29 November 2018

"Doughnut Psychiatry"?

I have put this post back at the top of this mess of a think tank because I think it is one of the only ones in the blog that is really worth having up.
I am glad it has had 63 views and I hope it has more because I think it has good potential for helping things.
In fact, if anyone wants to share or steal the idea, then steal away please!
No acknowledgement is necessary. This is not copyright or anything.

-----------------------------------

"You never change things by fighting the existing reality. To change something, build a 
new model that makes the existing model obsolete." 
Buckminster Fuller, theorist and proponent of the term "Spaceship Earth."

"Simply rebutting the dominant frame will, ironically, only serve to reinforce it.
And without an alternative to offer, there is little chance of entering, let alone winning,
the battle of ideas." 
Kate Raworth, economist and inventor of "Doughnut Economics".

I wonder if these observations have any relevance to the work of Thomas Szasz, to antipsychiatry and the need to change Psychiatry?

I think Psychiatry is fundamentally irredeemable and flawed.
I confess that I was close to thinking a similar thing about about Economics, until I recently read Kate Raworth's excellent book about that subject - "Doughnut Economics: 7 Ways to Think Like a 21st Century Economist."
Economics and Psychiatry are not the same thing at all.
But it might be useful to compare them. They are both - very broadly speaking - human or social sciences - that purport to deal with specific areas of human life. They are both prey to the drawbacks inherent to supposed social or human sciences - and are different from natural sciences. Social or human sciences sometimes aspire to the certainties of natural sciences, but it is debatable that this can achieved. It is a very important question for the philosophy of science.

"The human "sciences" are not merely unlike the psychical sciences; they are, in many ways, opposites. Whereas nature neither lies nor tells the truth, persons habitually do both."
Thomas Szasz.

In the case of comparing Economics and Psychiatry, one way that they are perhaps similar is that they both have two much sounder disciplines further up the "tree of science" that they both could be said to branch out from.
These two disciplines are perhaps much sounder for often being more speculative. They are Politics or Political Science (which gives rise to Economics) and Psychology (which gives rise to Psychiatry).
....

I have said elsewhere that I am antipsychiatry. I do believe that psychiatry should be abolished as an official medical discipline.

But is there scope for a "Doughnut Psychiatry"?
By this I would mean a radical rethink of Psychiatry in the light of Thomas Szasz's thought, in a similar way to the radical rethink that "Doughnut Economics" gives to conventional economics.
By it I would mean a radically reformed and simplified form of psychiatry, without any medicalization or coercion.

"Doughnut Pyschiatry" could conceivably be medical in the sense that there is conceivably a relation between the physical body including and especially the brain and nervous system and behaviour and mood - but not in the sense that there are such things as "mental illnesses."

All medical treatment in "Doughnut Psychiatry" would be voluntary and an attempt would be made to base it on science. On both of these two points this is the exact opposite of what happens now.

As Szasz said, "The discovery that all so-called "mental diseases" are brain diseases would mean the disappearance of psychiatry into neurology.” ;“No behavior or misbehavior is a disease or can be a disease. There is no mental disease. Period."

He also said: “I don’t deny the existence of brain diseases; on the contrary, my point is that if mental illnesses are brain diseases, we ought to call them brain diseases and treat them as brain diseases."

Szasz certainly recoiled from the term "Antipsychiatry". Which meant he allowed for some kind of psychiatry to exist. He believed people should be free to believe what they like. And if this included psychiatry or alchemy or homeopathy or astrology, then so be it. As a libertarian like him, I also think that people should be free to believe what they like. So do lots of people.

I do indeed think - as did Szasz - that psychiatry is comparable to alchemy, homeopathy or astrology.

It is one thing to tolerate alchemy, homeopathy or astrology - it would be another thing for a society to give them official recognition and support.

I personally think Psychiatry is a pseudoscience and a crime that needs to end. I don't think it can continue and I don't think that it can continue by another name or by its own name. I don't really think we need anything to "replace" psychiatry. If you think that we need anything to "replace" psychiatry, you have probably missed the point.

And yet even having written what I have just written, I still think that for at least two reasons there could be scope for a "Doughnut Psychiatry" - a simplified and re-thought Psychiatry.

Firstly, because of the need for a transition or a midway point being needed between a highly psychiatrized world that we seem to have now, and a minimally psychiatrized world - or indeed a psychiatry-free world - that we seek to head towards.

And secondly because of freedom. People should obviously be free to do what they like. There is no point in opposing coercion if you don't believe in freedom.

This re-thought form of Psychiatry would obviously not have to be called "Doughnut Psychiatry". I am just borrowing a phrase from Economics. It could have another name.

By it I would mean a form Psychiatry that actually helps people with problems in living - if they want that help; and a Psychiatry that utterly disbelieves in "mental illness".
A psychiatry that seeks to help rather than dictate diagnonsenses, stigmatize, imprison and destroy. A genuinely libertarian, non-medical and non-incarceratory psychiatry. A Psychiatry that - for the first time - would conscientiously stick to the Hippocratic Oath of doing no harm in Medicine.

I have just noticed that a doughnut is the same shape as a lifebuoy. It could be a lifebuoy to save people, and to save those who are suddenly thrown overboard by the sinking ship that Psychiatry is.

I have just seen that the same image of its being a lifebuoy obviously applies to the original "Doughnut Economics" itself, and I think that "Doughnut Economics" is genuinely the only lifebuoy that can save humanity from drowning!



"You don't need a reason to help people." A very apposite statement.
A psychiatry that genuinely helped people would be a new thing altogether.

It could in a sense be said that Szasz himself gave it a name: "Szasz proposes an alternative word to indicate psychotherapy – 'Iatrology', or healing with words. 
In his book The Ethics of Psychoanalysis (1965) he calls his form of psychotherapy 'autonomous psychotherapy'".

I do not really think a science of psychiatry is possible whilst it still holds on to the central concept of "Mental Illness".

With this concept totally knocked out of it - so it would leave a hole a bit like the one at the centre of a doughnut - perhaps a scientific Psychiatry could finally begin, and in the meantime it could maybe be a humane and decent practice. Maybe.

The space occupied by the doughnut in "Doughnut Economics" represents a safe and just space for humanity.
In the same way the doughnut in "Doughnut Psychiatry" could represent a safe and just space for the individual - which is free from the outer menace of coercion and free from the central intellectual "black hole" of medicalization.

(I knew I could find at least one reason to call it "Doughnut Psychiatry"!).

"Doughnut Psychiatry", or something like it, could maybe have a role to play.

Unhappiness is obviously not in itself a medical problem. 
But unhappiness could obviously in some way have LINKS to Medicine. It would be these possible links that "Doughnut Psychiatry" could allow for and explore, without becoming in any way unscientific.
................

Below is an attempt at a diagram for the conceptual doughnut that would be involved in "Doughnut Psychiatry". This has made me feel like a bit of a doughnut but there might be something interesting in it.
The inside of the doughnut is meant to be the INDIVIDUAL BIOLOGICAL HUMAN and the outside of the doughnut ring is the SOCIAL AND ENVIRONMENTAL WORLD.



----------------------------------------------------------------------------------------------------

Please see my blog "MENTAL ILLNESS DOES NOT EXIST":

https://citizensofamidne.blogspot.co.uk/


=================================

P.S. 5th December 2018.

I have just learnt that Szasz wrote about Economics in some detail in his excellent book "Faith in Freedom: Libertarian Principles and Psychiatric Practices" (2004).

In the book, he compares Economics and Psychiatry, and sees many similarities, implying that both are pseudosciences in similar ways.

"Viewed as the study of human action, economics and psychiatry are fraternal twins: economists are concerned mainly with the material and political consequences of choices and actions; psychiatrists, mainly with their political and interpersonal consequences." 
Thomas Szasz.

............