Monday, August 15, 2016

Is Psychiatry Driving Us Crazy?


We live in an age of triumphant materialism. I use the word “triumphant” on purpose. America is the greatest and most expensive military power in world history.  We spend more money on our military than do the seven other leading  countries combined, including Russia and China.  Add to this the wonders of modern technology, the triumph of capitalism and consumerism, and the success of the American plutocracy (the one percent), and it’s clear how much we’re invested in a materialist culture.

We could call these the gross manifestations of materialism in action. But there are also subtle manifestations.  The intangible effects, however, may be the most dangerous.  Acting out materialist values can place in jeopardy the humanity of human beings.  Psychotherapist, James Carpenter, shows how whole institutions can be infected in an essay that deserves to be widely read, Spiritual Emergency. (

The author begins with an account of how he handled a suicidal client who was having hallucinations.  Her name was Martha.  Martha’s hallucinatory reality was so dislocating and alienating, she spoke of her suicidal intentions. 

Carpenter explains what he did.  He sat Martha down and talked with her.  He treated her like a human being.  Addressing the issue of her hallucinations, he explained that the world that each of us experiences is to varying degrees constructed.  We all have different experiences and therefore construct different perceptual worlds.

We should therefore be tolerant of each other’s differences, and remember that we’re all human beings, in spite of our differences.  In effect, Carpenter was massaging Martha’s sense of reality.  It took some time, but the client’s thoughts of suicide subsided and she reached a point where she could say she survived an acute psychotic episode.

Carpenter now strikes another keynote: “If you are unfamiliar with the standard treatment of psychosis – drug treatment, exclusively –you won’t understand the odd approach I took with Martha.”  Established psychiatry views “acute psychosis” as caused by brain-disease, treatable only by drugs.   Psychosis is due to a defective brain and the assumption is that the only way out is pharmaceutical.  The problem is that the immediate relief at first afforded leads to addiction, and when you stop or reduce intake, the symptoms return, but magnified, driving you back to the drug. 

Not all psychiatrists are so pharmacocentric, as was Martha’s who gave her a chance to work with psychotherapy before being consigned to long-term dependence on drug therapy.  The brain-based assumption of psychosis sees the disease as meaningless, Carpenter observes, purely the result of a malfunctioning brain.  So try or invent new drugs, apply and hope for the best!  Just don’t dwell on the collateral damage of addiction, ruined lives, and suicide. 

Carpenter maintains that this methodical exclusion of psycho-therapy degrades the person by reducing her to a brain.  Exclusion rules out any attempt to look for the meaning of symptoms and thus to treat them psycho-logically.

Cases of acute psychosis – not chronic psychosis caused by known brain disease – are often the result of horrific personal trauma.  This was the case with Martha whose madness was an entirely meaningful reaction to the traumatic events she endured.  There was a story there she needed to unpack, insights to tease out, before she could move toward recovery.  

Carpenter believes this can only be done with the help of another human being , a human being with a ‘psyche’ who ‘cares for’ you.  The word for this process is psycho-therapy (‘care of the soul’).  Drugs may sometimes help, but they miss the soul (or psyche) of the healing process.  Martha’s story is that of a “spiritual emergency,” we should remember, not of an “impersonal state of disease”. 

I also reject the physicalist reduction of the person – the infinitely rich internal environment – to the operations of the brain.  It’s not just intellectually indefensible; morally, it’s a Pandora’s box.  With the criminal ills of Big Pharma out there --  see Peter Goetzsche’s crushing exposé[1]  --  we have the psychiatric-pharmaceutical complex driving us crazy -- causing addiction, suicide and accidental death.

Carpenter cites a 1992 study  of the World Health Organization (later repeated and confirmed) proving the long-term superiority of non-drug treatment of psychosis in so-called backward countries.  For the short-term, there’s no doubt that relief is more readily achieved by pharmaceuticals, but unfortunately with addiction and failure proven more likely in the long term.  Ironically, the unavailability of all the drugs may in the end be a boon.  Modern psychiatry, Carpenter says, has suffered “an astonishing self-abandonment.”  It has sold the wisdom of the soul for the promises of what can be done with the brain and come out of the deal poorer, in more ways than one.   

[1] See Peter Goetzsche (2013) Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare.  New York: Radcliffe Publishing.

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