I’ve been mining my file cabinets, perusing papers I wrote and articles I read in graduate school, and I came across one that has always intrigued me: The uses of hopelessness (American Journal of Psychiatry — Abstracts: Bennett and Bennett 141 (4): 559).

It would seem that to consider the utility of hopelessness is antithetical to my profession. Indeed, much of what I do is nurture hope and connection in someone who is unable to summon or create it, and facilitate his growth and healing so he can nourish himself. So isn’t promoting hopelessness destructive?

Bennett and Bennett suggest that, in certain cases, one can develop a false hope which interferes with accepting reality and prevents real growth from occurring. This succinct article provides three case studies describing how accepting the unchangeability of a situation led a patient to adapt constructively. They state that:

In the absence of scientific evidence to the contrary, it is tempting to regard the cause of an emotional problem as human in origin in order to make it seem more controllable and treatable; it is more frightening to be the victim of bad luck. Most theories of psychotherapy provide fertile ground for this temptation by positing causative relationships between emotional problems and factors in the patient’s personality or social relationships.

In other words, we still think of emotional problems as having an identifiable cause and that, once discovered, should be responsive to change. Any person who is unable to overcome an emotional problem may be viewed as resistant, or as our cultural stigma says, “isn’t trying hard enough” — as if a mental condition is a matter of will.

They continue:

It is paradoxical that theories designed to help bring about change and preserve hope for change may endanger self-esteem and make change more difficult.

To refute that bad luck and blind chance are active in our lives is to open the door to blaming the victim, the family, and society for the illness. On the other hand, belief that human suffering is in God’s control leads “the afflicted to question their lack of influence over God’s grace and so to doubt their own worth.”

If we can accept our human vulnerability to random suffering, we are also free to make more realistic assessments of the damage and to limit our send of personal responsibility for our pain. In the acceptance of helplessness and hopelessness lies the hope of giving up impossible tasks and taking credit for what we endure. Paradoxically, the abandonment of hope often bring new freedom.

I have used this approach in some situations, usually with issues that are intractable: the presence of bipolar or major chronic depression, for example, or someone whose personality has been deeply shaped in maladaptive ways. Rather than push for progress, at some point it has been meaningful to ask the question, “What can life be like if I accept this and it doesn’t change?” It’s a scary question, but it leads us to live in the present and refocus on what can be done now. Acceptance leads to another threshold where a person can truly see new possibilities, ones that are attainable. It also causes us to re-think what we imagine a quality life to be.