Posted by: thealienist | May 1, 2013

Foundations of Mental Health: Responsibility

One of the fascinating things about mental health issues is the realization that careful balance that needs to be observed in order to live life well.  One of the issues I frequently encounter in my life, in my patients’ lives, and in public discussion is the balance between responsibility and dependence.  Today, I would like to start a discussion on the side of responsibility.

This post was prompted by several news items I saw online that were addressing issues of sexual assault.  The items were focussed on avoiding “blaming the victim,” and, while I think that this is a very important issue, I think that they went too far in order to spare the victims any responsibility for the situation they suffered.

Whenever responsibility is mentioned in public debate, it seems that there is a tendency to try to place all responsibility on one person or group.  I seldom see public discussions in which the opponents share responsibility for the problems under consideration.  This is a weakness and a willful distortion of reality.  If we want to run our lives well, we need to recognize where we have responsibility and accept it and where we have no responsibility and endure it.  The serenity prayer has a lot of wisdom in it.

For example, one of the items I saw on the internet had a young woman protesting the “rape culture.”  She was standing in the street wearing only body paint that said, “Still not asking for it.”  The point of the article accompanying this picture was that nothing a woman does excuses rape.  I agree, but some things a woman does can increase her risk of rape, and she would be wise to take responsibility for it.  More recently, I saw a news segment in which several panelists were discussing the lack of appropriate punishment for sex offenses at colleges and universities.  One point the panel made was that they did not like the emphasis on women changing their behavior to prevent rape because it “made it seem like men cannot control their sexual urges.”  The backdrop for the discussion was “Don’t Get Raped.”  This remains (in my opinion) an unbalanced message.  Of course rapists are responsible for their rape, and men should be held responsible for their behavior.  But at least some women make themselves targets in predictable ways, and should be educated about the risk they put themselves in so that they can manage their own risk (within limits).  My concern about this is that when we take away responsibility from the victims, we place them in a world where they have no control.

On the other extreme, I have patients who take too much responsibility.  They overwhelm themselves with situations they have no ability to control and duties to those who can otherwise care for themselves.  Some of them have been scapegoated by their families, “friends,” or jobs.  Some build their self-image around their need to be the “caretaker.”  They feel important and needed, but they buy this at the cost of being constantly overwhelmed.

True responsibility, on the other hand, avoids extremes.  Avoiding responsibility leads on to abandon control of one’s own life.  Accepting too much responsibility gives one a false sense of control over one’s life.  To be responsible is to be honest about who I am and what I do.  It is to recognize the choices I have, the motivations I follow, the strengths and faults I possess, and the effects I have on others.

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