Hope
as a Syndrome
According
to the fount of all immediate knowledge, Wikipedia,
a “syndrome” is “a set of medical signs and symptoms that are correlated
together.” Let’s work with that.
Once a correlation between signs and
symptoms has been identified and accepted by physicians as important, doctors
who encounter one of the signs or symptoms in a patient can be alert for the
possible presence of the others. The
known association of one sign or symptom with another can be useful even before
the cause of the syndrome is discovered.
Sometimes, as with Acquired Immune Deficiency Syndrome, a single direct
cause is found, e.g. a virus. In other
cases, such as toxic shock syndrome, we learn that multiple causes can produce
very similar clusters of symptoms.
The concept of a syndrome gets used in
wider circles. In psychology, “syndrome”
labels many different clusters of dysfunction.
For example, the Munchausen syndrome, sometimes called “hospital
addiction syndrome,” is marked by the patient repeatedly feigning disease,
often many different kinds of disease.
Researchers speculate that Munchausen patients are trying to gain
sympathy or attention, but psychologists do not have a single theory about the
cause of the syndrome. Obviously,
researchers would like to discover the cause or causes of such disorders/syndromes,
but in some cases treatment can begin without that knowledge. It is enough to know that x correlates with
y, and that such-and-such treatment can reduce the negative effects of the
syndrome.
Now let’s move further afield.
Philosopher Adrienne Martin borrows a
usage from Margaret Urban Walker, who calls hope a syndrome. Martin and
Walker want to drain all the negative connotations from “syndrome” when talking
about hope. In medicine and psychology,
syndromes are bad; Martin and Walker think hope is good. The idea is that in hope there are
recognizable correlations or associations of a variety of signs or symptoms. Walker says, with Martin approving, that hope
is “characterized by certain desires
and perceptions, but also by certain
forms of attention, expression, feeling, and activity”
(my emphases).
That’s an amorphous and seemingly vague
collection of descriptors. Does it
really help us to call hope a syndrome, if the list of signs and symptoms
covers so much space?
Maybe.
Martin adopts the syndrome definition of hope because she is reacting
against a definition of hope that has dominated modern philosophers’ discussion
of hope. (In philosophy we say anything
after 1650 is “modern.” So the modern
philosophers Martin disagrees with include David Hume, who died in 1776.) Martin says that modern philosophers
generally agree that hope has two parts: a desire
that some outcome occur along with the belief
that the desired outcome is neither impossible nor certain. Martin calls this the “orthodox” view among
modern philosophers (which may be read as a humorous gibe at most of them, who
would hate being labeled orthodox in regard to almost any subject).
The modern “orthodox” definition of
hope: Hope = Desire + Belief that the desired thing is possible but not certain.
Martin agrees with this definition as
regards belief. We might wish for things that we know are
impossible, but we don’t hope for
them. And it hardly seems right to say
we hope for something we already have or that we are absolutely certain to
receive. So it seems that we hope for things
we believe are possible but not certain.
The place where Martin disagrees with
the modern definition regards “desire.” She
points to cases of “hoping against hope,” that is, cases in which people hope
for very unlikely things. Martin asks
that we imagine two cancer patients, Alan and Bess. The doctors have told Alan and Bess that the
experimental drug they would like to try has only a 1 in 10,000 chance of
curing them. Alan and Bess both agree to
the drug trial, but while Alan holds only faint hopes for a cure, Bess hopes
strongly. Now, Martin asks, how should
we explain the difference between them?
If hope is defined only as desire + belief, it seems we must say that
either Bess desires a cure more than Alan or that she is somehow fooling
herself about the chances that the drug will help her. Martin, who has spent time with actual cancer
patients, says neither of these explanations will do. Even if, in some cases, one person deceives
herself about the likelihood of her desired outcome or has stronger desires, is
it likely that this is true in all
cases of hoping against hope?
Martin says we need a better analysis
of hope. Hope is not merely desire +
belief. Other things come into play, and
that leads to the syndrome analysis of hope.
When we hope, we think about the
outcome we desire. We may imagine what
it would be like if the hoped for outcome occurred. We let our minds dwell on it. The presence of hope in our mind makes us
alert to happenings around us; we perceive events differently. Hope is often accompanied by positive
feelings; in a sense, we rejoice in anticipation of the hoped for outcome. Hope sometimes affects the decisions we
make. When we hope, we are able to
suffer setbacks without despairing of the eventual good result.
Thought, imagination, perception,
emotions, decisions, and actions: on the syndrome analysis hope is
complicated. That sounds right to me.
Martin asks us to consider a recent
parable of hope, The Shawshank Redemption. Andy and Red are friends in Shawshank
prison. Red, a prison veteran, warns
Andy against hope. “Let me tell you
something, my friend. Hope is a
dangerous thing. Hope can drive a man
insane.”[1] Against Red’s advice, Andy hopes to
escape.
For more than 20 years, Andy entertains
certain thoughts. He lets himself feel certain feelings. He
imagines certain future scenes. He
plans and executes certain actions. In the story, Andy eventually escapes. But the value of hope does not depend on this
happy outcome. Andy’s hope sustained him
through many years of imprisonment, and he would have enjoyed this benefit even
if his escape failed in the end. The
moral of the story is expressed in Andy’s words to Red: “Remember, Red, hope is
a good thing. Maybe the best thing, and
no good thing ever dies.”[2]
If hope is as complicated as the
syndrome analysis suggests, it may be that we understand it best through
stories. A narrative can show how the
different “signs and symptoms” hang together.
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