Tuesday, March 10, 2009

Psychiatry on Life Support

Wait, this was in 1962, in an interesting snippet from Aldous Huxley's Island, his final novel featuring, in compensation perhaps for Brave New World, a utopia. A young nurse from said paradise is complaining about a lecture from a visiting Western psychiatrist (one long paragraph in original; sorry):

"What was it about?"
"About the way they treat people with neurotic symptoms. We just couldn't believe our ears. They never attack on all the fronts; they only attack on about half of one front. So far as they're concerned, the physical fronts don't exist. Except for a mouth and an anus, their patient doesn't have a body. He isn't an organism, he wasn't born with a constitution or a temperament. All he has is the two ends of a digestive tube, a family and a psyche. But what sort of psyche? Obviously not the whole mind, not the mind as it really is. How could it be that when they take no account of a person's anatomy, or biochemistry or physiology? Mind abstracted from body--that's the only front they attack on. And not even on the whole of that front. The man with the cigar kept talking about the unconscious. But the only unconscious they ever pay attention to is the negative unconscious, the garbage that people have tried to get rid of by burying it in the basement. Not a single word about the positive unconscious. No attempt to help the patient to open himself up to the life force or the Buddha Nature. And no attempt even to teach him to be a little more conscious in his everyday life. You know: 'Here and now, boys.' 'Attention.'" She gave an imitation of the mynah birds. "These people just leave the unfortunate neurotic to wallow in his old bad habits of never being all there in present time. The whole thing is just pure idiocy! No, the man with the cigar didn't even have that excuse; he was as clever as clever can be. So it's not idiocy. It must be something voluntary, something self-induced--like getting drunk or talking yourself into believing some piece of foolishness because it happens to be in the Scriptures. And then look at their idea of what's normal. Believe it or not, a normal human being is one who can have an orgasm and is adjusted to his society." Once again the little nurse held her head between her hands. "It's unimaginable! No question about what you do with your orgasms. No question about the quality of your feelings and thoughts and perceptions. And then what about the society you're supposed to be adjusted to? Is it a mad society or a sane one? And even if it's pretty sane, is it right that anybody should be completely adjusted to it?"

The perennial critique of psychiatry is all there: the narrow reductionism (psychoanalytic at that time), the inattention to questions of value as pertaining to the well-lived life or the good society.

How will psychiatrists retrain when the utopia comes?


Retriever said...

Interesting omission (as from previous posts on the general topic): the financial cost. And rationing already occurring and likely to get worse.

Anonymous said...

I think a reprogammable holographic utopian world would be nice with unfixed psyches that could be recalibrated and switched off/on according to the shifting individual needs/moods/desires of the subjects in question. Psychiatrists would be charged with the delicate task of tuning the 'sanity'/'insanity' quotient to create the conditions necessary for a life optimally lived.

Novalis said...

Yes, the psychiatrist would become something like the new Cable Guy, complete with house calls; now there's a niche...