CRISIS IN TREATMENT CENTERS
Unlike a scientific revolution in the natural sciences which affects primarily an isolated group of scientists, a crisis in psychiatry is not only felt among psychiatrists but among all those confronted with the mentally ill. A common characteristic of mental health professionals in the social services and mental hospitals is demoralization and the cynical acceptance of the unsatisfactory methods of treatment for the patients. Patients are either given maintenance measures or are subjected to verbal psychotherapies, even though many of them do not respond well to talk. There is also a large measure of good-natured mothering and caring. The heroin addict is weaned on methadone, a substitute” for heroin /~ which is itself addictive. The depressed person is encouraged to talk about feelings. The manic is frequently ushered off for a ‘vacation’ on downers. The psychiatrist faced with , a patient claiming to be the Virgin Mary, broadcasting the wisdom of God in a downtown shopping center, is likely to first search for the right drugs to quiet the patient and appease the environment. The social worker endeavors to work with the client, his impossible family conditions, his neighbors, the police and even the court system. Many of these workers feel overburdened and impotent in the face of extreme states.
In spite of increasing sophistication in research and the interconnection between chemistry and psychotic behavior, there is still no one-to-one cause and effect relationship between disease agents and cures. The applicability of disease definitions based, to a great extent, upon the experiences of a given society seems to be a dangerous definition of a ‘physical’ disease. A mentally healthy person in our culture is, according to medical definitions, capable of verbally relating thoughts and feelings in the absence of physical disease. Definitions in terms of given cultural norms are bound to have limited application since they are value judgements related to the observer’s psychology rather than empirical reports of the client’s individual language and body gestures. A qualitative classification can hardly be expected to produce quantitative changes; therefore, it is logically inconsistent to even search for quantitative causes for ‘disease’ which have no quantitative measures!
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