I read some Psychiatric News. It is all “Rah, rah, psychiatry,” bragging about the American Psychiatric Association’s (APA’s) affiliations with universities, the government, and even the UN. Psychiatrists are “reaching out” to hitherto unidentified depressed women in Appalachia by using barely trained high school grads to help bring these women into treatment. Psychiatry (the APA) is congratulating itself for recognizing the link between poverty, lack of education, and other factors everyone recognizes—as well as stigma—to normalize mental illness by diagnosing everyone.
Meanwhile, I heard a snippet in the car, on NPR, in which they were questioning the belief that genius and insanity go hand in hand. Their conclusion was you don’t have to be crazy to be smart, but 47% of Americans have some kind of mental disorder at some point in their lives.
It occurs to me the definitions of mental disorders are so vague that no one—even and maybe especially psychiatrists—knows what they are talking about. For instance, President Trump has been diagnosed by the media and public opinion as a narcissist, but what is a narcissist? Is that a character definition or merely a trait, present in greater or lesser degree in all of us?
In modern parlance and for insurance purposes, the psychiatric diagnosis has come to define the person, assuming a significance far beyond its intrinsic validity. Psychiatric diagnosis is no better or worse than any label, but it has the sociological power of judgment pronounced by the priests of the “health care industry,” the scientific voo-doo masters of potions and incantations empowered to deliver—not relief—but diagnosis and treatment. This promises without promising and hints that failure to feel relief is the fault of the recipient, and by extension, the society that creates poverty and ignorance.
That psychiatry is aligning itself with other institutions, rather than questioning the institutional contributors to poverty and lack of education, seems misguided.
The wave of public consciousness seems to follow the institutional lead, while doubting its sincerity. Views from outside the mental health professions, on the mental health professions, seem cynical but grudgingly accepting that there may be special knowledge perceived only by a select few.
It appears Freud has been dismissed by the public and by the psychiatric establishment, yet I admire Freud’s insights and how he described tendencies of human nature, such as projection, transference, and their counter-balances, like projective identification and counter-transference. Transitional objects, which today has relevance with regard to medications. Freud’s stages of psychosexual development have utility, even now, even if they have not been formally incorporated in to the official DSM (Diagnostic and Statistical Manual of Mental Disorders). Masochism and sadism. Oral and anal fixations.
Psychiatry stands on Freud’s shoulders and kicks at his head. Where is the interest in dreams? Carl Jung claimed he split with Freud over the spiritual element in human nature, and more specifically, over psychic phenomena.
I believe that to recognize only material reality as valid is the claim and error of science as we know and understand it. Still, astrophysics is largely speculative and unprovable, except in indirect or limited sways. What do particle accelerators show about the nature of the universe? What relevance does that have to life?