Choice, responsibility and judgement: People of the Lie?

So, to refer to my first post on Christmas Day, is Dr. I right? - do I have the choice whether to be psychotic or not? Many would say there is no choice at all, that the only real choice is to take responsibility for one's illness, comply with one's treatment, and do one's best to get well. And so far I have done this. I am well. In fact, this whole question of choice is one which was much more pertinent to me a week or so ago. Since then I've had a little taste of depression again, and some breakthrough psychotic symptoms (I have basically recovered, though I still need medication) and it was pretty awful. Despite claims that psychosis is merely a special kind of sensitivity or intuition, psychotic illnesses are named thus because they are a form of suffering. For me, the choice is clear. I'm going to give the task of making everyday life more meaningful, and thereby choose not to be psychotic, everything I've got. (Ironically, though, one thing that has already made life more meaningful for me is writing this blog, so to some extent I'm still relying on the concept or memory of psychosis, if not the immediate experience, for meaning). It also has to be said that getting a few breakthrough symptoms is nothing like being 'frankly psychotic'. It's easy to bang on about what is lost when one gets well, and the positive elements of the psychotic world, when the most one suffers is the psychiatric equivalent of a mild head cold...

So what does this idea of choice mean when you are dinky di sick? I can't speak for anyone else, but I know that when I was first unwell and had not yet begun the hard yards of psychotherapy, untangling and picking apart my mixed-up ideas about how people and the world worked, I was definitely hurting many of the people closest to me. For that reason, the commitment to get well had to be about more than just improving my own quality of life. It had to be a moral issue. I couldn't have known at the beginning that when I was pronounced well I would go through a kind of spiritual crisis, but I'd like to think that if I did, I still would have held firm to that commitment.* The problem with making this a moral issue is that, having put in more than a decade of very hard work and unflinching honesty with myself and my doctors, and developing insight and the capacity to reflect upon my motivations, I find myself getting all 'judgey' about one person in particular who seemingly has not done these things, who has not taken responsibility, and is hurting people I love. I'm not proud of this.

I suppose the first thing I want to say to myself about it is: Not being the person in question, their doctor, or their God, who can you know they have not taken responsibility, Amber? The second is: You've obviously been toying with the idea of allowing yourself to become unwell, so where is your empathy, Amber??

In 'People of the lie: The hope for healing human evil', M. Scott Peck argues that the definition of human evil is enacted by the person who will not reflect upon themselves and take responsibility for their maladjustment (my paraphrase). Another version of this idea I read recently says, 'Evil is an extreme form of human unconsciousness'. What do I think of that? (What do you think of that?) Certainly, when we lack insight, self-awareness, and a degree of psychological maturity, we can hurt people. We can hurt ourselves, and in so doing, hurt others. The trap is that the difference between me and this person who allegedly has not taken responsibility seems so slight, resting on a single decision I made years ago (and could so easily not have made!) that judging him feels like very dangerous territory indeed...

*I want to be clear that I'm aware there are people for whom recovery is impossible, many of whom have hearts of absolute gold.
Rest in peace, Dave, we miss you...

Peck, M. Scott. (1990). People of the lie: The hope for healing human evil. London: Arrow.