I usually listen to National Public Radio when I’m doing my Saturday-morning shopping, but the thought of having to hear the oliagenous Krista Tippett sometimes drives me away, and today it drove me to an even more religious station—Moody Radio Chicago. It’s a production of the Moody Bible Institute, a famous evangelical Christian seminary and educational center in a big building downtown.
I listened to all kinds of nonsense, like people calling in and asking if God would still hear their prayers if they called him “Yeshua” (the host said “yes,” that God knows all languages—though I’m not sure what would happen if you called him “Allah” but he was really Yahweh). It’s actually quite interesting to hear how deeply people are steeped in their delusion. (Another caller asked whether it was necessary to pray with your head bowed.)
What made me ponder, though, was some stuff said during a break during. A drug addict—a guy who had taken and manufactured methamphetamine—testified about his recovery. He was once completely absorbed in meth, and, he said, neglected his kids and family. And then he got into a recovery program and, with the help of Jesus, he claimed that he was made whole and is no longer addicted to drugs.
So I thought to myself, “What if believing that Jesus was there for him really helped him get off drugs, even if Jesus didn’t exist and the whole Christianity thing was a scam?”
So here’s my question: suppose that someone did a scientific tests of two programs that purported to get people off drugs: the best non-religious program (you’d have to consult experts on this) and the best Jesus-based program)—and you found that the Jesus-based program had better results? Remember, this is just a hypothetical question? You can also couch it like this: “Suppose adding Jesus to the most efficacious secular program improved its cure rate even more?”
Suppose you’re a drug counselor. You want people to kick their addictions to harmful drugs like meth. But you don’t believe in Jesus because you’re an atheist. My question is this: Would it be okay to lie to your charges about Jesus if it helped them get off drugs?
Now don’t mess up the answer with stuff like, “It wouldn’t help” (my question is a hypothetical), or “we haven’t yet tested all alternatives.” I’m talking about what one should do now in the face of existing evidence. (I repeat that there’s no evidence I know of that religion helps—but it could!)
I’m going to dodge the significant question for at least a moment while I point out that right now, as I type, the Metropolitan Opera has just begun its regular weekly live matinee broadcast. Today it’s Offenbach’s Tales of Hoffman.
If you’re going to listen to the radio on Saturday — and that’s the only time I ever turn on the blasted contraption — that’s what you should turn into.
Most NPR-affiliated classical radio stations have live Web feeds if you don’t actually have a radio (which I don’t any more).
b&
I’ve always felt like religion would be completely unobjectionable – even positively joyous – if everyone could reach the point of agreeing that we start out by assuring each other we’re pretending, and we do it because we like to pretend. (Brochures would cover this in their “what’s this church about?” intros. Pastors would tell new members; parents would introduce their religion this way to their children.)
This is what we already do with books, movies, theatre, video games and… well, what we already just call pretending. And that stuff can be so fabulously fun and fascinating to its enthusiasts that it can change their life.
I imagine that would be an unobjectionable parallel. (“Patient, we’ve found some people really love pretending Jesus is helping them that we’re offering people who will both support you and pretend along with you.” Perhaps a bit of a shift would have to have occurred in some people’s thought so that this would necessarily sound considerate and not condescending.)
Tangentially it reminds me of Dawkins’ occasional reference that there are some who would prefer their doctors to lie to them about their actual medical condition. People’s preferences are real.
I know that isn’t quite what you’re saying – you’re suggesting not even going that far and just pretending without saying that’s what’s happening. That, I just… don’t think is conscionable, even with evidence. So, ultimately I suppose my answer to your specific question is no, I don’t think so. Others, please attempt to devastate me with hypotheticals if you like.
I was thinking along these lines too – and about parallels with placebos. The placebo effect is well known and robust but is it acceptable to lie to patients about the medication you are giving them? Apparently, you can often tell the patient that it is a placebo, but has helped many people, and still get a decent effect. So perhaps something similar would work with the Jesus effect.
Off topic so I won’t pursue it here, but this is incorrect. Placebos have very little objective effect at all and then only for subjective symptoms such as pain and nausea. And there is no evidence that telling people they are being given something that doesn’t work helps. The studies that seemed to show this are flawed.
I admit I don’t know much about whether the placbo effect still works when people are told they are taking a dummy pill – you may well be right that these studies are flawed. But if placebos have an effect on subjective symptoms such as pain, nausea or depression – that is surely still an effect.
Subjectively they feel better but objectively they do not. In other words, they think they feel better when, in actual fact they do not.
More often they merely report that they feel better when they actually don’t.
If a placebo makes you feel as if you can breathe easier but objective measurements show your lung function is unchanged, then you are not better, no matter how deluded you are into believing you are.
If your condition is asthma it could even be a fatal delusion.
And for depression?
Billy Joe: sorry, if I am seeming a bit combative this morning. And you are right that we are off topic. Anyway, I basically agree with you about objective measurements and certainly it could be dangerous if a patient felt better when they actually weren’t as in your asthma example.
Dr. Ben Goldacre has some videos regarding placebos. In the link below, while discussing comparing placebos against each other, he says “we know that four sugar pills a day, four dummy pills, are better than two sugar pills a day at clearing gastric ulcers”. And it’s measured objectively with a camera.
He also says that the placebo effect works even on skeptics. This suggests that telling someone that Jesus doesn’t exist, but also saying that it helps some people, shouldn’t cause loss of the effect (if there really is such an effect with religion).
He also touches on the ethics of treating patients with placebos – lying to them: he’s against it. He says when word gets out it undermines the credibility of what you say.
Sorry that the video imbedded itself and you have to link to youtube to see it.
The problem here is that he is referring to clinical trials. In clinical trials, everything not due to the active ingredient is lumped under placebo. It includes such things as regression to the mean. There are also methodological flaws such as selection bias, hawthorn effect, operator bias, reporting bias. And the authors’ conclusions don’t always accurately reflect the results of their studies. As I said, it’s complicated.
By objective effect, do you mean a measurable, physiological response? Or just that it must lead to a physiological response in it of itself, independent of our subjective beliefs (i.e., engagement of specific physiological pathways), to be considered objective? At first glance it makes sense that the placebo effect would only be useful for “treating” symptoms, such as depression, that engage or are connected to the same physiological pathways that a belief in something engages, though defining what is and is not connected may be less obvious. And, if there is a Placebo effect, it must be real in the sense that it does have a physiological response. I faintly remember a paper way back when (I forget most of the details, and I’m sure there’s many more recent papers on the subject) involving placebos and opiate receptor agonists and antagonists showing that a placebo indeed had a physiological effect–which of course it must to “work”, but I found it fascinating all the same.
I much enjoyed Steve’s response. My initial reaction was, very much along the lines of what I was thinking, but of course it wouldn’t work because, as BillyJoe pointed out, how could a placebo work if you didn’t “believe” in it, since the whole basis of the placebo effect depends in your belief that it will work?
But then again … The movie point. I will hear in the news that 15 innocent children were killed in a terrorist attack, or that hundreds were killed by a disease outbreak, or that a plane crash killed 121 people, and I will be saddened and sometimes even outraged, but then I’ll watch some animated movie about a completely made up robot or even a toaster, and its eyes will move in a sad way, and the music will play, and suddenly I’m balling, I feel such a deep connection to this character that is not only made-up, but not even an actual life form! It doesn’t matter that I know the news is real and that the movie is made up, my entire physiology is much more moved by the movie that I know is not real. And for this, I bet that we do find (or have probably already found but I’m not aware of it) indication that the placebo effect works even when we know it’s a placebo effect.
I’m not for all out lying to do what’s “best” for the patient, because, as mentioned by readers below, this breaks the integrity of the doctor and our overall trust in him or her. But I wouldn’t be against allowing or even encouraging a patient to hold a belief in Jesus if it helped them. For example, saying Jesus is real and he’ll guide you to recovery! Because this was shown to help a patient even though you knew it was a lie, is dishonest and would, in my opinion, lead to an overall negative consequence even if individual response was, at least in the beginning, positive. But something guiding like, “Have you thought about going to church? I know that this has helped some of my patients in the past.” Would be perfectly acceptable.
And, because of the “movie” I know it’s false but I experience it anyway placebo effect, I think that Steve’s idea of encouraging all of the positive attributes of church–community, happy singing, potlucks–but taking away all the problems that result from the ideologies that result from believing that it’s true, would be really useful in this case and in many others.
Could you please keep your comments shorter than this? I am looking for comments, not essays. Thank you.
To be honest? I’m all kinds of accommodating if I don’t have to lie personally. If someone in those circumstances claimed that Jesus transformed their life, I’m unlikely to challenge them.
That’s a bingo!
This question is similar to a post a month or two back, where the topic was a “what if” about empirical evidence that belief resulted in better outcomes. If the evidence is there, you have to acknowledge it – ie, the answer to this post’s question is “yes,” I think – but you don’t have to do the lying part. Refer the patient to the more effective treatment.
This seems like the same ethical dilemma presented by a physician’s decision to prescribe a placebo (and, after all, isn’t that what god really is in this context?). However, I think I would have less of a moral objection to prescribing a medical placebo than a “god” placebo, because the god placebo has so many more potentially serious adverse effects.
Warning: Side effects may include weekly boredom, perpetual anxiety about ending up in Hell, hostility towards people on different treatment plans, and insufferable politics. Do not stop taking any other medications your doctor may prescribe for this or other conditions. In rare cases, inquisitions, torture, burning at the stake, and crusades have been reported.
lol
Lol, indeed.
It’s more like the ethical dilemma in prescribing a placebo which isn’t a little sugar pill, but an alternative medicine ‘remedy’ which comes along with an entirely new and anti-science world view. Science-based medicine advocates go into this issue a lot. The adverse effects of getting into the alt med crowd and their conspiracy mindset is potentially life-changing and even life-ending.
On the main topic…I assume that, for the sake of the discussion, we’re taking it as a given that a belief in Jesus would actually be beneficial for recovering from substance abuse.
I’m first compelled to note that is a most extraordinary claim that I’d put right up there with Jesus curing emphysema from tobacco use. I’m at a loss to imagine a mechanism by which the physiological changes in one organ that lead to one disease would be susceptible to Chopra-style magical thinking but not another organ.
But, again, you’re asking us to set that aside to consider a different aspect of the question.
At this point I find two stumbling blocks.
First is the practicality. Let’s say that we discovered that faith in the Invisible Pink Unicorn (PBUHHH) was even more effective than faith in Jesus. Again, never mind the plausibility; take it as a given.
How realistic would it be to convince your typical drug addict in the reality of the Invisible Pink Unicorn (MPBOHHH)? If you play it straight, the patient will think you’re nuts. If you tell the patient it’s a mental exercise, that She isn’t real (even though She is, of course), some might go along with it and others won’t…but, at this point, what’s the benefit of picking one particular deity over another? Why Jesus, in other words?
The second is that we would also have to consider the negative consequences of such a belief, and I’m afraid I find those not merely substantial but overwhelming.
We could, again, of course, pretend that there aren’t any, in which case it’s not obvious that there’s any down side to this sort of deception. But, in the case of Jesus especially…well, that goddamned motherfucker is one of the worst sociopaths in all of ancient fantasy. He’s the “judge” who’ll send all who don’t kiss his ass in just the right way to be infinitely tortured by his brother. He’s the one who commanded his followers to kill all who won’t accept him as their king, and who’s prophesied to do exactly that himself “any day now.” He’s the one who’s come not to bring peace but a sword, and to rip families asunder — especially the ones who have the audacity to love each other more than they love him. And he’s even the one who, in the introduction to his most celebrated speech, condemns to hellfire all men who’ve ever admired a beautiful woman and failed to instantly gouge out their own eyes and chop off their own hands.
So, no. I could maybe buy the effectiveness of creative visualization techniques, but belief in Jesus is all but guaranteed to be worse than the disease it’s supposed to cure.
Cheers,
b&
I was tempted to think similarly that the costs would outweigh the benefits. But I am not sure that is necessarly true. What if you turned the question on it’s head and asked whether it would be beneficial for someone to be disabused of his religious beliefs at the expense of becoming a drug addict?
I am sure I can think of some religious friends whose lives – and the lives of those they influence – would be considerably worse.
In that case, permit me to turn the question on its other head.
What if the solution to drug addiction wasn’t Church of England style Christianity but rather to enlist in a brutal mercenary army and kill at least ten enemy soldiers in combat?
The Jesus delusion carries with it potentially dire societal consequences — witness the Inquisition, the Crusades, the Holocaust…if I could have turned all the Christians in the Nazi Party wearing “Gott Mit Uns” belt buckles into atheists at the cost of addicting them one and all to marijuana, you bet I would.
b&
Ben, I pretty much agree with you. I think there are an awful lot of downsides to religion. And yes, of course, if the answer to drug addiction was to enlist in a brutal mercenary army then I am unlikely to consider that a good idea.
But seeing as you mention Church of England-style Christianity, would you want your friend to reject that if it meant he became a drug addict? Perhaps you would and I am not sure that I wouldm’t agree with you. But I am not sure that I would.
I’m having a difficult time imagining a causal chain that would lead from somebody abandoning a CoE-style Christian faith and getting addicted to drugs. If I could get past that, I might be able to consider responding to your question…but the best I can come up with are the typical bizarre Christian fantasies that include atheists sacrificing babies to Satan.
b&
Well, it is a kind of thought experiment, I guess.
“And he’s even the one who, in the introduction to his most celebrated speech, condemns to hellfire all men who’ve ever admired a beautiful woman and failed to instantly gouge out their own eyes and chop off their own hands.”
Yep, must be that “original sin” that causes male fetuses to have erections in the womb. And the expectant mother thought that that was a kick of the foot. 😉
Could you give me chapter and verse? (Never thought I’d use that phrase in its original meaning.)
Re Church of England-style Christianity: my local vicar describes himself as an agnostic, and his wife as an atheist.
Assuming that’s directed towards me…this would be the vitriolic hate speech in question.
Most loverly, ain’t it? Exactly what one would expect of a love god!
Cheers,
b&
All this cutting and gouging would have at the time been tantamount to suicide… Which is contra-indicated by some other verse(s).
The Jesus thing is of course much wider in its implications than a placebo as has been pointed out by several commenters. But placebos themselves are dangerous in a similar manner, as they can be recommended to friends, without the contexts–medical study participation for one–that have been shown to make placebo effective for some.
When I did my psychiatry clinical rotation in the infamous Bellevue (no longer in operation, though some ‘nut’ try to convert it into a luxury hotel a few years back) back in my cobwebby past, my instructor advised that when talking with a delusional patient, you say something in the lines of, I accept that it your belief, but it is not mine. To this day, I use that approach when speaking with people who are adamant that non-evidential belief helps them.
Research is pointing out that holding delusions does help some live a better life for a certain kind of mind set, one that entertains a magical view. This perspective runs on a spectrum. This type can flourish in one culture, but flounder in another.
If you find abandoned mental institutions fascinating, feast on your eyes on Bellevue: http://www.scoutingny.com/the-creepiest-hospital-in-manhattan-arkham-asylum-in-nyc/
Fascinating link.
If the Jesus believe would help them get off the drugs, sure. I would say go ahead. If believing in fairies helped improve the rate, go for that too. It is the drug that will kill them not belief in some illusion.
I’m told the religion thing does not actually help with the AAA program but there I would say the same. If it somehow helped them get off the alcohol, go ahead.
“I’m told the religion thing does not actually help with the AAA ”
Sure, secular power can tow your car just as well as anyone.
lol
Shades of ad hom, but I’m suddenly curious if the incidence of auto accidents is higher among cars that sport a “Jesus is my copilot” sticker than it is among cars in general.
Jen Peeples of “Atheist Experience” tells a story about being a pilot in a plane when something went wrong. Her co-pilot (not sure which of them was supposed to be in charge) basically let go of the controls and covered her face with her hands to pray, leaving Jen to bring the plane in to land and save both their lives. The other pilot’s faith nearly got both of them killed.
I remember sitting in CofE Sunday School one Sunday morning about 80 years ago and listening to the vicar’s wife, Mrs.Woodyatt, tell us that if we didn’t close our eyes when we prayed, our prayers wouldn’t get through the Parish Hall ceiling. They would bounce back down and land in our laps and god would never hear, nor be able to answer them – Jesus H. Christ !!!!
Somewhere in Mark Twain’s autobiography is the story of the origin of the ‘H’ in Jesus H. Christ.
There I go. I asked for Chapter and Verse in a previous comment but don’t give it myself.
Some doctors face a similar question everyday. Acupuncture has been shown to be 100% placebo: You can use toothpicks instead of needles, and poke people wherever you want, as long as you do it convincingly, and get the same results as ‘real’ acupuncturists.
And yet, patients undergoing cancer treatment, for example, get real relief from their suffering with acupuncture.
It seems to me that it would be harder to recommend Jesus than acupuncture simply because Jesus comes with a lot of extra baggage that has negative consequences for society as a whole. Acupuncture, at least, has no side effects.
Again, off topic, so I won’t pursue it here, but you are incorrect. Acupuncture has never been found to be objectively useful for any condition. Period. If you want to pursue this can I recommend the following reference:
http://www.sciencebasedmedicine.org/category/acupuncture/
The potentially dangerous side-effect of acupuncture is, as I already mentioned, the possibility that it could act as the gateway drug for alternative medicine in general and the full-blown anti-science conspiracy mindset in particular. Alt med is its own religion, drawing heavily from vitalism, magical thinking, the naturalistic fallacy, and other spiritual assumptions.
It’s one thing I think to inform patients that there’s no good scientific evidence but it’s available for psychological props if they want it, some have liked it; it would be another thing to push its benefits as proven in order to strengthen the placebo effect.
I had acupuncture for pain about twenty years ago. It helped sometimes. On one occasion is was given incorrectly, and it was excruciatingly painful. The agony lasted for hours, and I thought the needle was in long after it was taken out. I’ve never tried it again.
Given Jerry’s scenario, I think it would be okay to lie, but better if later, it would be possible to contact those for him it was successful, and tell them the truth.
I think the truth is paramount.
The first 16 years of my lfe were based on a lie and I haven’t yet forgiven those who lied to me. Which is why I love listening to people like yourself, Christopher Hitchens, Stephen Fry, and Bob Geldof excoriate religion. Payback!
There are circumstances where I would not disabuse someone of their delusions, such as someone with a terminal illness, but I would never even contemplate encouraging these delusions under any circumstances.
A large percentage of the population already have life determining/destroying delusions and I think it’s time we all grew up and got over it. Our kids never believed in god and never discus anything to do with religion because it’s such a non issue with them.
It’s not exactly like prescribing a placebo. Placebos are inert. They are not dangerous to the recipient or society in general. One could argue that strong religious beliefs are harmful. Even if the potential benefit outweighs the potential harm for the individual, the doctor must also consider the public health implications. Obviously no one considers religion a public health issue. I’m just pointing out why it’s not a pure placebo situation.
By the way, some studies have been done on this. Religion based rehab is not better and may be worse than secular rehab.
Again this is simply not true. Placebos can definitely be harmful. People use placebo treatments all the time for serious illnesses and convince themselves for a time that they feel better. Some die because they have taken these placebos instead of treatments that could have actually saved their lives.
In Africa re the AIDS epidemic, religion is definitely considered a public health issue (Pope says don’t use condoms).Combat that religion there and presto AIDS cases for the whole public go down.
Not unless you’re a very, very good liar. Drug addicts tend to lie, a lot.
You can’t bullshit a bullshitter.
you can. But you need to be a pretty damned good bullshitter yourself.
Frequently it makes life simpler all round it the bullshitters can agree a common mutually beneficial course of action to impose upon the bullshittees. Or, as we call it at work, “politics”.
Concur. I’ve dealt with a couple of such con artists in my life. It was enough. A good, perhaps necessary, though painful, experience.
“Experience costs me more than I think I should have to pay, but I can’t seem to get it for any less.”
Anonymous Methodist Minister
No, I still w/couldn’t do it. Help or not it would be like moving the goal posts from one dependency to possibly another. I see no overall long term benefit.
“I … used … to .. be … addicted … to … drugs… now … I’m … addicted … to … Jesus.”
Exactly my thoughts.
One of the likely reasons religion may help some people deal with chemical dependency is because it’s simply a replacement. It’s a lot like a drug that can help you dive deeper into denial, that can numb you to reality. It’s no coincidence Marx likened it to an opiate.
Real solutions to problems should be as rooted in reality as they can be. Whatever the actual cause of the dependency is should be dealt with straightforwardly. Pretending the problem isn’t there by applying a Jesus bandaid is not a real solution.
Well, it seems we’re not on the same page after all.
I have a 40-something-y.o. nephew who was a crack addict and spent 5 years in prison for armed robbery. He’s now born-again, married, and working hard in construction. The whole family’s always been so lacking in critical thinking that I can barely bear to be around them, but I’d still say nephew is less of a threat to society than he used to be.
Reading your response to me at the bottom of the thread and Mr. Muth’s after writing the above has me rethinking the matter.
I suppose the best I can actually say, having no real-life experience with the issues surrounding this matter is that I don’t know.
But neither do I think one can just wave away the “effects on society” argument. If turning people xian were adopted as a protocol for addiction treatment, that’s potentially a lot of new xians walking around out there, doing all the awful things xians do that we complain about. The chances it would have an effect are pretty good, it seems to me.
One can indeed imagine ultimate effects that supersede proximate ones.
Where I think a lot of these intellectual discussions go wrong is in assuming (tacitly, not overtly) that all people are capable of becoming critical thinkers who can afford to and can handle thinking philosophically about life. That’s not my impression of our average citizens. It’s all well and good to say everything would be skookum if we could only get them to that state, but I can’t see how that’s ever going to happen. It could be that accepting/tolerating some benign, liberal version of religion that results in the best outcomes for some individuals might be a sort of least-bad intermediate step toward our ultimate goals.
I don’t see that as quite the same as accomodationism. Gnus at the same time need to keep working to improve educational and economic inequalities so that maybe more people will have a chance at intellectual development.
If you’ve read Hirsi-Ali’s Nomad you will remember that she advocates encouraging liberal Christians to essentially evangelize Muslims, reasoning that it would be an easier transition than to expect fundamentalists to jump directly to humanism.
Erm…that’s the “Little People” argument, and empirically refuted by Scandinavia and Japan.
At the least, whether or not they’re better at critical thinking in those countries than here, they certainly don’t need primitive superstitions to make it through the day.
b&
Well, I don’t think the “little people” argument is always in error. But by all means, do the experiment–find your nearest group of fundamentalists and start explaining the error of their ways to them. Let me know how it goes. 😉
Just because one-on-many deconversion attempts are likely to result in rioting doesn’t mean they’re doomed to their ignorance. Can you imagine what would have happened had you attempted to deconvert, say, a typical anti-Semitic Lutheran congregation in Denmark a couple centuries ago? Yet, today, you might not find very many believers even amongst those actually in the exact same pews on Sunday mornings these days.
b&
We are talking placebo effect. And greater the belief, the greater the effect. If a person truly has a belief in Jesus and that that would really help, there is going to be benefit. If an animist was in treatment and felt that a Power Animal was helping, you would get the same effect. It is a matter of belief, as long as that belief is stronger than the belief in the need for the addictive substance. The placebo effect has been shown time and again.
Okay, this is getting repetitive.
What you said about placebos is false, but in a complicated way that is not easy to express in a few words.
If you are interested, here is a reference:
http://www.sciencebasedmedicine.org/?s=Placebo
What exactly are you claiming is false? I agree with what you have previously said: that it can be dangerous to take a placebo if it means that you neglect to take essential medication for a serious disease; and it may well be true that the placebo effect vanishes when objective measurements are made; but are you saying that there is no such thing as a placebo effect? Nobody denies that the placebo effect is usually (always?) an effect on subjective measurements.
Sorry, I was commenting on this bit:
“The placebo effect has been shown time and again”
Which I took to mean “shown time and again to be useful”. It is not useful. The effects are small and short lasting. It cannot be used as a treatment for any disease.
I’m not so sure about that, not always and in in all cases, that is. We simply know too little about the placebo effect, it exists even in d*gs.
Are you certain? Got any links or details?
The big problem with “the placebo effect” is that it’s probably not just one effect but a range of biases, statistical manipulations, wishful thinking, reversion to the mean, the Hawthorne Effect and other confounding factors. It’s not just mind-over-body or feeling better, like Chopra seems to believe.
So when you say there’s a placebo effect in dogs, I become highly skeptical. Have you ruled out all the human biases in the people observing, rating and analyzing the results first? If the study wasn’t blinded to the observers, it becomes very easy for the humans to bias the results even if there was no change in the dogs or if the change had nothing to do with the treatment or the placebo. For instance, an older article about blinding, placebos and dogs: http://www.sciencebasedmedicine.org/is-there-a-placebo-effect-for-animals/
The ‘placebo effect in dogs’ is from Ben Goldacre’s “Bad Science”, but I lent the book (never to see it again), so I can’t give you his source. It think it is plausible it is indeed for a great part, if not entirely, induced by their handler’s expectations.
Nevertheless, exactly as you say (and that is what I meant), the mechanisms of the placebo effect are not well known, lots of speculation, very little hard evidence.
It is a useful notion though, since it allows -nay forces- us to study which effects of a treatment are real and which are not: for effects to be considered ‘real’ they must do significantly better than ‘placebo’.
Aw, come on, a few more times and it’ll be a running joke…
No, I’m done. I left a link for anyone who is interested.
No, I would not lie to a patient about the nature of reality even if I thought it would aid their recover from drug addition. While I suspect that delusional personal beliefs can have some positive consequences, I also suspect that furthering the notion that faith is a positive attribute is deleterious to society as a whole. A person convinced that Jesus is their personal God is ripe to be convinced of any sort of evidence-free nonsense. For example, there’s a positive correlation between those who accept Christ and those who believe that evolution is a lie, abortion equals murder, climate change is a hoax, and sending money to preachers can cure disease. However, even if there were only immediate positive consequences of delusional beliefs, I’d still rather live in a society that attempted to deal with reality as it is. In the long run it seems clear that the survive of our species depends on maturing from its current infancy, of which religious belief is a central characteristic. Lying to anyone about Jesus only retards that process.
For sure. You needn’t even lie. You could just say, after feeling out the attitude to religion of the person. ‘Use your religion to help. There is quite a bit of evidence etc. And don’t take the attitude of guilt, but confess honestly and bring up your deepest wishes in the matter and present it to Jesus who is the manifestation of unconditional love etc’ Such practices work on the mind and diminish the tendency to hide from emotions and the mess you might be in and maybe wallow in hopelessness and self pity.
Well all folks are different and you might have to be quite ingenious especially if you are asked why you yourself don’t believe. But some version of the above tends to give people the ‘belief’ that it is not only an uphill, endless lonely struggle-but there is some source of goodness.
I might have trouble outright lying but if I genuinely thought it would help then I would.
No.
Hasn’t AA performed this experiment? What I’ve read is that the organization isn’t particularly effective.
AA refers to a ‘higher power,’ not usually to a god. AA has and does work for some, but not all.
“AA has and does work for some, but not all.”
So does doing nothing, so that doesn’t undermine my statement.
I think AA may be more effective than doing nothing; NarcAnon, too. I do know people who have been turned around by each of those programs, but then the program may be a MacGuffin: what I mean by that is for the individuals for who it works, placebo style, maybe their wiring-for-addiction would have been as easily helped by medical intervention, and also maybe the lifestyle changes (acknowledging the addiction, living “one day at a time,” ending enabling in their family and social structure, the influence of sponsors) would be equally effective for that person with or without the “higher power” business. I wonder if secular humanist / atheist 12-step programs (they do exist) have any different outcomes compared to the goddy original? Not googling it now because this is a granted time hole, but now I’m curious.
“I think AA may be more effective than doing nothing; NarcAnon, too. ”
Most people quit on their own, which is what I call “nothing”.
The figures provided by AA are normally shown based on people who complete the program. But if you look at the data based on who started the program, the success rate falls dramatically. This article says the success rate is 1 in 15:
http://www.theatlantic.com/health/archive/2014/03/the-surprising-failures-of-12-steps/284616/
And NarcAnon is the Scientology program….
Thanks for the info – I did not know that about NarcAnon! Wow.
AA means the Christian god, they replaced the reference with “higher power” to get gov’t money and more sheep.
AA is not a treatment, and carefully avoids saying it is, just sort of doing it by innuendo.
You don’t even need to lie. At least one study indicates that prayer helps with self-control even if you’re an atheist. I think the hypothesis for why was something about engaging brain processes ordinarily engaged by talking to somebody about your goals. I think I saw the study discussed by Thomas Rees on Epiphenom.
Here’s the link.
http://www.patheos.com/blogs/epiphenom/2014/03/can-prayer-improve-your-self-control.html
legal9ball,
I think the study could have been done better. Why not test “free thought” against not just prayer, but also meditation, chanting, deep breathing, or really any exercise that calls for concentration of some sort?
I remember in summer Vacation Bible School, in the Southern Baptist church of my youth (age 9-12?), one morning the pastor holding forth on Dwight Moody. Of course, impressionable children are not going to hear anything negative from the pulpit about the featured luminary. As a youngster, one knows only what he is told.
Not quite an answer to this question, but as a psychotherapist I inevitably have had many patients who have been religious. They very often insist initially on knowing about my religious beliefs, a subject on which I remain silent, mainly because it is often useful in psychotherapy to find out what people imagine when they do not know.
In any case, in the case of addiction or other kinds of psychological vulnerability, I cannot see the point of stripping away the illusions or props that help people to get through their lives (we all have them, though they may not be as obvious as religion). In our starkest moments, life can be reduced to a few moments of pleasure between one oblivion and another. Some people are comfortable with that knowledge, others find it intolerable. It is no more my duty to bring people to that truth, than to the “truth of the risen Lord”.
“props that help people to get through their lives”
Perhaps they could develop more inner strength if they didn’t have those props? Religion tends to encourage helplessness and I would think that a therapist would want to encourage people to feel in control of their lives.
Religion also offers false hope, so while the hope might get them through one difficulty, they end up having to see their hopes dashed.
A woman I know told me that she was praying that her relationship with her son be repaired. I pointed out that she might have more success if she took action in the real world, rather than relying on a supernatural agency to repair damage that she had caused. She didn’t take my advice, of course, because prayers are much easier than actually doing something, but she would be better long-term to have her props taken away from her.
God did listen to her prayers, and he sent Greg Esres to help her out with a bit of practical advice. Apparently, she refused the help he sent her, and this will be pointed out to her when she reaches the pearly gates.
Checkmate, atheists!
Yes but remember — Everyone is a Christian even if they don’t know it!
Lol!
I agree, but the question wasn’t about actively interfering with their beliefs and stripping them away. Not the way I interpreted it, anyway. It’s about creating these beliefs — new beliefs — because in your wisdom you think it would be more effective to install and make use the religious mindset.
That’s a different issue.
I have a friend who went to a therapist and was told all about this wonderful New Age-ish church (Unity) and eventually invited to the services. The therapist drove her. My friend said it was so loving of her therapist to offer this. They became friends.
I told her it was unethical. Flat out. This astonished her.
I don’t know how heavily she was into woo before, but she is steeped deeply in it now. She believes things that aren’t just ludicrous, but rather scary. She’s become a lay therapist herself, a “spiritual counselor.”
In the absence of a social network that encouraged the belief, I doubt it would make a difference. Unless a person grew up with wolves, they would know before starting to use drugs that there is a cultural belief in a deity that reads minds and watches what you do. So acquiring or re-acquiring that belief won’d do the trick.
Being surrounded by a supportive group of people (church, group therapy, Narcotics Anonymous or whatever) would be 99% of the recovery. In a moment of weakness the thought that they could cheat and nobody would know could be downplayed by “Jesus would know” but it could also be downplayed by “You would know.” And the power of peer pressure could still work even in those moments of weakness. If there’s a 24/7 phone line that would eliminate the need for a supernatural eavesdropper.
Of course it would make sense to encourage and support Christian therapy to overcome a serious addiction problem, if it worked. What’s the down side in this hypothetical?
If it works, use it.
Now, would I be prepared to lead such a clinic and lecture patients? No. I’d leave it to the many Christians willing to do the reprehensible deed for me.
But notice, that it is unlikely to be effective if the patient is not already strongly inclined to belief. Thus, a reasonable approach for a clinic would be to provide two avenues of treatment. One Christian, the other not.
I think I remember reading somewhere that AA actually had established a secular alternative to what is normally a Christ-centered program.
The hard part of the question is not whether you’d accept it, offer it, or encourage its use to someone who was already religious. It’s whether you would do those things even if they weren’t already religious, based on the idea that changing their beliefs about God would help.
The down side is that the therapist isn’t neutral anymore; they’ve become an advocate and their client is in the role of convert. They’re also consciously lying.
In that case no.
Is there a Sunni or Shia version of AA? Zoroastrian? Shinto?
AA requires members to correct their “sins” rather than pray for forgiveness, so it’s not as Christian as people think.
AA tells people that the only way their addiction can be controlled is if they completely subjugate themselves to God, by whatever name. That it is not possible for their addiction to be controlled unless they do so.
I have seen this first hand several times, and it isn’t pretty. I personally find it disgusting and dehumanizing. Largely because I am nearly certain that it is completely unnecessary to dehumanize people to help them beat their addiction.
I don’t mean to claim that my few first hand experiences are representative of all AA programs everywhere. I am sure some are less bad than others.
Short term, win. Long term, lose.
Community draws people more than Jesus. There is power in numbers: when believers flock together their power is greater than the sum of their parts. Dangerous, but true.
If all you have is a 55 mm lens, all your depth of field and panoramic “epiphanies” are going to be restricted. It’s like having a filter that only lets in so much light and/or background data. However, if you have a wide angle or zoom lens, you have access to a broad spectrum of experiential realizations. Therapeutic breakthroughs attributed to religiosity provide a limited range coping skill that will invariably lead to disillusionment, co-dependence, increased anxiety, and cognitive dissonance — despite any short-term efficacy. This is why Christian “counseling” is, ultimately, an oxymoron.
Not OK. Jesus is just another drug.
I honestly believe that if religion, Jesus or any other helped, long term, we would know – lot of people attending churches and professing belief. I think all programs, including religious counseling (AA and higher power included) help initially, if someone is really seeking help, but the best help, again, long term, comes (whether religious or not) from people mentoring others. That’s how AA really works, in my opinion – the sponsors.
I am a social worker and from friends in my youth, who became ‘Jesus Freaks’, to observing people throughout my career – the folks who helped others (even and including preaching) were the ones who stayed straight the longest.
And it’s HoffmaN not Hoffma – my dratted keyboard!
I am wondering what the answer would be if the question were turned on it’s head. If you had a religious friend who could be disabused of his relious beliefs at the expense of becoming a drug addict, would it be worth it?
It’s hard to know how to take this hypothetical. If it’s belief in Jesus specifically which helps people then this might be evidence that this religion has some truth, in which case it wouldn’t be a lie. At the very least, you could say truthfully that belief in Jesus and believing that Jesus helps you will improve your outcome. So no need to lie.
In general, lying will harm the relationship so if we’re talking doctor-patient, or counsellor-patient, then trust and a good relationship is probably far more more important than any effect, so I’d still favour telling the truth. Perhaps there’s a way to get some of this specific outcome while still being honest? And those people that already believed in Jesus could be funnelled to Christian counsellors so they’d get the full effect without a “lie”.
My hope is that if there were significant (statistically & clinically) improvement we would investigate a lot more to see why it happens rather than merely giving in and telling a fairy tale to patients to gain some short-term advantage, at the cost of long-term mistrust.
This is my take as well.
Consider an alternate hypothetical in which it’s not Jesus but Dr. Zog’s Magical Mystery Potion that yields the enhanced cure rate. Surely before putting it into widespread practice we’d want to analyze the potion to try to isolate the specific therapeutic agent and determine why it has that effect. So why should the Jesus Cure be exempt from that sort of detailed deconstruction and validation?
I don’t see this as primarily a “placebo” argument, although it definitely overlaps with that. Because of the powerful behavioral/environmental component of addiction, this feels very different from, say, “Would you encourage cancer patients to believe?”
Particularly if someone is in substance-abuse treatment, the number-one priority is to establish that they can be successful in changing that behavior (and getting the cues for it out of their environment). If Jesus helps them make that leap, then they should have Jesus by their side — believing you can succeed in something difficult can, after all, require a leap of “faith.” There will be plenty of time when they’re better to reframe it as some flavor of “Everything you were looking for was right there with you all along.”
I would definitely not present it to the client without already finding they had a positive impression of religious faith, though. I would be annoyed by that recommendation myself, and I wouldn’t want to undermine a counseling relationship with someone else in that way.
Having lost two family members to drugs I would at the time have used just about any method to get them off drugs ad saved their lives. However, I do se that some could not do that.
“Would it be okay to lie to your charges about Jesus if it helped them get off drugs?”
No. Not only does it violate professional ethics, I would also be concerned about what would happen if the patient eventually learned the truth. For example if he/she strayed to this website.
No. As a drug counselor or therapist I would be ethically obligated to go along with a client’s supernatural beliefs if they seemed to be helping them (as long as I didn’t think there was something unusually risky about the particular beliefs themselves.) Under the situation, you exercise a prudent forbearance.
But it would be morally wrong on multiple levels to convert people to a lie “for their own good.” The Little People argument isn’t respectful of either side, the believer or the Higher Being. The ends does not justify the means. Once you go down that road the moral high ground is lost. You — and your client — will likely need it again some day. The desperate straits will re-emerge and now where the hell are you?
I’ll introduce another ethical issue: one ought to grant respect to religion as a truth claim and not treat the matter so cavalierly. I see more real honesty in mocking a religion as a foolish lie than I do in using it as a useful lie, a manipulative tool.
And I would be very surprised if the faithful don’t understand and respect that point, when it’s set out so bluntly. Any other reaction and they should be ashamed of themselves.
I don’t understand “unusually risky.”
I’m not sure. I’d think an “unusually risky” supernatural belief which would trip and divert a therapist’s legitimate concern might be serious cult involvement or magical thinking which prevents ‘normal’ life. Do they think the Magic 8 Ball is divinely inspired and follow it religiously? Would even a counselor who happens to be religious be worried?
The same general rules which apply to politics might also apply to religion. It isn’t a psychologist’s job to talk a client out of being a liberal Democrat or Tea Party Republican or a Communist. If they’re a member of a White Supremacist group, on the other hand, this might be a significant part of the problem which led them to a therapist’s office in the first place.
The ability to recognize that dividing line might be included in the expertise. I was just trying to cover the possibility of exceptions.
I’m not sure either….
Interesting that so many people make a comparison with placebos. I was thinking more of a comparison with a medicine with known potentially dangerous side-effects. You have to weigh the expected benefits of the medicine against the likelihood and potential severity of the side effects. And sometimes that is a very difficult judgement to make.
In this case I think it depends on which Jesus we are talking about. CofE Jesus? – go for it. Republican Jesus? – that’s a tough call.
it is not right to lie to others because it removes their ability to make an informed decision. “recovery” based on a lie will fail at the least touch.
I see it as more of the old Buddhist metaphor about the raft that is discarded after you reach the other side (that is, you can stop certain teachings and practices after you get to a particular stage).
Drug addiction, depression, etc. are such abject conditions that I feel almost anything can and should be used to bring people out of it. We can debate about truth and falsehood when those people are stable and at a point of “normalcy.”
After all, the foundation of secular humanism is human flourishing. If religion helps that for certain conditions, why not? But also remember Dr. Coyne’s reiteration that this is all hypothetical, that he knows of no evidence that religion actually does help. That’s why my position is the opposite, in light of the current evidence.
my question would be, where do you stop?
Do you mean like what kinds of lies you could tell? I know roughly “when” to stop (when the person regains some sort of normalcy), but I guess the lies could get more and more ridiculous.
I would definitely not lie if I felt that the patient couldn’t “dispose” of the raft later. Like, if losing God caused a relapse into suicidal behavior or drug behavior. I’d find another way. Of course, if there were no other way, better a believing person than a dead/addicted one.
even if that believer did harm in his belief? I know each case would be different, but I’m wondering if the person couldn’t dispose of the raft later and dragged others aboard….
I was thinking more along the lines of a “moderate” religious behavior. Maybe is more of a deist and needs God to talk to. Or maybe thinks of prayer as a “probability increasing” thing.
I would definitely go with the religious program if it helped.
On the flip side, suppose there were someone I knew we were absolutely depressed, and I knew that God was the only thing keeping him or her from falling into the abyss, or even suicide. Of course I wouldn’t try and take that away.
Addiction is as individual as the person who has it. If there was one “magic bullet” to make the addict stop, or have that epiphany to say enough is enough, I would be rich monetarily like Dr. Chopra.
All a support person can do is try to find a catalyst that might help. We all tell lies to ourselves and to others. In the end it really is up to the addict to say “I stop”.
Not love of spouse, child, extended family or insert “insert deity “, makes one bit of difference.
In “Cat’s Cradle”, one of Kurt Vonnegut’s earliest novels, he coins the word “foma” which he later defines as “harmless untruths, intended to comfort simple souls. An example: “Prosperity is just around the corner.”
I’ve met a lot of people who believed they’d been saved by Jesus from horrible messed-up lives. Frankly, they seemed better off with this belief than overwhelmed by alcohol, coke, etc. Humans are such suboptimal creatures that many cannot survive without lying to themselves and others. A lie that the liar himself believes is clearly an improved form of lie. In “Cat’s Cradle”, the characters learn to accept their need for foma. Perhaps we should too.
My own personal favourite quote from Cat’s Cradle, is ” one day this will all be yours”, the characters for those who are not familiar with the book, are looking out on a sea of dead humans. I could be miss quoting as I have not read the book in over thirty-five years, but it has always made me smile and Vonegut’s humour.
Definitely OK. (disclaimer: I am not a drug clinic counselor, but worked next to one for 15 years helping coordinate infectious disease efforts at the county level).
Like some others who seem to have more knowledge of either these ropes or have family who have died because of drugs/alcohol – you do what you can. The odds are so ridiculously stacked against you that it becomes not a matter of whether any given approach will work — but merely how long any given approach will work before the next relapse.
And some hypothetical about negative effects upon “society” just doesn’t cut it. There are three levels to consider: the individual patient, the personal network, and the “larger society”. As a counselor, you are dealing with the first two levels — with an eye on “harm reduction” being your #1 goal. (not “fixing” the problem, unless burning-out in your profession is your ultimate goal).
Frequently, your client holds onto all sorts of magical beliefs… frequently they lie and manipulate, and could be testing you to see if you’re full of shit. So one has to play cards close to the vest. It’s not about your beliefs, success or failure depends on the context of their lives – the nature of their personal support networks (or THEY surrounded by religious people… perhaps they are atheistic, surrounded by very supportive Jesus freaks – perhaps they’ve found some solace from the Krishnas).
What if the person finds out the falsity of their beliefs and relapses? Hell, they were going to relapse anyway, in all likelihood. How long were they off the drugs in the meantime? How many chains of infection (hepatitis / HIV) were broken in that meantime? How many prevented murder/suicides? If it was the purple hamster-spiders from Tralfamadore convincing the person for that moment to stay off drugs/alcohol, you go with it. If you say anything like “gotta hand it to those hamster-spiders”, it’s game over — you could be getting played, in which case you’ll never see that person again. On the other hand, if the person shoots you a worried look and asks you if they’re crazy to think those hamster-spiders could be helping – and what do YOU think? There’s a lot of ways of handling it without either challenging them or being a hypocritical douche — like “one thing I DO know… drugs are real. The harm they are causing are real.” Hopefully your client is not so far gone that you are talking hamster-spiders. Personal beliefs and the beliefs of those in the support networks are also very, very real. So you deal with it. You work with what you have got.
So the approach is as unique as the individual and their situation. It’s not like playing the surgical odds, rolling the dice and applying the cookie cutters. It’s like jazz – every situation is its own improvisation. And like making money playing jazz, you are probably going to lose eventually, anyway.
In this sense, being VERY well grounded in all sorts of prevalent myths and trite sayings associated with various faiths can only help you as a counselor. Since they’re all cherry-picked anyway, it helps to be able to pull anything out of your ass that furthers your harm-reduction goal.
client: aren’t the sins of the fathers visited upon the sons? what chance do I have?
counselor: doesn’t it also say “the Lord helps those who help themselves?”
rinse, cycle, repeat — if this happens to be the way the conversation keeps going… and is the only way to get the client to engage.
I don’t think Jerry is asking if we should actively deconvert Christians as part of addiction therapy. I would argue, and I’m pretty sure Jerry would agree with me, that that’s at least as bad as the proverbial last-minute attempt to deconvert somebody on a deathbed. And quite possibly substantially worse, if the addict is potentially subject to imminent relapse or clinical depression. Indeed, the approach you describe is the one I’d instinctively lean towards — one step at a time, and build upon whatever you’ve got to work with.
Rather, I think Jerry is asking if non-Christians should be proselytized to as part of addiction therapy, if it could hypothetically be demonstrated that such proselytization was a statistically effective form of treatment.
Considering your background, Stephen, I’d be interested in your take on that last one. As I already wrote above, I consider that a particularly unlikely hypothetical in the first place, and not justifiable even if the premise is granted…but you might have a different perspective from seeing these things in the trenches.
b&
Interesting… yep – the proverbial deathbed grandmother had popped into my mind as well, when I composed that last ditty.
From the trenches, I agree with your instinctive take that the hypothetical is particularly unlikely… so much so, that I have an impossible time granting the hypothetical and continuing to converse meaningfully about the topic. Much like fat people, trolley cars and levers, the game becomes unworkable, in practice, IMHO.
Unlike when dealing with physical / chemical / mechanical problems like chemo & cancer, or the chances of successfully pulling off delicate neurosurgery, the counselor is stuck with the biggest tools of the trade being the rapport they have with the client & what’s going on around the client. And this amounts to a bunch of lip-flapping, possibly referring to another counselor based on strengths and weaknesses of the various members of your team if there are stylistic personality clashes.
Even if it was shown that a Jesus-based or higher-power-based approach seemed to work better when one looks at overall associations program-wide, not only are the goings-on so capricious that it doesn’t matter at the individual & personal network levels, but trying to tease apart what is actually going on becomes difficult-to-impossible. How much of this hypothetical “higher-power” approach is really due to the fact that the client is embedded in support networks of goddites & mystics? It seems likelier to me that the scientific consensus would be wrong — that longitudinal studies designed to show causation (above mere correlation) were either poorly-designed, poorly executed, or even perhaps riddled with fraud. If my field cannot even get HIV-transmission-risk right, I shudder to think how wrong the psych majors could get it, when we are dealing with not only what is going on with the client, but what is happening between clients and their peers. Just too much chicken/egg going on.
Thanks for that — it matches my position very closely.
b&
Agree.
Beautifully put, too, by the way.
Thank you Stephen.
I was going to say (based on Jerry’s premise), Yes.
Individuals and their situations are so complex and variable, there’s no way you can know what ‘social consequences’ their belief in Jesus might have somewhere down the line. So their benefit in getting off drugs right now has to outweigh some hypothetical may-never-happen bad consequences somewhere in the future.
It’s something I’d personally rather not do, but I think, as you say, the patient’s interests have to outweigh the therapist’s feelings on the matter. If my wife were the patient then (if she already believed in Jesus) I wouldn’t hesitate for a moment. If she didn’t believe in Jesus – and it was quite definite that her chances were substantially improved by believing – then I’d think long and hard, but I’d do it.
(Incidentally, and curiously, everybody seems to have assumed that the ‘lie’ about Jesus was that ‘the Jesus of the Bible existed’. I can think of many other possible lies about Jesus, e.g. Jesus was a human time-traveller from the year 2500; Jesus was a shape-shifting alien from the planet Zog; etc etc. I’m not sure what relevance this has to the topic, though).
I’d say it isn’t worth it because instilling belief in a false model of the world will have a net negative affect, maybe not for the person saved from drug addiction but from the knock on effects. (Oh what a tangled web we weave when first we practice to deceive.)
Another way to look at it is “should we encourage religious belief if it helps people face death?” No, for the same reason.
Of course no one in trouble should be left hanging out to dry, religious help withheld, they should be provided with secular, science-based guidance on how to cope, get better and heal. The choice is not whether to help with religion or do nothing.
It’s really the same question as whether it is ethical to give placebos – basically lying to the patient. As far as I know such things are frowned on if not considered unethical.
I wouldn’t lie for religion but I would for placebos, because the patient isn’t being made to think they’re getting a magic pill but a legitimate medicine.
Lying is not so bad in and of itself. (How nice to see you!)
Same to you, Curt. Let’s do lunch some time…
A drug addict by defintion needs a prop, relacing one prop with another is not getting to the root of the problem, it’s a diversion.
Granted it may result in a healthy outcome, no drugs, maybe less criminal behaviours.. but we are still left with a problem, dependency on a fictional character, conjured up from thin air to give you strength, yes well we have heard all that before as they marched of to war.
I think it would also be prudent to look in the graveyards to see what those addicts have to say about it, for this evidence.
But, if evidence showed that Jesus worked, a lie about a lie (it just doesn’t sound as though it should work) who am I to tell you what crutch is the best fit..
I would prefer if said addict was, as been pointed out, relying on a support group of caring ex addicts,individuals and drug rehab professionals. Strengthening the individual cognitively and physically and arming them to face their addiction.
Someone with a broken leg needs a crutch. That doesn’t mean they would need a crutch forever. Ditto with substituting a relatively harmless emotional crutch for a harmful one. If the person really doesn’t have the wherewithal to face reality, not letting them have some kind of assistance would be cruel. If they are magical thinkers, let them believe in Jesus. Plenty of people who aren’t addicts have that belief. The goal of therapy for addiction is to help people to live a normal life, which in the 21st century still includes having a religious belief for 90% of people.
Thank you. That seems entirely commonsense. Methadone for the mind 😉
(That is, granting Jerry’s hypothetical postulate that it does work).
Jesus saves, Jesus doesn’t save and some people, no amount of Jesus will save them and of course some, just don’t want to be saved by any favour or reasoning.
My point here is, we are treating these people like children, so called saving them by telling a fairytale story. I’m sorry but that is just piling more untruth on centuries of lies, to which I’m sure you are well aware of.
What’s wrong with the truth about the drug, what it does, a truthful account of it’s impact on the body and on society, it’s repercussions on family and friends, is this not more valid?
There was an interesting article in Skeptic magazine – I want to say June, 2012 – on the efficacy of various treatments for “regular” neuroses, bipolar and depression (regular as opposed to psychopathology and psychosis). The author’s conclusions were twofold: was that CBT (cognitive behavioral therapy, not the one that shows up if you Google with Safe Search turned off – although who’s to say? Endorphins and adrenaline can be great mood enhancers!) was the only form of talk therapy that showed any significant success; and the most commonly-prescribed anti-depressants (Prozac and Zoloft, with or without amplifiers like Paxil, Welbutrin, etc.) were no more efficacious than placebos unless the patient believed, ie had confidence and trust in, the medicine. And he made quite a broad survey of the literature, both private and FDA-sponsored, to reach those conclusions.
I bring this up because folks have noted the placebo effect, and it is relevant to my answer to the Jeebus question. Which is a mostly “yes,” that as a recovery counselor, I think it would be irresponsible not to steer a patient toward the most efficacious treatment. It’s just that, from where I stand, assuming it’s specifically JC we’re talking about as the secret sauce in making recovery work, I would have to refer the person because I personally can’t promote an idea that I personally wouldn’t be able to believe myself.
And I would have to apply myself to understanding what it is about believing in The Naz that is so effective, under my standing assumption that there is an identifiable, real-world mechanism underlying it. If there were none found, I have to say I would be hard-pressed to remain in disbelief.
sub
If the person already believes in Jesus, you could harness that belief in the same way you might harness a person’s inner strength. However, I wouldn’t emphasize it, and I would never create a belief in someone who didn’t already have it. I know it’s just a hypothetical questions, but I believe analysis of the results that showed the Jesus method worked better would be because of a prior belief in Jesus in those clients.
Lie. It would be unethical to do otherwise if it improved outcomes.
You can always go see a shrink about your pathological lying afterwards.
I wouldn’t call it ‘pathological lying’ in those circumstances. It would have been undertaken for a good reason and in the patient’s interests, not yours.
But I agree, you might still need to talk to a shrink to reassure yourself afterwards.
I’m a consequentialist when it comes to this kind of problems (and perhaps to all kinds of problems). If something works, that’s a reason to do it. If something works better than all known alternatives (which is what I think the question is asking us to assume), then not doing it is simply irrational. And even unethical: I think it can be argued that a doctor is acting unethically if he knowingly chooses not to act in the patient’s best interest for so trivial a reason as that he’d rather tell one fewer lies.
Think of it this way. If the lie was not about Jesus but instead about, say, the patient’s look. Is it OK to tell the patient he’s looking good when in fact he isn’t, if telling the lie will help him recover better than not lying? I suppose most people wouldn’t object to that lie, and there really isn’t much reason to object. Now how is the lie about Jesus different? Maybe historically the Jesus lie has done great harm to humanity (though, like Prof. CC, I’m not sure how to weigh the evidence on this one), but that’s irrelevant to what you as a doctor should do to the patient in front of you. Maybe as an atheist you’re just more reluctant to lie about Jesus than to lie about the patient’s look (I imagine I would feel that way), but again that is irrelevant. Or maybe the lie about Jesus will have more downstream consequences than a lie about the patient’s look — that would be relevant, but with the possibility of post-treatment debriefing to minimize those consequences, I don’t think it’s a strong reason to withhold the benefit from the patient in the first place.
Okay, what does “oliagenous” mean? I searched all over. Can’t find a definition.
_____
You can’t have searched very hard. Google corrected the spelling for me:
“o·le·ag·i·nous”
1. rich in, covered with, or producing oil; oily or greasy.
2. exaggeratedly and distastefully complimentary; obsequious.
“candidates made the usual oleaginous speeches in the debate”
I believe Jerry probably meant “oleaginous”.
Sorry to reply on his behalf (sorrier still if I;m wrong), but it’s a word I love – I first encountered it in a limerick: there’s a folk dirty version, and a clean but if anything funnier version by Ogden Nash.
If you’re curious, “Calcutta” is the key word to add to a Google search
Just a note on Yeshua. The caller probably was referring to Jesus (i.e., god the son). Most christians pray to Jesus (as god), not God (the father). Yeshua (i.e., Joshua today) is the original Hebrew/Aramaic version, in Greek it got to be Iesous. The change to a “J” later on was to get back to the Hebrew “Y” (as in hallalujah, and also Jehovah[meant to be YHWH and popular in the 1700&1800s for God’s name]). But today everyone uses the current “J” sound on the Greek version for Yeshua, and Jesus happened. (Something like that)
Because there is a YES in Yes-hua!
I have not read the comments above (busy), but I would play it by ear. What matters most is that an addicted person get help and that they move forward in kicking a very dangerous and costly habit. So if it seems that a secular approach will work, I will do it (and be in harmony with my own feelings). If the patient was religious, I would likely try the secular approach first, but be open to some bible thumpin’ if needed. I certainly would not dispute them if they brought it up. But if a patient were very religious such that secular conversation was not in their language, I would use that as a motivation to help save them.
Their lives are in danger. Their family is suffering. They are a danger to themselves and to others, and they are a burden to an overtaxed medical system.
I would choke on it a little, and lie for Jesus if I thought that was the only way to help them.
I’m going to give a boring answer which I hope isn’t cheating: it would depend by how much the Jesus component helped.
I’d be willing to sacrifice a fair amount of extra efficacy in drug rehabilitation for the sake of honesty, and for not churning out proselytising Christians at the end of the process. But if the difference in efficacy becomes dramatic enough, at some point I’d have to simply grit my teeth and lie.
Or perhaps hire someone else to lie on my behalf, or maybe a Christian, who wouldn’t have to lie at all. I don’t think this particular lie is one I’d be good at telling.
It seems to me that the drug addict in the interview has replaced one dangerous addiction with an even more dangerous one.
A big part of the reason that this persons addiction was so dangerous is that the substances in question are deemed to be illegal and the penalties for using these substances far exceed any costs incurred by society by their use and most of these negative costs can be attributed to the fact that these substances are illegal in the first place.
And the blame for this very bad policy can be attributed directly to the religious injecting their morality into public policy.
This is so typically religious, slyly offering society a solution to a problem that they are the very cause of.
So while religion may have played some role in rehabilitating this individual the cost to a society that allows its social policy to be dictated by irrational ideology is too high a price to pay.
I think it depends primarily on three factors – how debilitating is the addiction, what brand of Christianity does the treatment lead to, and how much improvement does the treatment gain by incorporating Jesus. For example, I don’t think it would be worth converting a functioning alcoholic into a homophobic misogynistic Fred Phelps type fundamentalist, but it wouldn’t be so bad to save a meth addict by letting them believe in a Jesus is love type Christianity. Think about just how bad some forms of addiction can be. But the improvement over secular treatment would have to be very substantial to justify lying to patients.
I’d looks closely at the experimental design. There are other correlations that need to be inspected, and since this is likely to be a fairly long-duration and relatively expensive experiment, so it behoves us to get the most information from the expenditure.
Jerry’s experiment tests two fields of the “space” of thoughts on religion. There are multiple directions in that field of concepts. There are several more field that need to be examined : if you divide your experimental group by religion into atheists, Christians, Muslims and (what’s the 4th religion in the American context – Hinduism, Buddhism or Jedi?), then so far you’ve only examined the question of outcomes for (belief, treatment) pairs of (atheist, atheist), (Christian, atheist), (atheist, Christian), and (Christian, Christian). But there are other (belief, treatment) groupings to be examined too, such as (any belief, same belief) versus (any belief, different belief) and (no belief, any belief) and any belief, no belief).
As you classify belief into larger numbers of types (N), the complexity of the experiment increases, but the data available also increases to potentially (N^^2). this wouldn’t be any benefit if the size (and cost) of the experiment also increased as (N^^2). However, generally, it is possible to approach the (N^^2) information increase while only increasing the size (and cost) of the experiment at a rate slightly above (N^^1). But it does take fairly careful experimental design, to ensure that you do get the maximum data from the size of experiment you’re going to run.
Many people don’t realise this. In particular, politicians seem to be particularly bad at understanding this, which is one of the reasons that they’re not very good at getting to good answers. Actually, I’ll generalise a little more from politicians – social scientists in general (I know I’m unduly elevating the politicians, and unduly denigrating social scientists. At least I’m not lumping them in with economists.) aren’t terribly good at this.
In a more practical version of the same argument, my statistics course when I was at college had a particular focus on this sort of experimental design about how to optimise scarce resources to extract the maximum information from those resources. Our chief lecturer specialised in designing experiments where the limiting resource wasn’t money, but time and patients beyond conventional treatment on various cancers and other diseases. The people are pretty likely to die anyway [there is, of course, a spontaneous recovery rate – that’s your (no-treatment, survival) category], but if they’ve volunteered to help to improve treatment, it’s pretty important to get the most out of them. you never know – you might actually save some of their lives.
I quite enjoyed stats. But I couldn’t do it for a living – too intense.
As a social scientist, I give big thumbs-up to your analysis. Speaks volumes to my experience.
I didn’t notice your history in epidemiology until a few minutes ago (I think you were tearing stripes off Deepakitty). Clearly you’ve been more deeply involved in these matters.
Make those deaths count. Literally.
But isn’t that all beside Jerry’s point?
Assume the experiment was designed flawlessly, that it was carried out flawlessly, that the data are unimpeachable.
Given that, is it ok to lie to addicts and convert them to xianity in the hopes of mitigating their addiction?
But what exactly is this flawlessly designed experiment we’re supposed to imagine? Adding the single word “Jesus” to an otherwise secular treatment program, and getting better outcomes for believers and nonbelievers alike? I don’t think so.
In practice, there will be many differences in detail between religious and secular programs. A well-designed study will necessarily have to control for as many of those variables as possible, and try to isolate the effect to specific elements of the religious program. To the extent that it doesn’t, its results will not be unimpeachable.
My reading of Jerry’s question doesn’t involve imagining the experiment at all. It’s done. Somehow, and it doesn’t matter how for his question, it’s been demonstrated that being a xian helps you kick a drug habit.
Of course it matters how. If the claim was that being Mongolian helped you kick a drug habit, would you advise addicts to move to Mongolia? Of course not. You’d want to know what specific facts about Mongolians were relevant. Is their genes? Their diet? Their social systems or sleep habits? Until you can answer such questions you can’t claim to have demonstrated anything useful.
I think you’re still missing the point of the question. Any and all issues surrounding the efficacy of the “Jesus treatment” have been considered and resolved.
The point of his question is to get at whether people think a “sure-thing” cure (yes, that would be problematic in the real world; not in this thought experiment) would be worth lying and converting people to xianity.
I don’t think wanting to know how and why it works is missing the point. Knowing how things work is what enables us to design evidence-based treatments that are more effective than haphazard faith-based or folk remedies.
So I guess it just strikes me as implausible in the extreme that we could do all that research, answer all the questions, and still conclude that lying for Jesus is our best treatment option. If that’s a dodge then so be it.
That’s exactly how I read it too, mb.
Gregory–you’ll have to imagine that all your why’s & how’s have been answered and the answer is that belief in Jesus and only Jesus cures addicts. It’s a thought experiment.
OK, one last try and then I’m done.
I get that it’s a thought experiment, but the point of thought experiments is to actually think them all the way through. So it’s no good saying all the hows and whys have been answered and Jesus is the answer, because (as we’re fond of saying on this site) “God did it” isn’t an answer; it’s an excuse to stop thinking. Thinking it all the way through means figuring out what it is about Jesus belief that makes it effective, and if we know that, then we’ll know how to construct effective treatments based on naturalistic brain science without any supernatural baggage.
But if you’re going to insist that Jesus belief, and only Jesus belief, is effective in a way that no naturalistic treatment ever could be, then you’re essentially postulating that there’s something genuinely magical about Jesus belief. A conclusive demonstration of that goes far beyond curing addicts; it forces us to abandon our atheism and consider the possibility that Christianity might actually be true.
Either way, I claim, there’s no consistent scenario in which lying for Jesus is the right answer. Either we do more science and come up with a better option, or else our science fails us and we must concede that Jesus is real.
I don’t think I can make my position any clearer than that.
Yes.
My answer 1:- No [If I was working in a professional capacity as drugs counsellor]because unintended consequences are bound to kick in later.
My answer 2:- Yes [If I was operating in my personal capacity] I would lie about anything to save someone I love. Worry about consequences later – save a life now.
Let’s say that a Jesus based program is more effective. This leaves a couple of possibilities for its effectiveness: 1) Jesus is actually helping; 2) Belief in Jesus helps.
We can all agree it is not the first option. So it must have something to do with belief in Jesus. How does one prescribe this? You can’t simply decide to believe in Jesus anymore than you can decide to believe gravity doesn’t work. You have to be convinced and I don’t need to go into what the most effective methods for evincing belief in Jesus are here. If the patient still doesn’t come to believe in Jesus, you risk further damaging her psyche. On the other hand, indoctrination doesn’t seem like a great tradeoff either. So my answer is no, you shouldn’t lie and I haven’t even gone into the repercussions of the patient finding out you lied later on…
It seems to me that certainly religion could help as a placebo for people getting off drugs. The “Jesus” idea is obviously not important, but you could tailor it to anyone’s preexisting beliefs. So if they are christian, give them “Jesus”, if they are Muslim, give them Allah (or whatever else).
They probably have bigger problems to worry about as a meth addict, so maybe do whatever it takes that might increase chances of helping them? However, I don’t really think lying is usually the best answer.
Suppose long after their recovery you were to run into them again and tell them your true thoughts on the matter–if this were to hypothetically crush them and they return to using drugs then they seem like a rather hopeless human being.
This is of course a version of that nonsense some religious folk say about “not being able to be moral and atheist.”
I don’t think swapping one drug (meth) for another (religion) is a good thing, but I wonder there is a better of two evils?
I’m pretty sure I know how Sam Harris would respond to this.
Been waiting for someone to bring up Harris.
This is where he & I part ways.
Yeah, I’m not convinced there is *absolutely no* context in which lying would be acceptable.
I don’t think lying is called for in Jerry’s scenario, though.
Neither do I. I think one could take an agnostic approach, let the patient indulge illusions if it seemed the most effective course without going out of one’s way to endorse said delusions.
I just don’t think there’s one universal answer; so much depends on the background, life circumstances, and capabilities of the particular drug addict in question.
Absolute answers are easy when you’re merely indulging in an intellectual exercise, which I think Sam is doing no matter how many concrete examples he posits. I’d like to see his response were he to actually have Anne Frank in his attic and Nazis at his door…
You’re parting ways from a strawman. This caricature, of never lying isn’t advocated in Harris’s book “Lying.” He only discusses some consequences of lying and argues why it’s best, in general, to avoid it. As to Anne Frank being some great challenge that he hasn’t met, he has a chapter “Lies in Extremis” where he discusses this specifically. Basically, he argues that lies corrupt or undermine relationships so when we’re interacting with someone we do not have or wish to have a relationship with, then lying is a reasonable option. He does talk a little bit on how we may still consider a truthful option:
MB – the original question is very clear that lies are required in this hypothetical scenario.
Thanks, Alex. I knew he addressed the topic but have not read the entire booklet yet, only a few bits here and there; and the interview about lying he had with a philosopher and former mentor (which I’m having trouble digging up now because I forget the 2nd bloke’s name) that was posted on his website . In that conversation I must have picked up some false impressions of his stance on the matter.
I read “Lying” three years ago. Perhaps I’m not remembering it very well, but what I meant by “not acceptable in any context”, which was maybe not the correct way to put it, was that he doesn’t actually concede that lying could very well be the right thing to do in many cases. He mentions a professor of his who could, with Nazis at the door and Anne Frank in the attic, “still find truths worth telling and paths to greater catastrophes opened up by lying” – which doesn’t really do much as an argument, imo. I want to hear specifically what he would say to those Nazis.
I came away with the impression that he does think telling the truth is always better, but that we will sometimes “deem it necessary” to lie because we aren’t looking hard enough for the truthful way out. He writes that you could say to an armed murderer looking for a child who’s hiding in your house: “I wouldn’t tell you even if I did know”. That’s just not a practical option.
But like I said, perhaps I’m not remembering some subtleties and should read it again.
That’s what I remember about that interview, too. I ended up just really not liking the whole exchange. Some things are more important than truth.
My mother worked evenings as a Doctor’s assistant back in the 1950s (yes, the office was open evenings, and one of the Doctors was a woman!)- they had several large glass bottles full of different colored sugar pills in the back room and there were certain “regular” patients for whom the Doctor would “prescribe” these pills. As my mother went to fetch them, the patients would say things like, “Make sure they’re the yellow ones, honey; the Doctor gave me some of those green ones a while back, and they didn’t do a THING!”
Dr. Coyne,
I agree that there’s no evidence that religion tends to help as a rule. But isn’t it fair to say that there are individuals for whom only religion would help? I don’t think your question needs to be a hypothetical if framed this way.
This is a very interesting question. My answer varies depending on what we’re willing to assume. If we found using sound methods that the best Jesus-based program had better results for addicts *uniformly* across demographics, then yes, I would have no problem lying about the varied truthiness of Jesus. Addiction to drugs like methamphetamine is far more destructive to a person’s life (and to those they come in contact with) than believing in some kind of a divine Jesus. Besides, maybe once they clean their life up a bit, then they’ll be ready to tackle what reality is all about and have the strength and confidence to abandon their favourite Jesus myth.
However, I would guess that any study that proved the greater efficacy of a Jesus-soaked treatment would *not* be able to tell us if the effects were positive across all demographics. My guess – if something like this were shown to be true – would be that the greater effect would be felt amongst Christians, those who were raised in a Christian household, or those who were never really concerned with religion/spirituality/god(s) to begin with. In particular, it would be astounding to see such positive effects across those who strongly believe in a different deity or deities. So in most reasonable cases I could imagine, I would target my lying toward only those of a certain demographic.
Regardless, you follow the evidence, and treat the greater of two evils first.
so many questions, because statistics; because even with 99% efficacy, no one can predict which unlucky duck out of 100 won’t respond to treatment. but 99% is a great reason for giving 100% of patients a particular treatment.
but what if the efficacy of treatment “a” is only 25%, while treatment “b” is only 30%? do we go with only “b”? do any failures of treatment “a” tell us anything about the potential success of treatment “b”? what if “a” & “b” aren’t incompatible? should we go with both? for example, what if treatment “a” is conventional rehab, while treatment “b” is just treatment “a” plus jebus? (or allah or thor …)
I’d look at how the Jesus pitch actually works. I suspect that it’s convincing the addict that the problem is bigger than him. Jesus is just a convenient, imaginary, but widely accepted entity in that category.
If that’s the case, I’d pitch the same first part, and then try to teach what’s really going on, with induction/suppression of synthesis of various neurotransmitters and receptors in response to the drug(s), and work on instilling an understanding that that is why it’s bigger than him.
I wouldn’t put the cart before the horse on this one.
There have to be statistics on recidivism rates for “higher power” treatment, as well as for non-spiritual treatments like cognitive therapy.
It would be worth it to look to see if there actully is a significantly better outcome for a “come to Jesus!” approach before looking for ways to justify lying to someone, and without the need to get IRB approval.
Remember those studies which showed that meditation had positive effects… But only equal to sitting down quietly and relaxing with music or a good book? If there is no better outcome from indoctrinating someone with woo than from not, then don’t.
And remember, there are lot’s of things which can make someone feel good besides the panacea of religion, including the substance for which they are seeking treatment. Substituting one artificial happy-maker for another is a cop-out if one is trying to make a long-term change for the better in someone’s life.
No – because you can’t know where the lie leads, and if they ever find out that you lied to them, then their recovery is less likely to stick.
Surprisingly relevant quote from Woody Allen in the next post:
One must have one’s delusions to live.
I think if Jesus had a better success rate than secular programs it would be most appropriate to offer both to prospective clients. If you don’t believe in Jesus then you do the secular one and if you do you can do the religious one. I don’t see how insisting you hand your life over to Jesus can help those who don’t believe in him under any circumstances, so there is no point in sending them off to that program regardless of its success rate.
Some fascinating comments, as usual, but given the hypothetical, I don’t see any need to lie for Jesus (or Yeshua).
Jerry has said that the Jesus programme is the most effective, and I am assuming objective evidence, so I would just say that I recommend this programme, without mentioning J at all.
Oh, you’re right! PCC did make that a condition of the hypothetical question.
I think there is actual data which supports the opposite, but the big thing at the core is that you’re teaching someone to rely on something other than oneself, making it a likely short-term substitute. I’d still need to see the longterm recidivism rates, instead of concluding that a shortterm abatement indicates real effectiveness of teaching someone a delusion.
Incidentally, wasn’t there a recent story about an atheist who was being required to accept the higher power of a twelve-step program or go to jail? That’s another strong argument against advocating a religious treatment which requires someone to abandon reason or go to jail.
If that doesn’t bother a person, such a person seems like a great ally to religious fundamentalist justifications about the need to have a Christian nation. Jail or Jesus!
Being comfortable with that possible mandatory imposition of religion is too unamerican and antiscience for me, but if someone wants to argue for that kind of country, I’ll happily hear about the advantages.
Is it Ok to give a patient a placebo without telling its a placebo??
If you tell the patient, it’s no placebo anymore, just a sugar pill. I know, this doesn’t answer the question.
Is use of a placebo OK? Yes, if the patient knows that he is part of a clinical trial and that there is an x% chance that he is swallowing a placebo.
Now back to Jesus. Tell the Jesus story, and add that it is (just) a story. Might work just as well, and you don’t lie.
I realise that this may count as dodging the original question.
W K Clifford (1877) said in an article – The Ethics of Belief:
“The fact that believers have found joy and peace in believing gives us the right to say it is a comfortable doctrine and pleasant to the soul…..The question our conscience is always asking about that which we are tempted to believe is not – is it comfortable and pleasant – but is it true”. In the light of Clifford’s analysis the best an atheist could offer would be to point out that some people (hypothetically)have received the support they needed to quit drugs from among believers. If however the person takes that route he must understand that belief is not evidence based,is unsupported and overall not true. They may find in the future that the limb they have ventured out on gives way and there is a harder fall to come. Honest advice is the Humanist thing to do.
What I think is right and I would I actually would do are different (I consider that a flaw in my character, but friends have told me that makes me human).
So, the “noble lie.” In one way, I look at that as what would I do that would have the greatest good for the greatest number. Having looked into the issue, I’d say there is no “noble lie.” Because the “information” I gave the addict would get to other people and then they may accept magical thinking, which would lead to vaccine denial, climate change denial, etc. So, the addict should be told the truth (as we know it) and another method of a treatment should be established. Sounds good doesn’t it?
On the other hand, if I was actually treating that person? There is no way I would take away a placebo that allowed them to have a better life.
It’s very similar to the trolley experiment. I understand the logic of pushing the large man off the bridge. And in an antiseptic lab environment, I would readily answer, “Yes, I’ll push him off.” In reality, I don’t think there is a force in nature that could get me to actually push that guy.
I think Andrew Solomon answered this quite well in a wonderful speech at TED
I don’t see why lying would be necessary. You could simply say, “While I’m not a believer myself, I can tell you that this religiously-based program has the highest success rate. If you are open to that, you might want to consider it. If you are not open to that, there’s a non-religious program I can suggest which has also worked for people.” Why not just give the person information and let them make their own choice?
That’s how I see it too, Pamela.
Well, -tell them that you are pretty sure that there is no god
-free will being an illusion,
-and people really not being able to ‘choose’ to believe in something,
…then maybe if you told the patient that if s/he pretended to believe it might work as well as if they actually DID believe whatever it was (I mean in god belief), that might be acceptable.
Wow, I am a hypocrite.
I was tempted to say “No! Lying is wrong!” and then I realised, that for years I was thinking “Well, I am atheist, but at the same time I think it is alright that majority of people around me believes in christianity because of , so if I would be in charge of things probably I would support Catholic Church”
Damn you, mister. Now probably I will mull over this problem for several nights.
szopeno,
I think you left your comment incomplete. Believes in Christianity because of what?
Yes, there was (list of reasons to follow) but I used > and < (greater than and lesser than) signs, which were ignored by the blog software which probably treated it as some tag.
“List of reasons to follow” is not important here. The fact that I could believe that on societal level something is good, while on private level it is wrong – that is what disturbs me.