April 13th, 2012


Civilization without Civility: Nailing Down the Psychiatric Pathogen

In his analysis of the psychiatric profession, Thomas Szasz drew a distinction between neurology and psychiatry. When a physical lesion is discovered, the case falls into the category of neurology which addresses the lesion and its effects. Where there is no visible damage to the nervous system, psychiatry takes over with a speculative hypothesis of chemical imbalance. Another way to look at the same distinction is to consider pathology. In the case of neural damage, a pathogen is apparent. In the case of a "chemical imbalance," no physical pathogen has been discovered.

As we were discussing the fact that psychiatry recognizes stress as a causal factor in a number of cases, one of our students observed that the problem seems to be how the patient responds to stress. This led another student to make an interesting observation that the patient is the pathogen. Psychiatry treats the response to stress, and other environmental factors, by inhibiting responses that are deemed inappropriate by society. Doping up a patient with mind altering drugs subdues her activity to an acceptable level. The pathogen is not removed from society, but controlled in such a way that it is more acceptable.

Szasz was himself treated as a pathogen by the mental health profession. Anyone who reveals the dark side of psychiatry poses a threat to the profession and must be marginalized. This understanding of the patient-as-pathogen has broader ramifications because it indicts more than mere charlatan practice. It demonstrates a lack of care and sympathy on the part of people who prefer to dope up a relative rather than help them deal with their experience.

Psychiatry tends to aggravate this lack of sympathy by instilling fear in friends and relatives of mental patients. A psychiatrist will plant the seed of fear of destructive tendencies where such tendencies do not already exist. When someone like Jason Russell loses self-control to strut screaming and naked through his neighborhood, he is feared as a potential threat to himself and others. The psychiatrist charged with his care may even exaggerate the patient's potential for harm when talking with his family members. Doing so increases their likelihood to agree to detrimental treatment and to assist the doctor in convincing the patient that such treatment is in his best interest.

The patient is treated as a pathogen, but there is another pathology at work. Fearing someone who loses control in public is considered a rational fear. It is socially acceptable despite its emotional basis. Fearing the toxicity of brain damaging pharmaceuticals, on the other hand, is considered irrational despite its grounding in scientific evidence. On the one hand, the patient is treated as a pathogen. On the other hand, the charlatan practitioner behaves as a pathogen.

Is there anyone in your life that you would like to control with mind altering drugs?