Sunday, 20 May 2007

Adventures in Psychiatry

Tricky one, this. Forensics is a specific field with an ugliness all its own. There is undoubtedly admirable and difficult work being done by honourable and dedicated people. There are also competent and responsible career paths being carved out by ambitious but reasonable people. Then there are the many decent folk trying to be decent under difficult circumstances. This should go without saying. However, I am a glass-half-empty kind of guy, and these people are not the whole story. Nor are they the ones most likely to influence or succeed. Much of what goes on everywhere, at every level and in every field of human endeavour is half-arsed and complacent and conducted by monkeys with bad habits. I am not here to hand out flowers.

Labels indicate selective focus. They are too often carelessly and unhelpfully allocated - with insufficient consideration given to the impact on individuals of pat "professional" judgements (based too often on inadequate information and/or consultation.) The psychiatric system can be a lottery, and it can be a bully. Too much of it is about power and status and social control - and it therefore often shows itself as a blunt and indifferent instrument. Diagnoses shift without the bat of an eyelid, much less an admission of error. The notion that the whole edifice is outdated and unhelpful is inadmissable. Alternative interpretations are quickly shut down amid a flurry of proscriptions/prescriptions. Practices that were recently gospel are quickly anathema, and yet the power base struts on without pausing to consider that today's treatment is tomorrow's historical embarrassment. Humility is largely absent, philosophical debate discouraged, and doublethink rife. There is an unjustifiably confident officer class marching obediently from their psychiatric Sandhursts into the lives of people suffering personal trauma. There are better models available.
Society as a whole shirks its collective responsibility for mental health issues and satisfies itself with ignorance, obedience and stigma. People working in the mental health professions - as members of that society - are not immune to this.

The notion of "The Ether" was an attempt to grope towards an understanding of a more complex and subtle set of phenomena. We no longer find it useful to discuss matters in this simplistic and disconnected way (outside of poetics). Similarly with schizophrenia? Personality Disorder? Just because there is a WORD barrelling about our culture does not mean that there exists a correspondingly discrete and concrete phenomena in the physical universe that can be dealt with in isolation. Everything is more complex and inter-related than it seems. Psychology recognises this. Psychiatry does not.

Of course this could all be madness on my part. Everything's actually tickety-boo. Victorian classifications are bang-on and 21st century urban life is a perfect substitute for our environment of adaptation, so no one should have the teensiest problem in coping with it. Our Culture is good and brave and right and true and will last for ever and any discussion of its shortcomings indicates an irrational desire to live in Teheran (or Russia, again). It's all working out swimmingly.

...and don't get me started on the drug companies..!


david moxley said...
This comment has been removed by a blog administrator.

I'm not sure whether it was a desire to maintain some anonymity, or an unfortunate authoritarian instinct that led me to delete or reject comments on this post They were not uncalled for, and they were informed comment. I deleted the whole post and then reposted it after further comment. I think perhaps that I am just keeping some distance between Throbgoblins International and little old me. Sorry for the confusion, Dave.