psychiatry – inside(r) psychoanalysis

1. Every time I see any info at all about the Coronavirus I have a feeling of great longing. I know it’s selfish. I know many will suffer. But I long to catch it and die.

2. There are so many ways to die and many, many ways to keep living.

3. Hope: Every Black artist who did art in America during legal segregation. Everyone who does art at all while part of a group that is targeted by hate. (Jackie McLean was the son of a mixed Black-White couple, I think; I like the title of this album). (Psychoanalysis is art).

Cover of Jackie McLean's Let Freedom Ring.

4. Hope: My dog near me when I wake up in the morning.

White American bulldog curled up in bed, asleep, very close to me taking her picture.

5. Hope: Anne Carson’s playfully stating something and immediately undermining it, because life is too serious a business to be encapsulated by platitudes. Ex:

"You can never know enough, never work enough, never use the infinitives and participles oddly enough, never impede the movement harshly enough, never leave the mind quickly enough. — From *Short Talks*

6. As long as psychiatry

Is rooted in power imbalance
Is predicated on patients’ inability to judge for themselves what they want/need
Is financed by pharmaceutical companies and regularly uses pharma-controlled (mis)information, to the point that APA’s conferences are sponsored by pharmaceutical companies (!)
Is coercive and regularly uses law enforcement, in a unholy alliance of medicine and police/judicial authority, to wit:
- involuntary hospitalization in psychiatric units (coercion breeds abuse, invariably)
- involuntary drugging inside those facilities (even when drugging is oral, patients have to demonstrate they have taken the drug or be punished)
- use of punishments/rewards (“privileges”) in such facilities
- the patients cannot leave of their own volition, and when they leave they might have to abide by physician-dictated guidelines (stealthy parole)
- forced outpatient treatment, including
  - forced ECT and forced use of antipsychotic medication, which is court mandated and enforced by police (court hearings are nominally democratic but the voice of the patient is invariably overruled by the voice of the physician
  - forced attendance of day hospital (see above re: psych hospital’s overt and non-overt abuse of patients’ human rights)
- The police are deployed to people who express mental distress and are deemed “a danger to themselves,” often with intense traumatization and brutality.
- The phrase “danger to themselves” is a meaningless and authoritarian construct used solely to give some people power to dismiss and abuse some other people. It is often coupled, with or without reason, with “danger to others.”

it is an oppressive system and it must be resisted.

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.