Moral Reconation Therapy verses Mental Illness

Over several years, Moral Reconation Therapy ("MRT") has become a big business at Elgin Mental Health Center. Some people (clinicians or patients - the difference is minimal) like it, and some don't. But veteran administrators in Illinois' "forensic mental health system" must be aware that it presents a rather interesting, perhaps a rather dangerous, intellectual problem.

MRT situates the problem of criminal recidivism in dysfunctional behavioral choices and deficient moral reasoning. Psychiatry situates the problem of an NGRI acquittee's dangerousness in mental illness, a disease like any other, in the brain.

The MRT therapist at Elgin is basically telling patients that their problem is they lie, cheat, steal, betray, victimize and blame other people; and the fact that they are where they are (locked up in that fake "hospital") is their own fault entirely. 

At the same time, the psychiatrist is basically telling patients that it's only the mental illness that limits their ability to make behavioral choices or to reason morally; it's not their fault at all, they just need to take drugs to adjust their brains.

I have several clients who have failed or opted out of MRT because they cannot honestly reconcile the demand for acceptance of sole blame with the demand for acceptance of psychiatric doctrine on mental illness. They figure one idea or the other must be bullshit. But it sure is unacceptable to mention this discrepancy! 

The psychiatrists sure will tell the judges that any patient who questions the "illness needing medicine" view lacks insight and therefore remains dangerous. The MRT therapists sure will tell judges that any patient who blames their brain disease is being manipulative and therefore remains dangerous. The bottom line is, you have to lie, in the right way at the right time, or you can't ever get out.

This is the essential, overriding lesson of forensic mental health: You must become a really competent liar, to others, to society, and to yourself.

It's a terribly expensive lesson, in blood, treasure and human dignity.