A NEW PARADIGM
I’ve recently read an interesting article by Jacqui Dillon, Lucy Johnstone and Eleanor Longden. It’s titled Trauma, Dissociation, Attachment &Neuroscience: A new paradigm for understanding severe mental distress. The article was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Vol 12, No 3, September 2012)
Here are some quotes:
“A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualise human suffering across the whole spectrum of mental health difficulties. It is a strongly evidence-based synthesis of findings from trauma studies, attachment theory and neuroscience, which offers new hope for recovery. It also presents a powerful challenge to biomedical model psychiatry in that it is based on scientific evidence that substantiates and attests to what many individuals with first-hand experience of mental health problems have always known –– that the bad things that happen to you can drive you mad.”
“In this respect, an increasing number of sophisticated, large-scale population studies have provided powerful demonstrations of the impact of adverse life events in leading to psychosis. For example, research indicates that people abused as children are 9.3 times more likely to develop psychosis; for those suffering the severest kinds of abuse, the risk rises to 48 times.”
“This link appears to be a causal one, with dose-dependent relationships evident between the severity…, frequency … and number of types…of adverse experience and the probability of so-called symptoms.”
“This is not to say that abuse is the only causal factor in psychosis –– other experiences can also be profoundly damaging, like the long-term impact of racism, bullying, poverty and other social inequalities; the corrosive effects of psychological and emotional dysfunction within families; and the aftermath of intergenerational trauma.”
THE MEDICAL PARADIGM
From the above quotes it is obvious that the authors are not in agreement with the current psychiatric orthodoxy that conceptualizes psychotic thinking as caused by some kind of biogenetic neural pathology. Here, for example, is what the NIMH say:
“Schizophrenia is a chronic, severe, and disabling brain disorder that has affected people throughout history. About 1 percent of Americans have this illness.”
PSYCHIATRY WEARS BLINKERS
In the first quote from the Dillon et al study mentioned above, the authors state: “…the bad things that happen to you can drive you mad.”
Forty or fifty years ago that statement would, I think, have been accepted by most people as self-evident. Today, even though the broken brain theory has become widely accepted, many people still would have no difficulty acknowledging the common sense validity of this statement. But modern bio-pharmaceutical psychiatry tends to resist the notion that personal experiences of this sort have any kind of causative significance in this area. You’ve either got the illness or you haven’t.
I’ve often wondered why this is the case. Obviously there are turf and business interests involved, but recently I came across the text of an NPR interview with Daniel Carlat, MD, which I think has some relevance.
Dr. Carlat is a psychiatrist who after several years in private practice, became disgusted with himself and wrote a confession: Unhinged (2010). It’s an honest, interesting read, and took a lot of courage to write. A couple of months later, he was interviewed by NPR.
Here’s one excerpt from the interview that I found compelling:
“There’s kind of an unofficial policy among psychiatrists, at least among some, which is the ‘don’t ask, don’t tell’ policy, which is that when we have our patients coming in, we know we have 15 or 20 minutes to see them. We want to learn a certain amount about how they’re doing, obviously because we want to make sure our medications are working and if we need to increase the dose. But on the other hand, we don’t want to ask too many questions because if we start to hear too much information, we’re going to run into a time issue where we’re going to have to push them out of the office perhaps at a time that they’re going to reveal something that could really be crucial to understanding their treatment.”
Could it be that the reason psychiatrists see these matters so differently from the other professions is that the latter take the time to get to know the client as an individual, whereas psychiatrists actively avoid any interactions of this sort? Dr. Carlat makes it clear that he wasn’t just speaking for himself – but rather that this practice is a “…kind of unofficial policy among psychiatrists.”
If all you’re interested in is brain chemicals, then you’ll never see the person, and you’ll never get to see the matter from his/her perspective.