Putting Psychiatry on the Couch

Abstract

As a method of inquiry, a study of institutional corruption starts with the presumption that the individuals within the institution are “good people” who want to behave in an ethical manner, consonant with societal expectations and their own self-image as ethical beings. However, “economies of influence” encourage unethical or problematic behaviors throughout the institution, and eventually those behaviors become normative. At that point, you have a case of “good apples” working within a “bad barrel.” Moreover, the fact that problematic behaviors have become normative may lead to an institutional blindness. Those within the institution lose the capacity to see themselves—or their institution—from an outsider’s perspective. They will remain convinced that their behavior is ethical, confident that conflicts of interest have not altered their behavior, even while outsiders see their behavior as quite compromised, or even ethically outrageous.

It’s difficult to get a man to understand something if his salary depends upon his not understanding it.

—Sinclair Lewis, 1935¹