A therapy problem

At an out-of-state convention I was talking with another therapist who presented an interesting treatment problem.  I had no really adequate answer, and after having been a therapist for 60 years that's at least a little unusual.

His patient told him that many years previously he had committed some terrible crimes.  Without going into detail, the patient stated that he had accepted money to kill several people. More recently he had gotten sober for the first time in many years and had subsequently fallen into a severe depression.  He had become suicidal and been hospitalized.  

His therapist told me that later on in the therapy his patient recognized his nearly unbearable guilt as undoubtedly the driver for his suicidal impulses and depression.  The patient's depressive thoughts were severely self-blaming, and in some ways even appropriate.

Here are the questions the other therapist asked me.  Should he even be assisted in recovering from his depression?  Isn't his guilt an appropriate response to his behaviors?  Is it an appropriate use of psychotherapy to be relieved of the guilt for his crimes?  Is it acceptable to kill people and then expect to be relieved of the psychological cost of committing such awful crimes? Is that even ethical?

I thought a long time before I was able to give the other therapist any answer at all.  After some thought my initial response was that the first and second principle of the psychologist's ethical code is:  Do no harm. Act to help the patient.  There are no exceptions to those principles, and to me there should be none. 

That being said, the other questions are open for your answers.  I'll be glad to hear any comments.

So before that was what?

 I apologize for my ignorance of physics.  However, ignorance doesn't stop me from puzzling over the larger mysteries, such as the state of the universe at the moment of the Big Bang.  In fact, ignorance seems assist me in being puzzled.  So if you are knowledgeable in this area, you have my apology, and you might want to spend your time reading something more useful to you.  Nevertheless I will appreciate any comments.

In the universe entropy always increases, which is to say the universe gradually becomes more disordered, ultimately resulting in a state of maximum entropy or disorder in which nothing can happen.  Time has even been defined as taking its direction from increasing entropy, i.e. that time is the rate at which entropy increases.  

The point-universe at the moment of the Big Bang was in minimum entropy, or maximum order.  Since that moment. entropy and disorder have increased as we move slowly toward total disorganization.   At the end of the universe, it will become a "soup" of undifferentiated states of energy in which nothing can happen.  Time will have stopped since there can be no events. All the little fires will be out.  Like a giant firework display, the Universe will have happened. 

Prior to the Big Bang, what can be said of the nature of the universe?  Probably we can't use the concept "prior" since there would have been no time in existence.  Time requires events which it can discriminate between.  A famous physicist (whose name I can't recall) said that time was what kept everything from happening all at once.

At the moment of the Big Bang, an event occurred and thus time began.  We can't conceive of a prior universe existing without time.  "Prior" requires a preceding time.  Events require an increase in entropy, so there could be no events in a timeless universe.  We do know that the universe at the moment of the Big Bang must have been in a state of minimum entropy/maximum order.  

How did a state of maximum order occur, and how can it be described?  The Big Bang was an event, and therefore it happened within time and space.  How did that event happen prior to time? Once it has happened we can consider the order of events. But "before" the Big Bang nothing can exist. Time begins with the first event, the Big Bang.

To fall back into the supernatural and posit an agent who starts the Big Bang seems to me a cheap and superficial way of avoiding the problem.  The Big Bang is itself a causeless cause.  Since event history began with the Big Bang, it is pointless to assume a prior event.

Someone out there, please enlighten me.  I also recognize that it may be impossible to do that, but I will appreciate the attempt.

A request for rational thought in emotional times.

Much has been publicized about the way police officers differentially treat particular ethnic or other easily identifiable groups.  It is almost invariably implied that the differential treatment observed arises solely from the racial or religious (or other) biases of the police.  If group A is treated differently than group B, it is implied specifically that this is because of the attitudes of the police, not real differences between the groups.

This implication ignores the possibility that group A may behave differently than group B.  What if there is a higher rate of crime in group A than there is in group B?  Other factors may also make the groups actually different in their public or private behavior.  The police may of course be biased, and that can be a terrible thing.  The police may also be responding to legitimate and measurable differences between groups. 

In fact, of course, the factors of bias and behavioral differences may play into each other, each making the other factor more embedded and extreme.  We should also consider the important functions of “prejudice”, meaning, of course, to pre-judge a situation on a basis of incomplete data, as in to judge an individual solely on the basis of some group to which he belongs.  Nature seems to have intended prejudice as an emergency default judgment in a rapidly unfolding situation in which the data are not yet clear.  For instance, when a homeless stranger knocks on my door wanting to spend the night, my prejudices kick in instantly, based on the generalities I have in my head about homeless people.  Fair?  Of course not.  Pro-survival? Maybe so!  Certainly my first response is skeptical/distrustful, at least until I have thought through several scenarios.

Back to my original topic.  Police in particular frequently respond to a ongoing violent situation with little or no time to step back and rationally assess it.  Such situations invite, even demand, pre-judgment.  It is easy to observe that in video recordings of confrontations between police and groups of people that both sides display prejudice and over-generalization in their attitudes and behaviors, and this tends to intensify the irrational violence already beginning in the situation. In such situations, immediate distrust is not an irrational response, but it should not be the only factor.

Many questions need to be asked that are not being asked.  Instead we are encouraged to “take sides” without ourselves knowing all the facts.  Our responses are becoming more and more extreme and emotionally-driven.  Nobody asks if group A (or B) is actually more violent than the other, or asks if there are more crimes committed by group A than group B.  The society in which we live needs to look harder at how specific groups are treated.  If there is more violence or crime in group A than B, why is that?  We need to look at the systemic illness, not just the symptoms.  We need to address the illness itself, our systemic rationalization for the unfair treatment of various groups. 

Out of systemic unfairness comes rage against the system.  Systems don’t like to change.  We don’t like to change. Perhaps it takes rage to get us to pay attention, but rageful decisions are invariably exaggerated and extreme.  We need to think, not just feel, and think clearly and publicly about what we need to do differently.  Talk is cheap.  Change is hard, painful and anxiety-producing.  For change to last, it has to be studied and carefully planned. Immediate emergent responses are not a basis for real, stable solutions. We need to slow down and make our changes work.

More to follow.