The End of Psychiatry as We know it?

The End of Psychiatry as We know it?

Towards the end of my career as a medical practitioner I posed this question to myself on many occasions. It seemed to be that psychiatry had become increasingly irrelevant, except perhaps as an establishment tool.

By tool, I mean when something is used within medicine by various interests groups and institutions for their own interests, and not their patient’s, in an almost political manner.

Yet why should I be surprised? I had worked in psychiatric institutions and had increasingly become disillusioned, such that I could no longer pursue specialist training in psychiatry.

Yet I was and remain committed to helping people with mental distress. It is just that I could not find a place within my profession where I felt I could operate with integrity and in accordance with my beliefs.

The conclusions I came to, from all my experience and reflections, was that psychiatry lacked relevance in the modern era. During this period I read the so-called anti-psychiatry position of R D Laing, Michel Foucault and Thomas Szasz (the first and last were psychiatrists).

As a starting point, you may care to read the following article published recently on the ABC website http://www.abc.net.au/radionational/programs/futuretense/the-psychiatrists-are-revolting/5680842

What the article is effectively saying is that psychiatry is unlike any other medical speciality, when it should be based on biological evidence and neuroscience. A laudable position, although it will have to fight the culture of “subjectivity” that is the hallmark of psychiatry.

Historically, maybe such a subjective position was the best medicine could do with mental illness, as religion relinquished its hold from the more moral perspective. After all, society had to do something…

Yet maybe the problem is bigger than this? We are talking here about mental distress, not brain distress. It is probably appropriate to use neuroscience to understand brain physiology, disturbance and even pathology further. And if that is the position psychiatry takes, maybe it will collapse into neurology and die a peaceful death.

But is this valid? Is the “mind” just some sort of product of our brain chemistry, or something much more? Anyone who has sought the soul and experienced the spiritual influence within their life would answer with an unequivocal “yes”. And I would agree.

Medicine generally, and psychiatry, in particular, may have some powerful tools to deal with mental distress. But this is a long, long way from understanding the causes of that distress. For this we must step outside of medicine, and even science.

It is a fundamental that the brain and the mind are not the same thing. It is time we got over the illusion – or delusion. (Psychiatry deluded? Who said that?)

It is time we saw mental distress in the wider social, family and spiritual context where traditionally it has always been appreciated, and to which it should return.

A kind of “Back to the Future”: but for one like me, of a fundamentally holistic disposition, this can hardly be a surprise…