

Type

Ajax

M

Ajax (Sophocles)

Sword

Egoistic

Deianeira

F

The Trachinae (Sophocles)

Sword

Egoistic

Eurydice

F

Antigone (Sophocles)

Knife

Egoistic

Haemon

M

Antigone (Sophocles)

Sword

Egoistic

Jocasta

F

Oedipus Rex (Sophocles)

Hanging

Egoistic

Oedipus

M

Oedipus Rex (Sophocles)

Self-Blinding

Egoistic

Antigone

F

Antigone (Sophocles)

Hanging

Anomic

Heracles

M

The Trachinae (Sophocles)

Fire

Anomic

Hermione

F

Andromache (Euripides)

Suicidal Threats

Anomic

Phaedra

F

Hippolytus (Euripides)

Hanging

Anomic

Alcestis

F

Alcestis (Euripides)

Poison

Altruistic

Evadne

F

The Suppliants (Euripides)

Fire

Altruistic

Iphigenia

F

Iphigenia in Aulis (Euripides)

Axe

Altruistic

Macaria

F

The Heracleiadae (Euripides)

Knife

Altruistic

Menoeceus

F

The Phoenissae (Euripides)

Jumping

Altruistic

Polyxena

F

Hecuba (Euripides)

Sword

Altruistic

Note: M = Male, F = Female

Table 2 applies Durkheim’s terminology to the much smaller number in biblical narratives. Only 6 suicides can be found in the Hebrew Scriptures. Three can be classified as egoistic (Ahitophel, Zimri and Abimelech) and 3 are altruistic (Saul, Saul’s armor bearer and Samson). The important point is the far smaller percentage of suicides in Hebrew Scriptures.

Table 2: Suicides in the Hebrew Bible

Character

Gender

Source

Method

Type

Saul

M

1 Sam. 31:4

Sword

Altruistic

2 Sam. 1:6

1 Chron. 10:4

Saul’s Armor Bearer

M

1 Sam. 31:5

Sword

Altruistic

1 Chron. 10:5

Ahitophel

M

2 Sam. 17:23

Strangling

Egoistic

Zimri

M

1 Kings 16:18

Burning

Egoistic

Abimelech

M

Judg. 9:54

Sword

Egoistic

Samson

M

Judg. 16:30

Crushing

Altruistic

Note: M = Male, F= Female

Some 2,855 people (2,730 men and 1125 women) are mentioned in the 39 books of the Hebrew Scriptures spanning a period of 3,330 years (Ziffer, 2006). Only 6 are identified as completed suicides (see Table 2), yielding an overall suicide rate of 6/2855 or .02%, with none by women. A huge Chi-Square statistic emerges when we compare this biblical rate of .02% to the 7.2% suicide rate in the 26 plays of Sophocles and Euripides (Chi-Square = 141.39, p < .001). In addition, the Hebrew Scriptures present 6 suicide-prevention narratives absent in Greek writings (see Table 3).

Table 3: Suicide Preventions in the Hebrew Bible

Character

Gender

Source

Method

Rebecca

F

Genesis 27-28

Appropriate matchmaking

Moses

M

Numbers 11

Support and practical advice

Elijah

M

1 Kings 18-19

Protected withdrawal and nurturance

Jonah

M

Jonah

Protected withdrawal and guidance

David

M

Psalms 22

Renewal of faith in God

Job

M

Job

Renewal of relationship with God

Note: M = Male, F= Female

This article distills this information to develop a hands-on, practical and positive psychological approach to both treating people in despair and crisis, and even preventing them from reaching such a state in the first place. It is devoted to the idea that ancient biblical narratives properly used in a psychologically sophisticated way can provide an anti-tragic view of life which can be usefully employed by the modern therapist or counselor in treating suicidal patients.

We review the evidence regarding seven risk factors for suicide:

1) Feeling isolated and ignored

2) Feeling one’s life is without meaning

3) Feeling exiled from one’s home or homeland (feeling like a refugee or outcast)

4) Feeling unable to be oneself with others

5) Feeling one is alone in one’s life mission

6) Feeling abandoned by one’s child leaving the family nest and building his / her own life

7) Feeling doomed by a dysfunctional family of origin

We compare Greek and biblical narratives regarding each of these factors, demonstrating how Greek narratives lead to self-destructive behaviors while biblical narratives provide a safe way out of these dilemmas. With regard to preventing suicide, it depends on which humanities one is immersed in, that of Athens or Jerusalem.

1) Feeling Isolated and Ignored: Treating the Ajax Syndrome with the Elijah Intervention

We compare the Greek suicide story of Ajax with the biblical suicide-prevention story of Elijah with regard to the suicidal implications of being isolated.

The Ajax Syndrome

After the death of Achilles in the Trojan War, the Greek leaders choose Odysseus over Ajax to inherit his arms, making Ajax feel his honor is stained. Ajax sets out at night to murder Agamemnon, the leader of the Greek forces and Agamemnon’s brother Menelaus. The goddess Athena becomes angry and makes Ajax insane. Ajax slaughters sheep in the army’s flocks, and leads others to his tent, thinking that he is killing / torturing the Greek leaders themselves. As his madness passes, Ajax retreats humiliated and despondent into his tent, not disguising his suicidal thoughts.

Ajax cries, something he had always refused to do as it “befitted cowards only” (Sophocles, The Ajax, l. 320). Ah me, the mockery”, he cries, and continues “To what shame am I brought low” (l. 365). Ajax is overwhelmed by what has happened to him and sees no way out other than suicide. He has not received positive support from others. A message to the Greek chieftains ordering that Ajax not leave his tent alone is sent too late by his half-brother, Teucer. Ajax has already done so and has fallen on his sword (Sophocles, Ajax, ll.748-755, 848-849, 865).

The Elijah Intervention

The prophet Elijah represents a contrasting example of how to treat a depressed and suicidal person. In the midst of an ongoing conflict with Jezebel who wants to kill him (I Kings 19:1-2). Elijah is at the end of his rope, says he cannot go on, and expresses a wish to die (I Kings 19:3-4). God is portrayed as listening to his prophet Elijah and taking his statement to heart. An angel is sent to Elijah providing him with food and drink and allowing him to rest (I Kings 19:5-8). Elijah recovers his strength and goes to Mt. Horeb with the help of young Elisha (I Kings 19:15-18).

These two narratives are contrasted in Table 4.

Table 4: Elijah against Ajax

Stage

Ajax

Elijah

1 Precipitating Stressor

Ajax is humiliated by both Agamemnon and Athena.

Elijah is overwhelmed and exhausted from his harassment by Queen Jezebel.

2 Reaction

Ajax says he wants to die.

Elijah says he wants to die.

3 Response of Others

Ajax is allowed to leave his tent alone.

Elijah is sent an angel who brings him food, drink and companionship and lets him rest.

4 Effect

Ajax kills himself by falling on his sword.

Elijah recovers his strength and continues his mission in Horeb, and is given help by the younger Elisha.

2) Feeling one’s life is without meaning: Treating a Zeno Syndrome with a Job Intervention

Here we contrast the Greek suicide story of Zeno and the biblical suicide-prevention story of Job with regard to response to a misfortune and the importance of having an intrinsic meaning-structure (Victor Frankl, 1962).

The Zeno Syndrome

The inability to create meaning in one’s life often leads to feelings of utter despair. It can drive a person to very extreme, often destructive attitudes to try to artificially manufacture meaning. Zeno, founder of the Stoic school of philosophy, wrenched his toe on the way home from lecturing at the Stoa (porch). He catastrophizes this objectively minor mishap as a “sign from the gods that he should depart” and voluntarily holds his breath until he dies (Diogenes Laërtius, Lives of Eminent Philosophers, VII, 28). Zeno’s over-interpretation seems to represent an attempt to find meaning and purpose in an otherwise hopeless and meaningless world.

The medically impossible depiction of Zeno holding his breath until death negates the involuntary aspect of breathing and the Biblical conception that God breathes life into man and takes it away (Gen. 2:7). Zeno, like other Greek and Roman stoics, needs to control the conditions around his death, equating this control with a tragically-tinged sense of freedom (Seneca, De Ira (On Anger), 3.15.34, Epictetus, Discourses, 1.29).

The Job Intervention

Job, in contrast, does not commit suicide despite being assailed by far more serious misfortunes – the loss of his wealth, family, and health. His wife tells him to curse God and die (Job 2: 9) and his friends tell him to admit he deserves his punishment, but he refuses because he knows it is not true (Job 4-32). Job complains bitterly, is deeply grieved, and indeed wrestles with suicide, stressing the same method of death, strangling, as did Zeno. “So that my soul chooseth strangling, and death, rather than these bones.” (Job 7: 15). However, Job does not act on this feeling, reaffirming his relationship with his Creator: “Though He slay me, yet will I trust in Him” (Job 13: 15).

Exline, Kaplan, and Grubbs (2012) point to the importance of arguing within a relationship without leaving it. Job is anchored by a sense of a personal Creator who is with him from the moment of his birth and will be with him into his death and beyond. Thus, he can withstand far greater misfortune than can Zeno without the need to attribute cosmic meaning to it.

In contradistinction to Zeno, who is improbably described as “holding his breath until he dies,” the book of Job stresses that it is God himself that has given Job the breath of life. “The spirit of God hath made me, and the breath of the Almighty giveth me life.” (Job 33: 4). If He withdraws that breath, man returns to the dust from which he sprung (Psalms 104:29). And when God restores the breath, man rises again and renews the face of the earth. “Thou sendest forth Thy spirit, they are created; and Thou renews the face of the earth.” (Psalms 104:30)

Life for Job has inherent meaning and purpose, and this represents the best alternative and antidote to an obsession with dignity and rational suicide so endemic to Zeno the Stoic and contemporary culture.

A contrast of these two narratives is presented in Table 5.

Table 5: Job against Zeno

Stage

Zeno

Job

1 Precipitating Stressor

Zeno the Stoic trips and stubs / breaks a toe after giving a lecture at the Stoa.

Job suddenly and unexpectedly loses his property, children and health.

2 Reaction

Zeno thinks this is a sign from the gods that he should die.

Job complains but maintains his innocence and faith in God despite his misfortunes.

3 Response of Others

The reactions of others are not mentioned.

Job’s friends tell him he must be guilty. His wife tells him to curse God and die.

4 Effect

Zeno immediately holds his breath until he dies.

Job maintains his faith in God, proclaims his innocence, and is restored.

3) Feeling exiled from one’s home or homeland (as a refugee
or outcast): Treating the Coriolanus Syndrome with the
David Intervention

Let us compare the Roman story of Coriolanus and the biblical story of David with regard to constructively dealing with the experience of exile or being a refugee from one’s homeland.

The Coriolanus Syndrome

Shakespeare (1967) and Roman historians (Plutarch, 1909, and Livy [Titus Livius], 1960) tell of the legendary Roman commander Gnaeus Marcius whose military valor at Corioli against the Volsci, the 5th century BCE enemies of Rome, won him the honorary name Coriolanus. Plutarch describes Marcius as a man of great energy and strength of purpose whose violent temper and self-assertion prevented him from cooperating with people. Marcius became involved in angry arguments between the upper and lower classes of Rome. His outspoken insults to the plebeians led to his banishment and almost his execution, despite his glorious military service.

Obsessed with wreaking revenge on Rome, Marcius (Coriolanus) goes over to the Volsci, enemies of Rome, and persuades them to attack Rome. As Marcius’ Volsci army sits encamped before Rome, two delegations came from the city but could not persuade him to desist. Roman women then came forth spontaneously to the camp, accompanied by Marcius’ mother (Volumnia), wife and children. Marcius relents and withdraws the Volsci army. Plutarch says that he was murdered by the Volsci shortly after this withdrawal. Livy in his history of Rome tells of another report that Marcius lived on for many years and endured the miseries of exile. Though not a suicide story per se, there is no question that the rigidity of Coriolanus was a major factor in his death.

The David Intervention

David was also a war hero, but of a very different sort, described as playing the lyre for King Saul and loved by the people. He slays the Philistine giant Goliath not by brute strength but through agility and the use of a simple slingshot. Later, when his life is threatened because of the jealousy of King Saul, David flees his native Israel with a band of men to live under the Philistines, longtime foes of Israel (I Samuel 27).

Yet here the similarity to Marcius ends. David leaves not because he hates his countrymen but to save his life from King Saul’s anger against him. David is not a rigid perfectionist but remains deeply human. Even in exile, David does not turn from his love of Israel, despite Saul’s anger at him. In the period that David and his troops live among the Philistines, he leads his troops in war against common enemies of Israel and the Philistines. He is spared the conflict of having to fight for the Philistines in a decisive battle against Israel (1 Samuel 29:6-11). David becomes King of Israel after Saul’s death in this battle. As king, David (2 Samuel 6:12-23) does not show contempt towards the common people as Coriolanus did to the plebeians in Rome. Rather, David dances with the people when the ark is brought into Jerusalem, even though this earns him the contempt of his wife Michal.

A contrast of these two narratives is presented in Table 6.

Table 6: David against Coriolanus

Stage

Coriolanus

David

1 Precipitating Stressor

Roman military hero Coriolanus antagonizes his countrymen who exile him from Rome.

Military hero David flees Israel to escape Saul’s murderous jealousy.

2 Reaction

Coriolanus joins the Volsci, an enemy of Rome, to wreak vengeance against Rome.

David joins the Philistine enemy but maintains his love of Israel.

3 Response of Others

The Volsci do not trust him and the Romans fear he will lead the Volsci in battle against Rome. But, he does not attack Rome.

David avoids fighting Israelites. He attacks common enemies of Israel and the Philistines.

4 Effect

Coriolanus and the Volsci do not attack Rome but he remains condescending and insulting to the Volsci who murder him.

David remains loyal to Israel and the Philistine King Achish. David later becomes King of Israel.

4) Feeling one is unable to be oneself with others: Treating the Narcissus Syndrome with the Jonah Intervention

Let us contrast the Greek suicide story of Narcissus with the biblical suicide-prevention story of Jonah with regard to the importance of being able to integrate self and other.

The Narcissus Syndrome

Greek thought sees self and other as fundamentally opposed. One wins at the expense of the other losing. The Apollonian side of Greek culture represents a walled-off and disengaged intellect. The Dionysian side portrays an enmeshment which destroys individual boundaries. The terms “narcissism” and “narcissistic” have become almost bromides in modern society to describe people who are extremely selfish and self-involved. The actual story of Narcissus provides a much richer picture ending in his suicide. Strangely, the suicidal end of the story is largely ignored in modern psychology and psychiatry. Narcissus cannot successfully integrate self and other.

The earliest sources of the myth of Narcissus have long since been lost. Our most complete account from antiquity is in the Metamorphoses by Ovid (43 BCE to 17 or 18 CE). Narcissus is born out of a rape of his mother Liriope by a river god. When Liriope enquires from the Greek seer Tiresias about whether her son will live to a ripe old age she receives a strange answer: He [Narcissus] will live a long life as long as he doesn’t come to know himself (ibid, 3:343-350).

Narcissus grows to be a vain young man, so physically beautiful that many fall in love with him by simply looking at him (ibid, 3:359-378). Narcissus seems to be self-absorbed, treating his lovers of both sexes as mere mirrors of himself. Echo, the nymph who loves Narcissus in vain, is transformed, left merely repeating the words he says as an echo (ibid, 3:379-352). One would-be lover who feels scorned prays to the goddess of fate, Italicize Nemesis, and asks that Narcissus also fall hopelessly in love and be unable to achieve his desire (ibid, 3:405-406). Soon, Narcissus sees a beautiful youth in a pond, not realizing it is his own reflection. Narcissus is obsessed with the image in the brook, and looks at it night and day (ibid, 3:414-454).

Ultimately, however, Narcissus recognizes the face in the brook is his own (ibid, 3:463-473). The reflection becomes simultaneously an ideal and a mirror. He is not self-invested, but self-empty, driven to grasp his self, which has now been projected onto the outside world. Such a psychotic juxtaposition rips Narcissus apart. As Ovid expressed it, “How I wish I could separate myself from my body.” Narcissus finally becomes aware of the unobtainability of the figure he sees in the pond, his own reflection. He pines away until he dies, mourning the youth he loves in vain.

The suicidogenic element in the myth of Narcissus is the inability of Narcissus to successfully integrate his individuation and attachment behaviors. First, he is individuated at the expense of attachment (egoistic). Then he is attached at the expense of individuation (i.e., altruistic). Finally, he is overwhelmed by the irreconcilable confusion between his individuation and attachment issues (i.e., anomic) and resolves the conflict through self-murder, described by Ovid (ibid, 3,497-450) as pining away, and by Conon as actively stabbing himself in his chest (Conon, 1798, Narrationes, 24).

The Jonah Intervention

The story of Jonah begins with Jonah placed in an essentially similar individuation-attachment dilemma. God calls on Jonah to go to warn the people of Nineveh of their wickedness. Jonah does not want to go, but he is too God-fearing to defy the command and too strong-willed to submit. In desperation he flees to Tarshish and after his identity as a Hebrew is discovered, he tells his shipmates to throw him overboard when a terrible storm threatens the ship (Jonah 1:1-12). The story could thus end in Jonah’s suicide, but it doesn’t. God intervenes as a protective parent, swallowing Jonah in the protective stomach of a great fish until he overcomes his confusion. Jonah prays to God from the belly of the fish until he becomes stronger. Then the fish vomits him out on dry land (Jonah 2).

This pattern repeats itself. God again commands Jonah to go to Nineveh. This time Jonah goes and gives the people God’s message. They repent and are saved (Jonah 3:1-10). Jonah becomes angry and again expresses the wish to die and sits on the outskirts of the city (Jonah 4:1-3). Again, God intervenes, sheltering Jonah with a leafy bush from the burning sun (Jonah 4:6). After a worm destroys the protective bush, Jonah again expresses suicidal thoughts (Jonah 4:7-8). God intervenes, this time engaging Jonah in a dialogue to teach him the message of teshuvah (repentance) and divine mercy and that he can reach out to another without losing himself (Jonah 4:9-11). Biblical thinking sees self and other in harmony. Jonah avoids the polarities of disengagement and enmeshment. In the words of the biblical sage, Hillel, “If I am not for myself, who will be for me? If I am only for myself, what am I? If not now, when?” (Pirkei Avot 1:14).

A contrast of these two narratives is presented in Table 7.

Table 7: Jonah against Narcissus

Stage

Narcissus

Jonah

1 Precipitating Stressor

Narcissus was born of his mother’s rape. It was prophesied that he would have a long life “if he does not come to know himself.”

God asks Jonah to warn the wicked people of Nineveh to repent lest they incur great punishment. Jonah does not want to go and runs away to Tarshish.

2 Reaction

The handsome Narcissus heartlessly exhibits hubris by rejecting would be lovers of both genders.

God sends a great storm while Jonah is on a ship. When his Hebrew identity is discovered, he tells his shipmates he is the reason for the storm and they should throw him overboard. He does not drown because God sends a big fish to swallow him.

3 Response of Others

Nemesis causes Narcissus to become infatuated with a face he sees in a brook.

The fish vomits Jonah onto dry land. God again asks him to go to Nineveh to warn its inhabitants to repent and change their ways.

4 Effect

Narcissus realizes the unobtainable face is his. He commits suicide, passively (pining away) or actively (stabbing himself), depending on source.

Jonah warns the people of Nineveh but again becomes suicidal and sits outside the city under a hot sun. God shields Jonah with a gourd. Jonah complains when the gourd shrivels. God’s response teaches him mercy, compassion, and that he need not lose himself in reaching out to others.

5) Feeling one is alone and unsupported in one’s life mission: Treating the Oedipus Syndrome with the Moses Intervention

Let us compare the Greek suicide / self-mutilation story of Oedipus with the biblical suicide-prevention story of Moses regarding addressing the suicidal implications of feeling one is alone in one’s life mission.

The Oedipus Syndrome

Laius, King of Thebes, hears from an oracle that his newborn son Oedipus will murder him and marry his wife if / when he grows up. He unsuccessfully attempts to have him killed but Oedipus is saved and raised by the King and Queen of Corinth. As a young man, he hears his identity questioned at a dinner party. He goes to the Oracle of Delphi to inquire about his identity. The Oracle does not answer him but instead prophesies that he is destined to kill his father and marry his mother, whom he mistakenly thinks are the King and Queen of Corinth.

To avoid doing this, Oedipus flees to Thebes and kills an older man during an altercation on the road (not realizing the man is his father Laius). Oedipus solves the riddle of the Sphinx that has been terrorizing Thebes and is given his widowed mother (also unknown) as a wife as a reward. He begets four children with her. Oedipus does not seem able to solicit or accept help from anyone, being done in by riddles from the Oracle of Delphi, convoluted responses from the prophet Teiresias, and mistrust of his brother-in-law Creon. Oedipus never receives any real help he can fully trust (Sophocles, Oedipus Rex; Aeschylus, Seven against Thebes).

The Moses Intervention

For Moses also, birth brought danger of death. His life was threatened by Pharaoh’s decree to throw all Israelite newborn males into the Nile. Moses is sent away by his natural family when he is 3 months old to save his life and is rescued by Pharaoh’s daughter who sees him floating in the river in an ark among bulrushes. She brings him into Pharaoh’s palace to raise him. Significantly, Moses’ sister Miriam watched from a distance to know what would happen to him.

Moses does not consciously seek clues about his destiny but, based on the account of Moses going among his Hebrew “brethren,” one can see his latent identification. He kills an Egyptian who was attacking a Hebrew (Exodus 2:11-12). Moses later sees the burning bush and encounters the Hebrew God. God informs him of his mission to save the Children of Israel from Pharaoh.

Moses has a speech impediment – he stutters – but is genuinely helped in his mission by his older brother Aaron who does the public speaking for him. (Exodus 7). Despite Moses’ misgivings as to his own abilities, he does ultimately agree to God’s call and leads the Children of Israel out of slavery. But he subsequently feels overwhelmed by his task and unable to go on, crying to God in his despair: (Numbers 11:12). The demands are too great. Moses feels inadequate to the task. He doubts all the people can be provided for (Numbers 11:13, 21-23), blames himself (Numbers 11:14), and challenges God to kill him (Numbers 11:15). God responds and provides Moses with the help of 70 people, a Sanhedrin (Numbers 11:16-17).

A contrast of these two narratives is presented in Table 8.

Table 8: Moses against Oedipus

Stage

Oedipus

Moses

1 Precipitating Stressor

Oedipus’ mother sends infant Oedipus to a mountain top to die by exposure.

Moses’ mother sends infant Moses away to save him from being killed by Pharaoh.

2 Reaction

Oedipus is rescued and raised by the king of Corinth, a nearby state.

Moses is rescued and raised by the daughter of Pharaoh.

3 Response of Others

Oedipus’s identity is questioned. He has no one to talk to. He fails to get usable data from the Oracle of Delphi who speaks in riddles and entraps Oedipus into patricide and incest.

Moses kills an Egyptian who was mistreating an Israelite and flees Egypt. God appears to Moses, chooses him to lead the Israelites out of Egypt, and gives him necessary help.

4 Effect

Oedipus tries to save Thebes from a plague but is undone by riddles and misinformation, resulting in Oedipus’ blinding himself plus other killings and suicides.

Moses is able to carry out his mission in leading the Israelites to freedom.

6) Feeling abandoned by one’s child leaving the family nest and building his / her own life: Treating the Phaedra Syndrome with the Rebecca Intervention

Here we compare the Greek suicide story of Phaedra with the biblical suicide-prevention story of Rebecca regarding addressing the suicidal implications of feeling one’s child is going to live his / her own life.

The Phaedra Syndrome

In Euripides’ Hippolytus, Phaedra, the wife of King Theseus is caught in a miserable family situation, and at the same time she has unrealistic expectations of herself. By the goddess Aphrodite’s design, she falls madly in love with her stepson, Hippolytus. Though she resists her passion, her servant betrays her secret to Hippolytus. Phaedra then hangs herself (ll. 776-779), leaving behind a note that falsely accuses Hippolytus of raping her (ll. 882-898). Theseus believes the note and pronounces a curse of death on his son. The curse is soon fulfilled, and the truth of Hippolytus’s innocence is revealed too late. According to this play, the gods are selfish and cruel, utterly without compassion toward humans. Aphrodite plots to destroy Hippolytus for living in chastity and for his hatred of women (ll.665-667) by filling his stepmother, Phaedra, with passion for him, and turns the heart of his father against him.

Phaedra mixes an exaggerated sense of honor and guilt with a tendency toward self-punishment: (l. 317). She must hide her passion to save her honor: (l. 327) – even if it means suicide (l.331). There is no stopper in Phaedra’s rush toward suicide. She is too overwrought to remain silent, Aphrodite works against her, and her nurse betrays her by revealing the secret of her passion. Death seems to be the only cure: (l. 397). As she expresses it with finality, “I know only one way, one cure for these my woes, and that is instant death” (l. 599).

The Rebecca Intervention

The story of the biblical matriarch Rebecca is very different. After participating in the deception by which they have obtained Isaac’s blessing, Rebecca tells Jacob to go away to her brother Laban, so that he won’t be killed by his brother Esau who feels that Jacob has stolen his father’s blessing that rightly belongs to him (Gen. 27:42-45). But Rebecca has another motive as well in wanting Jacob to be sent away. Specifically, Rebecca tells Isaac that her life has been made miserable by Esau’s Hittite wives, and she worries that Jacob may similarly marry a daughter of Heth, the Cannanite:

And Rebecca said to Isaac, “I am weary of my life because of the daughters of Heth. If Jacob takes a wife of the daughters of Heth, like these who are the daughters of the land, what good shall my life be to me?” (Gen. 27:46)

Interpreting this as a “suicidal ideation” narrative may be somewhat overdrawn. Rebecca’s words seem more like a message to her husband: “Please fix this situation because I can’t stand it!” In any case, the tactic works. Isaac commands Jacob to not marry one of the daughters of Canaan, who are so offensive to Rebecca, and tells him to marry one of Laban’s daughters. Rebecca is relieved and there is no more mention of her “suicidal” musings (Gen. 28:1-4). Rebecca is not being seductive towards her son, nor is she trying to block him from living his own life. What she wants is that Jacob marry a suitable partner. When Isaac listens to her, Rebecca’s suicidal impulse is resolved.

A contrast of these two narratives is presented in Table 9.

Table 9: Rebecca against Phaedra

Stage

Phaedra

Rebecca

1 Precipitating Stressor

Phaedra falls in love with her stepson Hippolytus, wanting him for herself.

Rebecca is concerned that her son Jacob will marry a Hittite woman.

2 Reaction

Phaedra attempts to resist her passion but becomes very depressed.

Rebecca tells her husband Isaac “her life will not be worth living” if Jacob marries a Hittite woman.

3 Response of Others

Phaedra’s servant betrays the secret of her infatuation to Hippolytus.

Isaac tells Jacob to marry a daughter of Rebecca’s brother Laban.

4 Effect

Phaedra hangs herself after writing a note to her husband Theseus falsely accusing his son Hippolytus of raping her, leading to his death.

Rebecca is satisfied and does not speak of suicide again.

7) Feeling doomed by a dysfunctional family of origin: Treating the Antigone Syndrome with the Ruth Intervention

Let us compare the Greek suicide story of Antigone with the biblical life-affirming story of Ruth with regard to addressing the suicidal implications of coming from a dysfunctional (e.g., incestuous) family of origin.

The Antigone Syndrome

Greek thought posits that one is doomed when being born of a dysfunctional family. Oedipus expresses this succinctly “For now. I am forsaken of the gods, son of a defiled mother, and successor to his bed who gave me my own wretched being.” (Sophocles, Oedipus the King, ll. 1359-1361). This is played out in the story of Antigone, daughter and half-sister of Oedipus. She is the product of the incestuous union of Oedipus and his mother Jocasta.

Antigone is unable to separate herself from the incestuous nature of her birth. “From what manner of parents did I take my miserable being? And to them I go thus, accursed, unwed, to share their home” (Sophocles, Antigone, l. 869). Antigone (which in ancient Greek literally translates to “opposed to motherhood or anti-generative”) ultimately hangs herself after being buried alive because she tried to bury her dead brother Polyneices, a rebel against Thebes, against the order of her uncle Creon, the ruler of Thebes. Strikingly, Antigone says she values her brother more than a husband or a child because the latter can be replaced while the former cannot (Sophocles, Antigone, 907-913).

The Ruth Intervention

Biblical thought offers a hopeful alternative. One can overcome the effects of a dysfunctional or even an abandoning family. “Cast me not off, neither forsake me, O god of my salvation. For though my father and mother have forsaken me, the Lord will take me up.” (Psalms 27:9-10). When the sinful people of Sodom are destroyed, Lot and his two daughters escape. Thinking their father is the last living man, they get him drunk and have sexual relations with him, so that humanity will not perish (Genesis 19:31). Out of the union of Lot and his older daughter come the people of Moab (literally, “from the father” in Biblical Hebrew).

Therefore, the Moabitess Ruth is a product of incest, several generations removed. Nevertheless, Ruth does not remain a victim but progresses to become a survivor and an important figure in the history of Israel. This despite the fact that Ruth, her mother-in-law Naomi and her sister-in-law Orpah all are widowed while “strangers in a strange land,” without male relatives to protect them and thus vulnerable. Indeed, Orpah abandons Naomi and returns home. However, Ruth does not and in one of the most moving speeches in the Hebrew Bible she pledges her loyalty to her mother-in-law: “Whither thou goest, I will go ...” (Ruth 1:16-17).

Naomi accepts Ruth as her daughter, brings Ruth back with her to Judea, and facilitates Ruth’s marriage to her kinsman Boaz. Yet despite her losses and despite her dysfunctional family history several generations earlier, Ruth, unlike Antigone, is not suicidal. She thrives and becomes the mother of Obed and the ancestress of King David. She also integrates Naomi into her family in a beautiful way (Ruth 4).

A contrast of these two narratives is presented in Table 10.

Table 10: Ruth against Antigone

Stage

Antigone

Ruth

1 Precipitating Stressor

Antigone is the offspring of an unintentional incestuous relationship between Oedipus and his mother, Jocasta.

Ruth is a descendant of an intentional incestuous relationship by Lot’s older daughter with her father, albeit conducted for a positive reason.

2 Reaction

Though raised in a seemingly secure home, Antigone is unable to separate from her family of origin.

Ruth is widowed at an early age and not in her native land, but she is able to bond with her also widowed mother-in-law, Naomi.

3 Response of Others

Antigone over-identifies with her family of origin. She is buried alive because she will not let her brother, who died fighting against Thebes, remain unburied.

Naomi accepts Ruth as her daughter and brings Ruth back with her to Judea and facilitates Ruth’s marriage to Boaz, a kinsman of Naomi.

4 Effect

Antigone hangs herself, rejecting her would be lover. In Greek, Antigone means ‘against generativity (semen)’.

Ruth thrives, becomes the mother of Obed, ancestress of King David, and integrates Naomi into her family in a beautiful way.

Conclusion

Wellisch’s clarion call for a biblical psychology resonates with the contrasting representations of Biblical hope versus Greek hopelessness. In the Greek account, Zeus sent Pandora, the first woman, as punishment to Epimetheus whose half-brother Prometheus stole fire. One day, Pandora opened the box that Zeus sent with her. The box contained all the evils in the world, which flew out. Pandora closed the lid as quickly as she could, but too late. Only hope remained locked in the box and unavailable to people. (Hesiod,; Theogony, ll. 533-615; Works and Days, ll. 53-105; Plato, Protagoras, 320c-322a).

Hebrew Scriptures portray hope in a very different way. After the great flood, all living creatures, male and female came out from the ark built by Noah and repopulated the earth through their sexual union. God placed a rainbow in the heavens as a sign of His covenant with man that he will not send another flood (Genesis 9:13). The rainbow became the very symbol of hope.

Nowhere is this contrast more relevant than in the prevention of suicide. Biblical narratives provide a stopper to suicidal crises unavailable in the tragic Greek myths so ingrained in psychological thinking. We had better be careful which humanities and humanisms we pine for. In the biblical narratives, you can’t lose for winning. In the Greek classical narratives it is the exact opposite – you can’t win for losing. And lives are on the line!

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Sophocles (1938), Ajax translated by R. C. Trevelyan in The Complete Greek Drama: Volume 1 ed. by Whitney J. Oates & Eugene O’Neill, Jr. New York: Random House, pp. 315-368.

Sophocles (1938), Antigone. translated by R. C. Jebb in The Complete Greek Drama: Volume 1 ed. by Whitney J. Oates & EugeneO’Neill, Jr. New York: Random House, pp. 423-460.

Sophocles (1938), Oedipus at Colonus, translated by R. C. Jebb in The Complete Greek Drama, Volume I, edited by Whitney J. Oates & Eugene O’Neill, Jr., New York: Random House, pp. 613-670.

Sophocles (1938), Oedipus the King. translated by R. C. Jebb in The Complete Greek Drama: Volume 1 edited by Whitney J. Oates & Eugene O’Neill, Jr. New York: Random House, pp. 369-422.

Sophocles (1938), The Trachinae (Τραχίνιαι), translated by R. C. Jebb in The Complete Greek Drama: Volume I, edited by Whitney J. Oates & Eugene O’Neill, Jr., New York: Random House, pp. 465-504.

Tanakh: The Holy Scriptures. (1985), Philadelphia, PA and Jerusalem, Israel: Jewish Publication Society, full text.

Titus Livius (Livy) (1960), The Early History of Rome. Books I-V, translated by Aubrey De Selincourt, Penguin Classics (2002), pp. 496; The History of Rome: The First Eight Books, translated by Daniel Spillan, London: Henry G. Bohn (1849), online.

Wellisch, Erich (1954) Isaac and Oedipus: A Study in Biblical Psychology of the Sacrifice of Isaac, London: Routledge and Kegan Paul, preview.

Yerushalmi, Yosef Hayim (1993), Freud’s Moses: Judaism Terminable and Interminable. New Haven, CT: Yale University Press, pp. 192, review.

Ziffer, Eliyahu (2006), All the People of the Bible. Tel Aviv: Havav Publishers.

Table 1: Suicides in Greek Tragedy (Cont.)

Table 5: Job against Zeno (Cont.)

Paul Knepper

Central Washington University

The Return of the Crime Museum

For the first generation of criminologists, museums were essential for understanding crime. Cesare Lombroso, Hans Gross, Alexandre Lacassagne and Rodolphe Reiss collected objects connected to crime and punishment for public display (Montaldo 2013; Regener 2003; Valier 1998). Much of what their collections contained would now be seen as the history of forensic science, or bric-a-brac that has nothing to do with modern criminology. The crime museum seems to have lost its usefulness, if it ever had one, in developing knowledge of criminology.

Yet the public remains as interested as ever in crime museums. Every year, millions of tourists visit police museums throughout the world, from Buenos Aires to Seattle, Mexico City to Malta, and sites of former prisons, including Alcatraz Island, Robben Island, and Port Arthur (Buffington 2012; Caimari 2012; Piché and Walby 2016). In 2015, Scotland Yard staged a popular exhibition at the London Museum of items from its Black Museum, ordinarily closed to the public. Visitors got the chance to see items from the most notorious criminals in British history, from Jack the Ripper and Dr Crippen to the Kray twins.

Do crime museums have any value beyond a dubious entertainment afforded by “dark tourism” (Lennon and Foley 2000)? In this essay, I propose that crime museums do have value, and that academic criminology departments should display the material culture of crime and criminal justice in a deliberate and thoughtful way. To illustrate this, I will offer examples of crime museums and university departments I know about, including universities in the USA, UK and Switzerland. And, I will do so as a tribute to Shlomo G. Shoham. Museum collections fall outside the range of conventional criminology; the mainstream criminology textbooks and journals have no interest in such things. Shoham was never afraid to pursue topics outside conventional criminology.

Kinds of Museums

The words crime museum include a range of museums associated with crime, criminology, and criminal justice. Three basic kinds would be criminology museums, police museums, and prison museums. Many museums are a combination of these.

The most well-known criminology museum, the Lombroso Museum, re-opened at the University of Turin, in 2009. Cesare Lombroso started the museum in the late nineteenth century with a collection of skulls he obtained while working as a medical doctor in prisons and asylums. He revealed his collection to the public for the first time in 1884 as part of the anthropology exhibition at Turin’s Espoizione Generale Italiana. When the International Congress of Criminal Anthropology met in Rome a year later, Lombroso brought his collection. He filled the main hall of the Palazzo delle Belle Arti with skulls arranged on display tables, body parts floating in alcohol-filled jars, and faces revealed in photographs and death masks. The exhibition contained some 70 skulls of criminals, the entire skeleton of a thief, and sections of skin with tattoos. He displayed aspects of the criminal’s body in 300 photographs, life-size sketches, and handwriting samples (Montaldo 2013).

In 1892, Lombroso learned that the director-general of prisons, Count Bertrani-Scalia, had a collection of skeletons stored at the Regina Coeli prison and was thinking of starting a museum. It was just the thing Lombroso had in mind (Lombroso 1910). Lombroso set up his Museum of Criminal Anthropology at the University of Turin in 1899. It included a corridor of skeletons, allegedly those of notorious brigands from Southern Italy. The largest room contained a scale model of Eastern State Penitentiary in Philadelphia, surrounded by portraits on the walls of criminals and epileptics. Lombroso displayed “criminal types” obtained from government authorities in Spain, Mexico, Portugal, Chile, and Australia. He filled glass display cases with daggers used by Camorra; crucifixes of prisoners seeking redemption; and pottery pieces containing inscriptions of robbers and murderers. He displayed items made by prisoners, including a court scene molded from clay and sketches of shootouts with Carabinieri (Lombroso 1907).

Other criminology museums opened at the time: Paris, Lyons, Vienna, Berlin, Hamburg, Prague and London. Hans Gross founded the Museum of Criminology at the University of Graz in 1912. It re-opened in 2003. The collection contains skulls displaying various kinds of injuries; guns, knives and weapons; poisons; forged coins and currencies; and a wooden column that once concealed the body parts of a murdered woman. The collection documents the history of criminology. This includes Gross’s work in forensic science; specifically, the Tatortkoffer, the investigation tool box Gross developed for crime scene analysis. It also documents work in criminal psychology by Adolf Lenz and criminal typologies by Ernst Seelig of which the “work-shy thief” was believed to be the most common. The museum also documents “criminology’s darkest hour”: how the Graz school of criminology became an instrument of National-Socialist race policy in the 1930s (Bachhiesl 2008).

In addition to criminology museums, there are police and prison museums. The “Black Museum” at Scotland Yard established the paradigm for the police museum. It opened in the cellar of its headquarters in 1875 as a means of initiating new recruits to some of the materials associated with crime. By 1915, the collection included 600 items: revolvers, knives, ropes, plaster casts of murderers, and tools of burglars and swindlers, counterfeit diamonds, jemmies, skeleton keys, counterfeit coins and forged bank notes (Dilnot 1915, 118-122). The public had the opportunity to inspect museum items for the first time in 1946 when the Chief Constables Association of England and Wales staged an exhibition at the Royal Pavilion in Brighton. The items, shown with additional items from forensic laboratories and private collections, were meant to demonstrate the many aspects of police work and traditions police had developed working within communities (Tarry 1948, 176).

The Buenos Aires Police Museum, opened on the ground floor of its headquarters in 1899, was conceived on the Scotland Yard model. It functioned as a crime museum meant for police training. The collection opened to the public in 1932 as part of a police campaign to improve public understanding of the police function. The collection includes police uniforms, along with photographs, weapons, badges and equipment (Caimari 2012).

Prison museums are more recent than criminology and police museums. Generally, they have opened in buildings founded as prisons in the 19th century and decommissioned in the 20th century (Wilson et al. 2017).

The Horsens Prison Museum in Denmark claims to offer the world’s largest collection of prison items. It is a crime and prison museum, as well as a conference and business meeting center, and concert venue for live music. The prison, commissioned in 1853 for prisoners serving long sentences, closed in 2006. The museum collection includes an axe used to commit murder, the story of an escape through a tunnel dug with a spoon, and the oversize trousers left behind by an embezzler. The displays include shadows on the walls of prisoners and guards, and the sounds of walking and locking doors. Voices of prisoners can also be heard over an intercom system, including reflections about drug addiction and complaints about the fish for dinner. The walls feature a mural, created by motorcycle gang members, depicting a mix of masculine fantasy and Danish mythology.

Fremantle Prison in Western Australia was built in the 1850s with convict labor and continued to operate as a prison until 1991. It has been a significant attraction for tourists since 1992, with guided tours, an ice cream parlor, and a souvenir shop. Tourists inspect a vast collection of objects, including model boats made by a prisoner from oatmeal, glass and salt as well as murals painted by prisoners on cell walls. Tourists gain a sense of life in confinement from well-preserved architecture, and witness artifacts, signs and graffiti left by prisoners from colonial times to the present (Witcomb 2012).

Messages and Meanings in Exhibits

The purpose of crime museums has changed from what it was in the 19th century. In addition to research and training, crime museums offer public education, popular entertainment, and serve as memorial sites.

Research Laboratory

Crime museums are justified as sites for research. Sakki (2008) describes the Museum of Criminology at the University of Athens as a site for research and scientific development. Founded by Professor John Georgiadis in the 1930s, the museum contains tattoos on human skin; handguns, knives and swords; wax models of wounds and injuries; and narcotic substances. There is a plausible argument for using objects to answer some questions about the causes of criminal behavior. Eisner (2011) proposes the archaeology of weapons contributes to understanding long-term trends in violence.

Bronfman (2012), however, suspects the reverse is true. If there is a message about scientific knowledge, it is not the triumph of criminological knowledge, but the opposite. There is no “hidden logic” behind the items on display at the Museum of Legal Medicine at the University of Havana. It is a bewildering assortment of grotesque, banal, and sinister items: a flying donkey fashioned from bread crumbs; a fragment of tattooed brown skin; a Colt revolver; a necklace of St Barbara; maracas and a crucifix The assortment testifies to the failure of criminology to contain, categorize, and catalogue; to the inability of criminological science to grasp criminality (Bronfman 2012).

The Lombroso museum has been engaged in a legal battle over the skull of Villella. It was the inspiration – Lombroso claimed – for the historical science of criminal anthropology. The mayor of Motta Santa Lucia in the province of Catanzaro, Calabria, the village where Villella was born, has requested return of the skull for burial. The skull has no scientific value. Criminal anthropology has been exposed as a misogynist, racist ideology, not to mention a false theory of criminality. But the skull has value in the history of criminology. “It is difficult to consider Villella’s skull scientifically irrelevant and thus unworthy of display in a museum”, Silvano Montaldo, director of Lombroso Museum, explains, “That is, unless one believes that science must destroy the traces of its past” (quoted in Ystehede 2016).

Professional training

In the 19th century, the museum might have conveyed information of use to police. But this gave way to other justifications. In the 1940s, Chief Constable Frederick Tarry called for a central police museum in England, not to train new recruits, but to serve scientists and investigators. Further, many of the items exhibited, such as medals, badges, buttons, handcuffs, and truncheons, would serve to “improve communication between the public and police”. Above all, the museum would provide entertainment, with “exhibits connected with famous criminal cases” (Tarry 1946, 116).

As Caimari (2012) observes, there is not much within the exhibits found in a typical police museum today that teach techniques of prevention, control, or repression. The “floating objects” in crime museums, separated from time and place, have now lost their original purpose. Originally, they provided a pathway into the criminal underworld; into the secret knowledge of thieves, tricksters and other professional criminals. These “vestiges of unlawful inventiveness” are now covered with a “veneer of nostalgia”, invoking a yearning for an era when crime was simple, understandable, and contained in pry bars and fake coins (Caimari 2012, 144).

Public Education

The crime museum, it would appear, has more to offer the public than the police. The Seattle Police Museum, in Seattle, Washington, is a private, non-profit institution intended to educate the public about the “historic, cultural, technological and social transformations” of the municipal police and county sheriff’s department. The collection includes uniforms, weapons, photographs and documents dating to the 1880s. The museum was formed in 1997 through the initiative of police officer Jim Ritter, and operates with donations from police officers and sheriff’s deputies, admission, gift shop sales, rental of the facility, and grants. Ritter explains why the police are willing to pay: “In 2017, police-community relations are at a critical point in history, and the police museum has always been an effective way to foster a conversation through education, demystify the police, and share our story with those who are open to learn something new.”

The authorities have tried to use the crime museum as a medium for advancing the official view: to affirm the necessity of government power in the war against anarchy and criminality (Regener 2003). But what the government wants to say and what the public knows are not necessarily the same thing. The South Africa police museum in Pretoria began with a collection of artefacts from criminal cases: murder weapons, photographs of mutilated bodies, the effects of a female poisoner. Housed in the national police headquarters, it championed law and order over criminals, the triumph of “national security” over the threat of terrorism. By the 1990s, in post-apartheid South Africa, the building had become abhorrent. After failed efforts to freshen the exhibits and re-message the museum, it closed because of its own contradictions (Comaroff and Comaroff 2004).

Popular Entertainment

Museum collections were not developed within a coherent theoretical framework or systematic effort to collect data for analysis. Rather, they originated with the personal collections of individuals. These include trophies from legal cases, items linked to notorious crimes, and mementos from colleagues. Here we see the crime museum not as a site for research or training, but amusement.

Crime museums have gained popularity in recent years, perhaps less because of public interest in items associated with crime than because they have been incorporated within local tourism sites. The public visits decommissioned prisons and police museums, along with gravesites, past battlefields, and death camps as part of visitor attractions. “Dark tourism” raises ethical questions, particularly the operation of gift shops and souvenir stands. Sale of particular items at the 911 gift shop in New York City have been questioned as commercializing or trivializing the site of a mass murder.

Piché and Walby (2016) observe that the attempt to convert prisons into tourist attractions leads to an emphasis on notorious criminals, violent outbreaks and escapes, which encourages the view that prisoners are dangerous. In providing entertainment by emphasizing sensational moments in prison history, it reinforces the view of the prison as an obvious response to the “dangerous class”. These destinations tend to reinforce punitive views, and a dark nostalgia for punishment in “the old days” (Piché and Walby 2016, 7).

Memorial sites

Museums represent sites of “collective memory,” and because a crime museum deals with memories of events that brought suffering, pain, and loss, it raises unavoidable ethical questions. To put it another way, it has the function of a monument. “A public monument represents a kind of public recognition – in short, legitimacy – for the memory deposited there” (quoted in Kammen 2003, 42). What memories of crime and criminal justice in the past should be preserved into the future? Emphasis on crime and criminals can become a celebration of cruelty and destruction; a monument to injustice like Confederate generals on horseback in Richmond, Virginia, or the icons of happy Soviet workers that remain on a bridge in Vilnius, Lithuania.

Victims of crime are conspicuous by their absence in crime museums. The space is devoted to lawbreakers, to those who study them, patrol them and confine them. Incorporating victims is neither simple nor straightforward. When a Swedish artist, Jonas Wahlberg, offered to create a memorial to those massacred in the mass shooting at Utøya in 2011, he met with objections from several groups, including family members of victims. As the parent of one victim explained, “No one should be allowed to make money out of our daughter’s death” (Ystehede 2016, 342).

The value of crime museums

What is the value of crime museums to contemporary criminology? Crime museums have an important role in several ways.

First, to enter a museum is to experience time. It is easy to get the impression from criminologists that we are living in a rapidly changing world in which we face unprecedented crime problems. We live in an age of fear, insecurity, risk, or anxiety brought about by a globalization, technology, or mass culture. Criminologists refer to the present as the age of postmodernity or late modernity, surveillance society or pre-crime society, with novel threats of global crime, internet crime, trafficking and terrorism (Garland 2002; Zedner 2007).

From a historical perspective, such crime threats are not new or novel. Nor are the expressions of “chronocentricity”, the view that one period of history is coming to an end and we are starting another (Standage 1998, 199). Looking back, we can see that every generation believes this for one reason or another, whether wars, weather, disease, energy or technology. There is the belief that the internet has changed everything, but as Standage points out, although the equipment is different, the impact of the telegraph on society was strikingly similar. The emotions associated with the internet – hopes, fears, misunderstandings – are not consequences of technology but human nature (Standage 1998, 199). The crime museum has, or can have, an important mission of orienting students to historical time, the sources of continuity and change, to signs of hope and reasons for despair, to dreams and nightmares of previous generations.

To do this, the display must challenge the “Whig view” of history that saturates criminology (Knepper 2016, 6-7). It is common to follow a chronological arrangement in criminology textbooks. Criminology theory is taught as the emergence of one idea, replaced by another, until we have arrived at the present. In this view, we possess greater knowledge and insight into crime than anyone before. It is easy to create police and prison museums that affirm the Whig view of history. Arranging items in a chronological sequence suggests the progressive development of the response to crime, from the dark ages of brutality and torture to the enlightened, humanitarianism of modern prison and police techniques. This presentation fails to contain information about corruption, abuse or other aspects of criminal justice that do not furnish objects as readily available as uniforms, patrol cars and radios.

Second, the materiality aspect. In an age of virtual learning, the museum is more important than ever. The digital “documents” available on the internet change without notice, disappear to reappear somewhere else. Accounts of criminal events change, as if the past can be altered or undone at the touch of a keyboard. Objects can testify to the reality of injustice and victimization, they contain the cultural memory of what has happened regardless of the number of versions that flicker on the computer screen.

Among the items at the Seattle Police Museum is a length of rubber hose. The caption reads: “Extracting confessions from prisoners was performed in many ways in the early days of policing. Some police agencies in the early 1900s resorted to using the rubber hose to ‘encourage’ the truth to be revealed. Circa 1905. Seattle police”. It is unusual for a police museum to include such items. Police museums avoid malfeasance past or present (Buffington 2012, 160). But a museum has the power to provide a “counter memory.” Counter memories defy official narratives of the past and challenge institutions to acknowledge what they would prefer to forget (Young 1993).

There is value in crime museums if we understand the objects they contain as material culture. Material culture is difficult to define in precise terms. Material culture studies range across archaeology, anthropology, and history. Essentially, it refers to shared meanings attached to objects. An object such as a birthday present or wedding ring has a personal meaning, but in trying to understand objects as cultural materials, we are trying to uncover collective or shared meanings. Sturken (1997, 3) defines a cultural memory as “memory that is shared outside avenues of formal historical discourse yet is entangled with the cultural products and imbued with cultural meaning”.

Third, material culture has to do with the relationship of people to objects. There is an inescapable subjectivity. People bring their experiences, histories, and understanding. The learning that takes place in museums has been characterized as the “contextual model”. Falk and Dierking (2000) explain that within museums, there are several key factors that shape the learning experience. These have to do with personal context, sociocultural context and physical context. Prior knowledge, interests and beliefs play a tremendous part in the take-away message from museums, and this is particularly true of crime museums.

Museum displays explore shared meanings, which is where the curation aspect enters in. Exhibits need to have one big idea; to keep things focused on an overall message, and to think about visitors as “whole people” with many shared needs and interests. The curatorial-positivist stance (“Here is our knowledge and truth for you to learn”) has been replaced by the multiple-meanings context (“Here is what some people believe to be true”). The acknowledgement of uncertainties and disagreements about “what we know” has taken place in every discipline, and museum curators seek to create exhibits that are more inclusive (Roberts 1997).

The architecture of Fremantle Prison, which resembles a medieval fortress, is embedded in cultural imagination, and encourages “romantic narratives” of the colonial past, such as Irish Fenians who suffered under colonial justice. Wilson (2008) points out that the use of former prison officers as tour guides also encourages “official narratives” that reinforce the government’s view of imprisonment and neglect voices of convicts themselves. Wilson’s work sought to recover lost narratives; the stories of inmates and those “othered” by society at the time and by public history since then. The narratives challenge the established view, based on her interviews with tourists, curators, managers and former prison staff, and anthropological reading of the site, including architecture and graffiti.

The role of universities

A few universities possess extraordinary collections. The School of Criminal Sciences at the University of Lausanne retains items from the career of Rodolphe A. Reiss. Reiss, who founded the Institute of Forensic Science at Lausanne before the First World War, pioneered crime scene photography (Montani 2014). As the world’s first forensic laboratory based at a university, the collection secures the identity of Lausanne as a premiere site for the study of criminology. Visitors to the fourth floor of the Batochime Building are greeted by a nearly life-size statue of Reiss. Glass display cases contain equipment Reiss used to photograph crime scenes: ropes, knives, handguns and weapons; keys and picks for forcing locks; devices for sketching crime scenes; and a chair for Bertillon measurements. Other universities do not possess such materials, but that does not mean they cannot operate crime museums.

First, many universities do possess various objects, they’re just not on display. Central Washington University is a regional university with a modest role in the history of American criminology. It is located in the small farming town of Ellensburg, separated from Seattle, Tacoma, and most of the population of the state, by the mighty Cascade Mountains. Its degree program began in the 1970s, like hundreds of others, with a grant from the Law Enforcement Assistance Administration (LEAA). It has never been the home of August Vollmer or Edwin Sutherland; never produced “spot maps” of urban criminality such as Chicago, or sponsored a famous study of police patrol like Kansas City. Yet even Central Washington University has the makings of a crime museum. The university has a collection of police badges given by a graduate of the program, John Kozar. Many of these are prized by collectors. The Kozar collection has been valued at $50,000 and this is one of the reasons it’s not available to the public. Without a secure place for display, the badges remain locked away in file cabinets.

Second, universities have connections to collections that could be developed. It would be hard to find a city or region without a local museum, historical society, police department, or prison that did not have objects associated with crime (Kammen 2003, 84). Universities could partner with local organizations and museum groups that maintain items relating to crime and criminal justice. The University of Sheffield, in northern England, had one of the first university-based crime laboratories in the 1920s, and in 1976, opened one of the first centers for criminological research in the UK (Knepper 2018). This center was used for important studies of crime, and the papers of Sir Anthony Bottoms, who directed much of this research, remain in the School of Law. There is a museum in the city devoted to policing and a medico- legal society committed to its history. There are museums at the university devoted to glass manufacturing and zoology. But nothing to suggest Sheffield’s role in the history of British criminology.

Third, many universities already offer crime museums without realizing it. It is not uncommon to see displays of patches, caps, and other materials. I think this is the most important reasons for taking crime museums seriously and thinking about their potential to contribute to an academic department. The display of police patches or badges on a wall reflects a curatorial-positivist approach that presents criminal justice in an official, celebratory way. It suggests that students will be told what to learn in classrooms rather than classrooms in which students must develop skills to make sense of contradictory theories and research.

We know that students have different motivations for studying criminal justice. In a recent survey of 322 students at Central Washington University, we found that some took criminal justice courses because they wanted a career in the field, others because they found the subject interesting. They also bring prior knowledge, interests, beliefs and experiences. We found that 28% have worked, or have a family member who has worked, in criminal justice; 18% have been, or have a family member who has been, the victim of a crime; and 17% have, or have a family member who has, served time in jail. In breaking this down further, we found the percentage of families with crime victims to be higher among Latinos (Knepper, Nieffer and Mendez-Flores 2017).

The point is not that badges or patches should be removed from the halls of university departments of criminology. They are an important part of the story we want to tell. The point is to contextualize them with a variety of objects and materials to tell more of the story. Imagine a display of badges surrounded by quotations from various people about what the badge means to them: a retired police offer who wore the uniform for 30 years; a family member of a police officer killed in the line of duty; an undocumented immigrant working to support a family in Mexico; an African-American resident in an urban neighborhood. Acknowledging multiple meanings, and exploring the reasons behind emotions, as complex and contradictory as they are, encourages students to think about criminology as a critical form of inquiry.

Conclusions

Criminologists have forgotten about crime museums. The public has not. They represent an important way for people to explore crime, criminal justice and criminology. Departments of criminology at universities should develop crime museums.

Crime museums serve multiple, even contradictory purposes. They offer less in the way of research or training than they do in public education. The fact that they offer entertainment and constitute memorial expressions raises ethical questions, and will likely generate controversy. But they are important for situating criminology in history, for engaging students in the realities of crime and victimization, and for encouraging a complex understanding of criminal justice.

Many university departments already display patches, badges and other items from criminal justice organizations. These represent the material culture of criminal justice and the cultural aspects need to be explored. Without proper exhibits that help viewers appreciate multiple messages, and the different emotions the items inspire, such displays convey the wrong message about what criminology is about. Rather than celebratory displays, academic departments need displays that dig beneath the surface and elicit the analytical inquiry students should practice.

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Wilson, Jacqueline Z.; Sarah Hodgkinson; Justin Piché and Kevin Walby (2017), editors, The Palgrave Handbook of Prison Tourism. London: Palgrave Macmillan, pp. 1045, TOC.

Witcomb, Andrea (2012) “Tensions Between World Heritage and Local Values: The Case of Fremantle Prison (Australia)” pp 62-68 in Marie-Theres Albert, Marielle Richon, Marie Jose Vinals and Andrea Witcomb, eds, Community Development through World Heritage: World Heritage Papers 31. Paris: UNESCO, pdf download.

Young, James E. (1993) The Texture of Memory: Holocaust Memorials and Meaning, New Haven, CT: Yale University Press, pp. 415, review, review2, interview.

Ystehede, Per Jørgen (2016) “Contested spaces: On crime museums, monuments and memorials,” pp. 338-352 in Paul Knepper and Anja Johansen, eds, The Oxford Handbook of the History of Crime and Criminal Justice. New York: Oxford University Press, pp. 707, abstract, TOC.

Zedner, Lucia (May 2007) “Pre-crime and post-criminology?” Theoretical Criminology, 11(2): 261-281, abstract, abstract2.

Biography

Paul Knepper is professor of criminology in the Department of Law and Justice, Central Washington University, and visiting professor of criminology in the School of Criminal Sciences, University of Lausanne. He has co-edited several publications with Shlomo Shoham, including two volumes of Israel Studies in Criminology. Knepper and Shoham revived publication of the series in 2003, which had been founded by Shoham in the 1970s, in response to an attempt of the Association of University Teachers in the UK to boycott Israeli academics.

Arie Nadler

School of Psychological Sciences, Tel Aviv University

Intergroup Reconciliation and Victimhood:
Social Psychological Dynamics

The study of the roots of intergroup conflicts and ways to end them has been of major concern for all disciplines in the social sciences including social-psychology. These efforts were driven by a dual purpose: (a) to gain better basic understanding of intergroup dynamics of conflict, and (b) to promote harmonious and peaceful social life. In this chapter I describe research and theory on intergroup reconciliation and the work of my colleagues and my work in this area. I begin with a short discussion of the concept of reconciliation, proceed to describe the Needs-Based Model of reconciliation (Nadler & Schnabel, 2008; 2015) that served as the framework for our work, and conclude by discussing how feelings of collective victimhood may block reconciliation and how these negative effects on intergroup reconciliation can be ameliorated.

Intergroup Conflicts and Reconciliation: A General Perspective

Much past research and theory on intergroup conflict and its resolution has been guided by the ‘real conflict’ approach (Sherif et al., 1954/1961). Briefly stated, this approach views conflict as emanating from disagreements between adversarial parties on the distribution of material resources that both parties covet (e.g., land, water, money, etc.). This approach suggests that a conflict will end when the costs of continuing it are perceived by both parties as too high to bear. This will lead them to agree on a formula for the distribution of the desired resources between them. This formula for the end of conflict is said to be negotiated by two relatively rational negotiators who understand that to end the conflict they must accept less than their maximal demands.

However, conflicts between groups also continue, or end, because of the frustration or satisfaction of basic psychological needs (e.g., the need for security, self-esteem, etc.) (Scheff, 1994). In intergroup conflicts, parties hurt and humiliate each other and this often results in deep psychological wounds to both parties. The continuation of conflict, or its re-emergence after it had ended in agreement, are often linked to a party’s feelings of humiliation caused by their adversary’s actions. For example, Lindner (2006) suggests that one reason for the 2nd world war was the collective humiliation experienced by Germany following the end of the 1st world war and the terms of the Versailles treaty. The processes of reconciliation that are the focus of this chapter reside within this conceptual tradition that views the end of conflict as the process of healing the psychological wounds that were inflicted on the adversarial parties (Bar-Tal, 2013).

(a) Reconciliation-Outcome and process. While the ‘real conflict approach’ has dominated discussions of conflict and its ending in social science discussions in the 20th century, the ‘psychological needs’ approach has become increasingly dominant in social-psychological research in the last two decades. This is evidenced by the fact that ‘reconciliation’ is a central concept in many recent analyses and researches on the resolution of intergroup conflicts (Nadler, Malloy & Fisher, 2008; Nadler, 2012; Nadler, in press). The concept of reconciliation implies a ‘deeper level’ of ending conflict than other concepts used in this research context. Kelman (2008) suggests that reconciliation refers to an identity change of moving conflict-related elements (e.g., ‘we are moral’ and ‘they are immoral’) from the center to the periphery of the parties’ collective identity. Reconciliation is different than ‘conflict settlement’ (i.e., settling conflicting interests) or ‘conflict resolution’ (i.e., bettering relations between adversarial parties).

The formal definitions of reconciliation varied between those that focused on reconciliation as an outcome and described a picture of intergroup harmony, and those that focused on processes of reconciliation that may result in a harmonious social existence. The definition of reconciliation as ‘…acceptance…’ of the adversary, ‘…changed psychological orientation…’ toward them and ‘…seeing the humanity…’ of one’s adversary represents an example of a definition of reconciliation as an outcome (Staub, 2006, p. 868).

On the other hand, the process of reconciliation is regarded as a process of removing the conflict-related emotional barriers that separate adversarial parties (e.g., guilt feelings, feelings of victimhood, feeling humiliated) (Nadler, 2012). This view of the process of reconciliation guided much of our work in this context.

(b) Instrumental and Socio-emotional processes of reconciliation. In our work we distinguished between processes of instrumental and socio-emotional reconciliation (Nadler, 2012). Processes of instrumental reconciliation focus on removing the distrust that blocks the road towards ending the conflict. Processes of instrumental reconciliation consist of learning to trust one’s adversary by taking part in cooperative projects with them. For example, when two enemies cooperate to build a hospital that will serve their peoples, they may learn to trust their former enemy during this cooperation. These processes of reconciliation intentionally ignore issues of guilt, victimhood and humiliation that are commonly associated with the past conflict and focus on present cooperation that will, hopefully, dismantle the mutual distrust.

Socio-emotional processes focus on emotions that emanate due to the violent past and the physical and psychological wounds that each party inflicted on its adversary. This path toward reconciliation aims to disarm conflict-related emotions (e.g., vengefulness, Scheff, 1994) that may re-ignite a conflict and keep it going. An example for a socio-emontional processes of reconciliation is when the perpetrator accepts responsibility for past wrongdoings and seeks the victims’ forgiveness (Nadler & Liviatan, 2006).

Processes of Instrumental and Socio-emotional reconciliation differ in three major dimensions: (a) the goal of reconciliation, (b) its temporal focus, and (c) the envisioned future of reconciliation.

Regarding the goal, instrumental processes aim to repair the relationships between the adversaries. The goal is to restore trust and reduce animosity and mutual negative perceptions. The goal of socio-emotional processes is to heal conflict-related threats to parties’ identities (e.g., being viewed as the guilty perpetrator or the powerless victim). Socio-emotional processes are based on the assumption that unless these threats to adversaries’ identities are ameliorated, reconciliation will be difficult if not impossible. We will address these threats, and ways to ameliorate them, in more detail in a subsequent section that describes the Needs-Based Model.

Regarding temporal focus, instrumental processes focus on the present and Socio-emotional processes focus on the past conflict. In instrumental processes, adversaries cooperate in the present to ameliorate the distrust that dominates their relationships. They work to build trust by ‘letting bygones be bygones’. They work under the assumption that the key for a reconciled future is cooperation in the present. Socio-emotional processes relate to the past conflict. Parties seek to promote harmonious intergroup relationships by removing conflict-related psychological threats to their identities. Processes such as making apologies and granting forgiveness for past wrongdoings exemplify this focus. When completed successfully, such processes contribute towards healing the parties’ threatened identities. Here the assumption is that the key for a reconciled future is a confrontation with past wrongdoings and victimizations.

The third dimension that differentiates Instrumental and Socio-emotional processes is whether reconciliation aims to build a future of integration or separation between the two adversaries. Socio-emotional reconciliation is appropriate when the adversaries work to build a future of integration of adversarial groups under the roof of the same social identity. For example, when in the post-apartheid era blacks and whites envisioned a unified South Africa in which both groups will live together, processes of socio-emotional reconciliation seemed appropriate and were the basis of the Truth and Reconciliation Committee.

Instrumental processes are more appropriate when parties desire separate co-existence in a conflict-free environment. Consistent with this, truth and reconciliation committees are common in the era of post intra-societal conflicts (e.g., South Africa, Guatemala, etc.) while instrumental processes of trust-building are more common in the context of international conflicts where a border exists between the two adversaries (Long & Brecke, 2003). Applying this rationale to relations between Israelis and Palestinians suggests that addressing the past is important for reconciliation between Israeli Jews and Israeli Arabs (i.e., Palestinians who are Israeli citizens), while trust building is more important between the state of Israel and a separate and independent Palestine (Nadler & Shnabel, 2008). The Needs-Based Model, described below, deals with the psychological dynamics in processes of socio-emotional reconciliation.

The Needs-Based Model: Remedying Threats to Agency and Communion

The Needs-Based Model (NBM) of reconciliation posits that victims and perpetrators experience different identity-related threats and that ameliorating these threats is a precondition for reconciliation. What are the threats to the victims’ and perpetrators’ identities?

People have two basic needs that must be satisfied for psychological well-being. These are the needs for ‘agency’ and ‘communion’ (Bakan, 1966). The need for agency is the ‘individualistic’ desire of people to be competent, strong, efficacious and independent. The need for ‘communion’ is people’s ‘social’ need to affiliate with others, be liked, and share a feeling of belongingness with them. The NBM is based on the idea that victims suffer threats to their need for ‘agency’ and perpetrators to their need for ‘communion’. Regarding victims, when one is victimized, one is powerless and at the mercy of the perpetrator. On the other hand, being viewed as the perpetrator of wrongdoing produces a threat to one’s moral image which translates into a threat to one’s need for communion. Using the concept of ‘moral image’ and not ‘morality’ underscores this threat to communion. While a perpetrator may regard the violence that they had perpetrated as justified and necessary, the threat to one’s need for communion is based on the realization that others view these acts as morally questionable. When this is the case, the perpetrator faces the danger of being excluded from the ‘moral community’ to which they belong. In the case of individuals, others may shun their company and in more extreme cases actively exclude them by putting them behind bars. When the morally dubious party is a nation, other nations may enact various means to exclude it from the ‘community of nations’.

(a) Unilateral Amelioration of Threats to Communion and Agency. Victims and perpetrators do not stay indifferent in the face of these threats to their identities. They employ psychological or actual mechanisms to remedy these threats to identity. When taken unilaterally these actions are likely to prolong and intensify the conflict. Socio-emotional processes of reconciliation consist of a bi-lateral and interactive forms of ameliorating threats to the perpetrators’ need for communion and the victims’ need for agency.

A common unilateral way with which victims seek to ameliorate the threat to their agency is by taking revenge. In fact, revenge is good for the victim. Expressing this sentiment, Akhtar noted that “some revenge is actually good for the victim … it puts the victim’s hitherto passive ego in an active position … [and] imparts a sense of mastery and self-esteem” (Akhtar, 2002, p. 179). In a similar manner, perpetrators defend against threats to their moral image by psychologically distancing themselves from the victim and the wrongful actions they had committed. This may take the form of dehumanizing the victims, accusing them of ‘having brought it on themselves’, or viewing the sufferings they had caused as relatively inconsequential. These, and other cognitive mechanisms that are subsumed in Bandura’s theorizing on moral disengagement (Bandura, 1999). These mechanisms protect perpetrators against viewing themselves as morally deficient.

Although taking revenge and psychologically distancing oneself from morally questionable acts may be effective means of protecting against threats to victim and perpetrator identities, respectively, they are detrimental for the relationships between them. Acts of revenge are commonly viewed by the other side as an unjustified violence that needs to be avenged, thereby creating cycles of revenge that intensify rather than pacify the conflict. Similarly, cognitive mechanisms of psychological distancing prepare the ground for further acts of violence. For example, the lack of empathy associated with dehumanizing the other makes commission of further acts of violence easier.

The amelioration of psychological threats to adversaries’ identities bilaterally contributes to the reconciliation of the conflict. Making apologies for past wrongdoings by the perpetrator and reciprocal granting of forgiveness by the victim is a paradigmatic example of bilateral satisfaction of the needs for agency and communion, which contributes to reconciliation. In Mea Culpa: A sociology of apology and reconciliation, a pioneering analysis of the apology-forgiveness cycle, Tavuchis described the change that occurs in the wake of a successful apology-forgiveness cycle as ‘magic’. He wrote: “although both victim and perpetrator know that words cannot undo the past, in some magical way this is exactly what they do” (Tavuchis 1991, p. 8). Empirical research related to the Needs-Based Model seeks to uncover the psychological mechanisms of this ‘magic’ that occurs following a successful completion of an apology-forgiveness cycle.

(b) The Needs-Based Model Apology: Bilateral amelioration of threats. Agency and Communion. The perpetrator’s apology satisfies the victim’s need for ‘agency’ by changing the power relations between victim and perpetrator. During a victimization episode, the victim was powerless and at the hand of the perpetrator. Apology changes the balance of power between them. When the perpetrator apologizes, the victim has the power to grant or withhold the forgiveness that the perpetrator seeks. Pumla Gobodo-Madikizela, a member of the South African Truth and Reconciliation Committee in the 1990s, has written that the victim’s freedom of choice to forgive the perpetrator or not “… can paradoxically elevate a victim to a position of strength as the one who has the key to the perpetrator’s wish … the victim becomes the gatekeeper to what the outcast desires.” (Gobodo-Madikizela, 2004, p. 54). From this perspective, the perpetrator’s apology empowers the victims, restores their sense of agency, and reduces the need to remedy the threat to identity by unilateral actions such as taking revenge. On the other hand, the victims’ expression of forgiveness remedies the threat to the perpetrator’s moral image, reduces fears of social exclusion, and promotes the willingness for reconciliation. Therefore, the apology-forgiveness interaction ameliorates threats to victim’s agency and perpetrator’s communion, respectively. It lowers the emotional blocks of victim’s vengefulness and perpetrator’s psychological distancing that feed the fires of conflict. It should be noted that the Needs-Based Model uses the apology-forgiveness cycle as a paradigmatic example. It also asserts that many other ways that satisfy victim and perpetrator needs for agency and communion, respectively, will increase the parties’ willingness for reconciliation.

The chart in Figure 1 illustrates this process.

Figure 1: The Needs-Based Model of Reconciliation

The Needs-Based Model of Reconciliation has been empirically supported (cf. Nadler & Shnabel, 2015; Shnabel & Nadler, 2015 for reviews). For example, in one study (Shnabel, Nadler, Ullrich, Dovidio & Carmi, 2009), Palestinian citizens of Israel who had been reminded of their victimization (i.e., victims of the Kfar Kassem massacre) were more willing to forgive and reconcile with Israeli Jews (i.e., the perpetrators), after receiving a message affirming their group’s competence and overall efficacy (i.e., ‘agency’). In the same context, Israeli Jews (i.e., the perpetrators) evidenced higher willingness to reconcile with Palestinians after they had received a message affirming their group’s likeability and friendliness (i.e., a communion related message). When Jews were the victims (i.e., in the context of Israeli-German relations), they were more willing to reconcile after receiving a message affirming their group’s efficacy than a message affirming their communion-related qualities. Space limitations limit a full account of other research that has addressed extensions of the Needs-Based Model. For example, one line of research has examined what happens when, as is often the case in intergroup conflicts, the group is a both a victim and a perpetrator. The interested reader is referred elsewhere for a description (Nadler & Shnabel, 2015).

Victimhood and Collective Identity

The group’s history of victimization can be a central building block of its collective identity. When this is the case, past sufferings become the nucleus around which the group’s identity is built (i.e., the group’s ‘chosen trauma’, Volkan, 2006). Examples of this are the Battle of Kosovo in 1389 for Serbians and the Holocaust for Jews. Chosen trauma affect group members’ perceptions of an ongoing conflict and its resolution. The group’s attachment to their collective victimhood can be detrimental for reconciliation. For example, when Canadian Jews had been reminded of Jewish sufferings during the Holocaust, they were relatively less concerned about the implications of morally questionable actions of the Israeli army (Wohl & Branscombe, 2008).

Competitive victimhood constitutes another aspect of the negative role of collective victimhood in intergroup relations (Noor, Shnabel, Halabi & Nadler, 2012). Because of the psychological benefits of collective victimhood (e.g., garnering support from 3rd parties), groups in conflict compete over which is the ‘true victim’ (Noor et al., 2012). Competitive victimhood has been shown to dominate in intergroup conflicts in Northern Ireland (Noor, Brown & Prentice, 2008), the former Yugoslavia (Andrighetto et al., 2012), and the Middle East (Nadler & Shnabel, 2010), and is associated with lesser willingness to reconcile with one’s adversary. The adverse effects of collective victimhood on a groups’ willingness for reconciliation begs the question of how these effects can be ameliorated, thereby promoting willingness for reconciliation.

Ameliorating Collective Victimhood. Past research has identified three ways in which the ingroup’s attachment to its victimhood-centered identity can be reduced.

(a) The first suggests that if victimized groups were to understand their perpetrators’ perspective, their attachment to their victimization would be reduced and they will be readier to reconcile. The situation in Rwanda, where Tutsi victims realized that they also could have succumbed to the social pressures that their Hutu perpetrators were exposed to and become involved in a killing rampage against their neighbors, represents this path (Staub, 2006). This idea is echoed in Desmond Tutu’s assertion that victims will forgive their tormentors only if they can understand why they did what they did (Tutu, 1999).

(b) A second way to reduce attachment to collective victimhood is by cognitively uniting the adversaries under the same category of ‘victims of the conflict’. Israelis and Palestinians who had been induced to think of both groups as victims of their ongoing conflict evidenced higher willingness to forgive their adversaries (Shnabel, Halabi & Noor, 2013; Vollhardt & Bilali, 2014).

(c) A third way in which the dominance of collective victimhood may be reduced is the acknowledgment of the truth of victims’ past victimization. In my final comments, I want to emphasize the effects of acknowledging the truth of suffering on reconciliation.

The positive effects of acknowledging an ingroup’s past suffering have been supported by past research. Acknowledgment of the sufferings of victims in Chechnya had positive effects on their wellbeing (Maercker et al., 2009), and acknowledging the sufferings of political prisoners led to a reduction in their vengefulness towards their tormentors (David & Choi, 2009). Other research provided more direct evidence regarding the effects of acknowledgment on increased readiness for reconciliation. Armenian and Jewish students whose peoples’ victimization had been acknowledged by a Turkish and German speaker, respectively, had more conciliatory attitudes towards their former perpetrators (Vollhardt et al., 2014). In a consistent manner, recent research found that Israeli-Jews and Palestinians whose ‘chosen traumas’ (i.e., Jewish Holocaust and Palestinian Naqba, respectively), had been acknowledged by the adversary were more willing to make compromises for peace on key issues such as Jerusalem and the ‘right of return’, than those in a no-acknowledgment control group (Hameiri & Nadler, 2017). Conversely, the denial of a group’s ‘chosen trauma’ is experienced as re-victimization. In one study, the denial of the Armenian genocide led Armenian respondents to experience more feelings of resentment and anger than when such a denial had not occurred (Kalayjian, Shahinian, Gergerian, & Saraydarian, 1996).

While this research provides convincing evidence that acknowledgment of victimization promotes willingness for reconciliation, relatively less is known about the psychological mechanisms that explain this link and the variables that affect it. I am closing by suggesting this is an important area for future research. Some of these questions are: Why does the acknowledgment of victimization lead to greater willingness for reconciliation? Is an acknowledgment by one’s adversary (e.g., Israeli-Jews acknowledgment of Palestinian sufferings) imply acceptance of responsibility? Does it convey a sense of respect for the ingroup’s identity? Finally, there are degrees of acknowledgment and truth.

Acknowledgment may be a factual recounting, an admission of responsibility or what Jean Améry (1966) has labeled ‘Acceptance of Negative Identity’ when the perpetrator views the sufferings they had inflicted as part of who they are, i.e., Negative Possession of Identity. To use the example discussed in Amery’s writings, when Germans accept that their national identity includes not only Beethoven, Goethe & Schiller but also Hitler & Himmler, they are said to embrace their wrongdoings as a negative possession of their identity. Only then, says Amery, can the victims’ justified resentment be consummated.

References

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Yongjae Nam & Mahesh K. Nalla

The Effect of Childhood Violence Victimization Experiences on Dating Violence – The South Korean Experience

Abstract

As in many Western developed nations, South Korea has witnessed a large increase in dating violence in recent years. Prior studies that examined this phenomenon grounded their work in social-learning theory and found that a significant number of dating violence perpetrators experienced childhood domestic violence or school violence. This exploratory study examines the relationship between victimization by school or domestic violence and the perpetration of dating violence (emotional and physical) in South Korea. Using data from a survey of 163 South Korean university students who currently or previously had a dating partner, we find that young adults who had prior emotional or physical victimization experiences in school or at home are more likely to perpetrate violence on their dating partners.

Introduction

The ritual of dating by unmarried people that appeared in the West around the late 18th century has spread around the world. South Korea is no exception. Most college students between the ages of 18 and mid-twenties go through dating experiences before they get married (Kim, 2005). Although dating provides an opportunity to assess the other’s suitability as a prospective partner for developing an intimate relationship, conflicts of opinion and discordant situations occur throughout the dating process. Sometimes they worsen into negative physical actions (Gelles & Straus, 1979). Moreover, these personal differences not only cause emotional suffering, they have violent consequences that include sexual violence arising from repressive sexual intercourse (Yoon, Yang & Park, 2012). Because dating violence occurs within close relationships, defining a boundary between love and violence is difficult (Lee, 2016). The fact that dating violence occurs within a private domain makes active intervention a complex task (Ryu, 2014).

Contrary to popular belief that not much violence occurs in dating relationships, previous studies (Carlson, 1987; Gelles & Straus, 1979; Levy, 1991) indicated a significant amount of violent behavior and dating violence occurred during dating relationships. Forming dating relationships before establishing expectations about sexual relations leads people to experience conflicts due to problems in communication, differences in faith, individual variation, and living environment changes (Havighurst, 1968). Failure to deal appropriately with conflicts encountered during a dating relationship results in couples experiencing unpleasant feelings, lost intimacy, breakdowns in conversation, and undesirable breakups (Kim & Shagong, 2007; Smith & White, 2003).

Dating violence is experienced by as many as 69% of dating couples in the United States (Christensen et al., 2006; Logan et al., 2006) and by one out of three couples worldwide (Stappenbeck & Fromme, 2010; White & Smith, 2009). According to the Korean National Police Agency (2016), 36,480 people were arrested for dating violence from 2011 to 2015. In Korea, 7,296 people a year, an average of 20 people a day, suffer dating violence.

Dating violence is not a one-off event. In some instances, victims are exposed to long-term violence and if the intensity is severe, it can lead to life-threatening crime (O’Keefe, 1997). According to the Korean National Police Agency (2016), 542 murder cases were caused by dating violence over a period of 5 years. Considering the number of unreported cases due to the nature of dating relationships, it is likely more victims are exposed to dating violence (Johnson, 2006). In this study, childhood domestic violence and school violence experiences are considered influential factors. Therefore, it is important to measure victimization experiences of school violence and domestic violence and to identify factors that can prevent dating violence.

Dating Violence and Social Learning Theory

There is no consensus on the definition of dating violence (Atwater, 1992; Makepeace, 1981; Roche, 1986). In previous studies, phrases such as courtship violence (Riggs & O’Leary, 1989; Thompson, 1986), courtship abuse (Marshall & Rose, 1988; Puig, 1984; Sugarman & Hotaling, 1989), premarital abuse (Cate et al., 1982), and dating aggression (Stets, 1992) were used. The term dating violence was first introduced by Makepeace (1981) who examined courtship violence among college students. Since the history of research on dating violence is relatively new, the term and the concept are still undergoing refinement. However, we can identify the common elements in dating violence. They include violent behavior among two parties in a romantic relationship, with or without the premise of marriage, acting with the intent to exert physical, emotional, and sexual harm to the other party.

Dating violence not only causes physical injuries but also brings emotional harm and thereafter causes negative effects on social adjustment (Ahn, 2006). Studies suggest that victims of dating violence suffer stress, anxiety, depression, etc. relative to those not exposed to dating violence (Carroll et al., 2011; Kim & Kim, 2000) even in the absence of physical and sexual violence (Lee et al., 2012). What is serious in this regard is that dating violence can be a precursor to future spousal violence (Byun, 1993; Kelly & Loesch, 1983; Kim, 1998).

The theory most often employed to explain dating violence is social learning theory. According to this theory, people who grow up experiencing domestic violence, either directly or by witnessing parental violence, tend to exhibit violent tendencies in adulthood (Jaffe, Wolfe & Wilson, 1990). Bandura (1973) asserts through the concept of observational learning that aggression is learned by observing the behavior of others who are meaningful to them. In other words, by observing and learning the aggressive behavior of an intimate person, people acquire a propensity for violence through imitating the behaviors they are exposed to. Witnessing parental violence and childhood abuse and imitating such behaviors is an example of social learning theory. Our research indicates that exposure to violence or violent environments during childhood has a significant impact on dating violence behavior.

Preliminary studies of violence in the premarital phase, such as dating violence, show that this can later become a precursor of domestic violence (Cate et al., 1982; Kim, 1999; Kim & Kim, 2000; Makepeace, 1981; Riggs et al., 1990). Based on social learning theory, Riggs and O’Leary et al. (1989) proposed that intergenerational transmission of violence is a representative hypothesis explaining the negative effects of victimization experiences during childhood. Those young adults that had victimization experience of domestic violence and school violence are beginning to inflict violence on their partners. If violent behaviors developed during the dating relationship continue to lead up to marriage, the habits of violent interactions are likely to lead to domestic violence.

According to social learning theory, observing parents achieving their goals through using violence at home, children recognize that violence is the best way to solve problems. Although the punishment that parents administer to their children causes anger and negative feelings, it temporarily brings behavioral modification. In other words, people who experience violent situations in their childhood recognize that they can use violence on a family member or an intimate partner in order to punish bad behavior or change the behavior of the other person (Simons, Lin & Gordon, 1998). In this sense, exposure to violence or violent environments during childhood has a significant impact on dating violence behavior.

Domestic Violence, School Violence, and Dating Violence

Exposure to violent environments is a determinant of dating violence behavior (O’Keefe, 1997). Many studies (Choi, 2005; Dardis, Edwards, Kelley & Gidycz, 2013; DeMaris, 1987; Gover, Kaukinen & Fox, 2008; Kendra, Bell & Guimond, 2012) established a relationship between abusive childhood experiences and dating violence. Other studies (Choi, 2005; Wolfe & Korsch, 1994) discovered a link between dating violence and witnessing parental violence. Additionally, people who had frequent victimization experiences of school violence report that they suffer difficulties in dating relationships and marital life (Gilmartin, 1987). Consequently, victimization experience of school violence and childhood domestic violence experience not only affect the victim at the time of the violence but also cause psychosocial problems in the long term. Even as an adult, these victimization experiences have a negative effect on the dating relationship which ends up putting the dating partner at risk of becoming a victim of dating violence.

Experiences of physical violence with friends during adolescence was also found to be significantly related to violence against dating partners (Kim & Shagong, 2007; Schnurr & Lohman, 2008). In addition, 37% of children who experienced physical abuse are reporting the possibility of physical violence against their spouse or children, raising the issue of the circularity of violence (Choi, 2005; Lisak et al., 1996). In addition, those who grew up witnessing parental violence tend to use violent behaviors to solve the conflicts that happen in the course of their relationships (Bernard & Bernard, 1983).

It has been established that people who experienced physical abuse in their childhood are more aggressive toward others than those who did not (Dodge et al., 1990). Witnessing parental violence can be a significant factor even if direct violence experience is absent. According to Hart (1987), witnessing parental violence in childhood can be described as emotional abuse that makes victims live in an unstable environment and trauma may be experienced as a result of violence between the parents. Dodge et al. (1990) asserted that domestic violence experience prevents children from growing up in the right way which could lead them to become more severe perpetrators / victims of violence than their counterparts.

School violence can also be part of the experience of exposure to violent environments. In a Korean Institute of Criminology study, 56~57% of middle and high school students have victimization experience of school violence. In addition, a study by Kim & Kim (2000) showed that 37.6% of the 1,000 elementary, middle, and high school students in the Korean capital region experienced school violence. Therefore, many current college students have a high probability of having experienced school violence during their elementary, middle, and high school years.

Objectives

Although prior research showed that childhood domestic and school violence experience are related to dating violence, only a few studies have considered both variables together. From previous studies, we conclude that there is a positive relationship between the experience of domestic and school violence and the perpetration of dating violence.

The objectives of this study are:

First, to provide descriptive statistics for direct and indirect domestic violence experience, victimization experience of school violence, and perpetration of emotional and physical dating violence in South Korea.

Second, to examine the effect of school and domestic violence victimization on dating violence.

Finally, to examine if demographic characteristics such as gender, age, year in college, location of college, religion, military duty, economic status, and family composition influence dating violence.

Method

Participants

In this research, both snowball sampling and convenience sampling methods were used to collect data. College students were approached to participate in the online survey. An anonymous link to the survey was posted on Facebook. In addition, friends and acquaintances at several universities in Seoul, Daegu and Cheongju were asked to participate in the survey and also requested to ask their college friends to participate. Some students were requested to post the link on their Facebook page and several did so. In addition, emails with a link to the survey were sent to Korean college students who were studying abroad.

These non-probability sampling methods can be biased and contain limitations. They are less representative of all college students and less suitable for generalizing the results to other student populations. However, this was a preliminary study with a limited amount of funding and the sampling methods used were the most practical.

Participants in the study were 163 university students who filled out an online survey on a voluntary, anonymous, and confidential basis. According to Table 1, questionnaires were answered online by students attending 2-year community colleges and 4-year universities in the Korean capital region (79.8%) and provinces (20.2%). The data set consisted of 86 males (52.8%) and 77 females (47.2%) with an age distribution of 19~20 (14.1%), 21~22 (28.8%), 23~24 (12.9%), 25~26 (27.6%), 27~29 (14.7%) and 30+ (1.8%). Most were juniors and seniors (60.7%) and 88 students (54%) started college either in 2014 or earlier.

Fifty-seven males (35%) served in the military, which is mandatory for males in South Korea, and the other respondents were either exempted or women. The approximate economic status was low class for 6.1%, mid-low class for 14.1%, middle class for 44.2%, mid-upper class for 31.9%, and upper class for 3.7%. Most of the students were living with both of their parents (83.4%) and 68.7% had no religion. Regarding the state of the dating relationship, 66.9% claimed they love their partner and 33.1% said they do not. Dating relationship satisfaction was very satisfied for 13.5%, satisfied for 16.0%, average for 25.8%, dissatisfied for 28.8%, and very dissatisfied for 16.0%.

Questionnaire

In this study, independent variables were victimization experiences of school violence, domestic violence, and witnessing domestic violence. The dependent variable was perpetration of dating violence (emotional and physical).

The questionnaire consisted of 4 sections. The first section solicited responses about domestic violence experiences. Domestic violence was measured by direct experience of violence and by witnessing parental violence. The scale used to measure direct experience of domestic violence was the Conflict Tactic Scale (CTS) of Straus (1979) and the Parent-Child Conflict Tactics Scale (PCCTS) of Straus et al. (1998) as modified by Choi (2005) and Lee (2016). On the PCCTS, Choi (2005) excluded questions from emotional abuse and physical abuse that do not fit Korean culture. Also, witnessing parental violence was measured by using a modified version of the CTS formulated by Lee (2016). In this study, to elicit a candid answer, the questions began with emotional violence experiences followed by questions on the level of violence and finally leading up to physical violence experiences. The dependent variable domestic violence experience was measured by a Likert scale from 1 = never, 2 = once or twice a year, 3 = once or twice a month, 4 = more than once a week, 5 = almost every day’.

The second section of the questionnaire dealt with victimization experience of school violence. In this study, school violence was defined as ‘physical violence, mental harassment, bullying, extortion, threats or intimidation, profanity, and abuse by individuals or a group that occur between students in or near the school.’ The measure of school violence used the Bully / Victim Questionnaire of Olweus (1993) as modified and supplemented by Ahn (2001) and the Junior Questionnaire of Olweus (1991). This scale consists of 6 questions regarding physical violence, harassment, bullying, threat or intimidation, profanity, and abuse. Each item answer consisted of 1 = never, 2 = once or twice a year, 3 = once or twice a month, 4 = more than once a week, and 5 = almost every day. The total sum of the answers indicated the severity of school violence.

The third section asked about perpetration of dating violence. To measure dating violence perpetration, we used the scale by Choi (2005) who modified and supplemented the CTS and ABI (Abusive Behavior Inventory) of Shepard & Campbell (1992). CTS is the most widely used measure of domestic violence and dating violence research to measure physical violence. Because there is a limit to measuring emotional violence with CTS, it has been supplemented with the ABI to measure emotional violence in intimate relationships. This scale is divided into two dimensions: physical and emotional. Physical violence consists of 8 items and emotional violence consists of 9 items. Overall, dating violence perpetration consists of 17 items, with each item having five response options: 1 = never, 2 = once or twice a year, 3 = once or twice a month, 4 = more than once a week, 5 = almost every day. The higher the total score, the more severe the dating violence.

In order to control for extraneous variables that could improperly affect the relationship between the independent and dependent variables, the last section incorporated demographic data and questions about dating experiences.

Table 1: Demographic Statistics for Variables (N = 163)

%

M

SD

Min

Max

Background characteristics

Gender

1.47

0.50

1

2

Male

52.8

Female

47.2

Age

3.06

1.38

1

6

19 ~ 20

14.1

21 ~ 22

28.8

23 ~ 24

12.9

25 ~ 26

27.6

27 ~ 29

14.7

30 +

1.8

Year in college

2.88

1.14

1

4

Freshman

16.0

Sophomore

23.3

Junior

17.8

Senior

42.9

Location of college

1.20

0.40

1

2

Capital region

79.8

Provinces

20.2

Religion

1.31

0.47

1

2

Yes

31.3

No

68.7

Military duty

1.65

0.48

1

2

Yes

35.0

No

65.0

Economic status

2.15

0.73

1

3

Low or mid-low

20.2

Middle

44.2

Mid-upper or upper

35.6

Family Composition

1.17

0.37

1

2

Both parents

83.4

Other

16.6

Relationship status

1.67

0.47

1

2

Do not love partner

33.1

Love their partner

66.9

Level of satisfaction

2.82

1.27

1

5

Very dissatisfied

16.0

Dissatisfied

28.8

Average

25.8

Satisfied

16.0

Very satisfied

13.5

Dating violence perpetration results

The frequencies of dating violence perpetration are reported in Table 2. Ninety-two respondents (56.4%) claimed to have perpetrated dating violence. Of them, 73.9% claimed to have inflicted emotional violence and the other 26.1% reported committing physical violence in their dating relationships.

Table 2: Dating Violence Perpetration during Dating Relationship (N = 163)

Type of violence

Frequency

Rate

Emotional

68

41.7

Physical

24

14.7

Emotional violence

As shown in Table 3, 41.7% of the respondents reported having committed at least one of the 9 types of emotional violence at some point in their dating relationship. This indicates that about 4 out of 10 college students are likely to experience emotional violence during their dating relationship. Although emotional violence does not cause physical harm to the partner, in the light of previous research (Follingstad et al., 1991; Kasian & Painter, 1992), it is important to note that emotional violence can be accompanied by physical violence or may be a precursor to physical violence. In this context, it is worth noting that emotional violence occurs frequently.

Table 3 shows the distribution of the specific types of emotional violence. Twenty-nine students (17.8%) said they had ‘insulted or condemned’, 22 (13.5%) ‘screamed or yelled’, 16 (9.8%) ‘threatened to hit or throw stuff’, 34 (20.9%) ‘threatened to end the relationship’, 46 (28.2%) ‘accused their partner of paying too much attention to someone or something else’, 20 (12.7%) ‘checked up on their partner (listened to phone calls, called repeatedly at work)’, 46 (28.2%) ‘tried to keep their partner from doing something he / she wanted to do’, 21 (12.9%) ‘condemned parts of their partner’s body or negatively compared them with others’, and 13 (7.8%) ‘threatened to end the relationship if their partner refused to have sex’ at least once.

Table 3: Perpetration of Emotional Violence during Relationship (N = 163)

Type of Emotional Violence

Never

Once or twice a year

Once or twice a month

More than once a week

Insulted or condemned partner

134(82.2)

19(11.7)

8(04.9)

2(1.2)

Screamed or yelled at partner

141(86.5)

13(08.0)

7(04.3)

2(1.2)

Threatened to hit or throw stuff at your partner

147(90.2)

11(06.7)

3(01.8)

2(1.2)

Threatened to end the relationship

129(79.1)

24(14.7)

7(04.3)

3(1.8)

Accused partner of paying too much attention to someone else or something else

117(71.8)

23(14.1)

19(11.7)

4(2.5)

Checked up on your partner (listened to phone calls, called repeatedly at work)

143(87.7)

11(06.7)

6(03.7)

3(1.8)

Tried to keep partner from doing something he / she wanted to do

117(71.8)

23(14.1)

17(10.4)

6(3.7)

Condemned parts of your partner’s body or negatively compared them with others

142(87.1)

14(08.6)

5(3.1)

2(1.2)

Threatened to end relationship if partner refused to have sex

150(92.0)

12(07.4)

0(0.0)

1(0.6)

Physical violence

Findings related to physical violence that occurred during the relationship are based on answers to the 8 questions displayed in Table 4. Twenty-four (14.7%) respondents reported having committed at least one of the 8 types of physical violence during the relationship. This indicates that about 1 out of 7 college students are involved in physical violence in a dating relationship. Although the incidence rate seems low, some suggest caution in taking reported incidence at face value. Straus and Gelles (1990) note that perpetrators report less than the actual number of violent acts that are deemed to be socially inappropriate.

Findings related to physical violence experiences are reported in Table 4. Eighteen students (11.0%) said they ‘threw an object at their partner’, 18 (11.0%) ‘pushed hard’, 13 (8.0%) ‘slapped their partner’s cheek with the palm of their hand’, 7 (4.3%) ‘kicked or punched with a fist’, 6 (3.7%) ‘struck with objects (belt, golf club, etc.)’, 4 (2.4%) ‘beat up’, and 3 (1.8%) ‘choked’ their partner at least one time.

Table 4: Perpetration of Physical Violence (N = 163)

Type of Physical Violence

Never

Once or twice a year

Once or twice a month

More than once a week

Threw an object at partner

145(89.0)

15(09.2)

2(1.2)

1(0.6)

Pushed your partner hard

145(89.0)

17(10.4)

0(0.0)

1(0.6)

Slapped partner’s cheek with palm of your hand

150(92.0)

12(07.4)

0(0.0)

1(0.6)

Kicked or punched your partner with a fist

156(95.7)

6(03.7)

0(0.0)

1(0.6)

Struck your partner with object (belt, golf club, etc.)

157(96.3)

5(03.1)

0(0.0)

1(0.6)

Beat up your partner

159(97.5)

3(01.8)

0(0.0)

1(0.6)

Choked your partner

160(98.2)

3(01.8)

0(0.0)

0(0.0)

Threatened or injured partner with a weapon

152(93.3)

10(06.1)

0(0.0)

1(0.6)

Domestic violence experience

Findings related to child abuse and childhood exposure to domestic violence are shown in Table 5. A very large number of respondents [N = 146 (89.6%)] experienced direct or indirect domestic violence at least once. 139 (85.3) experienced direct domestic violence and 95 (58.3%) experienced indirect (witnessing) domestic violence as a child. In O’Keefe’s (1997) study, exposure to a violent environment was found to be a determinant of dating violence behavior. Therefore, the experience of domestic violence can be a predictor of dating violence and this high incidence rate should not be overlooked.

Table 5: Victimization Experience of Domestic Violence (N = 163)

Type of violence

Freq

Rate

Direct or Indirect Domestic Violence

146

89.6

Direct Domestic Violence

139

85.3

Indirect (witnessing) Domestic Violence

95

58.3

Direct domestic violence (child abuse)

Table 6 outlines the state of childhood domestic violence experience elicited by 14 questions. An experience of at least 1 incident of the 14 child abuse situations is considered as having an experience of child abuse. The findings show that 86 students (52.8) were ‘insulted’, 117 (71.8%) were ‘screamed or yelled at’, 58 (35.6%) were ‘told they would be kicked out of the house and sent somewhere else’, 47 (28.8%) were ‘threatened to be hit’, and 73 (44.8%) were ‘called bad names such as stupid, idiot, etc.’ at least once by their parents. Moreover, 95 parents (58.3%) ‘hit the child’s palms, calves, buttocks, etc. with a ruler or cane’, 46 (28.2%) ‘threw an object at the child’, 31 (19.0%) ‘pushed the child hard’, 30 (18.4%) ‘slapped the child’s cheek’, 29 (17.8%) ‘kicked or punched the child’, 37 (22.7%) ‘struck the child with objects (belt, golf club, etc.)’, 22 (13.5%) ‘beat up the child’, 12 (7.4%) ‘choked’ the child, and 12 (7.4%) ‘threatened or injured the child with a knife or weapon’ at least one time.

Table 6: Victimization Experience of Direct Domestic Violence (N = 163)

Type of Violence

Never

Once or twice a year

Once or twice a month

More than once a week

Insulted you

77(47.2)

45(27.6)

30(18.4)

11(6.7)

Screamed or yelled at you

46(28.2)

60(36.8)

44(27.0)

13(8.0)

Said you would be kicked out of the house

105(64.4)

38(23.3)

15(09.2)

5(3.1)

Threatened to hit you

116(71.2)

30(18.4)

13(08.0)

4(2.5)

Called you bad names (stupid, idiot, etc.)

90(55.2)

39(23.9)

22(13.5)

12(7.4)

Used ruler or cane to hit your palms, calves, buttocks, etc.

68(41.7)

57(35.0)

30(18.4)

8(4.9)

Threw an object at you

117(71.8)

32(19.6)

11(06.7)

3(1.8)

Pushed you hard

132(81.0)

26(16.0)

3(01.8)

2(1.2)

Slapped your cheek with the palm of a hand

133(81.6)

26(16.0)

4(02.5)

1(0.6)

Kicked/punched you with fist

134(82.2)

22(13.5)

6(03.7)

1(0.6)

Struck you with objects (belt, golf club, etc.)

126(77.3)

29(17.8)

6(03.7)

2(1.2)

Beat you up

141(86.5)

20(12.3)

1(00.6)

1(0.6)

Choked you

151(92.6)

10(06.1)

1(00.6)

1(0.6)

Threatened or injured you with a weapon

151(92.6)

12(07.4)

0(00.0)

0(0.0)

Witnessing parental violence

The experience of witnessing parental violence is shown in Table 7. The most common type of parental violence witnessed by students at least once during their childhood was ‘said insulting words’ which was reported by 78 students (47.9%). Fifty-six students (34.4%) saw parents ‘break or kick objects’, 38 (23.3%) saw a parent ‘throw an object at the other’, 33 (20.2%) saw a parent ‘push the other hard’, 20 (12.3%) saw a parent ‘slap the cheek of the other’, 18 (11.0%) saw a parent ‘kick or punch the other with a fist’ at least one time. Surprisingly, 14 students (8.6%) saw a parent ‘threaten or injure the other with a knife or weapon’ which is higher rate than the 12 students (7.4%) who saw a parent ‘strike the other with an object (belt, golf club, etc.)’, the 10 (6.1%) who saw one parent ‘beat the other’, and the 6 (3.7%) who saw one parent ‘choke the other.’

Table 7: Witnessing Parental Violence (N = 163)

Question

Never

Once or twice a year

Once or twice a month

More than once a week

Said insulting words

85(52.1)

40(24.5)

29(17.8)

9(5.5)

Broke or kicked objects

107(65.6)

42(25.8)

10(06.1)

3(1.8)

Threw an object at the other

125(76.7)

29(17.8)

8(04.9)

1(0.6)

Pushed the other hard

130(79.8)

27(16.6)

5(03.1)

1(0.6)

Slapped other’s cheek with palm of hand

143(87.7)

18(11.0)

1(00.6)

1(0.6)

Kicked or punched the other with a fist

145(89.0)

15(09.2)

2(01.2)

1(0.6)

Struck the other with objects (belt, golf club, etc.)

151(92.6)

9(05.5)

3(01.8)

0(0.0)

Beat the other

153(93.9)

7(04.3)

2(01.2)

1(0.6)

Choked the other

157(96.3)

5(03.1)

1(00.6)

0(0.0)

Threatened or injured other with a weapon

149(91.4)

13(08.0)

1(00.6)

0(0.0)

Influence of type of domestic violence on perpetration of
dating violence

We employed ANOVA (analysis of variance) procedures to examine dating violence perpetration rates among the groups that experienced no domestic violence, either direct or indirect (witnessing) domestic violence, or both direct and indirect domestic violence. The findings are presented in Table 8. The results indicate that perpetration of emotional violence was significantly higher in groups with domestic violence experience than the group without such experience. These differences were statistically significant (p < .01). A t-test indicated the difference between the group that experienced both direct and indirect domestic violence and the group that experienced neither was statistically significant (p < .001).

Table 8: Perpetration of Emotional Violence by Type of Domestic Violence Experienced (N = 163)

Direct or Indirect

Freq

Mean

S.D.

Signif

Neither

17

9.4706

1.0676

p < .01

Either One

58

9.9138

2.0112

Both

88

12.5682

5.8404

Table 9: Perpetration of Emotional Violence by whether Domestic Violence Experienced (N = 105)

Experienced

Freq

Mean

S.D.

Signif

Neither Type

17

9.4706

1.0676

p < .001

Both Types

88

12.5682

5.8404

According to Table 10, perpetration of physical violence was significantly higher in groups with domestic violence experience than the group without such experience, a finding that was statistically significant (p < .05). Similarly, the findings displayed in Table 11 also suggest statistically significant mean differences (p < .01) between the two groups.

Table 10: Perpetration of Physical Violence by Type of Domestic Violence Experienced (N = 163)

Direct or Indirect

Freq

Mean

S.D.

Signif

Neither

17

8.0000

0.0000

p<.024

Either One

58

8.1034

0.3598

Both

88

9.0227

2.9360

Table 11: Perpetration of Physical Violence by Type of Domestic Violence Experienced (N = 105)

Group

Freq

Mean

S.D.

Signif

No experience

17

8.0000

0.0000

p<.002

Experienced Both

88

9.0227

2.9360

Victimization experience of school violence

77 respondents, nearly half of all the students (47.2%), said they were the victims of school violence in some form. Riggs et al. (1990) found that being the victim of violence inflicted by other students was significantly associated with violence against dating partners. Therefore, being a victim of school violence can be a predictor of dating violence.

Answers to questions about being the victim of violence at or near school are shown in Table 12. 28 students (17.2%) ‘were beaten without a reason’, 39 (23.9%) ‘were deprived of money or property by being threatened or beaten’, 48 (29.4%) ‘were threatened or intimidated’, 50 (30.7%) ‘were verbally abused or insulted by other student’, 38 (23.3%) ‘were harassed (teased, suffered property damage, etc.) by other students’, and 49 (30.1%) ‘were bullied by other students’ at least once.

Table 12: Victimization Experience of School Violence (N = 163)

At or Near School was:

Never

Once or twice a year

Once or twice a month

More than once a week

Beaten without a reason

135(82.8)

22(13.5)

04(2.5)

2(1.2)

Deprived of money or property by being threatened or beaten

124(76.1)

35(21.5)

04(2.5)

0(0.0)

Threatened or intimidated

115(70.6)

40(24.5)

07(4.3)

1(0.6)

Verbally abused or insulted by other students

113(69.3)

34(20.9)

14(8.6)

2(1.2)

Intentionally harassed (teased, property, damaged, etc.) by other students

125(76.7)

28(17.2)

06(3.7)

4(2.5)

Bullied by other students

114(69.9)

31(19.0)

10(6.1)

8(5.0)

Influence of school violence on the perpetration of dating violence

An independent t-test was used to examine the difference in dating violence perpetration rates between the group that experienced school violence and group that did not. Table 13 shows that the perpetration of emotional violence was higher in the group with school violence experience than the group without such experience and the difference was statistically significant (p < .001). As shown in the Table 14, the difference in physical violence perpetration rates between the group that experienced school violence and group that did not was also statistically significant (p < .003).

Table 13: Perpetration of Emotional Violence Difference among School Violence Experienced Groups (N = 163)

School Violence Victim

Freq

Mean

S.D.

Signif

No

86

10.05

2.86

p < .001

Yes

77

12.70

5.79

Table 14: Perpetration of Physical Violence Difference among School Violence Experienced Groups (N = 163)

School Violence Victim

Freq

Mean

S.D.

Signif

No

86

8.08

0.35

p < .003

Yes

77

9.16

3.11

Additional Analysis

Relationship between domestic violence, school violence and
dating violence

Table 15: Effect of Domestic Violence and School Violence on Dating Violence (N = 163)

Variable

Emotional

Violence

Physical

Violence

B

SE

t

B

SE

t

Control Variable

Gender

-0.51

0.81

-0.63

-0.14

0.40

-0.35

Age

-0.31

0.37

-0.82

-0.20

0.18

-1.10

Economic status

0.02

0.36

0.06

0.07

0.17

0.41

No religion

0.39

0.65

0.60

0.40

0.31

1.28

Military duty (Yes)

0.35

0.96

0.37

0.41

0.47

0.87

Capital region

-0.58

0.74

-0.78

0.02

0.36

0.06

Year in college

0.17

0.41

0.40

0.13

0.20

0.67

Love partner

0.31

0.68

0.46

0.14

0.33

0.43

Relationship Satisfaction

-0.16

0.24

-0.68

0.00

0.12

0.03

Independent Variable

School Violence

0.36

0.11

3.24**

0.14

0.05

2.61*

Domestic Violence (Direct)

0.29

0.06

4.76***

0.16

0.03

5.48***

Witnessing Parental Violence

0.10

0.11

0.85

0.01

0.06

0.09

Adj R²

0.39

0.36

F-test (signif)

9.60***

8.58***

* p < .05, ** p < .01, *** p < .001

Table 15 presents the results of an Ordinary Least Squares analysis of the effects of domestic violence and school violence on 2 dependent variables: the perpetration of emotional and physical dating violence. Variance inflation factors (VIFs) were examined in order to confirm the small magnitude of the correlations. All of the VIFs were well below 10, which is a generally acceptable limit (Neter et al., 1996). Both models explain the variance of 39% and 36%, respectively. Of the various independent variables, none of the demographic variables were related to either of the two forms of domestic violence. However, both school violence and directly experienced domestic violence were strong predictors of the perpetration of both emotional and physical dating violence.

These findings suggest that the experience of school violence was positively related to both emotional (B = 0.36, p < .01) and physical (B = 0.14, p < .05) dating violence. Similarly, prior experience of domestic violence is a strong predictor of engaging in dating violence. For instance, prior domestic violence experience is positively related to engaging in emotional (B = 0.29, p < .001) and physical (B = 0.29, p < .001) dating violence. In other words, young adults who were victims of school violence and domestic violence have a higher propensity for engaging in physical violence with their dating partner.

Discussion

Dating violence has been increasing rapidly in recent years and, in some instances, the result has been fatal. This preliminary study was designed to understand the nature and extent of dating violence among young adults in South Korea. For this purpose, 163 college students in South Korea who previously or currently had a dating relationship were approached to participate in this study. Findings suggest that childhood victimization experiences of domestic violence and school violence are related to violent behavior during dating relationships. The results of this study are summarized as follows.

First, 41.7% of the respondents claimed they have perpetrated emotional violence and 14.7% claimed they have perpetrated physical violence against their dating partners. Although the rate of inflicting physical violence seems not so high, emotional violence can be a precursor to physical violence and perpetrators generally report less than the actual number of violent acts. Because the seriousness of dating violence is significant, the results of this study indicate an urgent need to formulate counter-measures against dating violence.

Second, findings from this study show a rather high incidence of young adults who experienced direct or indirect (witnessing) domestic violence. Of the survey respondents, 85.3% said they had experienced direct domestic violence at least one time and 58.3% said they had witnessed parental violence at least once during their childhood. Consistent with the findings from prior research that a violent parenting environment is a factor that causes violent behavior by children (Kim et al., 1990), our findings support the assertion that these figures cannot be ignored. In addition, the frequency of school violence victimization is high: 77 (47.2%) said they have been the victims of school violence.

In this study, the effects of the independent variables (being a victim of school violence and experiencing or witnessing domestic violence) on the dependent variable (the perpetration of emotional and physical dating violence) were measured by multiple regression analysis while controlling demographic variables. This study demonstrates that college students who had been the victims of school violence and direct domestic violence are more likely to engage in both of emotional and physical dating violence.

Examining the relationship between the main variables shows that experiencing domestic violence as a child has a direct impact on the occurrence of dating violence. College students who were victims of direct domestic violence are more likely to become perpetrators of both emotional and physical dating violence. It can be inferred that the violent behavior is the result of learning that intimate partners can be emotionally or physically abused in order to modify their behavior or resolve conflict situations.

Witnessing parental violence increased the likelihood of perpetrating emotional or physical dating violence but the effect was not statistically significant. In this study, the lack of statistical significance may be due to the small sample used to define the relationship. The result of this study was similar to the results of previous studies (Choi, 2005; Kim, 2010; Lee et al., 2012) that domestic violence experience increases dating violence.

Furthermore, being a childhood victim of school violence also increases the perpetration of both emotional and physical dating violence. The results of this study are in line with those of previous studies (Kim & Shagong, 2007; O’Keefe, 1997; Schnurr & Lohman, 2013; Spencer & Bryant, 2000). These studies assert that the experience of violent behavior with friends, especially those from school, are highly related to dating violence, suggesting the importance of violence prevention programs especially for adolescents.

The relationships between the key variables that we find throughout this study can be explained by the social learning theory proposed by Bandura (1973). Bandura explains that observing and learning aggressive behavior toward an intimate person can evoke aggressive tendencies by making one insensitive to aggression. Those who experienced domestic violence and school violence imitate violent behavior toward intimate others and use violence as a way to alleviate their anger in conflict situations. The findings from this study have important policy implications for addressing one form of gender violence. Social media and popular culture can play a significant role in communicating this message.

One of the limitations of this study is the usage of snowball and convenience sampling to collect data. These sampling methods produced a less representative sample of the college student population. Although 163 students constitute a reasonable sample size, future research should use larger samples and more appropriate sampling methods to facilitate generalization of the results. In addition, future research should include other factors in the research model that may influence the relationship between the independent and dependent variables.

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Table 1: Demographic Statistics for Variables (N = 163) (Cont.)

Table 3: Perpetration of Emotional Violence during Relationship (N = 163) (Cont.)

Table 6: Victimization Experience of Direct Domestic Violence (N = 163) (Cont.)

Table 7: Witnessing Parental Violence (N = 163) (Cont.)

Table 15: Effect of Domestic Violence and School Violence on Dating Violence (N = 163) (Cont.)

Graeme R. Newman and Pietro Marongiu

On Punishment

Introduction

In general terms, punishment may be defined as the intentional infliction of physical or mental pain or other consequences normally considered unpleasant, upon one or more persons, on account of an unacceptable act or omission, that breaks a rule, administered by a person other than the offender. (Newman, 2008, pp. 7-11).

While punishment is primarily a cultural process that naturally takes on many forms in different cultures, it is a universal form of social interaction and a significant fact of human life. We all impose or suffer punishment in formal and informal contexts. Punishment serves a number of important societal purposes: social control, social change, order maintenance, social cohesion, defining rules and laws, affirmation of justice, and even personal satisfaction. In other words, it is a “social fact.” It takes place in a vast number of social settings, extending from child correction to criminal justice.

All punishment, no matter how justified, is an act of aggression of one (or more) against another (or more). This aggression may be open (e.g., the active forms of corporal punishment such as whipping) or submerged (e.g., various forms of prison, rehabilitation, restorative justice, “time out,” etc.). Regardless of its mechanical application, it is always a destructive act. It surreptitiously destroys people’s lives so that it can restore them under the banner of doing good. It creates remorse in the punisher as much or more as in the punished. It is irresistible, always searching for ways to spread its evil wings. It takes on many forms, though righteousness is its favorite.

Because of its base aggression, punishment is always on the brink of excess. After all, excess is part of the nature of aggression, is it not? That is why there are many rules in contact sports, even war. Because of this tendency to excess, various ways of regulating punishment have emerged throughout history, many of these residing within societal institutions of various kinds.

The authority to punish

If we look at the forms and mechanisms of punishment throughout history, we can see that a first general distinction can be made between legal (judicial) and non-legal (non-judicial) punishments, each with their own special source of authority to administer punishments. Non-legal punishment is permitted by law in a certain territory, while judicial punishment is inflicted on a person for the commission of a crime or misdemeanor, according to the judgment and command of some lawful court. All judicial punishments are therefore legal punishments but not all legal punishments are judicial punishments. Judicial punishment takes place within the framework of a criminal law system that precisely defines the offences for which a fixed type of punishment is imposed. Such a system presupposes a State as the constituted authority to create the law and to effectively inflict punishments.

The bifurcation between judicial and non-judicial punishments might also be called “formal” and “informal” authorities to punish. Informal sanctions are those imposed by individuals or groups that lack this legitimate authority. Friends, family members, vigilante committees, civilian “regulators,” and paramilitary organizations are examples of informal sanctioning bodies. However, note that the characterization of authority to punish as “legitimate” implies an overarching political body that claims power over its subjects. Only it can make laws and command their implementation.

However, this observation overlooks customary law, embodying law and rules that may not be written but that are orally transmitted, and its associated punishments applied, by acknowledged “professionals” such as religious, clan or tribal leaders. These mechanisms offer a “third way” between formal and informal punishment, though how they work is immensely complicated. For example, in Jordan, “honor killings” are de facto legal or minimally punished. The Jordanian Penal Code exempts from punishment those who kill female relatives found “guilty” of committing adultery, thus damaging a family’s reputation. These homicides are viewed by the assailants (as well as by the law enforcement agencies) as legitimate punishments. This is an example where informal or non-judicial punishments are actually incorporated into the law of the State.

The Institutional spread of punishment

Punishment is a tool of particular institutions, of which criminal law is but one. The use of punishments in the sphere of crime, after all, is an extreme case in itself since crime is a very minor aspect of daily life. The uses of punishment (and its concurrent moral justifications) within the family and school have rarely been considered to the exhaustive extent as in criminal law. This may be because the stakes are generally much higher in the realm of criminal law where severe formal punishments are typically prescribed, mandated and applied (though there are some exceptions where the stakes may be much higher outside of criminal law, such as vigilantism and various forms of lynching).

The social control arising from these mechanisms is roughly of two kinds: centralized and decentralized. Centralized control occurs when a charismatic individual or group monopolizes punishment. This historically has occurred in smaller societies with a tribal structure, usually composed of family groups defined in different ways. Decentralized control occurs in complex societies, first formalized in the West in ancient Rome, where control of punishment was distributed across the Roman Senate, biennially elected consuls, fathers as absolute heads of households, various proconsuls, occasional dictators for special purposes, tax collectors, regional governors, military generals, and money lenders (the infamous Crassus). At the height of the Republic, even murder was essentially prosecuted privately.

Throughout the history of western civilization, the locus of control has shifted quite markedly. After the Romans, control (and its punitive mechanisms) was shared among three major institutions: Judaism, the oldest form of non-government control; Catholicism and the Holy Roman Empire where the locus of punishment shifted back and forth between Emperors who governed and aligned themselves with religious bodies; and Popes who expanded their punitive control into government. This sharp pyramid of punitive control expanded from the single monarch or priest at the top, through his supporters and entourage, merchants and their networks, tradesmen, and finally families living daily with death as they spawned large families, ravaged by disease, struggling through work as serfs or government servants to survive. In the more isolated geographical areas of Europe, punitive control remained at the local level among tribes, extended families that vied for the authority to apply punishment. These were (and some still are such as in Albania) those that developed intricate systems of applying punishment (feuding societies) through various forms of blood vengeance, such as the Sardinian Code of Vengeance, the Kanun of Albania, and various codes of the Bedouin of Saudi Arabia and parts of the Middle east (Marongiu and Newman, 1987, pp, 69-89).

An important principle of these forms and mechanisms of punishment delivery was that each institutional location of punishment “kept to itself.” This segmentation of punishment endured until the 21st century. That is, one could break a rule within the family (e.g., beat one’s wife or children) and it would have little to do with what one did in the workplace. In the 21st century this is no longer the case in the United States and elsewhere.

Regulating punishment

Punishment is regulated within institutional settings that guard against excess: family, school, workplace, sport, and criminal & civil justice. The rules define what acts are punishable, who may be punished, and how these rules should be applied.

Institutional settings classify and describe aggressive behaviors that are allowed and the limits to which they may go. Different institutions may compete for authority over different kinds of aggression, but the bottom line is that these institutions provide the authority for the punisher (justified aggressor) to use aggression against the offender (the aggressor).

Wherever humans live in groups, aggression occurs, and regulation of this aggression arises. Much has been written by historians and cultural anthropologists about the various forms of its control: totems, taboos, myths, religions of many kinds, codes of honor, criminal laws, state edicts, and pater familias. The list could go on. All of these mechanisms serve the same purpose: to control aggression, channel it into a form of social control, and prevent excess.

If we consider families as the primary organizing institution of society, then the rules and justifications for their enforcement are traditionally confined to the parents as authorized aggressors, and the children as unauthorized aggressors or miscreants.

In “post-modern” society, the extent to which families can impose punishment on offenders is severely limited, usually to the internal single family unit. In societies where the families are extended into tribal groups, the identification of aggressors (offenders) and who are the justified aggressors can be very complex. The complex rules are evident in the above mentioned feuding societies and the dueling codes of the 18th century upper classes in Europe and the Americas.

Of course, the major source of regulating punishment in civilized societies (that is, those that have a State apparatus) is the criminal law and its procedures which these days predominate in most if not all nations of the world. The extent to which these procedures and laws are consistently administered varies considerably according to the legal systems in place, the three major ones being Roman law (adversarial law, common law, and civil law), Socialist law (deriving from various forms of communism), and Islamic law. While Roman law has written codes for application of punishment, Socialist legal procedures range from highly specialized and detailed legal codes to broad, unstated laws and procedures. Mao, for example, famously abolished all Western criminal codes, and although some have been resurrected, the procedures for administering and applying punishment remain opaque.

In contrast, in Islamic law, the criminal punishments and procedures for their application remain open and essentially public, administered by professional interpreters of Islam. In those Islamic countries that have shaken off Western influence, there are no specific criminal codes, but there is much extensive and detailed interpretation of biblical and Islamic texts by Mullahs who specialize in this aspect of Islam.

In any event, we may say that the existence of these systems that regulate punishment serve one universal and essential purpose: to prevent the excesses of punishment that are always driven by aggression. The extent to which these systems have been (and are) successful in this endeavor is yet to be studied in detail. The dominant view in recent centuries has been that the Roman (i.e., Western) form of criminal law has been most effective in limiting the violence of punishment. However, we should not ignore the fact that Roman law has its roots in the ancient Roman civilization, which was, essentially, built on violence. The major challenge in keeping the lid on the excesses to which punishment can go is to search for the one universal measure of its containment: proportionality. That is, the punishment should always match the crime, the unquestioned, quasi-sacred principle of Western criminal law.

The problem of proportionality

It is today common wisdom that for punishment to be just, it ought to be responsive to the gravity of the offence. It should never exceed what is requisite to reform the criminal and to protect society. Whatever goes beyond this, is cruelty and revenge, the relic of a barbarous age. Yet all students of the history of crime and punishment have learned about the period in English history when individuals were hanged for stealing a loaf of bread. Or, in France, of the drawing and quartering of Damiens for attempted regicide. Or, among the Romans when the general Titus Manlius Torquatus ordered his own son beheaded for disobeying an order – even though that disobedience helped his army in battle. Today we say, how primitive, how sadistic, how outrageous. Surely those crimes did not call for those extremes? Something less, perhaps? A period in prison for stealing a loaf of bread (the less extreme alternative was transportation to penal colonies in Australia and elsewhere). A quick visit to the guillotine instead of drawing and quartering for attempted regicide, a whipping for disobeying an order (the common 50 lashes in the navies of the 18th century).

The history of crime and punishment has seen many attempts to re-configure the crime-punishment nexus. The Old Testament idea of the “law of Moses” – an eye for an eye – advanced the myth that responding in kind to an assault or wrong was a justified response. The wrong was matched by its equal. However, there are many examples in the Old Testament in which the punishment far outweighs the severity of the offense. Take Moses for example, who was denied entry into the Promised Land because his belief in God wavered just a bit.

The wrath of God on those who broke his covenant was extreme in the least: famines, decimations, eradication of entire tribes and cities. So, while the Lord said, “vengeance is mine,” He had in mind something other than an equal or matching response to the infraction. Furthermore, violence was clearly the mainstay of His punishment. Such was the severity of His punishments that a few acts of leniency amplified His “goodness’ or “kindness.” It is difficult to avoid the conclusion that the biblical idea of vengeance was excessive punishment, not a matching punishment; instead inflicting punishment so devastating and injurious, that the infraction would never be repeated. Deterrence was its model, not vengeance. Perhaps here we see the important distinction between vengeance and revenge. Revenge is very personal, and when it is personal, it is visited upon the culprit without mitigation, without restraint. It is nothing short of concentrated fury, though its implementation is coldly calculated.

For the Old Testament God, vengeance was a response that was also a threat. It expressed His frustration with the recalcitrance of his followers and/or his detractors. No matter how much his subjects tried to make up for their wrongdoing, forgiveness was rarely, if ever, possible. The fury of God’s vengeful response made it impossible to forget the infraction. It was not enough for his subjects to say or even show how sorry they were for their disobedience. They were sentenced to a life of suffering or death.

The New Testament view of punishment is not that much different as far as proportionality is concerned. In Dante’s Inferno, the Divine Will seems to impose disproportionate punishments. While punishments are carefully matched in classic vengeful fashion, they seem to be especially coercive. They are in fact identical in quality to the offenses, but are not identical in quantity, since they are endless; all crimes are craftily matched by their punishments. Although eternity is common to all forms of punishments there is a classification that provides for different degrees of guilt, which are punished progressively according to the seriousness of their sins. Dante’s development of the systematic and ritualized process of punishment and its justification reveals that obedience is the real objective and the reason for the journey of the soul through the three realms of the other world, thus providing the Church with the most powerful ideological justification for domination (Marongiu and Newman, 1987, pp. 51-57).

Today, we see this process in action in the “#metoo” movement, and the moral panics that have ensued. One can have one’s life and career destroyed, a lifetime of achievement gone, by the mere accusation of an infraction – inappropriate touching of another person (women are the usual complainants), saying hateful or suggestive things. There is another wrinkle in this punishment problem in contrast to the crimes and their punishments described above. There, the crimes were more or less in the present and they were crimes generally decided on by a judicial process of sorts. (The trial of Jean Calas was a travesty, as Voltaire demonstrated so forcefully.) But at least in those days there was a recognition that there had to be a systematic procedure for the finding of guilt.

Even the witch trials of Salem used procedures well established in the Hammer of Witches (Malleus Maleficarum) handbook used by the Inquisitors of the Holy Inquisition. Without the process of finding of guilt, one might just as well punish at random, an idea explored in Shirley Jackson’s famous story The Lottery. This does, of course, assume that punishment must be done. Note, however, that for punishment to be punishment and not aggression, it must be imposed by an authority, that is, legitimized.

In the 21st century, the parallel punishment system has emerged in social media, revealed by the #metoo movement, wherein it is simply enough to level an accusation, not of a current crime, but of one that reaches far back in the past – decades in fact – as the victim sees fit. This practice takes seriously the old idea that “everyone is guilty of something” (Kafka, “guilt is never to be doubted,”), brought to 20th century consciousness by Freud. And where there is guilt, punishment follows.

The defenders of #metoo accusations therefore argue that “he destroyed my life, so it’s only right that I now destroy his.” But are lives destroyed by old, not quite forgotten past actions of an accused offender? Is it possible to apply a value to the life course of individuals, saying that one life suffered and the other gained advantage because of an infraction many decades ago? Can the comparative amount of suffering be gauged with anywhere near the precision necessary to justify it? The life course of any individual is affected by any event at any time (seconds, minutes, days), events that are conditioned directly or indirectly by social and physical environments that are also forever changing.

Even if we take a seemingly obvious case of life destruction, such as, for example, the infamous 1978 Singleton case in California where Singleton raped and cut off the forearms of his adolescent victim, Mary Vincent. How can this kind of suffering be matched by its equivalent punishment, unless the actual event is repeated, that is, the offender is raped and his hands are cut off? Also, because the offender is much older than was his victim, he escapes many more years of the punishment, because technically the punishment and crime do not match, unless he lives longer than his victim.

The unanswered question underlying these pleas to match the crime by inflicting its equivalent on the offender is that there is no evidence at all that such a punishment has a “healing” effect. For those who have testified in trials, demanded that the offender face them in open court, there is the claim, or justification perhaps, that by making public the accusations, punishing the offender in public, this will put the matter behind the victims: they will no longer be visited each night by the horrors of their victimization. Yet is there any evidence that this will occur? There is none, nor can there be. For, as Freud and many others before and since him have shown, these horrors (even if amplified and invented by the victim) will never go away. Neither, for that matter, will the memories of aggression perpetrated by the offender go away. Both sides of the aggression/punishment must live with these events for the rest of their lives. No one can escape the past -- unless they can forget it. And even then, if we are to believe Freud and others, when we think we have forgotten horrors of the past, they live on deep in our unconscious, ready to spring forth at some unexpected provocation.

The solution to this predicament appears to be a drug or some other intervention that would erase memories, preferably selectively. Unfortunately, this works both ways. If we can erase the memories of one’s rape victimization, how does it affect the offender who knows that his victim will not suffer (long term) from his aggression? This quandary speaks loudly in the TV series Westworld where customers routinely raped, slaughtered and did whatever they liked to their robot prey. Because the memories of the robots were routinely erased, their suffering was thought to be wholly in the present, transient. That is, the “offenders” can believe that the robots did not suffer at all. They are only robots; they have no feelings.

There are many variants of this paradox. It is likely that those serial rapists who drug their victims, are trying to ensure that they have no memory of their victimization, thus imagining that they have not hurt their victims – a likely rationalization by such offenders as Bill Cosby found guilty of serial rapes in 2018. And indeed, if the victims were completely unconscious during the act, they certainly would have no memory of the violation itself. The matching punishment, in this case, would be to wipe out the memory that the offender had of his rapes, and to violate his body in a way that he cannot imagine, would it not? Or should it be the opposite? Make sure he remembers all his past rapes. But then that may be exactly what the offender enjoys, to relive those past acts of violent, sensual satisfaction.

Finally, the amount of punishment is clearly conditioned by the position of the victim in the evolutionary chain of life. A number of countries, for instance, have made it illegal to boil lobsters alive (the traditional method). Few have published the punishments, but they range from about $1,000 in Reggio Italy, to $2,000 in Sydney, Australia. What punishment would match this crime? And would the punishment change if the victim were an egg? A beetle? A mouse? A dog? A fetus? A human? We here just scratch the surface of the problem of proportionality, a venerable problem looked upon by jurists and lawyers of all stripes as settled law, a quasi-sacred principle to which all good jurists must aspire, as Gilbert and Sullivan wrote in their opera Mikado:

“My object all sublime

I shall achieve in time –

To let the punishment fit the crime –

The punishment fit the crime;”

The “butterfly effect”

One slap, delivered at a particular moment in time, can have extended, ripple effects, an idea that the Australian TV series of that name exploited. The greatest challenge in assessing the humanity, fairness or justice of a punishment is to assess, account for, and limit its ripple effects.

An essential part of the definition of punishment is that it should be inflicted only on the actor for an act that he/she has committed. And nothing more. But given the butterfly effect, this is an entirely impossible restriction on punishment, for every act, punitive, violent or even caring, is destined to have far reaching effects, to affect the immediate and distant social and physical environment of the actor. Others will inevitably be punished for what the actor did, even though they did nothing more than be connected in some way to the one punished. That is, they are punished for an act they did not commit.

Demonstrably, some punishments have far more ripple effects than others. For example, prison, as noted, has serious far reaching effects since it (a) removes a significant member of a family, often the parent who is a main source of income, which has inevitable subsequent effects on those left behind, and (b) places him/her with others in prison where his behaviors affect and are affected directly by the nature of the ongoing punishment, depending on the length of the sentence. Clearly, the longer in time that the punishment is applied, the greater the ripple effects will be.

In contrast, a short punishment that is confined only to the offender will have less ripple effects. For example, a flogging, say, of 10 lashes, is confined in time reducing the amount and extent of ripple effects (it can be aggravated by dividing it into punishment sessions, say 5 sessions of 2 lashes each thus extending the ripple effects). However, it can never completely reduce the butterfly effect, since the offender carries with him the experience of the punishment (in this case pain and possibly humiliation depending on how the flogging is carried out) and may therefore carry this with him to his physical and social environment. The extent to which this ripple effect affects his social life (and thus others) will depend entirely on his reactions to the punishment. Clearly, the effects of prison as punishment are largely out of the control of the one punished.

In sum, the butterfly effect shows incontrovertibly that making a punishment fit the crime is an impossibility.

Conclusions

Punishment is universally resented, but universally applied. It is impossible to conceive a real punishment without pain and suffering: the practical problem is what kind of punishment is reasonably proportionate, fair and certain. The moral problem is that punishment demands the intentional infliction of pain or suffering on an individual; those who punish are usually ambivalent about it, the punisher regretting the necessity to do it. This moral ambivalence is reflected in many societies, if not all. In order to avoid the guilt of intentionally inflicting pain on another human being (especially a child), punishment has to be “legitimized” and so societies have developed a whole system of formal and informal rules to do just that.

Though punishment takes on different forms in different cultures, there are universally three moral justifications that give credence to this legitimizing process.

The first is obedience, better known in the criminal justice world as deterrence – a forward looking justification that seeks to ensure that the infraction will not happen again.

The second is deserts, payback, “it serves you right,” or “he asked for it.” This view of punishment is commonly referred to in criminal justice as retribution, its more primitive version, revenge or vengeance. This is a backward looking justification, necessarily brought on the offender by his own action. It rests on a “categorical imperative” (that is, a blunt moral assertion) that every wrong deed must be punished because it was wrong, and most importantly with a punishment that fits the crime. Often the punishment reflects the offense in some way.

The third is redemption and its many relatives (restoration, rehabilitation, enlightenment, reform, and so on). This approach, which may also include within it elements of the first two justifications, rests on the assumption that it is through pain and suffering of punishment that the offender learns his lesson, and demonstrates to us that he truly understands the error of his ways, the horrible effects of his crime. On the positive side, this justification may have deep religious overtones, the enlightening functions of suffering that are recognized and practiced by most of the major religions of the world, whether through self-flagellation, austere restrictions on bodily movement during meditation, or strict diet. The problem, though, is to suffer in such a visible way that one’s confession of wrongdoing and expression of remorse is sufficiently convincing.

The way we punish can help the punished, the punisher and the victim to minimize the butterfly effect. There are, however, enormous challenges to devise punishments that take account of these effects equally, though one supposes that the victim should have priority over the type of punishment that would minimize its effects, or shall we say, cancel out the crime from the victim’s point of view. As far as the effects of punishment on the offender are concerned, again, it is difficult to identify with any precision the butterfly effects on the offender himself, its effects on his past and future relationships.

In order to meet the demands of proportionality, we must be able to find an end point to the punishment of the offender. We have seen that this is in practice an impossibility though a rough approximation could be achieved, depending on the specific types of punishments applied. Some punishments are well known for their long-term effects, such as prison. Others, such as acute corporal punishments (ranging from openly violent to minimally violent) can be engineered to have limited effects, at least in comparison to prison (Newman, Civilization and Barbarism, in press). Minimizing the violence of any punishment may be laudable, but it is certainly not achieved by the punishment of prison (also a violent punishment). To those who find the imposition of punishments that are even minimally violent politically incorrect, vicious and even degrading, we can only reply with Newman: “There’s little grace in punishment. Only justice.” (Newman, 2008, p. 287).

References

Newman, Graeme R. (2008). The Punishment Response 2nd. Ed. NJ: Transaction Publishers.

Marongiu, Pietro and Graeme R. Newman (1987). Vengeance: The Fight Against Injustice. NJ: Rowman & Littlefield, pp. 177, ISBN 9780847675401, Kindle $4.99, review.

Newman, Graeme R. (2020 press). Civilization and Barbarism: Punishing Criminals in the 21st Century. New York: SUNY Press.

Robert T. Rubin

Fading Influence of Humanism in Medicine – Illusion or Reality?

In many respects, the practice of medicine has become a zero-sum game between competing professional and economic forces, especially in the United States. Major changes in the landscape of medicine have been both beneficial and vexing, often at a cost to patients. These changes have led to a fading of humanism in medicine, for several reasons.

Benefits and detriments of advanced technology

First, there is no question that the rise of technology in medical practice has been advantageous for our personal health and welfare. As an example, modern imaging methods – CT, MRI, and ultrasound scans – have advanced illness diagnosis in ways not even imagined when these methods were in early development. Molecular genetics is in its early stage as a prelude to personalized medicine – when an individual’s illness presentation, understood at a genetic level as well as a symptom level, points to a treatment specifically for that person. For example, we now have genetic markers for at least certain kinds of malignant tumors that point toward specific chemotherapy protocols (Katz, 2018). In a few years, molecular medicine, with genetic profiling, likely will be standard practice in many medical specialties. Will this, however, reduce a sick human being to a series of machine printouts?

Second, computer technology has had a major impact on medical practice. It has made an enormous amount of medical literature available to the clinician at any place and at any time, via mobile devices connected to the internet. Computer technology is in the early stages of improving illness diagnosis via machine learning of algorithms and processing of huge amounts of data. Incredibly detailed anatomical images available with current state-of-the art imaging technology are being analyzed by algorithms that compare a patient’s images with a huge database of similar scans from other patients and normal individuals. These technological advances offer considerable promise for more precise medicine. As Verghese et al. (2018) pointed out, “… clinicians are biased toward optimistic prediction, often overestimating life expectancy by a factor of 5, while predictive models trained from vast amounts of data do better. Using these well-calibrated probability estimates of an outcome, clinicians can then act appropriately for patients at the highest risk.”

There is a downside, however, to the rise of computers in medical practice, in that the computer often sits on the desk between the clinician and the patient, and the clinician may pay more attention to completing the electronic medical record than to the other human being in the room. Many physicians find the electronic medical record to be cumbersome and demanding, because it must be fully completed to become part of the patient’s database. In the United States, there is a government mandate for all physician practices to convert to electronic medical records. Some practices have tried to address this by hiring medical scribes who, with handheld computers, follow physicians on their rounds and complete the electronic records as the physicians dictate their findings – a costly throwback to the days of dictating machines.

Economic Developments

From an economic standpoint, over the past several decades there has been increasing dominance of insurance companies, as well as state and federal governments, in controlling physician reimbursements and covered illnesses and treatments (Eisenberg, 1986). Over 20 years ago, I observed that, “Medicine is big business in America. Health care is now a full-fledged industry: The actuary stands with the physician at the bedside. The coin is the capitation contract for ‘covered lives,’ and the health maintenance organization (HMO) is emerging as the main administrative structure. ‘Managed care’ is the catch phrase, but who does the managing (physician or actuary) and toward what end is often not clear. Managed care by HMOs is an evolving system, and one can find recent examples of both their profit motivation and their implementation of innovative public health practices. But cost containment is the common denominator, pursued according to traditional business principles: The bottom line of the balance sheet is the supreme datum.” (Rubin, 1996).

These economic developments have forced physicians to see more patients, at lower pay per patient, to sustain a decent standard of living. Reduced time with patients means less time to listen to their stories – their fears and anxieties related to both their immediate symptoms and the broader circumstances of their lives. This may be the greatest problem of all facing humanism in U.S. medicine, in that it applies to all medical specialties. In my specialty, psychiatry, it has forced higher-paid psychiatrists, who are physicians and licensed to prescribe medications, to be merely the prescription writers for many patients, versus psychologists and social workers, who provide the bulk of the psychotherapies and other counseling interventions. It is ironic that in my psychiatric residency 55 years ago, I was taught to be my patients’ sole mental health clinician, under the rationale that, if it took two clinicians to manage a patient, how could we expect the patient to ever manage himself or herself? Over the last few decades this sensible rationale has been eroded by, of all things, economics.

Psychological Needs

Yet, no matter how fast medicine advances and how strong the outside forces on medical practice are, the psychological needs of the patient, and indeed of all mankind, remain constant. The field of social medicine only increases in importance as biomedical science becomes more precise and technical. In 1953, Masserman asked the following question of his psychiatric trainees: “Consider puny man, blessed with almost boundless imagery, but cursed since Paleolithic times with an
intelligence that perceives about him a vast, chaotic, infinitely threatening universe ready at any moment to harm or destroy him. What basic defenses … must he evolve, else suffer from anxiety so deep and pervasive that life would be intolerable?” Answers were that at least three basic processes were essential to man’s psychic economy. They constituted what Masserman called the Ur-defenses of man. He emphasized that “each of the three is contrary to the bitter evidence of our senses, … may therefore be called ‘delusional’ – and yet each is an article of faith so universal as to approach all that man can know of truth …” These Ur-defenses are the delusion of invulnerability and immortality, the delusion of the omnipotent servant, and man’s kindness to man. It is immediately apparent how powerful and vulnerable these are in the doctor-patient relationship: “Doctor, please don’t let me die. I know you can help me. Treat me with compassion!”

Over the many past decades, this theme has never been abandoned and has been repeatedly articulated: As Eisenberg (1980) indicated, “The transitions from person to patient and back represent social decision points rather than boundaries determined by shifting biological equilibria, as doctors so often suppose. Moreover, host resistance to pathogenic agents is weakened by social stress and strengthened by social support. Thus, the efficiency and effectiveness of medical care will be improved if the clinician, in assessing patient problems, systematically investigates the social determinants of the decision to seek help. The probability of resolving the patient’s difficulties will be enhanced by targeting treatment measures at the social components of the illness experience as well as at the pathophysiology of the disease process. … It is the patient who decides just how far to follow the treatment regimen after weighing its costs, its perceived utility, its impact on lifestyle and its meaning.”

All these truisms about medical practice can be summed up in the phrase, “therapeutic alliance.” In my experience, the strength of the therapeutic alliance can vary between zero and 100%, depending on the life circumstances of the patient and the clinical and interpersonal skills (otherwise known as “bedside manner”) of the physician (or physician assistant or nurse practitioner, both of whom are gaining increasing prominence as strong advocates of humanistic medicine).

Treating the Whole Patient

Now, in 2018, we again are at a familiar crossroads, with good intentions toward humanism still considered important, but being difficult to realize. As Greene and Loscalzo (2017) commented, “In the 21st century, the framework of biomedical research and clinical practice has begun to shift away from universal models of disease that generalize from close examination of diseased parts (organs, tissues, cells, or molecules) toward an approach that celebrates ‘personalized medicine’ and focuses, at least nominally, on the whole person… Superficially, this transition appears to mark a return to the early modern conception of the patient as ‘sick person,’ whose disease was considered inseparable from his or her complex constitutional inheritance and lived experience. Yet in practice, personalized medicine still tends to reduce the patient to a collection of precise molecular sequences. … The task of putting the patient back together again will be complex, arduous, and time consuming, but it promises a new articulation of the biologic and social sciences that are inextricably linked and essential to the advancement of medicine.”

With the tremendous technical medical advances that have occurred throughout the 20th century and continue apace during this early part of the 21st century, the humanistic needs of our patients remain constant. This is not new, and certainly during my medical career, beginning in the last half of the 20th century, I have continued to encounter commentary on the never-ending tension between the extremes of materialism and idealism.

For example, almost 60 years ago, Seymour Kety, a consummate neurobiologist, remarked that, “There are materialists and their psychological counterparts, the behaviorists, who solve the problem of explaining consciousness by ignoring it or denying that it exists. … Then there are the idealists and the extremists among them – the solipsists, who are so struck with the fundamental and undeniable reality of consciousness that they are led to deny any other existence than their own sensations, for they cannot conceive of what the material world would be like aside from them. The real difficulty with egocentricity … is that it makes representation, comprehension, and prediction hopelessly complicated.” (Kety, 1960). In my view, the continuing tension between the objective and the subjective, not just in medicine but in all spheres of life, underscores the sine qua non characteristics of both.

As Jimmie Holland, MD, a pioneer in understanding the psychosocial aspects of cancer, pointed out, “One of the things that I’ve learned in 40 years is that our emotions are exactly the same. They haven’t changed one iota over millennia. It’s fear. It’s worry. It’s what’s going to happen to me and what’s going to happen to my family. All of those fears are there. What the patient has always wanted and still wants is to know that this doctor cares about me.” (Roberts, 2018).

Indeed! Over millennia, our emotions have been exactly the same. And our humanism must remain exactly the same, in medicine as elsewhere in life. A professor of palliative medicine (a rather new medical subspecialty devoted to end-of-life care) recently commented on “…‘ethical erosion,’ a loss of empathy reported to occur during the process of medical education. It’s troubling to think that empathy would diminish precisely during the years when it is most needed.” (Kirkland (2017). She asked, “Do we need to fear that development of clinical skills inevitably results in numbing and emotional detachment?”

At the turn of the last century, I wrote a fanciful scenario for psychiatric education in the year 2050 that bears upon this question (Rubin, 2000). In brief, it was this:

“26 Aug 2050, 8 AM. I’m in my office, awaiting my weekly supervisory hour with John Smith, our senior resident in the Department of Integrative and Applied Neuroscience (formerly the Department of Psychiatry). John comes in, looking exhausted.

“What a night. I’ve been working on a very agitated and depressed female on pod 7A. I’ve tried everything in the book – multiple drugs for neurotransmitter manipulation, transcranial magnetic stimulation with and without reticular activating system targeting, etc. The patient’s a classic Mesolimbic Depression according to the Diagnostic and Statistical Manual of Neuroscience Diseases, so she should be almost completely remitted by now, but she’s had only minimal responses. I’m trying to arrange for the stereotaxic neurohospitalist to microinject her amygdalas with antisense oligonucleotide to CRH messenger RNA to suppress noradrenergic output from her loci coerulei, but the OR schedule is full for the next 48 hours. What else should I do?”

“John, tell me about this woman. How old is she, etc.?”

“She looks to be in her 30’s, CNS nuclei structurally intact by high-field MRI, cerebral magnetic fields normal bilaterally, continuously telemetered EEG spectral amplitudes slightly diminished. DNA single nucleotide polymorphism nanoarray unremarkable.”

“What else about her?”

“As I said, non-responsive to …”

“John,” I interrupt, “let me tell you a story. A true story.

“Fifty-two years ago, in 1998, I was supervising a resident much like yourself. For about three months he had been attempting to treat a depressed woman, single, in her early 30’s, who had obsessional thoughts about suicide. She was still living at home with her parents and not dating. She had had only one boyfriend in her life, for a few months in high school. According to the diagnostic manual available at that time, the patient had major depression and comorbid obsessive-compulsive disorder. The resident had tried three or four oral antidepressants, with a partial response to each, but no lasting improvement.

He, too, was at a loss for what else to do. Along with the resident, I interviewed this young woman. She was shy, spoke very softly, and looked down at her hands resting in her lap. I confirmed her life history and symptoms. I asked her if she felt any better since she had started treatment, and she said ‘yes, a little.’ ‘Have any of the pills helped?’ ‘I’m not sure.’ I asked her if she liked her doctor, and, quickly glancing up at the resident, she replied, ‘yes.’ After some additional conversation I indicated that I had just one last question: ‘What is the one thing you’d most like help with right now?’ The patient looked up at me, right into my eyes, and replied, ‘I want to get married.’

John looks at me blankly. “And the point is?”

“John, there’s an old French saying: Plus ça change, plus c’est la même chose. Let’s go talk with your patient.”

Today, 18 years after I wrote that futuristic fantasy, I remain an optimist. Any fading of humanism in medicine appears to be more illusion than reality: “Social science critiques that fail to recognize the anti-reductionistic developments within biomedical science increasingly attack a strawman. The fields of social medicine – anthropology, history, sociology, geography, philosophy, and epidemiology – raise questions that biomedical science has been unable to answer.” (Greene and Loscalzo, 2017).

As I indicated earlier in this essay, social medicine only increases in importance as biomedical science progresses. However, because of the waxing and waning of external forces on medical practice, ranging from funding for biomedical research to the economics of medical practice, as discussed above, there will continue to be a back-and-forth between biological reductionism on the one hand and social / psychological medicine on the other, as there has been over the last hundred years or so. With each cycle, there fortunately is increasing sophistication on both sides – the profound advances in medical genetics and molecular biology are counterbalanced by a greater awareness of the social / psychological needs of patients, as indicated by an increasing number of relevant articles in medical journals and increased teaching of the principles of social / psychological medicine in medical, nursing, and associated health science schools, at least in the United States. As a 4th-year medical student recently reflected, “The practice of medicine is simply poetry in motion. The art of medicine is the validation of everything that makes the human experience. [In medical school] I learned more about myself than I ever imagined. …” (Coulehan, 2017). The signs are encouraging.

In preparing this essay, I asked the four physicians among my children and their spouses (two pediatricians, one primary care physician, and one emergency room physician) to give me their perspectives on this topic. The primary care physician stated, “Physicians have lost their dignity to a system that is more about economics than compassion and caring.” The daughter who is a pediatrician (and fluent in Spanish) commented, “As clinicians we must have the humility to recognize that our experience may not be the patient’s experience. During my pediatric residency a baby was born who was healthy but missing the lower half of one arm. Because the parents only spoke Spanish, I was sent to talk with them. I was worried about how to explain my plan to refer them to orthopedics, and I wanted to reassure them how modern prosthetics could help their baby function well as she grew up. I walked into the hospital room prepared to see a grieving family, and I offered a generic greeting akin to ‘How’s it going, how are you?’ I saw the father cradling his infant. He beamed at me and said, ‘She’s beautiful!’ I realized then that the family didn’t need me to reassure them with medical facts; they needed me to celebrate the birth of their baby. I was focused on the missing limb; they saw the whole child. My experience was not their experience. This understanding guided how and when I shared the medical information with them. A powerful lesson!”

The daughter who is an emergency room (ER) physician (who theoretically should be least concerned with the humanistic aspects of medical practice, because of her brief contacts with patients) wrote, “… in my opinion, it is totally true that humanism is fading. Technology and specialization have advanced so rapidly that it is inevitable. Patients now consult ‘Dr. Google’ before they seek a doctor’s advice. It can be great and saves people from ER trips, but also gives them a list of unrelated ailments, and then they end up in the ER thinking they have terminal illnesses. … Additionally there is a much bigger push to not spread infection, I think starting with HIV [human immunodeficiency virus], but now with things like MRSA [methicillin-resistant staphylococcus aureus], so isolation and handwashing are constant. I don’t shake people’s hands if I can avoid it. I examine everyone, including newborns, with gloves. So, we have lost some of the human touch that was associated with medicine in the old days but … Every void gets filled eventually.” I must say, it was most heartening to read this!

In conclusion, I personally believe that, even with its ebbs and flows, humanism in medicine will continue to exist and to flourish – not only because it is an indispensable element in our patients’ recoveries, but also because we clinicians are made of the exact same stuff, physically and emotionally, as our patients.

Afterword

In the above essay I did not comment on the spiritual aspect of humanism in medicine, because I know nothing about it, except for one personal experience. From my conversations with Prof. Shoham many years ago, I believe he will find my experience interesting, so I will take the liberty to describe it. In January 2007, after several weeks of an apparent bronchitis, I had a chest CT exam, which showed multiple large lesions in both lungs, consistent with advanced metastatic carcinoma. This was on a Monday afternoon. I was referred to a pulmonologist, whom I saw on Tuesday. He ordered a PET scan, which I had on Wednesday. The PET scan was positive, indicating the lesions were metabolically active (consistent with, but not diagnostic of, malignancy). On Thursday I had multiple biopsies of the largest lesion, in my left lung. A pathologist was present, who examined the tissue microscopically and reported inflammation, but no malignant cells seen. The biopsies then were fully examined in the pathology laboratory, and on Friday I was informed of the diagnosis: chronic eosinophilic pneumonia (an “allergic” type of pneumonia), and no malignancy.

The five days from Monday to Friday were difficult, but filled with things to do, from multiple medical visits and procedures, to emotionally fraught visits with family members, to decision-making with an attorney and accountant about distribution of assets among my wife, children, and grandchildren. The five nights were worse. With my wife asleep, I was left alone with my thoughts about my impending demise – a “profound existential sadness,” as it has been called. Now I know why patients visit ERs at 3 AM with complaints they have had for days or weeks – at that hour, they are totally alone. Recall the Ur-defenses of man, described above: “Doctor, please don’t let me die; I know you can help me!”

I was treated with high-dose steroids and the lesions gradually resolved. Fortunately, there has been no recurrence. As others have said to me, “You dodged the bullet.” Perhaps I did, and I have asked myself, “Why?” The closest I have come to an answer occurred, again in the middle of the night, about a week after my diagnosis was made and I had started steroid treatment. I was the Chief of Psychiatry at the VA hospital in Los Angeles and lived on the hospital grounds. About 2 AM the Chief of Staff telephoned and indicated there had been a suicide in one of the veterans’ dormitories, and the victim’s roommate, a young combat veteran, was in the ER, very upset and somewhat suicidal himself. Would I go to the ER to see this young veteran? I dressed, walked to the ER, and spoke with the veteran for almost an hour. He wanted to go back to his room in the dormitory, where he would have been alone. I indicated I preferred he come into the hospital for the rest of the night, where he could talk with the nursing staff and allow himself to safely grieve over his roommate’s death. I persuaded him to stay in the hospital. The next day he was considerably calmer and was discharged back to the dormitory to be with a new roommate.

What is the point of this long-winded story? Walking back home from the ER to my living quarters about 4 AM, in darkness and solitude, I had many thoughts about this veteran and my insisting he be hospitalized, which created considerable work for hospital staff. These were my usual professional thoughts. But new questions entered my mind: Was I “allowed to dodge the bullet” by having a treatable illness and remain alive, so that I could continue to be a physician and help this young veteran and others? And, who or what force allowed me to do this? Was it a random, cosmic occurrence or more organized in some way, perhaps by a “higher power”? I recalled Einstein’s admonition that “… [G-d] does not throw dice.”

During that walk home, I would have been most pleased to have had the opportunity to share my thoughts with Prof. Shoham. I of course don’t believe he could have solved my existential quandary, but he would have helped me examine its different aspects. This is what a friend is for. And Prof. Shoham is a very good friend.

Acknowledgments

I thank Drs. Sharon Rubin, Bernard Carroll, Gordon Handelsman, Joel Auerbach, and Deborah Rubin for sharing their experiences and for helpful comments on the manuscript.

References

Coulehan, Jack (2017) Negative capability and the art of medicine, JAMA 318(24): 2429-2430, pdf, interview.

Eisenberg, Leon (1980) What makes persons “patients” and patients “well”? American Journal of Medicine 69(2): 277-286, doi.org/10.1016/0002-9343(80)90389-7, abstract.

Eisenberg, Leon (1986, online 2006) Health care: for patients or for profits? American Journal of Psychiatry 143: 1015-1019, abstract.

Greene, Jeremy A.; Loscalzo, Joseph (2017) Putting the Patient Back Together – Social Medicine, Network Medicine, and the Limits of Reductionism, New England Journal of Medicine 377(25): 2493-2499, review, lab.

Katz, Steven J.; Jagsi, Reshma; Morrow, Monica (Mar 2018) Reducing overtreatment of cancer with precision medicine: just what the doctor ordered, JAMA 319(11): 1091-1092, pdf, doi:10.1001/jama.2018.0018, CanSORT.

Kety, Seymour S. (Dec 1960) A biologist examines the mind and behavior, Science 132(3443): 1861-1870, abstract, page 1.

Kirkland, Kathryn B. (2017) Walking the shoreline: erosion, regrowth, and professional formation, JAMA 318(23): 2297-2298, page 1.

Masserman, Jules H. (1953) Faith and delusion in psychotherapy: the Ur-defenses of man, American Journal of Psychiatry 110: 324-333, page 1 obit, obit2, obit3.

Roberts, Sam (Jan 2018) Obituary: Jimmie Holland, who cared for the cancer patient’s mind, dies at 89, New York Times 7 January 2018, p. A23; obit2, wiki.

Rubin, Robert T. (1996) Editorial: HMOs and AHCs – In defense of town and gown, Science 273(5279): 1153, full text.

Rubin, Robert T. (Aug 2000) 2050: A parable for our time. American Journal of Psychiatry 157: 1213-1214, pdf+.

Verghese, Abraham; Shah, Nigam H.; Harrington, Robert A. (Jan 2018) What this computer needs is a physician: humanism and artificial intelligence. JAMA 319(1): 19-20, page1, abstract.

Frank J. Tipler

Genesis Chapter One is a Fine Textbook on Modern Cosmology

My dear friend Shlomo Giora Shoham (hereafter “Shlomo”) is a modern pioneer in interpreting the cosmology in Genesis. I especially recommend reading his “autobiographical” Moses: the Righteous Sky Gazer (Cambridge Scholars Publishing 2014) and his non-fictional analysis of creation, The Word of Light: Piercing the Veil of Chaos (Cambridge Scholars Publishing 2009).

What I intend to do in this essay is show that Genesis Chapter 1 is an accurate description of how the physical universe began. It is a fine textbook of modern cosmology. I agree with Shlomo that the writers of Genesis One did not have a clue that this was what they were doing. They thought they were describing a creation story that was a combination of the Egyptian and Mesopotamian creation stories (see Shlomo’s Moses). But we all know that the Torah has 70 faces, and it has 70 faces because God guided the writing.

Let me begin at the beginning, with Genesis 1:1, in my favorite translation, the 1395 C.E. John Wycliffe translation: “In the beginning, God made from nought heaven and earth.” In modern English, “In the beginning, God created all that exists out of nothing.” Two questions: (1) What cosmological evidence do we have that “God” exists? If He doesn’t exist, then obviously He doesn’t create anything. (2) What is meant by “creatio ex nihilo”?

Let me answer the second question first. I shall define “God” to be “a supernatural being that created the universe out of nothing”. Let me unpack this definition. “Supernatural” literally means “above nature,” or “outside of physics” (the Greek word for “nature”). Modern cosmology has established the existence of such a supernatural being, the cosmological singularity, an intrinsically infinite entity that exists outside of space and time, and an entity that is not subject to the laws of physics.

By “creation out of nothing” I mean that outside of the cosmological singularity and the physical universe determined by the singularity, there is nothing – no time, no space, no matter, no energy, no nothing. Furthermore, the cosmological singularity “exists” in the same mathematical sense that anything “exists,” namely, if we have a region of space and time we agree “exists,” then we infer the existence of regions outside of this region by mathematical continuation based on the laws of physics. This is how we infer the existence of the universe outside the past horizon. The universe is 13.8 billion years old, but we cannot see space further out than about 46 billion light years. By mathematical continuation, we infer the total universe is larger, and mathematically, we say we “attach” this later region to the part we can actually see. Similarly, we can attach the singularity to space-time, thereby getting the totality of all that exists. The laws of physics then tell us that there is nothing outside the singularity and the physical universe.

The cosmological singularity determines – my word for “creates” – the physical universe by determining that it is space and time and matter and energy that are the only existing entities outside the singularity, by determining the laws that govern these non-singular entities, and finally by determining the boundary conditions on these physical laws. I can show mathematically how the cosmological singularity thus determines these three, but I do not know a simple proof of how the cosmological singularity determines that it is space and time (rather than superstrings, say) that is the foundation of our universe. The only proof I know involves entire functions of a complex variable.

However, given space-time and general relativity, we can easily see how the Big Bang Singularity determines the boundary conditions on these laws that we assume the singularity determines. The state of the universe today is determined by the state of the universe yesterday, and the state of the universe yesterday was determined by the state of the universe the day before yesterday, and so on into the past until we reach the Big Bang Singularity. The laws of physics then tell us that we can go no further into the past, because time itself begins at – was begun by – the Singularity. Thus the boundary conditions on the laws are determined by Cosmological Singularity, which is to say, by God.

If this argument sounds similar to the Cosmological Argument of Maimonides and St. Thomas Aquinas, it should. The only difference between my Singularity Argument and their Cosmological Argument is that the latter assumed causal regress could not continue indefinitely. Modern cosmology proves that it cannot. The Cosmological Singularity is indeed the First Cause. Conversely, the Singularity Argument shows that the First Cause is the Singularity. There is no First Cause except the Singularity.

This is my exegesis of Genesis 1:1, showing that indeed this verse is an accurate textbook of modern cosmology, correctly giving a one-sentence description of how the universe began according to the latest physics. I shall use the same methods I used to interpret Genesis 1:1 to interpret the entire chapter. I shall combine my knowledge of modern cosmology and modern physics with my knowledge of how at least some of the “ancient authorities” interpreted the passages, and thus show that these are perfectly consistent. Not only “consistent,’ but predictive: had we physicists accepted the story in Genesis, we would have understood how the universe began.

This has already been illustrated in my exegesis of Genesis 1:1, because the ancient authorities have always interpreted this verse to mean that the universe has only existed for a finite time, that the universe is not infinitely old. Aristotle thought otherwise, and his cosmology was an infinitely old universe. Einstein accepted Aristotle’s cosmology, not the Biblical cosmology, and thus Einstein was led to make what he called the ‘worse mistake of my life,’ trying to model a non-expanding universe that would indeed be infinitely old. Einstein should have accepted his childhood rabbi’s cosmology.

Einstein and other early cosmologists also should have accepted the claim of most ancient authorities that “light” was the first created thing (Genesis 1:3). St. Augustine (in his book The Literal Interpretation of Genesis), Nachmanides and ibn-Ezra wondered what this “primordial light” was, and wondered why we don’t see it today. A modern cosmologist, reading Genesis 1:3, naturally realizes that “primordial light” is the primordial background radiation, which indeed was the first thing in the universe after time began. The reason we don’t see this radiation today is because of the expansion of the universe. The wavelength of the radiation has shifted so that the part of the primordial light, which was originally in the visible part of the spectrum, is now in the microwave band, and thus we need to build microwave receivers to “see” it. Once these instruments were built, the primordial light was seen. Had the Torah been taken seriously as a cosmology textbook, the background radiation would have been detected decades earlier.

The same is true for the expansion of the universe itself. In Genesis 1:6 (KJV), we read “And God said, ‘Let there be a firmament in the midst of the waters, and let it divide the waters from the waters’.” I italicize firmament because my own copy of the KJV has a footnote saying the word “firmament” actually means “expansion” in Hebrew. The Hebrew word translated as “firmament” or “expansion” is “raki’a” (רָקִיעַ). The writers of this verse thought it referred to a solid dome over the Earth, which they saw in the daytime to be a blue hemisphere. The word in Hebrew has the connotation of an object being expanded by being hammered out, hence its alternative meaning of “expansion”.

St. Augustine tells us (Literal Interpretation of Genesis, Book 1, Chapter 8) that “waters” in verses 2, 6 and 7 mean the “entire material universe.” So Genesis 1:6 tells us that God commanded the entire material universe to begin an expansion. As a cosmologist, I know that this is what the cosmology textbooks all say. It gets better. In his commentary on Genesis, Martin Luther said that in interpreting “raki’a,” one should think of the blowing up of a hog’s bladder – a form of balloon. I find it remarkable that the standard model modern cosmologists use to describe the expansion of the universe to lay people is an expanding balloon on which coins are pasted. The coins correspond to galaxies (which do not participate in the universal expansion), and the surface of the balloon, represents space itself, which does expand. Martin Luther’s model to understand the meaning of “raki’a” and the modern cosmologist model of the expanding universe are exactly the same.

Why would St. Augustine think “waters” referred to the entire material universe? To begin with, it is a very ancient idea that everything ultimately is made out of water. The Greek philosopher Thales believed this, and Aristotle (Metaphysics 983b) opined that Thales took this idea from “men of very ancient times,” who pictured the water gods Oceanus and Tethys as the parents of all creation. The Babylonian analogues of Oceanus (the god of saltwater) and his wife Tethys (the goddess of freshwater) are respectively Tiamat and Apsu. “Apsu” literally means “water” (“ab”) and “deep” (“zu”) in the ancient Mesopotamian language Akkadian; i.e., water that comes from deep inside the Earth via underground aquifers. The Mesopotamians believed that all freshwater, be they springs, lakes or rivers, originated from such aquifers. They believed there was a primordial freshwater sea deep under the Earth.

Oceanus/Tiamat/saltwater was a corresponding primordial sea above the Earth, so in this pair we have a division of primordial waters into two parts, one above the Earth (above the firmament) and one below the Earth (below the firmament). In Babylonian myth, the mixing of freshwater with saltwater created everything not aqueous. As Shlomo tells us in his two books referenced above, ancient Egyptian cosmology pictured an analogous origin of everything from water.

I’m sure that the writers of Genesis One thought their cosmology was similar to the Mesopotamian and Egyptian cosmologies. But it is different in one crucial aspect: the water itself was created by Elohim (אֱלֹהִים) and the process was totally controlled by Him. In modern cosmology, the Cosmological Singularity totally controls what happens in space-time, and this is even more true in quantum mechanics, which I have proven to be even more deterministic than classical mechanics (Proceedings of the National Academy of Sciences, 2014). Einstein got it right: God does not play dice with the universe.

If indeed God does not play dice, but instead controls it down to the quantum state, then He also controls the writing of the Bible, so that the Torah indeed has 70 faces.

So far, I have pointed out three claims made in Genesis One that agree with modern cosmology: (1) the universe has existed for only a finite time; (2) the first “stuff” in the universe was light, that is, the “primordial light” (St Augustine’s term) was the primordial background radiation, and (3) the first action in time was the expansion of the universe. Now I want to build on these claims and show that all of Genesis One agrees with modern cosmology, and further, can be used to guide research in modern cosmology.

We are told in Genesis 1:2 that the Spirit of God hovered over the surface of the “waters.” We are told in Genesis 1:3 that God said “Let there be light, and there was light”. We are told in Genesis 1:6 that there are two types of “waters,’ one type which is “above” the expansion, and another type which is “below” the expansion. How do were interpret these claims?

I propose combining our knowledge of fundamental physics with what the greatest Christian and Jewish commentators said the passages meant. First, consider “light.” What is “light” from the point of view of modern physics? Light is a gauge field. But we have known since the 1970’s that light – a form of electromagnetic radiation – is not a fundamental gauge field. Instead, there are three fundamental gauge fields: an SU(1) field, an SU(2)L field, and an SU(3) field. The first two combine today with the Higgs scalar field to give the gauge field that is the electromagnetic field: light. In addition to these fields (three gauge fields and the Higgs field), there is the cosmological constant (part of the dark energy).

As pointed out above, “water” was considered by the writers of Genesis to be a fundamental substance out of which everything else was made. Therefore, “waters” must refer to some of the above-mentioned fundamental fields. I’m going to claim that the same is true for ‘light.”

“Water” in the everyday sense is a fluid, which means it flows, and it exerts a pressure. If everyday water did not exert pressure, it would immediately collapse into a flat plane. So if by “water” as described in Genesis we mean a fundamental fluid exerting pressure, then all of the five above-mentioned fields are “water.” For that matter, everyday light is a fluid exerting pressure. (Light sails are a proposed propulsion system for interplanetary travel.) So we are led to identify three of the five fundamental fields with the two types of “water,” and one with the “light.” But which three of the five should we choose?

Let’s go back to Genesis 1:2, where we are told “the earth was without form and void.” The words in Hebrew translated “without form and void” are “tohu va bohu” (תֹהוּ וָבֹהוּ). Rashi points out that “the word תֹהוּ is an expression of astonishment and desolation, so that a person wonders and is astonished at the emptiness therein.” Thus Rashi interprets “tohu va bohu” as “astonishingly empty”. I’m going to build on Rahsi’s insight. If a traveler goes into the desert to the east of Jerusalem – I rented a car and did so with my wife on our honeymoon – it appears that one is not moving at all, since one wadi looks like another. It is totally devoid of life and vegetation: completely and astonishingly empty. One feels the desolation. An observer has a similar impression far out of sight of land in the Mediterranean Sea when it is calm. Moving from one point to another, it seems as if one has not moved at all. All directions look the same. The middle of the ocean is indeed “astonishingly empty.” Another translation of “tohu va bohu” is “trackless waste.”

In cosmology, we have a mathematical term for a universe in which “all directions look the same.” We say such a universe is “isotropic.” We cosmologists also have a term for “moving but it seems as if one has not moved at all.” We cosmologists call such a universe “homogeneous.” I’m going to follow St. Augustine and interpret “earth” to mean the entire universe. With this interpretation, “the earth was without form and void” means “at the very beginning of time, the entire universe was homogeneous and isotropic.”

Why should we believe this? Well, for one thing, the universe is observed to be homogeneous and isotropic to one part in one hundred thousand. But there is a deeper reason. The great Israeli physicist, the late Jacob Bekenstein, proved that if there were an initial singularity with particle horizons, then quantum field theory requires that the initial state of the physical universe had to have zero entropy, and thus had to be in a unique state of isotropy and homogeneity, exactly what is observed, and exactly what my interpretation of Genesis 1:2 requires. Jacob had actually solved two of the central problems of cosmology – Why is universe homogeneous and why is it isotropic? – but he did not accept his own result, because he knew that zero entropy implies zero temperature, and he thought the initial temperature was infinity, not zero.

I published a proof in March 2005 (Reports on Progress in Physics, 68(4):897) in which I showed that Jacob was wrong. It is possible for the initial state of the universe to have zero entropy and zero temperature because in an isotropic, homogeneous, and flat universe, the primordial radiation would necessarily have a Planck spectrum. Therefore, observing the primordial radiation to be Planck tells us nothing about its temperature. Such an observation just means the universe is isotropic, homogeneous, and flat.

Back to the choosing of three fields out of five possibilities, now that we know the universe initially had to be isotropic and homogeneous. The SU(1) field is ruled out, because it cannot be isotropic. A SU(1) field is mathematically similar to an electromagnetic field, which is made up of electric and magnetic fields, as its name says. At a point in space-time, therefore, an electromagnetic field would have its electric field, which is a vector, point in a definite particular direction, which violates isotropy.

The SU(3) field is too rich, and thus cannot define a unique initial state. Nachmanides (Ramban) argued (Commentary on Genesis 1:1) that the initial “stuff” in the universe created all other types of matter. I shall accept this interpretation by Ramban, and infer that at least one of the initial three fields had to create all matter. The SU(3) gauge field cannot do this (nor can the Higgs field or the cosmological constant), but the SU(2)L field can.

Since the SU(2)L field is the only remaining gauge field, and the primordial “light” must be a gauge field, I shall identify the primordial light of Genesis 1:3 with a primordial SU(2)L field. If such a field is all that initially exists, then its uniqueness implies that it is a self-dual field. Such a field would generate quarks and electrons and neutrinos, but no anti-matter. This means that combining the ancient Christian and Jewish sages’ interpretation of Genesis One with modern physics, we have solved one of the outstanding problems of cosmology, namely explaining why there is more matter than antimatter in the universe.

Now use Genesis 1:6 to identify the two types of “waters.” One type is “above the expansion” and the other is “below the expansion.” In English (and also in Hebrew) “above” and “below,” where applied to an action noun, can mean “not participate in” and “participate in” respectively. Thus, there would be one type of “water” – fundamental fluid – that does not participate in the expansion, and another type that does participate in the expansion.

The cosmological constant does not change during the expansion of the universe, nor does the Higgs vacuum. The SU(2)L field and the non-vacuum Higgs field do change during the expansion. So I identity the former two fields with the “waters above the expansion,” and the latter two fields with the “waters below the expansion.”

We are then told in Genesis 1:8 that God called the expansion “heaven,” and indeed the entire expanding universe is “heaven.” We are also told that the evening and the morning were the “second day.”

This brings us to the question of time duration. Christian theologians and Jewish rabbis have known for many centuries that the “day” of Genesis One cannot be the standard day of 24 hours. St. Augustine, for example, wrote in the year 415 C.E. (Literal Interpretation of Genesis, Book 5 Chapter 2): “One might easily think that this day was a day made up of a material light by whose circuit the hours of day and night are brought to us. But … [many “days” passed] before the Sun was made (for it was made on the fourth day), and it is by the presence of the Sun that the day with which we are familiar is constituted. When, therefore, we hear ‘When the day was made,’ … we are admonished to think of that day which may perhaps be a corporeal thing consisting in some sort of light unknown to us [my emphasis] … at least we know that it is different from the ordinary day with which we are familiar …”

I agree with St. Augustine that “day” in Genesis One cannot refer to a day of 24 hours. I also agree with him that “day” must however be defined in some way by “light.” But I want to go further and insist that a “cosmological day” must start with a dark period, and be followed by a light period, with a single “cosmological day” consisting of the combination of a single dark period and an immediately following light period, with the “cosmological day” ending with the beginning of a subsequent dark period. This latter point is very important, because in the Jewish calendar, all “days” begin and end at sundown.

I claim that the First Day of Genesis 1:5 was not a “day” of some non-zero duration, but rather the absolute zero of time. That is, I shall interpret Genesis 1:5 literally: “And God divided (or separated between) the light from the darkness.” God, in other words, separated the darkness and the light with His Own Body!

Rashi, in his commentary on verse 5, notes that this day was not called the “first day,” but rather “one day.” Rashi emphasized that wording is unique to this day, as all other days were called “second day,’ “third day,” and so forth. My interpretation is thus consistent with Rashi’s.

My interpretation also follows ibn Ezra’s Commentary on Genesis 1:1 on the meaning of the word “bara” (בָּרָא). Ibn Ezra points out that “bara,” usually translated “created,” actually has the connotation of “divide”. “Most commentators have said that creation means bringing forth something from nothing. … [bara’s] meaning is to cut, to place a divided border.” According to ibn Ezra, God literally “divides” nothingness from His creation.

With this interpretation of the First Day, the phrase in Genesis 1:2 “darkness was upon the surface of the deep,” means that there was no light in the ultimate darkness of nothingness, and the subsequent phrase “and the Spirit of God hovered over the surface of the waters” carries a double meaning. An entity can “hover over” only after a direction of up and down has been first defined. But there is no up and no down between nothingness and the created order. So God must be pictured as “hovering over” both. “Hovered over the waters” would then first refer to hovering over the types of “water” defined above. God would also hover over nothingness, which agrees with the translation of Genesis 1:2 of St. Jerome in the Vulgate: God moved over the abyss; i.e., nothingness.

Let me expand on my above exegesis of Genesis 1:1. Focus on the first word in Genesis, namely “Bereshit” (בְּרֵאשִׁית), the word which gives the Book of Genesis its name in the Jewish tradition, and which is usually translated “In the beginning.”

First of all, how do we even know that “bereshit” was there “in the beginning;” that is, in the original text of Genesis? Because we know that it was there in the earliest manuscripts we have. The Masoretic text of Genesis chapters 1 and 2 are almost exactly the same as the text in the Dead Sea Scrolls. The Masoretic text of Genesis and the text in the Dead Sea Scrolls are compared in this table.

Qumran Cave 4 Scrolls

Scroll

Date Written

Genesis

Comment

7

About 50 BCE

1:1-2, 1:4-22, 2: 6-7

Identical to Masoretic text

2

30-68 CE

1:1-28, 2:14-16

Identical to Masoretic text

4

About 50 BCE

1:18-27

Identical to Masoretic text

8

50-25 BCE

1:8-10

Contains “one collection” instead of “one place”

10

Before 68 CE

1:9, 1:13-16, 26-27, 2:1-3

In verse 9 after “it was so” is added “And the waters under the sky were gathered together to their place, and the dry land appeared.”

The Septuagint, a Greek translation of the Bible into Greek made about 300 B.C.E., also does not differ from the Masoretic text of Genesis. Finally, the Samaritan text of Genesis One differs in five places from the Masoretic text, but only in trivial ways. Thus “bereshit” was there “in the beginning!”

Actually, the Masoretic text (which dates from around the 7th century C.E.) does differ in an important way from the Dead Sea Scrolls, and indeed differs from the scrolls in modern synagogues: the Masoretic text has vowels, while the scrolls have only consonants. This can make a difference. The word “Bereshit” is spelled that way in the Latin alphabet because there is a sh’va (two dots) under the bet. This usually means the indefinite article “a” rather than the definite article “the.” If one wants to say “the,” one should put a qamatz under the bet. No difference in consonants, but a huge difference in meaning once the vowels are included.

I think we have to go with the Masoretic text, since it incorporates an oral tradition of rabbis going back a thousand years before the Masoretic text. Furthermore, if the definite article were intended, the usual way of expressing the definite article in Hebrew, adding the letter hey in front of the word, would have been used. The hey is in fact used in front of “heavens” (הַ) and also in front of “earth” (הָ) in the same verse. Generally speaking, in Hebrew if no definite article is used, the indefinite article is implied. So even in the all-consonants version of Genesis, an indefinite article is the most probable: a beginning rather than the beginning.

Rashi, Nachmanides and ibn Ezra, also accepting the Masoretic text and of course knowing all the above grammatical subtleties (my comment on the vowels is taken from ibn Ezra, who did not know modern Hebrew grammar, which disallows a qamatz under the bet in a noun in the construct state), interpreted “bereshit” as “When God began to create.”

But I am going to interpret the Masoretic no-hey text literally. If you look at the Wheeler-DeWitt equation of quantum gravity, all cosmological solutions have parallel universes, and of these, there is only one solution which yields the observed classical universe in which we find ourselves: a solution that insists on the existence of parallel universes exactly like our own, and which has ALL of them beginning at exactly the same Initial Singularity. In actual reality, then our one single universe (which is the focus of Genesis One) had A beginning. The collection of all the universes constituted THE beginning. In my interpretation, we are told in the first word of the Bible that the focus is on our single universe, but God created an uncountable number of other universes. Quantum cosmology is there in the beginning!

To return to the meaning of “day” and “first day,” recall that I have interpreted the first day to refer to the zero of time, a “day” without duration. I shall interpret the darkness of the first day with duration, which is to say the second day in which the expansion begins, to be the nothingness before creation, and the light of the second day to be first light of Genesis 1:3, which is to say, the SU(2)L gauge field.

The third day must begin with a period of darkness in which the primordial light is no longer “visible.” Remarkably, there is indeed a period of darkness in modern cosmology which is the natural beginning of the third day: the period that modern cosmologists call the Dark Ages. The Dark Ages begin about 380,000 years after the beginning of time, about 380,000 years after the Initial Singularity.

The Dark Ages begin when normal matter, which is already present in the universe, having been created out of the SU(2)L field earlier, decouples from the radiation. The cosmos is no longer opaque to radiation like the surface of the Sun, but instead transparent to the radiation. Now the normal matter can separate out from the radiation – can “appear” from the “water” – and form the first stars. (Note that the “dry land” appeared; it was already there.) The phrase “dry land” exactly catches the idea that matter has decoupled from the radiation (water).

The Dark Ages end when so much light has been generated by the first few generations of stars that much of the neutral hydrogen gas between what will become the galaxies has become re-ionized. So the “morning” of the third day begins about 150 million years into universal history, and continues until the intense period of early star formation has ceased, a billion or so years into the history of the universe. Then a new Dark Age will begin, and this will constitute the beginning of the fourth day.

There is another important event that occurred during the third day, according to Genesis 1:11 and 1:12, namely the appearance of vegetation in the universe. Both Abraham Loeb, the chairman of the Astronomy Department at Harvard (“The Habitable Epoch of the Early Universe,” International Journal of Astrobiology, 2014, 13(4): 337-339), and I (“Intelligent Life in Cosmology,” International Journal of Astrobiology, 2003, 2: 141-148) have proposed that life did not begin on our planet but instead evolved much earlier, long before our Sun and our planet Earth had formed.

I was motivated by my reading of Genesis One. I inferred that one-celled plant life must have evolved long before our Solar System formed 4.6 billion years ago, but I could not determine the date of evolution precisely. Loeb does better. He places it in the first few hundred million to one billion years after the beginning of time, exactly where it should be according to my interpretation of Genesis One. I pointed out in my paper that we can partially test this hypothesis. The most likely candidate for this sort of one-cell photosynthetic organism is cyanobacteria, and if so, then we should find such organisms elsewhere in the Solar System, since they would have fallen on other planets of our System, after their travel from the planet of their origin. (The cyanobacteria are blasted off their planet by supernovae.) One can go further. We are told in Genesis 1:11 that the vegetation was “herbs” and “fruit trees” that “bear seed.” Some of the one-cell photosynthetic organisms we find elsewhere in the universe should in some way resemble “herbs” and “fruit trees” in appearance, though being one-celled organisms, they will not be either. (If you look on the internet for pictures of these one-celled organisms, you will find some that indeed resemble “grass;” and others that resemble “fruit trees” with “fruit.”)

I cannot define precisely what the dark of the fourth day will be, but I can define the morning of the fourth day. It will be the supernova or series of supernovae that began our Solar System and the nearby visible stars. We know that most if not all of the stars that are visible to the naked eye were formed about the same time by a nearby series of supernovae in our spiral arm. Needless to say, our Moon and all the other planets of our Solar System were formed at the same time.

The end of the series of supernovae and the start of our Sun’s main sequence begins the morning of the fifth day when multicellular life began in the waters of the Earth. (In verses beginning with Genesis 1:20, “waters” now mean ordinary water, “earth” means the land mass of our planet Earth, and “firmament of heaven” refers to the blue dome overhead.)

The “mornings” of the fifth and sixth days, must, according to the logic I have used to determine the morning of the fourth day, begin with supernova. The “darkness” of these “days” may begin with the Dark Ages generated by asteroid impacts. In this case, the “morning” would begin with the disappearance of the huge amount of dust blown into the atmosphere by the impact and the resumption of sunlight reaching the surface of our planet, a sunrise indeed.

It is often claimed that there are two cosmologies in the book of Genesis, one given in Chapter 1 and the other in Chapter 2. This is not true. The first chapter of Genesis is a cosmology, and the second chapter is a cosmogony. This is a standard distinction made by astrophysicists. A cosmology is a description, including the beginning, of the universe as a whole, while a cosmogony is a description, including the beginning, of a small part of the universe, usually just our Solar System. It is obvious that Genesis 2 is concerned with just the Earth, and the beginning of the human race.

But there is another cosmology in the Tanakh, namely the poetic cosmology in the opening verses of Job Chapter 38, which begins God’s answer to Job, an answer explaining why there is evil in the world. The Problem of Evil, as it is called, is of course the greatest challenge to Judaism and Christianity: How can evil even exist if God is omnipotent, omniscient, and all-good? God tells Job: (38:4) “Where were you when I laid the foundations of reality … (38:7) When the morning stars sang together, and all the sons of God shouted for joy?” God tells Job that the goodness of reality is clear in the very beginning of the universe, and that when we “sons of God” see that beginning – which we are about to do – we will indeed shout for joy. This assertion of the goodness of creation echoes the same assertion in Genesis 1:4, 1:10, 1:13, 1:18, 1:21, and 1:25, ending with the assertion that the entirety of the temporal sequence is good in Genesis 1:31. So why does evil exist?

The usual answer, that God gave us free will and we chose evil, is unsatisfying. There are many evils, for instance being killed or injured by an earthquake, which are unrelated to any choice made by any living organism. I claim that the solution to the Problem of Evil is there in the beginning of Job 38, and indeed, the solution is there in the very first word of Genesis: there are an uncountable number of parallel universes. How does this solve the problem?

First, let us consider exactly what is meant by the phrase, “free will.” If this phrase has any ontological meaning, it must imply that we could have made a different choice than the actual choice we made. But how do we know we could have made a different choice? Perhaps we are merely puppets of deterministic physical law acting in a single universe, having no choice at all, but being manipulated to believe that we do.

The late Princeton philosopher David Lewis, in his book On the Plurality of Worlds, argued that we can truly be said to have had a choice between two options when we have chosen option one, only if there is another universe, every bit as real as our universe, but in which we chose option 2. According to quantum cosmology, such universes actually exist. And I have argued that the first word of Genesis asserts that these parallel universes actually exist. With parallel universes, we can have free will and Einstein’s determinism. Shlomo’s book, And Man Created God, has a nice expression that is very apt: “All is foreseen, but permission is given.”

There is another reason to expect the existence of parallel universes, and this reason follows directly from the goodness of God. In Jewish and Christian theology, God is restricted by absolutely nothing except His own Nature. In Genesis, we read repeatedly “And God said, ‘Let there be …” Creation by the Word of God. Effortless creation, creation not constrained in any way by pre-existing matter, or by physical laws. Utterly different from the creation myths of ancient Egypt and Mesopotamia, where the creation gods worked on a pre-existing chaos.

But God is totally constrained by His Nature, which is good. “Good” as we recognize it, since God has created us to recognize what He considers good to actually be good. He could have set the rules to be different than what they are, but He did not, and this tells us something. So in spite of appearances, there must be some good in the evils we see. So what is this good?

The answer was given by both Plato in Timaeus, and also by the great Christian theologian, Peter Abelard, a contemporary of Rashi. Plato and Abelard argued that God, being good, wants to maximize the amount of good in the reality He creates. Therefore, Plato and Abelard concluded, God must have actualized all possibilities. If an uncountable number of universes is possible, God must have actualized all of them.

In his book The Great Chain of Being: A Study of the History of an Idea, Arthur Lovejoy outlined the arguments of both Plato and Abelard, claimed that St. Thomas Aquinas also concluded that God must actualize all possibilities, and further that Plato used this conclusion to explain why God created anything in the first place. Note that David Lewis also accepted the idea that the plurality of universes gives us free will. I claim that the plurality of universes, which is both the solution to the Problem of Evil and a solution to be problem of free will, is asserted in the first word of Genesis. Both solutions are there in the very first word of the Torah. As is appropriate; without free will, without the possibility of personal responsibility, there can be no moral Law.

I like to imagine (but cannot prove) that Rashi and Abelard debated these issues. Abelard is known to have discussed biblical interpretation with rabbis, and to have travelled widely over France in his youth. Abelard set up his first school in Melun, a town located roughly 100 kilometers down the Seine from Troyes, the city of Rashi. From Rashi, Abelard could have learned that Elohim is a plural noun used with the singular verb bara in Genesis One. Abelard used this plurality in unity to argue that Elohim refers to the Christian Trinity: all three Persons of the One God were involved in creation. From Abelard, Rashi could have learned that Christians believed the pronouns in Genesis 1:26 – “Let us make man in our image …” – again referred to the Trinity. Rashi denounced this interpretation in his Commentary. Abelard would have insisted that the entire Trinity appeared to Abraham. Nonsense, Rashi would have replied. Genesis 18 clearly describes three angels, not a Trinity. A mutually useful interaction between Christian and Jew on theology!

I myself have benefited enormously from theological discussions with Shlomo Shoham. We are both very impressed with the Name of God given to Moses in Exodus 3:14, namely Ehyeh asher Ehyeh, which Rashi, in his Commentary, points out must be interpreted in the future tense. I wrote an entire book, The Physics of Immortality: Modern Cosmology, God and the Resurrection of the Dead, developing the idea of God as the Ultimate Future Singularity. Shlomo is writing his own book on this future tense interpretation, which I shall not comment on, as it has not yet appeared. (But as a hint of things to come, see Shlomo’s remarks on the Final Anthropic Principle on page 7 of his And Man Created God.) I look forward to reading his forthcoming book, and so should you.

Shlomo’s Festschrift book contains articles about the Decline of the Humanities. I think the decline is due to the fact that humanities professors are no longer interested in the Good, the True, and the Beautiful, and thus no longer teach these subjects. In my essay, I have just shown how a careful consideration of the True tells us quite a bit about the Good and the Beautiful. Contra Yeats, the center – physics – holds! Physics has never changed. In my Proceedings of the National Academy of Sciences, 2014 paper cited above, I proved mathematically that quantum mechanics is just classical mechanics made globally deterministic. I had earlier proved mathematically that relativity theory, the theory Einstein preferred to call “absolute theory,” is just constrained classical gravity theory. The center holds! Or to put it in a couplet:

Nature and Nature’s Laws lay hid in Night:

GOD said, “Let Newton be!” And all was Light.

Alexander Pope Epitaph intended for Sir Isaac Newton 1751

It did not last: the Devil, howling “Ho,

Let Einstein be,” restored the status quo.

John Collins Squire 1926

But GOD said, “No! Newton stands, unrefuted!

Albert’s math is just Isaac’s, undiluted!

Frank Jennings Tipler 2007