I’m having serious questions about the role of physicians in mental health. It seems to me that the mental health field should be returned to non-physicians, and physicians should limit themselves to neurology and the study of the brain. Which is in fact what they do anyway, except psychiatrists’ power to dictate the terms of the discourse is so strong that brain chemistry is becoming more and more the theoretical framework we use to talk about mental health and mental illness, and psychiatrists the people we naturally turn to to get an opinion about the way minds work.
We don’t need a dramatic philosophical revolution to re-establish, and collectively agree on, what we have always known: that the mind (the heart, the soul) and the brain are two separate, qualitatively different albeit related entities, and that we have only the faintest idea of how they are connected.
The specific forms of pain that attach to the mind should be the province, exclusively, of mind-specialists, or psychologists. Psychologists should be people who study the way people relate to themselves, the world, and others incessantly, and garner ever new knowledge about what makes all these relations happy and peaceful rather than unhappy and tortured. There is a tremendous amount of wisdom accumulated on this subject and psychologists should not engage with patients unless they 1. have put some serious efforts into delving into this wisdom, 2. keep delving into it, and 3. realize that there is much they won’t ever know.
Point 3. leads directly to recent movements in psychoanalysis according to which the person who knows best about the torture of the mind is the sufferer, and this knowledge, much of it unconscious, is the treasure the therapist and the patient need to unearth together.
Any other approach to mental pain is foolish. Unfortunately, the vast majority of people operating in mental health today use foolish approaches, and people stumble through life carrying untold burdens of suffering they could turn to each other to relieve.