Quote of the day - Aodhán O'Riordáin

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Late reflections on the Armstrong Affair: Faith – still not a virtue

I recently watched Alex Holmes’ fast-paced documentary Stop at Nothing: The Lance Armstrong Story.



Surprising in light of my previous lack of interest in Armstrong (or, frankly, cycling for that matter), the film caught my attention and led me to read David Walsh’s (2012) Seven Deadly Sins: My Pursuit of Lance Armstrong.* Not surprisingly, the story is most interesting to me in terms of what it suggests about problems of belief and faith in relation to politics.

I won’t say much about Armstrong personally, for a few reasons: first, I think Karen Horney’s chapter on the arrogant-vindictive type in Neurosis and Human Growth probably covers it; second, and relatedly, the cyclist Christophe Bassons, one of those harmed by Armstrong, has already provided a compassionate and reasonable response;** third, I think the focus on Armstrong as an individual, while necessary to understanding events, tends to divert attention from the social aspects of the phenomenon and to let others off the hook.

Many claim now that one of the most unsettling and upsetting facets of Armstrong’s masquerade was that he supposedly played upon people’s “best” inclinations. Another common belief is that pretty much everyone was innocently duped. I want to challenge these notions somewhat.

The most aggravating aspect of Armstrong’s project was his promotion of faith in faith and celebration of the faithful identity. He and the cycling big wigs consistently worked to create a community of the faithful that would exclude and shun doubters. He flattered his more credulous fans with the notion that they were better people for promoting Hope and Belief. While the believers were in reality the overwhelming majority, they were sold an image of themselves as members of a small elite whose gift of spirit set them apart from the cynical, faithless masses.

There was the constant refrain that the world was hostile to the possibility of recovery and great accomplishment and that “no one had believed.” “When I came back,” Armstrong claimed, “there was no interest. None.” After the 1999 Tour, he proclaimed:

Nobody believed in us. Nobody believed that if Lance Armstrong took the yellow jersey, with the help of his team, on Stage 8, how could they keep it to Stage 22? They thought the team would crack. But that team with seven out of nine guys being American – American team, American sponsor – they were the strongest team in the race. And everybody in Paris knew that. And I can assure you that at next year’s Tour de France, there will be no, there will be no doubters.

For the journalists who suspected or knew of the cheating but worked to feed the myth, the machine offered the self-image of champion of hope and protector of cycling.

As is always the case, the celebration of faith entailed a certain attitude toward, and treatment of, those who challenged the myth. Riders who stood against doping in cycling were pushed out. Journalists who published skeptical stories saw their careers threatened and friendships tested. More generally, skeptics were castigated in the traditional way: contrasted with the virtuous faithful, they were portrayed as mean, callous, lesser people who lacked the life-affirming spark of faith.*** In a speech at the end of the 2005 Tour which is especially sickening in retrospect (and maybe gag-inducing to some at the time, judging from the facial expressions on the cyclist standing behind Armstrong’s then-fiancée Sheryl Crow), Armstrong chastised all those who questioned him:

The last thing I’ll say for the people that don’t believe in cycling – the cynics and the skeptics. I’m sorry for you. I’m sorry you can’t dream big. And I’m sorry you don’t believe in miracles. But this is one hell of a race. This is a great sporting event, and you should believe.

A vivid illustration of this phenomenon was an accusation in a letter from a reader of the Sunday Times about David Walsh:

I believe Armstrong’s victory was amazing, a triumph in sport and life. I believe he sets a good example for all of us. I believe in sport, in life, and in humanity…Sometimes we refuse to believe for whatever reason. Sometimes people get a cancer of the spirit. And maybe that says a lot about them (Seven Deadly Sins, 185).

Armstrong identified himself with the cause of fighting cancer, with the Tour de France, with cycling, with America, and with hope itself, and then publicly chastised anyone who doubted this representative of all that is good. People calling out lies and challenging myths weren’t just seen as spiritually deficient, but as hostile to the communities Armstrong was allegedly raising up. Journalists like Walsh and even cyclists themselves (and cyclists like Paul Kimmage who’d become journalists) who were exposing the culture of doping and Armstrong’s involvement were viewed as enemies of the sport, of the community of cancer sufferers and survivors and their families, and of all those idealists who retained faith in human possibilities.

Neither the film nor the book discusses the political context of this propaganda for faith, but that context is essential. Armstrong’s Tour “victories” spanned 1999 to 2005. These were the years that bracketed 9-11 and the invasion of Iraq. If ever there was a time in which it was dangerous to encourage faith in faith and uncritical belief in the claims of powerful people, this was it. As with Armstrong, the media lined up behind the Bush administration and its mythology of WMDs and a months-long war. Questioners and dissenters, as the Dixie Chicks learned,



were excluded from the self-celebratory community of belief, threatened, and treated with hostility and condescension.

If there’s one bright spot in this story it’s that Armstrong won’t be able – at least in the immediate future – to advance his political ambitions. (Unfortunately, the psychologically similar Chris Christie remains in a position of political power.) But the political lessons of the Armstrong affair transcend him personally.

It’s true that the public was kept in the dark about his doping, although very suggestive evidence was provided by Walsh and others a full decade before Armstrong’s final “exposure.” But it’s unhelpful, I think, to focus on people’s ignorance or, worse, on how people’s supposedly best and purest motives were exploited by Armstrong’s machine. Wanting to believe in something or someone is certainly understandable. But it’s not a virtue. Ignoring evidence in favor of defending people who claim to embody our hopes and ideals, allowing questioners to be attacked, doesn’t make us better people, and can lead down some very harmful paths.

* The book is OK. The seven deadly sins of the title refer to Armstrong’s seven Tour de France “wins.” I expected the chapters to be organized around this theme, but the title doesn’t really have anything to do with the book. As several of the Amazon reviewers noted, it seems sort of rushed and needed better editing, especially in the early chapters. But it’s not bad. I did learn from it that the race started as a means to get attention and circulation for a rightwing paper with an anti-Dreyfus message. Like almost everything in modern France, then, the Tour emerged from the Dreyfus Affair. Unfortunately, the book’s brief discussion of this history almost suggests a parallel between that case and Armstrong’s, which is so wrong.

** “The world of sport,” Bassons concludes, “should forget him but should not destroy him psychologically. Armstrong is still a human being with an individual personality that was built during his childhood. I know he had a difficult childhood, which might explain his need to win at all costs, even if that meant not respecting other people.

Today I feel more pity than contempt for him. I always preferred to be in my position than in his. I am honest, straight and happy. I don’t think he can say the same” (Seven Deadly Sins, 398).

*** Contemptibly, this came to involve pressuring Greg LeMond, a survivor of childhood sexual abuse, to apologize for his public statements about Armstrong.

From Edmund Burke to the Twitter jerk

Over the past couple of weeks, Public Shaming has featured callous and hypocritical tweets about the loss of public benefits for poor people during the government shutdown: see here, here, here, here, here, here, here, here, here, and here.

These examples provided the perfect context for reading Corey Robin’s post about conservative icon Edmund Burke:

…Throughout his career, Burke’s financial state had been precarious. Much to his embarrassment, he was periodically forced to rely upon well timed gifts and loans from his wealthier friends and patrons.

So terrified was he of dying in a debtor’s prison that he struggled in his retirement to learn Italian. His hope, claimed one of the many visitors at his estate, was to flee England and “end his days with tollerable Ease in Italy.” (He also floated, apparently, the possibility of fleeing to Portugal or America.) “I cannot quite reconcile my mind to a prison,” he told a friend.

Thanks to the interventions of his well connected friends, Burke secured from Pitt in August 1795 two annuities that would wipe out his debts and a pension that, along with an additional pension and the income from his estate, would enable him and his wife to live in comfort into their old age.

Three months later, when Burke took up his pen against a proposal for the government to subsidize the wages of farm laborers during bad harvest years (so that they could sustain themselves and their families), he wrote, “To provide for us in our necessities is not in the power of government.”

Ah, a fine tradition of thought persisting through the centuries. Also, it's funny to imagine Burke tweeting.

Ireland reviews psych laws; radical critiques emerge

Ireland’s been in the news over the past few years as people there have tried to come to grips with the abuses committed by various institutions. This year, the government is reviewing the country’s mental health law, including “capacity” legislation. It’s promising that Amnesty International Ireland, which has made the mental health system a priority since 2003, is active in the discussions, while psych rights groups are also clamoring to be heard.

In this context, some psychiatrists are offering some radical criticism. Mad in America links to an interesting opinion piece by Pat Bracken in the Irish Journal of Psychiatric Medicine, focusing on the weighty question of whether there is a sufficient scientific basis to justify the (often coercive) power of psychiatry. Bracken writes:

In their defense of involuntary commitment, in The Reality of Mental Illness, Martin Roth and Jerome Kroll make an important point:

‘Since most people agree that civil commitment, i.e. involuntary incarceration of a person who has not committed a crime, and involuntary treatment (based upon what others believe is best for a person) represent massive [their emphasis] infringements of that person’s civil liberties and personal integrity, it follows that the factual basis and the ethico-legal justification for such a course must be suitably strong and unambiguous’.6

According to Roth and Kroll, if psychiatrists are ever going to be able to justify their role in such ‘massive infringements’ of civil liberty we will need to be very confident that our science is disinterested and robust and that our treatments are transparently effective. We will need to be confident that we can predict outcomes, and happy that we understand how our treatments work and for whom. Furthermore, we will need to be very clear that the benefit of these treatments completely outweighs their negative effects. Remember, no other branch of medicine has the power that psychiatry possesses. We will need to be at least as confident as the rest of medicine about the veracity of our science if we are to justify this power. Do we have such a science?

…[R]ecent metaanalyses [of research on antidepressants] represent not only a challenge to our prescribing but also question the foundations of contemporary psychiatric science itself. Rather than embrace the therapeutic reality and the theoretical implications of the placebo phenomenon and explore ways of incorporating these positively and transparently, a number of prominent psychiatrists have sought to justify current prescribing practices by dismissing the results of these meta-analyses. Some of them have done so by arguing that we should abandon the evidence-based medicine (EBM) approach. They say something like: ‘actually science isn’t that important in debates about psychopharmacology, what is really important is the experience of the doctor’. So we hear one prominent psychopharmacologist, MacAllister Williams, insisting that: ‘it matters little whether the patient responds due to the placebo effect or the specific pharmacological actions of the drug, as long as they get better’.11

But the whole logic of EBM, of double blind controlled trials, is to identify what part of therapeutic improvement is due to the placebo response. MacAllister Williams is telling us that this is not important: we know how to get our patients better with antidepressants and that is all that matters.

The psychiatric discourse around antidepressants is far from the ‘strong and unambiguous science’ demanded by Roth and Kroll. Is the science of anti-psychotics any more robust? The development of second generation antipsychotics was heralded as one of the great achievements of modern psychopharmacology. For many years after their introduction, psychiatrists told patients and relatives how safe and effective these drugs were. There was talk about a ‘breakthrough’ in the treatment of schizophrenia. Several years on, and the picture does not look so rosy. We now know that these drugs are possibly more toxic than the earlier ones and there is no evidence that they are more effective. Furthermore, in a major paper in the Lancet last year, evidence was presented to show that even the notion that these drugs represented a significantly different grouping was false.12 In an editorial comment on this paper, Peter Tyrer and Tim Kendall wrote: ‘The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed. But how is it that for nearly two decades we have, as some have put it, “been beguiled” into thinking they were superior?’.13

Antidepressants and antipsychotics are cornerstones of psychopharmacology. These are the drugs that are administered to patients when they are detained. Psychopharmacology is the usual form of treatment given to patients on an involuntary basis.

My argument is that the science we have available to us now, with its explanations and treatments, is simply not of the standard set by Roth and Kroll to justify the power that psychiatrists have been given. [emphasis added]