Nikola (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
megastalin) wrote2025-05-26 03:51 pm
megastalin) wrote2025-05-26 03:51 pm
Entry tags:
limits of psychiatry
I would really love to find a psychiatrist and/or psychologist who understands that mental health care is essentially lifelong palliative care and doesn't traffic in sugar and rainbows.
It's really the worst aspect of this day hospital thing. The forced nicety, the implication that some kind of a great comeback, some transformation is just around the corner if only we try hard enough if only we believe.
But that's not what's around the corner. Around the corner are new challenges at best and devastating crises at worst. Why pretend otherwise?
I firmly believe that once this civilisation returns to some form of rationality (which has, to put it lightly, fallen out of style worldwide) all of these therapeutic practices will be revised and most of them will cease to exist.
I keep looking at people here, they seem not all that responsive, kind of out of it. And I think to myself, surely they must have been admitted a few weeks before I did, this is the start of their treatment. But then the next day, I find out they've been here for 2 and half a months and are being released the next day!
They come in banged up, they leave banged up. The entire focus is on the process, not the outcome.
Psychiatry as it is now is like the astronomy of old before the heliocentric system. These astronomers, despite their fundamentally wrong model, were able to make accurate but limited predictions of the motions of the stars. So can psychiatry get the patient back from the ledge, with medication, with deep-sounding truisms (that don't stand up to further scrutiny) but can do little else in terms of elevating the patient's quality of life.
Why is this so? Because psychiatry is essentially solipsistic, it doesn't concern itself with the outside world, with social relations, or even the bare necessities of social life. No, as far as a psychiatrist is concerned, only you and your psyche exist. And once we get it somehow in order, while it being an open secret that we can't get it in order, something will mystically transform.
Eventually, soon, in a few centuries tops, this will be replaced with a kind of Marxist psychiatry that will center mental illness where it needs to be centered - in the society and group that generated the malady in the first place. It will be revealed that no mind or body is a wrong mind or body requiring medicalisation (in the broadest term, I don't mean just taking meds) but understanding and above all grace.
Until then, people like me, and there are so many of us, are left to contend with a system that we need to make us barely functional and alive, but that doesn't help otherwise and that's worse -- a system that is fundamentally violent and cruel and won't hesitate to punish you at a mere perception of being not quite contrite enough as you receive its ministrations.
It's really the worst aspect of this day hospital thing. The forced nicety, the implication that some kind of a great comeback, some transformation is just around the corner if only we try hard enough if only we believe.
But that's not what's around the corner. Around the corner are new challenges at best and devastating crises at worst. Why pretend otherwise?
I firmly believe that once this civilisation returns to some form of rationality (which has, to put it lightly, fallen out of style worldwide) all of these therapeutic practices will be revised and most of them will cease to exist.
I keep looking at people here, they seem not all that responsive, kind of out of it. And I think to myself, surely they must have been admitted a few weeks before I did, this is the start of their treatment. But then the next day, I find out they've been here for 2 and half a months and are being released the next day!
They come in banged up, they leave banged up. The entire focus is on the process, not the outcome.
Psychiatry as it is now is like the astronomy of old before the heliocentric system. These astronomers, despite their fundamentally wrong model, were able to make accurate but limited predictions of the motions of the stars. So can psychiatry get the patient back from the ledge, with medication, with deep-sounding truisms (that don't stand up to further scrutiny) but can do little else in terms of elevating the patient's quality of life.
Why is this so? Because psychiatry is essentially solipsistic, it doesn't concern itself with the outside world, with social relations, or even the bare necessities of social life. No, as far as a psychiatrist is concerned, only you and your psyche exist. And once we get it somehow in order, while it being an open secret that we can't get it in order, something will mystically transform.
Eventually, soon, in a few centuries tops, this will be replaced with a kind of Marxist psychiatry that will center mental illness where it needs to be centered - in the society and group that generated the malady in the first place. It will be revealed that no mind or body is a wrong mind or body requiring medicalisation (in the broadest term, I don't mean just taking meds) but understanding and above all grace.
Until then, people like me, and there are so many of us, are left to contend with a system that we need to make us barely functional and alive, but that doesn't help otherwise and that's worse -- a system that is fundamentally violent and cruel and won't hesitate to punish you at a mere perception of being not quite contrite enough as you receive its ministrations.
no subject
I think I understand where you're coming from. Despite how it might seem from my writing here, I am not anti-psychiatry and I don't believe people should "embrace their illness" and go off their meds. Embracing depression or schizophrenia seems the same as "I'm embracing my diabetes so I'm eating all the sugar I want and not taking insulin." Preposterous.
Regarding the capitalist view, you are correct. Still, an illness is basically defined as an inability or a difficulty in function, whether it's physical or mental functioning.
What I'm trying to get at perhaps clumsily, is that I disagree with mainstream psychiatry about both the etiology and treatment. They claim it's basically found solely in the individual, something (but we don't yet quite know what) malfunctions in the brain and you're depressed. Or you're having paranoid thoughts. And their treatment is likewise individual (even when it takes place in a group therapy setting), take your meds, "better yourself," "make a commitment to yourself," "fight," etc.
But when you listen to what the people are actually saying in the therapy groups (If you've been in therapy for 25 years you've probably sat in at least one circle) it nearly always has to with their social environment. They have "bad mothers," or they're lonely, or they find it hard to connect with others. This is never really brought into focus despite it featuring so prominently in discussion. The social and group dynamic is always reduced back to the individual and how the individual can deal and cope with it. Basically, to individual biology, but what I am trying to say is that the natural and the symbolic always work together.
A digression: it's becoming more and more clear with genetics, that genes can not only encode traits but encode "recipes" for traits to be socially transmitted and learned. If there's such a link on a genetic level between the individual and the social, how can we still cling to dualism?
So, why can't the community be more involved? We now have dating apps, and before dating apps we had matchmakers and even just friendly setups. Clearly, we recognize dating, love, and marriage as something that the community should try to facilitate. So why can't it be the same for mental health?
Why do we confine mental health to the clinic and to a professional's office and to hospitals? Mental health should be a societal Praxis. Not embracing illness, not making excuses for our dysfunctions wherever they may come from (hopefully one day we can know for sure), but working together to overcome, connect, and give mercy to each other.
no subject