Recently I read Life at the Bottom: The Worldview that Makes the Underclass by Theodore Dalrymple. I’m not sure I’ve ever read a book quite like this one.

Reading Life at the Bottom left me both horrified and humored. I felt like Dalrymple was describing real people that I’ve known, but I also felt like I was reading about some alien dystopia that was too terrible to be true.

Theodore Dalrymple is the pen name of Anthony Malcolm Daniels. He is a psychiatrist who has worked all over the world, both in modern Britain and in numerous third world countries. When he retired in 2005 he was working at City Hospital and Winson Green Prison, both in Birmingham, England. After retiring, Dalrymple has authored numerous books, most of which critique and criticize the dominant liberal-progressive approach to life in the twenty-first century.

Life at the Bottom contains a number of reflection essays where Dalrymple writes about his experience as a psychiatrist working with the underclass of British society. His dark sense of humor serves to take the edge off of otherwise terrible and terrifying stories about “life at the bottom” in Britain. The worldview and behavioral pattern that develops as Dalrymple reflects on thousands of patient interactions with members of the “underclass” is as follows:

• Many prefer economic security and relative poverty to freedom and the risk that comes with it.
• Personal responsibility is non-existent, especially when it comes to owning up to mistakes and sins.
• Therapy and treatment are expected services that doctors are to provide at the request of the patient.
• The absoluteness of the sexual revolution is not questioned even when it has disastrous consequences for women and children.
• Hatred of civic authority and disdain for the police are common and assumed.
• Television (and likely cell phones at this point) is thought of as a basic human right.
• Education is not valued, and those who desire education are often mocked, bullied, and harrased.
• Vulgarity, profanity, and even violence are a ubiquitous part of everyday vernacular and life.
• Wealth is something to be personally desired, but it is also something to be denied to others.
• Winning the lottery is a respectable way to obtain wealth, as most rich people obtained their wealth by oppressing the poor.
• Those who live in the drama of the underclass live in the “real world,” while everyone else lives in a fantasy world.
• Poverty has been redefined in relative rather than absolute terms, and this perpetuates class hatred, envy, and division.
• Those who benefit from government housing see no reason to steward or care for their “home.”
• Those who can claim the greatest need, even if that need is manufactured, will be the recipients of the greatest benefits from the government.
• The dominant morality is “nonjudgmentalism,” whereby no one dares to critique the life or beliefs of anyone else.

Dalrymple is describing a worldview, a way of life that dominates the “underclass” in Britain. This worldview and way of life creates “life at the bottom” that subsequent generations almost never escape. Thus, “life at the bottom” continues generation after generation for the underclass.

As a pastor, I’ve seen this same worldview, this same way of life in Texas, Kentucky, and Oklahoma. Not only is the diagnosis heart-breaking and terrifying, but the future prospects for life in the “civilized West” are increasingly bleak. I say this because our culture, like that of Britain, is hell-bent on asking and expecting the government to “step in and do something. Unfortunately, government is entirely incapable of doing anything helpful in the current cultural climate. I agree with Dalrymple’s conclusion:

“Every liberal prescription worsened the problem that it was ostensibly designed to solve. But every liberal intellectual had to deny that obvious consequence … Let millions suffer so long as he can retain his sense of his own righteousness and moral superiority … And so the prescription is: more of the same.”

Theodore Dalrymple, Life at the Bottom, p. 255

At best, the liberal approach to this crisis of culture will always and only be reactionary in attempting to remedy the consequences of the worldview that causes people to live “life at the bottom.”

The only hope for widespread cultural change in Britain, Texas, Kentucky, Oklahoma, or anywhere else in the west is a widespread return to a Christian worldview and a way of life that flows out of that worldview. More progressive, liberal government programs will only result in more people living “life at the bottom.”