"Mental" Illness: The Future of Treatment

One wit noted, “Neurotics build castles in the air. Psychotics live in these castles. And, psychiatrists collect the rent.”
Until the mid twentieth century sufferers of mental illness were warehoused in institutions where they were treated inhumanely. Like lepers they were isolated from the rest of society. Even in the U.S. they were used as guinea pigs for bizarre scientific experiments.
It is only within the past century that psychiatrists began to consider neuroses and psychoses as brain disorders. It is only with the past half century that they questioned the effectiveness of Freud’s talk therapy and opted for chemical intervention.
IMHO, much more needs to be learned about how human brains process a sense of reality, how epigenetic interactions affect that sense and how social indoctrinations exacerbate these conditions. Maybe then, psychiatry can advance intreatment beyond long-term psychoanalysis and short term chemical fix. A mentally ill person is not a case study, but is a human whose brain produces alternate senses of reality.

psychiatry is a discipline that stands right in between neurology and psychology… psychiatry is no longer here…it has divided into neurology and psychology…as far as treatment we have the quick fix…the system that pays the money is not interested in cure and prevention…the system is interested in illness not health…

Consider the notion of “time” in regards to mental health and the system designed to “help” people with so-called “mental problems.” There seems to be a meme in place that is based on getting people functional fast, to keep them on the job or living in their square peg world doing whatever it is they do there. Hence the ideas about brain dysfunction or chemical imbalance or neurological roots to the problem, with a diagnosis and a cocktail of drugs designed for that diagnosis. The DSM is now so fat that you’d practically need a forklift to move it.

People have forgotten that each of us lives in a social and economic nexus, one that is very oppressive and requires a good deal of conditioning in order to make us adaptable to it. The “sane” people are the ones who have been able to adapt and become hardcore sociopaths to a good degree, while the “insane” ones are those who have not been able to adapt to a very insane system. It’s a total clusterfuck for sure.

jonquil you are right…

I remember having a hard time deciding whether it would be worse to live under Hitler or under the APA.

But think about how many people know what you have correctly pointed out, yet nothing changes.

Neuroscience is replacing psychiatry (thank the powers that be). Psychology in the hands of politicians is replacing religion (oh shit). Obama signed a bill that allows experimentation on the unsuspecting public as long as it is in the interest of national security.

But we are but the guinea pigs, pawns, and puppets.

In my mind, one of the ‘good’ outcomes of the advancements in neuroscience is the recognition that mental ‘illness’ can be the result of the way the mind physically ‘works,’ which makes the ‘stigma’ of mental ‘illness’ nonsense. There may always be a time when psychiatry and/or psychology play a great part in neuroses, for example, which isn’t physically based, and no drug will ever ‘cure’ because no drug can take away a deep-seated fear. Only the tremendously fearful can do that. ‘Directed’ talk therapy can help in removing the onion-like layer of defense a neurotic has grown around her/himself as a means of defense. Even if talk therapy works, and the neurotic finds and acknowledges the kernel of ‘truth’ that leads to their fear, they may not want to change it.

Good posts, all. Now, where I agree or question:

  1. The DSM IV appears to be expanding to include every human tic as an aberration. Pharmaceutical companies can thereby exploit the glut of diagnoses and profit from specialized drugs.
  2. While I have a gut feeling that we do not live in a “sane” society, the feeling suggest I know what sanity is. It may include types of inhumane behavior I detest.
  3. I don’t think therapies go far enough to address the effects of diagnosis on self-image. For many a diagnosis translates as “DEFECTIVE HUMAN.”
  4. I don’t see this as a political issue. Politicians don’t control one’s conscience; maybe the media does. Power and control may owe much to survival competitions; not to some governing “body”.

Agreed. This is about two things: money and control of kids, mainly boys, who dare to be themselves and question authority.

As for sanity, Mark Twain wrote: “Sanity and happiness are an impossible combination;” as for insanity, Albert Einstein said that insanity is “doing the same thing over and over again and expecting different results.”

True. Not only that, but none of the diagnoses and treatments are actually based on sound science but rather circular insane reasoning like this one. Well, so and so is on medication so they must have a mental problem.

Mental health itself is a societal problem in that it really is not possible to separate any human out from the social nexus in which they live. If the society itself is broken or dysfunctional, then it is only logical that the humans within it will be broken and dysfunctional as well. One aspect of that dysfunction is deciding what and who is “normal” or not; and it becomes political when the government and the politicians buy into it and use the mental health memes in order to control minds and “information.”

Jonquil,
You sound a lot like Orwell.
IMHO, the future of any decent therapy for so-called “mental” illnesses depends on an accurate consideration of what comprises a human sense of reality. And, you are right that social, ignorant religious or political agendas make this consideration almost impossible.
I do know persons whose “minds” are in states that make them want to harm themselves or others. In these instances the “chemical fix” proves somewhat effective.

To my knowledge, the only reason for using the “chemical fix” is financial and logistic. True healing takes time and resource.

That is interesting too in that it kind of begs the question as to what aspect of a person’s reality has been compromised. Most of the observable symptoms we experience are manifestations of that vulnerability, but employed in such a way that distracts from, or even defends, it. However, if we can somehow determine what, neurologically or psychologically, has been compromised in any definitive sense, we might be able to infer why, and eventually how. But how do we develop a universal model of an ‘uncompromising’ mind, or sense of reality?

In my own opinion, most human beings experience a compromised sense of reality, and possibly on a regular basis. So now we focus our efforts on determining the severity and frequency of involuntary or compulsive reactions to those experiences. The more we treat the symptoms on a wider scale, the less likely we are to ever determine what causes them. Therefore, I honestly think psychiatry still has value insofar as it is a means of analyzing irrational behaviors that may have no logical connection to a cause. The connection could very well be one of entirely subjective, abstract associations, for instance. I’m not sure psychology and neuroscience can ever account for all possible specific cases, though they probably will supersede psychiatry in the development of general principles. Neuroscience seems like an inadequate replacement for psychiatry in terms of behavioral treatment.

If by “a compromised sense of reality,” you mean a reality ‘outside the norm,’ what’s the norm and who establishes it? Is that your question in what I’ve underlined?

I think the only answer can be, if a person’s ‘reality’ conflicts with the ‘realities’ of the people within his milieu to the extent that it’s extremely troublesome/worrisome to both, then the first person’s reality might be compromised and s/he should find out if it is. Both psychology and psychiatry (which seem to be merging) can help in those circumstances. But I think the danger in relying only on psy and psy is that both fields can hit on an explanation that gives irrational behavior(?) a cause, and turn it into an all-encompassing cause–even when that ‘cause’ can only be ‘proven’ through comparison of general symptoms, lumped together and given a label.

Neuroscience can, possibly, isolate physical ‘abnormalities’ and use drugs to reverse the effects of those ‘abnormalities’ in some instances–but not all. Psy and psy can lead to behavior modification and the patient’s understanding and agreement/acceptance of the diagnosis–but not all.

Neuroscience is more than the study of brain abnormalities, as far as mental behavior goes, however. Perhaps, to get away from the overuse and over-reliance on drugs that seems rampant in our society, there should be a blending of the three fields, devoted to ‘irrational behaviors.’–Psychology to test and evaluate, Neurology to eliminate abnormalities within the brain, and Psychiatry to treat what’s left after the first two have ‘cured’ through behavior modification and/or drugs depending on the cause. Have I made any sense?

Stat and Liz,
Your posts make sense to me. Let me give an example of a person I dearly love who has been diagnosed as paranoid schizophrenic. Using the net to get information about this, I found a decent site. I think it was from the Mayo(SIC) Clinic. The advice was that one should not try to judge or counter the sufferer’s hallucinations and delusions. These are the person’s current reality.
Lacan finds these “disorders” exemplified in how one uses language. I don’t know enough about that to comment. What I do know is that when I comfort my friend with hugs and attention, she often gets back to the type of reality I’m used to. IMHO, a caring psychotherapy, not that from a doctor watching his clock, can affect the disorder in positive ways.
As to a norm for the sense of reality, I don’t think any such animal exists. But there does exist states of mind from which harm to self or others becomes possible. These must be addressed.

Notice: hugs and attention… not drugs and pseudo-science claptrap invented by industries for profit. My own healing modality of choice is called “Breathwork.” It’s fantastic, and of course involves lots of love and physical closeness as the vibes move up the chakras and the feelings start moving. It’s the best method for accessing birth and very early memories that I know of, btw.

In the meantime, be very, very careful. I’m not a doctor, but, as a person, I’d say the personality, and person, you hold is extremely delicate. If you’re not trained in any of the fields mentioned so far, keep on hugging and holding, but rely on the docs. In paranoid schizophrenia, from what I’ve read, therapy will include drugs, simply to reach a state wherein the patient can accept other therapies. From what I’ve read, the disease is the result of a combination of factors, from genetic through environmental–which would suggest the triumvirate of specialists I’ve mentioned. I’m trying to be very careful with what I say because I’m not qualified to give medical advice–nor is this site.

Paranoid schizophrenia may be manageable. I’m not sure it’s totally curable. Drug therapy may dampen the delusions, but that diminishes the person’s idea of reality, doesn’t it? Would that contribute to the disease? You’ve already distanced yourself from your loved one by ‘intellectualizing’ the illness. People prone to philosophy do that–I know I do.

But I’ve found that there comes a time when ‘intellectualizing’ is, oftentimes, no more than a defense mechanism, which we all need.

We live in a society in which profit outweighs its collaterlal damage–physical, mental harm or even death. The latest statistics are that the the gulf of wealth between haves and have nots has never been greater, at least not for half a century. No remedies for the harm or considerations of deaths are possible under this type of blind obsession.

Thanks for the good advice. I do research on my friend’s condition and listen to ideas given here not to intellectualize, but to find out how to help her without being invasive. I would ask nothing of her that would compromise her integrity. The meds do stabilize, but I cannot believe that she is doomed to a lifetime of delusions and hallucinations that have to be kept at bay by drugs. I would not advise her to get off this regimen; but, I’ve found that honest affection can heal. We’re an elderly, pot-bellied couple, finding comfort in mutual caring.

It’s true that you have to be thoughtful when it comes to drugs. My brother is a psychologist who doesn’t believe in drugging people; but when he gets a client on drugs, he never just has them quit cold turkey. They work together and the client slowly weans off. It’s also important to have a support system in place while getting off the drugs.

You’re welcome. You’re a caring person, obviously, so it might be difficult for you to accept–there are some mental conditions that can’t be meliorated by anything other than drugs as part of a treatment package. I believe this is true with manic-depressive disorder (Bi-polar disorder) as well as paranoid schizophrenia. Think of it like this, a child with diabetes faces the rest of her/his life dependent of insulin because of a defect in the pituitary gland. Is there onus to being a diabetic?

Honest affection can help but there are some things it can’t heal.

Last piece of advice and then I’ll put up my shingle. You found the Mayo Clinic web site which is a good one for a lot of different things. Go back to the site and see if it lists any support groups in your area for care-givers of people with paranoid schizophrenia. It should; but, if not, Google "support groups for care-givers in (your area.) You need to learn what other people in your circumstances have learned.

There’s no reason why your friend can’t lead a ‘normal’ life, if she stays with her docs, her meds and you.

Bless you!!!