How to reconcile agency with mental illness

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squarepeg
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How to reconcile agency with mental illness

Post by squarepeg » 11 Mar 2017, 15:42

Something I am having a hard time with lately but am too embarrassed to bring up with anyone at church: We are taught that conditions like ADHD, autism, depression, bipolar, dementia, etc are not generally the person's fault. At least that is my understanding. And yet many of these conditions seem to affect the person's ability to exercise his/her agency fully. Someone on this forum shared his experience being able to overcome an addiction to pornography only after being adequately treated for ADHD. Parents of autistic children often note that changes in diet have profound effects on their behavior to where they're able to verbally communicate when off the special diet they were unable to do so. People with Alzheimer's sometimes cannot control their emotional reactions and may tell rude things at loved ones whom they would never ordinarily have treated that way.

Agency is supposed to be a gift that each of us is given. How do we make sense of this? Has anyone heard/read a good explanation?

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Re: How to reconcile agency with mental illness

Post by Curt Sunshine » 11 Mar 2017, 16:18

Agency is one's ability to choose what to do. It varies in extent from person to person - and we teach that people will not be condemned for things they can't control - areas where they aren't completely free.

Even though it I still a key part of our theology, grounded in the 2nd Adticle of Faith, most members never consider the scope of it. I think that is because our Western culture emphasizes individuality and independence and the idea that all can do anything (at least the "normal ones") so much that we don't want to admit we all are deficient or disabled in some way.

What do I take from it? My best is good enough. Not what I think my beat should be but what actually is my best. I know I am trying to do my best, so I don't get hung up on insisting I be even better. I try to be even better, but I value the effort and intent over the actual result, since I believe the gap has been bridged already.
I see through my glass, darkly - as I play my saxophone in harmony with the other instruments in God's orchestra. (h/t Elder Joseph Wirthlin)

Even if people view many things differently, the core Gospel principles (LOVE; belief in the unseen but hoped; self-reflective change; symbolic cleansing; striving to recognize the will of the divine; never giving up) are universal.

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SamBee
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Re: How to reconcile agency with mental illness

Post by SamBee » 11 Mar 2017, 17:16

Agency is relative. Can we stop breathing by choice? No. Well, a handful can but that's not the point. Can we choose (not) to make an unprovoked attack on someone? Yes. Well, again the vast majority of us can.

The biggest joke about agency is that it just won't go away. Theologians have debated the issue for millenia. Religion declines, and the shrinks get in on the act. And no one is none the wiser. The one thing I can argue against is the two extremes i.e. automatons vs free agents. It is just a matter of how far along that spectrum we are.

As an observer of humans, I certainly think that many of us do NOT use our free will as much as we might and are instead swept along by the currents of animal instinct and society.
DASH1730 "An Area Authority...[was] asked...who...would go to the Telestial kingdom. His answer: "murderers, adulterers and a lot of surprised Mormons!"'
1ST PRES 1978 "[LDS] believe...there is truth in many religions and philosophies...good and great religious leaders... have raised the spiritual, moral, and ethical awareness of their people. When we speak of The [LDS] as the only true church...it is...authorized to administer the ordinances...by Jesus Christ... we do not mean... it is the only teacher of truth."

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Heber13
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Re: How to reconcile agency with mental illness

Post by Heber13 » 11 Mar 2017, 19:01

One consideration I have had on this topic, is that by design, there are conditions in this life that put us in a place of relying on others at times. Sometimes, the choice is to accept what the limitations of the individual's situation is, and work within the limits given...and then agency makes sense. But there are many examples of things that limit a person's agency with uncontrollable factors. Even still, one is judged by the choices made within their scope of influence, and humbly accepting the fact there is a reliance on the group, or others, or God for the rest.

For example, with bipolar...the person's thinking may be impaired. That may make them impossible to deal with, and the person with bipolar can't see it to choose to think differently about things. However...there are many people with bipolar disorders that give in and accept the diagnosis, accept the help from others, accept the recommendations for medications, accept the coping mechanisms from DBT or other methods...and they can manage through their life, even with a mental illness. If they can learn to let go of stigma and their own fears, and accept help by others...they learn that by themselves they can't handle this condition. But they have a choice to fight against others trying to help them, or give in and accept the help and try to have a fairly normal life.

Mental illness is always on a scale. So...it depends on the severity to know how much a person can or cannot do with it. But, I believe our faith in the Atonement is that God makes up for the difference and so it becomes a level playing field for all. For the severly mentally ill...God knows their capacity and their heart, while we get judged on dealing those members of society and how we do it and how we protect ourselves without becoming uncaring.

Even still..that doesn't mean we can give the mentally ill a free pass and not hold them accountable. I wonder sometimes if we find out in the next life that Laman and Lemuel had mental disorders...Nephi at some point had to take his family and followers and get away from them. Mental illness or not, we choose how to protect ourselves and families.

Perhaps...the amount of agency varies by person...and therefore...takes a god to judge all. We all get physically sick during our existence, just various degrees of it and we manage it. Perhaps the same is with our minds...and we'll all be mentally ill at different times and different extents...we have to learn to manage it. The difference is trying to manage something that is impairing our thoughts to manage it. So...it may require reliance on others to help, which means, me trying to help others when they need it in the appropriate ways.

It is an interesting topic, because agency is at the center of the plan of happiness. And yet...mental illness seems to impact agency. Good topic.
Luke: "Why didn't you tell me? You told me Vader betrayed and murdered my father."
Obi-Wan: "Your father... was seduced by the dark side of the Force. He ceased to be Anakin Skywalker and became Darth Vader. When that happened, the good man who was your father was destroyed. So what I told you was true... from a certain point of view."
Luke: "A certain point of view?"
Obi-Wan: "Luke, you're going to find that many of the truths we cling to...depend greatly on our point of view."

ydeve
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Re: How to reconcile agency with mental illness

Post by ydeve » 11 Mar 2017, 22:15

I think agency is taught incorrectly in SS. We don't have the agency to choose to do whatever we want to do, whether or not others think it's the "right" choice. I don't have the agency to go out tonight and run a 4 minute mile, and some people really can't pick their chin up, get out of bed, and just get on with their day on any particular day. And trying to do what we don't have the agency to do doesn't work out. As Yoda said, "Do or do not, there is no try." If you're trying instead of doing, it's time to go find a different approach.

I spent a number of years of my life under the delusion that I had more agency than I thought I did. "Just trying harder" did nothing to address symptoms of what I now understand to be anxiety and ADHD. Understanding exactly where I do and do not have agency has been the main "trial" in my life so far, and I'm still learning how to best work within those limitations.

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Reuben
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Re: How to reconcile agency with mental illness

Post by Reuben » 12 Mar 2017, 05:50

Brain imaging studies have predicted certain simple decisions many seconds before the subjects are aware of making a decision. This suggests that most people are on autopilot most of the time. Conscious choice may be rare.

Psychological studies have found that people will defend decisions they didn't actually make if they thought they made those decisions. This suggests a model of decision-making where decisions are made subconsciously, and one purpose of conscious thought is to explain them.

Mindfulness and meditation have been shown to change basic desires and emotional states. (Most of the research has focused on reducing negative effects such as anxiety and intrusive thoughts.) This suggests that another purpose of conscious thought is to alter patterns of subconscious thought.

Other studies have shown that believing in free will causes people to act more morally. This suggests that, even if we don't have agency, it's often good for us to believe we do.

IMO, if we have some kind of agency, it's very limited. The choices we make - and therefore should be accountable for in an eternal judgment - are extremely high-level ("I'm a kind person"), post-hoc ("I won't do that again"), or immediately suppressive ("I really want to shout right now, but that would be wrong").

I think the kind of agency we're usually taught in Sunday School is ridiculously fine-grained and totally unsupportable. It might be good for people to believe it most of the time - until they believe it about the effects of an addiction, mental illness, bad medication, a strong negative personality trait, or anything else that can't be changed just by wanting hard enough to change it. Then believing in fine-grained agency won't change bad behavior, and can even make bad behavior worse as guilt and depression set in. Besides self-blame, it also leads judgment from others. Lots and lots of judgment.

To tie this back to squarepeg's original post, I think everyone has much less agency than is taught. Mental illness only illustrates that fact by reducing it further.
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LookingHard
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Re: How to reconcile agency with mental illness

Post by LookingHard » 12 Mar 2017, 06:58

I agree with many of the comments. A few comments that Reuben made about "your mind makes a decision and then lines up data to support that before you even sometimes have a chance to think about it" are reflected in a blog I posted https://wheatandtares.org/2017/02/07/th ... eous-mind/

But to be honest, I go even a bit farther than some of the other comments on how much the mind is in control more than "we" individually are. Let me give a few examples just in one area of hormones.

I know of someone that was working with an endocrinologist (Dr. dealing with hormones and such). She was in her 50's had been seeing the Dr. for a while. Suddenly after one visit she felt really odd. Everything around her turned sexual. She suddenly wanted to have sex all the time with her husband and couldn't get enough. It was driving her crazy. She went back to the Dr. for a followup a week later and she mentioned this to the Dr. and he reviewed her chart and said, "Well - you know what it is like being a teenage boy as my assistant gave you 10X the amount of testosterone you were supposed to have received." She said ever since then she has so much sympathy for young men.

Another was I heard someone that had a sex change operation, including full hormone treatment. They commented on the drastic change as, "I no longer believe in free will."

Another case was covered on 20/20 back a while. Suzie Hamilton was an Olympian and a married mom. She found she was bipolar. The doctor gave her some meds to especially help with the depressive mood swings. The problem was it revved up her sex drive out of control. She left her husband and daughter because she suddenly had the insatiable drive to be a high priced Las Vegas prostitute. She just HAD TO. After she got of those meds she went back to "normal" (luckily her husband stayed with her).

And one that I can't relate to is that of PMS. I have known nice women that grow horns once a month. A real Dr. Heckle and Mr Hyde. They are not in control of their moods as I generally am.

But having said all that, I do agree with BELIEVING you have free agency does drive one to consciously make more moral choices. I have known people that are so "what can I do, I was born into this situation and there is nothing I can do to improve it." That frame of mind really limits a person.

EDIT: after reading this is sounds like I am really strongly pushing we don't have any agency. That isn't my position. I think I am pushing against the often touted (even if implicitly) that we have full agency and each of us just need to overcome our base urges and we would be perfected.

Just to give another different example. In the US we have an obesity problem that I think stems from eating too much of the wrong things, not enough exercise, and a few other factors. Before we write off our appetite as 100% terrible, I have a friend that during cancer treatment lost his sense of taste. I figured, great - you can eat all those veggies you didn't like since it all tastes the same. I found out that this condition is considered a terminal illness that most people die within a shorter period than you think. Sure enough, my friend died within 6 months. It may have been from the cancer, but he had almost zero desire to eat anything. He was about at 50% of his pre-cancer weight. If the cancer had not ended his life, he certainly would have died from mal-nutrition shortly.
Last edited by LookingHard on 12 Mar 2017, 08:11, edited 1 time in total.

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SamBee
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Re: How to reconcile agency with mental illness

Post by SamBee » 12 Mar 2017, 07:41

DASH1730 "An Area Authority...[was] asked...who...would go to the Telestial kingdom. His answer: "murderers, adulterers and a lot of surprised Mormons!"'
1ST PRES 1978 "[LDS] believe...there is truth in many religions and philosophies...good and great religious leaders... have raised the spiritual, moral, and ethical awareness of their people. When we speak of The [LDS] as the only true church...it is...authorized to administer the ordinances...by Jesus Christ... we do not mean... it is the only teacher of truth."

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LookingHard
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Re: How to reconcile agency with mental illness

Post by LookingHard » 12 Mar 2017, 08:16

SamBee wrote:
12 Mar 2017, 07:41
Is this free will or not?

http://nzherald.co.nz/lifestyle/news/ar ... d=11811409
I almost wonder if this is getting back to the thread title. This person seems to have quite a compulsion to really be different.

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nibbler
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Re: How to reconcile agency with mental illness

Post by nibbler » 12 Mar 2017, 10:02

Reuben wrote:
12 Mar 2017, 05:50
To tie this back to squarepeg's original post, I think everyone has much less agency than is taught. Mental illness only illustrates that fact by reducing it further.
I agree.
Ray DeGraw wrote:
11 Mar 2017, 16:18
...we all are deficient or disabled in some way.
Yes, this too.

Our theology places so much emphasis on agency and our ability to chose right and wrong that certain questions have been raised.
Q: What about children? They can't determine right from wrong.
A: The Atonement covers them, they get a free pass to the Celestial kingdom. They are accountable at age eight.

Q: What about people with mental impairments? They can't be held accountable for their decisions.
A: Same answer, right? They do what they're going to do but the Atonement makes it right.

This quote is about judgment, which is slightly off topic, but I think it relates because when we talk agency it's often tied with how we'll be judged by god or others.
Joseph Smith wrote:... While one portion of the human race is judging and condemning the other without mercy, the Great Parent of the universe looks upon the whole of the human family with a fatherly care and paternal regard; He views them as His offspring, and without any of those contracted feelings that influence the children of men, causes ‘His sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust.’ He holds the reins of judgment in His hands; He is a wise Lawgiver, and will judge all men, not according to the narrow, contracted notions of men, but, ‘according to the deeds done in the body whether they be good or evil,’ or whether these deeds were done in England, America, Spain, Turkey, or India. He will judge them, ‘not according to what they have not, but according to what they have’; those who have lived without law, will be judged without law, and those who have a law, will be judged by that law. We need not doubt the wisdom and intelligence of the Great Jehovah; He will award judgment or mercy to all nations according to their several deserts, their means of obtaining intelligence, the laws by which they are governed, the facilities afforded them of obtaining correct information, and His inscrutable designs in relation to the human family; and when the designs of God shall be made manifest, and the curtain of futurity be withdrawn, we shall all of us eventually have to confess that the Judge of all the earth has done right.
...and along comes mental illness.

As pointed out in other comments, mental illnesses occur along a spectrum. It may be easy to see how someone that has severe mental illness lacks agency and difficult to see how someone that has relatively few or mild symptoms also lacks agency. Heck, I think many have problems recognizing that mental illness impairs our ability to choose even in the most extreme of cases. Often "I wouldn't have done that" takes over and we're right back to judging. When we think, "I wouldn't have done that" there's an implication that the other person has the same ability that we have, and we wonder why they made the wrong "choice," the choice we wouldn't have made.
Heber13 wrote:
11 Mar 2017, 19:01
For example, with bipolar...the person's thinking may be impaired. That may make them impossible to deal with, and the person with bipolar can't see it to choose to think differently about things. However...there are many people with bipolar disorders that give in and accept the diagnosis, accept the help from others, accept the recommendations for medications, accept the coping mechanisms from DBT or other methods...and they can manage through their life, even with a mental illness. If they can learn to let go of stigma and their own fears, and accept help by others...they learn that by themselves they can't handle this condition. But they have a choice to fight against others trying to help them, or give in and accept the help and try to have a fairly normal life.
That can be a tough path. More often than not a person with mental illness does not think that there's anything wrong with them. It's hard to accept help for a problem that you don't believe you have. If you were overweight would you resist help from others trying to get you to eat more because they thought you were anorexic? I'm not putting you on the spot or anything ;) , I'm attempting to convey how things might look from their perspective.

What drove my faith crisis is related to this subject, mine also had mercy and justice tossed in the mix. After a while universal salvation started bubbling to the surface, which had it's own head scratchers to deal with.
Of course I don’t want to get knocked down. But the single and sole solution to that fear is to not go anywhere where I can be knocked down. And is that not already being knocked down?
― Craig D. Lounsbrough

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