When psychiatry retraumatizes

Photo: Child Running Through A Labyrinth.

Before I became a psychotherapist, I often wrote, lectured, and blogged about damaging aspects of psychiatry. I am more hopeful now — not about psychiatry improving, but about truly helpful mental healthcare for people who might otherwise be labeled “chronically” mentally ill and forever take medications to tranquillize their internal demons. Since I began combining Sensorimotor Psychotherapy with CG Jung’s growth-focused theory of human nature, I have witnessed meaningful, lasting change happen without medications. I have also heard others talk about improved outcomes (both providers and clients) when trauma becomes the focus of care and joined with faith in lasting transformation.

But hope can be blinding (although it sure feels good). The following poem by Franz Wright, from his collection Wheeling Motel, reminds me the problem with psychiatry goes beyond pushing dubious drugs.

PEDIATRIC SUICIDE

Being who you are is not a disorder.

Being unloved is not a psychiatric disorder.

I can’t find being born in the diagnostic manual.

I can’t find being born to a mother incapable of touching you.

I can’t find being born on the shock treatment table.

Being offered affection unqualified safety and respect when
and only when you score dope for your father is
not a diagnosis.

Putting your head down and crying your way through elementary
school is not a mental illness, on the contrary.

And seeing a psychiatrist for fifteen minutes per month some subdoormat psychiatrist writing for just what you need lots more drugs to pay his mortgage Lexus lease and child’s future tuition while pondering which wine to have for dinner is not effective treatment for friendless and permanent sadness.

Child your sick smile is the border of sleep.

Abandoned naked and thrown to the world is not a disease.

She was unhappy just as I was only not as lucky.

Drugs never treat “friendless and permanent sadness” — never could and never will. Although I know this, I am sometimes softer on psychiatric meds than I imagined I would be, especially when I meet someone who has seen more cruelty than kindness, and for whom intimacy is both the scariest thing imaginable and the most desired — and at the same time. Medications can be a temporary solution for the “excess subjectivity” Auguste Comte so aptly characterized two centuries ago as the Western experience of madness. Psych meds can dampen the effects of a life lived too isolated and in the head, softening the edges of the inevitable fear that comes with feeling vulnerable, while nevertheless staying engaged with life.

I often disclose to clients who come to me on psychiatric meds that I think the pills are like stakes holding up a young tree. Much like when a sapling’s trunk grows fat and sturdy and the stakes can be removed, they too can reach a point when meds aren’t needed any longer. (With this analogy, I have neuroplasticity backing me up.) I believe this, and I hope they do too. But in my hope, I risk minimizing the journey out of psychiatry’s shadow, how they colluded with a story about the need for treatment (usually with synaptic gaps as one of the protagonists), when really, some pretty awful stuff usually happened to them — and to most people who regularly visit a psychiatrist.

Psychiatry retraumatizes when it tells stories about the nature of suffering that advance the profession and not the patient — like the dynamics a child encounters when forced to earn the unconditional love that is her birthright. Especially when people are being “treated” for the effects of childhood abuse and neglect, psychiatry risks crazy-making when the goal is to cure biology more than care for a person.

References

Davoine, Françoise, and Jean-Max Gaudillière. 2004. History Beyond Trauma: Whereof one cannot speak…thereof one cannot stay silent. Translated by Susan Fairfield. New York: Other Press.

Wright, Franz. 2009. Wheeling Motel. New York: Knopf.

© 2012 Laura K Kerr, PhD. All rights reserved (applies to writing and photography).

  • Tarunverma911

    Hello Laura.

    Argument of drugs vs anti-drug treatment is like a person who believes in God challenges a doctor that he can’t save the acute patient without prayers. Doctor tries his best but surrenders at last as no medicine works. Then suddenly the patient gains consciousness and starts breathing and his basic bodily processes regain some ‘normal’ functioning. Gog-believer would come and say, “See, Doctor, my prayer has saved him. You had failed in treatment but since I was praying for his good health and fast recovery for long so it is my prayers that have been heard and answered, and not your treatment.” That doctor would certainly not have any answer at first, though it is there in his mind that some physiological changes have occurred of which medicine may not have proper answers.

    Similarly, a psychiatrist is like this God-believer who says person is getting cured because of his ‘miracle medicine’. No psycho-social efforts are needed to cure this person’s illness’s causes. Whatsoever a psychotherapist would do, unless a medicine is given no-one can be permanently and miraculously cured. (This analogy can be extended at lengths.)

    A gross neglect of the actual causes!

    • LauraKKerr

      Thank you for your interest in this topic. I appreciation your response–very thought provoking.

  • PK421

    I see this post is old, but I wanted to throw in my two cents: I was bullied relentlessly as a kid (recently found a third grade report card where the teacher said, “Don’t let the others get to you…” At that time, I had had rocks thrown at me, been spat upon, punched, kicked, had my head shoved into ice on the ground, stuff stolen, pins stuck in me, etc. My dad is an alcoholic, mom loving, but had her own stuff, so, naturally, I was depressed. I was taken to a psychiatrist who started medicating me and treating me as a problem (I remember being so confused because I kept thinking, “well, who wouldn’t be depressed in my situation?”) I was put on prozac, and reacted poorly, and so began years of cocktails and hospitalizations, including seclusion. I am told it’s a miracle I survived. It wasn’t until I escaped the psych system that I started to get better with support of sympathetic therapists who helped me with PTSD and learned helplessness. I still struggle every day, but life gets easier each day. I am now 40 but am going through my mid 20s, essentially, just coming into my own because of all the time taken from me.

    • You have seen the darkest side of humanity. The learned helplessness you refer to sounds like it was an important defense response — a way to avoid aggravating bullies, who typically look for signs of anger or active defenses as a reason to escalate their aggression.

      When you say you are in your 40s but going through your mid 20s, I think it is now safe for you to discover the life you want to live, and the person you want to be. Many never get to where you are — that is, come into their own — even without your profound suffering. We all should regress from time to time, and devote energy to finding our most authentic selves. But yes, the commitment to heal can makes us acutely aware of what we could have been doing if not for what happened — and that includes abusive treatment by professionals.

      I am in my 50s, and still sometimes experience the shadow of my early life abuse, but more often I feel I understand life more deeply and am more empathetic because of what happened to me, although I am not grateful for being harmed. But I am grateful for the time I took to heal, which I believe has made me perhaps like you — making up for lost time — and with profound gratitude for the gift of life.

      I heard that John Nash, the Nobel Prize winning Economist, said that the time he had schizophrenia when he was in his 30s, while his peers’ careers were advancing, meant that later on in life when they were bored and smug, he still found life exciting.

      When you make the effort to heal as you are, life really can get a whole lot better — almost like living two lives.

      I wish you all the best.