Psychology of terminal diagnosis of a civilization

The unusual (and more or less simultaneous) outbreaks of violence at both the recent Notting Hill Carnival and the Reading Festival made me wonder if there is some particular sociological significance to it. This is especially so since other episodes of street violence and looting, including one in Oxford Street, have occurred in recent weeks, although they were little reported.

Now, there is an increasing prevalence of lawlessness in Britain, as elsewhere in the West, which has a number of easily identifiable causes from the breakdown of families and the abandonment of the Christian moral framework, to the victim culture that makes certain groups feel entitled to wreak revenge on ordinary people as supposed oppressors.

But I think one factor, peculiar to this particular phase of history, may be that violence by otherwise ordinary people is a sign of a mass psychological reaction to the increasing awareness that our whole civilization is imminently collapsing.


Individuals given a terminal medical diagnosis characteristically go through identifiable stages of psychological reaction, somewhat comparable to a kind of bereavement before the fact. To begin with, a sense of unfocused fear at some vague set of unfamiliar symptoms may be what sends them to the doctor in the first place. If not, fear is certainly part of the response to being given bad news as a result, say, of some routine test.

But at the point when the doctor (traditionally – maybe it’s delegated to health care assistants or smart phone algorithms nowadays!) sits the patient down and lays out the reasons that their days are certainly numbered, three other stages often occur.

The first stage is denial. In the extreme I’ve come across patients who, after a clear and detailed explanation of a poor prognosis from their consultant, got out of the clinic and said to their companion, “Thank goodness it’s not bad news!” More often, there’s just a sense of unreality about the seriousness of the situation, much like the Phoney War of 1939-40, when it must have been hard for most people to comprehend that war with Germany was not almost business as usual. Maybe the doctor was wrong. Maybe (for the Christian) I’ll pray and nothing bad will happen: I won’t go here into the role of psychological denial, by both victim and those praying, in so many false Charismatic healings.

But time, and increasing symptoms, begin to impress on the patient’s mind that this is not a drill, and the sense of disbelief gives way to some degree of resentment, or even aggression, that such a thing should happen to me. I well remember my dear, even-tempered, father who, on a liquidised diet because of carcinoma of the oesophagus, became unusually abrasive on a hastily arranged “last holiday” simply because my mother and brother could eat.

If all goes well, and the right support is at hand, eventually this stage gives way to a more peaceful acceptance of the inevitability and imminence of death. As any hospice worker will tell you, this can be a very fruitful time for healing family relationships, putting material or spiritual affairs in order, and even productive activities like achieving lifetime travel ambitions, finishing off that half-written novel, and so on.


Now, such a process of adjustment is probably common to all of us who aren’t “taken off” suddenly and unexpectedly. Furthermore, lesser degrees of the same reactions may occur when some other crisis looms, such as the forewarned collapse of a job or business, being wrongly accused and convicted of some crime, and so on.

But I think we can see the same kind of thing on a national scale as a whole population has to adjust to some shift in its fortunes, and so I see the current societal violence as partially symptomatic of the equivalent of the second, resentment, stage of my terminal diagnosis model in the light of creeping universal pessimism about the future of Britain and, indeed, the West. The violence is not, after all, directed primarily at the politicians who have caused many of our problems, or even at the police as their enforcers, but appears more to be just the random outbursting of deep internal frustration.

What is most worrying to me is that the closest parallel to our current situation, the collapse of the Soviet Union, was less traumatic than what threatens us. Neither Vladimir Putin nor the recently deceased Mikhail Gorbachev were lovers of the late Soviet system, but both have described its demise as a huge tragedy. And it was, because of the immense physical and psychological harm it did to the USSR’s huge population, reduced from being members of a world superpower to, in many cases, selling their possessions on the streets just to buy bread. The collapse led to the rise of corrupt oligarchs whose political power has only gradually been nibbled away by President Putin. And as many readers will have come to understand, the initial hopes of becoming partners in the “Free World” were dissolved by the West’s own oligarchs first requisitioning the resources of the bloc, and then apparently becoming determined to destroy its prosperity altogether, setting it up as a pantomime villain via Russiagate and other myths, with Putin as its Emmanuel Goldstein.

But for all that pain, Soviet Communism was an oppressive system in which nobody any longer believed, and it had only been in power for 70 years: I myself had a patient who was old enough to have fled the 1917 revolution. Russia’s rich history and culture were still capable, it seemed, of being retrieved, as was its Orthodox religious heritage, so that despite the long atheist suppression, 50% of Russians now identify as Russian Orthodox, and altogether 85% as believers in God – the highest rate of any European nation.

But for Britons, and indeed most Westerners, there is barely an institution that is not apparently being torn down, if it is not collapsing spontaneously. Not only is inflation threatening many with poverty in the absolute sense of lack of food, warmth and shelter, but fears for the collapse of the entire financial system are becoming mainstream, since there is now so much evidence that there is nothing to back it up – sharply contrasting with the BRICS focus on commodity-backed currencies.

The public, for all the Phoney War pretence, can see that the Net Zero policies are disastrous, and yet are being bludgeoned through by governments. Those governments themselves exude an air of terminal corruption and incompetence, especially as the truth about the gross mismanagement of COVID trickles out. That mismanagement has caused the effective collapse of health services, especially the now worse-than-useless NHS. And the belief that we are being consistently lied to by our media is now a majority one – though somehow the disbelief doesn’t apply to reporting on the Ukraine war, probably because of the longstanding demonisation of Russia by our government.

Even so, a great many people see that either Russia and China are winning the economic war we started by sanctions, or else that we are destroying our own economy through them. Whether they blame Putin or our sanctions for the price of food and its irregular appearance on supermarket shelves, they are well aware that their muesli has doubled in price over the summer and that even basics may soon be unaffordable, as they realistically calculate that they couldn’t afford to cook it anyway. It’s worse for poor pensioners, as one analysis suggests that fuel bills will account for 70% of the basic state pension in the New Year. And even if the well-to-do calculate that they would be able to afford a £15 pint of ale, they can see the centuries-old pubs closing down under the double whammy of COVID restrictions and inflation.

I could go on – and I will, for a little bit. Unlike Soviet Russians, Britons see their literature and history being deliberately destroyed from within, even as politicians make useless noises about the evils of wokeness. They see police underperforming on solving crimes, and overperforming on LGBT dancing, wrongthink monitoring, and suppressing legitimate protests whilst nodding at fanatical environmentalists. They see the established church denying its historical doctrines. They even see apparent attempts to write the historical British as people out of the present, by replacing them disproportionately by racial minorities in jobs and the media, by importing Albanians en masse and then losing touch with them, and by denouncing “whiteness” as the unforgiveable sin. And likewise they gain the impression of being written out of the past by dramas peopling Dickens’s London and Jane Austen’s Lyme Regis with a premature Windrush generation, and by the cancellation of Shakespeare and Chaucer altogether.

If they are not more than usually sceptical, people will even doubt that the very fabric of the nation will survive climate change and sea-level rise. The sceptical still see the land buried under wind and solar farms and chafe under the threat that both gas boilers and wood burners will soon be banned, along with private cars not running off an unreliable grid. But beyond that, thinking people cannot even be sure which of their opinions on these things is theirs, and which are engineered by behavioural psychologists in official Nudge Units.

In short, what is under imminent threat here is a thousand years of not only British, but European, Christian heritage. There is, apparently, nothing that we value scheduled to remain.

Now, it is true that the real situation has not been spelled out by mainstream journalists – pretty much the only person who saw it coming before the last year was Peter Hitchens. But terminal patients sense the truth even when doctors or relatives lie to them, and go through the same psychological stages, only without the support of others – which is why truth-telling became the medical norm in the hospice generation. Hence, Britain’s population might not be able to articulate a fully-formed forecast of just how bad things are getting – if indeed they are not in the stage of denial, which is all too likely given the precipice looming – but deep down they know it.

Christians, too, are badly informed, and are as prone to the vagaries of psychology as everybody else. That, I think, is why in a church setting I hear little optimism about the immediate future, but only muted pessimism and a lot of “business as usual” small talk. But I believe it is the Christians who, having a hope in the One who is bigger than earthly nations and whose empire will stand for eternity, are in the best position to work through the loss of so much, and so be in a position to help others cope effectively.

If, like a skilled medical consultant, we can use what influence we have both to inform our people about the genuine losses facing them, and yet counsel them wisely about what they still possess (to wit, all the riches of Christ), then we can help each other through the stages of denial and anger, through to that place of calm acceptance in which – of all people – we can do useful work in a bad situation.

Perhaps the biblical genre of lament may help us here – to bring our bereavement, together, before God may well encourage us to move beyond grief to a better, because spiritually grounded, hope, as well as into some practically useful activity.

This, I suspect, is where we need to be aiming at this point, rather than hoping against hope that everything blows over and that we can get back to business as usual. Sadly, Idon’t think that the God of Providence has left that door open.

Avatar photo

About Jon Garvey

Training in medicine (which was my career), social psychology and theology. Interests in most things, but especially the science-faith interface. The rest of my time, though, is spent writing, playing and recording music.
This entry was posted in History, Medicine, Politics and sociology, Theology. Bookmark the permalink.

Leave a Reply