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Psychological liberty has been constricted as rates of virtually all mental disorders and subclinical problems like racism have been rising in recent years and during the pandemic. But it's not too late.
In psychiatry, we don’t often talk about the phrase from the Declaration of Independence, “Life, Liberty, and the pursuit of Happiness.” Yet, the phrase is fitting in our field, especially during the COVID-19 pandemic.
Certainly, we try to preserve life by preventing suicide, homicide, and psychiatrically related medical problems. We will break our ethical principle of confidentiality if we make a clinical judgement that a life is in danger.
If we view liberty as psychological freedom, that is one of the essential aspects of our work. Most mental illness constrains psychological freedom of thought and action. Clinical depression, for instance, causes undue negative thinking that can even result in suicide.
Freud cautioned against patients against expecting greater happiness from treatment. Instead, he believed psychotherapy could treat neurotic misery, but a patient would still be left with ordinary human unhappiness.
Curiously, any degree of mania is one kind disorder that may increase happiness, temporarily. Since the time of Freud, we have learned more about the nature of happiness. Although the functional outcome of successful treatment should help a patient to find more happiness, it does not.
In the Declaration of Independence, life, liberty, and the pursuit of happiness was viewed as an “unalienable right” which our government was created to protect. It seems clear that our society has not provided enough of that protection from the pandemic. Medical experts have maintained that more lives have been lost than would have been with earlier action, delayed opening of live socializing, and much more extensive wearing of masks around other people. Fortunately, there is still time to backtrack and do better.
To combat the pandemic, our physical liberty was necessarily constricted, though that was anticipated to be temporary in order to reduce morbidity and mortality. Psychological liberty has also been limited as rates of virtually all mental disorders and subclinical problems like racism have been rising in recent years and during the pandemic.
Pursuit of happiness, of course, was more difficult given the unusual restriction of activities that previously brought happiness. On the other hand, people have found other ways that contribute to happiness under restrictions, including viewing creative and new video programs. Family life can increase or decrease happiness, depending on the quality of the relationships.
The Goldwater Rule limits what psychiatrists are supposed to say about our current societal leaders because analyzing them without an examination and permission to divulge a diagnosis would be unethical. However, we can—and should—comment on the outcomes of such leadership, including the life, liberty, and pursuit of happiness that our government is supposed to protect whenever practical and possible.