Beyond Therapy: A Set of Essays
On Miscellaneous Topics in Psychology and Psychiatry (2001-2003)

0. Psychiatric Dis(-)ease

	This short paper is an introduction to a series of six essays I wish to write on psychological topics. At the time of writing this short essay the first of these papers, Freudian Myths, has already been written. (1)

	Over the last one hundred years or so there has been much change in ‘our understanding’ of psychiatric phenomena. As noted in the first of these papers, the condition and diagnosis of hysteria, e.g., has radically altered from the time of Freud. What once was a very common ‘phenomenon’ is now very rare. Indeed, today, this expression of ‘hysteria’ applies to a narrow set of phenomena such as, e.g., hysterical conversion in the pseudo-paralysis of a limb. Medical science has made some progress since the time of Freud and we now no longer mis-diagnose certain forms of frontal lobe epilepsy as an hysterical condition. In the same manner we now no longer diagnose certain symptoms of multiple sclerosis, e.g., such as numbness and paralysis, as an instance too of hysteria. As a result the Freudian condition of hysteria has been practically analyzed out of existence. Moreover, we now no longer, hopefully, set out to diagnose one thousand and one complaints through the lens of a psychoanalytic framework and thereunder propose some form of ‘talk therapy’ as the perfect remedy for the same. On the other hand, the tendency today to see genes, and their expression through proteins (and enzymes, somatic structures, etc.), as the cause for all physiological conditions is, I believe, equally misguided as an attempt to find a deeper understanding of the causation of many forms of psychiatric disorder (etc., and the forms of treatment thought appropriate when searched for, and adopted, in such a narrow perspective). E.g., studies on the prevalence of schizophrenia in identical twins (raised apart at birth) might suggest that although there must be some inherent genetic predisposition this theoretical framework, as it stands, cannot account for the fact that identical twins do not necessarily acquire the same illnesses. And this type of observation seems to cross the entire spectrum of mental and somatic medical conditions. It would seem, I would conclude, that the genesis of illness is often the result of a number of interacting factors which might also include infections and/or the presence of post-viral complications, complex environmental and ecological concerns, imbalances in diet, differences in lifestyle and history, etc., etc. It may well be, in the instance of schizophrenia, or schizophrenic types of illness, that this condition may well arise from the presence of a genetic predisposition plus the complications of a viral illness (as indicated in the enlarged ventricles often seen in the CT scans of schizophrenic patients?). In such a light, therefore, genetic markers might only indicate an increased tendency for that indicated type of illness and not an absolute certainty that one will be afflicted by the corresponding disorder. Beware, therefore, insurance companies who might wish to read your unique genetic profile and misinterpret it accordingly in the light of this current fashion for a simplistic understanding of our genetic inheritance! (2)

The point I am trying to make here is that from a quick reading of medical history we are probably, indeed must be, over-reading, under-reading, misreading and just not reading various different types of psychiatric phenomena! In such a light the psychiatric profession should be humble and acknowledge that it will never have all the answers! That some of the answers it presently defends will need to be re-evaluated and perhaps modified, or simply left eclipsed by better explanations (with the potential for the delivery of a greater existential excess in sense, meaning and meaningfulness)! (3)

	In the second and third papers I will look at (a re-proposed typology of) psychosis and (a rehabilitation of the concept of) neurosis. I will also offer the suggestion that both conditions are in some way ‘inversely’ related by noting that it would appear that psychosis implicates a circadian rhythm that is lengthened over a time frame greater than one day whereas neurotic reactions to stress seem to involve an effective splitting or compression of the circadian rhythm within the space of a ‘normal’ day. Working on nights for many years, as a psychiatric nurse, I have observed psychotic patients not sleeping well one night but sleeping well the next (or the day after that in more severe cases) and finding this pattern repeats itself to the same extent that they remain relatively psychotic. On the other hand, as a nightshift worker, I believe the neurotic-like reaction to stress of not sleeping during the night-time is obviated by the surfacing of a circadian rhythm that looses it diurnal pattern; splitting or compressing itself within the space of a normal day. In my case, I have found I need to retire immediately on arriving home from work in the morning and by that stratagem receive an adequate sleep. Then again, other staff tell me that they prefer to retire in the afternoon. From this observation I have concluded that structured underneath a normal diurnal day are harmonic fractions that in their own manner reflect in some sense the patterns spread over a normal day. That under stress this sense of diurnal day is weakened to reveal these harmonic fractions (that would appear to then divide this day into two, or three, with the corresponding desire for six meals and two sleeps, etc., etc.). (4)

	In the fourth paper I will investigate what I call co-authored phenomena, i.e., the emission of texts apparently influenced and/or produced by more than one author as in the collaborative writing of a book, the work of a committee, hypnosis, ‘multi-personality’ disorders, the recounting of ‘past-life’ experiences, the pressure of intensive ‘interviews’ of potential incest ‘victims/survivors’, etc. As noted in my first paper, Freud may well be seen as the father of the ‘recovered memory’ syndrome in the way he often browbeat female patients into believing that they were victims of incestuous childhood abuse perpetrated by relatives, etc., because his theories prescribed the fact that they must have been abused in order to have demonstrated their current symptomatology. In acknowledging the nature of this type of phenomenon I would like to show that no presuppositionless question could be asked nor no presuppositionless answer can be given in the interactive space of an ‘interview’ (or in any other act of authoring or co-authoring) but that by various means, e.g., the utilization of transcendental suspensions, we can obviate much of the distortion presented in the authoring or co-authoring of any statements made by an individual or an ‘interviewed’ person or a group of individuals working in concert. That by such critical means we can phenomenologically re-create and re-evaluate such texts (and therein re-receive them as simulations in the manner they were apparently intended, i.e., experience them as either relatively authored or co-authored, etc!). (5)

	In the fifth paper I will be dealing with the problematic nature of deception and self-deception. Just how is it possible to deceive someone when knowing we are deceiving someone? Surely we must invoke some sense of a more public sense of self, as if it were other than our overall sense of self, in order to go ahead with such a deception? Moreover, how is it possible for the person to self-deceive themselves as if ‘someone else’ in the same manner? On the other hand, it is often possible to show that the person ‘knows’ in some form or other that they were entering into an act of deception and/or self-deception. E.g., the schizophrenic patient ‘knew he was God’ because ‘the voices were telling him so’. But if he was God why was he currently locked up in this psychiatric hospital, not able to leave, etc? How could he explain this fact? No doubt an answer will be dully proffered – that ‘God has to suffer’, ‘this is not a real mental hospital’, ‘that this God is everywhere at the same time’, etc, etc., but despite their inevitable evasion (of the ‘public reality’ of their situation) the often visible discomfit brought to bear by their being asked this type of question was often evidence enough that some part of them knew that such statements did indeed seem ‘crazy’ and that even they (or some part of them) did not absolutely believe in their own replies. (6)

	It seems to me that the only way to explain this type of problem is to invoke many different senses of self enlisted under an overall sense of self. That, therein, these various senses of self can lie to each other, deceive each other and thereby deceive others and on some occasions their own overall sense of self too. E.g., when I am imagining something I am invoking, or bringing relatively forward, a sense of self that can override the sense of reality envisaged by a less imaginative sense of self. Or, if I am going to tell a lie part of me must be able to entertain the deception at the same time as part of me knows, hopefully, that it is just that - a deception. The possible nature of the breakdown of this mechanism, as invoked by this type of model, helping us to understand how we can deceive not only others but also our very own overall sense of self(?). (7)

I would be very interested in knowing what other people think about this type of philosophical problem and what types of solution they might propose. (8)

	The last paper is to be titled Beyond Therapy with all the richness in meanings embedded in its intentional ambiguity. Which brings us back to the title of this paper – Psychiatric Dis(-)ease. (10)

	At the beginning of this essay I suggested that psychiatric disease has, more often than not, been misunderstood – as I stated it, from a quick reading of history we are probably, indeed must be, over-reading, under-reading, misreading and just not reading various different types of psychiatric phenomena! Moreover, we should draw the conclusion that in such a light the psychiatric profession should be humble and acknowledge that it will never have all the answers! This is not to say that there has been no progress in our understanding of psychiatric disorders, but, rather, to infer, that in the psychiatric profession as a whole there should be experienced a sense of overall dis-ease, discomfit, a sense of inner disturbance from an appreciation of the fact that this so-called science has often got the wrong end of the stick; not only in matters of diagnosis but also, unfortunately, in matters of treatment! (11)

	In this country of Australia we have had a succession of problematic issues, e.g., incompetence in the practice of sleep therapy at Chelmsford, controversy over the locking up/not locking up of people with a psychotic illness, just how should we deal with addiction, do we have any form of treatment that we can offer a person suffering from a sociopathic personality disorder, apparent epidemics of recovered memory syndromes, should psychiatry have anything to say in the raising of children and the list goes on an on… (12)

At this point in time I would like to stop and ask you what you might like to add to this open-ended list? (13)

	From this overall tenor of dis-ease with and within the psychiatric profession as a whole we might like to draw the conclusion that perhaps the psychiatric profession itself is (metaphorically) a ‘disease’ – a profession in a state of profound dis-ease (that may be more the ‘problem’ than the collective resolution of a set of problems)? This type of point was raised in my first essay where I noted that Freudian psychoanalysis was a professional travesty (an appellation that might also apply to other forms and variants of psychoanalytic practice?). That these and other practitioners could get away with their pseudo-scientific statements and practices as ‘scientific’ and ‘therapeutic’ without forms of careful and critical evaluation by that profession itself, by other psychiatric traditions and the public at large, and, engage in forms of arcane practice with little therapeutic merit I personally find simply appalling! Then, that such a type of practice, in its hegemonic misappropriation and concentration of power, could, with such temerity, then turn around and dismiss all other, ‘alternative’ forms of medicine, rightly or wrongly, of engaging in non-therapeutic behaviour I find almost beggars belief! But, then, those that preach this or that virtue often don’t actually practice the same (just as titles more often misrepresent than represent their texts). In the same vein, self-appellations of excellence, etc., more often than not have the habit of being ‘ironic’ in their portrayal of such self-deluded individuals and misguided institutions that ‘spend’ time advertising their own self-perceived virtues. This sad, sad observation then forces me to ask “are the current models of medicine and therapy adopted in these modern and post-modern times more a dis(-)ease themselves, in balance, than the generally evaluated overall quantum of success derived from their prescribed forms of therapy that do finally manage to ensue from within such cumbersome, non-self-critical, seemingly insightless, corporate-oriented, ‘political’ structures embedded in our presently underfunded ‘overfunded’ medical institutions?” Then again, the successful preservation of any institution must also cause us to ask “just what is it in our current medical institutions that does existentially function, is successful and beneficial, and, should allow us to continue (directly and indirectly) to support these core-facets of our institutions that do indeed facilitate a level of therapeutic outcomes commensurate to some degree with their claims to realize this type of result?!” Just what middle ground do we have here?? (14)

Again, I leave these important questions for you to think about and would enjoy to hear what you might have to say in this regard…,
						           Noël Tointon, Leura, 11.11.01. (15)