Review: Making bad decisions, a lecture by Dr Anthony Daniels, also known as Theodore Dalrymple

Controversial English psychiatrist and writer Dr Anthony Daniels, who uses the quirky pen name Theodore Dalrymple, was recently invited to present Maastricht University’s Tans Lecture. This annual lecture commemorates Dr Sjeng Tans who helped create the university 30 years ago.

Limburg media caught wind that the retired prison doctor would be speaking. He is often criticised for being anti-liberal and the media attention helped draw a large crowd to the UM’s Collegezaal theatre. Dalrymple did not let the audience down and delivered a contentious speech on why heroin addicts deserve little sympathy or government aid.

In his newest book, “Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy”, and in the Tans Lecture, entitled “Making bad decisions, about the way we think of social problems”, Dalrymple says heroin addicts are worthy of little tolerance. It is wrong to treat them as inanimate objects who are forced by societal evils to indulge into drugs. Welfare programs and medical treatments (like methadone clinics) aimed at “curing” addicts are pointless. While this claim is highly disputed, after treating around 15,000 troubled patients in Britain’s inner city, Dalrymple certainly has gained the authority to share his controversial ideas.

Dalrymple feels most people are unhappy and not even contented with life. We have a constant sense of unease as if we’ve just turned around the wrong corner. With all the wealth and our needs being taken care of, insecurities should have eased… But they didn’t.

Instead criminality and depression have increased. During Dalrymple’s career, when asking patients how they felt about life, only three people told him they were unhappy while thousands said they were depressed. Why is this?

Failed attempts to transcend our lives
Dalrymple spends much of the lecture setting out his theory on why thousands of people are depressed to the point that they “choose” to get hooked on heroin. He restricts his discussion to the UK and makes a point that his insights are descriptive rather than curative.

Historically people found ways to transcend or rise above their own lives. But this doesn’t happen in the UK anymore, Dalrymple contends. Unfortunately for the Brits, they’ve almost totally lost touch with finding any purpose to life, he says.

Dalrymple describes five ways to transcend, or find deeper meanings to our lives:

culture: catastrophic. The country is in intellectual ruins. There is no interest in history. Dalrymple often asks youth if they can explain to him who Shakespeare is, and to his dismay they usually cannot. They don’t know about World War I or II either. They don’t think about learning. Most people today live in an “internal present moment” with one event disconnected from another. Strong sensations in each moment are necessary. Silence is threatening as it leaves us alone with our own thoughts. The cultural elite are having their own identity crisis, asking questions like “What is the purpose of the arts?” Most people have little connection to the past, and as a consequence little connection to the future.

None of the above has led to transcendence. Some Brits follow football like a religion, but deep down Dalrymple says they realise no higher goal is achieved from the sport. With no higher purpose at hand, boredom - or the fear of boredom - is exacerbated with a sense of meaninglessness. People’s lives are in a state of prolonged crisis.

To mark his point, Dalrymple uses an analogy that raised many eyebrows in the audience, contending that battered women choose to stay with violent and abusive men because this is preferable to a boring life with a nice predictable man.

Just as in his other descriptions of vulnerable people, Dalrymple simplifies issues to such a degree that the broader context of a societal problem is lost. With the above example for instance, women might indeed be drawn to the excitement of a dangerous man, but there are well documented reasons battered women stay with abusers such as economic factors, fear of more abuse if partner comes after them, children, etc.

Heroin addicts are his equals
An audience member commented that Dalrymple seems to lack compassion for the underclass, and argued that people don’t actually choose poverty. People are trying to make their lives better and they are loads of factors that influence them to take hard drugs. “Do you really think addicts just make bad decisions when they get hooked?” he asked.

Dalrymple argued that addicts should not be treated as objects. He treats users as his equals and that’s why he feels they had the choice to do drugs. For him, it’s not true that people have no choice in their lives.

Much of the controversy that surrounds Theodore Dalrymple has to do with his dislike for government intervention with heroin addicts. He says they try and come up with technical solutions in the form of drugs to solve social dysfunctions that have more to do with the lack of transcendence than a need for methadone.

Dalrymple is also fed up with misconceptions about hard drugs. The general public’s understanding is that people somehow come across heroin and then are suddenly hooked. This just isn’t true, he claims. Rather addicts normally take heroin off and on for about a year before becoming hooked. His central point is that addicts certainly know what they’re getting into.

Excruciating withdrawal symptoms are another myth. In fact, Dalrymple says that anxiety over the withdrawal is the major problem. He uses many examples to prove that addicts can quit heroin without suffering from days of sweaty shakes such as often shown in Hollywood movies. He says Vietnam veterans dropped heavy use of heroin as soon as they returned to the USA.

An addiction researcher in the audience commented that Dalrymple’ message was positive in one way because it’s important to stress choice and give initiative back to the addict. But he also had some problems with the lecture. There are actual neurological changes in the frontal cortex of the brain after someone has been addicted to heroin, the researcher argued. Motivation and the ability to make choices are diminished. This goes against the proposition that addicts can freely choose to quit. Second, the researcher disagreed that addiction comes down to people making the wrong decision as a result of novelty seeking. There are many reasons why someone gets addicted: “If you’re in a slum with an addictive kind of genotype which craves lots of sensations, it’s logical that you’ll seek out drugs. This is not so if you are wealthy and live with a loving family,” he said.

Dalrymple agreed with much of this statement and added that some of us are just more fortunate than others. He says the lucky ones go through life like a “hot knife sliding through butter”. But he still thinks people ultimately make their own choices. In terms of neurological changes, Dalrymple defended his argument by citing the example of millions of Chinese addicts who almost immediately stopped taking drugs after Mao Tse Tung issued an order to shoot all addicts unless they quit.

What’s the attraction of heroin?
According to Dalrymple, people take mind altering substances because they are unhappy with life. The search for pleasure is their primary impetus. Heroin changes their state of mind by creating an oceanic feeling with the illusion that all is well and all will be well. The high leads to a false feeling of mastery and enlightenment.

Dalrymple says an addict is “deliciously aware that he’s opposing himself against society” and experiences this rebellion as an intellectual success. Nowadays opposing society, criticism and reform are what’s popular and viewed as good, no matter whether the opposition is actually beneficial or not. When heroin is totally banned, addicts get much of their excitement from the hide and seek game with authorities.

According to Dalrymple, addicts are treated as victims, and not as people making choices, bad ones but choices nonetheless. They are treated as automatons, mechanical toys that can’t make their own decisions. There is even a ridiculous role playing with users pretending to be sick while doctors pretend to cure them, Dalrymple adds.

Dalrymple offers no practical or political solution. He would tell many of his patients that their life had little or no purpose. When they would ask: “What is my purpose then doctor?”, Dalrymple coudn’t answer them.

One audience member came all the way from Luxemburg just to hear the lecture. He said that Dalrymple paints a very bleak picture of British society and asked, “Is there any hope for us?” Dalrymple’s final words reassured him a little: “My own life has gotten better over the years so I don’t think things are completely hopeless. Suffering people still recognise their own downfall which means we haven’t gone too far. People are still intelligent, and there isn’t a complete lack of understanding.”

By Danya Chaikel

Danya Chaikel is from Vancouver, Canada and recently graduated from law school. She has a background of working with migrants and promoting human rights. Danya recently moved to Maastricht to be with her Dutch partner.

Crowd discussing Theodore Dalrymple’s lecture outside of Collegezaal theatre, Maastricht University

More information: see Theodore Dalrymple (Wikipedia)