Wednesday, April 25, 2012

The problem of evil in psychotherapy

Recently, one of the clinicians I supervise asked me which direction to take with a client struggling with the question, "Why do bad things happen to good people." This is a question that comes up often in the psychotherapeutic session. It can be raised in a multitude of ways--"Why did I get sick," or "Why did my loved one die," or "Why did I have to get laid off?" These kinds of questions are posed frequently in therapy.  Often, there is an aspect of "What did I do to deserve this?" to these questions.

(Side note: I call this issue "the problem of evil" because it  is a philosophical question of how evil can exist in a just world. For those who believe that there exists a God who is omnibenevolent, omnipotent, and omniscient, the problem is often phrased as "How could God allow evil in the world?". However, the problem of evil is not limited to theists--many people believe that "what goes around comes around," or in some other kind of force that rewards goodness and punishes transgressions. The success of the book The Secret shows how much traction there is in a belief that the universe reciprocates our thoughts and actions.)

If we are working in a existential framework, we admit that there are no reasons for the good things or bad things that happen, and it is our own storytelling processes that create such meanings. I encouraged the clinician with whom I was working to examine the client's belief underlying the idea that there are reasons why bad things happen, with the idea that this exploration may assist the client in coming to some kind of acceptance of the things that have happened.

The truth is that the things that happen to us are not a referendum for how we are living our life--our outcomes are not evidence of how good or bad we are. In the specific case brought to me, this client is religious, so I suggested that this clinician would examine this belief in the framework of the client's religion. And, as with any cognitive distortion, I recommended that the client gather evidence to support or refute the idea that only good things should happen to good people.

I'm playing a winning game here and I know it. No religion in the world has failed to address this problem. In fact, a strong case can be made that one of the functions of religion is to address the problem of evil. And many people will find the classical explanations of why there is evil in the world satisfactory--explanations that do not blame the person for the things that have happened. For example, it is often comforting to believe that "God is testing me," or "I'm supposed to learn something from this," or "God never gives us more than we can handle."

But what about those for whom these beliefs are not comforting?

The alternative explanation to the question, "Why do bad things happen to good people?" is that bad things happen to everyone, and selection bias produces our belief otherwise. The world is not just, and misery comes to us all. So in the process of therapy, we could then look at our selection bias, which can be helpful, but it does not address the larger and more frightening reality that we live in a world that is not just.

Frequently, there is no answer to the question "What did I do to deserve this?" Somethings things just happen to us for no good reason. And while this can be comforting in one way, as it relieves us of responsibility for actions which are truly beyond our control, it can also be deeply terrifying because it may lead to the conclusion that the world is chaotic, painful and unpredictable.

For example, think of a child that assumes control for the condition of her family, her parents' relationship, or even abuse or neglect. Of course a child has no control of any of this, but it may be easier to assume that one has control than to face a world which can be painful for no good reason.

And so it can be difficult to face a world in which bad things happen to good people--or even simpler, in which bad things happen--and mitigating that difficulty is sometimes the object of existential psychotherapy.

While it may be terrifying to face a reality that the world can be a dangerous, threatening place, it is also redemptive. Facing this difficulty reality allows for a person to take responsibility for the things that she or he can actually have responsibility over. I can take responsibility for the ways that I act, or whether/how I accept my life circumstances. I can stop tilting at windmills and I can take responsibility for the things that I can control. Instead of believing, "If I do good things then only good things will happen to me," I can instead consider how I can best exist and thrive in a world in which things both good and bad happen to us.





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