The Other Side of the Wafer-Thin Barrier

This week, SOAP (Speak Out Against Psychiatry) held a demonstration at the Institute of Psychiatry in London. It follows a long period of widespread criticism of the DSM and its political influence.
I'm with the SOAP people in spirit, because I think someone needs to hold up a mirror to psychiatry, and I hope that psychiatry will be smart enough to look earnestly at itself.

I've written a little about this (see here and here) but I am by no means the most vocal critic or the most prolific writer on the DSM5 and all its problems. A good distillation of the issues, which is kept up-to-date with current material, can be found on the Beyond Meds blog - the DSM update page is here.

The SOAP web page for this event is well worth a read. There, they explain their position that human suffering is more than a medical issue, and so we should not rely upon a medical treatment for wider problems. Normal human experiences, they say, are being medicalized which results in people being labelled.
I agree, and have agreed for some time.  The DSM5 threatens to turn grief into a disorder, and child tantrums into a disorder. This is a dangerous form of 'mission creep'.

My instinctive opposition to diagnostic labelling comes, I think, from what I have learned in my training and experience as a psychotherapist. I have also had some experience of the mechanisms of psychiatry and psychopharmacology, which lead me to believe that both practices have departed significantly from what I hold to be the work of healing mental illnesses.

An article shared on Twitter recently notes that "Psychiatry was not - on Freud's watch - to be swallowed by medicine". Perhaps Freud intended that psychoanalysis be practiced by people who did not go through the sheep-dipping of medical training, and who could connect in a different way to their 'patients' as a result. Clearly, Freud knew that looking at people through a medical lens could be an inherently limited approach.

It's interesting to note the boundaries getting fuzzy here, between psychiatry (which is a branch of medicine) and psychotherapy. It's true that some psychiatrists are also trained psychotherapists who have undertaken extensive personal therapy themselves. But it's true too that many psychiatrists are just doctors. Some of these doctors are working on the assumption that their medical degree and psychiatric training entitles them to carry out psychotherapeutic enterprises under the banner of psychiatry. They also work on the assumption that their medical training (and with this I include the social, cultural, and heirarchical effects of medical and psychiatric training) will not somehow infiltrate the relationship, and the treatment that they offer. As if the person that we are, and the experiences we have, can somehow be irrelevant once we are in the room with a patient.

No.

The article also quotes Robert Spitzer, who headed the development of DSM-III. In a hugely telling remark, he is reported to have said: "..looks very scientific..... It looks like they must know something". For me, this is symbolic of the eternal struggle of medicine as a science - to name, to understand, and thus to defend against the impossible anxiety of NOT knowing.

"The medical model is a wafer-thin barrier against uncertainty" - Irvin Yalom

So, I question psychiatry as it's practiced today because of its over-emphasis on naming, and understanding stuff - much of which (like grief, tantrums, and the stress of someone's death) is actually the stuff of LIFE and not really there to be understood through a medical model.
I want to be prepared to sit on the other side of that barrier, where there is chaos, confusion, or hurt, and allow that to be the stuff. Because that's what I believe people want and need from soul-healing.

Here's the article, by the way

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Grief, Loss, and the Meme generation

The death of Amy Winehouse has sparked an understandable flood of tributes from friends, family, and fans. Undoubtedly she was a troubled soul, and I'm not intending to launch into an analysis of all that. Suffice it to say, she lost a battle that is all too common in our world.

I noticed that the tributes started to come in extremely early - mostly via the social networking site Twitter (with Facebook following closely behind). Wife of the former UK Prime Minister, Sarah Brown, was the first to be quoted on the BBC News channel; I couldn't think of any other reason to air her comments, other than perhaps being the first cleb-type to have tweeted in those first few hours. It seemed weird to me.

We have all become used to the more creative demonstrations of grief; the roadside shrine, the photo pinned to a tree, the coloured and pictured headstones. I guess that the 'new' way some people have of expressing their feelings is to tweet it, or add a comment on their Wall.
I'm curious about this, though. Will it lead to an individualized grief that precludes the face-to-face sharing of sadness?
Even more worrying is the thought that, in the future, the importance of tweeting something (for the world to see?) will come to outweigh the authenticity of the sentiment.

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