There are almost as many theories of psychiatry and psychology as there are practitioners. Which theories work? Which don’t? Nobody seems interested in finding out, lest someone’s lucrative income be lost.
Some years ago, when we suffered another of those acute reforming impulses, the powers that be decided that too many mental patients were locked up. Why, now with our new miracle drugs, they can all be let go and receive outpatient treatment in their hometowns, said the powers that be.
That was one of the reforms that sounded good, but it had two flaws. In most towns, there were no outpatient treatment facilities, and there still aren’t. The second flaw was to expect that people who are mentally ill will nevertheless show the discipline to take their medications without any supervision. I should add that a third flaw in the reformist scheme was the usual blind faith in pills. The main result of this reform was to greatly increase the number of homeless people.
Psychiatry remains the most primitive of the medical arts. Most of the medical arts concern themselves with mechanics of the body. There is an infection. One of the organs in the body goes awry. These, at least, are tangible things that doctors can see, locate and sometimes repair.
The psychiatrist, alas, deals with the mind, which is not the same thing as the brain. The brain is the machine. The mind is the product of that machine, and it is an intangible product. We might liken the brain to a movie projector and the mind to the flickering images that are projected.
But where exactly are these images? Where are the voices no one else can hear? Where are those things no one else can see? Another problem psychiatry faces is that most mental patients do not realize they are ill. If you’ve ever talked with a delusional person, you will know that he or she has no doubt whatsoever that the delusion is real. Such people, first of all, are difficult to persuade to seek treatment, and if they do, the treatment is often difficult or ineffective.
The medical profession, like the legal profession, is supposedly self-regulating and self-policing, but neither one does a decent job at either task. Perhaps one day a creative prosecutor will charge with manslaughter members of a medical board that refuses to lift the license of an incompetent physician. That might get their attention by reminding them that they are responsible for the consequences of their decisions.
Because physicians claim to be scientists rather than artists, it’s past time to subject the various theories of psychology and psychiatry to scientific testing and then reject the theories that fail the test. As for the law, perhaps the liability laws should be revised to make the psychiatrist or psychologist who says a person represents no threat to himself or others subject to suit when the opinion turns out to be wrong.
It is obvious that when someone turns a dangerous person loose on society, he or she shares responsibility for whatever harm that dangerous person causes. We hold dog owners liable if their dog attacks someone, yet we let psychiatrists get away with unleashing people who are far more dangerous than a pit bull.
Crimes are never caused by inanimate objects. They are always caused by humans.
Later - Monty
