Psychiatry still has big problems and so does our model of the human mind

This interview with Robert Whitaker— Psychiatry Now Admits It’s Been Wrong in Big Ways – But Can It Change?—is well worth reading. Whitaker has been an influential critic of psychiatry’s misuse of antipsychotic drugs as well as its models for diagnosis and treatment.

In addition to all of the problems Whitaker describes in the linked article—failed diagnostics, failed theories, failed “disease models,” failed treatments, making matters worse for the mentally ill, and drugging children and minors without their consent—I would further submit that our generally accepted model of the human mind itself is as deeply flawed.

Rather than starting with the idea that humans have or develop personalities that do or don’t adapt well to some ambiguous social standard, we would do better to start with the idea that humans are fundamentally interactive beings, beings that communicate.

If our interactions are good, we will be well enough. If our communications with even one other person are deeply satisfying and as truthful as we are able, we will be even better than well enough.

People go crazy because their relations to no one are satisfying. In a very real sense, poor communication and shallow interaction condemn most humans to a sort of solitary confinement, where the inner network of semiotic reality cannot interface satisfactorily with the network of any other person’s semiotic reality.

For individuals who are fortunate enough to have a suitable partner, FIML practice will likely fix this problem while also fixing most emotional dissatisfaction. It accomplishes this by providing a means for people to fully engage their inner semiotic networks with each other.

The dead end of the traditional mental health model of a “personality-being-well-adapted-to-a-group-or-culture” is, sadly, best illustrated by the profession of psychiatry itself. I believe Whitaker is right in saying that

… it is going to be so hard for psychiatry to reform. Diagnosis and the prescribing of drugs constitute the main function of psychiatrists today in our society. From a guild perspective, the profession needs to maintain the public’s belief in the value of that function. So I don’t believe it will be possible for psychiatry to change unless it identifies a new function that would be marketable, so to speak. Psychiatry needs to identify a change that would be consistent with its interests as a guild.

If even psychiatry as a group needs to “identify a change… consistent with its interests as a guild,” it is clear that groups cannot be taken as a standard for wellness.

If even a group of doctors of the mind cannot get it right, how can any other group be expected to?

And if groups cannot, neither can cultures. And if none of that is right, neither is the notion of a “personality” that “adapts” to those vague standards.

This is an important point: groups can be and are just as crazy as individuals. In fact, many groups are crazier than individuals. The idea that people have “personalities” that must “adapt” in a way that is “satisfying” to an extremely dubious group standard is bankrupt and cannot be fixed. Of course individuals can adapt to laws and clearly stated mores and taboos, but adaptations based on such emotionally unsatisfying generalities will never produce wellness.

The individual can only be well when the individual can communicate their authentic semiotic reality with another, and in turn, receive similar communication from that other.

Semiotics is the right word to use here because its definition includes communicative signs and the meanings of those signs as they are variously interpreted by the individuals using them. Furthermore, the term semiotics implies, or necessarily extends to, networks of communicative signs and their inevitably differing individual interpretations.

2 comments on “Psychiatry still has big problems and so does our model of the human mind

  1. khipu says:

    “In a very real sense, poor communication and shallow interaction condemn most humans to a sort of solitary confinement…”

    One observation about animals in captivity/solitary confinement is that they often or at least sometimes resort to excessive grooming (which can cross the line into self-harm or self-mutilation) as a neurotic response to their circumstances. They may, for instance, pluck out feathers or fur and end up with bald patches.

    Trichotillomania and compulsive skin-picking are also observed in humans and can be stress-related.

    But it occurs to me that an analogous phenomenon may also be going on the semiotic realm; whereby humans, condemned as they are to a sort of semiotic solitary confinement, resort to excessive grooming of the ego or “personality” or autobiography.

  2. ABN says:

    “… humans, condemned as they are to a sort of semiotic solitary confinement, resort to excessive grooming of the ego or “personality” or autobiography.”

    This is an excellent point. In this vein, we might also say that confirmation that ego-grooming has been successful would be the person getting what they were grooming themselves for, i.e. status, money, fame, sex, disfigurement, self-abasement, etc.

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