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.
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.