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National Observer Home > No. 54 - Spring 2002 > Book Reviews

Book Review: Life at the Bottom, by Theodore Dalrymple

Chicago: Ivan R. Dee, 2001, pages 263 and index, $61.95.

Theodore Dalrymple will be known to many readers as a regular writer in The Spectator and The Daily Telegraph. He is an English psychiatrist who spends much of his time dealing with criminals and drug addicts in a slum hospital and a prison in England.

The author is notable for his unfashionably firm views in dealing with criminals and addicts. In recently commenting upon this book he said,

"You can actually break down [the criminal culture] by saying to them, ‘Now come on! You didn't burgle that house because of your bad childhood, you burgled that house because you wanted to take something in it and you didn't know how else to go about getting it because you're unskilled, you have no intention of getting any skills’ - and they start laughing! And oddly enough, when I speak with them quite plainly, my relations with them improve."

Similarly, in response to drugs:

"Drug addicts come in and they spin me a line, and I just won't have it. There's initially friction because I refuse to prescribe for them and one of the things that's very difficult to get across is that withdrawal effects from heroin, for example, are very minor. They're trivial . . . It's not the way it's portrayed but it is actually the truth. I can't tell you how many people I’ve withdrawn from heroin. You never get any problems with it. It's not like withdrawal from serious drinking, which can be, and often is, a medical emergency. From a medical point of view, I'm much more worried in the prison when someone tells me he's an alcoholic. I'm much more worried about the physical consequences of his withdrawal because they are really serious, and he can die from them. But nobody ever dies from heroin withdrawal. With the vast majority of them, you just take them aside and say: ‘I'm not prescribing anything for you, I will prescribe symptomatic relief if I see you have symptoms, but what you tell me has nothing to do with it, I'm not going to be moved by any of your screaming.

I certainly think that we need more repression. I mean we need our police to be able to say, ‘You will not be drunk in the street, and if you are drunk in the street you will be taken to court, and if you're taken to court you will be punished, and the punishment will hurt, and if you do it again the punishment will hurt even more’."

Theodore Dalrymple is critical of the drug-treating establishment, which has a vested interest:

"We’ve ceased to play it straight. One of the reasons is that people are very sentimental. When it comes, for example, to dealing with drug addicts, there's no question in my mind that the drug-treating establishment tries to ingratiate itself with the drug-takers by seeing everything from their point of view. But I don't see it from their point of view. I see what they're doing as wrong. It's wrong from every point of view and it's wrong for them personally, and I'm not going to tell them anything else. I refuse to use their argot. I call needles ‘needles’ and syringes ‘syringes’. I absolutely refuse to pretend that I have anything to do with their (I hate to use the word ‘culture’) way of life."

His analysis of "racism" is refreshing:

"The whole apparatus of anti-race-discrimination should be dismantled because it's quite unnecessary. It makes things worse, it makes people paranoid. I believe it to be deeply pernicious - and I don't even believe that prejudice is necessarily a harmful thing for the person who suffers it (within reason), because it can actually be a spur to achievement - obviously within reason. I don't think you can police private feelings. And there's a danger if you have a complete disjunction between public policy and private feeling . . .

Now, one of the things is that we’ve lost all sense of cultural confidence. If you have cultural confidence, the sense that you have something worthwhile, you can easily absorb these people, but if you are constantly going on and saying how terrible we are and how there's nothing in our culture that is worthwhile, then eventually it becomes true. I can't see anything worthwhile in British culture now - there isn't anything. There are of course worthwhile people, but the overwhelming majority of it is charmless, worthless."

It is clear from these comments that Life at the Bottom will provoke different reactions amongst readers. Some may be inclined not to accept that a "no-nonsense" attitude towards criminals, drug takers and rejectors of social values is desirable or effective. However the author's wide experience in hospitals and prisons, and his obvious intelligence, require that his views be considered very seriously. As an antidote to fashionable loose thinking, Life at the Bottom has much value.


National Observer No. 54 - Spring 2002